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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.
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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.
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 unidirectional bonding where the parent initiates the interaction without the need for the baby's response. This action shows a one-way connection from the parent to the infant. In contrast, choices A, C, and D involve mutual interaction between the parent and the baby, indicating bidirectional bonding where both parties are actively engaging with each other. Option A involves the parent responding to the baby's cry, option C involves the baby responding to comforting measures, and option D involves the parents stimulating and entertaining the baby, all of which require reciprocal actions from both the parent and the baby.
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 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 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.