A nurse is assessing a newborn who is receiving dual phototherapy via overhead lights and a fiberoptic pad for the treatment of hyperbilirubinemia. Which of the following actions should the nurse take?

Choice A reason: Maintaining therapy with the fiber optic pad while allowing parental holding during feedings is correct because it ensures continuous treatment while promoting bonding and feeding. Fiberoptic phototherapy pads are safe to use during holding, and they do not interfere with feeding. This approach balances effective bilirubin reduction with essential parent-infant interaction, which supports emotional well-being and breastfeeding success. Choice B reason: Discontinuing overhead lights based on stool frequency is incorrect. Increased stooling is a common effect of phototherapy due to bilirubin excretion, but it is not a criterion for discontinuation. Therapy is guided by bilirubin levels and clinical assessment, not stool count. Stopping therapy prematurely could result in rebound hyperbilirubinemia. Choice C reason: Swaddling the newborn before placing them on the fiber optic pad is inappropriate because swaddling blocks light exposure to the skin, reducing the effectiveness of phototherapy. Direct skin exposure is necessary for maximum bilirubin breakdown. Choice D reason: Determining the positioning of overhead lights by assessing axillary temperature is incorrect. Temperature monitoring is important to prevent overheating, but light positioning is determined by distance and angle to maximize skin exposure, not by temperature readings.