Practice Question
A nurse caring for a client who postpartum and has mastitiex.
Answer Choices:
Rationale:
Hgb 12 g/dL → Unrelated to diagnosis
🔷Mastitis is an infectious/inflammatory process of the breast parenchyma and does not directly alter hemoglobin unless there is independent blood loss.
🔷A value of 12 g/dL is within the expected postpartum range and shows no signal of hemorrhage or anemia that would change the mastitis plan.
🔷Trends in Hgb are not used to gauge response to breast infection therapy; clinical signs (pain, erythema, fever) and WBC trend are more informative.
🔷Therefore, this lab is clinically neutral for judging improvement or deterioration of mastitis.
Client reports decreased level of pain → Sign of potential improvement
🔷Pain/tenderness correlate with local inflammation; a subjective drop in pain after antibiotics, effective milk removal, and anti‑inflammatories suggests declining inflammatory burden.
🔷Improvement in pain often parallels softening of the affected quadrant, less induration/erythema, and better milk flow, indicating resolution of ductal stasis.
🔷Symptom relief within 24–48 hr is the expected trajectory in uncomplicated mastitis.
🔷Thus, reduced pain is a favorable clinical trend consistent with treatment response.
Temperature 38.4 °C (101.1 °F) → Sign of potential worsening condition
🔷Persistent fever ≥38.0 °C beyond 24 hr of appropriate therapy raises concern for ongoing infection or evolving breast abscess.
🔷Although the temperature declined from 38.9 → 38.4 °C, it remains above the threshold, which is not the expected rapid defervescence of straightforward mastitis.
🔷Continued fever warrants reassessment for drug‑resistant organisms (e.g., MRSA), improper milk drainage, or localized collection needing imaging/drainage.
🔷Result: this finding signals insufficient control and the need to escalate evaluation.
WBC count 35,000/mm³ → Sign of potential worsening condition
🔷Postpartum leukocytosis can be physiologic, but is typically ≤20–25K; a rise from 28K → 35K indicates an amplifying systemic inflammatory response.
🔷When coupled with persistent fever, such leukocytosis suggests progressing infection rather than resolution.
🔷Elevated WBC at this level increases concern for bacteremia or abscess formation and justifies broader coverage and/or diagnostic imaging.
🔷Therefore, this trend is a clear deterioration marker.
Purulent nipple discharge → Sign of potential worsening condition
🔷Purulence denotes active bacterial infection within the ducts and raises suspicion for a localized abscess—a complication of mastitis.
🔷This is not expected with improvement; instead, it indicates ongoing suppuration that often requires culture, ultrasound, and possibly incision/needle drainage plus adjusted antibiotics.
🔷Presence of purulent drainage also heightens infection control/feeding considerations (e.g., avoid infant contact with drainage; continue milk removal safely).
🔷Hence, it is a red‑flag progression finding.
Moderate lochia rubra → Unrelated to diagnosis
🔷On postpartum day 3–4, lochia rubra of moderate amount remains physiologically normal and reflects uterine involution, not breast infection status.
🔷Mastitis does not alter the lochia pattern, so changes here neither confirm nor refute treatment response.
🔷Monitoring lochia remains important for postpartum care, but it is independent of the mastitis clinical course.
🔷Thus, this finding is not linked to improvement or worsening of mastitis.
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This question is from RN Maternal Newborn 2023 Exam which contains 69 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: ATI Exam(s)
- Domain: RN ATI Maternal & Newborn Care
- Answer Choices: 0