A nurse is providing teaching to a client who has fibrocystic breast changes and is experiencing breast discomfort during menstruation. Which of the following instructions should the nurse include?

Correct Answer: C

Rationale: Rationale: The correct answer is C) Decrease sodium intake before menstruation. Fibrocystic breast changes are characterized by lumpy, painful breasts due to hormonal fluctuations. Sodium can cause water retention, exacerbating breast tenderness. By decreasing sodium intake, the client can reduce fluid retention and breast discomfort during menstruation. Option A) Increase potassium intake is incorrect because potassium is not directly related to fibrocystic breast changes or breast discomfort. Option B) Increase fluid intake to 3 liters per day is not appropriate as excessive fluid intake may not alleviate breast discomfort and could lead to other health issues. Option D) Decrease daily fiber intake is incorrect as fiber is essential for overall health and has no direct impact on fibrocystic breast changes. In an educational context, it is crucial for nurses to provide evidence-based teaching to clients. Understanding the physiological basis for recommendations helps clients make informed decisions about their health. By explaining the rationale behind dietary modifications, nurses empower clients to manage their symptoms effectively.

Correct Answer: D

Rationale: In maternal newborn nursing, understanding the importance of proper nutrient intake during pregnancy is crucial for the health of both the mother and the developing fetus. In this scenario, the correct answer is D) Calcium. Calcium plays a vital role in pregnancy as it is essential for the development of the baby's bones, teeth, heart, and muscles. During pregnancy, the mother's body has an increased demand for calcium to support the growth and development of the fetus. If the mother does not consume an adequate amount of calcium, the baby may draw calcium from the mother's bones, putting her at risk for bone density loss and other complications. Now, let's discuss why the other options are incorrect: A) Vitamin E: While Vitamin E is important for overall health, it is not specifically highlighted as a nutrient that needs a significant increase during pregnancy. B) Vitamin D: Vitamin D is essential for calcium absorption, but the question specifically asks about nutrients to increase intake, and typically Vitamin D levels are monitored through supplementation rather than dietary intake. C) Fiber: While fiber is important for overall digestive health, it is not a nutrient that needs a significant increase during pregnancy compared to the increased need for calcium. Educationally, this question highlights the importance of understanding the specific nutrient needs during pregnancy and the implications of inadequate intake. Nurses need to be able to provide accurate information and guidance to pregnant women to support a healthy pregnancy and ensure optimal outcomes for both the mother and the baby.

Correct Answer: D

Rationale: In the context of maternal newborn nursing, it is crucial for the nurse to understand the significance of laboratory results during pregnancy. In this scenario, the nurse should report a platelet count of 140,000/mm3 to the provider. Thrombocytopenia, which is a low platelet count, can be a concerning finding in pregnancy as it may lead to complications such as bleeding disorders or preeclampsia. Therefore, timely communication of this result to the provider is essential for further evaluation and management to ensure the well-being of both the mother and the unborn baby. Regarding the other options: - A) A white blood cell count of 11,000/mm3 is within normal limits and does not typically require immediate reporting. - B) A hemoglobin level of 11.2 g/dL may be slightly low but is not as concerning as a low platelet count in this context. - C) A hematocrit level of 34% is also within an acceptable range for a pregnant individual and does not warrant immediate notification to the provider. Educationally, understanding the rationale behind the importance of specific laboratory values in pregnancy equips nurses with the knowledge to prioritize and communicate critical findings effectively. It also underscores the role of the nurse in advocating for the health and safety of both the mother and the fetus by promptly identifying and addressing abnormal results.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Premature ovarian failure. Premature ovarian failure is a significant factor affecting fertility as it refers to the loss of ovarian function before the age of 40, leading to infertility due to the depletion of ovarian follicles. This condition results in decreased estrogen production and irregular or absent menstrual cycles, impacting the client's ability to conceive. Option B) Renal calculi, Option C) Dysmenorrhea, and Option D) Recurrent urinary tract infection are incorrect choices for factors affecting fertility. Renal calculi are kidney stones and do not directly impact fertility. Dysmenorrhea is severe menstrual cramps but does not necessarily affect fertility unless it is associated with an underlying condition like endometriosis. Recurrent urinary tract infections, while they can cause discomfort and complications, do not directly influence fertility unless they lead to pelvic inflammatory disease, which is not directly mentioned in the question. Educationally, understanding the factors that affect fertility is crucial for nurses working in maternal newborn care. By correctly identifying these factors, nurses can provide appropriate support, education, and referrals for clients experiencing infertility issues. It also underscores the importance of a comprehensive infertility assessment to determine the underlying causes and develop a suitable care plan for the client.

Correct Answer: A

Rationale: Rationale: The correct answer is option A) Heart disease. Terbutaline is a tocolytic medication used to inhibit preterm labor by relaxing the uterine smooth muscle. It is contraindicated in clients with heart disease due to its potential to cause cardiovascular side effects, such as tachycardia and arrhythmias. Administration of terbutaline in clients with underlying heart disease can exacerbate these conditions and pose a serious risk to the client's health. Option B) Cervical dilation of 2 cm is not a contraindication for terbutaline administration. In fact, terbutaline is often used in cases of preterm labor where cervical dilation has begun to help delay labor and allow for administration of corticosteroids to improve fetal outcomes. Option C) Gestational age of 34 weeks is not a contraindication for terbutaline use. Terbutaline can be used up to 37 weeks of gestation to delay preterm labor and allow for appropriate interventions to improve neonatal outcomes. Option D) Allergy to penicillin is unrelated to the administration of terbutaline. Allergy to penicillin would not impact the use of terbutaline in managing preterm labor. Educational context: Understanding contraindications for medications used in maternal newborn nursing is crucial for nurses caring for pregnant clients. By knowing the contraindications of medications like terbutaline, nurses can ensure safe and effective care for both the mother and the fetus. It is essential to consider the client's medical history and potential risks associated with medication administration to make informed decisions that promote positive outcomes for both the mother and the newborn.