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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.
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The nurse is caring for a client following breast reconstruction surgery using autogenous tissue. When assessing wounds from the surgical procedure, in which area would the nurse assess the wound from which tissue was taken?
- A. The vastus lateralis
- B. The rectus femoris
- C. Gluteus maximus
- D. Rectus abdominis
Correct Answer: D
Rationale: The area in which tissue is taken for breast reconstruction surgery is from the rectus abdominis muscle in a manner similar to a 'tummy tuck.' The nurse must assess this site for healing or complications.
The nurse is caring for a client who will be having artificial implants for breast reconstruction. The client is arriving at the physician's office for which procedure to be completed before the surgery can be done?
- A. Incisional alignment
- B. Tissue expansion
- C. Fluid drainage
- D. Pain control
Correct Answer: B
Rationale: Before an implant for breast reconstruction can produce an optimum cosmetic appearance, the skin and tissue on the chest wall are expanded to provide a large enough space to fill and approximate the size of the remaining breast. The other options are not correct.
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.
A suspicious breast lump is noted on a mammogram. The client asks the nurse which diagnostic test confirms if the lump is cancerous or benign. Which response by the nurse is most correct?
- A. An ultrasound
- B. A biopsy
- C. A magnetic resonance imaging (MRI)
- D. A clinical breast exam
Correct Answer: B
Rationale: To confirm whether a breast lump is cancerous or benign, a tissue sample must be obtained to examine the cells. Although an ultrasound, MRI, and clinical breast exam provide data on the characteristics of the lump, only examining the tissue can specifically identify if and what type of cancer is present.
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.