Nokea
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.
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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: Rationale for correct answer A:
1. Breastfeeding stimulates the release of oxytocin.
2. Oxytocin causes uterine contractions.
3. Uterine contractions help the uterus return to its pre-pregnancy size.
4. Severe uterine cramps post-delivery are likely due to increased oxytocin release from breastfeeding.
Summary of why other choices are incorrect:
B: Afterbirth pains are typically crampy, but the scenario specifies severe pain on the first day after delivery, which is more likely due to breastfeeding.
C: Daily administration of oxytocin would not lead to sudden severe cramps on the first day post-delivery.
D: Uterus shrinking back to prepregnancy size causes cramping, but the timing and severity described in the scenario point more towards oxytocin release from breastfeeding.
The nurse in a postpartum unit frequently teaches patients regarding breast care. Which teaching is most helpful to the breastfeeding patient?
- A. Run warm water over breasts while in the shower.
- B. Wear a supportive bra for 24 hours a day.
- C. Express milk by a breast pump or manually.
- D. Take analgesics for breast pain management.
Correct Answer: C
Rationale: The correct answer is C because expressing milk by a breast pump or manually helps in relieving engorgement, preventing mastitis, and maintaining milk supply. This action also allows for proper milk removal and promotes breastfeeding success.
A: Running warm water over breasts can provide temporary relief but does not address the underlying issue of engorgement or milk expression.
B: Wearing a supportive bra is important, but doing so 24 hours a day can lead to discomfort and potential issues with milk supply and breast health.
D: Taking analgesics may provide pain relief but does not address the root cause of the issue and may mask potential problems.
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 to establish a proper milk supply, prevent engorgement, and ensure adequate milk removal. This frequent nursing schedule stimulates milk production and prevents the breasts from becoming overly full. Choice B is incorrect because avoiding soap on the breast does not directly prevent engorgement. Choice C is incorrect as hydration is important but not the primary method to prevent engorgement. Choice D is incorrect because binding the breast with a towel or stretch bandage can constrict milk flow and lead to engorgement.
The nurse in a postpartum unit frequently teaches patients regarding breast care. Which teaching is most helpful to the breastfeeding patient?
- A. Run warm water over breasts while in the shower.
- B. Wear a supportive bra for 24 hours a day.
- C. Express milk by a breast pump or manually.
- D. Take analgesics for breast pain management.
Correct Answer: C
Rationale: The correct answer is C because expressing milk by a breast pump or manually helps maintain milk supply, prevent engorgement, and relieve discomfort. It also allows for milk storage and feeding flexibility.
A: Running warm water over breasts can lead to oversupply and disrupt milk production.
B: Wearing a bra 24/7 can lead to constriction and may decrease milk flow.
D: Taking analgesics only masks the pain without addressing the underlying issue of milk expression.
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: Pregnancy and birth experiences, which can either enhance or impede the process of becoming a mother. Reviewing the prenatal and labor records helps the nurse understand the mother's experiences during pregnancy and childbirth, which can significantly impact her transition to motherhood. By knowing these experiences, the nurse can identify any factors that may enhance or impede the mother's adjustment to motherhood. This information allows the nurse to provide tailored support and interventions to assist the mother in her transition.
Choice B is incorrect because prenatal classes are not directly related to reviewing prenatal and labor records to understand the mother's experiences. Choice C is incorrect as preexisting maternal conditions are not the main focus when reviewing records for the transition to parenthood. Choice D is also incorrect as it focuses on neonate issues, which are not the primary concern when reviewing prenatal and labor records for assisting the mother and father in making the transition to parenthood.