A physician writes in a breastfeeding mother's chart, 'Ampicillin 500 mg q 6 h po. Baby should be bottle fed until medication is discontinued.' What should be the nurse's next action?

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: A

Rationale: The correct answer is A - Gravida 5, para 5. Afterbirth pains are caused by uterine contractions as the uterus returns to its pre-pregnancy size. The more pregnancies a woman has had, the more stretched and prone to stronger contractions her uterus becomes. In this case, a gravida 5, para 5 patient has had multiple pregnancies and deliveries, leading to a higher likelihood of severe afterbirth pains. The other choices are incorrect because a primipara (B) would have less uterine stretching, a patient bottle feeding her first child (C) would still experience afterbirth pains due to uterine contractions, and a patient breastfeeding her second child (D) would experience milder afterbirth pains due to the release of oxytocin during breastfeeding which helps the uterus contract and reduce bleeding.

Correct Answer: A

Rationale: Rationale: - A: Fundus palpable at umbilicus level at 12 hours postpartum is concerning for uterine atony or retained placental fragments. - B, C, D: These findings are within normal range for fundal height postpartum and do not require further assessment. Summary: - Choice A is correct because it indicates a potential issue with uterine involution. - Choices B, C, D are incorrect as they reflect normal fundal height findings postpartum.

Correct Answer: C

Rationale: The correct answer is C: “They will fade to silvery lines but won’t disappear completely.” This response is the best because it provides a realistic expectation to the patient. Stretch marks may lighten over time but typically do not completely disappear. Choice A is incorrect as it provides a definitive and discouraging answer. Choice B is vague and does not offer a clear timeframe. Choice D is incorrect as it gives an overly optimistic timeline that may not be realistic for most individuals. Overall, choice C is the most accurate and supportive response for the patient's query.

Correct Answer: D

Rationale: The correct answer is D because the rubella vaccine contains live virus and poses a risk to the fetus if the patient becomes pregnant within 28 days of receiving the vaccine. Providing instructions about the risks of pregnancy after vaccination is crucial to prevent potential harm to the fetus. A: Incorrect - Specific instructions are necessary due to the live virus in the vaccine. B: Incorrect - Drinking fluids does not address the specific risks associated with pregnancy after vaccination. C: Incorrect - Stopping breastfeeding is not necessary after receiving the rubella vaccine.