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 D
Explanation
Choice A rationale
A resting respiratory rate of 35 breaths/minute for a 4-month-old infant is within the normal range (typically 30-60 breaths/minute). Therefore, this finding alone does not indicate acute respiratory distress.
Choice B rationale
Bilateral bronchial breath sounds are normal findings when auscultated over the trachea. However, their presence over the peripheral lung fields can indicate consolidation, such as in pneumonia. While abnormal in the periphery, it is not an isolated sign of acute respiratory distress.
Choice C rationale
Diaphragmatic respirations, also known as abdominal breathing, are the predominant and normal breathing pattern in infants and young children due to the preferential use of the diaphragm for respiration. This is not a sign of respiratory distress.
Choice D rationale
Flaring of the nares is a significant clinical sign of increased work of breathing and respiratory distress in infants. It indicates that the infant is attempting to decrease airway resistance and maximize oxygen intake by dilating the nasal passages. This is a compensatory mechanism indicating respiratory compromise.
Correct Answer is B
Explanation
Choice A rationale
Deep tendon reflexes are neurological assessments primarily used to evaluate neuromuscular excitability, particularly in conditions like preeclampsia where magnesium sulfate is administered. They are not indicated for managing fetal heart rate decelerations or chorioamnionitis, as these conditions do not directly impact spinal reflex arcs or necessitate this specific neurological monitoring. Normal reflexes range from 1+ to 2+.
Choice B rationale
Late decelerations, occurring after the peak of a contraction, indicate uteroplacental insufficiency, meaning reduced blood flow and oxygen to the fetus. A left side-lying position alleviates compression of the vena cava and aorta by the gravid uterus, thereby increasing venous return to the heart and improving uterine perfusion and oxygenation to the fetus, which is a crucial intervention.
Choice C rationale
Insertion of an indwelling urinary catheter to monitor hourly output is primarily indicated for assessing renal perfusion and fluid balance, particularly in critically ill clients or those at risk for fluid volume alterations, such as severe preeclampsia. It does not directly address or correct the underlying physiological cause of late fetal heart rate decelerations. Normal urine output is typically greater than 30 mL/hour.
Choice D rationale
Collecting a urine specimen for electrolytes and protein is a diagnostic measure for evaluating renal function, hydration status, and potential complications like preeclampsia, which presents with proteinuria. While important for overall assessment, it does not provide an immediate physiological intervention to improve uteroplacental perfusion and resolve acute fetal distress manifested by late decelerations.
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