Which client would be most likely to have severe afterbirth pains and request a narcotic analgesic?
a. Gravida 5, para 5
b. Primipara who delivered a 7-lb boy
c. Client who is bottle feeding her first child
d. Client who wishes to breastfeed as soon as her baby is out of the neonatal intensive care unit
ANS: A
The discomfort of afterpains is more acute for multiparas because repeated stretching of muscle fibers leads to loss of uterine muscle tone. The uterus of a primipara tends to remain contracted. Afterpains are particularly severe during breastfeeding, not bottle feeding. The non-nursing mother may have engorgement problems. She should empty her breasts regularly to stimulate milk production so she will have the milk when the baby is strong enough to nurse.
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