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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Concepts Covered:

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

Study Plan Lessons

Alpha-fetoprotein (AFP) Lab Values
Antepartum Testing
Stages of Fetal Development Nursing Mnemonic (Proficiently Expanding Fetus)
What the Heck is Antepartum Testing? – Live Tutoring Archive
Antepartum Testing Case Study (45 min)
Babies by Term
Blood Cultures
Blood Glucose Monitoring
Body System Assessments
Clindamycin (Cleocin) Nursing Considerations
Congestive Heart Failure (CHF) Labs
Disseminated Intravascular Coagulation (DIC)
Eye Prophylaxis for Newborn (Erythromycin)
Eye Prophylaxis for Newborn
Erythroblastosis Fetalis
Fetal Development
Fetal Distress Interventions Nursing Mnemonic (Stop MOAN)
Fetal Environment
Fetal Heart Monitoring (FHM)
Fetal Heart Monitoring Like A Pro – Live Tutoring Archive
Fetal Heart Monitoring Like A Pro 2 – Live Tutoring Archive
Gestational Diabetes (GDM)
Gestational Diabetes and Why YOU Should Know About It – Live Tutoring Archive
Gestational HTN (Hypertension)
Glucagon Lab Values
Glucose Tolerance Test (GTT) Lab Values
Gravidity and Parity (G&Ps, GTPAL)
HELLP Syndrome
HELLP Syndrome – Signs and Symptoms Nursing Mnemonic (HELLP)
Hemoglobin A1c (HbA1C)
Isotonic Solutions (IV solutions)
Labor Progression Case Study (45 min)
Leopold Maneuvers
Magnesium Sulfate
Magnesium Sulfate (MgSO4) Nursing Considerations
Magnesium Sulfate in Pregnancy
Mastitis
Maternal Risk Factors
Mechanisms of Labor
Meds for Postpartum Hemorrhage (PPH)
Meds for PPH (postpartum hemorrhage)
Methylergonovine (Methergine) Nursing Considerations
Newborn Physical Exam
Newborn Reflexes
Nifedipine (Procardia) Nursing Considerations
Nursing Care Plan (NCP) for Abruptio Placentae / Placental abruption
Nursing Care Plan (NCP) for Chorioamnionitis
Nursing Care Plan (NCP) for Diabetes Mellitus (DM)
Nursing Care Plan (NCP) for Dystocia
Nursing Care Plan (NCP) for Maternal-Fetal Dyad Using GTPAL
Nursing Care Plan (NCP) for Meconium Aspiration
Nursing Care Plan (NCP) for Newborns
Nursing Care Plan (NCP) for Placenta Previa
Nursing Care Plan (NCP) for Preterm Labor / Premature Labor
Nursing Care Plan (NCP) for Process of Labor
Nursing Care Plan (NCP) for Transient Tachypnea of Newborn
Nursing Care Plan for (NCP) Fetal Alcohol Syndrome (FAS)
Nursing Care Plan for Newborn Reflexes
Nursing Case Study for Maternal Newborn
Nutrition Assessments
Nutrition in Pregnancy
Nutritional Requirements
OB (Labor) Nurse Report to OB (Postpartum) Nurses
OB Non-Stress Test Results Nursing Mnemonic (NNN)
OB Pharm and What Drugs You HAVE to Know – Live Tutoring Archive
Obstetrical Procedures
Opioid Analgesics in Pregnancy
Pediatric Vital Signs (VS)
Physiological Changes
Possible Infections During Pregnancy Nursing Mnemonic (TORCH)
Postpartum Discomforts
Postpartum Hematoma
Postpartum Hemorrhage (PPH)
Postpartum Interventions
Postpartum Physiological Maternal Changes
Postpartum Thrombophlebitis
Precipitous Labor
Preeclampsia (45 min)
Preeclampsia, Eclampsia, and HELLP Syndrome for Certified Emergency Nursing (CEN)
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Preload and Afterload
Premature Rupture of the Membranes (PROM)
Preterm Labor
Probable Signs of Pregnancy Nursing Mnemonic (CHOP BUGS)
Process of Labor – Baby Nursing Mnemonic (ALPPPS)
Process of Labor – Mom Nursing Mnemonic (4 P’s)
Process of Labor 2 – Live Tutoring Archive
Prolapsed Umbilical Cord
Promethazine (Phenergan) Nursing Considerations
Prostaglandins
Prostaglandins in Pregnancy
Protein (PROT) Lab Values
Retinopathy of Prematurity (ROP)
Signs of Pregnancy (Presumptive, Probable, Positive)
Stages of Fetal Development Nursing Mnemonic (Proficiently Expanding Fetus)
Subinvolution
Terbutaline (Brethine) Nursing Considerations
Tocolytics
Tocolytics
Umbilical Cord Vasculature Nursing Mnemonic (2A1V)
Uterine Stimulants (Oxytocin, Pitocin)
Uterine Stimulants (Oxytocin, Pitocin) Nursing Considerations
VEAL CHOP Nursing Mnemonic (Fetal Accelerations and Decelerations) (VEAL CHOP)