The nurse visits a client at home who delivered a healthy newborn ...

[bobbie]

The nurse visits a client at home who delivered a healthy newborn 2 days ago. The client is complaining of breast discomfort. The nurse notes that the client is experiencing breast en-gorgement.
 
  The nurse provides which instructions to the client regarding relief of the engorge-ment? Select all that apply. 1. Feed the infant at least every 2 hours for 15 to 20 minutes on each side.
  2. Avoid breast-feeding during the time of breast engorgement.
  3. Apply moist heat to both breasts for about 20 minutes before a feeding.
  4. Massage the breasts gently during a feeding, from the outer areas to the nipples.
  5. Wear a supportive bra between feedings.

Question 2

The nurse caring for a client admitted to the hospital with acute back pain understands that this problem can be most likely caused by which of the following? Select all that apply.
 
  1. Scoliosis
  2. Twisting of the spine
  3. Hyperflexion of the spine
  4. Sciatic nerve inflammation
  5. Herniation of an intervertebral disk
  6. Degeneration of the vertebral posterior facet joints

[softEldritch]

Answer to Question 1

1, 3, 4, 5

Rationale: During breast engorgement, the client should be advised to feed the infant frequently, at least every 2 hours, for 15 to 20 minutes on each side. The infant will have an easier time latching on if the client softens her breast and expresses her milk before a feeding. Instruct the client to apply moist heat to both breasts for about 20 minutes before a feeding. This can be done in the shower or with warm wet towels. During a feeding, it is helpful to massage the breast gen-tly from the outer area to the nipple. This helps stimulate the let-down and flow of milk. The cli-ent also should be instructed to wear a supportive bra between feedings.

Answer to Question 2

2, 3, 5

Rationale: Acute back pain is sudden in onset and is usually precipitated by injury to the lower back, such as with hyperflexion, twisting, or disk herniation. Degenerative vertebral changes, sciatica, and scoliosis are more likely to cause chronic back pain, which can be more insidious in onset and may also be accompanied by degeneration of the intervertebral disk.