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NU 330 > Chapter 5 > Flashcards

Chapter 5 Flashcards

1
Q

what is the #1 medical complication related to childbearing

A

Perinatal Mood and Anxiety Disorders (PMADs)

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2
Q

PMADs is ___ and ____

A

detectable and treatable

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3
Q

why do we care about PMADs?

A

we have the opportunity to help women with prior undiagnosed mental illness or those at risk for continued mental illness

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4
Q

what societal tragic consequences can PMADs lead to?

A
  • relationship problems/divorce
  • disability/unemployment
  • child neglect and abuse
  • developmental delays/behavior problems
  • infanticide/homicide/suicide
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5
Q

when do PMADs occur?

A
  • depression and anxiety disorders can occur any time in pregnancy or in the first year postpartum
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6
Q

PMAD is replacing what narrow definition term?

A

PPD

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7
Q

what % of mothers experience baby blues?

A

80% experiencing baby blues lasting for the first two weeks after baby arrives

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8
Q

prevalence of serious depression and/or anxiety in pregnancy or postpartum period

A

1 in 7 mothers

**spikes to 1 in 5 during months 5-7 postpartum

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9
Q

prevalence of postpartum psychosis

A

1-2 in 1000 women

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10
Q

prevalence of fathers with depression in the postpartum period

A

1 in 10 fathers

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11
Q

myths of motherhood

A
  • getting pregnant is easy/hard
  • 50% of pregnancies are unplanned
  • becoming a mother is easy/natural
  • being pregnant is easy or always wonderful
  • labor and delivery will always go as planned
  • breastfeeding is natural and will be easy
  • the baby will sleep all the time
  • superwoman/wife/mother is the expectation
  • all pregnancies are wanted
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12
Q

pregnancy equivalency myths

A
  • pregnancy = live baby
  • pregnancy = love in a relationship
  • pregnancy = healthy baby
  • pregnancy = fulfillment
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13
Q

PP psychological and physiological changes

A
  • focus on baby/forming attachment
  • fatigue/sleep deprivation
  • loss of freedom, control and self esteem
  • hormonal changes
  • birth not going as expected
  • learning new roles
  • role transitions
  • dreams and expectations
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14
Q

feelings of “loss”

A
  • loss of freedom/feeling tied down
  • loss of old identity
  • loss of control
  • loss of a body image
  • loss of self esteem
  • loss of financial means
  • loss of image of career/loss of career potential
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15
Q

types of perinatal mood disorders

A
  • depression
  • anxiety or panic disorder
  • obsessive compulsive disorder
  • psychosis
  • bipolar
  • post-traumatic stress disorder

** These disorders can affect people at any time in their lives however there is a marked increase in prevalence of these disorders during the pregnancy and postpartum period.

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16
Q

is postpartum blues a mild form of depression?

A

no

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17
Q

postpartum blues peaks at what time?

A

peaks 3-5 days after delivery

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18
Q

features of postpartum blues

A

tearfulness, lability, reactivity

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19
Q

postpartum blues: predominant mood

A

happiness

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20
Q

is postpartum blues related to stress or psychiatric history?

A

no

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21
Q

what is believed to be the cause of postpartum blues?

A
  • hormone withdrawal
  • maternal bonding hormones
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22
Q

baby blues affects what % of new mothers

A

80%

23
Q

symptoms of baby blues

A

** these symptoms are MILD
- crying
- feeling overwhelmed with motherhood
- being uncertain

24
Q

cause of baby blues

A

due to the extreme hormone fluctuation that happens in the days and weeks surrounding birth

25
Q

how long does baby blues last?

A

lasts 2 days to 2 weeks

26
Q

contributing factors to baby blues

A
  • extreme sleep deprivation
  • fatigue
27
Q

perinatal depression symptoms

A
  • OVERWHELMED
  • lack of feelings toward the baby
  • inability to take care of self or family
  • loss of joy, pleasure, interest
  • anxiety
  • isolation
  • “this doesn’t feel like me”
  • mood swings
  • worthlessness
28
Q

anxiety symptoms

A
  • Agitated
  • Inability to sit still
  • Excessive concern about baby’s or her own health
  • High Alert
  • Appetite changes- usually rapid weight loss
  • Sleep Disturbances- inability to fall or stay asleep
  • Constant Worry
  • Racing thoughts
  • Shortness of breath
  • Heart palpitations
29
Q

OCD is characterized by

A

intrusive, troubling thoughts (obsessions) and repetitive, ritualistic behaviors (compulsions) which are time consuming, cause significant distress and impair functioning

