The nurse is performing a newborn assessment on a 37-week-gestation newborn at 2 hours of life. The nurse notes a small tuft of hair on the lumbosacral area of the spine. Which neural tube defect will the nurse associate with this assessment finding?

Choice A reason: Beginning formula supplementation is not the first step in addressing issues with breastfeeding. Introducing formula might reduce the infant’s breastfeeding efficiency and disrupt milk supply. The focus should initially be on correcting the breastfeeding technique to ensure successful and comfortable breastfeeding for both mother and baby.

Choice B reason: Cleansing the breast with soap and water is not recommended as it can dry out the nipples and exacerbate cracking. It is more appropriate to clean the breasts with warm water and avoid harsh soaps that could strip natural oils and worsen nipple damage.

Choice C reason: Repositioning the baby is a crucial step in addressing breastfeeding issues such as cracked nipples and a painful latch. Ensuring a proper latch can significantly reduce nipple trauma and improve comfort during breastfeeding. Techniques like ensuring the baby’s mouth covers more areola and changing breastfeeding positions can help achieve a better latch.

Choice D reason: Administering ibuprofen may help relieve pain temporarily, but it does not address the root cause of the breastfeeding issue. The primary focus should be on correcting the baby's latch and positioning to prevent ongoing nipple damage and pain during breastfeeding. Pain management should be considered alongside addressing the underlying problems.

Choice A reason: Pathologic jaundice is an abnormal condition that typically appears within the first 24 hours of life. It often indicates an underlying health problem and requires prompt medical evaluation and intervention.

Choice B reason: Both pathologic and physiologic jaundice are not treated with exchange transfusions of maternal O-negative blood. Exchange transfusions are only considered in severe cases of jaundice, typically for pathologic jaundice when other treatments are ineffective.

Choice C reason: Physiologic jaundice is a common and usually harmless condition that occurs in many newborns, peaking around the second or third day of life. It does not result in kernicterus, a rare but severe form of brain damage caused by very high levels of bilirubin. Pathologic jaundice, if untreated, may lead to kernicterus.

Choice D reason: Physiologic jaundice generally does not require transfer to the neonatal intensive care unit. It is usually managed with simple interventions, such as phototherapy, and often resolves on its own as the newborn's liver matures and becomes more efficient at processing bilirubin.