A nurse is reinforcing discharge instructions with a postpartum client about breastfeeding.
Which of the following statements by the client indicates an understanding of the teaching?
I will increase my potassium intake while breastfeeding.
I will maintain adequate fluid intake to quench my thirst.
I will maintain the same caloric intake as during pregnancy.
I will increase my intake of vitamin
The Correct Answer is B
Choice A rationale
While potassium is essential, there is typically no specific recommendation to increase intake beyond general healthy eating during breastfeeding. The focus is on adequate intake of fluids, calories, and certain nutrients like protein, calcium, iron, and Vitamin D. The recommended daily potassium intake for lactating women is 2,800 mg.
Choice B rationale
Maintaining adequate fluid intake to quench thirst is a critical and accurate instruction. Milk is primarily composed of water, so the process of lactation increases the mother's fluid requirements to maintain hydration and support consistent milk production, preventing dehydration, which is typically regulated by responding to the sensation of thirst.
Choice C rationale
Caloric needs during exclusive breastfeeding increase compared to pregnancy, typically by about 330 to 400 extra calories per day above pre-pregnancy needs, due to the energy demands of synthesizing milk. Maintaining the same caloric intake as during pregnancy will likely lead to an energy deficit, potentially compromising maternal reserves or milk supply.
Choice D rationale
While Vitamin K is essential for blood clotting, there is no specific instruction to increase its intake above the Recommended Dietary Allowance (RDA), which is 90 mcg/day for lactating women, as it's widely available in a balanced diet. The primary concern is often Vitamin D and calcium, not a significant increase in Vitamin K.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Normal vaginal fluid is acidic due to the presence of Lactobacillus species, which convert glycogen to lactic acid, maintaining a pH typically between 4.5 and 6.0. Amniotic fluid is alkaline, with a pH usually ranging from 7.0 to 7.5. Therefore, a pH of 5.3 indicates acidic vaginal secretions, suggesting the fluid is likely not amniotic fluid and ruling out premature rupture of membranes (PROM).
Choice B rationale
Nitrazine paper is used to test the pH of vaginal fluid. It is impregnated with a pH-sensitive dye. When the paper comes into contact with acidic fluid (normal vaginal secretions, pH < 6.0), it will remain yellow or turn a yellow-green color. This result indicates an acidic environment, which is inconsistent with the alkaline nature of amniotic fluid (pH≥ 6.5), making PROM unlikely.
Choice C rationale
Ferning refers to the characteristic microscopic crystallization pattern that dried amniotic fluid forms due to its salt and protein content. A negative ferning test means the characteristic pattern is absent. This negative result suggests the fluid is not amniotic fluid, thereby providing evidence against the diagnosis of premature rupture of membranes (PROM).
Choice D rationale
Nitrazine paper turning a dark blue color (or royal blue, deep blue-green, or deep blue) indicates an alkaline pH of 6.5 or greater. Amniotic fluid is alkaline, typically with a pH of 7.0 to 7.5. Therefore, this color change strongly suggests the presence of amniotic fluid, which is the defining diagnostic finding for premature rupture of membranes (PROM).
Correct Answer is B
Explanation
Choice A rationale
Taking ferrous sulfate (iron supplement) with milk is contraindicated because calcium in dairy products can significantly inhibit the absorption of non-heme iron in the gastrointestinal tract by forming insoluble complexes. Optimal absorption occurs in an acidic environment, so milk diminishes the supplement's efficacy in treating or preventing iron-deficiency anemia in pregnancy.
Choice B rationale
Taking ferrous sulfate with a glass of orange juice is highly recommended because ascorbic acid (Vitamin C), present in orange juice, acts as a powerful reducing agent, converting ferric iron (Fe+) to the more readily absorbed ferrous form (Fe+) and thus significantly enhancing its bioavailability and absorption in the small intestine.
Choice C rationale
Taking ferrous sulfate with a midday meal or any large meal may decrease gastrointestinal irritation but also substantially reduces the iron's absorption. Food components, such as phytates and tannins, can chelate iron. It is best absorbed when taken one hour before or two hours after meals for maximal absorption.
Choice D rationale
Taking ferrous sulfate with breakfast is generally discouraged if the breakfast contains dairy, eggs, or cereals high in phytates, as these inhibit absorption. For optimal absorption, iron should be taken on an empty stomach with a source of Vitamin C (like orange juice), unless gastrointestinal side effects necessitate taking it with a small amount of food.
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