Chapter 20: Transition to Parenthood

10. 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 Feedback a. Mothers are very hungry immediately after delivery. The nurse should provide the client with food. b. Baby care skills should be taught during the "taking-hold" phase. c. Baby care needs should be discussed during the "taking-hold" phase. d. A discussion of sexual issues should be deferred until the "taking-hold" phase or the "letting go" phase.

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 mother-infant attachment as evidenced by woman requesting baby being placed in bassinet d. At risk for impaired mother-infant attachment related to disappointment as evidenced by calling baby "he"

A Feedback a. The potential is for impaired parenting related to disappointment in the gender of the baby. b. Holding baby away from her body during the first few hours is part of the maternal touch process. c. Focusing on eating during the first few hours is a behavior of taking-in and is anticipated during this phase. d. Some parents have not selected a name for their baby and will refer to their baby as "he" or "she." There is concern if the woman calls her baby "it."

12. 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 These are classical signs of the initial stage of Rubin's maternal touch.

New parents express concern that because of the mother's emergency cesarean birth under general anesthesia, they did not have the opportunity to hold and bond with their daughter immediately after her birth. The nurse's response should convey to the parents that: A. Attachment, or bonding, is a process that occurs over time and does not require early contact. B. The time immediately after birth is a critical period for humans. C. Early contact is essential for optimum parent-infant relationships. D. They should just be happy that the infant is healthy.

A. Attachment, or bonding, is a process that occurs over time and does not require early contact.

Factors that can hamper a couples transition to parenthood include which of the following? Select all that apply A. First experience with newborns B. Change of employment C. Adolescent father

A. First experience with newborns B. Change of employment C. Adolescent father

Parents can facilitate the adjustment of their other children to a new baby by: A. Having the children choose or make a gift to give to the new baby on its arrival home. B. Emphasizing activities that keep the new baby and other children together. C. Having the mother carry the new baby into the home so she can show him or her to the other children. D. Reducing stress on other children by limiting their involvement in the care of the new baby.

A. Having the children choose or make a gift to give to the new baby on its arrival home. Having the sibling make or choose a gift for the new baby helps to make the child feel a part of the process. Special time should be set aside just for the other children without interruption from the newborn. Someone other than the mother should carry the baby into the home so she can give full attention to greeting her other children. Children should be actively involved in the care of the baby according to their ability without overwhelming them.

Your postpartum assignment includes a 15 year old first time mother who gave birth to a healthy baby girl 6 hours ago. The 16 year old father of the baby was present for the birth and is present while you are caring for the mother. Which nursing actions are appropriate? select all that apply A. Include the new father in infant care teaching sessions B. Ask the new father to tell you about his labor and birth experience C. Include the new father in teaching session on contraception D. Include the new father in teaching session on postpartum blues

A. Include the new father in infant care teaching sessions B. Ask the new father to tell you about his labor and birth experience C. Include the new father in teaching session on contraception D. Include the new father in teaching session on postpartum blues

When working with parents who have some form of sensory impairment, nurses should consider which information when writing a plan of care? (Select all that apply) A. One of the major difficulties visually impaired parents experience is the skepticism of health care professionals B. Visually impaired mothers cannot overcome the infant's need for eye-to-eye contact C. The best approach for the nurse is to assess the parents' capabilities rather than focusing on their disabilities D. Technologic advances, including the Internet, can provide deaf parents with a full range of parenting activities and information E. Childbirth education and other materials are available in Braille.

A. One of the major difficulties visually impaired parents experience is the skepticism of health care professionals C. The best approach for the nurse is to assess the parents' capabilities rather than focusing on their disabilities D. Technologic advances, including the Internet, can provide deaf parents with a full range of parenting activities and information E. Childbirth education and other materials are available in Braille. The skepticism, open or hidden, of health care professionals throws up an additional and unneeded hurdle for the parents. Other sensory output can be provided by the parent, other people can participate, and other coping devices can be used. After the parents' capabilities have been assessed (including some the nurse may not have expected), the nurse can help find ways to assist the parents that play to their strengths. The Internet affords an extra teaching tool for the deaf, as do videos with subtitles or nurses signing. A number of electronic devices can turn sound into light flashes to help pick up a child's cry. Sign language is acquired readily by young children. Childbirth education and other materials are available in Braille.

