Page 805 - Saunders Comprehensive Review For NCLEX-RN

259. Answer: 1, 2, 3, 4

Rationale: Mastitis is an inflammation of the lactating breast as a result of
infection. Client instructions include resting during the acute phase, maintaining a
fluid intake of at least 3000 mL/day (if not contraindicated), and taking analgesics to
relieve discomfort. Antibiotics may be prescribed and are taken until the complete
prescribed course is finished. They are not stopped when the soreness subsides.
Additional supportive measures include the use of moist heat or ice packs and
wearing a supportive bra. Continued decompression of the breast by breast-feeding
or breast pump is important to empty the breast and prevent the formation of an
abscess.
Test-Taking Strategy: Focus on the subject, treatment measures for mastitis.
Think about the pathophysiology associated with mastitis to answer correctly.
Recalling that supportive measures include rest, moist heat or ice packs, antibiotics,
analgesics, increased fluid intake, breast support, and decompression of the breasts
will assist in answering the question.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Teaching and Learning
Content Area: Maternity: Postpartum
Health Problem: Maternity: Infection/Inflammation
Priority Concepts: Client Education; Inflammation
Reference: McKinney et al. (2018), pp. 611-612.

260. Answer: 4

Rationale: Mastitis is inflammation of the breast as a result of infection. It
generally is caused by an organism that enters through an injured area of the
nipples, such as a crack or blister. Measures to prevent the development of mastitis
include changing nursing pads when they are wet and avoiding continuous pressure
on the breasts. Soap is drying and could lead to cracking of the nipples, and the
client should be instructed to avoid using soap on the nipples. The mother is taught
about the importance of hand washing and that she should breast-feed every 2 to 3
hours.
Test-Taking Strategy: Note the strategic words, need for further instruction. These
words indicate a negative event query and the need to select the option that
identifies the incorrect client statement. Recalling that the use of soap is drying to the
skin and could cause cracking and provide an entry point for organisms will direct
you easily to the correct option.
Level of Cognitive Ability: Evaluating
Client Needs: Health Promotion and Maintenance
Integrated Process: Teaching and Learning
Content Area: Maternity: Postpartum
Health Problem: Maternity: Infection/Inflammation
Priority Concepts: Client Education; Inflammation
Reference: Lowdermilk et al. (2016), pp. 625, 813.

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