A nurse is caring for a postpartum client.

Exhibits

Which of the following statements by the client indicates an understanding of the discharge teaching?

"Because of my baby's weight loss, I need to supplement with formula after breastfeeding."

"I should make sure that my baby feeds 8 to 12 times per day."

"I should cover my sore nipples with plastic-lined breast pads after every feeding."

"My baby's stools should turn to a yellow color within the next day or two." "I can increase my milk supply by drinking more water."

"I should expect my breasts to become harder. warmer, and more tender when my milk comes in."

Answer and Explanation

Correct Answer : B,D,E

A. Supplementing with formula after breastfeeding due to perceived weight loss may indicate a misunderstanding of normal newborn feeding patterns and could potentially interfere with establishing a sufficient milk supply. Breastfeeding on demand and ensuring proper latch and
positioning are essential for successful breastfeeding. This statement suggests a need for further education about newborn feeding and breastfeeding management.
B. Breastfeeding frequency is crucial for establishing and maintaining milk supply. Newborns typically need to breastfeed at least 8 to 12 times per day to ensure they receive enough milk and to stimulate milk production in the mother's breasts. This statement indicates that the client
understands the importance of frequent feeding for successful breastfeeding.

C. While covering sore nipples with breast pads can provide comfort and protect clothing from leakage, using plastic-lined breast pads after every feeding may not be necessary and could
potentially worsen nipple discomfort. Plastic-lined breast pads can trap moisture, which may
contribute to nipple soreness or increase the risk of developing nipple thrush. Education may be needed to clarify appropriate nipple care and management of nipple discomfort during
breastfeeding.

D. Meconium stools, which are dark and sticky, are normal for newborns in the first few days of life. As the baby begins to digest breast milk, their stools transition from meconium to a yellow, seedy consistency. This statement indicates that the client understands what to expect regarding the color and consistency of their baby's stools after transitioning to breastfeeding.
E. This statement demonstrates an understanding of breast engorgement, a common occurrence when milk production increases in the breasts. Breasts may become harder, warmer, and more
tender when milk "comes in" or when lactation is established. Recognizing these signs indicates that the client is aware of normal changes in their body related to breastfeeding.

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Correct Answer is C

Explanation

a. "Place the retainer clip across the newborn's abdomen":

This statement is incorrect and potentially dangerous. The retainer clip should be positioned at the level of the armpits to secure the harness straps. Placing it across the abdomen could cause abdominal injury in the event of sudden braking or a crash.

b. "Keep the car seat rear-facing until the newborn can sit unsupported":

While this is generally true and important safety advice, it is not directly related to the positioning of the newborn in the car seat. Instead, it addresses the orientation of the car seat itself. Rear-facing car seats are safer for infants as they provide better protection for the head, neck, and spine in the event of a crash.

c. "Position the newborn at a 45-degree angle in the car seat":

This is the correct recommendation. Newborns should be positioned at a 45-degree angle in the car seat to prevent their head from falling forward and potentially obstructing their airway. Many car seats come with angle adjusters or indicators to help achieve this optimal positioning.

d. "Place the shoulder harness straps below the level of the newborn's armpits":

Placing the shoulder harness straps below the level of the newborn's armpits is incorrect. The straps should be positioned at or slightly below the level of the shoulders to provide proper restraint. Placing them too low increases the risk of the baby slipping out of the harness in the event of a crash.

A. 110/min B. 48/min C. 22/min D. 100/min

Correct Answer is B

Explanation

a. 110/min - This respiratory rate is higher than the expected reference range for a newborn. Newborns typically have respiratory rates between 30 to 60 breaths per minute.

b. 48/min - This respiratory rate falls within the expected reference range for a newborn, which is typically between 30 to 60 breaths per minute.

c. 22/min - This respiratory rate is lower than the expected reference range for a newborn. Newborns typically have respiratory rates between 30 to 60 breaths per minute.

d. 100/min - While this respiratory rate is within the expected range, it's at the upper end of the range for a newborn. Typically, newborns have respiratory rates between 30 to 60 breaths per minute, so a rate of 100/min may be considered slightly elevated.

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A nurse is caring for a postpartum client. Exhibits Which of the following statements by the client indicates an understanding of the discharge teaching?

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A nurse is caring for a postpartum client.

Exhibits

Which of the following statements by the client indicates an understanding of the discharge teaching?