Mastitis

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Miriam Wahrman
MSN/Ed,RNC-MNN
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Mastitis (Image)
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Outline

Overview

  1. Bacterial infection associated with breastfeeding

Nursing Points

General

  1. Most commonly occurs in breastfeeding mothers
    1. Can occur at any time during lactation
    2. Most commonly occurs 2-3 weeks after delivery

Assessment

  1. Flu-like symptoms
    1. Aches
    2. Chills
    3. Febrile
  2. Pain, tenderness
  3. Localized edema, redness

Therapeutic Management

  1. Continue to promote lactation despite mastitis – it is safe
  2. Either manually express or utilize a breast pump at least q4hr
  3. Administer pain meds and antibiotics if indicated
  4. Support breasts with bra without underwire, which can irritate the already inflamed breast and potentially clog ducts

Nursing Concepts

  1. Infection Control
  2. Comfort
  3. Nutrition

Patient Education

  1. Take antibiotics as prescribed
  2. Continue to breastfeed
  3. Use warm compresses

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Transcript

In this lesson I will explain mastitis and how you will provide care for this patient.

Ok let’s get a few basics on mastitis out of the way. So mastitis is a bacterial infection that most commonly occurs in breastfeeding mothers. It can occur anytime but most commonly a few weeks after delivery.

So what is our patient going to look like. She will have flu-like symptoms so aches,chills, febrile. There will be pain, tenderness, localized edema, and redness at the site. This is really occurring because there is a blocked milk duct that then milk gets stuck in and grows bacteria. So that is why you get a tender area and redness. It will be localized at that site. We never see our patients get mastitis because it happens after they are home but I had it with both of mine and it just comes on so suddenly. I remember feeling a little achy and so tired and couldn’t really figure out what was wrong because my throat didn’t hurt, no stuffiness or anything and then suddenly had a temperature of 102. I had the super tender red spot so all the classic symptoms. So off I went to get an antibiotic. This image here is a very severe case where an abscess has formed at the nipple. So usually you will have a reddened area on the breast where the infection is starting. If left untreated or just a severe case an abscess can form at that spot that needs to be drained. Ok let’s look at our therapeutic management.
How are we going to treat this patient? She must continue to breastfeed or pump. Breastfeeding is best because it is natural so it will empty breasts the best, but she needs to keep milk moving so whatever her choice is. It is safe to still feed, however if an abscess forms it is sometimes contraindicated by physicians. The abscess needs to be drained so they might advise the mother to not feed while it heals. She will still need to hand express milk from that side if she wishes to continue to breastfeed after it has healed. The milk might taste different to the baby from that side because of the pus that can be present. She can absolutely still continue to feed on the unaffected side like normal if she chooses.Warm compresses can help with comfort and with milk flow as well. She will be given antibiotics that she must take and finish. Pain medications as well like ibuprofen can help.with the pain and discomfort. So make sure she is educated on all of this as well.

Ok so what have we learned? Mastitis is a bacterial infection in the breast that comes on suddenly with flu like symptoms. So aches, chills, high temperature. There will be a red tender spot at the breast usually. These patient need to continue to breastfeed to help keep milk flowing and moving. One complication that can develop is an abscess so when there is an abscess breastfeeding is contraindicated but otherwise they need to keep feeding. And the patient must take antibiotics as treatment.

Make sure you check out the resources attached to this lesson and review symptoms and management. Now, go out and be your best selves today. And, as always, happy nursing.

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OB

Concepts Covered:

  • Pregnancy Risks
  • Labor Complications
  • Newborn Complications
  • Fetal Development
  • Terminology
  • Prenatal Concepts
  • Newborn Care
  • Postpartum Care
  • Postpartum Complications
  • Medication Administration
  • Labor and Delivery
  • Studying
  • Communication

