Ch. 13 Transition to parenthood

The nurse is counseling a lesbian couple who have decided to have a child. Which considerations does the nurse present with regard to which partner will become pregnant? Select all that apply. 1. Consider the age and health of each partner. 2. Evaluate each partner's career goals. 3. Decide which partner has better insurance. 4. Determine who will be on the birth certificate. 5. Identify which woman desires to be pregnant.

1. Consider the age and health of each partner. 2. Evaluate each partner's career goals. 3. Decide which partner has better insurance. 5. Identify which woman desires to be pregnant.

The nurse on a postpartum unit focuses on how to assist the father in identifying his role with the neonate. Which intervention by the nurse is most helpful? 1. Encourage the couple to identify mutual expectations of the fathering role. 2. Critique the father's methods of providing physical care for the neonate. 3. Provide written materials about the physical and emotional role of a father. 4. Observe for a competitive attitude between the parents about providing baby care.

1. Encourage the couple to identify mutual expectations of the fathering role.

The nurse is interested in promoting coparenting because of the high likeability that at some point, both parents will be working outside the home. After reading research by Davis, Schoppe-Sullivan, Mangelsdorf, and Brown (2009), the nurse learns that which factor impacts coparenting the most? 1. Infant temperament 2. Father's interest 3. Strength of support systems 4. Mother's expectations

1. Infant temperament

Loutzenhiser, McAuslan, and Sharpe (2015) performed a study regarding maternal and paternal fatigue and factors associated with fatigue across the transition to parenthood. Which evidence- based conclusion is made regarding fatigue and the transitioning parents? 1. Levels of prenatal and postnatal fatigue are associated. 2. Postnatal fatigue remains consistent for a period of 1 year. 3. Poor sleep quality in fathers is related to depressive symptoms. 4. The length of couple relationship strongly impacts parenteral fatigue.

1. Levels of prenatal and postnatal fatigue are associated.

The nurse on a postpartum unit is focused on providing care that will assist the mother and father in making the transition to parenthood. For which reason does the nurse review the prenatal and labor records? 1. Pregnancy and birth experiences, which can either enhance or impede the process of becoming a mother. 2. Awareness of prenatal classes that will help identify and focus on learning needs of both parents. 3. Identification of preexisting maternal conditions that may interfere with parenting transitions. 4. Knowledge regarding questions and concerns the mother and father may have about neonate issues.

1. Pregnancy and birth experiences, which can either enhance or impede the process of becoming a mother.

The nurse uses research from Greenberg and Morris (1974) as a guideline for identifying the presence of engrossment in a new baby by the father. Which behaviors exhibit paternal-infant bonding related to engrossment? Select all that apply. 1. Seeing the baby as attractive 2. Perceiving the baby as being perfect 3. Having a desire to touch the baby 4. Indicating an increasing sense of self esteem 5. Positively commenting about the baby's features

1. Seeing the baby as attractive 2. Perceiving the baby as being perfect 3. Having a desire to touch the baby 4. Indicating an increasing sense of self esteem 5. Positively commenting about the baby's features

The nurse in a postpartum unit evaluates new parents for risk factors that can indicate problems with bonding/attachment. Which situations does the nurse recognize as a cause for bonding/attachment problems? Select all that apply. 1. The mother experienced eclampsia in the third trimester of pregnancy. 2. The neonate is being treated for meconium aspiration syndrome. 3. The mother experienced dystocia in the second phase of labor. 4. The father of the neonate is in the military and not yet home on leave. 5. The mother's mother lives next door and is available to help with the baby.

1. The mother experienced eclampsia in the third trimester of pregnancy. 2. The neonate is being treated for meconium aspiration syndrome. 3. The mother experienced dystocia in the second phase of labor.

The nurse on a postpartum unit is acutely aware that cultural influences impact the patient's process of "becoming a mother." For which cultural influences does the nurse assess? Select all that apply. 1. What amount of time the mother spends in each phase 2. Differences in the mother's expectation related to ability to rest 3. How the mother physically recovers from labor and delivery 4. Mother's involvement in decision making for the first few months 5. Whether the mother seems interested in how to care for her baby

1. What amount of time the mother spends in each phase 2. Differences in the mother's expectation related to ability to rest 4. Mother's involvement in decision making for the first few months 5. Whether the mother seems interested in how to care for her baby

The nurse is observing a new mother interact with her baby and notices the mother holding the baby close to her body. However, the nurse also notices that the mother does not hold the baby in an enface position. Which question is most appropriate for the nurse to ask? 1. "Can I help you with a nice position in which to hold your baby?" 2. "What can you tell me about your family's beliefs with new babies?" 3. "Is there some reason that I have not seen you look into your baby's eyes?" 4. "Your baby is so expressive, have you looked into his eyes yet?"

