Question

Case Studies Essentials of Maternity, Newborn, and Women's Health Nursing Chapter 22: 2. Alyssa, age 26, had a cesarean delivery 7 days ago and is breast-feeding her baby. She calls the office today and reports that she has a temperature of 102. (Learning Objective 5)

 1. Given the limited information you have, describe the four most likely types of infection Alyssa may have contracted.

 2. What additional questions do you want to ask her to try to ascertain the cause of her fever?

 3. Describe the care required to treat each of these infections. Not answered yet.

Answer 1

1 The possible infections that Alyssa may have contracted might be

• Cystititis.
• Infection of the reproductive organs that occur within 28 days days of delivery.
• Thrombophlebitis
• Mastitis

2 I would like to ask her

• Whether she had burning pain during urination and lower abdomen pain.
• Whether her vaginal dischrge has a fleshy odour similar to a menstrual period.
• Whether she is having localized heat and swelling on the breast
• Whether she is having pain,stiffness and swelling of affected leg.

3 Cystitis

• Encourage frequent and complete emptying of bladder.
• Encourage fluids to 3000ml/day.
• Administer antibiotics as prescribed.
• Instruct the client in the methods of prevention and treatment of cystitis.

Infection

• Monitor vital signs
• keep the client warm and chilled.
• Isolate the client from the infant only if the client can infect the child.
• Provide nutritious,high calorie ,high protein diet.
• Encourage fluids to 3000 to 4000 ml/day if not contrindicated.

Mastitis

• Instruct the client in good handwashing and breast hygiene techniques.
• Promote comfort.
• Apply heat or cold to the site as prescribed.
• Maintain lactation in breast-feeding mothers.
• Encourage the client to wear supportive bra.

Thrombophlebitis.

• Specific therapies may depend on the location of thrombophlebitis.
• Maintain bedrest.
• Elevate affected leg.
• Never massage the leg.
• Monitor for manifestations of pulmonary embolism