Maternity PrepU CH. 17
A 2-day old newborn is crying after being circumcised and the mother is attempting to comfort the infant but he continues to be fussy. Which statement by the nurse would best support the mother's actions? "You would probably be more successful if you wrapped him in on a warm blanket." "Many mothers find that offering a nipple dipped in sugar water helps soothe a baby after a painful procedure." "Let me show you how to calm him down. I've been doing this for many years." "Maybe you your husband will have better luck calming him down. Why don't you let him hold him?"
"Many mothers find that offering a nipple dipped in sugar water helps soothe a baby after a painful procedure." Explanation: Parents need support when trying to care for their newborn infants. By offering positive phrases and encouraging the mother in her caretaking, the nurse conveys acceptance and confirms the mother's abilities.
The nurse is performing an assessment on a 2-day postpartum client and discovers a boggy fundus at the umbilicus and slightly to the right. The nurse determines that this is most likely related to which situation? Uterine atony Full bowel Bladder distention Poor bladder tone
Bladder distention Explanation: Most often the cause of a displaced uterus is a distended bladder. Ask the client to void and then reassess the uterus. According to the scenario described, the most likely cause of the uterine findings would not be uterine atony. A full bowel or poor bladder tone would not cause a boggy and displaced fundus.
The parents of a newborn are upset that their newborn needs treatment for ophthalmia neonatorum. The nurse should explain this is related to which maternal infection? Select all that apply. Chlamydia Gonorrhea Trichomonas Syphilis Candidiasis
Chlamydia Gonorrhea Explanation: Colonization of chlamydia and gonorrhea in the vaginal tract can lead to ophthalmia neonatorum in the newborn, which infants contract at birth. The treatment is the use of an antibiotic ophthalmic ointment that is usually applied within the first hour. Trichomonas, syphilis, and candidiasis do not cause ophthalmia neonatorum.
Which intervention would be appropriate for the nurse to include in the plan? Ensure early and frequent parent-newborn interactions. Encourage contact between the newborn's skin and parental clothing. Have the parents participate in newborn care once a day. Urge parents to talk to each other when holding the baby.
Ensure early and frequent parent-newborn interactions.
A nurse is caring for a breastfeeding client who reports engorgement. The nurse identifies that the client's condition is due to not fully emptying her breasts at each feeding. Which suggestion should the nurse make to help her prevent engorgement? Feed the baby at least every two or three hours. Apply cold compresses to the breasts. Provide the infant oral nystatin. Dry the nipples following feedings.
Feed the baby at least every two or three hours. Explanation: The nurse should suggest the client feed the baby every two or three hours to help her reduce and prevent further engorgement. Application of cold compresses to the breasts is suggested to reduce engorgement for non-breastfeeding clients. If the mother has developed a candidal infection on the nipples, the treatment involves application of an antifungal cream to the nipples following feedings and providing the infant with oral nystatin. The nurse can suggest drying the nipples following feedings if the client experiences nipple pain.
One hour after birth the nurse is assessing a neonate in the nursery. The nurse begins by assessing which parameters? Inspecting posture, color, and respiratory effort Checking for identifying birthmarks or skin injuries Auscultating bowel sounds, and measuring urine output Determining chest and head circumference
Inspecting posture, color, and respiratory effort Explanation: The nurse begins by assessing the neonate's posture, color, and respiratory effort. These three parameters provide a general overview of the infant's condition and adaptation to extrauterine life. Skin condition and birthmarks as well as head and chest circumference are part of the comprehensive physical and are documented within the first day of life. Bowel sounds are not present until about 15 minutes after birth and the infant may not void until 24 hours of age.
The nurse is admitting to the floor a woman who just gave birth. What medical and pregnancy history would the labor and delivery nurse include in the report? Length of labor Maternal blood type The newborn's weight Apgar scores
Maternal blood type Explanation: Medical and pregnancy history would include information pertinent to the mother, which would be the mother's blood type, Rh, and rubella status. History of the length of labor are part of the labor and birthing history. The infant's Apgar scores and birth weight are part of the newborn history.
