Maternity Nursing: Postpartum Q 14
A nurse is preparing a list of self-care instructions for a PP client who was diagnosed with mastitis. Which of the following instructions would be included on the list. Select all that apply.
A. Take the prescribed antibiotics until the soreness subsides.
B. Wear a supportive bra.
C. Avoid decompression of the breasts by breastfeeding or breast pump.
D. Rest during the acute phase.
E. Continue to breastfeed if the breasts are not too sore.
Correct Answer: B, D, and E.
Mastitis is an infection of the lactating breast. Client instructions include resting during the acute phase, maintaining a fluid intake of at least 3 L a day, and taking analgesics to relieve discomfort. Additional supportive measures include the use of moist heat or ice packs and wearing a supportive bra. Non-steroidal anti-inflammatory drugs (NSAIDs) can be used for pain control. Heat applied to the breast just before emptying can help increase milk letdown and facilitate with emptying. Cold packs applied to the breast after emptying can help reduce edema and pain. Providers should ensure the patient that breastfeeding with mastitis is safe and that they should continue to do so if desired. If the patient does not wish to continue to breastfeed, they should be counseled on the importance of continuing to empty the breasts and taught alternative methods such as the use of a breast pump or manual expression.
Option A: Antibiotics may be prescribed and are taken until the complete prescribed course is finished. They are not stopped when the soreness subsides. If the symptoms of lactational mastitis persist beyond 12 to 24 hours, antibiotics should be administered. Because S. aureus is the most common cause, antibiotic therapy should be tailored accordingly. In the setting of mild infection without MRSA risk factors, outpatient treatment can be initiated with dicloxacillin or cephalexin.
Option C: Continued decompression of the breast by breastfeeding or pumping is important to empty the breast and prevent formation of an abscess. The initial management of lactational mastitis is symptomatic treatment. Continuing to fully empty the breasts has shown to decrease the duration of symptoms in patients treated both with and without antibiotics. Patients should be encouraged to continue to breastfeed, pump, or hand express. If the patient stops draining the milk, further stasis occurs, and the infection will progress.