The nurse can help a father in his transition to parenthood by: A. Pointing out that the infant turned at the sound of his voice B. Encouraging him to go home to get some sleep C. Telling him to tape the infant's diaper a different way D. Suggesting that he let the infant sleep in the bassinet

A. Pointing out that the infant turned at the sound of his voice

You are providing discharge teaching to your patient. In addition to her newborn son, she has a 2 year old daughter. which will you include? select all that apply A. Stressing the importance of quality time with her daughter B. Instructing the woman to include the 2 year old in the care of her baby brother C. Explaining that all children experience some degree of sibling rivalry. D. Instructing the woman to explain to her daughter the reasons babies cry

A. Stressing the importance of quality time with her daughter B. Instructing the woman to include the 2 year old in the care of her baby brother C. Explaining that all children experience some degree of sibling rivalry. D. Instructing the woman to explain to her daughter the reasons babies cry

In the United States, the en face position is preferred immediately after birth. Nurses can facilitate this process by all of these actions except: A. Washing both the infant's face and the mother's face B. Placing the infant on the mother's abdomen or breast with their heads on the same plane C. Dimming the lights D. Delaying the instillation of prophylactic antibiotic ointment in the infant's eyes

A. Washing both the infant's face and the mother's face

The nurse notes that a Vietnamese woman does not cuddle or interact with her newborn other than to feed him, change his diapers or soiled clothes, and put him to bed. In evaluating the woman's behavior with her infant, the nurse realizes that: A. What appears to be a lack of interest in the newborn is in fact the Vietnamese way of demonstrating intense love by attempting to ward off evil spirits. B. The woman is inexperienced in caring for newborns. C. The woman needs a referral to a social worker for further evaluation of her parenting behaviors once she goes home with the newborn. D. Extra time needs to be planned for assisting the woman in bonding with her newborn.

A. What appears to be a lack of interest in the newborn is in fact the Vietnamese way of demonstrating intense love by attempting to ward off evil spirits.

You are assigned a hearing impaired first-time mother. When you are entering the room, your patient is looking away from you. Which of the following is the most appropriate way to get her attention? A. flick the overhead lights on and off B. Make a loud noise as you enter C. Tap the woman on her shoulder D. Walk to her bed and wave your hand

A. flick the overhead lights on and off

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 other's expectations of the fathering role. d. Provide the man with information on infant care.

ANS: a, b, c, d Each of these actions can assist the father in his transition. It is important for the man to be able to learn and practice infant care skills in a nonthreatening environment. It is also important for the man to be able to openly talk about his feelings regarding fatherhood and for the couple to identify mutual expectations of the fathering role.

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.

ANS: a, b, d Adolescent parents may have a more difficult transition to parenthood because they have not made the transition to adulthood. Financial concerns can hamper the transition to parenthood because the focus of attention may be on where to get money to pay for daily living expenses versus on the care of their newborn. Decreased ability to read and comprehend information regarding child care may hamper the ability to gain knowledge about the care of their child.

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.

ANS: a, b, d Parent bonding can be delayed by prolonged periods of separation from their child. The other three actions support parent bonding with their newborn.

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 child's adjustment to the new baby. Nursing actions that will facilitate the older son's 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 baby's 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.

ANS: a, c, d Two-year-olds enjoy being close to their mothers, including lying next to their mothers or being held. Changing diapers is not viewed as a pleasurable experience and is not developmentally appropriate for a 2-year-old. Children enjoy being able to hold their sibling and feeling "grown up."

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.

ANS: b, c, d In traditional Chinese beliefs and practices, the woman is to rest and female family members take care of the woman and her infant. During the first month, the woman is to avoid yin energy by eating specific foods and avoiding drinking or touching cold water.

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.

ANS: c, d It is important to first have the couple discuss with each other their expectations of the fathering role. Once this has occurred, then the woman and nurse need to support the man in his role of infant care. Both parents need to receive information about infant care and infant behaviors, and both parents need to be praised for their interactions with their baby.

