MATERNAL CHAP 19 BAYBEH
While breastfeeding, all of the following can contribute to sore nipples EXCEPT
Allowing the nipples to dry after each feeding
The nurse is helping a mother prepare to breast-feed her newborn for the first time. Which position should the nurse point out will be most appropriate with her cesarean incision site?
Football hold
Which feeding position should the nurse recommend for a woman who has just had a cesarean?
Football hold
A new mother asks the postpartum nurse if she can leave the unit for a few minutes to smoke. Which response by the nurse is most appropriate at this time?
I cannot stop you from smoking. However, I would caution you about exposing your newborn to secondhand smoke."
Choose the correct statement regarding breast milk production
Oxytocin is responsible for the let-down reflex, and prolactin stimulates milk production.
Choose the correct statement regarding breast milk production.
Oxytocin is responsible for the let-down reflex, and prolactin stimulates milk production.
The nurse asks a new mother how she is planning on feeding her newborn. The mother responds that she is planning on formula feeding her baby. Which of the following is the best response for the nurse to give the mother?
"Have you considered breastfeeding? There are some real benefits that it can offer you and your baby."
A client is 6 weeks postpartum and has been breastfeeding exclusively. She began pumping 2 days ago in anticipation of going back to work. She notices that her milk is blue-tinged. How should the nurse counsel this client?
"A slightly bluish color is normal."
A nursing instructor is teaching new mothers about nutrition and the actual calories infants need for maintenance and growth. Which of the following statements by one of the mothers indicates a need for further instruction?
"All infants require the same amount of calories."
The nursing instructor is reviewing with students ways to assess if the infant is getting enough at each feeding. Which of the following statements by a student demonstrates an understanding of these concepts?
"Assess the infant's voiding, growth, and alertness."
A woman comes to the clinic for her first postoperative check after a cesarean birth. When the nurse asks her about what type of birth control she plans to use, she tells the nurse that she is breastfeeding so she does not need to worry. What is the nurse's best response?
"Breastfeeding is not a foolproof method of birth control."
Which statement by the nurse would best support a new mother's choice to bottle feed her baby?
"By formula-feeding your newborn, you will know how much the baby takes each feeding and allows others to fed the baby."
Which statement by the nurse would best support a new mother's choice to bottle-feed her baby?
"By formula-feeding your newborn, you will know how much the baby takes each feeding and allows others to fed the baby."
During a postpartum parenting class, a client reports that she has switched her 6 month old from formula to cow's milk to save money. Which of the following responses from the nurse would be most appropriate?
"Cow's milk should not be used with infants younger than 9 months."
The nurse would provide additional teaching if which statement was made by a new mother?
"I will have to buy bottled, 'natural' water for mixing formula."
A client tells you she is unsure whether her baby is getting enough milk when she breast-feeds. Your best response would be:
"If your baby appears content between feedings and is wetting diapers, he/she is getting enough milk."
A G1 P1 mother asks the nurse "Why is my baby losing weight? He dropped 6 oz from yesterday to today. Is my breast milk not good?" Which answer is the best response to this new mother?
"It is normal for breastfed newborns to lose as much as 7% of birth weight the first 3 days after birth."
A new mother asks the nurse if she can leave the unit for a few minutes to smoke a cigarette. Which response by the nurse is most appropriate?
"It is preferred that you not smoke while breastfeeding since you will expose your infant to secondhand smoke."
A first-time mother learning to breastfeed her newborn is worried her baby is not getting enough milk. Which statement made by the nurse is most appropriate?
"Look at the number of wet and diapers with stool plus how many times the baby is feeding in a 24 hour period."
The nurse is assisting a new mother with breast-feeding her infant, and she is concerned about producing enough milk. The nurse determines the mother needs more teaching when she makes which comment?
"My husband is bringing bottles of water for our baby."
A new mother who is about to be discharged expresses concern about how to know her baby is getting enough breast milk. Which response should the nurse prioritize
"Observe if your baby is eating 8-12 times a day.
A new mother who is about to be discharged expresses concern about how to know her baby is getting enough breast milk. Which response should the nurse prioritize?
"Observe if your baby is eating 8-12 times a day."
A young couple are discussing how long the mother should breast-feed and cannot agree on a time frame. What is the best response from the nurse when they question the nurse about it?
"The recommendation is to use only breast milk for the first 6 months, then add other foods until 12 months."
