Which assessment finding in a newborn places them at risk for physiological jaundice?

Choice A rationale

A positive rubella serum antibody titer indicates immunity to rubella infection, which is protective during pregnancy. It is not an abnormal finding and does not require immediate reporting. Rubella immunity is important to prevent congenital rubella syndrome in the fetus, a severe condition causing defects such as deafness or cardiac anomalies.

Choice B rationale

Blood pressure of 144/94 mmHg is elevated and indicates gestational hypertension, which could progress to preeclampsia if not managed. Preeclampsia can lead to complications such as eclampsia, placental abruption, or maternal and fetal mortality. Normal blood pressure during pregnancy is less than 140/90 mmHg, making this finding critical to report.

Choice C rationale

Copious leukorrhea is a common physiological change in pregnancy due to increased estrogen levels and vascularity. It is usually benign and protective, preventing infections by maintaining a mildly acidic environment in the vagina. This finding does not warrant immediate concern unless associated with infection symptoms.

Choice D rationale

An O-negative blood type requires administration of Rh immunoglobulin to prevent Rh isoimmunization, but this is routinely managed in pregnancy. It is not an urgent issue unless there are concerns about fetomaternal hemorrhage or alloimmunization, which could harm an Rh-positive fetus.

Choice A rationale

Removing a pacifier does not align with preventing SIDS. Studies suggest pacifier use during sleep reduces the risk of SIDS by maintaining airway patency and ensuring better sleep quality, though it should be used appropriately without attaching strings or clips that may pose risks.

Choice B rationale

Feeding every 2 hours does not directly prevent SIDS but supports adequate nutrition for growth and development. While proper feeding schedules are important, specific sleeping arrangements and environment management play a more significant role in reducing SIDS risk.

Choice C rationale

Placing the newborn on their back to sleep aligns with safe sleep recommendations to prevent SIDS. This position reduces the risk of airway obstruction and promotes proper breathing. The supine sleep position is widely endorsed by health organizations for its protective effect.

Choice D rationale

Draping a blanket over the newborn increases the risk of suffocation and overheating, both of which are associated with SIDS. It is essential to keep sleep environments free of loose items and ensure the baby is dressed appropriately for the room's temperature to reduce these risks.