The nurse is aware of concern about the increasing numbers of severe maternal morbidity (SMM). It is believed to be related to changes in the overall health of the population of women giving birth. Which reasons does the nurse identify as causes of SMM? Select all that apply.

Correct Answer: B

Rationale: The correct answer is B: Prepregnancy obesity. This is because obesity is a well-established risk factor for severe maternal morbidity. Obesity increases the likelihood of complications during pregnancy and childbirth, such as gestational diabetes, preeclampsia, and cesarean deliveries. A: Increases in maternal age may be a risk factor for certain complications but not directly related to SMM. C: Cesarean deliveries can be a risk factor for SMM, but it is not the main cause. D: Inability to pay for health care is a social determinant of health and may impact access to care, but it is not a direct cause of SMM.

Correct Answer: C

Rationale: The correct answer is C: Interpersonal psychotherapy. This is supported by research as an evidence-based intervention for reducing postpartum depression. It focuses on improving relationships and communication skills, which can help women cope with the challenges of motherhood. A: Telephone-based peer support may be helpful, but it is not specifically mentioned in the research by Dennis and Dowswell (2013) as a beneficial intervention. B: Partner report of symptoms can be useful in identifying postpartum depression, but it is not a recommended intervention according to the research. D: Teaching for self-recognition of problems is important, but it is not as effective as interpersonal psychotherapy in reducing postpartum depression according to the research.

Correct Answer: D

Rationale: The correct answer is D, postpartum endometritis. This infection is commonly caused by sexually transmitted infections (STIs) and chorioamnionitis. Endometritis is inflammation of the endometrium lining the uterus after childbirth. Mastitis (A) is a breast infection, pneumonia (B) is a lung infection, and cesarean wound infection (C) is an infection at the site of the cesarean incision. These options are incorrect as they do not specifically relate to the postpartum infection caused by STIs and chorioamnionitis.

Correct Answer: D

Rationale: The correct answer is D: WBCs 10,000. An elevated white blood cell count (WBC) is a common sign of infection as the body produces more WBCs to fight off pathogens. This increase in WBC count is known as leukocytosis and is a key indicator of an ongoing infection. In contrast, choices A, B, and C are not direct indicators of infection. A painful fundal massage may suggest uterine atony, breast-feeding every 2-3 hours is a normal part of postpartum care, and a pulse rate of 72 is within the normal range. Therefore, the most reliable assessment finding suggesting a possible infection is an elevated WBC count.

Correct Answer: A

Rationale: Correct Answer: A. Provide antipyretic. Rationale: 1. Mastitis is an inflammation of the breast tissue usually caused by infection. 2. Antipyretics help reduce fever, a common symptom of infection. 3. Providing antipyretics can help alleviate discomfort and promote healing. 4. Stopping antibiotics when redness is resolved (choice B) may lead to recurrence of infection. 5. Encouraging the person to stop breast-feeding (choice C) can negatively impact milk production and bonding. 6. Starting an IV and preparing for signs of sepsis (choice D) is an extreme measure not indicated unless sepsis is confirmed.