A breastfeeding mother and her baby are being discharged home after delivery. The nurse is providing anticipatory guidance about what signs to expect the baby to exhibit every 24 hours by the end of the first week. Which of the following should the nurse include in his/her instructions?

Correct Answer: A

Rationale: Rationale: The correct answer is A) The baby will have at least 6 wet diapers. During the first week postpartum, it is crucial for the nurse to educate the mother about signs of adequate breastfeeding and infant hydration. Monitoring diaper output is an essential indicator of infant well-being. At least 6 wet diapers per day indicate that the baby is adequately hydrated and receiving enough breast milk. Option B) The baby will have at least 6 pasty stools is incorrect because the frequency of bowel movements varies among infants, and stool consistency can change based on multiple factors, including breastfeeding. Option C) The baby will breastfeed at least 6 times is incorrect as the frequency of breastfeeding can vary greatly among infants, and it is more important to focus on the baby's cues for feeding rather than a specific number of feedings. Option D) The baby will gain at least 6 ounces is incorrect because weight gain can vary in the first week, and it is not a reliable daily indicator of successful breastfeeding. Educationally, it is crucial for nurses to provide evidence-based anticipatory guidance to support successful breastfeeding and infant care. Understanding normal infant behaviors and growth patterns helps mothers feel confident in caring for their newborns. Monitoring diaper output is a simple yet effective way to assess infant hydration and feeding adequacy.

Correct Answer: C

Rationale: In the scenario of a vaginal delivery of a macrosomic baby where the nurse midwife requests nursing assistance, the appropriate action by the nurse would be to provide suprapubic pressure (Option C). This is the correct choice because suprapubic pressure can help to facilitate the delivery of a macrosomic baby by aiding in the descent of the baby through the birth canal. Option A, estimating fetal length and weight, would not be the most immediate or helpful action to take during the delivery process. Assessing the intensity of contractions (Option B) is important but may not directly address the specific need for assisting in the delivery of a macrosomic baby. Assisting the woman with breathing (Option D) is also important but may not directly address the need for physical assistance in the delivery process. In an educational context, understanding the appropriate actions to take during different stages of labor and delivery, especially in situations such as delivering a macrosomic baby, is crucial for nurses and healthcare providers. Providing suprapubic pressure can be a critical intervention in assisting with the safe delivery of the baby and ensuring the well-being of both the mother and the infant.

Correct Answer: C

Rationale: In this scenario, the most appropriate nursing diagnosis is "Impaired urinary elimination" (Option C). This choice is correct because the client has just voided a small amount of urine after delivery, which is insufficient considering the normal expected urine output postpartum. The assessment findings of a fundus 4 cm above the umbilicus and deviated to the right with moderate lochia rubra indicate a possible urinary retention issue, which aligns with impaired urinary elimination. Option A, "Impaired skin integrity," is incorrect as there is no evidence in the scenario to support this diagnosis. Option B, "Fluid volume deficit," is not the most appropriate as the client has just voided urine, suggesting the kidneys are producing urine and fluid volume is being maintained. Option D, "Toileting self-care deficit," is not the priority at this time as the main concern is the client's urinary elimination status post-delivery. Understanding the nursing diagnoses related to postpartum care is crucial for providing comprehensive care to new mothers. Impaired urinary elimination can lead to complications such as urinary retention and bladder distention, which can impact the client's recovery post-delivery. It is important for nurses to assess and address such issues promptly to prevent further complications and promote the well-being of the client.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Uterine cramping. A positive fetal fibronectin assessment at 28 weeks gestation indicates an increased risk of preterm labor. Uterine cramping in this context could be a sign of preterm labor, which is a serious condition requiring immediate medical attention to prevent premature birth and its associated complications for both the mother and the baby. A) Headache and B) Visual disturbances are not typically associated with a positive fetal fibronectin assessment in pregnancy. While they could be concerning symptoms in other contexts, they are not directly related to the current situation of potential preterm labor. D) Oliguria refers to decreased urine output and is not a typical symptom associated with preterm labor indicated by a positive fetal fibronectin assessment. While oliguria can be a sign of other medical issues, in this case, uterine cramping is the most important symptom to address promptly. Educationally, understanding the significance of fetal fibronectin assessments and their implications for preterm labor is crucial for nurses caring for pregnant women. Recognizing the signs and symptoms of preterm labor and knowing when to seek immediate medical attention is vital in ensuring the best outcomes for both the mother and the baby.

Correct Answer: D

Rationale: In the context of pharmacology education, understanding the cardinal moves of labor is crucial as certain medications can impact labor progression. The correct chronological order of the cardinal moves of labor is D) Internal rotation, A) External rotation, B) Flexion, and C) Extension. The correct answer, D) Internal rotation, occurs when the fetus rotates to align its head with the mother's pelvis, facilitating descent through the birth canal. This move is essential for the optimal passage of the baby during childbirth. Option A) External rotation typically follows internal rotation and involves the fetus rotating further as it moves through the birth canal. This move helps the baby's shoulders navigate the maternal pelvis. Option B) Flexion is when the baby's head flexes towards its chest, allowing the smallest diameter of the head to present first during delivery, aiding in the passage through the birth canal. Option C) Extension is the final move where the baby's head extends as it emerges from the birth canal, enabling the rest of the body to follow smoothly. Understanding the sequence of these cardinal moves is vital for healthcare providers involved in labor and delivery to monitor the progress of labor, anticipate potential complications, and intervene appropriately if necessary. Pharmacology students should grasp this concept to appreciate how medications may impact the natural process of labor and delivery.