The nurse instructs a class of postpartum women on methods to avoid nipple soreness while breastfeeding.
Which comment by a class participant indicates the need for further instruction?

The correct answer is choice C. Ask what the patient ate and drank within the last day or two.This is because the nurse needs to assess the patient’s current nutritional status and eating habits before providing any education or advice.The nurse can then tailor the counseling to the patient’s specific needs and preferences.

Choice A is wrong because it is not the first action that the nurse should take.While it is important to explain the importance of adequate nutrition for the patient’s own growth and development, this should be done after assessing the patient’s current situation.

Choice B is wrong because it is not the first action that the nurse should take.While it is important to explain the relationship between the patient’s eating habits and fetal development, this should be done after assessing the patient’s current situation.

Choice D is wrong because it is not the first action that the nurse should take.While it is important to discuss with the patient the basic nutritional requirements of pregnancy, this should be done after assessing the patient’s current situation.

The normal ranges for nutritional intake during pregnancy vary depending on the age, weight, activity level, and health status of the patient.

However, some general guidelines are:

• Increase calorie intake by about 300 calories per day

• Increase protein intake by about 25 grams per day

• Increase calcium intake by about 1000 milligrams per day

• Increase iron intake by about 27 milligrams per day

• Increase folic acid intake by about 600 micrograms per day

• Increase fluid intake by about 8 to 10 cups per day

The correct answer is choice D. Wear a supportive bra.This will help suppress lactation and reduce the discomfort of engorgement.

The other choices are wrong because:

• Choice A. Manually express colostrum as necessary.This will stimulate milk production and prolong engorgement.

• Choice B. Apply hot compresses to the breasts.This will increase blood flow and swelling in the breasts and worsen engorgement.

• Choice C. Massage the breast tissue surrounding the areola.This will also stimulate milk production and prolong engorgement.

Normal ranges for breast engorgement are not applicable as it is a subjective experience that varies among women.However, some signs of engorgement include firm, tender, swollen breasts, flat or inverted nipples, and low-grade fever.Engorgement usually resolves within 24 to 36 hours after it begins.