You are in the postpartum unit where a Day two G1P1 Mother is working hard at breastfeeding her baby. She is concerned that the baby is fussy between feedings. The advice you would give her is:
Put baby to breast for non -nutritive sucking to calm baby
Give the baby pacifier
Put the baby in the nursery so mom can get some rest
Supplement with formula
The Correct Answer is A
A) Put baby to breast for non-nutritive sucking to calm baby:
Non-nutritive sucking (sucking without feeding) is a natural way for babies to self-soothe. It can help calm a fussy infant and also promote bonding between mother and baby. This action also stimulates milk production in the mother. It's a safe and effective way to comfort the baby without introducing unnecessary interventions. Non-nutritive sucking can help regulate the baby's sucking reflexes and provide comfort until the next feeding.
B) Give the baby pacifier:
While pacifiers can help some babies self-soothe, they can interfere with breastfeeding, especially in the early days. Introducing a pacifier too soon may confuse the baby’s natural sucking pattern and affect the latch, which can impact breastfeeding success. It’s typically recommended to wait until breastfeeding is well-established, around 3-4 weeks, before introducing a pacifier.
C) Put the baby in the nursery so mom can get some rest:
While maternal rest is important, removing the baby from the mother's care in the early postpartum period may interfere with the breastfeeding process. Breastfeeding on demand is crucial for establishing a good milk supply, and keeping the baby close for frequent feedings (and comfort) will help with this. Encouraging rest is important, but it shouldn't come at the expense of bonding and feeding.
D) Supplement with formula:
There is no indication that the baby is not getting enough nutrition at this point. Fussy behavior between feedings is common in newborns and can be due to various factors such as the baby's need for comfort, a growth spurt, or a short interval between feedings. Supplementing with formula is not necessary unless there is a clear indication of inadequate milk supply or other medical concerns, which isn’t evident in this situation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) "I'll walk you to the bathroom and stay with you."
After delivery, the patient is at risk for orthostatic hypotension and falling, especially within the first few hours postpartum. Even though the patient feels alert and active, her body is still adjusting after childbirth, and she may be unsteady. The nurse should assist her to the bathroom and provide supervision for her safety. Walking the patient to the bathroom ensures she can safely get there while allowing the nurse to assess her mobility and vital signs if necessary.
B) "I will get a bedpan for you."
While a bedpan may be appropriate if the patient is unable to get out of bed, this response does not prioritize the patient's expressed desire to go to the bathroom. Since she is alert, active, and able to communicate, walking her to the bathroom is a safer and more appropriate option than offering a bedpan. Using a bedpan would also restrict her mobility unnecessarily.
C) "Leave your peri-pad in place after you use the restroom so I can check your bleeding when you get back."
This does not address the immediate concern of the patient’s safety in getting to the bathroom. The nurse's priority should be her safety and mobility right after delivery, especially as the patient is still recovering and may be at risk for fainting or falling.
D) "Wait until I have had a chance to assess you first."
While it is important to assess the patient’s physical state postpartum, the response here should focus on immediate safety rather than delaying her need to use the restroom. A full assessment can be conducted later, but it is not appropriate to restrict the patient's autonomy when she has already indicated the need to go to the bathroom.
Correct Answer is A
Explanation
A) A rubella injection is advised:
Since the rubella titer is non-immune, the woman is not protected against rubella, which is important to address during the postpartum period. The rubella vaccine is typically given to women who are non-immune to rubella after childbirth, but it is contraindicated during pregnancy because it is a live vaccine. The best action in this case would be to administer the rubella vaccine to the postpartum woman before discharge, with instructions to avoid becoming pregnant for at least 28 days after vaccination to prevent harm to a future fetus.
B) A blood transfusion is advised:
The hematocrit of 30% indicates that the woman has mild anemia, but it does not require immediate intervention like a blood transfusion. Normal hematocrit levels for postpartum women typically range between 32% and 42%. A transfusion would be indicated if the hematocrit were much lower (usually below 20-25%) or if there were symptoms of significant blood loss, which are not indicated in this case.
C) The nurse should contact the provider for an antibiotic order:
There is no indication from the provided laboratory results or the scenario that the woman requires antibiotics. Group B Streptococcus (GBS) was negative, which eliminates the need for prophylactic antibiotics. There is no mention of any infection risk requiring an antibiotic prescription, and since her GBS result is negative, antibiotics are not warranted.
D) RhoGAM injection should be administered within 72 hours:
RhoGAM (Rh immunoglobulin) is typically administered to a woman with Rh-negative blood who has given birth to an Rh-positive baby to prevent Rh sensitization in future pregnancies. In this case, the woman has an Rh-positive blood type (A+), so she does not need RhoGAM. RhoGAM would only be necessary if the woman had an Rh-negative blood type, which she does not.
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.
