Prior to discharge, a new mother who is breastfeeding wonders the best way to know her newborn is getting enough milk.
Which information should the practical nurse (PN) provide?
Use an on-demand feeding schedule.
Count the number of wet diapers per day.
Initiate feeding on the same breast each time.
Supplement with formula between feedings.
The Correct Answer is B
Choice A rationale
Using an on-demand feeding schedule allows the newborn to feed when hungry, which is important for establishing milk supply and meeting the infant's needs. However, it does not directly provide a quantitative measure of milk intake, as duration and frequency can vary.
Choice B rationale
Counting the number of wet diapers per day is an objective and reliable indicator of adequate hydration and milk intake in a breastfed newborn. Typically, a newborn should have at least 6-8 wet diapers per 24 hours by the end of the first week of life, indicating sufficient milk consumption.
Choice C rationale
Initiating feeding on the same breast each time is incorrect. It is generally recommended to alternate breasts with each feeding or offer both breasts at each feeding to ensure equal stimulation and drainage, which helps maintain milk supply in both breasts and prevents engorgement.
Choice D rationale
Supplementing with formula between feedings is not recommended as a primary method to assess milk intake and can interfere with the establishment of a robust breastfeeding relationship. It can decrease the infant's demand for breast milk, potentially reducing the mother's milk supply and introducing allergens.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
While nausea can occur from analgesics used during labor, and solid foods might exacerbate it, this is not the primary or most critical reason for withholding them. The major concern is related to potential aspiration during anesthesia or an emergency. Analgesics can also cause gastric stasis, but the aspiration risk remains paramount.
Choice B rationale
If general anesthesia becomes necessary during labor, the risk of pulmonary aspiration of gastric contents is significantly increased due to delayed gastric emptying and relaxation of the gastroesophageal sphincter. Aspiration pneumonitis can lead to severe respiratory complications. Therefore, withholding solid foods minimizes this critical risk.
Choice C rationale
Gastric emptying time actually increases during labor, meaning food remains in the stomach for a longer duration. This prolonged retention of gastric contents heightens the risk of aspiration if the client requires general anesthesia or experiences emesis. Reduced peristalsis contributes to this extended emptying time.
Choice D rationale
Autonomic nervous system stimulation, specifically sympathetic activation, during labor leads to a decrease in gastrointestinal motility and peristalsis. This physiological response contributes to delayed gastric emptying, increasing the volume of gastric contents and subsequently elevating the risk of aspiration.
Correct Answer is A
Explanation
Choice A rationale
Rho immune globulin (RhoGAM) is administered to Rh-negative mothers who have given birth to an Rh-positive baby. This injection prevents the mother's immune system from developing antibodies against Rh-positive red blood cells, which could otherwise harm future Rh-positive fetuses in subsequent pregnancies through hemolytic disease of the newborn.
Choice B rationale
If the mother is Rh positive and the baby is Rh negative, there is no risk of Rh incompatibility. The Rh-positive mother's immune system will not produce antibodies against the Rh-negative fetal red blood cells, as she already possesses the Rh antigen. Therefore, Rho immune globulin is not indicated in this scenario, as there is no sensitization risk.
Choice C rationale
When both the mother and the baby are Rh negative, there is no Rh incompatibility. Since neither the mother nor the baby has the Rh antigen, the mother's immune system will not be stimulated to produce anti-Rh antibodies. Consequently, Rho immune globulin administration is unnecessary in this situation, as no immune response will be triggered.
Choice D rationale
The Rh status of the father is relevant in determining the potential for Rh incompatibility, but it does not directly dictate the need for Rho immune globulin. The critical factor is the Rh status of the mother and the baby. If the mother is Rh positive, regardless of the father's Rh status, she will not produce Rh antibodies, and RhoGAM is not indicated.
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