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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.

Answer and Explanation

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.

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Correct Answer is A

Explanation

A. Heat loss. Newborns are highly susceptible to heat loss due to their large surface area relative to body weight and limited ability to generate heat. Cold stress can lead to hypoglycemia, respiratory distress, and metabolic acidosis. To prevent this, the nurse should dry the newborn thoroughly, provide skin-to-skin contact, and use a radiant warmer or warm blankets immediately after birth.
B. Fluid balance. While newborns require close monitoring of fluid balance, they are born with sufficient fluid stores. Dehydration is not an immediate concern within the first few minutes of life. Initial interventions focus on thermoregulation and establishing respiration.
C. Bleeding tendencies. Newborns have low vitamin K levels, which increase the risk of bleeding. However, vitamin K prophylaxis is given within the first hour after birth and is not the immediate priority over establishing adequate oxygenation and thermoregulation.
D. Hypoglycemia. Hypoglycemia is a concern, especially in infants of diabetic mothers or those with low birth weight. However, preventing heat loss is a higher priority, as cold stress can contribute to hypoglycemia. Once thermoregulation is established, glucose monitoring can be performed as needed.

A. Establish the frequency of headaches. B. Ask about a history of delivering large babies. C. Examine the client for pedal edema. D. Collect a urine sample to screen for protein.

Correct Answer is D

Explanation

A. Establish the frequency of headaches. While assessing headache history is important, an excruciating headache in a pregnant client with elevated blood pressure is a concerning sign of possible preeclampsia. Immediate evaluation for organ involvement, such as proteinuria, is more critical than determining headache patterns.
B. Ask about a history of delivering large babies. A history of macrosomia is more relevant for assessing gestational diabetes rather than hypertensive disorders. In this case, the priority is identifying potential complications of preeclampsia, which requires urine protein testing.
C. Examine the client for pedal edema. Although edema can be a sign of preeclampsia, it is also common in normal pregnancy. Generalized edema, particularly in the face and hands, may be more concerning, but the presence or absence of edema does not confirm or rule out preeclampsia.
D. Collect a urine sample to screen for protein. Proteinuria is a key diagnostic criterion for preeclampsia, along with hypertension and systemic symptoms such as severe headache. A urine dipstick or 24-hour urine collection helps determine if the client has preeclampsia, which requires urgent management to prevent complications like eclampsia or placental abruption.

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Exhibits Which education by the nurse will help resolve the issue for the client? Select all that apply.

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Naxlex Comprehensive Predictor Exams

The nurse receives a newborn within the first minutes after a vaginal delivery and intervenes to establish adequate respirations. Which priority issue should the nurse address to ensure the newborn's survival?

Correct Answer is A

Explanation

A client who is 37 weeks gestation comes to the women's health clinic reporting an excruciating headache. On examination, the nurse determines the client has an elevated blood pressure. Which action should the nurse implement next?

Correct Answer is D

Explanation

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Exhibits

Which education by the nurse will help resolve the issue for the client? Select all that apply.