Day 1 - 5 postpartum is significant in breastfeeding success due to what process?
Developing Prolactin Receptor Sites
Decreasing Oxytocin
Decreasing Estrogen
Increasing Estrogen
The Correct Answer is A
A) Developing Prolactin Receptor Sites:
The first 1-5 days postpartum are critical for breastfeeding success because this period is when the prolactin receptor sites in the mother's breast tissue are being established. Prolactin is the hormone responsible for milk production, and the more prolactin receptor sites developed, the more efficiently the body can respond to the baby’s sucking and produce milk. This is the foundation for a successful breastfeeding relationship, as proper stimulation in these early days encourages the long-term supply of milk.
B) Decreasing Oxytocin:
Oxytocin is the hormone responsible for milk ejection (let-down) and is crucial for breastfeeding. In the early postpartum period, oxytocin levels are actually high and remain important for milk release, not decreasing. A decrease in oxytocin would impair milk ejection, which could affect breastfeeding success.
C) Decreasing Estrogen:
Estrogen levels drop significantly after delivery, which is part of the process that allows milk production to take precedence over pregnancy-related hormones. However, the drop in estrogen is more of a secondary event in breastfeeding success compared to the development of prolactin receptor sites. Estrogen primarily impacts lactation later, such as with the onset of menstruation.
D) Increasing Estrogen:
Estrogen levels rise during pregnancy, but they begin to decrease rapidly after birth. Higher levels of estrogen inhibit lactation during pregnancy, which is why the postpartum drop in estrogen is important for milk production to commence. However, an increase in estrogen would actually hinder the initiation of lactation and is not a factor in the success of breastfeeding in the early postpartum period.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) Mother Rh-, baby Rh+:
RhoGAM (Rh immune globulin) is administered to a mother who is Rh-negative and has delivered a baby who is Rh-positive. If the Rh-negative mother is exposed to Rh-positive blood (via the baby’s blood during delivery), her immune system may start producing antibodies against Rh-positive cells, which could affect future pregnancies. The RhoGAM injection works by preventing the mother from developing these antibodies, thereby protecting any subsequent pregnancies from hemolytic disease of the newborn (HDN) in which the mother’s antibodies attack the baby’s red blood cells. This is a crucial preventive measure to avoid sensitization to Rh-positive blood.
B) Mother Rh-, baby Rh-:
If both the mother and baby are Rh-negative, there is no concern about the development of antibodies because there is no exposure to Rh-positive blood. Therefore, RhoGAM is not necessary in this situation.
C) Mother Rh+, baby Rh+:
In this scenario, the mother is Rh-positive, so she cannot develop antibodies against Rh-positive blood, regardless of the baby's Rh status. Hence, RhoGAM is not required because there is no risk of Rh incompatibility.
D) Mother Rh+, baby Rh-:
Since the mother is Rh-positive, there is no risk of her immune system attacking an Rh-negative baby’s red blood cells. Thus, RhoGAM is not needed in this case either.
Correct Answer is A
Explanation
A) Massage the fundus:
The first priority in this situation is to massage the fundus to help control potential postpartum hemorrhage caused by uterine atony. A boggy fundus (soft and not firm) suggests that the uterus is not contracting effectively, which can lead to excessive bleeding. Massaging the fundus stimulates uterine contractions, which can help reduce bleeding by compressing the blood vessels that were supplying the placenta. The nurse should begin with this intervention immediately to address the most likely cause of the bleeding.
B) Take the patient's blood pressure:
While vital signs such as blood pressure are important for assessing shock or ongoing hemorrhage, massaging the fundus takes priority in this scenario to directly address the cause of the bleeding. Taking the blood pressure is not the most immediate intervention for this specific situation because the primary issue here is uterine atony, not hemodynamic instability (although it will need to be assessed shortly thereafter).
C) Start an IV:
Starting an IV may be important if there is significant blood loss, but it is not the first priority in this scenario. The nurse should first focus on stabilizing the uterus by massaging the fundus. IV access will become more critical if the bleeding is not controlled after the fundus is massaged and other interventions are required.
D) Have the patient empty her bladder:
While a full bladder can sometimes displace the uterus and cause it to be less effective at contracting, this is a secondary concern. The first priority is to address the uterine atony by massaging the fundus. Once the fundus is firm and bleeding is under control, the nurse can then consider having the patient empty her bladder to ensure it isn't interfering with the uterus' ability to contract.
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