A postpartum mother is diagnosed with mastitis.

Which of the following symptoms should the nurse identify as a common sign of mastitis?

Choice A rationale

Continuous milk leakage from both breasts, known as galactorrhea if not related to nursing, is generally not a specific or common sign of mastitis. Mastitis is an infection typically affecting only one breast and is characterized by localized inflammation, not bilateral, continuous milk secretion unrelated to feeding. Milk leakage is more commonly associated with an abundant milk supply or hormonal shifts.

Choice B rationale

Painful, swollen lymph nodes in the neck (cervical lymphadenopathy) are not typically the primary or characteristic symptom of mastitis. Mastitis is a localized breast infection, and associated lymphadenopathy is usually observed in the ipsilateral (same side) axilla, reflecting the regional lymphatic drainage of the infected breast tissue.

Choice C rationale

Severe pain in both breasts without any associated signs of redness or swelling is more suggestive of conditions like engorgement or possibly non-infectious inflammatory processes. Mastitis, being a bacterial infection, classically presents with localized pain, fever, and distinct signs of inflammation, specifically unilateral warmth, redness, and swelling (erythema and edema).

Choice D rationale

Mastitis is an inflammation of the breast tissue, often caused by a bacterial infection, and the classic signs reflect this inflammatory process. The symptoms include localized redness (erythema), swelling (edema), warmth, and systemic signs like fever (temperature usually >38.5°C or >101.3°F), chills, and body aches, usually confined to one breast.

Choice A rationale

A newborn should typically feed every 2 to 3 hours, or 8 to 12 times in a 24-hour period. Sleeping for 8 hours straight between feedings, especially in the early weeks, may indicate insufficient milk intake, especially if the baby has not regained birth weight, and should be reported to a healthcare provider.

Choice B rationale

Adequate output is the most reliable indicator of sufficient milk transfer and intake in the newborn. A baby who is content after most feedings and produces 6 to 8 wet diapers (urine should be pale/clear) and 3 to 4 loose, yellow stools in a 24-hour period by day 4 of life is generally receiving enough breast milk.

Choice C rationale

Newborns usually experience a normal physiologic weight loss, losing 5.

Choice D rationale

While feeding frequently is normal, only feeding every 3 to 4 hours may not be adequate for all newborns, especially in the first few weeks as the mother establishes her milk supply and the baby is learning to feed. Newborns should be fed on demand whenever they show feeding cues, which is often 8 to 12 times a day.