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The nurse is assessing a client who is 2 weeks postpartum.
The nurse would be concerned about mastitis if which of the following were noted? Select all that apply.

Urinary frequency.

Flu-like symptoms.

Unilateral breast tenderness.

Unilateral breast erythema.

Uterine tenderness.

Bilateral breast firmness.

Answer and Explanation

Correct Answer : B,C,D

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.

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Correct Answer is C

Explanation

Choice A rationale

Increasing weight loss is an incorrect characteristic. Nephrotic syndrome is marked by massive proteinuria, which leads to a decrease in plasma oncotic pressure. This fluid shift from the intravascular space to the interstitial space results in significant fluid retention, causing weight gain and edema, not weight loss. The body holds onto fluid, masking any potential muscle or fat wasting.

Choice B rationale

Increased urinary output is not a characteristic of nephrotic syndrome. The condition is associated with severe fluid retention and decreased plasma volume, leading to oliguria, or a decreased urinary output. The kidneys are not effectively filtering protein and fluid is being retained in the body, which directly reduces the amount of fluid that can be excreted as urine.

Choice C rationale

Generalized edema is the most common and striking characteristic of nephrotic syndrome. The massive loss of protein, particularly albumin, in the urine leads to a significant decrease in serum albumin levels. Albumin is crucial for maintaining plasma oncotic pressure. The resulting decrease in oncotic pressure causes fluid to shift from the bloodstream into the interstitial spaces, resulting in widespread or anasarca edema.

Choice D rationale

While hypertension can occur, it is not the most common characteristic associated with nephrotic syndrome. The primary physiological change is the massive proteinuria leading to hypoproteinemia and subsequent edema. Hypertension may develop as a result of volume overload, but it is not a hallmark sign. The most prominent and defining symptom is the severe edema.

A. A client with a localized area of breast tenderness. B. A 4-hour post-op cesarean section client reporting a pain scale score of 3/10. C. A client with a moderate amount of dark red lochia. D. A client with uterine tenderness, foul-smelling lochia, and a new temperature of 102 degrees

Correct Answer is D

Explanation

Choice A rationale

A localized area of breast tenderness is a potential sign of mastitis, which, while requiring attention, is not an immediate life-threatening condition. The client can be seen after more acute priorities, as mastitis typically develops over days.

Choice B rationale

A pain score of 3/10 in a 4-hour post-op client is an expected finding and can be addressed after more critical clients. This level of pain is not indicative of an acute, unstable physiological state that requires immediate intervention.

Choice C rationale

Moderate, dark red lochia is a normal finding 4 hours postpartum. The lochia is a mixture of blood, tissue, and mucus, and its color and amount are expected to change over time without indicating an immediate danger to the client.

Choice D rationale

Uterine tenderness, foul-smelling lochia, and a new temperature of 102 degrees F are classic signs of postpartum endometritis, a serious uterine infection. This presents a high risk for sepsis and septic shock, making it the highest priority for immediate assessment and intervention. .

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The nurse is assessing a client who is 2 weeks postpartum. The nurse would be concerned about mastitis if which of the following were noted? Select all that apply.

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The nurse is assessing a client who is 2 weeks postpartum.
The nurse would be concerned about mastitis if which of the following were noted? Select all that apply.