The LPN is assessing a 1-day-old newborn and notices a large amount of white drainage and redness at the base of the umbilical cord. What is the best response by the nurse? Call the doctor immediately to ask for intravenous antibiotics and document finding. Carefully clean the area with a damp washcloth and cover it with an absorbent dressing and document finding and intervention. Notify the charge nurse, because it represents a possible complication, and document the finding. Show the mother how to clean the area with soap and water, and document the intervention.
Notify the charge nurse, because it represents a possible complication, and document the finding. Explanation: The base of the cord should be dry without redness or drainage, and the umbilical clamp should be fastened securely. The white drainage and redness are potential signs of an infection and would need to be reported immediately to the RN by the LPN. Antibiotics may or may not be necessary, however.
A postpartum woman is concerned about constipation following delivery. What factor(s) contribute to this problem? Select all that apply. Poor diet after delivery Perineal pain Hemorrhoidal discomfort Iron supplements Intake of too many fluids
Perineal pain Hemorrhoidal discomfort Iron supplements Explanation: After delivery, many women experience a great deal of perineal pain, as well as hemorrhoidal pain, which leads to constipation because the woman is reluctant to defecate, fearing pain. Additionally, iron supplements contribute to constipation also.
A nurse is preparing to administer erythromycin ointment to a 1-hour-old newborn. What will the nurse do first? Administer the medication in each eye. Review the health care provider's order. Apply gloves and obtain the medication. Explain the procedure to the caregivers.
Review the health care provider's order. Explanation: Prior to administering the erythromycin ointment, the nurse will review the order. The nurse would then explain the procedure to the caregivers, apply gloves, and administer the medication in both eyes.
A postpartum client delivered her infant 1 day ago and the nurse is monitoring her blood pressure. What position would the nurse place the client in to get the most accurate reading? Lying flat in the bed on her back Lying on the right side for 5 minutes Sitting up in the bed Sitting on the side of the bed for 2 to 3 minutes
Sitting on the side of the bed for 2 to 3 minutes Explanation: In order to get the most accurate reading on a client's blood pressure, it is advised to have the client sit up on the side of the bed for several minutes to prevent orthostatic hypotension and a falsely low blood pressure.
Prior to discharge from the hospital, a nurse is checking the fundal height for a new mother who delivered 2 days ago. The nurse would anticipate which finding? Level with the umbilicus One fingerbreadth below the umbilicus Two fingerbreadths below the umbilicus At the pubic bone
Two fingerbreadths below the umbilicus Explanation: Immediately after delivery, the uterine fundus should be at the level of the umbilicus. One day postpartum, the height is one fingerbreadth below the umbilicus and by Day 2, the fundal height is two fingerbreadths below the umbilicus.
A nurse is caring for a non-breastfeeding client in the postpartum period. The client reports engorgement. What suggestion should the nurse provide to alleviate breast discomfort? Apply warm compresses. Wear a well-fitting bra. Express milk frequently. Apply hydrogel dressing.
Wear a well-fitting bra. Explanation: The nurse should suggest the client wear a well-fitting bra to provide support and help alleviate breast discomfort. Application of warm compresses and expressing milk frequently are suggested to alleviate breast engorgement in breastfeeding clients. Hydrogel dressings are used prophylactically in treating nipple pain.
The nurse is reviewing the health records of several clients who gave birth during the previous shift. For which client would the nurse monitor more frequently for maternal hemorrhage? a client who birthed an 8 lb 6 oz (3799 g) neonate a client diagnosed with placenta succenturiate a client who showered 12 hours after birth of a healthy term neonate a client with a pulse rate of 88 beats/min and a blood pressure of 102/64 mm Hg
a client diagnosed with placenta succenturiate Explanation: Placental succenturiate is a concern for maternal hemorrhage if the accessory lobes of the placenta are retained after delivery. The other conditions are not associated with a higher than usual concern for hemorrhage, although all postpartum clients are observed for hemorrhage.
