A nurse is planning to obtain a blood specimen from a newborn via a heel stick. Which of the following actions should the nurse take?

Choice A rationale Cooling the newborn's heel causes vasoconstriction, which reduces blood flow to the area. This would make it more difficult to obtain an adequate blood sample and could lead to repeated punctures, increasing the risk of discomfort and tissue damage for the newborn. Optimal blood flow is crucial for a successful heel stick. Choice B rationale Puncturing the center of the newborn's heel risks damaging the calcaneus bone, which can lead to osteomyelitis, an infection of the bone. The proper technique involves puncturing the lateral aspects of the heel to avoid bone injury and ensure patient safety. Choice C rationale Cleansing the puncture site with an alcohol gauze pad prior to the procedure is essential for asepsis. Alcohol acts as an antiseptic by denaturing proteins and dissolving lipids in bacterial cell membranes, effectively reducing the microbial load on the skin surface and minimizing the risk of introducing pathogens into the bloodstream during the puncture. Choice D rationale Administering vitamin K is typically done shortly after birth to prevent hemorrhagic disease of the newborn, as newborns have immature livers and insufficient gut flora for vitamin K synthesis. It is not routinely administered 30 minutes prior to every blood draw and is unrelated to the immediate procedure of obtaining a heel stick sample.