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 intake of vitamin K.”.
"I will increase my potassium intake while breastfeeding.”.
"I will maintain the same caloric intake as during pregnancy.”.
"I will maintain adequate fluid intake to quench my thirst.”. . . .
The Correct Answer is D
Choice A rationale
While vitamin K is important for coagulation and is often supplemented in newborns, increasing maternal intake of vitamin K during breastfeeding is not a primary nutritional recommendation for the mother. The focus for maternal nutrition during lactation is generally on overall caloric and fluid intake, and specific macronutrients and micronutrients that support milk production.
Choice B rationale
While potassium is an essential electrolyte, and maintaining appropriate levels is crucial for overall health, there isn't a specific recommendation to significantly increase potassium intake beyond general dietary guidelines for a breastfeeding mother. The emphasis is typically on adequate fluid and overall balanced nutrition rather than targeted potassium supplementation for lactation.
Choice C rationale
Breastfeeding significantly increases a mother's energy expenditure due to the metabolic demands of milk production. Therefore, maintaining the same caloric intake as during pregnancy would be insufficient to meet these increased energy needs, potentially leading to maternal fatigue and weight loss. An increase of approximately 330-400 additional calories per day is typically recommended.
Choice D rationale
Adequate fluid intake is crucial for successful lactation. Breast milk is approximately 87% water, and the process of milk synthesis requires a substantial fluid volume. Maintaining adequate hydration, guided by thirst, ensures sufficient substrate for milk production and prevents maternal dehydration, which can negatively impact milk supply and overall well-being. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Transcutaneous electrical nerve stimulation (TENS) is primarily used during the first and second stages of labor to manage discomfort by interfering with pain signal transmission through nerve stimulation. Its effectiveness significantly diminishes in the third stage, which involves the expulsion of the placenta, as the pain sensation during this stage is distinct and less responsive to superficial nerve modulation.
Choice B rationale
Gestational diabetes itself is not a contraindication for TENS use. TENS therapy works by stimulating sensory nerves to block pain signals or release endorphins. The metabolic changes associated with gestational diabetes do not interfere with the biophysical mechanisms by which TENS alleviates pain, making it a safe option for pain management in this population.
Choice C rationale
Increasing TENS intensity during a contraction aligns with the physiological response to labor pain. As uterine contractions intensify, the perceived pain increases. Manually adjusting the TENS unit's intensity during a contraction allows for a dynamic and responsive pain management strategy, providing greater counter-stimulation when the pain is at its peak, enhancing its efficacy.
Choice D rationale
TENS does not eliminate pain during a contraction but rather reduces its perception. It works by activating large diameter afferent nerve fibers, which inhibits the transmission of nociceptive signals via the gate control theory of pain. It also may stimulate the release of endogenous opioids, modulating pain pathways, leading to a reduction in pain intensity, not complete abolition.
Correct Answer is []
Explanation
Rationale for correct condition Endometritis is a postpartum uterine infection, often following cesarean birth and prolonged rupture of membranes. It presents with a boggy, tender uterus, foul-smelling lochia, fever or chills, and malaise. This client’s symptoms—uterine tenderness, foul lochia, and systemic signs—are classic for endometritis. Bottle-feeding increases risk due to lack of uterine oxytocin stimulation. Early recognition is critical to prevent sepsis.
Rationale for correct actions Oxytocin promotes uterine contractions, aiding involution and reducing bacterial proliferation in retained lochia. A firm uterus also minimizes bleeding. Broad-spectrum antibiotics target polymicrobial pathogens common in endometritis, including Escherichia coli and anaerobes. Prompt antibiotic therapy reduces systemic spread and improves recovery.
Rationale for correct parameters Lochia characteristics reflect uterine healing; foul odor and increased volume suggest ongoing infection. Monitoring changes helps evaluate treatment response. Temperature is a key systemic marker of infection; decreasing fever indicates therapeutic effectiveness. Persistent fever may signal treatment failure or complications.
Rationale for incorrect conditions Urinary tract infection typically presents with dysuria, urgency, and suprapubic pain—not uterine tenderness or foul lochia. Deep vein thrombosis involves unilateral leg pain, swelling, and warmth, which are absent here. Engorgement causes breast discomfort, not systemic symptoms or uterine findings.
Rationale for incorrect actions Increased fluid intake supports general health but does not directly treat endometritis. Anticoagulants are used for thrombosis, not uterine infection. Ice packs relieve breast engorgement but are unrelated to uterine infection management.
Rationale for incorrect parameters Leg circumference is relevant for DVT, not uterine infection. Nipple integrity is important for breastfeeding issues, not applicable here. Bladder distention is not contributing to uterine tenderness or infection in this case.
Take home points
- Endometritis is a common postpartum infection, especially after cesarean birth and prolonged rupture of membranes.
- Key signs include uterine tenderness, foul-smelling lochia, and systemic symptoms like fever or chills.
- Management includes uterotonic agents and broad-spectrum antibiotics.
- Differentiate from UTI, DVT, and breast engorgement based on localized versus systemic findings.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.