The nurse is caring for a patient three days postpartum who is exclusively breastfeeding. Upon assessment, the patient has cracked nipples, engorged breasts, and a painful latch. What will the nurse include in the patient's plan of care? Select all that apply.

Ibuprofen.

Vigorous massage.

Cold compress.

Formula supplements.

Lactation consult.

Answer and Explanation

Correct Answer : A,C,E

Choice A reason: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can help relieve pain and reduce inflammation associated with cracked nipples and engorged breasts. It is commonly used to manage postpartum pain and can provide significant relief, making breastfeeding more comfortable for the patient.

Choice B reason: Vigorous massage is not recommended for engorged breasts as it can cause additional pain and may worsen the condition. Gentle massage may help in some cases, but vigorous massage can lead to tissue damage and further discomfort. The focus should be on gentle techniques to manage engorgement.

Choice C reason: Cold compresses are effective in reducing swelling and providing pain relief for engorged breasts. Applying cold packs to the breasts can help reduce inflammation and soothe discomfort, making it easier for the patient to breastfeed. Cold therapy is a simple and non-invasive method to manage engorgement and related symptoms.

Choice D reason: Formula supplements are generally not recommended as a first-line intervention for breastfeeding issues, especially when the goal is to promote exclusive breastfeeding. Introducing formula can interfere with milk supply and the breastfeeding process. Instead, addressing the underlying issues such as latch and nipple care is more appropriate.

Choice E reason: A lactation consult is an essential intervention for a patient experiencing breastfeeding difficulties. Lactation consultants are trained to provide support and guidance on breastfeeding techniques, including how to achieve a proper latch, manage engorgement, and care for cracked nipples. Their expertise can significantly improve the breastfeeding experience and help resolve common issues.

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Correct Answer is ["A","C","D"]

Explanation

Choice A reason: Lethargy and hypotonia are critical findings in a child who was left in a closed car. These symptoms can indicate severe dehydration, heat stroke, or other serious conditions that require immediate medical attention.

Choice B reason: Elastic skin turgor generally indicates good hydration status and is not an immediate concern that needs to be reported urgently in this context.

Choice C reason: An apical heart rate of 64 beats per minute is significantly low for a 14-month-old child, indicating bradycardia, which can be a sign of severe heat stress or dehydration. This finding needs immediate reporting.

Choice D reason: A blood pressure of 100/54 mmHg is within the normal range for many paediatric patients, but in the context of being left in a hot car, it can suggest potential complications and should be monitored closely. However, it is not as critical as the heart rate and mental status findings.

Choice E reason: A flat anterior fontanel is a normal finding in infants and does not require urgent intervention in this context.

A. The baby will eat on a schedule of every two to three hours for at least 15 minutes. B. Do not wake them for feeding. Never wake a sleeping baby. C. I will feed my baby when they start smacking their lips or sucking on their hands. D. It is important for a baby to cry. If I respond too soon, they will be spoiled.

Correct Answer is C

Explanation

Choice A reason: This statement suggests a rigid schedule for feeding, which may not always align with an infant's natural hunger cues. While some babies may follow a regular feeding pattern, it's essential to prioritize the baby's hunger cues over a strict schedule. Feeding on demand, when the baby shows signs of hunger, is generally recommended to ensure they receive adequate nutrition and comfort.

Choice B reason: Advising not to wake a sleeping baby for feeding is not accurate for all situations. Newborns, especially in the first few weeks, may need to be woken for feeding if they are not gaining weight adequately or if they have medical conditions that require regular feeding. It is important to balance letting the baby sleep and ensuring they get enough nutrition, particularly in the early stages.

Choice C reason: Feeding the baby when they start smacking their lips or sucking on their hands demonstrates an understanding of responding to hunger cues. These behaviours are early signs of hunger, and feeding the baby at this stage can prevent them from becoming overly hungry and fussy. This approach aligns with best practices for feeding on demand, promoting healthy growth and development.

Choice D reason: This statement reflects a misunderstanding of infant care. Crying is a late sign of hunger, and it is important to respond to early hunger cues to prevent distress. The idea that responding too soon to a baby's needs will spoil them is a myth. Timely and responsive care fosters a sense of security and trust in the caregiver-infant relationship, contributing to the baby's overall well-being.

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The nurse is caring for a patient three days postpartum who is exclusively breastfeeding. Upon assessment, the patient has cracked nipples, engorged breasts, and a painful latch. What will the nurse include in the patient's plan of care? Select all that apply.

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Naxlex Comprehensive Predictor Exams

The emergency department nurse is assessing a 14-month-old child who was left inside a closed car for an hour. The outside temperature was 88 degrees Fahrenheit. Which assessment findings will the nurse report immediately to the health care provider? Select all that apply.

Correct Answer is ["A","C","D"]

Explanation

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Correct Answer is C

Explanation

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