Which postpartum client would the nurse advise to pump her breasts to provide breast milk to her newborn? Select all that apply.
- an infant with respiratory distress who is in the NICU - an infant with a latch score of 5 on two different observations - a woman with an inverted nipple using a breast shield to no avail
Which statement from the parents of a 20-week-old infant will require further teaching related to supplying protein needed by a newborn?
"We have a milk cow, so we never have to worry about running out of milk for this baby."
Parents of a 3-month-old infant have questions about supplying breast milk to a daycare. Which statement made by the parents indicates to the nurse that further education is needed? Select all that apply.
"We will tell the daycare to open a can of liquid formula if they run out of breast milk." "During feeding, we will tell the workers to place a soft, rubbery nipple on the bottle." "We will only supply bottles that contain polycarbonate written on the bottle label." "We will have the workers discard the nipple if milk is dripping at a rapid rate."
On admission to the labor and delivery unit for a scheduled elective induction, a 21-year-old P1001 expresses to the nurse her desire to bottle-feed. What is the best response from the nurse?
"Would you like any information on breastfeeding?"
Parents of a 3-month-old infant have questions about supplying breast milk to a daycare. Which statement made by the parents indicates to the nurse that further education is needed? Select all that apply
- "We will tell the daycare to open a can of liquid formula if they run out of breast milk." - "During feeding, we will tell the workers to place a soft, rubbery nipple on the bottle." - "We will only supply bottles that contain polycarbonate written on the bottle label." - "We will have the workers discard the nipple if milk is dripping at a rapid rate."
Prior to discharging a new breastfeeding mom with her newborn, which key points should the nurse review? Select alll that apply.
- Breastfed infants will receive linoleic acid from breast milk in order to meet the growth needs of the body. - The mother who is breastfeeding should drink fluoridated water, not bottled water.
A new mother asks the nurse if this thin, watery milk is adequate enough to meet her newborn's nutritional needs. Which information is accurate for the nurse to share with this mother? Select all that apply.
- Colostrum is easy for the newborn to digest since it is high in protein and low in sugar and fat. - Colostrum has maternal antibodies that will help protect the newborn from illness
The nurse is educating daycare workers on breast milk and supplemental feedings for newborns. What information will the nurse include? Select all that apply
- It is acceptable to wash bottles and nipples in a dishwasher. -Supplemental feeding bottles should be plastic and marked "safe for infant feeding."
The nurse will assess the newborn for which potential cause of excess sleepiness? Select all that apply.
- Review bilirubin level for elevation. - Check glucose level for possible hypoglycemia.
Breastfeeding is generally encouraged except under certain conditions. Which conditions contraindicate breastfeeding? Select all that apply.
- When the mother takes certain medications, such as antineoplastics - When the mother has active tuberculosis - When the mother is diagnosed with breast cancer
Evidence-based practice research has discovered that which women are most likely to breastfeed exclusively for the first 6 months? Select all that apply.
- women who did not smoke during pregnancy - older women with a higher income
A mother who is breastfeeding asks the nurse when she should start weaning her infant. Which time factor should the nurse point out is the recommended time?
1 year
How many calories does an ounce of breast milk contain on average?
20
The nurse is reviewing discharge instructions with a young couple. The nurse determines they understand how to properly use prepared formula and will discard any leftover refrigerated formula after which time frame?
24 hours
The nurse is assisting a new mother develop a sample meal plan for her to meet the nutritional needs of herself and her breast-fed infant. How many additional calories should the nurse encourage the mother to include?
500 kcal/day
The new mother has decided to formula-feed her infant and is unsure when to introduce soft foods. Which age should the nurse point out will be appropriate to introduce her infant to mashed fruit and vegetables?
6 to 8 months
You are caring for an infant with a birth weight of 8 lbs. 5 oz. What would be an acceptable discharge weight for this infant?
7 lbs. 12 oz.
A nurse is working with four new mothers and assessing their ability to breastfeed. For which mother would breastfeeding be appropriate and safe?
A mother who smokes cigarettes
The nurse is teaching a breast-feeding class for nursing students. Teaching has been effective when the student can cite which of the following maternal conditions in which breast-feeding is contraindicated? Select all that apply
Active untreated tuberculosis Chemotherapy Illegal drug use HIV
While breastfeeding, all of the following can contribute to sore nipples except:
Allowing the nipples to dry after each feeding
All of the following are maternal benefits of breastfeeding EXCEPT
Decreased risk of adult-onset asthma
All of the following are maternal benefits of breastfeeding except:
Decreased risk of adult-onset asthma
The nurse is preparing a presentation for a health fair on the benefits of breast-feeding. Which noted long-term benefit should the nurse prioritize?