Seven hours ago, a multigravida woman gave birth to a male infant weighing 4,133 g. She has voided once and calls for a nurse to check because she states that she feels "really wet" now. Upon examination, her perineal pad is saturated. The immediate nursing action is to: inspect the perineum for lacerations. increase the flow of an IV. assess and massage the fundus. call the primary care provider or the nurse-midwife.
assess and massage the fundus. Explanation: This woman is a multigravida who gave birth to a large baby and is at risk for hemorrhage. The other actions are to be done after the initial fundal massage.
A postpartum client has a fourth-degree perineal laceration. The nurse would expect which medication to be prescribed? ferrous sulfate methylergonovine docusate bromocriptine
docusate Explanation: A stool softener such as docusate may promote bowel elimination in a woman with a fourth-degree laceration, who may fear that bowel movements will be painful. Ferrous sulfate would be used to treat anemia. However, it is associated with constipation and would increase the discomfort when the woman has a bowel movement. Methylergonovine would be used to prevent or treat postpartum hemorrhage. Bromocriptine is used to treat hyperprolactinemia.
When describing the hormonal changes that occur after birth of a newborn, the nurse would identify a decrease in which hormone as being associated with breast engorgement? estrogen progesterone prolactin human chorionic gonadotropin (hCG)
estrogen Explanation: Decreased levels of estrogen are associated with breast engorgement and with the diuresis that occurs postpartum. Progesterone and hCG are not involved with breast engorgement. Prolactin levels remain elevated in the lactating woman for milk synthesis and secretion, but decrease within 2 weeks for the woman who is not breast-feeding.
A postpartum client has decided to bottle feed her newborn. After teaching the woman about it, the nurse determines that the teaching was successful based on which client statement(s)? Select all that apply. "I will use warm water to mix the powdered formula." "I will be sure not to use the microwave to warm the formula." "I will make sure the nipple and neck of the bottle are filled with formula during a feeding." "I will store any formula left over from a feeding in the refrigerator." "I will get my newborn to suck by touching the nipple to the lips."
"I will be sure not to use the microwave to warm the formula." "I will make sure the nipple and neck of the bottle are filled with formula during a feeding." "I will get my newborn to suck by touching the nipple to the lips." Explanation: Teaching about bottle feeding should include the following: mixing powdered formula with room temperature water to allow better mixing and quicker dissolution of lumps; storing any formula prepared in advance in the refrigerator to keep bacteria from growing but discarding any formula not taken during a feeding; making sure that the nipple and neck of the bottle are always filled with formula to prevent the newborn from taking in too much air; and stimulating the sucking reflex by placing the nipple to the newborn's lips.
A new mother is concerned because it is 24 hours after birth and her breasts have still not become engorged with breast milk. How should the nurse respond to this concern? "It takes about 3 days after birth for milk to begin forming." "I'm sorry to hear that. There are some excellent formulas on the market now, so you will still be able to provide for your infant's nutritional needs." "You may have developed mastitis. I'll ask the primary care provider to examine you." "You are experiencing lactational amenorrhea. It may be several weeks before your milk comes in."
"It takes about 3 days after birth for milk to begin forming." Explanation: The formation of breast milk (lactation) begins in a postpartal woman regardless of her plans for feeding. For the first 2 days after birth, an average woman notices little change in her breasts from the way they were during pregnancy, since midway through pregnancy she has been secreting colostrum, a thin, watery, prelactation secretion. On the third day postpartum, her breasts become full and feel tense or tender as milk forms within breast ducts and replaces colostrum. There is no need to recommend formula feeding to the mother. Mastitis is inflammation of the lactiferous (milk-producing) glands of the breast; there is no indication that the client has this condition. Lactational amenorrhea is the absence of menstrual flow that occurs in many women during the lactation period.
The postpartum client and her husband are excited about their new baby. However, they are also concerned about getting pregnant again too soon and ask about using birth control. Which instruction should the nurse include in their discharge education to address this issue? "You may have intercourse until next month with no fear of pregnancy." "Ovulation may return as soon as 3 weeks after birth." "You will not ovulate until your menstrual cycle returns." "Ovulation does not return for 6 months after birth."
