If a newborn's hands and feet are cyanotic (bluish) and there is circumoral pallor (pale skin around the mouth) when the infant cries or feeds, it is important for the nurse to take immediate action. This could be a sign of a serious condition called cyanotic congenital heart disease, which occurs when there is a problem with the heart that causes an inadequate oxygen supply to the body. The nurse should report these findings to the infant's healthcare provider as soon as possible, as this is a medical emergency that requires prompt evaluation and treatment. In the meantime, the nurse should monitor the infant closely for any other signs or symptoms of heart problems, such as rapid breathing, difficulty feeding, or changes in the infant's skin color. The nurse should also continue to support the infant's feeding and provide comfort measures as needed.