Decreased risk of ovarian cancer
Which of the following instructions should a nurse give to a client whose infant has galactosemia?
Feed the infant a lactose-free formula
The nurse is conducting prenatal counseling with pregnant women in the community. An 18-year-old G1 P0 in her 36th week states, "I don't know if I should breast-feed or not. Isn't formula just as good for the baby?" What is the nurse's best response? A. The benefits of breast-feeding are equal to those of formula feeding. B. It is ultimately the woman's choice whether she wants to breast-feed or not C. The immunologic properties in breast milk cannot be duplicated in formula. D. The economic status of the woman is an important breast-feeding consideration.
C. The immunologic properties in breast milk cannot be duplicated in formula.
Which type of breast milk is highest in antibodies
Colostrum
The nurse is teaching young parents discharge instructions. Which form of birth control should the nurse point out will be the best option for the breast-feeding mom who hopes to have more children later?
Condoms
The nurse is preparing a care plan for a new mother who desires to breast-feed. Which action should the nurse prioritize if the mother has a history of breast implants?
Consult a lactation specialist for assistance.
The nurse is preparing discharge instructions for a new mother who has been learning to breast-feed. Which response should the nurse prioritize when the mother questions her ability to produce enough milk for her infant?
Drink a lot of fluids
A nurse is giving a new mother some tips regarding breastfeeding. Which of the following should she mention?
Empty one breast completely before feeding the baby from the other breast
The nurse is leading a group discussion of new mothers about breast-feeding. Which instruction should the nurse prioritize as the best method to increase their milk supply?
Empty the breast as completely as possible.
A woman who had a cesarean is getting ready to be discharged from the hospital. Before she leaves, she asks you to assess her breasts because she has pain on both sides. The nurse notices that both breasts are hard, warm, and tender to the touch. Her vital signs are normal. What does the nurse suspect?
Engorgement
A woman who had a cesarean is getting ready to be discharged from the hospital. Before she leaves, she asks you to assess her breasts because she has pain on both sides. The nurse notices that both breasts are hard, warm, and tender to the touch. Her vital signs are normal. What does the nurse suspect?
Engorgement
Colostrum is an anterior pituitary hormone that acts on the acinar cells of the mammary glands to stimulate the production of milk.
False
The nursing instructor is conducting a teaching session illustrating the basics of feeding newborns. The instructor determines the class is successful after the students correctly choose which disorder as a contraindication to breastfeeding?
Galactosemia
The young mother has been breast-feeding her newborn; however, the nurse is concerned the infant is not thriving and may need to be switched to a formula. When questioned by the mother, the nurse should point out which condition that would be a contraindication for the infant to continue breast-feeding?
Galactosemia
The young mother has been breast-feeding her newborn; however, the nurse is concerned the infant is not thriving and may need to be switched to a formula. When questioned by the mother, the nurse should point out which condition that would be a contraindication for the infant to continue breastfeeding?
Galactosemia
When asked by a father to compare the feeding habits of formula-fed and breastfed infants, what is the correct response from the nurse about breastfed infants?
Go approximately 3 hours between feedings.
The nurse is assisting a primigravida woman make decisions and prepare for her baby. The nurse should point out that breast-feeding is not an option for this client based on which assessment finding?
Human immunodeficiency virus infection
The lactation nurse is working with a woman who is experiencing some difficulties getting her newborn to "latch on" to her breast. They are trying various positions to see which is best for this infant. The nurse will document which nursing problem related to this teaching session?
Imbalanced nutrition, less than body requirements related to poor latch
Which is true regarding mineral requirements in the newborn?
Infants who are formula-fed should drink an iron-enriched formula for at least 12 months
Which of the following instructions should a nurse give to a lactating client about how to break suction during a feeding?
Insert a finger into the corner of the baby's mouth between the gums
Which of the following is an advantage of breastfeeding that directly benefits the mother?
It aids in uterine involution
The nurse is conducting a prenatal class on the pros and cons of breastfeeding versus formula feeding. Which deciding factor should the nurse prioritize when assisting these parents to make their decision?
It based on their personal preference and situation.
