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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.

A.

"Because of my baby's weight loss, I need to supplement with formula after breastfeeding."

B.

"I should make sure that my baby feeds 8 to 12 times per day, and on demand."

C.

"I should cover my sore nipples with plastic-lined breast pads after every feeding."

D.

"My baby's stools should turn from the dark greenish color meconium to a yellow color within the next day or two."

E.

I can increase my milk supply by drinking more whole milk.

F.

I should expect my breasts to feel full, warm, and slightly tender when my milk comes in.

Question Solution

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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View Related questions

Correct Answer is A

Explanation

Choice A rationale

Uterine atony is a common complication following polyhydramnios because the excessive amniotic fluid can lead to uterine overdistension, which in turn can cause poor uterine

muscle tone and increased risk of postpartum hemorrhage.

Choice B rationale

Thrombophlebitis is an inflammation of a vein with clot formation, but it is not directly associated with polyhydramnios.

Choice C rationale

Postpartum preeclampsia is high blood pressure and signs of organ damage after delivery, but there is no direct link between polyhydramnios and this condition.

Choice D rationale

Retained placental fragments can lead to postpartum hemorrhage but are not specifically associated with polyhydramnios.

Correct Answer is ["A","B","C"]

Explanation

Choice A: Give betamethasone 12 mg IM now and repeat in 24 hr.

Rationale: Betamethasone is administered to accelerate fetal lung maturity in cases of preterm labor. Given the client's gestational age of 31 weeks, this intervention is appropriate to help reduce the risk of respiratory distress syndrome in the newborn.

Choice B: Begin loading dose of magnesium sulfate 9 g over 30 min.

Rationale: Magnesium sulfate is used for neuroprotection of the fetus in preterm labor to reduce the risk of cerebral palsy. The loading dose is typically given to achieve therapeutic levels quickly.

Choice C: Position the client in a lateral position.

Rationale: Positioning the client in a lateral position helps improve uteroplacental blood flow and can reduce the intensity of contractions, which is beneficial in managing preterm labor.

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