a.Refer to the ‘Clinicians Practice Guide to the Mental Health

1300 28-year-old female, 8 days postpartum, reporting feeling “achy all over” and a continuous burning sensation in left breast for past day. Further reports having chills and shivering last night. Gravida 2 para 2. Pregnancy was uneventful. Infant was born by vaginal delivery at 39 weeks. Client has a son, 2 years of age, at home whom she attempted to nurse for three weeks but quit because of severely sore nipples. Client desires to stop nursing this child. The couple did not attend breastfeeding classes. During the last 24 hours, the client nursed every 2.5 hours, switching breasts every 10 minutes. Feedings take 20 to 30 minutes. Breast examination revealed moderately engorged breasts. Nipples are everted, 1 cm in size. A hard, tender lump noted from 1 to 3 o’clock on the left breast. Erythema and heat noted over area. Areolae 3.5 cm moist and intact. BP 112/74, HR 96, RR 16, T 100.40F (38C)

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