Chapter 22, Transition to Parenthood

Which statement describes a parental behavior that can hinder infant attachment?

"All the baby seems to do is cry and want to eat."

Which condition is indicated for a postpartum client who is sad, cries frequently, complains that other family members are neglecting her, is restless, and has a headache?

"Baby blues"

Which statement made by the father of a newborn would be categorized in the "expectations and intentions" phase of early development of the involved father role?

"I want to be involved in the care of my son as much as possible."

Which client statement describes the taking-hold phase during adjustment to the postpartum period?

"I want to learn how to give the baby a bath."

Which nursing statement is objectionable to the Mexican postpartum client when advising about methods to improve mother-infant attachment?

"Maintain sustained, direct eye contact with your child."

Which nursing response is appropriate for a lactating client who states "Whenever I try to breastfeed, my baby starts crying and won't latch properly?"

"Massage your breast to increase milk supply."

Which statement describes an infant behavior that can hinder parental attachment?

"My baby does not smile as much as I thought she would."

Which behavior indicates an older child is not adapting well to the newborn and may have feelings of sibling rivalry?

Always tries to grab the parents' attention

Which nursing action is appropriate in regard to bonding for the parents of a neonate who has been transferred to the neonatal intensive care unit?

Assure the parents that a delay in contact will not inhibit attachment with the baby.

Which process is described when the parent comes to love and accept a child, and the child comes to love and accept a parent?

Attachment

Which process is reflected when a postpartum client states, "Everyone says that my baby looks like her father, but I feel like her eyes and nose are similar to mine."?

Claiming

Which is a characteristic feature for a postpartum client experiencing "baby blues"?

Cries for no apparent reason

Which behavior of the infant indicates effective attachment with the parents? Select all that apply.

Crying when wet or hungry Making eye contact with parents Lifts arms up on seeing the father

Which nursing intervention is beneficial for the adolescent postpartum client who is unable to provide safe and adequate care?

Demonstrating care routines to the client

Which behaviors are exhibited during the letting-go phase of maternal role adaptation? Select all that apply.

Emergence of family unit Sexual intimacy relationship continuing Defining one's individual roles

Which nursing action is appropriate when a tired client, her partner, and their newborn with temperature instability are admitted to the postpartum unit after a 2-hour recovery from a cesarean delivery?

Encourage the client's partner to place the infant skin to skin.

Which nursing intervention promotes a healthy relationship between the father and infant in a set of adolescent parents having difficulty transitioning to parenthood?

Encourage the partners to discuss the father's involvement.

Which nursing intervention reinforces the new functions and roles for family members struggling to adapt to the changes brought by the newborn's arrival?

Encouraging and supporting the family members' efforts

Which are the phases of early development of the involved father role?

Expectations and intentions; confronting reality; creating the role of the involved father; and reaping the rewards

Which nursing instruction is appropriate to include when teaching a group of postpartum women about coping with postpartum blues? Select all that apply.

Get plenty of rest. Perform deep breathing exercises. Soak in the bathtub for 20 minutes.

Which nursing interventions are appropriate when helping a client cope with postpartum blues? Select all that apply.

Get plenty of rest. Plan to get out of the house occasionally. Use the La Leche League or community mental health centers.

Which parent action facilitates the adjustment of their other children to a new baby?

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

Which is a facilitating behavior when considering parental attachment?

Hovering around the infant, directing attention to and pointing at the infant

Which opportunities reflect integration of co-parenting for same-sex couples? Select all that apply.

Labor support Cutting the cord Rooming-in during hospitalization Legal involvement with naming the child

Which nursing instruction is appropriate for new parents who complain of disturbed sleep? Select all that apply.

Limit the time for visitors. Use infant naptime to sleep. Ask other family members to assist in daily tasks.

Which process is described when the infant's behaviors and characteristics call forth a corresponding set of maternal behaviors and characteristics?

Mutuality

Which statements are accurate regarding a nurse working with parents who have a sensory impairment? Select all that apply.

One of the major difficulties visually impaired parents experience is the skepticism of health care professionals. The best approach for the nurse is to assess the parents' capabilities rather than focusing on their disabilities. Technologic advances, including the Internet, can provide deaf parents with a full range of parenting activities and information. Visually impaired parents need the opportunity to hold and touch the baby after birth.