11. 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 As the mother's physical condition improves, she begins to take charge and enters the taking-hold phase where she assumes care for herself and her infant. At this time, the mother eagerly wants information about infant care and shows signs of bonding with her infant. During this phase, the nurse should closely observe mother-infant interactions for signs of poor bonding, and if present, implement actions to facilitate attachment.

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 a. Bonding is defined as the emotional feelings that begin during pregnancy or shortly after birth between the parent and the newborn. Bonding is unidirectional from parent to newborn. b. Correct. Characteristics of engrossment are visual awareness of baby, tactile awareness of baby, perception that baby is perfect, strong attraction to baby, feeling of strong elation, and increased self-esteem. c. Couvade syndrome relates to a set of pregnancy symptoms the father experiences during pregnancy of the woman. d. Attachment is a connection that forms from parent to infant and infant to parent. Attachment has a lifelong impact on the developing individual.

Many first-time parents do not plan on their parents' help immediately after the newborn arrives. What statement by the nurse is the most appropriate when counseling new parents about the involvement of grandparents? A. "You should tell your parents to leave you alone." B. "Grandparents can help you with parenting skills and also help preserve family traditions." C. "Grandparent involvement can be very disruptive to the family." D. "They are getting old. You should let them be involved while they can."

B. "Grandparents can help you with parenting skills and also help preserve family traditions."

Which statements are true regarding coparenting. Select all that apply A. implies that the parenting roles are equal in the amount of child care responsibilities B. Consists of parental figures supporting each other in the rearing of their child C. Can be affected by the infants temperament D. Can be affected by the man's cultural beliefs

B. Consists of parental figures supporting each other in the rearing of their child C. Can be affected by the infants temperament D. Can be affected by the man's cultural beliefs

Factors that influence a man's transition to fatherhood include which of the following? select all that apply A. educational level B. Cultural expectations C. Socioeconomic status D. Support from partner

B. Cultural expectations C. Socioeconomic status D. Support from partner

Other early sensual contacts between infant and mother involve sound and smell. Nurses should be aware that despite what folk wisdom might say: A. High-pitched voices irritate newborns. B. Infants can learn to distinguish their mother's voice from others soon after birth. C. All babies in the hospital smell alike. D. A mother's breast milk has no distinctive odor.

B. Infants can learn to distinguish their mother's voice from others soon after birth.

The maternity nurse promoting parental-infant attachment should incorporate which appropriate cultural beliefs into the plan of care? (Select all that apply.) A. Asian mothers are encouraged to return to work as soon as possible. B. Jordanian mothers have a 40-day lying-in after birth. C. Japanese mothers rest for the first 2 months after childbirth. D. Encourage Hispanics to eat plenty of fish and pork to increase vitamin intake. E. Encourage Vietnamese mothers to cuddle with the newborn.

B. Jordanian mothers have a 40-day lying-in after birth. C. Japanese mothers rest for the first 2 months after childbirth. Asian mothers must remain at home with the baby up to 30 days after birth and are not supposed to engage in household chores, including care of the baby. Jordanian mothers have a 40-day lying-in after birth, during which their mothers or sisters care for the baby. Japanese mothers rest for the first 2 months after childbirth. Hispanic practice involves many food restrictions after childbirth, such as avoiding fish, pork, and citrus foods. Vietnamese mothers may give minimal care to their babies and refuse to cuddle or further interact with the baby to ward off "evil" spirits. Asian mothers must remain at home with the baby up to 30 days after birth and are not supposed to engage in household chores, including care of the baby. Jordanian mothers have a 40-day lying-in after birth, during which their mothers or sisters care for the baby. Japanese mothers rest for the first 2 months after childbirth. Hispanic practice involves many food restrictions after childbirth, such as avoiding fish, pork, and citrus foods. Vietnamese mothers may give minimal care to their babies and refuse to cuddle or further interact with the baby to ward off "evil" spirits.

With regard to the adaptation of other family members, mainly siblings and grandparents, to the newborn, nurses should be aware that: A. Sibling rivalry cannot be dismissed as overblown psychobabble; negative feelings and behaviors can take a long time to blow over. B. Participation in preparation classes helps both siblings and grandparents. C. In the United States, paternal and maternal grandparents consider themselves of equal importance and status. D. Since 1990, the number of grandparents providing permanent care to their grandchildren has been declining.

