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: Documented increases in maternal age is a likely cause for SMM; older women have increased risk. Obesity is a general health risk in the United States; prepregnancy obesity causes increased incidences of SMM. Cesarean deliveries are increasing, and surgical procedures always carry a risk for complications. Preexisting chronic medical conditions are a contributor to the increasing rates of SMM.

Correct Answer: C

Rationale: Research from Dennis and Dowswell (2013) reveals that psychosocial and psychological interventions significantly reduce the number of women who develop postpartum depression. Beneficial interventions include telephone-based peer support, interpersonal psychotherapy, and professionally based postpartum home visits.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) postpartum endometritis. Postpartum endometritis is an infection of the endometrial lining of the uterus that typically occurs after childbirth. It is often caused by ascending genital tract infections, including sexually transmitted infections (STIs) and chorioamnionitis. Option A, mastitis, is incorrect as it is an infection of the breast tissue, not the uterus. Option B, pneumonia, is a respiratory infection and not typically associated with postpartum complications. Option C, cesarean wound infection, is more localized to the surgical site and does not involve the uterine lining. Understanding postpartum complications, especially infections like endometritis, is crucial for healthcare providers working with postpartum individuals. Recognizing the signs and symptoms of these infections is vital for prompt diagnosis and treatment to prevent serious complications such as sepsis. Educating healthcare professionals on the risk factors, causes, and appropriate management of postpartum infections is essential in providing quality care to postpartum individuals and improving maternal health outcomes.

Correct Answer: D

Rationale: In postpartum complications, an assessment finding suggesting a possible infection is an elevated white blood cell count (WBCs 10,000). This is because an increased WBC count is a typical response of the body to an infection, indicating the presence of an inflammatory process. Option A, painful fundal massage, is more indicative of uterine atony or retained placental fragments rather than infection. Option B, breast-feeding every 2–3 hours, is a normal postpartum activity and does not specifically suggest infection. Option C, a pulse rate of 72, falls within the normal range and does not directly point towards infection. Educationally, understanding the significance of various assessment findings postpartum is crucial for nurses and healthcare providers to detect and manage complications promptly. Recognizing the importance of interpreting lab values like WBC count can lead to early identification and treatment of infections, ultimately improving patient outcomes.

Correct Answer: A

Rationale: In the case of mastitis, which is an infection of the breast tissue that commonly occurs in breastfeeding individuals, the correct nursing intervention of providing antipyretics (Option A) is crucial. Antipyretics help to reduce fever, which is a common symptom of mastitis. By managing the fever, the person's overall comfort and well-being can be improved, and the body's ability to fight the infection can be supported. Option B, stopping antibiotics when redness is resolved, is incorrect because antibiotics should be completed as prescribed to ensure that the infection is fully treated and to prevent recurrence or development of antibiotic-resistant strains. Stopping antibiotics prematurely can lead to treatment failure and potential complications. Encouraging the person to stop breastfeeding (Option C) is also incorrect. Continuing breastfeeding on the affected breast is actually recommended as it helps to drain the breast and promote healing. Ceasing breastfeeding abruptly can lead to engorgement, worsening of symptoms, and potential complications like abscess formation. Starting an IV and preparing for signs of sepsis (Option D) is not the initial nursing intervention for mastitis. While monitoring for signs of sepsis is important in severe cases, it is not the first-line intervention. Prompt administration of antipyretics, continuation of antibiotics, promoting breastfeeding, and providing supportive care are typically the primary nursing interventions for mastitis. Educationally, understanding the appropriate nursing interventions for mastitis is essential for providing effective care to individuals experiencing this condition. It is important for nurses to be knowledgeable about the management of mastitis to promote optimal outcomes for both the individual and their infant.