2 OB Chapter 18 - Postpartum Psychosocial Adaptations

The home-care nurse is visiting a new mother who delivered 1 week ago. The mother complains about not being able to sleep and that she is tired and cries easily. The best response by the nurse would be: "Having a baby is difficult; it will be a long time before you get a good night's sleep." "Maybe your mother can come in and help you out." "It is normal for this to happen and it should go away in 2 weeks. It must be very difficult for you to feel this way with a new baby." "The hospital nurses must not have taught you enough information about the changes you will experience during these first 6 weeks."

"It is normal for this to happen and it should go away in 2 weeks. It must be very difficult for you to feel this way with a new baby."

Nursing measures to promote bonding and attachment include which of the following? (Select all that apply.) Assist the parents in unwrapping the baby to inspect. Point out that when the infant grasps the mother's or father's finger, this is a natural reflex. Explain the physical changes in the newborn, such as molding, as being normal. Encourage the mother to let the infant stay in the nursery as much as possible so the mother can rest. Position the infant in a face-to-face position with the mother.

Assist the parents in unwrapping the baby to inspect. Position the infant in a face-to-face position with the mother.

To promote bonding during the first hour after birth the nurse can do which of the following? (Select all that apply.) Delay procedures if appropriate Allow father to hold newborn Demonstrate proper bottle feeding techniques Allow as much contact with the newborn as possible Use the time to do parent teaching on newborn characteristics

Delay procedures if appropriate Allow father to hold newborn Allow as much contact with the newborn as possible

Explain the taking in phase...

During the taking-in phase the mother is focused primarily on her own need for fluid, food, and sleep. She may be passive and dependent. This is normal and lasts about 2 days.

The new parents express concern that their 4-year-old son is jealous of the new baby. They are planning on going home tomorrow and are not sure how the preschooler will react when they bring the baby home. Which of the following suggestions by the nurse will be most helpful? Be aware that the child may regress to an earlier stage. Have the mother go into the house alone and spend time with the child before the father brings the baby in. Have the child stay with a grandparent until the parents adjust to the new baby. Tell the child that he is a "big boy" now and doesn't need his crib so the new baby will be using it for a while.

Have the mother go into the house alone and spend time with the child before the father brings the baby in.

The maternal adaptation phase in which the mother relinquishes her previous role as a being childless and her old lifestyle is called _______________.

Letting-go

Explain post partum blues...

Postpartum blues begins in the first week and usually last no longer than 2 weeks. The mother needs to be supported during this time and given accurate information about the process. Responses a and b belittle the mother and may make her feel inadequate. Response d places blame on someone else and does not deal with the problem.

A new father of 1 day expresses concern to the nurse that his wife, who is normally very independent, is asking him to make all of the decisions. The nurse can best explain this as: a normal occurrence because the mother is in pain. an abnormal occurrence that needs to be assessed further. a normal occurrence because the mother is in the taking-in phase. a normal occurrence because the mother is frustrated with the care of the newborn

a normal occurrence because the mother is in the taking-in phase.

When making a visit to the home of a postpartum woman 1 week after birth, the nurse should recognize that the woman would characteristically: express a strong need to review events and her behavior during the process of labor and birth. exhibit a reduced attention span, limiting readiness to learn. attempt to meet the needs of the infant and is eager to learn about infant care. have reestablished her role as a spouse/partner.

attempt to meet the needs of the infant and is eager to learn about infant care. Taking hold A/B taking in D letting go

The development of a strong emotional tie of a parent to a newborn is called _____________.

bonding

When the father develops a bond with the new infant and has an intense interest in how the infant looks and responds, this is called ________________.

engrossment

The day after her delivery, the woman complains that she did not lose all the weight she had gained during the pregnancy. The nurse can best respond to the mother with the knowledge that: she has lost the majority of the weight and the rest will be gone within 1 week. she has lost some of the weight and the rest will slowly disappear within 6 weeks. it will take about 6 to 12 months for all of the weight gained with the pregnancy to disappear. most women do not lose all of the weight gained with each pregnancy.

it will take about 6 to 12 months for all of the weight gained with the pregnancy to disappear.

The new mother comments that the newborn "has his father's eyes." The nurse recognizes this as: part of the bonding process called claiming. the mother trying to find signs of the baby's paternity. the mother trying to include the father into the bonding process. part of the letting-go phase of maternal adaptation.

part of the bonding process called claiming.

A newborn is rooming-in with his teenage mother, who is watching TV. The nurse notes that the baby is awake and quiet. The best nursing action is to: pick the baby up and point out his alert behaviors to the mother. tell the mother to pick up her baby and talk with him while he is awake. focus care on the mother, rather than the infant, so she can recuperate. encourage the mother to feed the infant before he begins crying.

pick the baby up and point out his alert behaviors to the mother.

A primiparous woman is in the taking-in stage of psychosocial recovery and adjustment following birth. The nurse, recognizing women's needs during this stage should: foster an active role in the baby's care. provide time for the mother to reflect on the events of the childbirth. 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. promote maternal independence by encouraging her to meet her own hygiene and comfort needs.

provide time for the mother to reflect on the events of the childbirth.

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: tell the woman she can rest after she feeds her baby. recognize this as a behavior of the taking-hold stage. record the behavior as ineffective maternal-newborn attachment. take the baby back to the nursery, reassuring the woman that her rest is a priority at this time.

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