A nurse is caring for a postpartum client who is breastfeeding their newborn and reports that their nipples have become sore and cracked.
Which of the following statements should the nurse make?
"Begin each feeding with the breast that is most sore, so the newborn spends less time on it.”.
"Use breast pads with a moisture-proof lining to keep the nipples moist.”.
"Breastfeed the baby less frequently to give the nipples time to heal.”.
"Apply colostrum to the nipples after feeding to help them heal.”.
The Correct Answer is D
Choice A rationale
Initiating feeding on the less sore breast is generally recommended when nipples are sore or cracked. The newborn's initial suck is often the strongest and most vigorous, which can exacerbate pain and damage on an already compromised nipple. Starting on the less sore side allows for a gentler initial latch and flow.
Choice B rationale
Using breast pads with a moisture-proof lining can trap moisture against the nipples, creating a warm, damp environment that promotes bacterial or fungal growth, potentially worsening soreness or leading to infection. Air drying and absorbent, breathable pads are generally preferred for nipple healing.
Choice C rationale
Reducing feeding frequency can lead to breast engorgement, which further complicates breastfeeding and can decrease milk supply. Frequent, shorter feedings are often more comfortable for the mother and help maintain milk production while allowing the nipples to heal gradually.
Choice D rationale
Applying colostrum to the nipples after feeding is beneficial due to its immunological properties and moisturizing effect. Colostrum contains antibodies and growth factors that can promote healing, reduce inflammation, and provide a protective barrier against infection, aiding in the recovery of sore and cracked nipples.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Epigastric pain in a pregnant client, especially at 33 weeks gestation, can be a symptom of preeclampsia, a serious hypertensive disorder of pregnancy. This pain may indicate hepatic involvement and impending eclampsia, requiring immediate medical evaluation to prevent severe maternal and fetal complications.
Choice B rationale
Leukorrhea, an increase in vaginal discharge, is a common physiological finding during pregnancy due to increased estrogen levels and blood flow to the vaginal area. It is typically thin, white, and odorless, and does not generally require reporting unless accompanied by itching, odor, or color changes.
Choice C rationale
Excessive salivation, or ptyalism, is a common and benign complaint during pregnancy, often attributed to hormonal changes. While bothersome, it does not indicate a pathological condition and is not a finding that requires reporting to the provider.
Choice D rationale
Darkening of the skin on the face, known as chloasma or melasma gravidarum, is a normal physiological change in pregnancy caused by increased melanin production due to hormonal fluctuations. It is a cosmetic issue and not indicative of a medical concern requiring provider notification.
Correct Answer is A
Explanation
Choice A rationale
The American Academy of Pediatrics recommends that infants remain in a rear-facing car seat until they reach the maximum height or weight allowed by the car seat manufacturer, which often corresponds to approximately 2 years of age or older. This position provides superior protection for the infant's head, neck, and spine in the event of a frontal collision by distributing crash forces more effectively.
Choice B rationale
A five-point harness, not a four-point harness, is the standard and safest restraint system for infant and child car seats. The five points of attachment (shoulders, hips, and crotch) distribute crash forces across the strongest parts of the body, providing maximum protection and preventing ejection from the seat.
Choice C rationale
For a rear-facing car seat, the shoulder harness straps should be positioned at or *below* the baby's shoulders. This ensures that the straps are snug and correctly restrain the child, preventing upward movement and potential ejection during a collision. Placing them above the shoulders would not provide optimal restraint.
Choice D rationale
An infant car seat should be positioned at a 45-degree angle, not a 30-degree angle. This reclined position is crucial for maintaining an open airway for the infant, especially newborns who lack full head and neck control, and for preventing their head from falling forward, which could obstruct breathing.
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