2. "What can you tell me about your family's beliefs with new babies?"

The nurse is researching for evidence-based practice related to a mother's response during the postpartum period. Based on research by Rubin and Mercer, which finding will the nurse be able to easily implement to change the culture of the unit? 1. Satisfaction questionnaires 2. Alterations in terminology 3. Decrease nurse/patient ratios 4. Soliciting paternal expectations

2. Alterations in terminology

Dayton et al. (2016) performed qualitative research regarding expectant fathers' beliefs and expectations. The nurse identifies which theme as emerging from this research? 1. Men felt that the role of being a father can be learned. 2. Men described fathering as an extremely difficult task. 3. Men rely on other men to support the fathering role. 4. Men believe that the nurturing role is always the mother's.

2. Men described fathering as an extremely difficult task.

The nurse is aware that some parenting skills are acquired through the process of intentional learning. Which activity does the nurse associate with intentional learning? 1. The couple observes other individuals who are mothers and fathers. 2. The couple attends hospital classes addressing newborn and infant care. 3. The couple discusses with each other how they were parented. 4. The couple watches media containing parenting roles.

2. The couple attends hospital classes addressing newborn and infant care.

Which behavior does the nurse identify as a demonstration of unidirectional bonding between a parent and infant? 1. The parents respond to the baby's cry. 2. The parents call the baby by name. 3. The baby responds to comforting measures. 4. The parents stimulate and entertain the baby.

2. The parents call the baby by name.

The nurse is providing care for a new mother during a follow-up visit 6 weeks after a vaginal delivery. The mother begins to cry and reports difficulty with eating and sleeping. The nurse identifies postpartum blues and cites which reason as the most likely cause? 1. Fatigue related to a "fussy" baby 2. Frustration over physical appearance 3. Changes in hormonal levels 4. Stress related to new mother role

3. Changes in hormonal levels

The postpartum nurse is planning a home visit to a mother who delivered her baby 1 week ago. Which finding indicates to the nurse a possible problem with mother-infant bonding? 1. The mother is pleased to have the nurse visit her home and baby. 2. The baby's grandmother is present and involved with mother/baby care. 3. The mother focuses the visit on her physical recovery and concerns. 4. The baby's father is on "paternity leave" and involved with the baby.

3. The mother focuses the visit on her physical recovery and concerns.

The nurse is providing postpartum care for an adolescent mother and her family. Which factor is most important for the nurse to consider when planning teaching about neonatal care? 1. The grandparents decided they want to be involved. 2. The parents need to discuss their expectations of each other. 3. The mother is determined the father should be involved. 4. Information must be presented on an age-appropriate level.

4. Information must be presented on an age-appropriate level.

As a result of the previously mentioned research study, the nurses in a postpartum facility will implement which evidence-based change? 1. Continue to assess the level of fatigue for the mother during postpartum period. 2. Assist fathers in recognizing and managing stress and depressive symptoms. 3. Encourage the father to go home and rest while the mother is hospitalized. 4. Promote strategies to decrease fatigue during both prenatal and postnatal periods.

4. Promote strategies to decrease fatigue during both prenatal and postnatal periods.

A new mother expresses frustration about how to know what her baby wants. The mother states, "I don't know what I expect, but then, the baby doesn't know either." Which situation does the nurse use as an example of neonate communication? 1. The baby is content to lie still on the mother's abdomen. 2. The baby is easily awakened if irritated by loud noises. 3. The baby resists eye contact if bored or disinterested. 4. The baby roots for the breast when the cheek is stroked.

4. The baby roots for the breast when the cheek is stroked.

Bonding is bidirectional from parent to infant and infant to parent.

False

True/False Eye movements are an example of newborn/infant style of communication.

True

Which of the following nursing actions can assist a man in his transition to fatherhood? (Select all that apply.) a. Ask the man to share his ideas of what it means to be a father. b. Demonstrate infant care such as diapering and feeding. c. Engage couple in a discussion regarding each others expectations of the fathering role. d. Provide the man with information on infant care.

a. Ask the man to share his ideas of what it means to be a father. b. Demonstrate infant care such as diapering and feeding. c. Engage couple in a discussion regarding each others expectations of the fathering role. d. Provide the man with information on infant care.

