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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 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.
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 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.
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, Ecchymosis, Discharge, and Approximation. These components focus on physical aspects like inflammation, bruising, wound healing, and discharge. Pain assessment is important but not part of the REEDA acronym, which specifically addresses visible signs of perineal healing postpartum. A thorough assessment should include pain evaluation separately. Choices A, B, and C are incorrect because they are covered by the REEDA acronym, focusing on perineal coloration, suture line appearance, and amount of swelling, respectively.