The following newborns are three-hours old and are sleeping.
The registered nurse should notify the provider about which newborn?

Choice A rationale

A history of pelvic inflammatory disease may result in complications like infertility or chronic pelvic pain but does not specifically indicate endometriosis. Endometriosis involves the ectopic implantation of endometrial tissue, unrelated to infection from PID.

Choice B rationale

An atypical Papanicolaou smear suggests cervical cell abnormalities due to infection, inflammation, or dysplasia, but it does not correlate with endometriosis, which is a distinct gynecological condition involving ectopic endometrial tissue growth.

Choice C rationale

Dysmenorrhea unresponsive to NSAIDs is a defining symptom of endometriosis. This pain results from the inflammatory response and cyclic bleeding of ectopic endometrial tissue, which can cause significant discomfort and impair quality of life.

Choice D rationale

Abdominal bloating several days before menses may be linked to hormonal fluctuations or gastrointestinal issues but is not a primary symptom of endometriosis. While some affected individuals experience bloating, it is not a diagnostic feature like severe, treatment-resistant pain. .

Choice A rationale

Maximizing skin exposure to phototherapy lights ensures effective breakdown of bilirubin through photoisomerization, reducing serum bilirubin levels. Phototherapy converts unconjugated bilirubin to water-soluble isomers that are excreted via bile and urine. Exposing more skin enhances light absorption, increasing treatment efficacy. Normal bilirubin levels in newborns range from 1 to 12 mg/dL. This intervention aligns with standard protocols for managing hyperbilirubinemia in neonates.

Choice B rationale

Applying lotion during phototherapy can cause skin burns by altering light penetration and causing a thermal effect. It may also increase the risk of skin irritation and infections. Phototherapy lights generate heat, and lotions can exacerbate these effects, leading to complications. Effective bilirubin management depends on clean, dry skin under the lights.

Choice C rationale

While eye shields are critical to protecting the infant’s retina and cornea from potential phototoxicity, removing them during breastfeeding is necessary. This promotes bonding and facilitates feeding. Continuous shield use can obstruct parental interaction and feeding, which are vital for infant care. Shielding should only occur during phototherapy exposure.

Choice D rationale

Swaddling restricts skin exposure to the therapeutic lights, negating the benefits of phototherapy. It prevents effective breakdown of bilirubin as less skin is exposed to the treatment. Neonates under phototherapy should be minimally clothed, often only wearing a diaper, to maximize light absorption and ensure treatment success.