A nurse is assessing a client who is 3 days postpartum and is breastfeeding.The nurse notes that the fundus is three fingerbreadths below the umbilicus, lochia rubra is moderate, and the breasts are hard and warm to palpation.The client is exhibiting early indications of mastitis.Which of the following interventions should the nurse make?
Explanation & Rationale
Choice A rationaleApplying heat to the breasts in mastitis can increase blood flow and potentially worsen inflammation. While heat can be comforting for engorgement, in mastitis, it may exacerbate the inflammatory response and should be used cautiously or avoided in the acute phase. The primary goal is to remove milk and reduce inflammation.Choice B rationaleRemoving the nursing bra might provide some temporary comfort if the bra is too tight and constricting milk flow. However, it does not address the underlying infection or inflammation of mastitis. Supportive nursing bras are generally recommended to provide support without restricting milk ducts.Choice C rationaleGiven the early indications of mastitis, such as a hard, warm area in the breast, moderate lochia rubra (which is normal for postpartum day 3), and a fundus appropriately descended, additional interventions are indeed indicated to prevent the progression of the infection and promote healing. Ignoring these signs could lead to a more severe infection.Choice D rationaleContinued breastfeeding is crucial for managing mastitis. Frequent emptying of the breasts helps to remove the stagnant milk, which can contribute to the infection. Breast milk has antimicrobial properties that can aid in resolving the infection. Encouraging the client to breastfeed frequently on the affected side, starting with that side, promotes drainage and healing.