Test2 - Ch 35 Ob

Front 1

What is the significance of mental health disorders in the postpartum period?

Back 1

They can interfere with the attachment to the newborn and family integration, and some may threaten the safety and well-being of the mother, the newborn, and other children

Front 2

What is the rate of detection of postpartum depression and anxiety symptoms?

Back 2

Less than 33%

Front 3

What is the predominant mental health disorder in the postpartum period?

Back 3

Mood disorders

Front 4

What is the most common mood disorder in the postpartum period?

Back 4

70% of women experience a mild depression or "baby blues" after the birth of a child; however, functioning of the woman is usually not impaired

Front 5

What is the nurse's role in regards to postpartum psychologic complications?

Back 5

1. Offering anticipatory guidance
2. Assessing the mental health of new mothers
3. Offering therapeutic interventions
4. Making referrals when necessary

Front 6

How is postpartum onset of depression described?

Back 6

Occuring within 4 weeks of childbirth

Front 7

How is postpartum depression prevented?

Back 7

According to Dennis (2004c), effectiveness of the preventative approaches could not be measured because of a lack of well-designed studies

Front 8

What did the research studies focus on?

Back 8

1. Antidepressants
2. Estrogen and progesterone and thyroid therapy
3. Docosahexanoic acid
4. Calcium supplementation

Front 9

What has been found to be related to postpartum depression?

Back 9

1. Neurotransmitter deficiencies

2. Psychosocial and marital adjustments

Front 10

What are the risk factors for postpartum depression?

Back 10

1. Prenatal depression
2. Low self-esteem
3. Stress of child care (i.e. multiple births)
4. Prenatal anxiety
5. Life stress
6. Lack of social support
7. Marital relationship problems
8. History of depression
9. "Difficult" infant temperament
10. Postpartum blues
11. Single status
12. Low socioeconomic status
13. Unplanned/unwanted pregnancy

Front 11

What is postpartum depression?

Back 11

An intense and pervasive sadness with severe and labile mood swings and is more serious and persistent than postpartum blues

Front 12

What are the major symptoms of postpartum depression (differentiating it from postpartum blues)?

Back 12

Intense fears, anger, anxiety, and despondency that persist beyond the baby's first few weeks

Front 13

What is the incidence of postpartum depression in adolescent mothers?

Back 13

2.5 times more than adult mothers

Front 14

What characteristics differentiate postpartum depression from nonpostpartum mood disorders?

Back 14

The mother's ruminations of guilt and inadequacy feed her worries about becoming an incompetent and inadequate parent (with PPD)

Front 15

What are the distinguishing features of postpartum depression?

Back 15

1. Irritability that flares up with little provocation and may escalate to violent outbursts or dissolve into uncontrollable sobbing

2. Rejection of the infant, often caused by abnormal jealousy

Front 16

What do women with postpartum major depressive episodes often experience?

Back 16

1. Severe anxiety
2. Panic attacks
3. Spontaneous crying long after the usual duration of baby blues

Front 17

What attitudes do women with postpartum depression exhibit toward their infant?

Back 17

1. Disinterest
2. Annoyance with care demands
3. Blaming because of her lack of maternal feeling

Front 18

What are the pharmacological treatment options for postpartum depression?

Back 18

1. Antidepressants
2. Antianxiety
3. ECT

Front 19

What is postpartum psychosis?

Back 19

A syndrome most often characterized by depression, delusions, and thoughts by the mother of harming either the infant or herself

Front 20

What are the symptoms of postpartum psychosis?

Back 20

1. Fatigue
2. Insomnia
3. Restlessness
4. Episodes of tearfulness and emotional liability
5. Suspiciousness
6. Confusion
7. Incoherence
8. Irrational statements
9. Obsessive concerns about the baby's health and welfare
10. Auditory hallucinations

Front 21

What is bipolar disorder?

Back 21

A mood disorder that is preceded or accompanied by manic episodes, characterized by elevated, expansive, or irritable moods

Front 22

What are the clinical manifestations of a manic episode?

Back 22

At least three of the following symptoms present for at least 1 week:

1. Grandiosity
2. Decreased need for sleep
3. Pressured speech
4. Flight of ideas
5. Distractibility
6. Psychomotor agitation
7. Excessive involvement in pleasurable activities without regard for negative consequences

Front 23

What is the treatment of choice for postpartum psychosis?

Back 23

Antipsychotics and mood stabilizers such as lithium, as well as hospitalization

Front 24

What are some examples of antipsychotic medications?

Back 24

1. Chlorpromazine (Thorazine)
2. Fluphenazine (Prolixin)
3. Haloperidol (Haldol)
4. Perphenazine (Trilafon)
5. Thioridazine (Mellaril)
6. Thiothixene (Navane)
7. Trifluoperazine (Stelazine)

Front 25

What are some examples of mood stabilizers?

