Exam (elaborations)
CLC Exam 2022
- Course
- Institution
Exam of 37 pages for the course CLC at CLC (CLC Exam 2022)
[Show more]
Content preview
CLC EXAM 2022 QUESTIONS WITHCORRECT DETAILED ANSWERS
e What are green/shiny stools a sign of? - -sign of overproduction leading to less fat in milk, faster
digestion causing not enough time for lactase to digest the lactose in milk. An improved latch could allow
for more fat flow
Signs of oversupply - Rapid weight gain in infant, unsettled baby after feeding, recurrent plugged ducts
and mastitis, painful feedings, voluminous (huge volumes of) stools- often green & shiny
What causes nipple pain? - Improper latch--> need lactation support to help with proper latch on, good
seal
True/false: baby should be pulled into breast. - False! Do not pull baby into breast, let baby tilt head back
for optimal latch. Hand on back of baby's head can interfere baby's interoral function by restricting the
movement of the cranio-cervical spine--> causes nipple trauma. Make sure crook of arm in cradle
position does not block baby from being able to fully tilt back.
Should a latch be symmetric or asymmetric? - Asymmetric! A baby should form a teat with breast tissue
underneath the nipple as part of a latch
What is a symmetric latch - Not a good latch, causes nipple damage
Asymmetric latch - Optimal attachment to the breast, where the baby's lips are not centered in
relationship to the areolar, but rather vertically off-centered with the baby's chin and lower lip closer to
the edge of the areola than the baby's upper lip. A baby should form a teat with breast tissue
underneath the nipple as part of a latch
Do nipple creams work? - Continued questions of effectiveness, fear of ingestion by baby
Should a frenotomy be suggested for tongue tie? - No study was able to report that frenotomy led to
better long term breastfeeding
Tongue tied breastfeeder - -complete feeding assessment and suggest ways to optimize latch.
-refer onward for diagnosis (have PCP diagnose TT)
-provide support
What is a fissure straight down the nipple evidence of? - A symmetric latch. Top lip needs to have good
seal, moist part of lip should be touching nipple, can roll out top lip, to reduce injury during BF
Is there a deep latch with nipple stretching? - If nipple not stretched deeply into mouth, less oxytocin
flows, less fat is in mix. With less fat, milk digested quicker = not enough time for baby to make enough
lactase to digest lactose in milk.
What to do for oversupply? - Decrease additional stimulation/milk removal if possible
,Consider block feeding (only nursing on one side only per feeding)
Watch for mastitis
Try australian posture (mother down under, baby on top)
Consider donating to milk bank
Consult with HCP for medical dx
How many mL considered oversupply? - normal milk production = 750-1000 mL/day
Thrush during BF - painful for mother & baby.
may be visible or may not (whiteness that can't be wiped off)
-mother will have itchy, flaky, shiny skin
-candida not found inside the ducts or milk
Treatment of candida on breast - -nystatin first line
-flucanizole second line
-throw out all yeast vectors (pacifiers sterilize breast pumps)
-flucanazole oral capsules may be used to clean yeast vectors due to the biofilm created on pacifiers by
candida
What to do if antifungal treatment for yeast doesn't work? - Not candida infection!
Reynaud's Phenomenon - -vasospasm of nipple, recognized by triple color sign: from white--> blue-->
raspberry or bicolor sign white --> raspberry.
pain is extreme and spasmodic (not continuous)
-this happens after feeding once baby's mouth comes off nipple has vasospasm, feels like frostbite
treatment of reynauds - -prevent/decrease cold exposure
-avoid vasoconstrictive drugs such as caffeine and hypertensive drugs, nicotine
-can use nifedipine or calcium channel blocker
Nipple pain and poor milk transfer that is persistent despite optimal latch - -can use nipple shield as a
test to see if baby exerting too much pressure?
