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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Maternal Fetal Medicine

Concepts Covered:

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

Study Plan Lessons

Abruptio Placenta for Certified Emergency Nursing (CEN)
Abruptio Placentae (Placental abruption)
Anemia in Pregnancy
Antepartum Testing
Babies by Term
Betamethasone and Dexamethasone
Betamethasone and Dexamethasone in Pregnancy
Breastfeeding
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)
Certified Nurse Midwife
Day in the Life of a Labor Nurse
Day in the Life of a Postpartum Nurse
Discomforts of Pregnancy
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Ectopic Pregnancy
Ectopic Pregnancy for Certified Emergency Nursing (CEN)
Emergent Delivery (OB) (30 min)
Emergent Delivery for Certified Emergency Nursing (CEN)
Epidural
Episiotomy – Evaluation of Healing Nursing Mnemonic (REEDA)
Erythroblastosis Fetalis
Factors That Can Put a Pregnancy at Risk Nursing Mnemonic (RIBCAGE)
Fertilization and Implantation
Fetal Alcohol Syndrome (FAS)
Fetal Development
Fetal Heart Monitoring (FHM)
Fetal Heart Monitoring Like A Pro – Live Tutoring Archive
Fetal Heart Monitoring Like A Pro 2 – Live Tutoring Archive
Fetal Wellbeing Assessment Tests Nursing Mnemonic (ALONE)
Fundal Height Assessment for Nurses
Gestation & Nägele’s Rule: Estimating Due Dates
Gestational Diabetes (GDM)
Gestational Diabetes and Why YOU Should Know About It – Live Tutoring Archive
Gestational HTN (Hypertension)
Gravidity and Parity (G&Ps, GTPAL)
Glucose Tolerance Test (GTT) Lab Values
Hemorrhage (Postpartum Bleeding) for Certified Emergency Nursing (CEN)
Infections in Pregnancy
Incompetent Cervix
Initial Care of the Newborn (APGAR)
Labor Progression Case Study (45 min)
Magnesium Sulfate in Pregnancy
Mastitis
Maternal Risk Factors
Mechanisms of Labor
Meconium Aspiration
Meds for Postpartum Hemorrhage (PPH)
Meds for PPH (postpartum hemorrhage)
Menstrual Cycle
Newborn of HIV+ Mother
Nursing Care Plan (NCP) for Abruptio Placentae / Placental abruption
Nursing Care Plan (NCP) for Chorioamnionitis
Nursing Care Plan (NCP) for Ectopic Pregnancy
Nursing Care Plan (NCP) for Gestational Hypertension, Preeclampsia, Eclampsia
Nursing Care Plan (NCP) for Gestational Diabetes (GDM)
Nursing Care Plan (NCP) for Hyperemesis Gravidarum
Nursing Care Plan (NCP) for Maternal-Fetal Dyad Using GTPAL
Nursing Care Plan (NCP) for Process of Labor
Oxytocin (Pitocin) Nursing Considerations
Placenta Previa
Placenta Previa for Certified Emergency Nursing (CEN)
Postpartum Discomforts
Postpartum Hemorrhage (PPH)
Postpartum Interventions
Postpartum Thrombophlebitis
Preeclampsia (45 min)
Preeclampsia, Eclampsia, and HELLP Syndrome for Certified Emergency Nursing (CEN)
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Pregnancy Labs
Premature Rupture of the Membranes (PROM)
Preterm Labor
Preterm Labor for Certified Emergency Nursing (CEN)
Probable Signs of Pregnancy Nursing Mnemonic (CHOP BUGS)
Prostaglandins in Pregnancy
Rh Immune Globulin (Rhogam)
Rh Immune Globulin in Pregnancy
Threatened/Spontaneous Abortion for Certified Emergency Nursing (CEN)