A 16-year-old woman delivers a healthy, full-term male infant. The nurse notes the following behaviors 2 hours after the birth: Woman holds baby away from her body; woman refers to baby as he; woman verbalizes she wanted a baby girl; woman requests that baby be placed in the bassinet so she can eat her lunch. The most appropriate nursing diagnosis for this woman is: a. At risk for impaired parenting related to disappointment with baby as evidenced by verbalizing she wanted a girl b. At risk for impaired parenting related to nonnurturing behaviors as evidenced by holding baby away from body c. At risk for impaired motherinfant attachment as evidenced by woman requesting baby being placed in bassinet d. At risk for impaired motherinfant attachment related to disappointment as evidenced by calling baby he

a. At risk for impaired parenting related to disappointment with baby as evidenced by verbalizing she wanted a girl

The nurse is caring for a postpartum woman who gave birth to a healthy, full- term baby girl. She has a 2-year-old son. She voices concern about her older childs adjustment to the new baby. Nursing actions that will facilitate the older sons adjustment to having a new baby in the house would include which of the following? (Select all that apply.) a. Explain to the mother that she can have her son lie in bed with her when he is visiting her in the hospital. b. Teach her son how to change the babys diapers. c. Assist her son in holding his new baby sister. d. Recommend that she spend time reading to her older son while he sits in her lap

a. Explain to the mother that she can have her son lie in bed with her when he is visiting her in the hospital. c. Assist her son in holding his new baby sister. d. Recommend that she spend time reading to her older son while he sits in her lap

The nurse is developing a plan of care for a client who is in the taking-in phase after delivering a healthy baby boy. Which of the following should the nurse include in the plan? a. Provide the client with a nutritious meal. b. Teach baby care skills like diapering. c. Discuss the pros and cons of circumcision. d. Counsel her regarding future sexual encounters.

a. Provide the client with a nutritious meal.

Which of the following nursing actions are directed at promoting bonding? (Select all that apply.) a. Providing opportunity for parents to hold their newborn as soon as possible following the birth. b. Providing opportunities for the couple to talk about their birth experience and about becoming parents. c. Promoting rest and comfort by keeping the newborn in the nursery at night. d. Providing positive comments to parents regarding their interactions with their newborn

a. Providing opportunity for parents to hold their newborn as soon as possible following the birth. b. Providing opportunities for the couple to talk about their birth experience and about becoming parents. d. Providing positive comments to parents regarding their interactions with their newborn

Which of the following factors place a new mother at risk for parenting? (Select all that apply.) a. She is 17 years old. b. Family income is below the average income. c. Her parents live in the same city and are perceived as helpful. d. She dropped out of school at age 13

a. She is 17 years old. b. Family income is below the average income. d. She dropped out of school at age 13

The postpartum nurse caring for a 20-year-old G1 P0 woman who 3 hours ago delivered a healthy full-term infant, observes the woman who is lightly touching her baby girl with her fingertips but who seems to be uncomfortable holding her baby close to her body. Which of the following is an accurate interpretation of these observed behaviors? a. The woman is in the initial stage of maternal touch. b. The woman is in the taking-in phase. c. The woman is having difficulty in bonding with her baby. d. The woman needs to be medicated for pain.

a. The woman is in the initial stage of maternal touch.

The nurse notes that a new father gazes at his baby for prolonged periods of time and comments that his baby is beautiful and he is very happy having a baby. These behaviors are commonly associated with: a. Bonding b. Engrossment c. Couvade syndrome d. Attachment

b. Engrossment

The perinatal nurse observes the new mother watching her baby daughter closely, touching her face, and asking many questions about infant feeding. This stage of mothering is best described as: a. Taking in b. Taking hold c. Taking charge d. Taking time

b. Taking hold

The nurse is caring for a recently immigrated Chinese woman in the postpartum unit. Based on cultural beliefs and practices of the woman, the nurse would anticipate which of the following? (Select all that apply.) a. The woman prefers cold water for drinking. b. The woman prefers not to shower. c. The woman prefers to have her female relatives care for her baby. d. The woman prefers to have her family bring her food to eat.

b. The woman prefers not to shower. c. The woman prefers to have her female relatives care for her baby. d. The woman prefers to have her family bring her food to eat.

Which of the following nursing actions are directed at assisting men in their transition to fatherhood? (Select all that apply.) a. Encourage the woman to take on the major responsibility for infant care. b. Talk to the man, away from his partner, about his expectations of the fathering role. c. Praise the father for his interactions with his infant. d. Provide information on infant care and behavior to both parents.

c. Praise the father for his interactions with his infant. d. Provide information on infant care and behavior to both parents.

A woman on the day of discharge from the postpartum unit requests clean towels so she can take a shower, asks a number of questions regarding breastfeeding, and shares that she is nervous about taking her baby home and not being able to remember everything she has been taught. These are behaviors associated with: a. Bonding b. Taking in c. Taking hold d. Attachment

c. Taking hold

19. When providing care to a multiparous mother, the nurse needs to assess for the presence of ___________ between the older children and the new baby.

sibling rivalry