The nurse is preparing a 4-day-old infant with a serum bilirubin level of 19 mg/dL (325 µmol/L) for discharge from the hospital. When teaching the parents about home phototherapy, which instruction should the nurse include in the discharge teaching plan?

Total Bilirubin Reference Range: Newborn: 0.1 to 10.5 mg/dL (1.7 to 180 µmol/L)

Choice B reason: Erythrocytes, hemoglobin, and hematocrit are laboratory results that are not as critical as serum potassium, calcium, and phosphorus in a client who has end-stage renal disease (ESRD.. Erythrocytes are red blood cells that carry oxygen from the lungs to the tissues. Hemoglobin is a protein in erythrocytes that binds oxygen. Hematocrit is the percentage of blood volume that is occupied by erythrocytes. ESRD can cause anemia (low erythrocyte, hemoglobin, and hematocrit levels) due to reduced production of erythropoietin, a hormone that stimulates erythrocyte formation, by the kidneys. Anemia can cause fatigue, pallor, or shortness of breath.

Choice C reason: Leukocytes, neutrophils, and thyroxine are laboratory results that are not as relevant as serum potassium, calcium, and phosphorus in a client who has end-stage renal disease (ESRD.. Leukocytes are white blood cells that fight infection and inflammation. Neutrophils are a type of leukocyte that respond to bacterial infection. Thyroxine is a hormone that regulates metabolism and growth. ESRD can cause leukopenia (low leukocyte levels) and neutropenia (low neutrophil levels) due to impaired immune function and increased susceptibility to infection. ESRD can also cause hypothyroidism (low thyroxine levels) due to reduced clearance of thyroid hormones by the kidneys. Hypothyroidism can cause weight gain, cold intolerance, or depression.

Choice D reason: Blood pressure, heart rate, and temperature are not laboratory results, but vital signs that should be monitored in a client who has end-stage renal disease (ESRD.. Blood pressure is the force of blood against the walls of the arteries. Heart rate is the number of times the heart beats per minute. Temperature is the measure of body heat. ESRD can cause hypertension (high blood pressurE. due to fluid overload and activation of the renin-angiotensin-aldosterone system, a hormonal pathway that regulates blood pressure and fluid balance. Hypertension can cause headache, chest pain, or stroke. ESRD can also cause tachycardia (high heart ratE. due to anemia, fluid overload, or electrolyte imbalance. Tachycardia can cause palpitations, dizziness, or heart failure. ESRD can also cause fever (high temperaturE. due to infection or inflammation. Fever can cause chills, sweating, or delirium.

Choice A reason: Reminding the UAP to apply a fitted respirator mask before entering the client's room is not a necessary action for the nurse to take. A respirator mask is a type of personal protective equipment (PPE. that filters out airborne particles and droplets that may contain infectious agents. A respirator mask is required for clients who have or are suspected of having airborne diseases, such as tuberculosis, measles, or chickenpox. Influenza is a respiratory disease that is transmitted by droplet contact, not by airborne contact.

Choice B reason: Instructing the UAP to notify the nurse of any changes in the client's respiratory status is not a specific action for the nurse to take. Respiratory status is an assessment of the client's breathing pattern, rate, depth, effort, and oxygen saturation. Respiratory status can be affected by various factors, such as infection, inflammation, obstruction, or injury. The nurse should monitor the client's respiratory status regularly and teach the UAP to report any signs or symptoms of respiratory distress, such as dyspnea, cyanosis, wheezes, or cough.

Choice D reason: Assigning the UAP to provide care for another client and assuming full care of the client is not a feasible action for the nurse to take. The nurse should delegate tasks according to the scope of practice, competency, and availability of staff. The nurse should not reassign staff without a valid reason or without consulting with other team members. The nurse should also not assume full care of a client unless it is necessary or appropriate. The nurse should supervise and evaluate the UAP's performance and provide feedback and guidance.