B. Participation in preparation classes helps both siblings and grandparents.

A primiparous woman is in the taking-in stage of psychosocial recovery and adjustment following birth. Recognizing the needs of women during this stage, the nurse should: A. Foster an active role in the baby's care. B. Provide time for the mother to reflect on the events of and her behavior during childbirth. C. Recognize the woman's limited attention span by giving her written materials to read when she gets home rather than doing a teaching session now. D. Promote maternal independence by encouraging her to meet her own hygiene and comfort needs.

B. Provide time for the mother to reflect on the events of and her behavior during childbirth. Once the mother's needs are met, she would be more able to take an active role, not only in her own care but also the care of her newborn. Women express a need to review their childbirth experience and evaluate their performance. Short teaching sessions, using written materials to reinforce the content presented, are a more effective approach. The focus of the taking-in stage is nurturing the new mother by meeting her dependency needs for rest, comfort, hygiene, and nutrition.

The nurse observes several interactions between a postpartum woman and her new son. What behavior, if exhibited by this woman, does the nurse identify as a possible maladaptive behavior regarding parent-infant attachment? A. Talks and coos to her son B. Seldom makes eye contact with her son C. Cuddles her son close to her D. Tells visitors how well her son is feeding

B. Seldom makes eye contact with her son Talking and cooing to her son is a normal infant-parent interaction. The woman should be encouraged to hold her infant in the en face position and make eye contact with him. Cuddling is a normal infant-parent interaction. Sharing her son's success at feeding is a normal infant-parent interaction.

The nurse observes that a 15-year-old mother seems to ignore her newborn. A strategy that the nurse can use to facilitate mother-infant attachment in this mother is: A. Tell the mother she must pay attention to her infant B. Show the mother how the infant initiates interaction and attends to her C. Demonstrate for the mother different positions for holding her infant while feeding D. Arrange for the mother to watch a video on parent-infant interaction

B. Show the mother how the infant initiates interaction and attends to her

In follow-up appointments or visits with parents and their new baby, it may be useful if the nurse can identify parental behaviors that can either facilitate or inhibit attachment. What is a facilitating behavior? A. The parents have difficulty naming the infant. B. The parents hover around the infant, directing attention to and pointing at the infant. C. The parents make no effort to interpret the actions or needs of the infant. D. The parents do not move from fingertip touch to palmar contact and holding.

B. The parents hover around the infant, directing attention to and pointing at the infant. Reluctance to name the baby is an inhibiting behavior. Hovering over the infant, as well as obviously paying attention to the baby, is a facilitating behavior. Failure to interpret the actions and needs of the infant is an inhibiting behavior. Lack of fingertip, palmar touch, and holding represents an inhibiting behavior.

your postpartum patient is a 25 year old white single woman who gave birth to a healthy infant. She is 36 hours post birth. you note that she holds her infant as a distance and refers to it as it. Based on this assessment, your initial nursing actions include A. Obtain referral for a social worker B. ask the woman to tell you about her pregnancy and childbirth experience C. teach her the importance of holding her baby close to her body. D. take her baby to the nursery so she can have some uninterrupted sleep.

B. ask the woman to tell you about her pregnancy and childbirth experience

9. 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 Feedback a. Bonding is defined as the emotional feelings that begin during pregnancy or shortly after birth between the parent and the newborn. Bonding is unidirectional from parent to newborn. b. In the taking-in phase, women are dependent and need assistance with self-care and care of the infant. c. Correct. These are common behaviors of women in the taking-hold phase. Women during this phase have moved to being more independent and able to initiate self-care. They are highly interested in learning about the care of their baby but can easily become frustrated and discouraged when they do not immediately master a new skill. d. Attachment is a connection that forms from parent to infant and infant to parent. Attachment has a lifelong impact on the developing individual.

Of the many factors that influence parental responses, nurses should be aware that all of these statements regarding age are true except: A. An adolescent mother's egocentricity and unmet developmental needs interfere with her ability to parent effectively. B. An adolescent mother is likely to use less verbal instruction, be less responsive, and interact less positively than other mothers. C. Adolescent mothers have a higher documented incidence of child abuse. D. Mothers older than 35 often deal with more stress related to work and career issues, as well as decreasing libido.