-OT involvement
-in rare cases baby have a strong sucking vacuum as measured by a pressure transducer or nipple shield
Clogs/plugs - Palpable lumps of milk within the lumen or duct system, usually not visible. Solids dont get
absorbed...could be too tight of a bra slowing flow of milk
,what to do for clogs/plugs - Encourage massage using side of hand and warm compresses. Do double
nursing by doubling up on side of clog to push it out. point baby's chin toward clog
See PCP if clog hasnt moved in 24-48 hours or systemic symptoms of inflammation (flu like s/s)
When to call PCP for clog/plug - If plug hasn't moved in 24-48 hrs or systemic signs of inflammation (flu
like s/s)
Causes of clogs/plug - too tight nursing bra
what eis ea ebleb e- esmall ewhite espots eon ethe eface eof ethe enipple ethat elook elike emilk-filled eblisters. eone
educt eopening eis eusually ecovered
what edoes ea ebleb efeel elike e- epainful estabbing epinpoint epain
how eto eget erid eof eblebs e- eSame eas eclog etreatment. eSometimes eneed et ebe elanced eby eHCP
Common emastitis e- e-can ebe enon-infective eor einfective e
-blocked educts efrom eengorgment, ehurried efeedings, enipple eshield e(pressure ewill ebuild euntil emilk
esneaks eout eof espace, ebody ereacts eto ethis elike einvader)
causes eof ecommon emastitis e- e-tight ebra e(look efor eindentation eof ebreast estraps)
-use eof ebreast eshell eor enipple eshell
-attachment edifficulties
-anemia ein ethe emother
-tongue etie ein ebaby e(ineffective emilk eemptying)
s/s ecommon emastitis e- esystemic- efever, eill, emalaise, eredness, epain, eone einflamed ebreast
What ebacteria ecauses einfective emastitis e- eStaphylococcus
tx ecommon emastitis e- eNSAIDS efirst eline ebut emake esure ediagnosed eby ePCP
-must ekeep epumping/breastfeeding eto ekeep emilk eflowing. ekeeps ebreasts esoft/comfortable eto eavoid
eabscess edevelopment
Abscess eon ebreast e- eLocalized eareas eof epus eand enecrotic etissue ethat ecan edevelop ewith ea ebreast
einfection
•Can edevelop ein ethe esubcutaneous, eintramammary, eretromammarylayers
•Symptoms einclude epain, eswelling, eredness, efever, eincreased eWBC ecount, epalpable emass
-pocket eof epus eforms ein ethe ebreast
-from euntreated emastitis
, Antibiotics efor emastitis? e- eUsually efor edouble emastitis, enot egenerally eproscribed efor eone ebreast
ecommon emastitis. eIf etreatment euneffective econsider eanemia, eductal eor einflammatory ebreast ecancer
Double emastitis e- eEMERGENT eAND eUNCOMMON- etissue eof eboth ebreasts einflamed.
organism ecause eof edouble emastitis e- estrep e-potentially efatal, ewhole ebody einflammation, esepsis
-not ea eproblem ewith emilk
signs eof einflammatory ebreast ecancer e- e- ebreast etissue eis ered, ewarm, ehas eorange epeel e(peau
ed'orange), epitting eappearance eon eskin esurface e
- ebreast emass emay eor emay enot ebe epresent
True/false: eMRSA ecan elook elike emastitis ewhen eon ebreast e- eTRUE ecan emasquerade eas emastitis. emight
esee epeeling eskin, epitting. ecan ealso ecause elesions eand eabscess.
Abscess eon ebreast eis efull eof e... e- ePUS enot eMILK. eas emany eas e60% epositive efor eMRSA.
can eyou enurse eon esame eside eas eabscess e- eNo eshould enurse eon eother ebreast. emust ebe eaware eof
epossible econtamination eon eflanges, epump eparts, ecan enot etrack einfection efrom eone eside eto eother.
abscess esurgical eintervention e- ecan ecut ethrough enerves eand educts. etry eto eavoid esurgical eintervention
treatment eof eabscess e- edrainage ethrough eultrasound-guided etechnique eis efirst echoice e(needle
easpiration eoften ehas eto ebe erepeated)
Report eany esuspicious earea eof ethe ebreast eto ea equalified eprovider ebecause eit ecould ebe... e- eMRSA eor
eherpes- efatal efor ebabies
Goldsmith's esign e- eThe eassociation eof ea ebaby's epersistent erefusal eof eone ebreast ewith epossible ebreast
ecancer ein ethe emother
-can ealso ehappen esuddenly ewith eolder ebabies e
-rule eout ecommon eproblems esuch eas eear einfection, eteething, ebirth etrauma e
-CA emay ebe ediagnosed eas elate eas e5 eyrs eafter ethis esign
Neonatal ehypoglycemia e- e-symptomatic einfants e= eglucose eof e40 erequires eper eAPP
-dextrose e& eBF e= efirst eline etx
-SGA, eLGA, ediabetic emoms, elate epreterm einfants eat egretest erisk
Signs eof eneonatal ehypoglycemia e- e• eJitteriness, etremors
• ePoor emuscle etone
• eDiaphoresis e(sweating)
• ePoor esuck, efailing eto esustain elatch
• eTachypnea
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller knowledgeNest. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $9.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
79223 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now