A breastfeeding mother mentions to the nurse that she has heard that babies sleep better at night if they are given a small amount of rice cereal in the evening. Which of the following comments by the nurse is appropriate?

Correct Answer: B

Rationale: The appropriate comment by the nurse is option B) It is recommended that babies receive only breast milk for the first 4 to 6 months of their lives. This response aligns with current guidelines from organizations such as the World Health Organization and the American Academy of Pediatrics, which recommend exclusive breastfeeding for the first 6 months of life. Introducing rice cereal or other solid foods too early can increase the risk of allergies, digestive issues, and obesity. Breast milk provides all the necessary nutrients for a baby's growth and development in the first months of life. Option A is incorrect because giving rice cereal to babies to promote better sleep is not evidence-based and can be harmful to their immature digestive systems. Option C is incorrect because it does not provide any explanation or guidance to the mother. Option D is incorrect as it suggests introducing solid foods like applesauce and apple juice at ages that do not align with the recommended guidelines. From an educational perspective, it is crucial for nurses and healthcare providers to stay updated on current recommendations regarding infant feeding practices to provide accurate and evidence-based information to parents. Educating parents on the benefits of exclusive breastfeeding and the risks associated with early introduction of solid foods is essential for promoting the health and well-being of both the mother and the baby.

Correct Answer: A

Rationale: In this scenario, the correct action for the nurse to perform first is option A) Assist the woman to breastfeed. This is the most appropriate action because initiating breastfeeding soon after birth has numerous benefits for both the mother and the baby. Breastfeeding immediately after birth helps establish a strong bond between the mother and baby, promotes the release of oxytocin to reduce postpartum bleeding, and provides vital colostrum rich in antibodies for the newborn. Additionally, early breastfeeding can help the mother's uterus contract, aiding in the expulsion of the placenta and reducing the risk of postpartum hemorrhage. Option B) Dress the baby in a shirt and diaper is incorrect because dressing the baby can wait until after the initial breastfeeding session, which is a more critical and time-sensitive intervention. Option C) Administer the ophthalmic prophylaxis is important but can be done after the initial breastfeeding session since it does not require immediate action. Option D) Take the baby's rectal temperature is unnecessary at this moment as the baby's Apgar score is 9/9, indicating good overall health, and the priority is to establish breastfeeding for the numerous benefits it provides. In an educational context, understanding the importance of early breastfeeding initiation can help nurses prioritize care effectively in the immediate postpartum period to promote optimal maternal and infant outcomes. This knowledge empowers nurses to provide evidence-based care that supports the physical and emotional well-being of both the mother and the newborn.

Correct Answer: D

Rationale: In this scenario, option D is the correct answer because the baby being latched only to the nipple and not to a significant portion of the areola can cause pain during breastfeeding. When a baby latches onto just the nipple, it can lead to improper positioning and shallow latch, resulting in increased friction and pressure on the nipple, causing pain and potential damage. Option A is incorrect because a frenulum attached to the tip of the tongue does not directly cause pain during breastfeeding. Option B is incorrect as the baby forming a trough around the breast is a natural breastfeeding behavior and not a cause of pain. Option C is also incorrect as frequent and long feedings are expected in the early postpartum period to establish milk supply and support the baby's nutritional needs. Educationally, it is important for caregivers and healthcare professionals to understand the significance of proper latch and positioning during breastfeeding to prevent pain and ensure successful breastfeeding outcomes. Teaching mothers about correct latch techniques, positioning, and signs of a good latch can help prevent issues such as pain and nipple damage, ultimately supporting a positive breastfeeding experience for both the mother and baby.

Correct Answer: B

Rationale: In this scenario, the correct action for the nurse to take is option B, which is to call the doctor and question the order. This is the best course of action because it is crucial to ensure the safety and well-being of both the mother and the baby, especially considering the impact of medications on breastfeeding. Calling the doctor allows the nurse to seek clarification on the physician's rationale for requesting bottle feeding during the mother's medication course. It also presents an opportunity to discuss alternative antibiotics that are safe for breastfeeding mothers, as well as strategies to continue breastfeeding while on medication if possible. Option A is incorrect because blindly following the order without questioning could potentially compromise the health of the baby and disrupt the breastfeeding relationship. Option C is not advisable as it disregards the physician's instruction regarding bottle feeding, which may have important implications related to the medication's effects on the infant. Option D, while seeking information from a reference source is valuable, the immediate concern of ensuring the safety of the mother and baby warrants direct communication with the prescribing physician. In an educational context, this scenario highlights the importance of advocating for the patient's well-being, effective communication among healthcare team members, and the need to critically evaluate orders that may have significant implications for vulnerable populations like breastfeeding mothers and their infants. It underscores the significance of evidence-based practice and interprofessional collaboration in delivering safe and patient-centered care.

Correct Answer: C

Rationale: The correct answer is C: The mother can consume a variety of good calcium sources like broccoli and fish with bones as well as dairy products. Educational Rationale: Breast milk production is not solely dependent on the mother's consumption of milk. While dairy products are good sources of calcium, it is essential for the nurse to educate the mother that a variety of calcium sources can support adequate breast milk production. By emphasizing the inclusion of foods like broccoli and fish with bones, the nurse promotes a well-rounded diet that meets the mother's nutritional needs. Why the other options are incorrect: A) Option A is incorrect because there is no specific requirement for a mother to drink a set number of glasses of milk per day to produce quality breast milk. B) Option B is also incorrect as it limits the mother's dietary choices by focusing primarily on milk consumption rather than a diverse range of calcium-rich foods. D) Option D is misleading as it shifts the focus to protein intake, which although important, is not directly related to the mother's ability to produce high-quality breast milk. Educational Context: In a postpartum setting, it is crucial for healthcare providers to offer evidence-based information to support new mothers in making informed decisions regarding breastfeeding. By providing accurate information on nutrition and breastfeeding, nurses can empower mothers to make choices that support both their own health and the health of their baby. Encouraging a balanced diet rich in various nutrients, including calcium from a variety of sources, can contribute to successful breastfeeding outcomes.