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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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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: Correct Answer: D - Determine who will be on the birth certificate.
Rationale: The nurse should not present the consideration of who will be on the birth certificate because legal parentage can be determined through various means regardless of who gives birth. The birth certificate can be amended to include both partners, and legal agreements can be put in place to establish parental rights. Focusing on the birth certificate may limit the couple's options and overlook the importance of legal protections for both partners and the child.
Summary of Incorrect Choices:
A: Considering the age and health of each partner is important for making informed decisions about pregnancy but does not specifically address the issue of who will become pregnant.
B: Evaluating each partner's career goals is important for planning but is not directly related to the decision of who will carry the pregnancy.
C: Choosing based on insurance is a practical consideration but should not be the primary factor in deciding which partner will become pregnant as it does not address the complexities of parenthood and family dynamics
Which behavior does the nurse identify as a demonstration of unidirectional bonding between a parent and infant?
- A. The parents respond to the baby's cry.
- B. The parents call the baby by name.
- C. The baby responds to comforting measures.
- D. The parents stimulate and entertain the baby.
Correct Answer: B
Rationale: The correct answer is B because calling the baby by name demonstrates a unidirectional bond where the parent is actively engaging with the infant without requiring a response. In this scenario, the parent is initiating communication and bonding with the baby. The other choices involve reciprocal interactions between the parent and infant, which do not solely demonstrate a unidirectional bond. Choice A involves the parent responding to the baby's cry, which is a reaction to the infant's behavior. Choice C involves the baby responding to comforting measures initiated by the parent. Choice D involves the parents stimulating and entertaining the baby, which implies a back-and-forth interaction rather than a unidirectional bond.
A multiparous patient reports severe uterine cramps the first day after a vaginal delivery. The nurse is aware the patient is breastfeeding and associates the patient's pain primarily with which occurrence?
- A. An increase in oxytocin release related to the newborn suckling
- B. The presence of intense afterbirth pains related to multiparity
- C. An expected response to the daily administration of oxytocin
- D. The efforts of the uterus to return to a prepregnancy condition
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Breastfeeding stimulates the release of oxytocin.
2. Oxytocin causes uterine contractions, aiding in the expulsion of placenta and reducing postpartum bleeding.
3. The patient's severe uterine cramps are likely due to increased oxytocin release from breastfeeding.
4. This is a normal response, known as afterpains, and is common in breastfeeding mothers.
Summary:
- Choice B is incorrect as afterbirth pains are typically milder in primiparous women.
- Choice C is incorrect as oxytocin is not typically administered daily postpartum.
- Choice D is incorrect as uterine involution occurs gradually over weeks, not causing sudden severe cramps.
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: "The baby's sucking during breastfeeding releases the hormone oxytocin, which stimulates the uterus to contract." This response is correct because oxytocin is released during breastfeeding, causing the uterus to contract, which is a normal physiological response postpartum. This contraction-like pain is known as afterpains and is a natural process to help the uterus return to its pre-pregnancy size.
A: "I will call the doctor and let him know your concern." This response does not address the woman's question and does not provide appropriate education about the normal postpartum process.
B: "You may be getting an infection and will have to stop breastfeeding." This response is incorrect as it jumps to a conclusion without considering the normal physiological process of breastfeeding.
C: "This is normal because your uterus is shrinking back to the normal size." While this response acknowledges the normal process, it does not provide the specific mechanism behind the contraction-like pain experienced by the woman.
The nurse is educating a postpartum woman on how to prevent engorgement. Which action of the patient indicates effective learning?
- A. Breastfeeding the infant every 2 to 3 hours
- B. Avoiding using soap on the breast when bathing
- C. Drinking 8 to 10 glasses of water during the day
- D. Binding the breast with a towel or stretch bandage
Correct Answer: A
Rationale: The correct answer is A because breastfeeding the infant every 2 to 3 hours helps in emptying the breasts regularly, preventing engorgement. This frequent feeding stimulates milk production and prevents milk buildup. Choice B is incorrect as soap can dry out the skin, leading to cracked nipples. Choice C is important for overall hydration but not directly related to preventing engorgement. Choice D is incorrect as binding the breast can lead to blocked milk ducts and worsen engorgement.