Back 25

1. Carbamazepine (Tegretol XR)
2. Clonazepam (Klonopin)
3. Gabapentin (Neurontin)
4. Lamotrigene (Lamictal)
5. Lithium carbonate (Eskalith)
6. Topiramate (Topamax)
7. Valproic acid (Depakene, Depakote, & Depakote ER)

Front 26

What is the Edinburgh Postnatal Depression Scale (EPDS)?

Back 26

A self-report assessment designed specifically to identify women experiencing postpartum depression

Front 27

What are some nursing diagnoses for postpartum depression?

Back 27

1. Risk for violence toward self or children r/t PPD
2. Situational low self-esteem in the mother r/t stresses associated with role changes
3. Compromised family coping r/t increased care needs of mother and infant
4. Risk for impaired parenting r/t inability of depressed mother to attach to infant
5. Risk for injury to newborn r/t mother's depression and psychotropic medications via breast milk

Front 28

What are some activities to prevent postpartum depression?

Back 28

1. Educate close family and friends about postpartum emotional problems

2. Take care of self : eat a balanced diet, exercise regularly, get enough sleep.

3. Share feelings with someone close to you; don't isolate yourself at home

4. Don't overcommit yourself or feel like you need to be a superwoman

5. Don't place unrealistic expectations on yourself

6. Don't be ashamed of having emotional problems after your baby is born - it happens in approximately 15% of women

Front 29

What is the criteria for measuring the seriousness of a suicidal plan?

Back 29

1. Method
2. Availability
3. Specificity
4. Lethality

Front 30

What is the most lethal method for suicide?

Back 30

Shooting

(with hanging a close second)

Front 31

What is the least lethal method for suicide?

Back 31

Slashing one's wrist

Front 32

What is the most serious symptom of postpartum depression?

Back 32

Suicidal thoughts or attempts

Front 33

What signs of mother-infant bonding can nurses observe for?

Back 33

1. Eye-to-eye contact
2. Holding, touching, or cuddling
3. Talking to the baby and calling baby by name
4. Initiation of appropriate care

Front 34

Why are MAOIs not prescribed more frequently for postpartum depression or psychosis?

Back 34

Hypertensive crisis

Front 35

What are the signs of hypertensive crisis?

Back 35

1. A throbbing, occipital headache
2. Stiff neck
3. Chills
4. Nausea
5. Flushing
6. Retroorbital pain
7. Apprehension
8. Pallor
9. Sweating
10. Chest pain
11. Palpitations

Front 36

What substance found in many foods can cause a hypertensive crisis?

Back 36

Tyramine

Front 37

What are the PNS effects of antipsychotropic medications?

Back 37

1. Constipation
2. Dry mouth
3. Blurred vision
4. Tachycardia
5. Urinary retention
6. Weight gain
7. Agranulocytosis

Front 38

What are the CNS effects of antipsychotropic medications?

Back 38

1. Akathisia
2. Dystonias
3. Parkinsonism-like symptoms
4. Tardive dyskinesia
5. Neuroleptic malignant syndrome

Front 39

What factors influence the amount of drug an infant will receive through breastfeeding?

Back 39

1. Amount of milk produced

2. Composition of the milk (mature milk vs. colostrum)

3. Concentration of the medication

4. Extent to which the breast was emptied during a previous feeding

5. Infant's ability to absorb, metabolize, and excrete ingested medication

Front 40

What are some possible alternative/complementary therapies for postpartum depression?

Back 40

1. Acupuncture
2. Acupressure
3. Aromatherapy - jasmine, ylang ylang, rose
4. Herbal - lavender tea
5. Healing touch/therapeutic touch
6. Massage
7. Relaxation techniques
8. Reflexology
9. Yoga

Front 41

What are the symptoms of panic attacks?

Back 41

1. Shortness of breath
2. Palpitations
3. Chest pain
4. Choking
5. Smothering sensation
6. Fear of losing control

Front 42

What are potential nursing diagnoses of women experiencing postpartum panic disorder?

Back 42

1. Anxiety r/t postpartum adaptations and expectations

2. Fear r/t obsessions or thoughts about harming others

3. Powerlessness r/t feelings of losing control

4. Deficient knowledge r/t postpartum mental health problems

Front 43

What is the treatment of choice for postpartum panic disorder?

Back 43

Selective serotonin reuptake inhibitors (SSRIs)

Front 44

What are some suggested nursing considerations for postpartum psychologic complications?

Back 44

1. Education
2. Empowerment for the woman
3. Identify triggers
4. Family and social support
5. Support groups
6. Sensory interventions (such as music therapy or aroma therapy)
7. Behavioral interventions (such as breathing exercise and progressive muscle relaxation)
8. Cognitive interventions (such as positive self-talk)