A nurse in the newborn nursery is caring for a group of newborns. Which of the following newborns requires immediate attention?

Choice A rationale While voiding is expected, the normal range for the first void is typically within the first 24 to 48 hours of life. A newborn not voiding at exactly 24 hours warrants continued monitoring, but it is not an immediate emergency unless there are other signs of distress or an obvious obstruction. Choice B rationale Acrocyanosis is a normal, transient condition in the newborn characterized by a bluish discoloration of the hands and feet due to sluggish peripheral circulation. It is common for up to 24 hours after birth and does not require immediate intervention, only ongoing assessment to ensure central color is pink. Choice C rationale Most healthy newborns pass meconium, the first stool, within the first 24 hours of life, with almost all passing it by 48 hours. A lack of meconium passage at 24 hours requires investigation for potential intestinal issues, such as Hirschsprung's disease or meconium plug, but an elevated temperature signals more acute distress. Choice D rationale A temperature of 100.5 degrees F (38.1 degrees C) in a newborn, which is above the normal range (typically 97.7 to 99.5 degrees F or 36.5 to 37.5 degrees C), is a serious finding. Newborns are susceptible to rapid temperature changes, and hyperthermia can indicate sepsis, dehydration, or environmental issues requiring immediate assessment and intervention.