"Ovulation may return as soon as 3 weeks after birth." Explanation: Ovulation may start at soon as 3 weeks after birth. The client needs to be aware and use a form of birth control. She needs to be cleared by her health care provider prior to intercourse if she has a vaginal birth, but in the event that she has intercourse, needs to be prepared for the possibility of pregnancy. Ovulation can occur without the return of the menstrual cycle, and ovulation does return sooner than 6 months after birth.
During a postpartum home visit, a woman tells the nurse that her hip joints are sore, just like they were when she was pregnant. Which information would the nurse likely include when teaching the woman about this condition? Select all that apply. "You will probably need to take an opioid pain medicine for a few weeks." "This soreness should go away in about 6 to 8 weeks." "Let me show you how to use good body mechanics to lessen the problem." "It is important to lie down on your back at least 3 times a day." "It is important to get this checked out with an x-ray just to make sure."
"This soreness should go away in about 6 to 8 weeks." "Let me show you how to use good body mechanics to lessen the problem."
A woman who gave birth 24 hours ago tells the nurse, "I've been urinating so much over the past several hours." Which response by the nurse would be most appropriate? "You must have an infection, so let me get a urine specimen." "Your body is undergoing many changes that cause your bladder to fill quickly." "Your uterus is not contracting as quickly as it should." "The anesthesia that you received is wearing off and your bladder is working again."
"Your body is undergoing many changes that cause your bladder to fill quickly." Explanation: Postpartum diuresis occurs as a result of several mechanisms: the large amounts of IV fluids given during labor, a decreasing antidiuretic effect of oxytocin as its level declines, the buildup and retention of extra fluids during pregnancy, and a decreasing production of aldosterone—the hormone that decreases sodium retention and increases urine production. All these factors contribute to rapid filling of the bladder within 12 hours of birth. Diuresis begins within 12 hours after childbirth and continues throughout the first week postpartum.
A nurse is providing care to a woman who is 6 hours postpartum. The nurse suspects urinary retention based on which finding? fundus at the level of the umbilicus moderate amount of lochia rubra 50 to 70 mL urine per void every hour urine clear yellow in color
50 to 70 mL urine per void every hour Explanation: Urinary retention is a major cause of uterine atony, which allows excessive bleeding. Frequent voiding of small amounts (less than 150 mL) suggests urinary retention with overflow and a need for catheterization. A uterus at the level of the umbilicus, moderate lochia rubra, and clear yellow urine are normal findings.
The nursing instructor is conducting a class exploring the various changes that occur in the early postpartum period. The instructor determines the session is successful when the students correctly point out which definition of bonding? A process of developing an attachment and becoming acquainted with each other The skin-to-skin contact that occurs in the birth room An ongoing process in the year after birth Family growing closer together after the birth of a new baby
A process of developing an attachment and becoming acquainted with each other Explanation: Bonding in the maternal-newborn world is the attachment process that occurs between a mother and her newborn infant. This is how the mother and infant become engaged with each other and is the foundation for the relationship. Bonding is a process and not a single event. The process of bonding is not a yearlong process, and the family growing closer together after the birth of a new baby is not bonding.
A new mother is in the second developmental stage of becoming a mother and is becoming independent in her actions. Which action by the nurse would best foster this stage? Changing the infant's diapers for the mother Demonstrating how to do cord care on the newborn Correcting the mother when she holds the newborn incorrectly. Telling the mother to feed the baby when it cries.
Demonstrating how to do cord care on the newborn Explanation: When a mother enters the independent period of the second stage of becoming a mother, the nurse can assist her best by supporting her and praising her when she cares for the newborn. By demonstrating cord care to her, it empowers her to do the cord care the next time it is needed. The nurse's job is to not take over but to assist the mother in caring for her newborn.
A client is exhibiting signs of engorgement, but her milk is still flowing easily. Which suggestion should the nurse prioritize? Restrict fluid intake to 2 L each day. Ensure the baby empties the breasts at each feeding Apply ice packs before a feeding. Wear a tight fitting bra at all times.
