The nurse assesses a 12-hour-old newborn's serum bilirubin level and finds it to be 14 mg/dl. What nursing intervention would be included in the plan of care for this newborn?

Question

1. Continue to observe.
2. Begin phototherapy.
3. Begin blood exchange transfusion.
4. Stop breastfeeding.

Answer 1

2
Rationale 1: Continued observation is only appropriate with normal findings.
Rationale 2: Jaundice within 24 hours of birth is due either to Rh incompatibility or ABO incompatibility, and requires phototherapy.
Rationale 3: Newborns with a bilirubin of 20 mg/dl or above might need an exchange transfusion.
Rationale 4: The newborn should continue to breastfeed, even when undergoing phototherapy.