When using the LATCH assessment tool, the nurse will evaluate breastfeeding using which factors?
Latch, audible swallowing, type of nipple, nipple comfort, and hold/positioning
A breast-feeding mother, 1-month postpartum, calls the clinic and reports left breast soreness, a temperature of 100.4oF (38oC), and feeling tired all the time. The nurse suspects the mother is experiencing which situation after revealing she is still trying to breast-feed on a regular schedule?
Mastitis
Breastfeeding is contraindicated in all of the following conditions in the mother except
Mastitis
Breastfeeding is contraindicated in all of the following conditions in the mother except:
Mastitis
The nurse is conducting a prenatal class on breastfeeding. The nurse determines the class is successful when the young parents correctly choose which time frame is recommended for breastfeeding the infant?
One year
The nurse is assisting a new mother to begin breastfeeding her newborn. Which action should the nurse prioritize?
Position the infant in her arms, across her abdomen, stroking the infant's cheek with her nipple
A nurse is caring for a pregnant client who inquires about the benefits of breast feeding. The nurse explains that secretory immunoglobulin A found in breast milk helps the infant by:
Protecting the gastrointestinal tract from foreign proteins
A nurse is caring for a pregnant client who inquires about the benefits of breast feeding. The nurse explains that secretory immunoglobulin A found in breast milk helps the infant by:
Protecting the gastrointestinal tract from foreign proteins
A patient in the early stage of labor informs the nurse that she is planning to breastfeed. She tells the nurse that this is her first baby and wants to begin breastfeeding as soon as possible. When should the nurse tell the mother she will be able to start breastfeeding?
immediately after birth
When educating a woman about newborn feedings, what instruction should the nurse give on the proper way to heat a bottle?
Running it under warm water or in a bottle warmer
A mother has opted to formula feed her 2-month-old baby. She proudly announces to the nurse during an office visit that she uses only the best bottled spring water to prepare the formula. How should the nurse respond?
She should tell the mother to switch to using fluoridated water from the tap
Which factors affect a woman's decision to breastfeed? Select all that apply.
Socioeconomic Culture Past experience Family Work status
Dietary needs change from pregnancy to lactation. What should breastfeeding mothers be advised?
That even if a mother has adequate fat stores, calorie intake should increase
Which of the following is true regarding storing breast milk?
Thawed breast milk must be used within 24 hours.
The nurse is conducting prenatal counseling with pregnant women in the community. An 18-year-old G1 P0 in her 36th week states, "I don't know if I should breast-feed or not. Isn't formula just as good for the baby?" What is the nurse's best response?
The immunologic properties in breast milk cannot be duplicated in formula.
A breast-feeding mother calls the clinic, asking how much water she should be giving her 2-month-old infant. What would the nurse recommend to this mother?
The infant does not need any water supplement if nursing well.
A mother delivers her newborn and has chosen to formula-feed her baby. She asks the nurse how to keep her breasts from making milk. How would the nurse respond to the mother's question?
The mother needs to understand that she will produce some milk, but wearing a constrictive bra will help dry up the milk supply.
Annie, a new mother, is talking with the nurse about breast-feeding. She asks, "How does lactation work?" The best answer by the nurse is:
The newborn sucking on the breast stimulates the pituitary gland causing the release of prolactin and oxytocin. Prolactin causes synthesis and release of breast milk and oxytocin causes contraction of the smooth muscle around the alveoli of the breast.
A client opts to feed formula to her newborn baby. Which instruction should the nurse give to the client regarding the proper procedure for bottle-feeding?
Tilt the bottle while feeding
Caloric requirement per kilogram of body weight in newborns is more than twice that of adults
True
Caloric requirement per kilogram of body weight in newborns is more than twice that of adults.
True
A nursing instructor teaching about growth and development informs the students that the period when growth is the most rapid is which of the following?
neonatal
A new mother of twins asks the nurse if there is any way she can feed them both at the same time. Which piece of equipment would the nurse recommend for this situation?
pillow supports designed with wider sides to allow the twins to feed at the same time
A student nurse asks the preceptor how breastfeeding protects the infant from getting ill due to viruses and bacteria. Which physiologic concept will the nurse discuss with this student?
properties of immunoglobulin A (IgA)
Which feeding position should the nurse suggest as most beneficial for the mother who had a cesarean birth?
sitting in a chair using a football hold with the newborn on a pillow on the mother's lap