Exhibits

For each assessment finding, click to indicate whether findings from this client's assessment are generally associated with mastitis, endometritis, or could be a sign of both conditions. Each row must have only one response option selected.

A. Determine if the child can administer the insulin. While older children with type 1 diabetes can learn to self-administer insulin, a newly diagnosed 10-year-old may not yet have the skills or confidence to manage injections independently. The primary caregiver should first learn the procedure to ensure proper insulin administration.
B. Ask if the father can help with the injections. While involving another caregiver can be helpful, the mother, as a primary caregiver, needs to learn how to administer insulin. Avoiding the task entirely could compromise the child’s diabetes management, so supporting the mother in overcoming her fear is the priority.
C. Assess the mother's parenting skills. A fear of needles does not indicate poor parenting skills. Many people have needle-related anxiety, and the nurse should focus on providing support and education rather than questioning the mother’s ability to care for her child.
D. Encourage the mother to handle the needles. Helping the mother gradually become comfortable with insulin syringes through guided handling, demonstration, and practice can reduce her fear and build confidence. The nurse can use hands-on teaching techniques, such as allowing the mother to practice with an orange before injecting her child, to ease anxiety and ensure she can perform the procedure effectively.

• Mastitis: Mastitis is an infection of breast tissue that occurs when milk stasis leads to bacterial overgrowth, usually caused by Staphylococcus aureus. The client's firm, red, warm area on the breast, fever (101.2°F), chills, body aches, and fatigue all strongly indicate mastitis rather than other breast conditions.
• Engorgement: Engorgement occurs when the breasts overfill with milk, leading to swelling and tenderness. However, engorgement typically affects both breasts, does not cause fever or flu-like symptoms, and resolves with regular breastfeeding or pumping.
• Blocked milk duct: A clogged duct occurs when milk flow is obstructed, leading to a tender lump in the breast. While a blocked duct can progress to mastitis, it does not cause fever or systemic symptoms unless infection develops. The presence of fever and flu-like symptoms in this client suggests mastitis, not just a blocked duct.
• Inflammatory breast cancer: This rare but aggressive form of breast cancer causes redness, swelling, and skin thickening, but it is not associated with fever or acute symptoms like mastitis. It does not develop suddenly but rather progresses over time, making mastitis the more likely diagnosis in this case.
• Abscess: If mastitis is not treated promptly, it can lead to a breast abscess, a localized collection of pus requiring drainage. Signs of progression to an abscess include fluctuant swelling, worsening pain, and persistent fever despite antibiotic treatment.
• Breastfeeding intolerance: Mastitis can cause temporary discomfort during breastfeeding, but it does not lead to true breastfeeding intolerance. In fact, continued breastfeeding helps resolve mastitis by improving milk drainage.
• Nipple thrush: Nipple thrush (Candida infection) causes burning pain and white patches in the infant’s mouth but is not a complication of mastitis, which is bacterial, not fungal.
• Postpartum haemorrhage: Postpartum hemorrhage is caused by uterine atony, retained placenta, or coagulation disorders, not mastitis. Mastitis is localized to the breast and does not affect uterine bleeding.