What are the contraindications for a patient wanting to have a TOLAC?

Choice A rationale

Blood glucose level changes are unrelated to hyperbilirubinemia and phototherapy, which specifically target bilirubin metabolism in the newborn's liver and skin.

Choice B rationale

A decrease in transcutaneous bilirubin (TcB) levels shows effective phototherapy, as it converts bilirubin into water-soluble isomers that can be excreted.

Choice C rationale

Skin color changes from yellow to normal indicate reduced bilirubin levels, but the most accurate measure of phototherapy efficacy is the decrease in TcB levels.

Choice D rationale

Weight gain is not an indicator of effective phototherapy; it reflects overall nutrition and hydration status rather than bilirubin metabolism and excretion.

Choice A rationale

Delusions indicate severe psychiatric conditions like postpartum psychosis, not depression. Depression involves low mood, energy, and interest, without detachment from reality. Delusions reflect loss of reality testing, requiring different interventions. Common in severe psychoses like schizophrenia.

Choice B rationale

Euphoria indicates abnormally elevated mood, seen in manic episodes of bipolar disorder, not depression. Depression involves sadness, hopelessness, and low energy. Euphoria's excessive positivity contrasts with depressive symptoms, including impaired functioning and behavior regulation.

Choice C rationale

Flat affect signifies reduced emotional expression, common in depression. Depressed individuals exhibit lack of response to pleasurable activities, social withdrawal, and emotional blunting. This impairment in emotional expressiveness reflects major depressive disorder.

Choice D rationale

Insomnia, common in depression, affects sleep patterns, causing difficulty initiating or maintaining sleep. It contributes to fatigue, cognitive impairment, and mood disturbances. Insomnia reflects dysregulated sleep-wake cycles in depression, impacting daily functioning.

Choice E rationale

Fatigue is frequent in depression, marked by persistent tiredness despite rest. It stems from sleep disturbances, low energy, and anhedonia. Fatigue affects concentration, motivation, and physical activity, manifesting as psychomotor retardation in depression.