The mother of a premature infant born at 32 weeks' gestation ...

[mwit1967]

The mother of a premature infant born at 32 weeks' gestation expresses the desire to breastfeed her child. An appropriate suggestion by the nurse would be:
 
  1. Mothers who cannot directly breastfeed should talk with and stroke their infants during gavage feedings, as this can help facilitate milk letdown.
 
  2. The letdown reflex is best initiated by having the baby suck at the breast.
 
  3. Pumping should be done no more than three times daily, making sure to empty each breast completely.
 
  4. You should begin pumping by six hours postpartum to ensure adequate milk production.

Question 2

The nurse wants to do a quick evaluation of a one-month-old infant's hearing. Which assessment will provide the best information?
 
  1. Examining the ear canal with an otoscope
  2. Using a vibrating tuning fork placed against the child's skull
  3. Using tympanometry
  4. Using a noisemaker in the infant's presence to evaluate the child's response

[Toya9913]

Answer to Question 1

4

Rationale:

1. Just because a newborn is premature does not preclude the mother from breastfeeding. The mother can breastfeed unless some other issue is present.
2. Pumping the breast can facilitate milk letdown.
3. Breast pumping should be done at least five or more times per day to ensure an adequate supply of milk.
4. It is best for the mother to initiate the letdown reflex by stimulating the breast prior to feeding so that the infant will not have to suck as hard, which can burn unnecessary calories. The sooner the mother can begin breast pumping postpartum, the more likely she is to produce an adequate milk supply.

Answer to Question 2

4
Rationale 1: Inspection of the ear canal and membrane will not provide any information on the infant's hearing ability.
Rationale 2: In a school-age child, this will test bone conduction, but it is not appropriate for an infant.
Rationale 3: Tympanometry is a tool to evaluate the movement of the tympanic membrane. Although related to sound transmission, it is not the best response.
Rationale 4: This is a quick, simple evaluation of the child's ability to hear sounds. The child's response can be a stopping of activity, widening of the eyes, or turning toward the sound.
Global Rationale:

[mwit1967]

Thanks for the timely response, appreciate it

[patma1981]

Excellent