Following a vaginal delivery, a postpartum client is troubled by severe cramping after breastfeeding her newborn.
Which explanation describes the most likely reason for the client's pain?

Choice A rationale

Propping a bottle can lead to several adverse outcomes for an infant. It increases the risk of aspiration, as the infant may not be able to control the milk flow adequately. It can also contribute to otitis media due to milk pooling in the eustachian tubes and is associated with dental caries, particularly bottle mouth syndrome, and impaired bonding.

Choice B rationale

Sharing the observation with the charge nurse without first addressing the issue directly with the mother is not the most immediate or appropriate action. The PN should first attempt to educate and guide the mother, as this is within the scope of practice for direct client care and education.

Choice C rationale

Asking the mother if she is too tired is speculative and may be perceived as judgmental, potentially creating a barrier to effective communication and education. The PN's role is to provide health education and guidance regarding safe infant feeding practices, focusing on the behavior rather than the mother's perceived fatigue.

Choice D rationale

While observing the infant's behavior during feeding is important for a comprehensive assessment, the immediate and most critical action is to intervene with the unsafe practice of bottle propping. Observing further without addressing the identified risk delays necessary education and intervention to ensure infant safety.

Choice A rationale

While postpartum depression is a serious concern, immediately asking about suicidal thoughts without first establishing a broader understanding of the client's feelings can be premature and potentially alienating. It is essential to first assess the general emotional state and bonding difficulties before jumping to severe mental health concerns.

Choice B rationale

Explaining that this is a common feeling can minimize the client's distress and validate her experience, but it does not provide an avenue for her to express her specific concerns or for the PN to fully assess the depth of her feelings. It can prematurely close off further discussion and assessment.

Choice C rationale

Determining if her husband is bonding with the baby shifts the focus away from the client's own feelings and experiences, which is the primary concern in this situation. While partner involvement is important, the immediate priority is to understand and address the client's reported lack of bonding.

Choice D rationale

Encouraging the client to talk about her feelings provides an open and supportive environment for her to express her specific concerns regarding bonding. This allows the practical nurse to gather more information, assess the severity of the issue, and identify appropriate interventions or referrals if needed, promoting therapeutic communication.