Nursing Diagnosis and Care Plan for Mastitis

Mastitis, an inflammation of breast tissue that may or may not involve infection, is a common condition, particularly affecting lactating women. Often stemming from a plugged milk duct, mastitis can cause significant discomfort and concern for new mothers. This guide provides a comprehensive nursing care plan for mastitis, outlining key assessments, interventions, and desired outcomes to effectively manage this condition and support breastfeeding mothers.

Understanding Mastitis: Pathophysiology

Mastitis typically occurs in breastfeeding women due to ineffective milk removal, leading to milk stasis in the breast ducts. This milk stasis can be caused by infrequent feedings, poor latch, or blocked milk ducts from tight clothing or pressure. While inflammation is the primary component of mastitis, infection can develop when bacteria, often from the baby’s mouth or the mother’s skin, enter the breast tissue through cracked nipples or milk ducts. Understanding this pathophysiology is crucial for effective nursing interventions and patient education.

Subjective and Objective Data in Mastitis

Nurses play a vital role in assessing and identifying mastitis through both subjective and objective data collection.

Subjective Data:

Fatigue: Patients often report feeling unusually tired or exhausted.
Unilateral Breast Pain and Tenderness: Pain is typically localized to one breast and described as aching, burning, or throbbing. Tenderness to touch is also a common complaint.
Burning Sensation During Breastfeeding: Pain may intensify during breastfeeding due to milk let-down and nipple stimulation.
General Malaise: A general feeling of being unwell, including body aches and discomfort.

Objective Data:

Redness and Swelling: Inflammation manifests as visible redness and swelling, typically in a wedge-shaped area of the affected breast.
Fever: Elevated body temperature is a common sign, indicating a systemic inflammatory response, especially if infection is present.
Chills: Shivering or chills may accompany fever.
Breast Warmth: The affected area of the breast will feel warmer to the touch compared to surrounding tissue.

Nursing Diagnoses for Mastitis

Based on the subjective and objective data, relevant nursing diagnoses for a patient with mastitis may include:

Pain related to breast inflammation as evidenced by patient report of unilateral breast pain and tenderness, and objective findings of redness, swelling, and warmth to touch.
Hyperthermia related to inflammatory process or infection as evidenced by elevated body temperature and chills.
Impaired Comfort related to mastitis symptoms as evidenced by patient report of fatigue and general malaise.
Interrupted Breastfeeding related to breast pain and discomfort as evidenced by patient report of burning sensation during breastfeeding.
Risk for Infection related to cracked nipples and milk stasis (if applicable).
Deficient Knowledge related to mastitis management and breastfeeding techniques as evidenced by the need for lactation education.

Nursing Interventions and Care Plan for Mastitis

The nursing care plan for mastitis focuses on alleviating symptoms, preventing complications, and supporting continued breastfeeding.

1. Assess Vital Signs:

Intervention: Monitor temperature, pulse, respiration, and blood pressure regularly.
Rationale: To detect systemic infection indicated by fever, tachycardia, or changes in blood pressure. Vital signs provide a baseline and track the patient’s response to treatment.

2. Conduct a Thorough Breast Exam:

Intervention: Assess both breasts, noting the location, size, and characteristics of redness, swelling, and tenderness. Palpate for lumps or areas of induration. Examine nipples for cracks or fissures.
Rationale: To establish a baseline assessment of the mastitis and monitor for changes. Assessing nipple integrity helps identify potential entry points for infection. Monitoring for lumps is important to differentiate mastitis from other breast conditions.

3. Encourage Hydration:

Intervention: Advise the patient to increase fluid intake, especially water.
Rationale: Adequate hydration supports overall health and milk production. It also helps to maintain milk flow and prevent milk stasis.

4. Apply Warm and Cold Compresses:

Intervention: Recommend warm compresses before breastfeeding and cold compresses after breastfeeding or milk expression.
Rationale: Warm compresses before feeding aid in milk duct dilation and milk flow, facilitating breast emptying. Cold compresses after feeding help reduce pain, swelling, and inflammation by constricting blood vessels and numbing nerve endings.

5. Administer Medications as Prescribed:

Intervention: Administer analgesics such as ibuprofen or acetaminophen for pain and inflammation as ordered. Administer antibiotics if prescribed for bacterial infection.
Rationale: Analgesics provide symptomatic relief from pain and reduce inflammation. Antibiotics are necessary to treat bacterial infections associated with mastitis and prevent complications like abscess formation.

6. Provide Lactation Education and Support:

Intervention: Observe breastfeeding technique, including positioning and latch. Educate on proper latch techniques, frequent and effective breast emptying, alternating breasts during feedings, and different breastfeeding positions. Encourage manual milk expression after feedings if needed. Consult with a lactation consultant as necessary.
Rationale: Proper breastfeeding techniques are crucial for preventing milk stasis and ensuring effective breast emptying. Addressing latch issues and providing support can improve breastfeeding comfort and success. Lactation consultants offer specialized expertise in breastfeeding management.

Desired Outcomes

Following the nursing care plan, the patient should achieve the following outcomes:

Pain Reduction: Patient reports decreased breast pain and tenderness.
Reduced Inflammation: Objective findings of decreased redness, swelling, and breast warmth.
Afebrile: Patient maintains a normal body temperature without chills.
Maintains Effective Breastfeeding: Patient successfully continues breastfeeding with improved comfort and milk flow.
Absence of Infection: Patient exhibits no signs of worsening infection or abscess development.
Patient Education: Patient demonstrates understanding of mastitis management, breastfeeding techniques, and preventive measures.

Key Points to Remember

Mastitis is a treatable condition, and with prompt and appropriate nursing care, women can effectively manage symptoms and continue breastfeeding. Early recognition, patient education, and supportive interventions are essential to positive outcomes. Emphasize the importance of continued breastfeeding or milk expression, even with mastitis, as it is crucial for clearing the infection and preventing recurrence. Encourage mothers to seek support from healthcare providers and lactation consultants to ensure successful breastfeeding journey.