A nurse is caring for a 28-year-old postpartum female client in the postpartum unit.
Medical History:
The client is on postpartum day 1. She is breastfeeding her newborn every 4 to 5 hours for 30 to 40 minutes each time. She reports some nipple discomfort during the feedings. The nurse assisted the client with positioning and latch and recommended the client awaken the newborn to feed every 3 hours during the day. The newborn voided twice and passed two meconium stools in the past 24 hours.
Vital Signs:
Blood Pressure: 120/80 mmHg
Pulse: 80 bpm
Respirations: 16/min
Temperature: 36.8°C (98.2°F)
Pulse Ox: 99%
Nurses Notes: On postpartum day 2, the client reports breastfeeding every 3 to 4 hours and experiencing nipple discomfort during some feedings. No physical findings of nipple trauma are noted, and the breasts are soft. The client denies feelings of fullness. The newborn voided twice and passed three meconium stools in the second 24 hours of life. Discharge teaching was provided to the client regarding breastfeeding.
Querry: Which of the following statements by the client indicates an understanding of the discharge teaching? Click to highlight the client statements that indicate an understanding of the discharge teaching.
"Because of my baby's weight loss, I need to supplement with formula after breastfeeding."
"I should make sure that my baby feeds 8 to 12 times per day, and on demand."
"I should cover my sore nipples with plastic-lined breast pads after every feeding."
"My baby's stools should turn from the dark greenish color meconium to a yellow color within the next day or two."
I can increase my milk supply by drinking more whole milk.
I should expect my breasts to feel full, warm, and slightly tender when my milk comes in.
Correct Answer : B,D,F
Choice A rationale:
Supplementing with formula is not necessary based on the given information. The baby is voiding and passing stools adequately, indicating proper feeding. Instead, feeding on demand and ensuring frequent breastfeeding will help address any concerns about the baby's weight.
Choice B rationale:
Feeding 8 to 12 times per day and on demand is recommended to ensure adequate milk supply and proper growth and development of the newborn. Frequent feeding helps to establish and maintain milk production.
Choice C rationale:
Using plastic-lined breast pads is not recommended as they can trap moisture and create an environment that promotes nipple irritation and infection. It is better to use breathable, non-plastic-lined breast pads.
Choice D rationale:
It is correct that a newborn's stools should transition from the dark greenish color meconium to a yellow color within a few days as the baby begins digesting breast milk.
Choice E rationale:
Drinking more whole milk does not directly increase a mother's milk supply. Milk supply is primarily regulated by the frequency and efficiency of breastfeeding or pumping.
Choice F rationale:
Expecting the breasts to feel full, warm, and slightly tender when the milk comes in is accurate. This usually occurs around the third or fourth day postpartum and indicates that the milk production process is underway.
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Correct Answer is A
Explanation
Choice A rationale
A boggy and displaced fundus typically indicates bladder distention. Assisting the client to void can help relieve bladder distention, allowing the uterus to contract properly and
reducing the risk of postpartum hemorrhage.
Choice B rationale
Asking the client to rate her pain is important, but it does not address the immediate issue of a boggy, displaced fundus, which suggests bladder distention.
Choice C rationale
Encouraging the client to move to the left lateral position might help with blood flow and comfort but does not resolve the issue of a boggy fundus due to bladder distention.
Choice D rationale
Kegel exercises strengthen pelvic floor muscles but do not address the immediate concern of a boggy, displaced fundus caused by bladder distention.
Correct Answer is D
Explanation
Choice A rationale
A family history of breast cancer, particularly in a close relative like a sister, is a significant risk factor for breast cancer.
Choice B rationale
Exposure to radiation, particularly in the chest area, increases the risk of developing breast cancer.
Choice C rationale
Current use of oral contraceptives can slightly increase the risk of breast cancer, though the risk diminishes after stopping the pills.
Choice D rationale
Age less than 25 years is not a risk factor for breast cancer; risk increases with age.