A postpartal client who is bottle feeding develops breast engorgement. Which is the best recommendation for the nurse to provide this client?
Avoid stimulation of the breasts and wear a tight bra.
Take a prescribed analgesic and expose breasts to air.
Place warm packs on both of the breasts.
Express a small amount of breast milk by hand.
The Correct Answer is A
A. Avoiding stimulation of the breasts and wearing a tight bra helps to decrease milk production and manage engorgement for clients who are bottle-feeding. This approach helps to prevent further stimulation that could exacerbate engorgement.
B. Taking a prescribed analgesic and exposing breasts to air may provide temporary relief but does not address the underlying issue of managing engorgement for a bottle-feeding client.
C. Placing warm packs on the breasts can increase milk production and is not appropriate for managing engorgement in a bottle-feeding client, where the goal is to reduce milk supply.
D. Expressing a small amount of breast milk by hand can worsen engorgement and is not recommended for bottle-feeding clients who need to reduce milk production.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Monitoring blood glucose levels is important in managing sepsis, especially for patients with diabetes or on glucose-lowering medications, but it is not the immediate priority in the sepsis protocol.
B. Keeping the head of the bed raised 45 degrees helps optimize oxygenation and reduce the risk of ventilator-associated events, which is critical for a patient in septic shock to improve respiratory function and reduce complications.
C. Assessing the warmth of extremities is part of general assessment but does not directly address the management of septic shock. The focus should be on more immediate interventions outlined in the sepsis protocol.
D. Maintaining strict intake and output is important for monitoring fluid status but does not directly manage the sepsis protocol’s critical components such as oxygenation and infection control.
Correct Answer is B
Explanation
A. Initiate seizure precautions: Seizure precautions are not directly related to the administration of dopamine for hypotension. Dopamine primarily affects cardiovascular function.
B. Measure urinary output every hour: Monitoring urinary output is essential because dopamine can increase renal perfusion, and adequate urine output indicates effective renal function and response to treatment.
C. Monitor serum potassium frequently: While monitoring potassium levels might be necessary in some situations, it is not a primary focus of dopamine therapy unless there are specific concerns about electrolyte imbalances.
D. Assess pupillary response to light hourly: Pupillary response is not a primary concern when administering dopamine unless there are symptoms of neurological compromise, which is not indicated in this scenario.
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