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A breastfeeding postpartum woman tells the nurse, "I am not sure I want to breastfeed because I notice that when I feed my baby, I have strong contraction-like pain. Is something wrong?" Which response by the nurse is most appropriate?
- A. "I will call the doctor and let him know your concern."
- B. "You may be getting an infection and will have to stop breastfeeding."
- C. "This is normal because your uterus is shrinking back to the normal size."
- D. "The baby's sucking during breastfeeding releases the hormone oxytocin, which stimulates the uterus to contract."
Correct Answer: D
Rationale: The correct answer is D because the baby's sucking during breastfeeding releases oxytocin, which stimulates the uterus to contract. This is known as the "let-down reflex" and is a normal physiological response to breastfeeding. The contraction-like pain the woman is experiencing is likely due to the uterus shrinking back to its normal size postpartum.
Choice A is incorrect because there is no need to immediately involve the doctor for this normal physiological response. Choice B is incorrect as pain during breastfeeding is not necessarily a sign of infection. Choice C is incorrect because it does not provide the specific mechanism of how breastfeeding triggers uterine contractions.
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A nurse is preparing to perform a fundal assessment on a postpartum client who delivered 12 hours ago. What should the nurse do first?
- A. Lower the head of the bed
- B. Locate the level of the fundus
- C. Assist the woman to the bathroom to empty her bladder
- D. Massage the fundus
Correct Answer: C
Rationale: The correct first step is to assist the woman to the bathroom to empty her bladder. This is important to ensure an accurate fundal assessment, as a full bladder can displace the uterus and lead to incorrect fundal height measurement. Lowering the head of the bed (Choice A) is not necessary for a fundal assessment. Locating the level of the fundus (Choice B) should come after ensuring the bladder is empty. Massaging the fundus (Choice D) is not indicated until after the fundal assessment is completed.
A breastfeeding postpartum woman tells the nurse, "I am not sure I want to breastfeed because I notice that when I feed my baby, I have strong contraction-like pain. Is something wrong?" Which response by the nurse is most appropriate?
- A. "I will call the doctor and let him know your concern."
- B. "You may be getting an infection and will have to stop breastfeeding."
- C. "This is normal because your uterus is shrinking back to the normal size."
- D. "The baby's sucking during breastfeeding releases the hormone oxytocin, which stimulates the uterus to contract."
Correct Answer: D
Rationale: The correct answer is D. Oxytocin is a hormone that is released during breastfeeding in response to the baby's sucking, causing the uterus to contract. This helps the uterus return to its pre-pregnancy size and reduces postpartum bleeding. Choice A is incorrect as the issue does not require immediate doctor intervention. Choice B is incorrect as pain does not necessarily indicate infection. Choice C is incorrect as it does not explain the role of oxytocin in uterine contractions during breastfeeding.
The nurse is counseling a lesbian couple who have decided to have a child. Which considerations doesn't the nurse present with regard to which partner will become pregnant?
- A. Consider the age and health of each partner.
- B. Evaluate each partner's career goals.
- C. Decide which partner has better insurance.
- D. Determine who will be on the birth certificate.
Correct Answer: D
Rationale: The correct answer is D because determining who will be on the birth certificate is not a relevant consideration when discussing which partner will become pregnant. The birth certificate can be adjusted later, and it does not impact the decision-making process for pregnancy.
A: Age and health are important factors to consider for the partner who will become pregnant.
B: Evaluating career goals can help determine the impact of pregnancy on each partner's professional life.
C: Insurance coverage can be important when planning for pregnancy and childbirth, as it can affect access to healthcare services.
The nurse is preparing to perform a visual assessment of the perineum of a postpartum patient. The nurse will use the REEDA acronym. Which specific assessments isn't covered by REEDA?
- A. Perineal coloration
- B. Suture line appearance
- C. Amount of swelling
- D. Description of pain
Correct Answer: D
Rationale: The correct answer is D, Description of pain. The REEDA acronym stands for Redness, Edema (swelling), Ecchymosis (bruising), Discharge, and Approximation (suture line). Pain description is not specifically covered by REEDA, as it focuses on the physical aspects of the perineal assessment. Describing pain would fall under a separate assessment category such as pain scale assessment. Choices A, B, and C are incorrect because they are all aspects that are included in the REEDA assessment for the perineum.
The nurse on a postpartum unit is focused on providing care that will assist the mother and father in making the transition to parenthood. For which reason does the nurse review the prenatal and labor records?
- A. Pregnancy and birth experiences, which can either enhance or impede the process of becoming a mother.
- B. Awareness of prenatal classes that will help identify and focus on learning needs of both parents.
- C. Identification of preexisting maternal conditions that may interfere with parenting transitions.
- D. Knowledge regarding questions and concerns the mother and father may have about neonate issues.
Correct Answer: A
Rationale: The correct answer is A because reviewing prenatal and labor records helps the nurse understand the mother's pregnancy and birth experiences, which can influence her transition to motherhood. By knowing these experiences, the nurse can provide tailored support and interventions.
Choice B is incorrect because prenatal classes are not the main focus for reviewing records, although they may be helpful. Choice C is incorrect because preexisting maternal conditions are important but not the main reason for reviewing records in this context. Choice D is incorrect because the focus is on the mother's experiences rather than neonate issues.