A nurse is reinforcing teaching with a client who is breastfeeding and has mastitis.Which of the following responses should the nurse make?
Completely empty each breast at each feeding or use a pump.
Nurse the infant only on the unaffected breast until resolved.
Wear a tight-fitting bra until lactation has ceased.
Limit the amount of time the infant nurses on each breast.
The Correct Answer is A
Choice A rationale
Completely emptying each breast at each feeding or using a pump helps prevent milk stasis, which can lead to mastitis. Ensuring the breasts are fully emptied reduces the risk of blocked ducts and infection.
Choice B rationale
Nursing on only the unaffected breast can lead to engorgement and worsening of mastitis in the affected breast. It is important to continue breastfeeding on both sides to maintain milk flow and prevent complications.
Choice C rationale
Wearing a tight-fitting bra can restrict milk flow and exacerbate mastitis. A well-fitting, supportive bra is recommended to avoid further complications.
Choice D rationale
Limiting the time the infant nurses on each breast can lead to incomplete emptying and increase the risk of mastitis. It is important to ensure the breasts are fully emptied to prevent infection.
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Correct Answer is D
Explanation
Choice A rationale
Rho(D) immune globulin is not indicated if both the client and the newborn are Rh positive. There is no risk of Rh incompatibility in this scenario.
Choice B rationale
Similarly, if both the client and the newborn are Rh positive, there is no need for Rho(D) immune globulin.
Choice C rationale
If both the client and the newborn are Rh negative, there is no risk of Rh incompatibility, and Rho(D) immune globulin is not needed.
Choice D rationale
Rho(D) immune globulin is indicated when the client is Rh negative and the newborn is Rh positive. This prevents the development of Rh antibodies in the client, which could affect future pregnancies.
Correct Answer is C
Explanation
Choice A rationale
A cervical or perineal laceration would typically result in continuous bleeding rather than a gush that stops. The uterus would also not be firm and midline if there were a significant laceration.
Choice B rationale
Abnormally excessive lochia rubra flow would be continuous and not stop after a gush. The uterus being firm and midline indicates that the bleeding is not excessive.
Choice C rationale
A normal postural discharge of lochia occurs when pooled blood in the vagina is expelled upon standing or changing position. This is common and expected in the postpartum period.
Choice D rationale
A vaginal hematoma would present with localized pain and swelling, and the bleeding would not stop suddenly. The uterus being firm and midline also indicates that a hematoma is unlikely.