Term
| What is an affective disorder in OB care and what is included? |
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Definition
a mood disorder it is disturbances in function, affect or thought process
Includes baby blues, postpartum depression and postpartum psychosis |
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Term
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Definition
(not really an affective disorder b/c gone by 2 weeks)
Transient, self limiting
begins first week and ends by 10 days
lasts NO LONGER than 2 weeks
70-80% of mothers |
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Term
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Definition
insomnia
fatigue
irritability
anxiety
tearfulness |
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Term
| What to remember about baby blues? |
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Definition
| IT DOES NOT INTERFERE WITH NORMAL FUNCTION |
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Term
| Possible causes of baby blues |
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Definition
emotional letdown
postpartum discomforts and fatigue
concerns about attractiveness
not linked to hormonal fluctations |
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Term
| Care for baby blues (include teaching) |
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Definition
tell to report if symptoms worsen or persist for longer than 2 weeks
prepare the patients for mild depression
offer your empathy and support |
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Term
| Common thoughts among new mothers who have postpartum blues |
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Definition
usually negative or worrysome
perfect mother
concern that baby or another family member may die
if something bad happens, mothers fault
being a parent is not as wonderful as expected
OFFER EMOTIONAL SUPPORG AND ENCOURAGEMENT |
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Term
| Postpartum depression statistics |
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Definition
10-15% pregnancies
within 2 weeks-3 months but any time during the rirst year postpartum
unknown cause |
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Term
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Definition
previous hx
first pregnancy
hormonal flucations
personality characteristics
chronic stressors (single mother, financial) |
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Term
| What personality characteristics may contribute to PPD? |
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Definition
immature patient
low self esteem
ambivalent about pregnancy |
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Term
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Definition
depressed/sad mood
loss of interest in usual activities
may not be able to feel pleasure or love but does care for the baby
sees infant as demanding and feels inept at being a mother
intense feelings of anxiety, unworthiness, guilt, shame, agitation, and loss of self
weight changes
sleep disturbances
loss of usual emotional response (possible wont look at husband)
anxiety
tearfulness
sleep disturbances
worthlessness or incompetence
change in appetite
possible suicidal thoughts |
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Term
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Definition
Antidepressants (give them some time)
social support groups
cognitive behavioral therapy
interpersonal therapy
ECT therapy (change rhythyms in the brain) |
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Term
| Describe the impact on the family |
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Definition
Family may decrease interactions with the depressed mother
impaired communication because she withdraws from others
decreased libido may affect relationship with other
fathers may have to help pick up the slack and may become depressed
interactions with infant are tense, irritable, and feels less competent
may not pick up on infants cues or smiles
infants are fussier and more discontented possible later cognitive and behavioral problems |
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Term
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Definition
SSRI and tricyclic antidepressants
may be continued for six months
BREASTFEEDING CONSIDERATIONS? |
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Term
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Definition
ASK THE MOTHER!
may feels guilty
mental illness stigma may prevent her from getting care
postpartum depression predictors inventory revised
screen for excessive fatigue
inform that many feel depressed, which shows interest and acceptance
family support: isolation?
inappropriate expressions of blame or anger? |
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Term
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Definition
| Risk for ineffective coping |
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Term
Nursing interventions for PPD
Demonstrating caring
providing anticipatory guidance
Helping to verbalize feelings |
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Definition
acknowledge that they seem depressed and it is not her fault
need for frequent contact with other adults to avoid isolation
adequate rest and nutrition
teach s/sx of ppd
may not want to express negative feelings
DO NOT TRIVILIZE THE PROBLEM!!!
discuss realties of parenting and that it is often exhausting
rehearse some situations that may occur |
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Term
Nursing interventions:
Enhancing sensitivity to cues
helping family members
Discussing options and resources |
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Definition
point out cues and explain meaning
skin to skin to increase bonding
assess infants G&D
weight tain, and mothers ability to comfort infant
suggestions to continue breastfeeding
MEDICATION FOR BREASTFEEDING?
include the father, explain effect of PPD, discuss signs with him, ways to help the mother
Ask about stressors that may contribute
assist to identify those availible for support
telephone numers for support groups |
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Term
| Postpartum Psychosis statistics |
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Definition
1-2 women per 1000 births
rapid onsed 2-3 days postpartum
Birth may be a trigter for another disorder |
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Term
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Definition
major depression
psychotic disorders
bipolar or schizoaffective disorder
contributing factors: hormone shifts OB complications, sleep deprivation, and increased environmental distress |
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Term
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Definition
confusion
agitation
outbursts of anger
odd affect
withdrawn
sleeplessness
bizarre behavior
inability to function
autidory hallucinations
delusions (baby is dead or defective)
neglect hygiene care |
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Term
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Definition
Lithium
Carbmazepine
Valproic acid
Risperidone |
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Term
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Definition
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Term
| What is PP considered, what is the major concern, and what should the nurse do? |
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Definition
psychiatric emergency
concern is for the mother harming self or baby
DO NOT SENT THEM HOME. INTERVENE RIGHT THERE. SEND POLICE TO HOUSE |
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Term
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Definition
feeling overwhelmed
ppd
lack of attention to responsibility and personal hygiene
domestic conflict
fantasizing about being single/no children |
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Term
| What is necessary once the mother has been diagnosed with PP? |
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Definition
| Psychiatric hbospitalization to prevent suicide and infanticide |
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