A multiparous client, 28 hours after a cesarean birth, who is breastfeeding, has severe cramps or afterpains.
The nurse explains that these are caused by:
Accumulation of flatulence after a cesarean birth.
Release of oxytocin during a breastfeeding session.
Adverse effects of the medication administered after birth.
Healing of the abdominal incision after a C-section.
The Correct Answer is B
Choice A rationale
Accumulation of flatulence can cause abdominal discomfort after a cesarean birth, but it does not directly stimulate uterine contractions leading to afterpains. Afterpains are specifically related to the involution of the uterus, not gastrointestinal motility.
Choice B rationale
Breastfeeding stimulates the release of oxytocin from the posterior pituitary gland. Oxytocin is a powerful uterotonic hormone that causes the uterus to contract to its pre-pregnant size. These contractions are experienced as afterpains, especially in multiparous women whose uterine muscles may have less tone.
Choice C rationale
While some medications administered after birth can have side effects, severe cramps or afterpains are primarily a physiological response to uterine involution and the hormonal changes associated with breastfeeding, rather than a direct adverse effect of medication.
Choice D rationale
Healing of the abdominal incision after a C-section causes incisional pain, which is distinct from the cramping sensation of afterpains. Afterpains are specifically due to uterine contractions, not the healing process of the abdominal wall.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
This notation indicates three pregnancies (G3), one term birth (T1), two preterm births (P2), one abortion (A1), and three living children (L3). While the number of living children is correct, the total number of pregnancies is underestimated by excluding the current pregnancy.
Choice B rationale
This notation accurately reflects four pregnancies (G4: the elective abortion, the daughter, the twins, and the current pregnancy), one term birth (T1: the daughter born at 40 weeks), two preterm births (P2: the twin boys born at 34 weeks), one abortion (A1: the elective abortion), and three living children (L3: the daughter and the twin boys).
Choice C rationale
This notation indicates three pregnancies (G3), one term birth (T1), one preterm birth (P1), one abortion (A1), and three living children (L3). The number of preterm births is incorrect, as there were two preterm births (the twins).
Choice D rationale
This notation indicates four pregnancies (G4), one term birth (T1), one preterm birth (P1), one abortion (A1), and three living children (L3). The number of preterm births is incorrect, as there were two preterm births (the twins).
Correct Answer is B
Explanation
Choice A rationale
Wrapping the baby in warmed blankets addresses heat loss through conduction (direct contact with a cooler surface) and radiation (heat transfer to cooler surroundings). While helpful for maintaining warmth, it does not directly prevent heat loss from convection.
Choice B rationale
Convection is the loss of heat to cooler air currents moving across the skin surface. A blowing fan increases the rate of convective heat loss by continuously moving cooler air over the newborn. Moving the infant away from a blowing fan minimizes this heat transfer mechanism, thus preventing heat loss from convection.
Choice C rationale
Drying the baby after a bath primarily prevents heat loss through evaporation, as the evaporation of water from the skin surface cools the body. While important for thermoregulation, it does not directly address convective heat loss.
Choice D rationale
Placing the baby in a warmer, such as a radiant warmer, primarily prevents heat loss through radiation by providing a warm surface that emits infrared heat towards the infant. It also helps maintain the ambient air temperature, indirectly reducing convective heat loss, but moving away from a direct air current is the most direct way to prevent convection.
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