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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 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.
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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 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.
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 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: The correct answer is A: An increase in oxytocin release related to the newborn suckling. After delivery, breastfeeding stimulates the release of oxytocin, causing uterine contractions. This helps the uterus to contract, reduce bleeding, and return to its normal size. This process can result in uterine cramps, especially in multiparous women.
B: The presence of intense afterbirth pains related to multiparity - Afterbirth pains are common in multiparous women, but they are different from uterine cramps due to breastfeeding.
C: An expected response to the daily administration of oxytocin - The patient is breastfeeding, not receiving daily oxytocin administration.
D: The efforts of the uterus to return to a prepregnancy condition - While this is true, the primary reason for the uterine cramps in this scenario is the increased oxytocin release from breastfeeding.
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.