What is the priority intervention for a significantly anemic newborn resulting from hemolytic disease?

The priority intervention for a significantly anemic newborn resulting from hemolytic disease is exchange transfusion. This procedure involves replacing the infant's blood with donor blood to rapidly correct severe anemia, which can occur due to hemolytic disease, often stemming from Rh or ABO incompatibility between the mother and the newborn.

In cases of hemolytic disease, the infant’s red blood cells are being destroyed at an accelerated rate, leading to a decline in hemoglobin levels. Exchange transfusion not only provides fresh red blood cells to improve oxygen-carrying capacity but also helps to remove bilirubin, which may be elevated due to breakdown of red blood cells, thereby reducing the risk of severe jaundice and potential neurological complications.

Other interventions, such as broad-spectrum antibiotic therapy, may be appropriate for treating or preventing infections, and monitoring for jaundice is essential but secondary to correcting the anemia. Similarly, while intravenous fluids can support hydration and assist in other aspects of care, they do not address the immediate and critical need for correcting anemia caused by hemolysis. Thus, exchange transfusion stands out as the most urgent intervention in this scenario.