Ensure the baby empties the breasts at each feeding Explanation: Breast engorgement occurs as the breasts begin to produce milk. As the infant begins the process of breast feeding, the woman's body will begin to adjust and produce just enough milk for the infant. The mother should ensure the infant empties each side at each feeding to ensure there will be plenty of milk for each feeding. The woman should not restrict her fluid intake but ensure she gets plenty of fluids to ensure an adequate supply of milk. Wearing a tight fitting bra would be appropriate if the mother decides to bottle-feed her baby, but not if she is breastfeeding. She should wear a bra which is supportive. It would be more appropriate to apply warm compresses or take a warm shower before feeding her infant to help with engorgement as it encourages the let-down factor.
A postpartum mother calls the nurse in and tells her that her right calf hurts whenever she walks around the room or in the hall. What other data needs to be collected in assessing this client for a DVT? Select all that apply. Feel the right calf for increased warmth. Note any reddened areas on the right calf. Note capillary refill of the toes. Measure the diameter of both calves. Have the mother actively flex both legs for equal movement.
Feel the right calf for increased warmth. Note any reddened areas on the right calf. Measure the diameter of both calves. Explanation: A deep vein thrombus (DVT) is suspected in a client who is complaining of pain in her calves and, upon inspection, there is redness of the calf, increased size, and increased warmth. It is not advised to have the client actively flexing her legs due to the risk of dislodging the clot. Checking capillary refill will provide no more information related to a DVT.
The client, G5 P5, is resting comfortably with her infant after 14 hours of labor. The nurse is conducting an assessment and notes the uterine fundus is two fingers above the umbilicus and feels soft and spongy. Which action should the nurse prioritize after noting the delivery was completed 12 hours ago? Put on the call button to summon help Gently massage the fundus until it tones up Administer oxytocics to prevent uterine atony Teach the woman to perform periodic self-fundal massage
Gently massage the fundus until it tones up Explanation: After delivery, the fundus should be firm and at the umbilicus or lower. The more pregnancies and the larger the infant, the more at risk for complications secondary to atony of the uterus for the patient. The first action is to massage the uterus until firm. The scenario described does not indicate any need to summon help. The administration of oxytocics to prevent uterine atony can only be done by order of the health care provider. Teaching the woman to perform self-fundal massage is not appropriate at this time. It would be appropriate after the atony of the uterus is corrected.
A nurse is performing an assessment on a female client who gave birth 24 hours ago. On assessment, the nurse finds that the fundus is 2 cm above the umbilicus and boggy. Which intervention is a priority? Notify the primary care provider, and document the findings. Have the client void, and then massage the fundus until it is firm. Assess a full set of vital signs. Check and inspect the lochia, and document all findings
Have the client void, and then massage the fundus until it is firm. Explanation: The fundus in a postpartum client should decrease 1 cm below the umbilicus each day. The fundus should also be firm to decrease the risk of postpartum hemorrhage. All of the listed interventions are appropriate, but a firm fundus is the priority.
Which assessment finding 1 hour after birth should be reported to the health care provider? Fundus of uterus is palpable at the level of the umbilicus. Fundus is displaced to the right, and bladder is hard. Large, bruised hemorrhoids are protruding from the anal opening. Lochia rubra is saturating a pad every 45 to 60 minutes.
Lochia rubra is saturating a pad every 45 to 60 minutes. Explanation: The nurse should ask the woman to turn over so her buttocks can be inspected in order to ensure that blood is not pooling beneath her. If the nurse observes a constant trickle of vaginal flow or the woman is soaking through a pad every 60 minutes, she is losing more than the average amount of blood. She needs to be examined by her health care provider to be certain there is no cervical or vaginal tear, or that poor uterine contraction is not causing excessive bleeding. Following perineal assessment, the nurse should assess the rectal area for the presence of hemorrhoids. If any are present, the nurse should document their number, appearance, and size in centimeters. Fundus of uterus palpable at the level of the umbilicus is a normal finding immediately after birth. When the fundus is displaced to right and bladder is hard to palpation, the bladder is full, and the nurse needs to assist the client in emptying the bladder. The health care provider should be notified if a catheter needs to be inserted and there are no standing prescriptions for an in-and-out cath following birth.
