Which of the following is an appropriate nursing intervention to promote thermoregulation in an infant patient?

A. Negative Doll's eye reflex: By 9 months, the doll's eye reflex (in which the eyes move in the opposite direction of the head) should no longer be present. Its absence is normal and does not require intervention.

B. Negative Crawl reflex: The crawling reflex typically fades by 6 weeks and is replaced by voluntary movements by this age. A negative crawl reflex at 9 months is expected and does not warrant concern.

C. Positive Babinski reflex: A positive Babinski reflex is considered normal in infants up to about 12 months. It involves dorsiflexion of the big toe when the sole is stroked and does not require intervention in a 9-month-old.

D. Positive Moro reflex: The Moro reflex (startle reflex) typically disappears by 4 months of age. Its persistence at 9 months may indicate neurological immaturity or dysfunction and requires further evaluation.

A. Serum bilirubin level has increased from 6 hr ago: An increase in bilirubin suggests that phototherapy is not working effectively or that bilirubin is still accumulating faster than it is being broken down. This finding indicates a need for further assessment or adjustments to therapy.

B. Jaundice moves from chest to groin level: Jaundice typically progresses in a cephalocaudal direction. Movement toward the groin reflects worsening hyperbilirubinemia rather than improvement, so this would not indicate effective treatment.

C. Hemoglobin and hematocrit have increased: These values are not direct indicators of bilirubin reduction or phototherapy effectiveness. Elevated levels could reflect dehydration or other unrelated factors in a newborn.

D. Transcutaneous bilirubin (TCB) level has decreased from 6 hr ago: A decreasing TCB level shows that bilirubin levels are lowering in response to phototherapy. This is the most reliable, noninvasive indicator that the treatment is effective and progressing as intended.