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":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"A"},"G":{"answers":"B"}}
Explanation
Placement of an internal fetal spiral electrode is contraindicated because it requires ruptured membranes and no active vaginal bleeding. In cases of antepartum bleeding, especially without rupture of membranes, it increases infection risk and fetal injury.
Laboratory testing (CBC, blood type, Rh factor, coagulation studies) is anticipated to evaluate maternal blood loss, anemia, blood type compatibility, and coagulation status. These are essential for managing bleeding risk and potential transfusions.
IV fluids are anticipated to maintain maternal hemodynamic stability and manage possible blood loss, preventing hypovolemia and hypotension.
Abdominal ultrasound is anticipated for placental localization, fetal wellbeing assessment, and to differentiate causes of bleeding (placenta previa vs. abruption).
Betamethasone administration is anticipated at 30 weeks to accelerate fetal lung maturity in case of preterm delivery.
Continuous fetal heart rate (FHR) monitoring is essential to assess fetal status and detect hypoxia or distress promptly.
Digital cervical exam is contraindicated due to risk of exacerbating bleeding and infection in the presence of unknown placental position or bleeding source.
Correct Answer is A
Explanation
Choice A rationale
Magnesium sulfate toxicity causes central nervous system depression, including respiratory depression. A respiratory rate of 12 breaths/min indicates that the respiratory depression has resolved, suggesting the calcium gluconate, a magnesium antagonist, has effectively reversed the neuromuscular blockade caused by magnesium. A normal respiratory rate is 12-20 breaths/min.
Choice B rationale
Absent deep tendon reflexes (DTRs) are a sign of magnesium sulfate toxicity due to its depressant effect on neuromuscular transmission. If calcium gluconate were effective, DTRs would return to normal or become less diminished, indicating resolution of magnesium's inhibitory effects on the nervous system.
Choice C rationale
Slurred speech is a neurological symptom associated with magnesium sulfate toxicity, reflecting central nervous system depression. If calcium gluconate were effective in reversing the toxicity, slurred speech would improve or resolve as the central nervous system depression diminishes.
Choice D rationale
Urine output of 22 mL/hr indicates oliguria, which can be a sign of worsening preeclampsia or kidney dysfunction, and is not an indicator of effective calcium gluconate administration for magnesium toxicity. Adequate urine output (typically >30 mL/hr) is essential for magnesium excretion and overall renal function.
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