A nurse is caring for a new mother who is breastfeeding her term newborn. The newborn weighed 3.4 kg (7.5 lb) at birth and weighed 3.3 kg (7.3 lb) on the second day of life. The mother expresses concern about the weight loss and asks the nurse about the amount of her breast milk. Which of the following responses by the nurse is appropriate?
"A healthy newborn can lose 6% of his birth weight before starting to gain weight."
"Why don't you switch to formula to make sure your baby is eating enough?"
"It is common for new mothers to worry that they are not making enough milk for their baby."
"Your newborn will need to remain in the hospital so his weight can be monitored."
The Correct Answer is A
Choice A rationale: Weight loss in the first few days after birth is normal for newborns, and a weight loss of up to 7-10% of the birth weight is considered within the expected range. A 6% weight loss is within normal limits, and it is reassuring to inform the mother that this is typical.
Choice B rationale: Suggesting switching to formula is not necessary based on the weight loss described. Breastfeeding provides adequate nutrition for most newborns, and early weight loss is typical and not a cause for alarm.
Choice C rationale: While it is true that new mothers may worry about breastfeeding and milk supply, this response does not address the specific weight loss concern and might not fully reassure the mother.
Choice D rationale: A 6% weight loss is within the expected range for a newborn and does not warrant hospitalization. It is a normal finding, and most newborns will start to regain their birth weight within a few days of life.
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Related Questions
Correct Answer is D
Explanation
A. Breast engorgement typically occurs around days 3 to 5 postpartum, so encouraging frequent nursing at 14 hours postpartum will not impact milk production at this stage.
B. A temperature of 37.7°C (100°F) is a normal postpartum finding due to dehydration and hormonal changes. It does not require reporting unless it exceeds 38°C (100.4°F).
C. Increasing IV fluids is not necessary unless there is evidence of dehydration or another medical indication.
D. A slightly deviated fundus suggests bladder distension, which can interfere with uterine involution. Asking the client to empty her bladder helps the uterus contract properly and prevents complications such as postpartum hemorrhage.
Correct Answer is ["A","B","D","E"]
Explanation
Choice A rationale:
This statement indicates an understanding that a loose-fitting diaper will help prevent irritation and promote healing after circumcision.
Choice B rationale:
Applying petroleum jelly to the circumcision site helps keep the area moist and prevents the Plastibell from sticking to the penis during healing.
Choice C rationale:
While keeping the penis clean is essential, the use of soap is usually not recommended for the first few days after circumcision. Warm water and gentle patting are generally sufficient.
Choice D rationale:
Bleeding after circumcision should be reported to the doctor as it may indicate a complication that needs attention.
Choice E rationale:
The Plastibell device typically falls off on its own within a week after the circumcision procedure.
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