Study Plan Lessons

Abortion in Nursing: Spontaneous, Induced, and Missed
Abruptio Placentae (Placental abruption)
Acyclovir (Zovirax) Nursing Considerations
Addicted Newborn
Alpha-fetoprotein (AFP) Lab Values
Anemia in Pregnancy
Antepartum Testing
Antepartum Testing Case Study (45 min)
Babies by Term
Betamethasone and Dexamethasone
Betamethasone and Dexamethasone in Pregnancy
Breastfeeding
Butorphanol (Stadol) Nursing Considerations
Cardiac (Heart) Disease in Pregnancy
Causes of Chorioamnionitis Nursing Mnemonic (Pregnancies Are Very Interesting)
Causes of Labor Dystocia Nursing Mnemonic (Having Extremely Frustrating Labor)
Causes of Postpartum Hemorrhage Nursing Mnemonic (4 T’s)
Chorioamnionitis
Day in the Life of a Labor Nurse
Day in the Life of a Postpartum Nurse
Discomforts of Pregnancy
Disseminated Intravascular Coagulation (DIC)
Dystocia
Ectopic Pregnancy
Ectopic Pregnancy Case Study (30 min)
Emergent Delivery (OB) (30 min)
Epidural
Episiotomy – Evaluation of Healing Nursing Mnemonic (REEDA)
Erythroblastosis Fetalis
Eye Prophylaxis for Newborn
Factors That Can Put a Pregnancy at Risk Nursing Mnemonic (RIBCAGE)
Family Planning & Contraception
Fertilization and Implantation
Fetal Alcohol Syndrome (FAS)
Fetal Circulation
Fetal Development
Fetal Distress Interventions Nursing Mnemonic (Stop MOAN)
Fetal Heart Monitoring (FHM)
Fetal Environment
Fetal Wellbeing Assessment Tests Nursing Mnemonic (ALONE)
Fundal Height Assessment for Nurses
Gestation & Nägele’s Rule: Estimating Due Dates
Gestational Diabetes (GDM)
Gestational HTN (Hypertension)
Glucose Tolerance Test (GTT) Lab Values
Gravidity and Parity (G&Ps, GTPAL)
HELLP Syndrome
HELLP Syndrome – Signs and Symptoms Nursing Mnemonic (HELLP)
Hematomas in OB Nursing: Causes, Symptoms, and Nursing Care
Hemorrhage (Postpartum Bleeding) for Certified Emergency Nursing (CEN)
Hepatitis B Vaccine for Newborns
Homocysteine (HCY) Lab Values
Hydatidiform Mole (Molar pregnancy)
Hyperemesis Gravidarum
Hypovolemic Shock Case Study (OB sim) (60 min)
Incompetent Cervix
Infections in Pregnancy
Initial Care of the Newborn (APGAR)
Intra Uterine Device – Potential Problems Nursing Mnemonic (PAINS)
Labor Progression Case Study (45 min)
Leopold Maneuvers
Lung Surfactant for Newborns
Magnesium Sulfate (MgSO4) Nursing Considerations
Magnesium Sulfate in Pregnancy
Mastitis
Maternal Risk Factors
Mechanisms of Labor
Meconium Aspiration
Meds for Postpartum Hemorrhage (PPH)
Menstrual Cycle
Newborn of HIV+ Mother
Newborn Physical Exam
Newborn Reflexes
Nursing Care Plan (NCP) for Abortion, Spontaneous Abortion, Miscarriage
Nursing Care Plan (NCP) for Abruptio Placentae / Placental abruption
Nursing Care Plan (NCP) for Chorioamnionitis
Nursing Care Plan (NCP) for Dystocia
Nursing Care Plan (NCP) for Ectopic Pregnancy
Nursing Care Plan (NCP) for Gestational Diabetes (GDM)
Nursing Care Plan (NCP) for Gestational Hypertension, Preeclampsia, Eclampsia
Nursing Care Plan (NCP) for Hyperemesis Gravidarum
Nursing Care Plan (NCP) for Incompetent Cervix
Nursing Care Plan (NCP) for Mastitis
Nursing Care Plan (NCP) for Maternal-Fetal Dyad Using GTPAL
Nursing Care Plan (NCP) for Meconium Aspiration
Nursing Care Plan (NCP) for Neonatal Jaundice | Hyperbilirubinemia
Nursing Care Plan (NCP) for Newborns
Nursing Care Plan (NCP) for Placenta Previa
Nursing Care Plan (NCP) for Postpartum Hemorrhage (PPH)
Nursing Care Plan (NCP) for Premature Rupture of Membranes (PROM) / Preterm Premature Rupture of Membranes (PPROM)
Nursing Care Plan (NCP) for Preterm Labor / Premature Labor
Nursing Care Plan (NCP) for Process of Labor
Nursing Care Plan for (NCP) Fetal Alcohol Syndrome (FAS)
Nursing Care Plan (NCP) for Transient Tachypnea of Newborn
Nursing Case Study for Maternal Newborn
Nutrition in Pregnancy
OB (Labor) Nurse Report to OB (Postpartum) Nurses
OB Non-Stress Test Results Nursing Mnemonic (NNN)
Obstetric Trauma for Certified Emergency Nursing (CEN)
Obstetrical Procedures
Opioid Analgesics in Pregnancy
Oral Birth Control Pills – Serious Complications Nursing Mnemonic (Aches)
Oxytocin (Pitocin) Nursing Considerations
Pediatric Vital Signs (VS)
Phytonadione (Vitamin K) for Newborn
Placenta Previa for Certified Emergency Nursing (CEN)
Possible Infections During Pregnancy Nursing Mnemonic (TORCH)
Post-Partum Assessment Nursing Mnemonic (BUBBLE)
Postpartum Discomforts
Postpartum Hematoma
Postpartum Interventions
Postpartum Physiological Maternal Changes
Preeclampsia (45 min)
Postpartum Thrombophlebitis
Precipitous Labor
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Pregnancy Labs
Pregnancy Outcomes Nursing Mnemonic (GTPAL)
Preterm Labor for Certified Emergency Nursing (CEN)
Process of Labor – Mom Nursing Mnemonic (4 P’s)
Process of Labor – Baby Nursing Mnemonic (ALPPPS)
Prolapsed Umbilical Cord
Prostaglandins in Pregnancy
Rh Immune Globulin in Pregnancy
Signs of Pregnancy (Presumptive, Probable, Positive)
Stages of Fetal Development Nursing Mnemonic (Proficiently Expanding Fetus)
Tips & Advice for Newborns (Neonatal IV Insertion)
Threatened/Spontaneous Abortion for Certified Emergency Nursing (CEN)
Tocolytics
Uterine Stimulants (Oxytocin, Pitocin) Nursing Considerations
VEAL CHOP Nursing Mnemonic (Fetal Accelerations and Decelerations) (VEAL CHOP)