Nokea
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.
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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: "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 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, expressing milk by a breast pump or manually. This is the most helpful teaching for a breastfeeding patient as it helps maintain milk supply, prevent engorgement, and relieve discomfort. Expressing milk also allows for flexibility in feeding schedules and helps store milk for later use.
A: Running warm water over breasts in the shower may provide temporary relief but does not address milk expression.
B: Wearing a supportive bra is important, but it is not necessary to wear it 24 hours a day.
D: Taking analgesics for breast pain management should not be the first line of treatment and does not address the root cause of the issue.
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 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 a lesbian couple decides which partner will become pregnant. The birth certificate can typically be amended to include both partners as legal parents regardless of who gives birth.
A: Considering the age and health of each partner is important for assessing pregnancy risks.
B: Evaluating career goals may impact decisions around timing and balancing work and parenthood.
C: Deciding which partner has better insurance is relevant for covering prenatal care and delivery costs.
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.