A mother asks whether or not she should be concerned that her baby never opens his mouth to breathe when his nose is so small. Which of the following is the nurse's best response?

"Babies usually breathe in and out through their noses so they can feed without choking."

"You are right. I will report the baby's small nasal openings to the pediatrician right away.*

*Everything about babies is small. It truly is amazing how everything works so well."

"The baby does rarely open his mouth but you can see that he isn't in any distress.

Answer and Explanation

The Correct Answer is A

A) "Babies usually breathe in and out through their noses so they can feed without choking.":
Newborns are obligate nasal breathers, meaning they primarily breathe through their noses rather than their mouths, which helps coordinate breathing with feeding. This nasal breathing mechanism helps prevent aspiration and ensures that babies can feed while still breathing. It is perfectly normal for a baby to primarily use their nose for breathing, especially in the early days of life, and no cause for concern should be raised about small nasal openings unless the baby is showing signs of respiratory distress.

B) "You are right. I will report the baby's small nasal openings to the pediatrician right away.":
A small nasal opening is common in newborns and is not usually a cause for alarm unless it interferes with breathing, feeding, or shows signs of a more significant anatomical issue. There is no immediate need to report it unless the baby is having trouble breathing or feeding. The nurse should offer reassurance instead.

C) "Everything about babies is small. It truly is amazing how everything works so well.":
While this response may seem comforting, it is not very informative. It dismisses the mother’s concern rather than providing a clear and educational explanation. Reassuring the mother with factual information about why babies breathe through their noses and how this works effectively for them would be more helpful.

D) "The baby does rarely open his mouth but you can see that he isn't in any distress.":
This response minimizes the importance of the mother’s question and doesn’t fully address her concern. While it’s true that babies rarely open their mouths to breathe, the explanation needs to focus on the physiological reasoning behind it. The nurse should also reassure the mother that nasal breathing is normal in newborns and not typically a concern unless signs of distress are present.

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Correct Answer is A

Explanation

A) Prolactin:
Prolactin is the primary hormone responsible for stimulating milk production in the postpartum period. In breastfeeding mothers, prolactin levels remain elevated, especially during the first few weeks after delivery, to support lactation. This hormone is released in response to suckling and is essential for maintaining a steady milk supply. Elevated prolactin levels help establish and maintain breastfeeding during the early postpartum period, even as other pregnancy-related hormones begin to decline.

B) Estrogen:
Estrogen levels drop sharply after childbirth, as the placenta is no longer present to produce this hormone. The decline in estrogen is one of the factors that helps initiate lactation. While estrogen rises later during the postpartum period as the body returns to its non-pregnant state, it is not elevated during the immediate postpartum period in breastfeeding women.

C) Progesterone:
Similar to estrogen, progesterone levels fall quickly after delivery. Progesterone is involved in maintaining pregnancy, and its levels decrease significantly once the placenta is delivered. A reduction in progesterone is one of the hormonal changes that triggers the onset of lactation. It does not remain elevated in the immediate postpartum period.

D) Human placental lactogen (hPL):
hPL is produced by the placenta during pregnancy to support fetal growth and prepare the breasts for lactation. However, after delivery, hPL levels decline rapidly because the placenta is expelled. It is not elevated in the immediate postpartum period.

E) Relaxin:
Relaxin is a hormone that helps to soften the cervix and relax the ligaments in preparation for childbirth. Its levels are elevated during pregnancy and drop significantly after delivery. It does not remain elevated in the postpartum period, particularly in breastfeeding women.

A. Excessive uterine bleeding B. urinary tract infection C. ruptured bladder D. bladder wall atony

Correct Answer is A

Explanation

A. Excessive uterine bleeding:
Bladder distention can displace the uterus to the right and elevate it above the umbilicus, interfering with uterine contraction. This displacement prevents the uterus from contracting effectively, which can lead to excessive uterine bleeding, a serious complication. When the uterus does not contract properly, it may not effectively compress the blood vessels, increasing the risk of hemorrhage. Immediate attention to bladder distention is crucial to prevent this potentially life-threatening issue.

B. Urinary tract infection:
While urinary tract infections (UTIs) can occur in the postpartum period, especially if the bladder is not emptied completely, they are not the most immediate or serious consequence of bladder distention. The priority is to address the distended bladder to prevent complications like excessive bleeding. A UTI would be a concern later, but it would not be the most acute risk following delivery.

C. Ruptured bladder:
A ruptured bladder is a rare and severe complication but is not the most likely consequence of bladder distention in the immediate postpartum period. Bladder rupture typically occurs due to significant trauma or extreme distention, which is not common in this situation. The more immediate concern is uterine atony and hemorrhage due to displaced uterine tone from bladder distention.

D. Bladder wall atony:
Bladder wall atony could result from severe bladder distention, causing difficulty in voiding. However, this is not the most serious consequence immediately after birth. Bladder distention typically results in impaired uterine contraction, which causes bleeding rather than atony of the bladder wall itself. Addressing bladder distention will help prevent complications such as hemorrhage rather than focusing on bladder atony initially.

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A mother asks whether or not she should be concerned that her baby never opens his mouth to breathe when his nose is so small. Which of the following is the nurse's best response?

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What hormone remains elevated in the immediate postpartum period in a breastfeeding patient?

Correct Answer is A

Explanation

Correct Answer is A

Explanation

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