Exhibits
Which education by the nurse will help resolve the issue for the client? Select all that apply.
Wear an underwire bra around the clock.
Apply warm compresses to affected area before feeding.
Pump breasts if feeding will be missed, due to absence from the infant.
Pump breastmilk and feed it to infant instead of nursing.
Finish antibiotics even if symptoms improve.
Maintain activity due to the risk of blood clots with extra rest.
Wash hands before handling the breast.
Start infant on the unaffected side, so there is less pain when infant is the hungriest.
Vary breastfeeding positions at each feeding.
Correct Answer : B,C,E,G,H,I
A. Wear an underwire bra around the clock. Tight-fitting bras, especially underwire bras, can contribute to milk stasis by restricting milk flow and increasing the risk of clogged ducts. Instead, the client should wear a well-fitted, supportive bra without underwire to promote comfort and adequate milk drainage.
B. Apply warm compresses to affected area before feeding. Warm compresses help increase circulation, promote milk let-down, and relieve pain in cases of mastitis. Applying warmth before breastfeeding can help soften the breast and improve milk flow, reducing milk stasis.
C. Pump breasts if feeding will be missed, due to absence from the infant. Milk stasis occurs when the breast is not emptied regularly, increasing the risk of mastitis. Pumping or hand-expressing milk when unable to breastfeed prevents engorgement and reduces the likelihood of infection.
D. Pump breastmilk and feed it to infant instead of nursing. Direct breastfeeding is preferred unless the pain is too severe or an abscess has formed. Pumping can be beneficial to relieve engorgement, but exclusive pumping is not necessary in mastitis unless advised by a healthcare provider. Continued direct breastfeeding helps clear infection by draining the affected breast.
E. Finish antibiotics even if symptoms improve. Mastitis is commonly treated with antibiotics, and completing the full course prevents recurrence and antibiotic resistance. Stopping antibiotics early can lead to incomplete eradication of bacteria and persistent infection.
F. Maintain activity due to the risk of blood clots with extra rest. Rest is essential for recovery from infection, and while postpartum clients have a slightly higher risk for blood clots, moderate rest should be encouraged. The client should engage in light activity as tolerated but should not avoid rest, as fatigue can contribute to a weakened immune response.
G. Wash hands before handling the breast. Mastitis can be caused by bacterial contamination from the skin, baby’s mouth, or hands. Proper hand hygiene before breastfeeding or pumping reduces the risk of introducing bacteria into milk ducts and worsening the infection.
H. Start infant on the unaffected side, so there is less pain when infant is the hungriest. Babies suck more vigorously at the beginning of a feeding. Starting on the unaffected side reduces pain and discomfort in the affected breast while ensuring the infant is still able to empty both breasts adequately.
I. Vary breastfeeding positions at each feeding. Different nursing positions help ensure all milk ducts are effectively drained, reducing the risk of continued milk stasis. Positions such as cradle hold, football hold, or side-lying nursing can improve drainage in different areas of the breast.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["D","G","H"]
Explanation
A. After a feeding, the nipple is creased. A creased nipple suggests a poor latch, which can lead to ineffective milk removal and increase the risk of recurrent mastitis. A proper latch should be deep, with the baby covering a large portion of the areola, ensuring effective drainage of the breast.
B. The feelings of fatigue continue, but there are no chills, achiness, or dizziness. While the absence of chills, achiness, and dizziness indicates improvement, persistent fatigue may suggest anemia, inadequate hydration, or continued recovery from infection. Fatigue alone does not confirm complete resolution of mastitis.
C. The infant continues to want to nurse all the time. Cluster feeding can be normal during growth spurts, but persistent frequent feeding beyond 2–3 hours may indicate poor milk transfer, low supply, or ineffective latch. Mastitis resolution should result in more effective milk drainage and a more predictable feeding pattern.
D. The temperature taken at home is 99.0° F (37.2° C). A normal temperature suggests that the infection and systemic inflammation have resolved. Mastitis is characterized by fever, so its absence indicates improvement.
E. Pain during feeding lasts for 10 of the 20 minutes of the feed. Persistent pain, especially for half the feeding duration, may indicate ongoing inflammation, nipple trauma, or unresolved infection. Resolution of mastitis should lead to pain-free or minimal discomfort during feeding.
F. Pumping continues on the right side instead of breastfeeding on that side. If the affected breast is still too painful for direct nursing, this suggests ongoing inflammation or poor resolution of mastitis. Ideally, the mother should be able to comfortably breastfeed from both breasts.
G. The red area on her right breast has resolved. The disappearance of redness, swelling, and warmth indicates resolution of localized inflammation and infection, confirming improvement in mastitis.
H. The infant is breastfeeding every 2 to 3 hours for 20 minutes in a variety of positions. Effective breastfeeding frequency and positioning ensure proper milk drainage, reducing the risk of recurrence. Mastitis resolution should allow the mother to comfortably breastfeed at regular intervals with different holds to promote complete emptying of all milk ducts.
Correct Answer is B
Explanation
A. Weight gain. While albumin administration increases intravascular volume, leading to temporary fluid retention, the goal in nephrotic syndrome is to shift fluid from the interstitial spaces back into circulation. The expected outcome is a reduction in edema, not an overall weight gain. A persistent increase in weight could indicate continued fluid retention rather than treatment effectiveness.
B. Reduction of edema. Nephrotic syndrome is characterized by hypoalbuminemia, which causes fluid to leak from the blood vessels into the tissues, leading to generalized edema. Albumin 25% IV works by increasing oncotic pressure, drawing fluid back into the bloodstream. Once in circulation, excess fluid is excreted by the kidneys, resulting in decreased swelling, especially in the face, abdomen, and lower extremities.
C. Improved caloric intake. Nephrotic syndrome affects fluid balance but does not typically lead to reduced appetite unless complications arise. While improved well-being may lead to better nutritional intake, this is not the primary expected outcome of albumin therapy.
D. Reduction of fever. Fever is not a direct symptom of nephrotic syndrome, though it may occur with infections due to immunosuppression from protein loss. Albumin therapy does not have antipyretic properties, so a reduction in fever would not indicate the medication’s effectiveness in managing nephrotic syndrome.
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