C. Adolescent mothers have a higher documented incidence of child abuse.

The nurse hears a primiparous woman talking to her son and telling him that his chin is just like his dad's chin. This woman's statement reflects: A. Mutuality B. Synchrony C. Claiming D. Reciprocity

C. Claiming

With regard to parents' early and extended contact with their infant and the relationships built, nurses should be aware that: A. Immediate contact is essential for the parent-child relationship. B. Skin-to-skin contact is preferable to contact with the body totally wrapped in a blanket. C. Extended contact is especially important for adolescents and low-income women because they are at risk for parenting inadequacies. D. Mothers need to take precedence over their partners and other family matters.

C. Extended contact is especially important for adolescents and low-income women because they are at risk for parenting inadequacies.

When helping a woman cope with postpartum blues, the nurse should offer what appropriate suggestions? (Select all that apply.) A. The father should take over care of the baby, because postpartum blues B. are exclusively a female problem. C. Get plenty of rest. D. Plan to get out of the house occasionally. E. Asking for help will not foster independence. F. Use La Leche League or community mental health centers.

C. Get plenty of rest D. Plan to get out of the house occasionally. F. Use La Leche League or community mental health centers. Suggestions for coping with postpartum blues include: · Remember that the "blues" are normal and that both the mother and the father or partner may experience them. · Get plenty of rest; nap when the baby does if possible. Go to bed early, and let friends and family know when to visit and how they can help. (Remember, you are not "Supermom.") · Use relaxation techniques learned in childbirth classes (or ask the nurse to teach you and your partner some techniques). · Do something for yourself. Take advantage of the time your partner or family members care for the baby—soak in the tub (a 20-minute soak can be the equivalent of a 2-hour nap), or go for a walk. · Plan a day out of the house—go to the mall with the baby, being sure to take a stroller or carriage, or go out to eat with friends without the baby. Many communities have churches or other agencies that provide child care programs such as Mothers' Morning Out. · Talk to your partner about the way you feel—for example, about feeling tied down, how the birth met your expectations, and things that will help you (do not be afraid to ask for specifics). · If you are breastfeeding, give yourself and your baby time to learn. · Seek out and use community resources such as La Leche League or community mental health centers. One nationally recognized resource is: Postpartum Support International

Which statement regarding postpartum depression (PPD) is essential for the nurse to be aware of when attempting to formulate a plan of care? A. PPD symptoms are consistently severe. B. This syndrome affects only new mothers. C. PPD can easily go undetected. D. Only mental health professionals should teach new parents about this condition.

C. PPD can easily go undetected. PPD symptoms range from mild to severe, with women having good days and bad days. Screening should be done for mothers and fathers. PPD may also occur in new fathers. PPD can go undetected because parents do not voluntarily admit to this type of emotional distress out of embarrassment, fear, or guilt. The nurse should include information on PPD and how to differentiate this from the baby blues for all clients on discharge. Nurses also can urge new parents to report symptoms and seek follow-up care promptly if they occur.

During a phone follow-up conversation with a woman who is 4 days postpartum, the woman tells the nurse, "I don't know what's wrong. I love my son, but I feel so let down. I seem to cry for no reason!" The nurse would recognize that the woman is experiencing: A. Taking-in B. Postpartum depression (PPD) C. Postpartum blues D. Attachment difficulty

C. Postpartum blues

When making a visit to the home of a postpartum woman 1 week after birth, the nurse should recognize that the woman would characteristically: A. Express a strong need to review events and her behavior during the process of labor and birth. B. Exhibit a reduced attention span, limiting readiness to learn. C. Vacillate between the desire to have her own nurturing needs met and the need to take charge of her own care and that of her newborn. D. Have reestablished her role as a spouse/partner.

C. Vacillate between the desire to have her own nurturing needs met and the need to take charge of her own care and that of her newborn. This is characteristic of the taking-in stage, which lasts for the first few days after birth. This is characteristic of the taking-in stage, which lasts for the first few days after birth. One week after birth the woman should exhibit behaviors characteristic of the taking-hold stage. This stage lasts for as long as 4 to 5 weeks after birth. This reflects the letting-go stage, which indicates that psychosocial recovery is complete.

