A patient, G2 P1102, who delivered her baby 8 hours ago, now has a temperature of 100.2°F. Which of the following is the appropriate nursing intervention at this time?

Correct Answer: D

Rationale: In this scenario, the appropriate nursing intervention at this time is option D) Encourage intake of water and other fluids. Postpartum fever, defined as a temperature of 100.4°F or higher after the first 24 hours and during the first 10 days following delivery, is a common complication. It is often caused by dehydration due to the physiological stress of labor and delivery, as well as inadequate fluid intake postpartum. Encouraging the intake of water and other fluids is crucial in this situation as it helps to rehydrate the patient, which can aid in reducing her temperature and preventing further complications. Dehydration can also affect milk production and delay the recovery process postpartum. The other options are less appropriate in this scenario: A) Notify the doctor to get an order for acetaminophen: While acetaminophen can help reduce fever, addressing the underlying cause of the fever, which in this case is likely dehydration, is more important. B) Request an infectious disease consult from the doctor: There is no indication in the scenario to suggest that the fever is due to an infectious disease, so this option is not warranted. C) Provide the woman with cool compresses: While this can provide symptomatic relief, addressing the dehydration with fluid intake is more important in this situation. In an educational context, understanding the importance of monitoring postpartum patients for signs of complications, such as fever, and knowing appropriate nursing interventions can help prevent further health issues and promote better outcomes for both the mother and the newborn. It highlights the significance of holistic care in the postpartum period, focusing on hydration and physiological well-being.

Correct Answer: D

Rationale: In this scenario, option D, "Many mothers lose weight when they breastfeed because the baby consumes about 600 calories a day," is the most appropriate response. This answer is correct because breastfeeding does indeed burn extra calories, aiding in weight loss for many mothers. It also provides positive reinforcement for the woman's concerns about weight without promoting unhealthy dieting practices. Option A is incorrect because simply drinking milk does not make a diet appropriate during breastfeeding. Option B is incorrect as it suggests that dieting will reduce vitamin content in breast milk without any evidence to support this claim. Option C is incorrect as the specific caloric requirement mentioned is not universally applicable to all breastfeeding women. From an educational perspective, it is crucial to address postpartum weight concerns sensitively and accurately. Educators should emphasize the importance of maintaining a balanced diet while breastfeeding to ensure both maternal and infant health. Encouraging healthy lifestyle choices and debunking myths surrounding postpartum weight loss is key in supporting new mothers through this period.

Correct Answer: A

Rationale: In this scenario, the correct action for the nurse to advise the client is option A) Intermittently apply ice packs to her axillae and breasts. This is because the client is exhibiting signs and symptoms of mastitis, which is an inflammation of the breast tissue often caused by a blocked milk duct or bacterial infection. Applying ice packs can help reduce inflammation, pain, and redness associated with mastitis. Option B) Apply lanolin to her breasts and nipples every 3 hours is incorrect because lanolin is typically used to soothe dry or cracked nipples, which is not the primary issue in this case. Option C) Express milk from the breasts every 3 hours is incorrect because in the presence of mastitis, frequent expression of milk can exacerbate the inflammation and discomfort. Option D) Ask the primary health care provider to order a milk suppressant is incorrect because milk suppressants are not typically indicated for mastitis unless there are specific circumstances that warrant their use. Educationally, it is important for nurses to recognize the signs and symptoms of mastitis in breastfeeding mothers and to provide appropriate guidance on management strategies. Understanding the pathophysiology of mastitis and knowing how to differentiate it from other breast conditions is crucial for effective nursing care in the postpartum period.

Correct Answer: D

Rationale: In postpartum period, breastfeeding mothers have increased nutritional needs, particularly for vitamin A and iron. The correct answer, D) 1 1/2 cup raw broccoli, is the most suitable option as broccoli is a rich source of both vitamin A and iron. Vitamin A is essential for vision, immune function, and skin health, while iron is crucial for preventing anemia and supporting energy levels. Option A, raw celery dipped in cream cheese, lacks significant amounts of vitamin A and iron compared to broccoli. Option B, yogurt mixed with a banana, provides some vitamin A but lacks sufficient iron content. Option C, a strawberry milkshake, may contain some vitamin A from the strawberries but lacks iron and has added sugars which may not be the healthiest choice. Educationally, this question highlights the importance of proper nutrition for breastfeeding mothers to support their own health and the health of their infants. It emphasizes the significance of including a variety of nutrient-rich foods in their diet to meet their increased nutrient requirements during the postpartum period. By understanding the nutritional needs of breastfeeding mothers, nurses can provide valuable guidance to support their overall well-being.

Correct Answer: B

Rationale: The correct answer is B) Breastfeeding mothers have decreased incidence of diabetes mellitus later in life. This statement is true because breastfeeding has been associated with several long-term health benefits for mothers, including a decreased risk of developing diabetes mellitus later in life. Breastfeeding helps to regulate blood sugar levels and improve insulin sensitivity, which can lower the risk of developing type 2 diabetes. Option A is incorrect because breastfeeding mothers usually take longer than 3 weeks to completely involute postpartum. The process of involution, where the uterus returns to its pre-pregnancy size, can take around 6 weeks. Option C is incorrect because while breastfeeding can have positive effects on bone density during the postpartum period, there is no conclusive evidence to suggest that breastfeeding mothers have higher levels of bone density after menopause compared to bottle-feeding mothers. Option D is incorrect because breastfeeding mothers may actually experience more frequent bouts of infection immediately postpartum due to factors such as physical stress, sleep deprivation, and hormonal changes associated with breastfeeding. Educationally, understanding the impact of breastfeeding on maternal health is crucial for healthcare providers to support and educate new mothers on the benefits of breastfeeding for both themselves and their infants. It is important to provide evidence-based information to empower mothers to make informed decisions regarding infant feeding practices.