30
Q

classic OCD symptoms

A
  • cleaning
  • checking
  • counting
  • ordering
  • obsession with germs and cleanliness
  • checking on baby
  • hypervigilance
31
Q

what are the components of the “OCD cycle”

A

obsessions, anxiety, compulsions, relief

32
Q

prevalence of OCD

A
  • general population: 1.08%
  • pregnant women: 2.07%
  • postpartum women: 2.43%
33
Q

incidence of OCD (in pregnancy/postpartum)

A
  • in pregnancy: 2.1-13.7%
  • in postpartum: 2.3-15.2%
34
Q

___ and ___ are associated with the onset of OCD

A

pregnancy and postpartum

**more frequently than other life events

35
Q

risk factors associated with postpartum OCD

A
  • primiparity
  • first 4 weeks of PP period
  • higher levels of anxiety
  • previous hx of OCD
  • avoidant personality disorder
  • personal hx of major depression
  • existence of OCD related dysfunctional belief
36
Q

OCD % prevalence: primiparity vs multiparity

A

primi: 6.57%
multi: 1.8%

37
Q

what is PTSD?

A

Anxiety disorder after a terrifying event or ordeal in which grave physical harm occurred or was threatened

**subjective (“it’s in the eye of the beholder”)

38
Q

symptoms of PTSD

A
  • intrusive re-experiencing of a post traumatic event
  • isolation from family and friends
  • “emotional numbing”
  • hyperarousal/hypervigilance
  • avoidance
39
Q

are postpartum blues and baby blues the same thing or different?

A

same thing, different names

40
Q

postpartum PTSD themes

A
  • perception of lack of caring
  • poor communication
  • feeling of powerlessness
  • do the ends justify the means
41
Q

PTSD theme: perception of lack of caring

A
  • feeling abandoned
  • stripped of dignity
  • lack of support or reassurance
42
Q

PTSD theme: poor communication

A
  • moms felt invincible
43
Q

PTSD theme: feeling of powerlessness

A
  • betrayal of trust
  • didn’t feel protected by staff
44
Q

PTSD theme: do the ends justify the means?

A

healthy baby justified traumatic delivery?
- healthy mommy, healthy baby

45
Q

PTSD in NICU parents: risk factors

A
  • neonatal complications
  • lower gestational age
  • greater length of stay in NICU
  • stillbirth
46
Q

PTSD treatments

A
  • EMD (eye movement)
  • CBT (cognitive behavioral therapy)
47
Q

prominent symptoms of PTSD in NICU parents

A
  • intrusive memories of infant’s hospitalization
  • avoidance of childbirth reminders
48
Q

types of birth trauma

A
  • Emergency c/s
  • Postpartum Hemorrhage
  • Preterm Birth
  • Infant in NICU
  • Vacuum or forceps delivery
  • Severe Pre-ecclampsia
  • 3rd or 4th degree laceration
  • Hyperemesis
  • Traumatic Vaginal Birth
49
Q

onset of psychosis

A

usually within first 3 weeks after delivery

50
Q

postpartum psychosis symptoms

A
  • Delusions (baby is possessed by the devil)
  • Hallucinations (seeing someone else’s face where the baby’s should be)
  • Insomnia
  • Confusion/disorientation (worse than in normal postpartum psychoses).
  • Rapid mood swings (worse than in normal postpartum psychoses).
  • Waxing and waning (can appear to see normal in-between psychotic symptoms).
51
Q

postpartum depression in dads is ____ as common as adult male population in the US

A

twice

52
Q

dads with depression symptoms

A
  • initial high after gives way to depression
  • irritable
  • agression
  • hostility
  • distancing or “checking out”
  • not very likely to show sadness
53
Q

factors that would exacerbate PMADs

A
  • Complications in pregnancy, birth or breastfeeding
  • Age related factors : teenage or perimenopause
  • Climate Stressors: Seasonal affective disorders Mania or Depression
  • Perfectionism, high expectations (“Superwoman Mentality”)
  • Pain (intolerable/untreated)
  • Sleep Disturbances
  • Abrupt discontinuation of breastfeeding.
  • Childcare Stress/Relationship stress
  • Losses- miscarriages, neonatal death, stillborn, elective termination
  • History of childhood sexual abuse
54
Q

treatment options for PMADs

A
  • medical evaluation and treatment
  • social support and practical help
  • new parent classes and groups
  • mental health counseling

NU 330 (18 decks)

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