Exhibits

The nurse reviews the client's history and physical, the nurses' notes, and the flow sheet.

Select the findings that will help the nurse determine what is causing the client's symptoms.

A. Describe genetic testing protocols. Genetic testing is useful for identifying hereditary conditions, but it does not address the immediate health concerns of a pregnant client with opioid use disorder. Early prenatal care is more critical for monitoring fetal development and reducing complications associated with substance use.
B. Sign up for group therapy sessions. Group therapy can provide emotional support and coping strategies, but it is not the most immediate or essential step for ensuring a healthy pregnancy. While therapy is beneficial, comprehensive prenatal care should be prioritized to monitor fetal growth and manage opioid withdrawal safely.
C. Start a prenatal care plan as soon as possible. Early prenatal care is essential for monitoring the effects of methadone therapy on both the mother and fetus, ensuring appropriate fetal development, and managing potential complications such as neonatal abstinence syndrome (NAS). Prenatal visits will also provide guidance on nutrition, lifestyle modifications, and necessary medical interventions.
D. Discontinue the methadone right away. Abruptly stopping methadone can cause severe withdrawal symptoms in both the mother and fetus, increasing the risk of miscarriage, preterm labor, or stillbirth. Methadone maintenance therapy is the recommended treatment for opioid addiction during pregnancy, as it stabilizes maternal opioid levels and reduces harm to the fetus.

• Mastitis: Mastitis is an infection of breast tissue that occurs when milk stasis leads to bacterial overgrowth, usually caused by Staphylococcus aureus. The client's firm, red, warm area on the breast, fever (101.2°F), chills, body aches, and fatigue all strongly indicate mastitis rather than other breast conditions.
• Engorgement: Engorgement occurs when the breasts overfill with milk, leading to swelling and tenderness. However, engorgement typically affects both breasts, does not cause fever or flu-like symptoms, and resolves with regular breastfeeding or pumping.
• Blocked milk duct: A clogged duct occurs when milk flow is obstructed, leading to a tender lump in the breast. While a blocked duct can progress to mastitis, it does not cause fever or systemic symptoms unless infection develops. The presence of fever and flu-like symptoms in this client suggests mastitis, not just a blocked duct.
• Inflammatory breast cancer: This rare but aggressive form of breast cancer causes redness, swelling, and skin thickening, but it is not associated with fever or acute symptoms like mastitis. It does not develop suddenly but rather progresses over time, making mastitis the more likely diagnosis in this case.
• Abscess: If mastitis is not treated promptly, it can lead to a breast abscess, a localized collection of pus requiring drainage. Signs of progression to an abscess include fluctuant swelling, worsening pain, and persistent fever despite antibiotic treatment.
• Breastfeeding intolerance: Mastitis can cause temporary discomfort during breastfeeding, but it does not lead to true breastfeeding intolerance. In fact, continued breastfeeding helps resolve mastitis by improving milk drainage.
• Nipple thrush: Nipple thrush (Candida infection) causes burning pain and white patches in the infant’s mouth but is not a complication of mastitis, which is bacterial, not fungal.
• Postpartum haemorrhage: Postpartum hemorrhage is caused by uterine atony, retained placenta, or coagulation disorders, not mastitis. Mastitis is localized to the breast and does not affect uterine bleeding.