A breastfeeding mother calls the obstetrician's office with a complaint of pain in one breast. Upon inspection, a diagnosis of mastitis is made.
Which of the following nursing interventions is appropriate?
Advise the woman to apply ice packs to her breasts.
Encourage the woman to breastfeed frequently.
Inform the woman that she should wean immediately.
Direct the woman to notify her pediatrician as soon as possible.
The Correct Answer is B
Choice A rationale
Applying ice packs can help reduce pain and swelling, but it is not the best intervention for a breastfeeding mother with mastitis. Ice can constrict blood vessels and may hinder milk
flow, which can exacerbate the condition.
Choice B rationale
Frequent breastfeeding helps to empty the affected breast and prevent milk stasis, reducing the risk of abscess formation and promoting faster healing. The mechanical action of
nursing can help clear the infection and provide relief.
Choice C rationale
Weaning immediately is not advised as it can lead to engorgement and milk stasis, worsening the infection. Continuing to breastfeed ensures the breast is regularly emptied, aiding
in recovery.
Choice D rationale
While notifying the pediatrician may be necessary if the baby is affected, it does not directly address the mother's condition or provide immediate relief. Primary management focuses
on treating the infection and maintaining milk flow.
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Correct Answer is B
Explanation
Choice A rationale
While massaging the fundus and ensuring IV access are correct initial actions, methylergonovine (Methergine) is typically used for patients without hypertensive history due to its
potential to raise blood pressure.
Choice B rationale
This option correctly identifies initial steps and appropriate medication. Carboprost-tromethamine (Hemabate) is effective in controlling postpartum hemorrhage and can be safely
used in patients with hypertension when oxytocin is insufficient.
Choice C rationale
Quantifying blood loss is essential but it is not an immediate priority when the patient is showing signs of significant bleeding and instability. Immediate intervention to control bleeding
takes precedence.
Choice D rationale
Assisting the patient to the restroom and then massaging the fundus overlooks the immediate need to control bleeding. This approach may delay necessary treatment and increase
the risk of further hemorrhage.
Choice E rationale
Straight catheterization and oxytocin maintenance are part of the management of postpartum hemorrhage but do not address the immediate need to ensure uterine contraction and
control active bleeding as effectively as the initial steps outlined in Choice B. .
Correct Answer is A
Explanation
Choice A rationale
Methylergonovine (Methergine) is used to manage postpartum hemorrhage by stimulating uterine contractions. It is especially useful in cases like this where rapid uterine tone is needed.
Choice B rationale
Magnesium sulfate is used to prevent seizures in preeclamptic patients, not to manage postpartum hemorrhage. This choice is incorrect in this context.
Choice C rationale
Carboprost-tromethamine (Hemabate) is also used for treating postpartum hemorrhage but is typically a secondary option to methylergonovine and may have more side effects.
Choice D rationale
Fresh frozen plasma (FFP) is used to replace clotting factors in cases of coagulopathy, not as a primary intervention for postpartum hemorrhage in this patient.