The perinatal nurse assisting with establishing lactation is aware that acute mastitis can be minimized by:
Wearing a nipple shield for the first few days of breastfeeding.
Wearing a tight sports bra 24 hours a day.
Frequent breastfeeding or pumping.
Avoiding feeding if the nipple is cracked.
The Correct Answer is C
Choice A rationale
A nipple shield is a device used to help with latch difficulties or for sore nipples, but it is not a primary preventative measure for mastitis. In fact, improper use can sometimes lead to incomplete milk removal and milk stasis, which can increase the risk of developing mastitis.
Choice B rationale
Wearing a tight sports bra can cause breast compression, which may lead to milk stasis and clogged milk ducts. This can increase the risk of developing mastitis. Frequent and complete milk removal is the most effective preventative strategy.
Choice C rationale
Frequent and complete milk removal is the most effective way to prevent mastitis. By breastfeeding or pumping often, milk ducts are kept clear, preventing milk stasis. Milk stasis provides a perfect environment for bacterial growth, which is the primary cause of mastitis.
Choice D rationale
Avoiding feeding from a cracked nipple can lead to milk stasis in the affected breast, which increases the risk for mastitis. It is important to continue feeding or pumping from the affected breast, using proper technique and addressing the cause of the cracked nipple to promote healing.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D","E"]
Explanation
Choice A rationale
Terbutaline (Brethine) is a beta-2 adrenergic receptor agonist used as a tocolytic to relax the uterine muscles and inhibit contractions, primarily to delay preterm labor. Its effect is opposite to what is needed in postpartum hemorrhage, where the goal is to stimulate uterine contractions to stop bleeding. Therefore, it is not used to manage PPH.
Choice B rationale
Magnesium sulfate is a central nervous system depressant and a smooth muscle relaxant. It is primarily used to prevent seizures in preeclampsia and to a lesser extent as a tocolytic. Its muscle-relaxing properties would be counterproductive in a PPH, as uterine contraction is needed to stop bleeding.
Choice C rationale
Carboprost Tromethamine (Hemabate) is a prostaglandin F2 alpha analogue that causes intense uterine contractions. It is effective in managing postpartum hemorrhage by helping the uterus to contract and compress the blood vessels at the placental site, thereby reducing blood loss.
Choice D rationale
Oxytocin (Pitocin) is a synthetic form of the hormone oxytocin. It is a first-line drug used to prevent and treat postpartum hemorrhage. It stimulates powerful and rhythmic contractions of the uterine muscle, which constricts the uterine blood vessels, thereby controlling bleeding.
Choice E rationale
Methylergonovine (Methergine) is an ergot alkaloid that acts on the smooth muscle of the uterus, increasing the tone, rate, and amplitude of contractions. It is highly effective in treating PPH, but it is contraindicated in women with hypertension due to its vasoconstrictive properties
Correct Answer is ["B","C"]
Explanation
Choice A rationale
Delayed cord clamping, or waiting for a period after birth. before clamping and cutting the umbilical cord, is not included in the active. management of the third stage of labor. Active management focuses on interventions. that expedite the delivery of the placenta and reduce postpartum blood loss. Delayed cord clamping is typically part of physiologic or expectant management. and can increase blood loss, which is why it is avoided in active management.
Choice B rationale
Controlled traction on the umbilical cord is a key component. of active management of the third stage of labor. After the placenta has. separated, gentle, downward traction is applied to the cord while simultaneously. applying fundal counter-pressure. This maneuver assists in the expulsion of the. placenta and helps to minimize the risk of uterine inversion. The procedure. should be done with caution and expertise.
Choice C rationale
Administration of oxytocin, typically within one minute. of the baby's birth, is a critical part of the active management of the third. stage of labor. This prophylactic administration of a uterotonic drug stimulates. uterine contractions, which hastens the separation and expulsion of the placenta. and significantly reduces the risk of postpartum hemorrhage. The usual dose is 10. units intramuscularly.
Choice D rationale
Fundal massage is part of postpartum care, but it is not. typically performed before placental delivery as part of active management. Massaging a flaccid or atonic uterus helps it to contract and reduce bleeding, but. this is done after the placenta has been expelled. Performing fundal massage. prior to this can interfere with the natural placental separation process. *.
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