A nurse on a postpartum unit is caring for a client who is breastfeeding and experiencing breast engorgement. Which of the following interventions should the nurse plan to implement to promote comfort for this client?

Advise the client to avoid using a breast pump

Provide the client with ice packs for her breasts.

Encourage the client to wear a loose-fitting bra.

Applying purified lanolin to the breasts can help soothe and moisturize the nipples, making breastfeeding more comfortable and providing relief from breast engorgement.

Answer and Explanation

The Correct Answer is D

A)   Incorrect- Using a breast pump can actually help relieve breast engorgement by expressing excess milk, so this advice is not appropriate.
B)   Incorrect- Applying ice packs to the breasts can decrease milk production and might not provide as much relief as other interventions.
C)   Incorrect- Wearing a supportive, well-fitting bra is a good recommendation, but it might not provide enough relief for breast engorgement on its own.
D)   Correct - Applying purified lanolin to the breasts can help soothe and moisturize the nipples, making breastfeeding more comfortable and providing relief from breast engorgement.

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Correct Answer is A

Explanation

A) Correct - A hemoglobin level of 9.5 g/dL in a full-term newborn is lower than the expected range and should be reported to the provider for further evaluation.
B) Incorrect- Platelets of 225,000/mm3 are within the normal range for newborns and do not require immediate reporting.
C) Incorrect- A glucose level of 60 mg/dL is within the normal range for a newborn and does not require immediate reporting.
D) Incorrect- A white blood cell count of 10,000/mm3 is within the normal range for a newborn and does not require immediate reporting.

A. A client who has a reddened area on their right calf B. A client who reports painful uterine contractions during breastfeeding C. A client who has a urinary output of 125 mL in 4 hr D. A client who reports changing their perineal pad every 2 hr

Correct Answer is C

Explanation

A) Incorrect- A reddened area on the calf might indicate a potential blood clot (deep vein thrombosis), which is important to assess but may not be the highest priority.
B) Incorrect- Painful uterine contractions during breastfeeding can be a normal response due to oxytocin release during breastfeeding and might not require immediate reporting.
C) Correct - A urinary output of 125 mL in 4 hours is significantly low and could indicate inadequate fluid intake, potential urinary retention, or other issues that need prompt attention. It is a sign of impaired renal function. This could indicate dehydration, blood loss, infection, or kidney injury. The nurse should assess the client's fluid intake and output, vital signs, urine specific gravity, and serum electrolyte levels. The nurse should also monitor the client for signs of hypovolemia, such as tachycardia, hypotension, and decreased skin turgor.
D) Incorrect- Changing a perineal pad every 2 hours is within the normal range for postpartum bleeding and might not require immediate reporting.

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A nurse on a postpartum unit is caring for a client who is breastfeeding and experiencing breast engorgement. Which of the following interventions should the nurse plan to implement to promote comfort for this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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A nurse on a postpartum unit is caring for a client who is breastfeeding and experiencing breast engorgement. Which of the following interventions should the nurse plan to implement to promote comfort for this client?