Chapter 16 Discharge Planning and Teaching

Chapter 16  Discharge Planning and Teaching

Complete Chapter Questions And Answers
 

Sample Questions

Multiple Choice

1. A nurse is making a home visit on the seventh postpartum day to assess a 23-year-old primipara woman and her full-term, healthy baby. Breastfeeding is the method of infant nutrition. The woman tells the nurse that she does not think her milk is good because it looks very watery when she expresses a little before each feeding. The nurse’s best response is:
a. “This is normal. You only have to be concerned when your baby does not gain weight.”
b. “What types of foods are you eating? A lack of protein in the diet can cause watery looking breast milk.”
c. “How much fluid are you drinking while you are nursing your baby? Too much fluid during the feeding session can dilute the breast milk.”
d. “This is normal and is referred to as foremilk which is higher in water content. Later in the feeding the fat content increases and the milk becomes richer in appearance.”

ANS: d

Feedback
a.
Correct information but does not provide information for the woman to understand the different types of milk.
b.
Incorrect information.
c.
Incorrect information.
d.
Correct. This provides an explanation for the consistency of the milk and reassures the woman that the appearance of the milk is normal.

KEY: Integrated Process: Teaching and Learning | Cognitive Level: Application | Content Area: Maternity | Client Need: Health Promotion and Maintenance | Difficulty Level: Moderate

2. A postpartum woman, who gave birth 12 hours ago, is breastfeeding her baby. She tells her nurse that she is concerned that her baby is not getting enough food since her milk has not come in. The best response for this patient is:
a. “I understand your concern, but your baby will be okay until your milk comes in.”
b. “Your baby seems content, so you should not worry about him getting enough to eat.”
c. “Milk normally comes in around the third day. Prior to that, he is getting colostrum which is high in protein and immunoglobulins which are important for your baby’s health.”
d. “You can bottle feed until your milk comes in.”

ANS: c

Feedback
a.
Incorrect because it does not inform the woman of what to expect with the stages of milk.
b.
This conveys a message that the woman’s concern is not important.
c.
This response provides information on the stages of milk production to help the woman understand her newborn’s nutritional needs.
d.
Incorrect response. It is important to avoid bottles until breastfeeding has been well established.

KEY: Integrated Process: Teaching and Learning | Cognitive Level: Application | Content Area: Maternity | Client Need: Health Promotion and Maintenance | Difficulty Level: Easy

3. Which of the following positions for breastfeeding is preferred for a 2-day post-cesarean-birth woman?
a. Lying down on side
b. Sitting
c. Cradle
d. Cross-cradle

ANS: a

Feedback
a.
Having the woman lying on her side to breastfeed prevents pressure on her abdomen and the pain that can result from the pressure.
b.
In this position, the baby is on the woman’s abdomen, and this can be painful for the woman.
c.
In this position, the baby is on the woman’s abdomen, and this can be painful for the woman.
d.
In this position, the baby is on the woman’s abdomen, and this can be painful for the woman.

KEY: Integrated Process: Teaching and Learning | Cognitive Level: Comprehension | Content Area: Maternity | Client Need: Safe and Effective Care Environment | Difficulty Level: Moderate

4. Painful nipples are a major reason why women stop breastfeeding. A primary intervention to decrease nipple irritation is:
a. Teaching proper techniques for latching-on and releasing of suction
b. Applying hot compresses to breast prior to feeding
c. Instructing woman to express colostrum or milk at the end of the feeding session and rub it on her nipples
d. Air drying nipples for 10 minutes at the end of the feeding session

ANS: a

Feedback
a.
Correct. All of the answers are correct, but problems with latching-on are a primary cause of nipple irritation.
b.
All of the answers are correct, but problems with latching-on are a primary cause of nipple irritation.
c.
All of the answers are correct, but problems with latching-on are a primary cause of nipple irritation.
d.
All of the answers are correct, but problems with latching-on are a primary cause of nipple irritation.
KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Application | Content Area: Maternity | Client Need: Health Promotion and Maintenance | Difficulty Level: Moderate

5. The nurse is developing a discharge teaching plan for a 21-year-old first-time mom. This was an unplanned pregnancy. She had a prolonged labor and an early postpartum hemorrhage. The woman plans to breastfeed her baby. She plans to return to work when her baby is 3 months old. Based on this information, the three primary learning needs of this woman are:
a. Breastfeeding, bathing of the newborn, and infant safety
b. Breastfeeding, storage of milk, and nutrition
c. Breastfeeding, contraception, infant safety
d. Breastfeeding, storage of milk, and rest

ANS: b

Feedback
a.
These are important learning needs but do not reflect an understanding of learning needs based on early postpartum hemorrhage and returning to work in 3 months.
b.
Because this is the woman’s first time breastfeeding and she plans to return to work, it is important that she feels comfortable with her understanding of breastfeeding and knows how to store her milk when she returns to work. Because she had a postpartum hemorrhage, she needs to learn what foods are high in iron.
c.
These are important learning needs but do not reflect an understanding of learning needs based on early postpartum hemorrhage and returning to work in 3 months.
d.
These are important learning needs but do not reflect an understanding of learning needs based on early postpartum hemorrhage.

KEY: Integrated Process: Teaching and Learning | Cognitive Level: Comprehension | Content Area: Maternity | Client Need: Health Promotion and Maintenance | Difficulty Level: Difficult