The nurse is caring for several postpartum clients on the unit. Which client's reaction should the nurse prioritize for possible intervention? Hesitates to hold newborn, expressing disappointment with baby's appearance. Neglects to engage or provide care or show interest in infant. Tearful for several days, difficulty eating and sleeping. Express doubt in ability to care for newborn.
Neglects to engage or provide care or show interest in infant. Explanation: A mother not bonding with the infant or showing disinterest is a cause for concern and requires a referral or notification of the primary health care provider. Some mothers hesitate to take their newborn and express disappointment in the way the baby looks, especially if they want a child of one sex and have a child of the opposite sex. Expressing doubt about the ability to care for the baby is not unusual, and being tearful for several days with difficulty eating and sleeping is common with postpartum blues.
Under which circumstances should gloves be worn in the newborn nursery? Select all that apply. Providing the first bath Changing a diaper Performing a heel stick Accucheck Feeding the newborn a bottle Taking the newborn's crib to the mother's room
Providing the first bath Changing a diaper Performing a heel stick Accucheck Explanation: Universal precautions, such as wearing gloves, is necessary whenever the nurse is likely to come in contact with bodily fluids, such as when changing a diaper, performing the initial bath after birth, and drawing blood for testing. Gloves are not needed with formula feedings or when transporting the newborn in its crib to the mother's room.
Elevation of a client's temperature is a crucial first sign of infection. However, when is elevated temperature not a warning sign of impending infection? when the white blood cell count is less than 10,000/mm³ during the first 24 hours after birth owing to dehydration from exertion after any period of decreased intake when the elevated temperature exceeds 100.4°F (38°C)
during the first 24 hours after birth owing to dehydration from exertion Explanation: Rapid breathing during labor and birth and limited oral intake can cause a self-limited period of dehydration that is resolved after birth by the diuresis that shortly follows. The option of "any period" is too broad and falsely encompasses all conditions. The other options are signs of infection.
A nurse is assessing uterine involution of a postpartum woman. When reviewing the woman's labor and birth record, which factor would the nurse identify as potentially delaying involution? Select all that apply. hydramnios birth of triplets labor of 4 hours grand multiparity limited use of analgesia
hydramnios birth of triplets grand multiparity Explanation: Involution will occur most dependably in a woman who is well nourished and who ambulates early after birth as gravity may play a role. Involution may be delayed by a condition such as the birth of multiple fetuses, hydramnios, exhaustion from prolonged labor, grand multiparity, or physiologic effects of excessive analgesia.
When caring for a mother who has had a cesarean birth, the nurse would expect the client's lochia to be: greater than after a vaginal birth. about the same as after a vaginal birth. less than after a vaginal birth. saturated with clots and mucus.
less than after a vaginal birth. Explanation: Women who have had cesarean births tend to have less flow because the uterine debris is removed manually along with delivery of the placenta.
During the fourth stage of labor, the nurse assesses the client's fundal height and tone. When completing this assessment, the nurse performs which action to prevent prolapse or inversion of the uterus? places index and middle fingers across the muscle palpates the abdomen while feeling the uterine fundus massages the fundus carefully to expel any blood clots places a gloved hand just above the symphysis pubis
places a gloved hand just above the symphysis pubis Explanation: The nurse can prevent prolapse or inversion of the uterus by placing a gloved hand just above the symphysis pubis that guards the uterus and prevents any downward displacement that may result in prolapse or inversion. To assess the client's rectus muscle, the nurse places the index and middle fingers across the muscle. Palpating the abdomen and feeling the uterine fundus or massaging the fundus carefully to expel any blood clots would be of no benefit in preventing prolapse or inversion of the uterus.
