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 C
Explanation
Choice A rationale
Encouraging the client to empty her bladder is a common practice to prevent uterine atony and excessive bleeding. However, in this scenario, the fundus is already midline and firm at the umbilicus, indicating that the uterus is well-contracted. Therefore, this action is not necessary.
Choice B rationale
Notifying the client’s provider is not required in this situation. The findings of a light amount of lochia rubra and a firm, midline fundus are normal for 6 hours postpartum. There are no signs of complications that would necessitate contacting the provider.
Choice C rationale
Documenting the findings and continuing to monitor the client is the appropriate action. The client’s condition is stable, and the findings are within the expected range for 6 hours postpartum. Ongoing monitoring will ensure that any changes in the client’s condition are promptly addressed.
Choice D rationale
Increasing the frequency of fundal massage is not needed in this case. The fundus is already firm and midline, indicating that the uterus is well-contracted. Excessive fundal massage can cause discomfort and is unnecessary when the uterus is already in a good position.
Correct Answer is C
Explanation
Choice A rationale
A high-fat diet is not recommended for breastfeeding mothers. While fats are an essential part of a balanced diet, excessive intake of high-fat foods can lead to unhealthy weight gain and may not provide the necessary nutrients for both the mother and the baby. Breastfeeding mothers should focus on a balanced diet that includes healthy fats, proteins, and carbohydrates to support their nutritional needs and milk production.
Choice B rationale
Stopping prenatal vitamins is not advisable for breastfeeding mothers. Prenatal vitamins contain essential nutrients such as folic acid, iron, and calcium that support the health of both the mother and the baby. Continuing to take prenatal vitamins can help ensure that breastfeeding mothers receive adequate nutrients, especially if their diet may not provide all the necessary vitamins and minerals.
Choice C rationale
Breastfeeding mothers need an additional 450-500 kCal per day to meet their increased energy requirements. This extra caloric intake supports milk production and helps the mother maintain her energy levels. The additional calories should come from a balanced diet that includes a variety of nutrient-dense foods.
Choice D rationale
Consuming only 8-16 oz of water per day is insufficient for breastfeeding mothers. Adequate hydration is crucial for milk production and overall health. Breastfeeding mothers should aim to drink at least 8-10 cups (64-80 oz) of water per day to stay hydrated and support their body’s increased fluid needs.