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Exhibits

Which education by the nurse will help resolve the issue for the client? Select all that apply.

Wear an underwire bra around the clock.

Apply warm compresses to affected area before feeding.

Pump breasts if feeding will be missed, due to absence from the infant.

Pump breastmilk and feed it to infant instead of nursing.

Finish antibiotics even if symptoms improve.

Maintain activity due to the risk of blood clots with extra rest.

Wash hands before handling the breast.

Start infant on the unaffected side, so there is less pain when infant is the hungriest.

Vary breastfeeding positions at each feeding.

Answer and Explanation

Correct Answer : B,C,E,G,H,I

A.   Wear an underwire bra around the clock. Tight-fitting bras, especially underwire bras, can contribute to milk stasis by restricting milk flow and increasing the risk of clogged ducts. Instead, the client should wear a well-fitted, supportive bra without underwire to promote comfort and adequate milk drainage.
B.   Apply warm compresses to affected area before feeding. Warm compresses help increase circulation, promote milk let-down, and relieve pain in cases of mastitis. Applying warmth before breastfeeding can help soften the breast and improve milk flow, reducing milk stasis.
C.   Pump breasts if feeding will be missed, due to absence from the infant. Milk stasis occurs when the breast is not emptied regularly, increasing the risk of mastitis. Pumping or hand-expressing milk when unable to breastfeed prevents engorgement and reduces the likelihood of infection.
D.   Pump breastmilk and feed it to infant instead of nursing. Direct breastfeeding is preferred unless the pain is too severe or an abscess has formed. Pumping can be beneficial to relieve engorgement, but exclusive pumping is not necessary in mastitis unless advised by a healthcare provider. Continued direct breastfeeding helps clear infection by draining the affected breast.
E.   Finish antibiotics even if symptoms improve. Mastitis is commonly treated with antibiotics, and completing the full course prevents recurrence and antibiotic resistance. Stopping antibiotics early can lead to incomplete eradication of bacteria and persistent infection.
F.   Maintain activity due to the risk of blood clots with extra rest. Rest is essential for recovery from infection, and while postpartum clients have a slightly higher risk for blood clots, moderate rest should be encouraged. The client should engage in light activity as tolerated but should not avoid rest, as fatigue can contribute to a weakened immune response.
G.   Wash hands before handling the breast. Mastitis can be caused by bacterial contamination from the skin, baby’s mouth, or hands. Proper hand hygiene before breastfeeding or pumping reduces the risk of introducing bacteria into milk ducts and worsening the infection.
H.   Start infant on the unaffected side, so there is less pain when infant is the hungriest. Babies suck more vigorously at the beginning of a feeding. Starting on the unaffected side reduces pain and discomfort in the affected breast while ensuring the infant is still able to empty both breasts adequately.
I.   Vary breastfeeding positions at each feeding. Different nursing positions help ensure all milk ducts are effectively drained, reducing the risk of continued milk stasis. Positions such as cradle hold, football hold, or side-lying nursing can improve drainage in different areas of the breast.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

A. Variability of fetal heart rate. While fetal heart rate (FHR) variability is important, it is not the most immediate concern after epidural administration. Maternal hypotension can reduce placental perfusion, leading to fetal distress, but the priority is detecting and managing hypotension before significant FHR changes occur.
B. Station of presenting part. The fetal station indicates the descent of the presenting part in the birth canal but is unrelated to epidural anesthesia. Although epidurals can impact labor progression, station assessment is not the most critical immediate concern after administration.
C. Level of pain sensation. Assessing pain relief is necessary, but it is secondary to monitoring for maternal hypotension, which can cause serious complications for both mother and fetus. Pain control should be evaluated after ensuring hemodynamic stability.
D. Maternal blood pressure. Epidural anesthesia can cause vasodilation and sudden hypotension due to sympathetic blockade, leading to decreased placental perfusion and fetal distress. Frequent blood pressure monitoring is essential to detect hypotension early and intervene with IV fluids, repositioning, or vasopressors if needed.

A. Detection of early symptoms of Jarisch-Herxheimer reaction. B. Collection of serial anaerobic cultures of vaginal discharge. C. Implementation of contact precautions to prevent spread of infection. D. Administration of a supervised parenteral antibiotic protocol.

Correct Answer is D

Explanation

A. Detection of early symptoms of Jarisch-Herxheimer reaction. The Jarisch-Herxheimer reaction is a transient inflammatory response that occurs after antibiotic treatment for certain spirochetal infections, such as syphilis. It is not associated with pelvic inflammatory disease (PID) or its treatment, making this answer unrelated to the client’s condition.
B. Collection of serial anaerobic cultures of vaginal discharge. PID is a clinical diagnosis based on symptoms and risk factors rather than routine anaerobic cultures. Vaginal cultures are not commonly used to guide treatment, as PID is often polymicrobial and empirical broad-spectrum antibiotic therapy is preferred.
C. Implementation of contact precautions to prevent spread of infection. PID is not a highly contagious condition requiring contact precautions. While it is often caused by sexually transmitted pathogens like Chlamydia trachomatis or Neisseria gonorrhoeae, transmission occurs through intimate contact rather than casual hospital exposure.
D. Administration of a supervised parenteral antibiotic protocol. Hospitalization is recommended for clients with severe PID, those who do not respond to oral therapy, or those at risk for complications such as tubo-ovarian abscess. In this case, the client has been on oral and IV antibiotics for 14 days without resolution, necessitating inpatient management with supervised intravenous antibiotic therapy to ensure effective treatment and prevent further complications.

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Exhibits Which education by the nurse will help resolve the issue for the client? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which is the most important assessment for the nurse to conduct following the administration of epidural anesthesia to a client who is at 40-weeks gestation?

Correct Answer is D

Explanation

Correct Answer is D

Explanation

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Exhibits

Which education by the nurse will help resolve the issue for the client? Select all that apply.