Postpartum Depression
What is the greatest risk for a woman diagnosed with postpartum psychosis? A) Infanticide B) Hallucinations C) Insomnia D) Poor judgment
Answer: A All of these are common symptoms of postpartum psychosis, but the greatest risk for a woman with postpartum psychosis is suicide and/or infanticide. The woman who is psychotic may experience delusions or hallucinations that support her perceptions that the infant should not be allowed to live.
Which data should suggest to the home health nurse that the client experiencing postpartum depression is improving? A) Client wearing clean clothes, holding baby while rocking in a chair B) Spouse making dinner, client in bed asleep, baby in rocker in the kitchen C) Dirty dishes in the sink, beds unmade, and client wearing clothing for sleep D) Client watching television in the living room while the baby is in the crib crying
Answer: A The nurse who observes the client wearing clean clothes, holding the baby while rocking in a chair, should determine that treatment for postpartum depression has been effective because these are signs the client is improving. The other choices would indicate lack of interest in child care and care of the home. The client who is sleeping while the spouse is making dinner and watching the baby would indicate treatment has not been effective at all.
The home care nurse is planning care for a client with a history of postpartum depression after the births of all her children. Based on this data, which will the nurse include in the client's plan of care? Select all that apply. A) Encouraging the client to take advantage of those who want to help and maintain outside interests B) Contacting the healthcare provider to ensure the client is prescribed medication for postpartum depression C) Ensuring the client is getting adequate sleep D) Focusing on the care the other children need E) Instructing the client to eat a healthful diet with limited alcohol intake
Answer: A, C, E Because the client has a history of postpartum depression with other children, the nurse needs to plan prevention strategies for the client. By taking advantage of those who want to help and maintaining outside interests, the client may prevent the onset of postpartum depression. Instructing to eat a healthful diet with limited alcohol intake and get adequate sleep are other strategies to prevent postpartum depression. The other interventions would not help prevent postpartum depression.
The postpartum client states that she cannot understand why she does not enjoy being with her baby. Based on this data, which does the nurse suspect the client is experiencing? A) Postpartum infection B) Postpartum depression C) Postpartum psychosis D) Postpartum blues
Answer: B Postpartum depression is characterized by feelings of failure and self-accusation, among others. Postpartum psychosis is more severe, and includes hallucinations and irrationality, which are not represented in this situation. Postpartum infection has nothing to do with this situation. Postpartum blues is characterized by mild depression interspersed with happier feelings, and is self-limiting.
Which nursing intervention would the nurse anticipate carrying out to meet the needs of the family of a client experiencing postpartum depression? A) Emotional support for the newborn B) Emotional support for the father C) Temporary placement of the newborn in foster care D) Child care for the newborn
Answer: B The father may have a difficult time adjusting to both a newborn and the mother's postpartum depression. The father may feel hurt or worried about the mother and overwhelmed by additional responsibilities. Although newborns need security and safety, nursing interventions of emotional support are not age appropriate. The child should not be placed in foster care unless the mother threatens harm to the newborn and no one else is available to care for the child. The nurse is not responsible for providing child care for the newborn.
The nurse caring for a postpartum client would consider the nursing diagnosis of ineffective coping when the client demonstrates which behavior? A) Reading material on care of a newborn B) Lying in bed, lights dim, and refusing to spend time with the baby C) Cuddling the new infant D) Talking with friends and family on the phone
Answer: B The postpartum client who is lying in bed in a darkened room and not wanting to spend time with the new baby is demonstrating signs of ineffective coping. The other behaviors would not indicate ineffective copying but rather effective coping.
The nurse is assessing a client who is 4 weeks postpartum. The client reports having no appetite and wanting to sleep all day. What does this information suggest to the nurse? A) The client is feeling blue, which is normal. B) The client's sleep-wake cycle is disrupted. C) The client may be experiencing postpartum depression. D) The client is developing postpartum psychosis.
Answer: C
A nurse working in labor and delivery is assessing a client's risk for developing postpartum depression. Which is a risk factor for this disorder? A) Multiparity (multiple pregnancies) B) Overwhelming family support C) History of bipolar disorder D) Supportive relationship with spouse
Answer: C A history of bipolar disorder is a risk factor for the development of postpartum depression. Primiparity (first pregnancy) is a risk factor, not multiparity. Lack of family support and lack of spousal support are risk factors for the development of postpartum depression.
A client who is breastfeeding has been diagnosed with postpartum depression after delivering her first child. Which medications does the nurse anticipate being prescribed for this client? Select all that apply. A) Diazepam B) Phenytoin C) Paroxetine D) Fluoxetine E) Sertraline
Answer: C, E Sertraline is recommended to be the first-line treatment for postpartum depression. Paroxetine is the alternative first-line treatment for postpartum depression. Fluoxetine is not recommended for lactating women because of the long half-life and the risk of the medication crossing into the breast milk. Diazepam and phenytoin are not used to treat postpartum depression.
The nurse is instructing a new mother on the strategies to prevent the development of postpartum depression. Which instructions will the nurse include in the teaching session with the client? Select all that apply. A) Restrict fluids and eat a low-fat diet help to avoid the onset of postpartum depression. B) Realize that feeling depressed after delivering a baby is normal and can last for months. C) The only way to avoid postpartum depression is to not have children. D) Encourage the client to plan how to manage the baby's care needs at home to help adjust to motherhood. E) Instruct the client to recognize the signs and symptoms of postpartum depression and phone the healthcare provider if these occur.
Answer: D, E The nurse should instruct the client on the signs and symptoms of postpartum depression with the direction to phone her healthcare provider if this occurs. The nurse should also encourage the client to plan how to manage the baby's care needs at home to help adjust to motherhood. It is not normal to feel depressed for months after delivering a baby. Not having children is not the only way to avoid postpartum depression. Restricting fluids and eating a low-fat diet will not prevent postpartum depression and could harm the new mother's physiologic status.
