A nurse is caring for a 36-hr old infant. The nurse is preparing the infant for phototherapy. For each nursing action, click to specify if the action is indicated or contraindicated for the newborn.

Rationale • Supplement feeding with sterile water: Sterile water provides no nutritional value and dilutes electrolyte balance, increasing health risks without reducing bilirubin. It can interfere with adequate breast milk intake, which is essential for promoting bilirubin excretion. Hydration for jaundiced infants must come from breast milk or formula, not water. • Dress in only a diaper: Phototherapy requires maximum skin exposure so bilirubin can be broken down effectively through light absorption. Limiting clothing allows more surface area to receive therapeutic light. Keeping only a diaper on also prevents overheating or obstruction from unnecessary garments. This setup ensures optimal treatment efficiency. • Cover newborn’s eyes with a shield: The bright phototherapy lights can damage the newborn’s developing retina, so eye protection is essential. Soft shields prevent retinal injury while still allowing the infant to move comfortably. The shields are removed only during feeding or parent interaction to allow bonding. Consistent use is a critical safety component of phototherapy. • Breastfeed every 2 to 3 hr: Frequent breastfeeding promotes bilirubin excretion through stooling and hydration, supporting the infant’s ability to lower bilirubin naturally. More frequent feeds also prevent lethargy from worsening and help maintain stable glucose levels. Breast milk intake is a key measure for preventing severe hyperbilirubinemia progression during phototherapy. • Apply lotion to skin every 4 hr: Lotions can absorb heat and increase skin irritation under phototherapy lights. Some topical products may also intensify light absorption, raising the risk of burns. The newborn’s skin must remain clean and dry to prevent adverse reactions. Avoiding lotions keeps the skin safe during therapy.