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A nurse is caring for a client who is breastfeeding and states that her nipples are sore and cracking. Which of the following actions should the nurse take?

A.

Assess and ensure the newborn has a successful latch.

B.

Recommend increasing the length of time between feedings.

C.

Educate the client to apply mineral oil to the nipples between feedings.

D.

Educate the client to keep the nipples covered between breastfeeding sessions.

Answer and Explanation

The Correct Answer is A

Choice A rationale

 

Ensuring the newborn has a successful latch is crucial for preventing and treating sore and cracked nipples. A poor latch can cause nipple trauma and pain.

 

Choice B rationale

 

Increasing the length of time between feedings is not recommended as it can lead to engorgement and further complications. Frequent breastfeeding helps maintain milk supply and prevents issues like mastitis.

 

Choice C rationale

 

Applying mineral oil to the nipples is not recommended. Instead, using expressed breast milk or medical-grade lanolin can promote healing.

 

Choice D rationale

 

Keeping the nipples covered between breastfeeding sessions is not necessary and can sometimes exacerbate the problem. Allowing the nipples to air dry or using hydrogel pads can be more beneficial.

 


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Correct Answer is D

Explanation

Choice A rationale

Pumping out the milk when breasts become engorged can provide temporary relief, but it can also stimulate further milk production, leading to continued engorgement. This is not recommended for clients who are not planning to breastfeed.

Choice B rationale

Not wearing a bra throughout the day can lead to discomfort and inadequate support for engorged breasts. Wearing a supportive bra, such as a sports bra, can help alleviate discomfort and provide necessary support.

Choice C rationale

Applying hot packs to the breasts can increase blood flow and exacerbate engorgement. Cold packs or ice packs are recommended to reduce swelling and provide relief from discomfort.

Choice D rationale

Avoiding stimulation to the nipples is an effective measure to reduce milk production and alleviate breast engorgement. This includes avoiding activities that may stimulate the nipples, such as pumping or hand expressing milk.

Correct Answer is D

Explanation

Choice A rationale

An increase in lochia is not an indicator of the effectiveness of oxytocin. Lochia is the vaginal discharge after childbirth and its amount can vary.

Choice B rationale

The absence of breast pain is not related to the effectiveness of oxytocin, which is used to prevent postpartum hemorrhage by promoting uterine contractions.

Choice C rationale

An increase in blood pressure is not an expected outcome of oxytocin administration. Oxytocin primarily affects the uterus.

Choice D rationale

A firm fundus to palpation indicates that the uterus is contracting effectively, which is the desired effect of oxytocin administration to prevent postpartum hemorrhage.

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