A nurse is caring for a postpartum client who is breastfeeding and has been diagnosed with mastitis of the right breast. Which of the following instructions should the nurse include in client teaching? Select all that apply.

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11ecbb05_cc25_4e1e_b433_816b7b4da36e_MD0009_00 Lactational mastitis (infection and inflammation of breast tissue) may result from inadequate milk duct drainage or poor breastfeeding technique. Bacteria from the infant's nasopharynx or mother's skin can enter the nipple, especially if it is damaged, and multiply in stagnant milk. Manifestations include fever, muscle aches, and breast pain and inflammation (eg, warmth, redness, edema). Staphylococcus aureus is the most common causative organism and requires antibiotic treatment (eg, dicloxacillin, cephalexin). In addition, the nurse should encourage the client to: Continue breastfeeding frequently (ie, every 2-3 hr) to ensure adequate milk drainage. Ensure proper breastfeeding technique (eg, alternate newborn feeding positions, proper latch). Apply warm compresses and massage the breast to facilitate complete emptying (Option A). Cool compresses can also be used between breastfeeding as needed for comfort. Ensure adequate rest, nutrition, and hydration (Option C). Relieve pain and inflammation with analgesics compatible with breastfeeding (eg, acetaminophen, ibuprofen) (Option D). Wash hands before and after feeding. (Option B) The milk is safe because the newborn is already colonized with maternal microorganisms. Giving pumped or hand-expressed breast milk is acceptable, although direct breastfeeding is preferred because milk ducts are most efficiently drained with this method. (Option E) Underwire or tight bras are not recommended because milk flow is impeded, which worsens engorgement. Soft, supportive bras encourage milk flow. Educational objective: Treatment for lactational mastitis includes antibiotic therapy, continued breastfeeding, breastfeeding support (eg, proper latch technique), warm compresses, massage, adequate nutrition and hydration, and appropriate analgesics (eg, ibuprofen, acetaminophen).

A Nurse Is Caring for a Postpartum Client Who Is