You observe a new father gently touching his newborn son and spending time gazing at his son. These behaviors are characteristics of A. entrainment B. attachment C. engrossment D. bonding

C. engrossment

Your postpartum patient is 10 hours post birth. She experienced an uncomplicated labor and birth and her newborn is full term with apgar scores of 9 and 9. During your assessment you note that she was hungry and very interested in telling you about her birth experience You had to remind her to change and feed her baby. Base on this assessment, you determine that she is A. having difficulty bonding with her baby B. not concerned about her baby's needs C. in the taking-in phase D. in the taking-hold phase

C. in the taking-in phase

Nursing activities that promote parent-infant attachment are many and varied. One activity that should not be overlooked is the management of the environment. While providing routine mother-baby care, the nurse should ensure that: A. The baby is able to return to the nursery at night so that the new mother can sleep B. Routine times for care are established to reassure the parents C. The father should be encouraged to go home at night to prepare for mother-baby discharge D. An environment that fosters as much privacy as possible should be created

D. An environment that fosters as much privacy as possible should be created

After birth, a crying infant may be soothed by being held in a position in which the newborn can hear the mother's heartbeat. This phenomenon is known as: A. Entrainment B. Reciprocity C. Synchrony D. Biorhythmicity

D. Biorhythmicity

After giving birth to a healthy infant boy, a primiparous woman, 16, is admitted to the postpartum unit. An appropriate nursing diagnosis for her at this time is "risk for impaired parenting related to deficient knowledge of newborn care." In planning for the woman's discharge, what should the nurse be certain to include in the plan of care? A. Tell the woman how to feed and bathe her infant B. Give the woman written information on bathing her infant C. Advise the woman that all mothers instinctively know how to care for their infants D. Provide time for the woman to bathe her infant after she views an infant bath demonstration

D. Provide time for the woman to bathe her infant after she views an infant bath demonstration

A 30-year-old multiparous woman has a boy who is 2 1/2 years old and now an infant girl. She tells the nurse, "I don't know how I'll ever manage both children when I get home." Which suggestion would best help this woman alleviate sibling rivalry? A. Tell the older child that he is a big boy now and should love his new sister B. Let the older child stay with his grandparents for the first 6 weeks to allow him to adjust to the newborn C. Ask friends and relatives not to bring gifts to the older sibling because you do not want to spoil him D. Realize that the regression in habits and behaviors in the older child is a typical reaction and that he needs extra love and attention at this time

D. Realize that the regression in habits and behaviors in the older child is a typical reaction and that he needs extra love and attention at this time

Four hours after a difficult labor and birth, a primiparous woman refuses to feed her baby, stating that she is too tired and just wants to sleep. The nurse should: A. Tell the woman she can rest after she feeds her baby. B. Recognize this as a behavior of the taking-hold stage. C. Record the behavior as ineffective maternal-newborn attachment. D. Take the baby back to the nursery, reassuring the woman that her rest is a priority at this time.

D. Take the baby back to the nursery, reassuring the woman that her rest is a priority at this time. The woman should not be told what to do and needs to care for her own well-being. The taking-hold stage occurs about 1 week after birth. Because the woman needs to rest does not indicate ineffective maternal-newborn attachment. The behavior described is typical of this stage and not a reflection of ineffective attachment unless it persists. Mothers need to reestablish their own well-being to effectively care for their baby.

In follow-up appointments or visits with parents and their new baby, it is useful if the nurse can identify infant behaviors that can either facilitate or inhibit attachment. What is an inhibiting behavior? A. The infant cries only when hungry or wet. B. The infant's activity is somewhat predictable. C. The infant clings to the parents. D. The infant seeks attention from any adult in the room.

D. The infant seeks attention from any adult in the room.

which 2 day postpartum woman has an abnormal finding that requires intervention? A. a 23 year old arabic woman who plans to breastfeed but wants to bottle feed until her milk comes in B. a 28 year old chinese woman who refuses to take a shower. C. a 20 year old japanese woman who has her mother care for her baby. D. a 19 year old caucasian woman who requests that her baby stay in the nursery so she can sleep.

