The nurse is providing patient teaching to a client who plans to bottle feed her newborn infant. Which of the following information should be included in the education session?

Correct Answer: B

Rationale: In this scenario, option B is the correct answer. It is crucial to educate the client that if the bottle nipple is not filled throughout the feeding, the baby may intake a large amount of air, leading to potential issues like gas or colic. This knowledge helps prevent discomfort for the infant and promotes proper feeding techniques. Options A, C, and D are incorrect for several reasons. Option A provides incorrect guidance on burping frequency, as it is recommended to burp the baby more frequently, not just after every 3 ounces. Option C advises heating formula in the microwave, which can create hot spots and burn the baby's mouth, posing a safety risk. Option D suggests propping the bottle, which increases the risk of aspiration, choking, and may also lead to overfeeding. From an educational perspective, it is essential to emphasize evidence-based practices in patient teaching to ensure optimal outcomes for both the infant and the mother. Providing accurate information on bottle feeding techniques enhances the client's knowledge and promotes the well-being of the newborn. It is crucial for nurses to deliver clear, concise, and accurate instructions to empower parents in caring for their infants effectively.

Correct Answer: D

Rationale: In this scenario, the correct question the nurse should ask is D) “When was the last time you fed the baby?” This question is crucial because engorgement is often due to inadequate breastfeeding frequency causing milk buildup. By knowing when the baby was last fed, the nurse can assess if the engorgement is due to infrequent feedings. Option A, asking about a warm shower, is not as pertinent as directly inquiring about the baby's feeding schedule. Option B, asking about an electric breast pump, may not address the immediate concern of engorgement and is not as relevant as feeding frequency. Option C, asking about fluid intake, while important for breastfeeding mothers, is not as directly related to the issue of engorgement as the timing of the last feeding. From an educational perspective, this question highlights the importance of understanding the physiological processes of breastfeeding and how engorgement can occur. It also emphasizes the significance of assessing breastfeeding practices and providing appropriate support and guidance to promote successful breastfeeding outcomes in postpartum care.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Obtain assistance for neonatal resuscitation. A baby with an Apgar score of 3 at one minute after birth indicates severe distress and requires immediate intervention. Neonatal resuscitation is crucial to support the baby's breathing and circulation, potentially saving its life. Option A) Administer ophthalmic prophylaxis is incorrect because at this critical moment, the priority is to address the baby's low Apgar score and potential need for resuscitation, rather than administering ophthalmic prophylaxis. Option B) Placing the baby on the abdomen of the mother is inappropriate in this situation as the baby needs urgent medical attention due to the low Apgar score. Option D) Repeating the Apgar score may lead to a delay in providing necessary care to the distressed newborn. It is crucial to act promptly in situations where immediate intervention is required. Educationally, understanding the significance of Apgar scores and knowing appropriate actions in response to low scores is essential for healthcare professionals working in obstetrics and neonatal care to ensure the best outcomes for both mothers and babies.

Correct Answer: C

Rationale: In the case of an infant of a diabetic mother with macrosomia (birth weight >4,000g), the correct answer to monitor for is C) Respiratory distress. These infants are at higher risk for respiratory distress syndrome due to delayed lung maturity and increased risk of meconium aspiration. Monitoring for signs such as tachypnea, retractions, nasal flaring, and cyanosis is crucial in these babies. Option A) Hyperreflexia is not typically associated with infants of diabetic mothers but may occur in conditions like hypocalcemia or CNS disorders. Option B) Hypoglycemia is a common concern in infants of diabetic mothers due to their exposure to high maternal blood glucose levels. However, it is not the primary concern immediately after birth. Option D) Opisthotonus, a condition characterized by arching of the back, is not a common manifestation in infants of diabetic mothers but may be seen in conditions like meningitis or severe hypoxic-ischemic encephalopathy. Educationally, understanding the specific risks associated with infants of diabetic mothers and how to monitor and manage these risks is essential for healthcare providers working in neonatal care settings. This knowledge ensures prompt recognition of potential complications and appropriate interventions to optimize outcomes for these vulnerable newborns.

Correct Answer: D

Rationale: In this scenario, option D is the most appropriate response for the nurse to provide to the client. The correct answer is that the baby's blood supply and the mother's blood supply are completely separate throughout the pregnancy and delivery process. This is due to the presence of the placental barrier, which prevents direct mixing of maternal and fetal blood. This separation ensures that each circulatory system remains independent while still allowing for exchange of nutrients and waste products. Option A is incorrect because the separation of blood does not occur when the placenta is born; rather, it is a continuous process throughout pregnancy. Option B is incorrect as well, as clamping the umbilical cord does not stop blood mixing, as mixing does not occur in the first place due to the placental barrier. Option C is also incorrect since the separation of blood occurs due to the placental barrier and is not solely related to the baby taking its first breath. Educationally, understanding the physiology of maternal-fetal circulation is crucial in the field of pharmacology, especially in high-risk pregnancy situations where medication administration may impact both the mother and the fetus. Nurses must be well-versed in explaining these concepts to patients to ensure they have a clear understanding of the processes occurring during pregnancy and delivery.