A nurse is planning care for a newborn who has hyperbilirubinemia and is to receive phototherapy. Which of the following interventions should the nurse include?

Choice A reason: Clothing the newborn in light cotton is inappropriate during phototherapy. The infant should be undressed except for a diaper to maximize skin exposure to the light. Covering the skin reduces the effectiveness of phototherapy. Choice B reason: Checking the newborn’s temperature every 8 hours is insufficient. Infants under phototherapy are at risk for temperature instability, so monitoring should occur at least every 2–4 hours. Waiting 8 hours could miss early signs of hypothermia or hyperthermia. Choice C reason: Administering water between feedings is contraindicated. Newborns should not receive water because it can cause electrolyte imbalance and interfere with nutrition. Adequate hydration should be maintained through frequent breastfeeding or formula feeding. Choice D reason: Placing the newborn 45 cm (18 in) from the light source is correct. This distance ensures effective exposure while preventing overheating or burns. Proper positioning is essential for safe and effective phototherapy.