D. a 19 year old caucasian woman who requests that her baby stay in the nursery so she can sleep.

True/False Bonding is bidirectional from parent to infant and infant to parent.

False Bonding is unidirectional from parent to infant. Attachment is bidirectional.

True/False The postpartum nurse is caring for a couple who experienced an unplanned emergency cesarean birth. The nurse observes the following behaviors: Parents are gently touching their newborn. Mother is softly singing to her baby. Father is gazing into his baby's eyes. Based on this data, the correct nursing diagnosis is altered parent-infant bonding related to emergency cesarean birth.

False Cesarean birth can place the parents at risk for bonding, but based on the observed interaction with their newborn, the parents display positive signs of bonding.

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

True Crying, cooing, facial expressions, eye movements, cuddling, and arm and leg movements are all examples of newborn/infant style of communication.

Parents can facilitate the adjustment of their other children to a new baby by: a) Having children at home choose or make a gift to give the new baby on his or her arrival home b) Emphasizing activities that keep the new baby and other children together c) Having the mother carry the new baby into the home so she can show the other children the baby d) Reducing stress on the other children by limiting their involvement and care of the new baby

a) Having children at home choose or make a gift to give the new baby on his or her arrival home

When the infant's behavior and characteristics call forth a corresponding set of maternal behaviors and characteristics, this is called: a) Mutuality b) Bonding c) Claiming d) Acquaintance

a) Mutuality

The nurse observes several interactions between a postpartum woman and her new son. What behavior, if exhibited by this woman, does the nurse identify as a possible maladaptive behavior regarding parent-infant attachment? a) Talks and coos to her son b) Seldom makes eye contact with her son c) Cuddles her son close to her d) Tell visitors how well her son is feeding

b) Seldom makes eye contact with her son

In follow-up appointments or visits with parents and their new baby, it may be useful if the nurse can identify parental behaviours that can either facilitate or inhibit attachment. What is a facilitating behavior? a) The parents have difficulty naming the infant b) The parents hover around the infant, directing attention to and pointment at the infant c) The parents make no effort to interpret the actions or needs of the infant d) The parents do not move from fingertip touch to palmar contact and holding

b) The parents hover around the infant, directing attention to and pointment at the infant

When working with parents who have some form of sensory impairment, nurses should realize that all of these statements are true except: a) One of the major difficulties visually impaired parents experience is the skepticism of health care professionals b) Visually impaired mothers cannot overcome the infant's need for eye-to-eye contact c) The best approach for the nurse is to assess the parents' capabilities rather than focusing on their disabilities d) Technologic advances, including the Internet, can provide deaf parents with a full range of parenting activities and information

b) Visually impaired mothers cannot overcome the infant's need for eye-to-eye contact

The early postpartum period is a time of emotional and physical vulnerability. Many mothers can easily become psychologically overwhelmed by the reality of their new parental responsibilities. Fatigue compounds these issues. Although the baby blues are a common occurrence in the postpartum period, about one-half million women in America experience a more severe syndrome known as postpartum depression (PPD). Which statement regarding PPD is essential for the nurse to be aware of when attempting to formulate a nursing diagnosis? a) PPD symptoms are consistently severe b) This syndrome affects only new members c) PPD can easily go undetected d) Only mental health professionals should teach new parents about this condition

c) PPD can easily go undetected

While making a visit to the home of a postpartum woman 1 week after birth, the nurse should recognize that the woman would characteristically: a) Express a strong need to review the events and her behavior during the process of labor and birth b) Exhibit a reduced attention span, limiting readiness to learn c) Vacillate between the desire to have her own nurturing needs met and the need to take charge of her own care and that of her newborn d) Have reestablished her role as a spouse or partner

c) Vacillate between the desire to have her own nurturing needs met and the need to take charge of her own care and that of her newborn

Health care providers demonstrate a variety of reactions to lesbian couples including failure to acknowledge the "other mother's" role in pregnancy, birth, and parenting. Integration of the non-childbearing partner into care includes offering the same opportunities afforded male partners of heterosexual women. These include all except: a) Labor support b) Cutting the cord c) Rooming in during hospitalization d) Breastfeeding the infant

d) Breastfeeding the infant