A patient who is still breast-feeding her infant has arrived at ...

[dmcintosh]

A patient who is still breast-feeding her infant has arrived at the clinic complaining of sore breasts. The physician has diagnosed mastitis. Which of the following statements made by the patient will require correction by the nurse?
 
  A)
  They tell me this is usually caused by a Staph infection.
  B)
  I need to make sure to wash my hands thoroughly before touching my breasts.
  C)
  I need to stop breast-feeding until all my antibiotics have been taken.
  D)
  A clogged duct in my breast has become clogged.

Question 2

A 55-year-old male has presented to the emergency department because he is alarmed at the genitourinary symptoms he has experienced over the last several days.
 
  He reveals that he has had a number of new sexual relationships during a tropical vacation that ended 5 days ago. Over the last several days, he has had increasing pain in his urethra and a creamy yellow discharge from his penis. For the last 2 days, the discharge has been occasionally blood tinged. What differential diagnosis would be the care team's first priority?
  A)
  Chancroid
  B)
  Syphilis
  C)
  Chlamydia
  D)
  Gonorrhea

[bobsmith]

Answer to Question 1

Ans:
C

Feedback:

Mastitis is inflammation of the breast. It most frequently occurs during lactation but also can result from other conditions. In the lactating woman, inflammation results from an ascending infection that travels from the nipple to the ductile structures. The most common organism isolated is Staphylococcus. The offending organism originates from the suckling infant's nasopharynx or the mother's hands. Infection and inflammation cause obstruction of the ductile system. The breast becomes hard and, inflamed. It is advisable for the mother to continue breast-feeding during antibiotic therapy to prevent this.

Answer to Question 2

Ans:
D

Feedback:

The rapid onset and bloody penile discharge that the client cites are characteristics of gonorrhea. Neither the onset nor the symptomatology matches syphilis or chancroid, and Chlamydia typically takes longer to manifest and does not normally include bloody discharge.