Which of the following is done for management of acute mastitis?

I. Continue breastfeeding or frequent emptying of the breast.
II. Administer appropriate antibiotics and analgesics as prescribed.
III. Apply warm compresses before feeding and cold compresses after feeding.

Appeared in: KPSC Staff Nurse - 2021

Explanation

The management of acute mastitis involves a combined approach to address infection, milk stasis, and symptoms.
Continuing to breastfeed or otherwise empty the breast is the cornerstone of treatment to prevent milk stasis and the formation of a breast abscess.
Antibiotics are essential to treat the underlying bacterial infection (commonly Staphylococcus aureus), and analgesics provide symptomatic relief from pain and fever.
Supportive measures like applying warm compresses before feeding to aid milk flow and cold compresses after feeding to reduce inflammation and pain are standard practice.

Option A: This option is incomplete. While continuing to empty the breast and using compresses are correct, it omits the essential use of antibiotics to treat the infection and analgesics for pain and fever.
Option B: This option is incomplete. It correctly includes breast emptying and medications but omits the supportive comfort measures like warm and cold compresses, which help manage symptoms and facilitate milk removal.
Option C: This option is critically incorrect because it omits the most important intervention: continuing to empty the breast. Failure to remove milk from the affected breast significantly increases the risk of the condition worsening and developing into a breast abscess.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Management of Acute Mastitis as background academic context rather than a clinical decision trigger.
Nurses play a vital role in educating and supporting mothers with mastitis, emphasizing the importance of not stopping breastfeeding from the affected side, as this is a common misconception that can lead to worsening infection.
Failure to completely empty the breast and/or not completing the full course of antibiotics are major risk factors for the development of a breast abscess, a serious complication requiring drainage.
What if? If a mother with mastitis develops a palpable, fluctuant mass and her fever persists despite 48 hours of antibiotics, a breast abscess should be suspected. The next step would be an ultrasound for diagnosis, followed by needle aspiration or incision and drainage, along with continued antibiotic therapy.

How to Approach the Question

This is a multiple-component question where you must evaluate the correctness of several statements.
First, read the question stem to identify the core topic: management of acute mastitis.
Evaluate each Roman numeral statement (I, II, III) individually based on your knowledge of postpartum complications and their management.
Statement I: Is continuing breastfeeding correct for mastitis? Yes, this is crucial to prevent milk stasis.
Statement II: Are antibiotics and analgesics used? Yes, mastitis is an infection that causes pain and fever.
Statement III: Are warm and cold compresses used? Yes, these are standard comfort measures to aid milk flow and reduce swelling.

Concept Tested & Keywords

QeeXYsa-coaWr3f3J6a4rL

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 456-458

E6 Obstetrics Williams p. 68-92

Practise the full KPSC Staff Nurse - 2021

Attempt every question from this paper in a timed mock, then review the full solution for each one.