The nurse on a postpartum unit observes a patient who delivered 2 days ago. The nurse notices extreme agitation and depressed mood. The patient states, “I think that my baby is deformed inside and we have to fix him.” Which risk factor is most strongly related to possible postpartum psychosis (PPP)?

Correct Answer: B

Rationale: The correct answer is B) Personal history of bipolar disorder. Postpartum psychosis (PPP) is a severe form of postpartum mental illness that can manifest with symptoms such as extreme agitation, delusions, and hallucinations. Women with a personal history of bipolar disorder are at a significantly higher risk for developing PPP due to the underlying vulnerability to mood disturbances and psychotic symptoms. Option A) Separation from the baby’s father is not directly linked to PPP. While support from the baby's father can be beneficial, it is not a primary risk factor for PPP. Option C) Prolonged labor resulting in cesarean is a physical risk factor and is not strongly associated with the development of PPP. Option D) Loss of the first child from a heart defect is a traumatic event but is not as strongly related to PPP as a personal history of bipolar disorder, which directly affects the individual's mental health. Educationally, understanding the risk factors for postpartum complications like PPP is crucial for healthcare providers working in maternal health to identify and support women at risk. Proper screening, early intervention, and appropriate referral to mental health professionals are essential in managing postpartum mental health issues effectively.

Correct Answer: C

Rationale: Neonatal macrosomia, which can cause edema around the urethra, is a risk factor for UTI. Operative vaginal deliveries, forceps, or vacuum extractor, which can cause edema around the urethra, is a risk factor for UTI. Poor oral fluid intake and urinary catheter insertion during the labor process are also risk factors.

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.