OB ATI: Chapter 18 - Baby Friendly Care

A nurse is caring for a client who is 1 day postpartum. The nurse is assessing for maternal adaptation and mother-infant bonding. Which of the following behaviors by the client indicates a need for the nurse to intervene? (Select all that apply.) A. Demonstrates apathy when the infant cries B. Touches the infant and maintains close physical proximity C. Views the infant's behavior as uncooperative during diaper changing D. Identifies and relates infant's characteristics to those of family members E. Interprets the infant's behavior as meaningful and a way of expressing needs

A, C

A client in the early postpartum period is very excited and talkative. She is repeatedly telling the nurse every detail of her labor and birth. Because the client will not stop talking, the nurse is having difficulty completing the postpartum assessments. The appropriate action by the nurse is to A. come back later when the client is more cooperative. B. give the client time to express her feelings. C. tell the that client she needs to be quiet so the assessment can be completed. D. redirect the client's focus so that she will become quiet.

B

A home-health nurse is conducting a visit to the home of a client who has a 2-month-old infant and a 4-year-old son. The client expresses frustration about the behavior of the 4-year-old who was previously toilet trained and is now frequently wetting himself. The nurse should provide education and explains to the client that A. her son was probably not ready for toilet training and should wear training pants. B. her son is showing an adverse sibling response. C. this indicates the child requires counseling. D. this can be resolved by sending the child to preschool.

B

A nurse concludes that the father of an infant is not showing positive signs of parent-infant bonding and appears to be very anxious and nervous when the infant's mother asks him to bring her the infant. Which of the following is an appropriate nursing intervention to promote father-infant bonding? A. Hand the father the infant, and suggest that he change the diaper. B. Ask the father why he is so anxious and nervous. C. Tell the father that he will grow accustomed to the infant. D. Provide education about infant care when the father is present.

D

A nurse in the delivery room is planning to promote maternal-infant bonding for a client who just delivered. Which of the following is the priority action by the nurse? A. Encourage the parents to touch and explore the neonate's features. B. Limit noise and interruption in the delivery room. C. Place the neonate at the client's breast. D. Place the neonate skin-to-skin on the client's chest.

D

behaviors that impair and show lack of mother-infant bonding

apathy, disgust when voids, spits up, expression of disappointment, turning away, no close proximity, no talking, rough handling, ignoring completely

behaviors that facilitate mother-infant bond

consider infant a family member, face to face eye contact, assigns meaning to infant's behavior and views positively, identify unique characteristics of infant and relates them to family members, naming infant, touching, close proximity, feeding, changing diaper, responding to infant cries, smiles, talks to, sings to infant

becoming connected

development father-infant bond, 3 stages, experiences feelings of attachment to infant

making commitment

development father-infant bond, 3 stages, takes responsibility of parenting

making room for infant

development of father-infant bond, 3 stages, modifies his life to include care of infant

nursing interventions to assist in father-infant bond

education on infant care when father is present, encouragement, guidance and involving him as full partner rather than just a helper, encourage couples to verbalizes concerns and expectations related to infant care

impaired parenting

emotional detachment, inability to care for infant (risk neglect and failure to thrive), failure to bond increases risk physical and or emotional abuse

true or false: it is not part of nursing interventions for impaired parenting to give clients/caregivers information about social networks that provide support system where client and caregivers can get assistance

false

true or false: it is not part of nursing interventions for impaired parenting to involve outreach programs dealing with self-care, parent-child interactions, child injuries, and failure to thrive

false

true or false: nursing intervention for impaired parenting does not include home visits by nurse and group sessions for discussing infant care and parenting problems

false

signs of mood swings

feelings of being down, inadequacy, anxiety related to ineffective breastfeeding, emotional lability with frequent crying, flat affect, withdrawn, feeling unable to care for infant

positive responses from sibling

interest and concern for infant, increased independence

interdependent

letting go phase of maternal role attainment, family as a unit, resumption of role (intimate partner, individual)

early initiation of breastfeeding

nursing intervention that facilitate maternal-infant bond, encouraging to recognize infant readiness cues, offering assistance as needed

infant care teaching

nursing intervention that facilitate maternal-infant bond, improvement in confidence when this is taught

skin to skin contact

nursing intervention that facilitate maternal-infant bonding, immediately after birth

rooming-in

nursing intervention that facilitate maternal-infant bonding, quiet and private environment

reality

paternal adaptation, 3 stages, discovers that his expectations may not be met, might feel sad, frustrated, jealous, embraces need to be actively involved in parenting

transition to mastery

paternal adaptation, 3 stages, father decides to become actively involved in care

expectations

paternal adaptation, 3 stages, has preconceived ideas about what it will be like to be a father

adverse responses from sibling

signs of rivalry and jealousy, regression in toileting and sleep habits, aggression toward infant, increased attention-seeking behaviors and whining

dependent-independent

taking hold phase of maternal role attainment, day 2 to 3 up to 10 days to several weeks, baby care and improving care-giving competency, needs acceptance from others to take charge, want to learn and practice

dependent

taking in phase of maternal role attainment, first 24 to 48 hr, meeting personal needs, rely on others for assistance, excited, talkative, need to review birth experience with others

facilitate sibling acceptance

tour obstetric unit, let sibling be the first one to see infant, provide gift from infant to give to sibling, arrange one parent spend time with sibling while other is caring for infant, allow older siblings to help in providing care, provide preschooler with doll to care for

true or false: as part of nursing intervention for impaired parenting emphasize verbal and nonverbal communication skills between client, caregivers, infant

true

true or false: as part of nursing intervention for impaired parenting provide continued assessment of client's parenting abilities, and other caregivers for infant

true

true or false: nursing intervention for impaired parenting includes encouragement of support of grandparents and other family members

true

true or false: part of nursing intervention for impaired parenting is notifying programs that provide prompt and effective community interventions to prevent more serious problems from occuring

true

true or false: patient's emotional and physical condition, and the infant's physical condition, also culture, age, socioeconomic level after birth can all affect the family's bonding process

true