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The nurse is instructing a woman at 6 months postpartum on weaning her infant from breastfeeding. What interventions will the nurse suggest? (Select all that apply.)
- A. Omit newborn's favorite feeding first.
- B. Eliminate one feeding at a time.
- C. Expect the need for comfort feeding.
- D. Formula will need to be provided to substitute for feeding.
- E. Pump breasts in place of eliminated feeding.
Correct Answer: B,C,D
Rationale: When weaning a newborn from breastfeeding, the mother should eliminate the favorite feeding last. One feeding should be eliminated at a time, and the need for comfort feeding should be expected. In younger infants formula will need to be substituted. The mother should not be instructed to pump in place of eliminated feeding or the breasts will continue to produce milk.
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While instructing a new mother on formula preparations, the nurse would include what types? (Select all that apply.)
- A. Ready-to-feed formula
- B. Concentrated liquid formula
- C. Powdered formula
- D. Cow's milk
- E. Canned evaporated milk
Correct Answer: A,B,C
Rationale: Formula choices are ready-to-use, concentrated liquid formula that will be diluted according to the infant's needs, and powdered formula that is mixed as needed. Cow's milk and canned evaporated milk are unsuitable, because they are nutritionally inadequate and stress the kidneys.
What will the nurse's instructions for a new mother to care for the infant's umbilical cord include?
- A. Keeping the area covered with a sterile dressing
- B. Dressing the stump with antibiotic ointment at every diaper change
- C. Fastening the diaper low to allow for air circulation
- D. Giving the newborn a daily tub bath until the cord falls off
Correct Answer: C
Rationale: Diaper placement below the umbilical stump allows for drying by air circulation.
What should the nurse's first action be when postpartum hemorrhage from uterine atony is suspected?
- A. Teach the patient how to massage the abdomen and then get help.
- B. Start IV fluids to prevent hypovolemia and then notify the registered nurse.
- C. Begin massaging the fundus while another person notifies the physician.
Correct Answer: C
Rationale: Massaging the fundus is the immediate action to stimulate uterine contractions and control bleeding, while another person notifies the physician for further management.
The nurse is giving a shower to a patient who had a cesarean section 2 days previously. What interventions should be included before, during, and after the shower? (Select all that apply.)
- A. Leave abdominal dressing open to air.
- B. Position patient with back to water stream.
- C. Cover infusion site with rubber glove.
- D. Provide a shower chair.
- E. Confirm ambulation ability.
Correct Answer: B,C,D,E
Rationale: The patient should be evaluated for ambulatory ability, and the abdominal dressing and infusion site should be covered with a waterproof cover. The patient should be provided a shower chair and positioned with her back to the water stream.
A woman asks about resumption of her menstrual cycle after childbirth. What should the nurse respond?
- A. A woman will not ovulate in the absence of menstrual flow.
- B. Most nonlactating women resume menstruation about 2 months postpartum.
- C. Generally, a woman does not ovulate in the first few cycles after childbirth.
- D. The return of menstruation is delayed when a woman does not breastfeed.
Correct Answer: B
Rationale: Menstrual periods resume in about 6 to 8 weeks if the woman is not breastfeeding.