A nurse receives a call from a parent concerned their toddler ingested half of a bottle of ferrous sulfate vitamins.  What should the nurse instruct the parent to do? 

Choice A rationale

Urinary frequency is not a typical symptom of mastitis. This symptom is more commonly associated with urinary tract infections or a normal postpartum physiological response due to the increased diuresis that occurs as the body eliminates excess fluid from pregnancy.

Choice B rationale

Flu-like symptoms such as fever, chills, malaise, and myalgia are systemic inflammatory responses often accompanying mastitis. These symptoms are caused by the body's release of cytokines in response to the bacterial infection, leading to a widespread systemic reaction.

Choice C rationale

Unilateral breast tenderness is a classic localized sign of mastitis, indicating inflammation and infection within the affected breast tissue. This localized pain is a direct result of tissue damage and the inflammatory cascade triggered by bacterial proliferation.

Choice D rationale

Unilateral breast erythema, or redness, is a cardinal sign of inflammation and infection in mastitis. This symptom is caused by vasodilation of local blood vessels and increased blood flow to the infected area, a key component of the inflammatory response.

Choice E rationale

Uterine tenderness is not a symptom of mastitis. Uterine tenderness, particularly with foul-smelling lochia and fever, is indicative of a postpartum uterine infection, such as endometritis, which is a different clinical condition affecting the reproductive tract.

Choice F rationale

Bilateral breast firmness is not a typical symptom of mastitis. This finding is more consistent with bilateral breast engorgement, which is a physiological process characterized by venous and lymphatic stasis, and not a localized bacterial infection.

Choice A rationale

A saturated perineal pad within 15 minutes suggests a significant hemorrhage. The most common cause of postpartum hemorrhage is uterine atony, a lack of uterine muscle tone. Assessing the fundus first allows the nurse to determine if the uterus is firm or boggy, a key indicator of atony, and to perform a fundal massage if needed to stimulate contractions and reduce bleeding.

Choice B rationale

While an IV infusion may be necessary to restore blood volume, initiating it is not the first action. The nurse must first determine the cause of the bleeding. The fundus assessment provides critical diagnostic information and an immediate opportunity for intervention (massage) that could resolve the bleeding before initiating a fluid resuscitation.

Choice C rationale

Assessing vital signs is important but should not be the first action. In a situation of heavy bleeding, the priority is to identify and address the source of the hemorrhage. A fundal assessment provides this information immediately. Vital signs will change in response to blood loss, but the fundal assessment provides the most direct and immediate action to stop the bleeding.

Choice D rationale

The health care provider must be notified, but this action is not the first step. The nurse must first gather essential assessment data, such as the condition of the fundus, and initiate immediate interventions like a fundal massage if indicated. Notifying the provider without this information will delay appropriate care.