A nurse is planning care for a client who is breastfeeding and has mastitis. Which of the following interventions should the nurse include? (Select all that apply.)

Instruct the client to wash their hands prior to breastfeeding.

Teach the client about proper latching-on techniques.

Encourage the client to alternate breastfeeding with formula feeding.

Instruct the client to avoid using a breast pump.

Encourage the client to allow their nipples to air dry after feedings.

Answer and Explanation

Correct Answer : A,E

A. Instruct the client to wash their hands prior to breastfeeding: Correct. Proper hand hygiene helps to prevent the spread of infection, which is important for a client with mastitis. Washing hands before breastfeeding is a crucial infection control measure.

B. Teach the client about proper latching-on techniques: Correct. Proper latching-on techniques can help prevent further complications and ensure effective milk removal, which can help in managing mastitis and preventing recurrence.

C. Encourage the client to alternate breastfeeding with formula feeding: Incorrect. Breastfeeding should continue as usual because it helps to empty the breast and relieve engorgement, which is crucial for managing mastitis. Formula feeding could exacerbate the problem by increasing engorgement.

D. Instruct the client to avoid using a breast pump: Incorrect. Using a breast pump can be beneficial for managing mastitis by helping to relieve engorgement and ensure proper milk drainage. The pump should be used correctly and hygienically.

E. Encourage the client to allow their nipples to air dry after feedings: Correct. Allowing the nipples to air dry helps prevent further irritation and infection. It is important for maintaining skin integrity and comfort during mastitis.

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Correct Answer is D

Explanation

A. Incorrect. While the administration of Rh(D) immune globulin is important, it is not an immediate priority compared to more urgent postpartum concerns.

B. Incorrect. Breast fullness is common and usually resolves with proper breastfeeding or pumping; it does not generally indicate an immediate issue.

C. Incorrect. An increase in urinary output is a common physiological change after delivery and usually does not indicate an urgent issue.

D. Correct. Saturating a perineal pad every hour indicates heavy bleeding (potential postpartum hemorrhage) and requires immediate assessment and intervention to manage potential complications.

A. Bradycardia B. Flushed face C. Hypotension D. Polyuria

Correct Answer is C

Explanation

A. Incorrect. Bradycardia is not typically associated with decreased cardiac output but can indicate other conditions.

B. Incorrect. A flushed face is not a specific indicator of decreased cardiac output.

C. Correct. Hypotension is a sign of decreased cardiac output, which can occur due to excessive vaginal bleeding.

D. Incorrect. Polyuria is not directly related to decreased cardiac output; it may be related to other conditions.

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A nurse is planning care for a client who is breastfeeding and has mastitis. Which of the following interventions should the nurse include? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

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Correct Answer is C

Explanation

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