Postpartum Complication questions
The nurse is caring for a postpartum mother suspected of developing postpartum psychosis. Which of the following statements accurately characterize this disorder? 1. Symptoms start 2 days after delivery. 2. The disorder is common in postpartum women. 3. Symptoms include delusions and hallucinations. 4. Suicide and infanticide are uncommon in this disorder. 5. The disorder rarely occurs without psychiatric history.
3 and 5 A postpartum woman should be suspected of psychosis if she exhibits manic-depressive behaviors (delusions or hallucinations), generally starting within 4 weeks postpartum. Typically, the woman has a past history of a psychiatric disorder and treatment. The disorder occurs in less then 1% of postpartum mothers. It's considered a medical emergency. Suicide and infanticide are common.
On the 2nd postpartum day, a client tells the nurse she feels anxious and tearful. Which response by the nurse would be appropriate? 1. "It isn't unusual to have those feelings after delivery." 2. "How have you coped with other problems in your life?" 3. "To whom do you usually talk when you have problems?" 4. "Don't worry. You'll be fine."
1. "It isn't unusual to have those feelings after delivery." Approximately 50% to 70% of postpartum clients experience transient depression during the first 7 to 10 days after delivery. The nurse should ask about the client's previous coping mechanisms and current support persons only after assuring her that her feelings are expected. Telling the client she'll be fine blocks further communication.
A client gives birth to a stillborn infant at 36 weeks' gestation. When caring for this client, which strategy by the nurse would be most helpful? 1. Be selective in providing the information that the client seeks. 2. Encourage the client to see, touch, and hold the dead infant. 3. Provide information about possible causes of the stillbirth only if the client requests it. 4. Let the child's father decide what information the client receives
2. Encourage the client to see, touch, and hold the dead infant. When caring for a client who has suffered perinatal loss, the nurse should provide an opportunity for her to bond with the dead child and allow the child to become part of the family unit. Parents who aren't given such a chance may experience fantasies about the child, which may be worse than the reality. If the child has gross deformities, the nurse should prepare the client for these. If the client doesn't ask about her child, the nurse should encourage her to do so and provide any information she seems ready to hear. The client needs a full explanation of all factors related to the experience so she can grieve appropriately. Letting the child's father decide which information the client receives is inappropriate.