A nurse is reinforcing discharge instructions about breastfeeding with a client. Which of the following statements should the nurse make?

"You should recognize that your baby sucking on his hands is a hunger cue."

"You should feed your baby for 10 minutes on each breast.”

"You should feed your baby six times a day."

"You should wake your baby at least every 6 hours at night for feedings."

Answer and Explanation

The Correct Answer is A

(A) "You should recognize that your baby sucking on his hands is a hunger cue."
Recognizing hunger cues is crucial for successful breastfeeding. Early hunger cues like sucking on hands, rooting, and lip-smacking indicate that the baby is ready to feed. Responding to these cues can help establish a good breastfeeding routine and ensure the baby gets adequate nutrition before becoming too distressed to feed effectively.

(B) "You should feed your baby for 10 minutes on each breast."
Feeding duration can vary significantly among babies. Some may need longer than 10 minutes on each breast, while others might feed more efficiently in a shorter time. Instead of a strict time limit, it's important to encourage the mother to allow the baby to feed until they show signs of being full, such as pulling away from the breast or falling asleep.

(C) "You should feed your baby six times a day."
Newborns typically need to feed more frequently than six times a day. Most newborns breastfeed 8-12 times in 24 hours. Limiting feeds to six times a day may not provide sufficient nutrition and can affect the baby’s growth and milk supply.

(D) "You should wake your baby at least every 6 hours at night for feedings."
Newborns, especially in the first few weeks, often need to be fed more frequently than every 6 hours, including at night. Typically, it’s recommended to wake a baby to feed if they sleep for more than 4 hours at a time in the early weeks to ensure adequate intake and to help establish the mother’s milk supply.

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Correct Answer is D

Explanation

(A) Assist the client to empty her bladder:
Emptying the bladder is an essential intervention, especially in laboring women with epidural anesthesia, as a full bladder can contribute to hypotension. However, in this scenario, the priority is to address the hypotension directly with fluid administration. After stabilizing the client's blood pressure, assisting with bladder emptying would be appropriate.

(B) Place the client in knee-chest position:
The knee-chest position is not typically indicated for managing hypotension. While this position can increase venous return to the heart and potentially increase blood pressure, it is not the initial intervention for hypotension associated with epidural anesthesia. Intravenous fluid administration is the primary intervention to increase blood pressure in this situation.

(C) Administer methylergonovine IM:
Methylergonovine is a medication used to prevent or treat postpartum hemorrhage by causing uterine contractions. It is not indicated for the management of hypotension associated with epidural anesthesia during labor. Administering methylergonovine in this situation could potentially exacerbate hypotension and should be avoided.

(D) Give a bolus of lactated Ringer's:
The client's blood pressure is low (80/40 mm Hg), indicating hypotension. Hypotension can be a common side effect of epidural anesthesia during labor. Administering a bolus of intravenous fluids, such as lactated Ringer's solution, is the initial intervention to address hypotension. Fluid administration helps increase intravascular volume, improving blood pressure and perfusion to vital organs.

A. Weigh the newborn's wet diaper. B. Determine the newborn's respiratory rate. C. Auscultate the newborn's bowel sounds. D. Swaddle the newborn in blankets.

Correct Answer is B

Explanation

Answer: B. Determine the newborn's respiratory rate.

Rationale:

A. Weigh the newborn's wet diaper:
While monitoring fluid output is important in assessing hydration status and overall health, it is not the immediate priority. In the context of a newborn with neonatal abstinence syndrome (NAS), the respiratory status takes precedence, especially given that withdrawal can affect respiratory function.

B. Determine the newborn's respiratory rate:
Assessing the respiratory rate is crucial, as newborns with NAS may experience respiratory distress, including increased respiratory effort or apnea. Identifying any respiratory issues early allows for prompt intervention, which is vital for the newborn's safety and well-being. Ensuring adequate respiratory function is a priority in this population.

C. Auscultate the newborn's bowel sounds:
While assessing bowel sounds is relevant to monitoring gastrointestinal function and potential withdrawal symptoms, it is not the immediate priority. Changes in bowel sounds may occur due to the syndrome, but respiratory assessment should come first to ensure stability.

D. Swaddle the newborn in blankets:
Swaddling can provide comfort to a newborn with NAS; however, it is not the first action to take. Comfort measures are important, but they should follow critical assessments of the newborn's respiratory and overall clinical status to ensure safety.

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A nurse is reinforcing discharge instructions about breastfeeding with a client. Which of the following statements should the nurse make?

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