Client teaching is conducted throughout a client's hospitalization and is reinforced before discharge. Which self-care items are to be reinforced before discharge? Select all that apply. resumption of intercourse activity resumption of prepregnancy environment signs and symptoms of infection infant formula selection
resumption of intercourse activity signs and symptoms of infection Explanation: The correct answers give information on managing changes in her new role as a mother. The assumption cannot be made that her prepregnancy diet is still appropriate, and the formula choice should be discussed with her pediatrician.
The nurse is assessing a client at a postpartum visit. Which hemodynamic change will the nurse expect the client to exhibit? rise in hematocrit transient tachycardia increase in circulatory blood volume increase in cardiac output
rise in hematocrit Explanation: Hemoglobin and erythrocyte values vary during the early postpartum period, but they should approximate or exceed prelabor values within 2 to 6 weeks. As the woman excretes extracellular fluid, hemoconcentration occurs, with a concomitant rise in hematocrit. Puerperal bradycardia, with rates of 50 to 70 beats per minute, is common during the first 6 to 10 days postpartum. Blood volume decreases following placental separation, contraction of the uterus, and increased stroke volume. Cardiac output begins to increase early in pregnancy and peaks at 20 to 24 weeks' gestation at 30% to 50% above prepregnant levels. Cardiac output decreases during the postpartum period following placental separation, contraction of the uterus, and increased stroke
A nurse is meeting with a client who developed overdistention of the abdominal muscles during her pregnancy. Which action should the nurse prioritize to best assist this client recover from this situation? apply warm compresses apply moist heat massage the muscles suggest proper exercise
suggest proper exercise Explanation: This client developed diastasis recti, a condition in which the abdominal muscles separate during the pregnancy, leaving part of the abdominal wall without muscular support. Exercise can improve muscle tone when this condition occurs. Application of warm compresses, application of moist heat, and massaging the muscles gently will not correct this situation.
Which factor might result in a decreased supply of breast milk in a postpartum client? supplemental feedings with formula maternal diet high in vitamin C an alcoholic drink frequent feedings
supplemental feedings with formula Explanation: Routine formula supplementation may interfere with establishing an adequate milk volume because decreased stimulation to the client's nipples affects hormonal levels and milk production. Vitamin C levels have not been shown to influence milk volume. One drink containing alcohol generally tends to relax the client, facilitating letdown. Excessive consumption of alcohol may block letdown of milk to the infant, though supply is not necessarily affected. Frequent feedings are likely to increase milk production.
A woman comes to the clinic for her first postpartum visit. She gave birth to a healthy term neonate 2 weeks ago. As part of this visit, the woman has a complete blood count drawn. Which result would the nurse identify as a potential problem? hematocrit 42% (0.42) white blood cell count 14,000/mm3 (14 ×109/L) hemoglobin 12.5 g/dL (125 g/L) platelets 350,000/µL (350 ×109/L)
white blood cell count 14,000/mm3 (14 ×109/L) Explanation: The white blood cell count, which increases in labor, remains elevated for the first 4 to 6 days after birth but then falls to 6,000 to 10,000/mm3 (6 to 10 ×109/L). An elevated white blood cell count would be suspicious for infection. The hemoglobin, hematocrit and platelet levels are within normal parameters for this woman.
The nurse describes the changes in stool that a new mother would see when feeding her newborn formula. Which description best indicates what the mother would observe after several days? greenish, tarry, thick black stool thin, yellowish, seedy brown stool sour-smelling, yellowish-gold stool yellow-green, pasty, unpleasant-smelling stool
yellow-green, pasty, unpleasant-smelling stool Explanation: The stool of formula-fed newborns varies depending on the type of formula ingested, but it typically is yellow, yellow-green, or greenish, loose, pasty, or formed with an unpleasant odor. Greenish-black tarry stool denotes meconium. Thin, yellowish, seedy brown stool characterizes the transitional stool that occurs after meconium. Sour-smelling yellowish-gold stool that is loose and stringy to pasty in consistency is typical of a breastfed newborn stool.
