Davis Edge Chapter 16: Newborn Nutrition

A breastfeeding mother is planning to return to work and asks the nurse how to store her breast milk. What is the best response by the nurse? "Keep the milk warm in a thermos at your desk." "You can store breast milk for 6 to 8 hours at room temperature." "Expressed milk can remain in the refrigerator for a month." "Do not store breast milk in a freezer as it damages the milk proteins."

2. Rationale: Milk expressed into a clean container can remain at room temp for up to 8 hours.

A new mother who is breastfeeding is discussing feeding cues with the postpartum nurse. The nurse knows that education has been effective when the mother breastfeeds the baby after the baby displays what behavior? The baby has started to cry. The baby makes sucking motions. The baby stretches the legs out straight. The baby waves the arms in the air after being startled.

2. Rationale: sucking sounds or sucking of fingers or hands are feeding cues of the newborn, displayed 30 minutes before the infant cries.

A woman and her partner are discussing plans to breastfeed with the nurse. The partner states, "I know breastfeeding is recommended, but how can I help?" What is the best response by the nurse? "Many partners feel left out of the breastfeeding process." "You can feed formula while the mom is resting." "Are you having second thoughts about the decision to breastfeed?" "The most important thing you can do to help her is to support her in her decision to breastfeed."

4. Rationale: Supporting the mother's decision to breastfeed has a significant influence on her success at breastfeeding. Test-taking tip: Key phrases from the question stem may be repeated within the correct answer. In this question, the phrase "How can I help?" is repeated in the answer "You can help by..."

A postpartum woman calls the clinic about her 4-day-old infant. The baby is not scheduled for a well-baby visit for another 10 days. The mother states, "I am worried that my baby is not getting enough to eat at the breast." Which response by the nurse about effective breastfeeding would be appropriate? "As long as your baby gains its birth weight back by 1 month, breastfeeding is effective." "It is normal for your nipples to be sore after breastfeeding." "It is important that you take the baby off the breast after 15 minutes of breastfeeding." "You should anticipate your baby to void eight times per day."

4. Rationale: The newborn should have at least eight wet diapers and several stools per day once breastfeeding is established.

A nursing student walks into a client's room on the postpartum unit and notices several bottles of formula in various states of use sitting around. What should the student do at this time? Because the student nurse doesn't know which bottle was used last, they should instruct the client to throw away all the bottles except the one used last. The student nurse should report it to the nurse for the client to take care of. The family may have a reason to keep all the bottles, so the student nurse should ask if there is a reason for the bottles to still be in the room. The student nurse should remind the client that all bottles should be discarded after each use.

4. Rationale: The student should remind the client that all bottles should be discarded after each use. Not addressing the situation could cause the infant to be given a bottle that is contaminated.

The nurse understands that which of the following is a reason women stop breastfeeding before the eighth week? Engorgement Painful nipples Mastitis Thrush

2. Rationale: Painful nipples and improper latch are the primary reasons women stop breastfeeding before the eighth week.

Which one of the following clients should be counseled to not breastfeed her infant? A mother diagnosed with active tuberculosis the same day she delivers. A mother with a past history of cocaine use. A mother with herpes simplex virus (HSV). A mother who is a vegetarian.

1. Rationale: A client with active and untreated tuberculosis should not breastfeed.

Place the stages of breast milk in the correct chronological order. Transitional milk Colostrum Mature milk

2, 1, 3 Rationale: Colostrum is the first breastmilk that an infant receives and is high in immunoglobulins. As the milk begins to come in, transitional milk is present from 6 to 13 days, until the transition to mature milk is complete.

During discharge education, the nurse informs the parents of a newborn to anticipate increased fussiness and need for frequent feeds around 2 weeks of age. What does the nurse describe as the contributing factor for these symptoms? Growth spurt Colic Lactose intolerance Constipation

1. Rationale: Infants will go through growth spurts at 3 to 5 days, 1 week, 6 weeks, 3 months, and 6 months.

The labor and delivery (L&D) nurse is reviewing the chart of a client admitted in labor. When answering the client's questions, which would prompt the nurse to provide further education? "I plan to breastfeed, but can I start with a bottle?" "I plan to breastfeed, and I'd like the baby to come to my abdomen and straight to my breast at delivery." "I plan to breastfeed, so I know it's important to do skin-to-skin contact as much as possible." "I plan to breastfeed, so I'd like to see a lactation consultant to help with options."

1. Rationale: This response shows the mother does not understand the initiation of lactation starts with skin-to-skin contact and breastfeeding within 1 hour of birth.

A client is breastfeeding her full-term newborn for the first time. She reports to the nurse that her nipples are sore. What suggestion can the nurse provide to the client after observing the feeding? "Bring your breast to the baby, as this will help the baby latch." "Get all of the nipple and as much areola as you can in the baby's mouth." "Let the baby suck only on the tip of the nipple." "Use a pacifier as a tool to get the baby to suck appropriately."

2. Rationale: All of the nipple should be in the baby's mouth and as much areola as possible so that the baby creates a firm seal around the areola.

A pregnant client presents to the labor and delivery (L&D) unit in active labor with a history of no prenatal care. Initial laboratory work indicates a positive HIV status. What should the nurse advise the client to do? Complete a living will. Do not breastfeed the infant. Do not tell the family about the result. Consider placing the baby up for adoption.

2. Rationale: HIV can be transmitted through breastmilk, so HIV-positive women should not breastfeed to decrease the risk of transmission to the infant. Test-taking tip: Identifying the key words is important in a nursing question, as some info may not be important to answering the questions. For example, in this question, there are two important consideration: no prenatal care and HIV-positive upon admission. However, the "no prenatal care" aspect does not impact the answer and the main focus is HIV status.

A primiparous mother who delivered 2 weeks ago has called the clinic complaining of a fever, flu-like symptoms, and pain in her right breast. What is the best response by the nurse? "You need to start feeding the baby formula so your milk will dry up and you're no longer engorged." "This is a normal finding at 2 weeks; you should take some ibuprofen for the pain." "These are signs of a serious condition. You need to be seen today." "You can make your baby sick if you nurse him while you're sick. You both should be seen right away."

3. Rationale: The clients needs antibiotics and should be assessed by the provider as soon as possible.

A nurse has been working on the mother-baby unit caring for four mother-baby couplets. Throughout the day, all mothers have been observed while breastfeeding their infants. Which mother would the nurse provide with further education? The client places her hand away from the areola and cups the breast. The client places the infant in a cross-cradle hold with a pillow. The client leans forward to guide the nipple to the infant's mouth. The client starts on the same breast with each feeding.

3. Rationale: The infant should always be brought to the nipple, and the nipple should never be brought to the infant. Bringing the infant to the nipple supports an effective latch.

A client asks the nurse how she knows if the baby is getting enough to eat. What is the best response by the nurse? "The baby's suckle should be strong enough to cause mild discomfort." "The infant will feed for at least 20 minutes per side." "Your breasts will feel full and firm which indicates adequate milk supply." "The baby will be drowsy and relaxed after feeding."

4. Rationale: A satiated infant will relax the body and hands and release from the breast.