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?
Assess and ensure the newborn has a successful latch.
Recommend increasing the length of time between feedings.
Educate the client to apply mineral oil to the nipples between feedings.
Educate the client to keep the nipples covered between breastfeeding sessions.
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
The rubella vaccine should not be taken during pregnancy. It is a live attenuated vaccine, and there is a theoretical risk of harm to the developing fetus. Therefore, it is recommended to receive the vaccine before pregnancy.
Choice B rationale
The rubella vaccine is not recommended during each pregnancy. It is typically given as part of the MMR (measles, mumps, rubella) vaccine series in childhood, and immunity is usually lifelong. A booster dose is not needed during each pregnancy.
Choice C rationale
The rubella vaccine is not related to the Rh status of the baby. The vaccine is given to prevent rubella infection, which can cause serious birth defects if contracted during pregnancy.
Choice D rationale
The correct statement is that the client should avoid pregnancy for 28 days after receiving the rubella vaccine. This is to ensure that the live attenuated virus does not pose a risk to a developing fetus.
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.