Which statement regarding postpartum depression (PPD) is essential for the nurse to be aware of when attempting to formulate a plan of care?

PPD can easily go undetected.

Which are strategies for facilitating sibling acceptance of a new baby? Select all that apply.

Plan individual time with each child. Give the older child a T-shirt that says "I'm a big brother" (or "sister"). Have a small gift from the baby to give to your older child each day he or she visits in the hospital. Arrange for your older child to be among the first to see the newborn. Let him or her hold the baby in the hospital.

Which condition is indicated for a 4-day postpartum client who had a vaginal delivery, reports being restless, has insomnia, and is having regular episodes of headache?

Postpartum blues

Which condition describes a postpartum client who often cries for no reason and reports that she is experiencing a difficult time in her life for 6 weeks since delivery?

Postpartum depression (PPD)

Which nursing intervention is appropriate for the mother who lays her hungry, crying baby on the side of the bed and continues reading her book?

Promotion of child-parent attachment

Which cultural characteristic is exhibited when a Vietnamese client avoids cuddling the infant?

Protecting the infant from evil spirits

Which describes a nursing intervention to implement when working with visually impaired parents?

Provide an explanation about the expected routines.

Which nursing intervention is appropriate for a primiparous female client who is in the taking-in phase of psychosocial recovery and adjustment after birth?

Provide time for the mother to reflect on the events of and her behavior during childbirth.

Which are interventions utilized to promote parent-infant attachment? Select all that apply.

Providing rooming-in while in the hospital. Assisting parent(s) to participate in infant care. Encouraging parent(s) to hold the infant close to the body. Providing an opportunity for parent(s) to see, hold, and examine the newborn immediately after birth.

Which behavior describes the father of a newborn during the second phase of parenthood?

Realizes his inconsistent expectations from fatherhood

Which phases does the father of a newborn experience during the transition to parenthood? Select all that apply.

Reaping rewards phase Confronting reality phase Expectations and intentions phase

Which infant behavior can lead to parental disappointment?

Regurgitating and vomiting often

Which is a maladaptive behavior regarding parent-infant attachment?

Seldom makes eye contact with her son

Which nursing strategy is appropriate to recommend to a family when promoting bonding between a preschool-age child and a newborn?

Send a photograph of the baby for the child to take to school.

Which are facilitating behaviors when assessing infant behaviors affecting parental attachment? Select all that apply.

Smiles Enjoys being cuddled and held Vocalizes; cries only when hungry or wet

Which nursing action is appropriate for the primiparous client who had a difficult labor and birth and refuses to feed her baby stating that she is tired and just wants to sleep?

Take the baby back to the nursery, reassuring the woman that her rest is a priority at this time.

Which intervention addresses the client complaint she cannot make eye contact with her baby when lying on her chest?

Teach the mother to hold the newborn in the en face position.

Which action of the couple during the second phase of transition to parenthood indicates that they would cope well with this emotional phase?

The mother takes time out from infant care and spends time with the father.

Which is a reason a client who was very excited to deliver the baby has suddenly become quiet and uninterested after childbirth?

The parent is disappointed with the child's sex.

Which findings indicate that new parents are experiencing difficulty with parent-infant attachment? Select all that apply.

They comment that their child is not very attractive. One parent is preoccupied with career and work-related obligations.

Which rationale supports the nurse asking a client "Who takes care of your child at home, and are you able to get adequate rest?"

To determine the adequacy of a support system

Which is the purpose of placing a neonate on the mother's chest and dimming the light in the room?

To encourage eye contact with the mother

Which is a newborn benefit when placed on the client's bare chest in the prone position?

To improve the newborn's thermoregulation

Which nursing instruction is appropriate postpartum counseling for a lesbian couple whose non-childbearing female partner expresses a wish to breastfeed the newborn without inducing lactation?

Use a supplemental feeding device (SFD).

Which behavior is appropriate for a postpartum client 1 week after birth?

Vacillates 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

Which parent(s) behaviors are assessed when determining attachment? Select all that apply.

When parents are holding the infant, what kind of body contact is seen? How comfortable do the parents appear in terms of caring for the infant? When the infant is awake, what kinds of stimulation do the parents provide? What type of affection do they demonstrate to the newborn, such as smiling, stroking, kissing, or rocking? Do the parents speak about the infant in terms of identification—who the infant resembles, and what appears special about their infant over other infants?