A home health nurse is teaching a client who is breastfeeding about managing breast engorgement. Which of the following client statements indicates understanding of the teaching?
"I'll feed my baby every 2 hours."
"I'll apply cold compresses 20 minutes before each feeding."
"I'll try drinking an herbal tea to reduce the engorgement."
"I'll let my baby drain one breast at each feeding."
The Correct Answer is A
Feeding the baby every 2 hours helps to ensure frequent emptying of the breasts, which can help alleviate engorgement by reducing milk stasis and promoting milk production regulation.
Applying cold compresses before feeding may temporarily reduce discomfort but does not address the underlying cause of engorgement or promote milk removal.
Drinking herbal tea is not proven to effectively reduce breast engorgement, and it is important for the client to focus on frequent breastfeeding or pumping to alleviate engorgement.
Allowing the baby to drain one breast at each feeding may lead to uneven milk production and exacerbate engorgement. It is important for the client to offer both breasts at each feeding to ensure adequate milk removal from both breasts.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is A.
Rationale for A: Drying the skin is crucial to prevent hypothermia, as newborns can quickly lose body heat. This action also stimulates the newborn and promotes circulation.
Rationale for B: Administering eye prophylaxis is important to prevent gonococcal ophthalmia, but it can be done after ensuring the newborn is warm and stable.
Rationale for C: Placing an identification bracelet is necessary for safety, but it is not as immediate a concern as ensuring the newborn's temperature is regulated.
Rationale for D: Administering vitamin K is important for preventing hemorrhagic disease in newborns, but it can be performed after addressing the newborn's immediate needs, such as warmth.
Correct Answer is B
Explanation
A. Pain following a cesarean birth is important to address, but it may not indicate an urgent need for assessment compared to other potential complications.
B. A client with preeclampsia requires close monitoring of blood pressure to prevent
complications such as eclampsia, which can lead to seizures and other serious consequences. An elevated blood pressure reading warrants immediate attention.
C. A client scheduled for discharge following a laparoscopic tubal ligation is stable and can likely wait for assessment until after higher-priority clients have been seen.
D. While it's important to monitor for bleeding after a vaginal birth, the absence of bleeding reported by a client 24 hours postpartum may not indicate an immediate need for assessment compared to the potential urgency of managing preeclampsia.
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