Nokea
A female client is diagnosed with breast abscess. She would like to continue to breast-feed her newborn. Which action by the nurse would be most appropriate in this situation?
- A. Encourage the client to include a client content in the diet.
- B. Instruct the client to wear a tight-fitting bra.
- C. Reduce the frequency of removing and reapplying the dressings.
- D. Assist the client to pump the breasts to remove breast milk.
Correct Answer: D
Rationale: The nurse should help the client pump the breasts and remove breast milk to prevent engorgement. Because the client has decided to continue breast-feeding, the client should wear a loose-fitting bra. Including protein content in the diet would be correlated to the client's current situation. Frequency of dressing changes does not play a role in the intervention.
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The lactation nurse is caring for a mother who is 2 weeks postpartum and has mastitis. Which statement, made by the client, requires instruction and is the probable cause of the mastitis?
- A. I feed the baby every 2 hours.
- B. I break the baby's such before pulling the baby off of the breast.
- C. I nurse the baby on one breast each feeding.
- D. I use a lanolin ointment on my dry nipples.
Correct Answer: C
Rationale: Because the client has mastitis, emptying each breast with alternate feedings is important. The baby's such is strongest at the beginning of the feeding, thus, the mother should alternate the breast that the baby starts nursing from. If not, one breast would not be drained of the milk.
The nurse is obtaining a history from a client who states recurrent breast tenderness. The client inquiries if there is something wrong with her breasts. Which question by the nurse is a priority?
- A. Do you have a history of breast disorders and cancer in the family?
- B. Does the tenderness occur around the same time each month?
- C. Have you pulled a muscle or had any injury to the breast?
- D. When did you first recognize the symptoms?
Correct Answer: B
Rationale: The breasts are part of the female reproductive system, and they respond to the hormonal cycle associated with ovulation, menstruation, and pregnancy. Because the hormonal cycle is monthly, it is best to ask the client if the tenderness occurs at the same time each month. The other options are also important questions to ask.
A client complains of having tender and painful breasts, often feeling multiple jumps within the breast tissue. The nurse would need to gather additional information about which of the following?
- A. Alcohol and caffeine consumption
- B. Client's workplace in relation to the surroundings
- C. Timing of symptoms in relation to the menstrual cycle
- D. Bathing frequency and living surroundings
Correct Answer: C
Rationale: Considering that the client has tender and painful breasts and often feels lumps within her breast tissue, it is most likely that she suffers from fibrocystic breast disease. To confirm these findings, the nurse should ask relevant questions about the characteristics and timing of symptoms in relation to the menstrual cycle. Symptoms of fibrocystic breast disease are noticeable before menstruation and usually state during menstruation. The size of one cyst becomes larger before menstruation and often changes with the menstrual cycle. The nurse should further ask the client about her habits of smoking and consuming coffee, chocolate, and caffeinated soft drinks, not alcohol, because they aggravate the condition. Workplace surroundings or cleanliness habits do not matter because fibrocystic breast disease is not infectious.
The nurse is providing care to a client who has had surgery as treatment for breast cancer. The nurse would be alert for the development of which condition?
- A. Lymphedema
- B. Fibrocystic breast disease
- C. Fibroadenom
- D. Breast abscess
Correct Answer: A
Rationale: Lymphedema occurs in some women after breast cancer surgery. It causes disfigurement and increases the lifetime potential for infection and poor healing. Fibrocystic breast disease and fibroadenom are two benign breast conditions that occur usually in premenopausal woman. Breast abscess is the infectious and inflammatory breast condition that is common among breast-feeding mothers.
A client is scheduled to undergo a procedure to lift breasts that have drooped because of significant weight loss. The nurse identifies this procedure as which of the following?
- A. Reduction mammoplasty
- B. Mastopexy
- C. Autogenous breast reconstruction
- D. Mastectomy
Correct Answer: B
Rationale: A mastopexy is a procedure that involves lifting a breast. This procedure is similar to a reduction mammoplasty (removal of glandular breast tissue, fat, and skin bilaterally to decrease the size of large pendulous breasts), although the incision and scar line are smaller and the recovery time is shorter. Autogenous breast reconstruction involves the harvesting of the client's tissue from the rectus abdominis muscle to create a new breast. A mastectomy is a removal of a breast.