A 3-day-old infant who weighs 6 lb (2722 g) is fed formula every 4 hours. Newborns require about 73 mL of fluid per pound (454 g) of body weight each day. In light of this information,approximately how much formula should the infant receive at each feeding?

A) Soft, nontender, colostrum is present:
In the early postpartum period, specifically on day 1, the woman is still in the process of transitioning from producing colostrum (a thick, yellowish fluid rich in antibodies) to mature breast milk. The colostrum may be present, but the breasts are typically not soft and nontender. Instead, they are more likely to be swollen and tender as the milk production ramps up. Therefore, this is not the typical finding on day 1 postpartum.
B) Swollen, warm, and tender upon palpation:
This is the expected finding on day 1 postpartum, especially for a primiparous woman. After childbirth, the breasts begin the transition from producing colostrum to mature breast milk. The increased blood flow and milk production cause the breasts to become swollen, warm, and tender to the touch. This condition is often referred to as engorgement, which is common within the first few days after delivery, particularly in breastfeeding mothers. Engorgement usually peaks around day 3 but may begin to occur slightly earlier, as the body adjusts to milk production.

C) Leakage of milk at let-down:
This finding is more typical of a woman who is further along in the postpartum period, usually after her milk has transitioned from colostrum to mature milk. Milk let-down and the associated leakage typically occur later, often after a few days (around day 3 or later). On day 1, the milk supply is still establishing itself, and leakage is less common.

D) A few blisters and bruises on each areola:
Blisters and bruises on the areola could indicate improper latch or trauma from breastfeeding. This is not a typical or expected finding in a woman who is only 1 day postpartum. If this occurs, the nurse should assess the infant’s latch and the breastfeeding technique to prevent further complications. Such findings should be addressed promptly, but they are not considered normal on day 1.

A) A rubella injection is advised:
Since the rubella titer is non-immune, the woman is not protected against rubella, which is important to address during the postpartum period. The rubella vaccine is typically given to women who are non-immune to rubella after childbirth, but it is contraindicated during pregnancy because it is a live vaccine. The best action in this case would be to administer the rubella vaccine to the postpartum woman before discharge, with instructions to avoid becoming pregnant for at least 28 days after vaccination to prevent harm to a future fetus.

B) A blood transfusion is advised:
The hematocrit of 30% indicates that the woman has mild anemia, but it does not require immediate intervention like a blood transfusion. Normal hematocrit levels for postpartum women typically range between 32% and 42%. A transfusion would be indicated if the hematocrit were much lower (usually below 20-25%) or if there were symptoms of significant blood loss, which are not indicated in this case.

C) The nurse should contact the provider for an antibiotic order:
There is no indication from the provided laboratory results or the scenario that the woman requires antibiotics. Group B Streptococcus (GBS) was negative, which eliminates the need for prophylactic antibiotics. There is no mention of any infection risk requiring an antibiotic prescription, and since her GBS result is negative, antibiotics are not warranted.

D) RhoGAM injection should be administered within 72 hours:
RhoGAM (Rh immunoglobulin) is typically administered to a woman with Rh-negative blood who has given birth to an Rh-positive baby to prevent Rh sensitization in future pregnancies. In this case, the woman has an Rh-positive blood type (A+), so she does not need RhoGAM. RhoGAM would only be necessary if the woman had an Rh-negative blood type, which she does not.