Chapter 20: postpartum issues in mental health

Question 1

postpartum blues

Answer 1

• not a psychiatric disorder
• very common in first few days after delivery
• etiology includes hormone shifts and fatigue
• generally, resolves a few days after delivery w/ rest and support

Question 2

postpartum psychiatric disorders

Answer 2

• postpartum depression
• postpartum psychosis

Question 3

postpartum depression

Answer 3

clinical depression that occurs to a mother shortly after the birth of the baby (usually within 3 months)

Question 4

postpartum psychosis

Answer 4

• sudden onset of psychotic symptoms after the birth of a baby

Question 5

postpartum depression

Answer 5

• highest risk in patients with previous history of depression
• symptoms include those typical of depression that last at least 2 weeks within the first 6 months after delivery
• symptoms often include impaired ability to care for infant

Question 6

treatment of postpartum depression:

Answer 6

antidepressants
psychotherapy and family support

Question 7

antidepressants for postpartum depression

Answer 7

• though these are treatment of choice, some are excreted in breast milk
• discussion w/ physician the risks and benefits of taking these medications

Question 8

postpartum psychosis

Answer 8

• a medical emergency, as baby could be at risk
• generally, patient has history of psychiatric disorder, especially bipolar
• women taking lithium may stop medication during pregnancy due to risk to fetus for birth defects leading to exacerbations

Question 9

postpartum psychosis symptoms

Answer 9

• disorganized behavior
• extreme mood shifts
• insomnia
• delusions that often center around the baby
• bizarre behavior
• risk of infantacide and/or suicide
• syjmptoms may begin during pregnancy

Question 10

treatment

Answer 10

• emergency psychiatric treatment that may include hospitalization
• safety of infant must be ensured
• mood stabilizer and antipsychotic medications
• rapid tranquilization may be required when large doses of antipsychotics are needed to control behavior

Question 11

pharmacologic treatment

Answer 11

• risk to infant w/ breastfeeding from mood stabilizers
• education about risks and benefits of breastfeeding must be part of prenatal teaching

Question 12

nursing care for the postpartum patient

Answer 12

• support
• education for patient and family
• safety
• monitoring of high risk patients prenatally
• appropriate medication management