Exam 2 - Perinatal Mental Health

Question 1

___% of birthing persons experience some kind of mood disturbance postpartum

Answer 1

85

Question 2

the 3 subclasses of postpartum psychiatric disorders are

Answer 2

(1) baby blues
(2) postpartum major mood disorders
(3) postpartum psychosis

Question 3

____ is considered a medical emergency

Answer 3

postpartum psychosis

Question 4

Transient period of “depression”

Answer 4

baby blues

Question 5

_____ may be d/t hormonal fluctuations, sleep deprivation, and role change

Answer 5

baby blues

Question 6

when does baby blues peak?

Answer 6

3-5 days after delivery

Question 7

baby blues usually resolves ____

Answer 7

10-12 days postpartum

Question 8

symptoms of baby blues are

Answer 8

(1) mood lability
(2) anxiety
(3) sleeplessness
(4) crying
(5) loss of appetite

Question 9

baby blues is a risk factor for ___

Answer 9

postpartum depression

Question 10

the biggest role for the nurse in baby blues is

Answer 10

education

Question 11

4 pieces of education a nurse can provide for someone with baby blues include

Answer 11

(1) s/s of depression
(2) provide resources
(3) discuss sleep hygiene
(4) discuss infant behavioral regulation

Question 12

major/minor depressive episodes that occur during pregnancy or the first 12 months after birth

Answer 12

perinatal depression

Question 13

Psychiatric illness in which patients experience one or more major depressive episodes that include (1) 2 weeks or longer; (2) functional impairment; (3) 5 or more symptoms

Answer 13

DSM-5 MDD diagnosis

Question 14

Name at least 3 symptoms of MDD

Answer 14

(1) depressed mood
(2) diminished interest or pleasure (anhedonia)
(3) changes in weight
(4) insomnia or hypersomnia
(5) psychomotor agitation or retardation
(6) fatigue
(7) poor concentration
(8) suicidal ideation

Question 15

Name at least 3 risk factors for perinatal depression

Answer 15

(1) maternal anxiety
(2) life stress
(3) h/o depression
(4) lack of social support
(5) unintended pregnancy
(6) domestic violence
(7) lower income / Medicaid insurance
(8) smoking
(9) single status

Question 16

_____ is the biggest risk factor for postpartum depression

Answer 16

depression during pregnancy

Question 17

breastfeeding problems are a risk factor for

Answer 17

postpartum depression

Question 18

preterm birth or infant admission to NICU puts the mom at risk for

Answer 18

postpartum depression

Question 19

name at least 3 risks to the infant being exposed to recurrent or postpartum depression

Answer 19

(1) impaired bonding
(2) impaired emotional development
(3) language impairment
(4) impaired attn
(5) impaired cognitive skills
(6) impaired parenting behavior

Question 20

you are more likely to have postpartum depression, rather than baby blues if…

Answer 20

(1) h/o mood d/o before postpartum
(2) more severe symptoms
(3) symptoms are lasting longer

Question 21

EPDS is a tool to ___

Answer 21

screen for perinatal depression

Question 22

the most common pharmacologic treatment for postpartum depression is

Answer 22

sertraline / zoloft

Question 23

why is sertraline the preferred med for postpartum depression?

Answer 23

(1) safe during pregnancy and breastfeeding
(2) can titrate the dose
(3) often taken during pregnancy

Question 24

sertraline can cause ____ to neonates at birth

Answer 24

respiratory depression (transient)

Question 25

what is the most important thing to do to for the pt with pharmacologic tx?

Answer 25

counsel the pt on risk and benefit

Question 26

name 3 other common drugs used for postpartum depression tx

Answer 26

celexa, lexapro, prozac, paxil

Question 27

postpartum psychosis risk factors

Answer 27

(1) bipolar disorder (2) h/o postpartum psychosis (3) family h/o psychotic illness (4) cessation of meds for bipolar (5) sleep deprivation (6) prior pregnancy loss

Question 28

postpartum psychosis s/s

Answer 28

manic/mixed episode that includes decreased sleep, psychosis, and agitation

Question 29

___% of pts with postpartum psychosis will relapse

Answer 29

80

Question 30

How can we assess pts with concern for harming their infant?

Answer 30

(1) obsessions (2) ego-dystonic vs ego-systonic thoughts (3) intent and plan (4) psychosis (5) suicidal thoughts

Question 31

name the key parts of treatment for postpartum psychosis

Answer 31

(1) hospitalization (2) initiation of meds (3) sleep hygiene (4) preventative plan in place

Question 32

anxiety disorders risk factors

Answer 32

(1) younger (2) female (3) minimal social support (4) family h/o anxiety disorder

Question 33

____ is the most common psychiatric condition in postpartum

Answer 33

anxiety

Question 34

perinatal anxiety disorder includes

Answer 34

(1) GAD (2) OCD (3) PTSD (4) depression and anxiety together

Question 35

when can a mother develop perinatal anxiety?

Answer 35

(1) immediately after delivery through 6 weeks (2) during pregnancy (3) weaning or return of menses (4) undiagnosed (5) fear, anxiety, stress

Question 36

s/s of postpartum GAD

Answer 36

(1) constant worry (2) feeling that something bad will happen (3) racing thoughts (4) disturbances of sleep and appetite (5) inability to sit still (6) physical symptoms

Question 37

Repetitive, intrusive images and thoughts that are frightening and can feel like they “come out of the blue”

Answer 37

perinatal OCD

Question 38

intrusive thoughts, which are persistent, repetitive thoughts or images related to the baby that are upsetting

Answer 38

obsessions

Question 39

postpartum person may do certain things over and over again to reduce her fears and obsessions

Answer 39

compulsions

Question 40

how do you treat perinatal OCD?

Answer 40

CBT and medication

Question 41

____ occrs after the patient perceives childbirth to be traumatic

Answer 41

perinatal PTSD

Question 42

perinatal PTSD presents itself as

Answer 42

nightmares, flashback, avoiding reminders of the event, and depression

Question 43

patients who have a birth very different from their expectations or desires can be at risk for ___

Answer 43

perinatal PTSD

Question 44

what is the treatment for perinatal PTSD?

Answer 44

pt should talk through their experiences and how they perceived them

Question 45

the main four types of therapy for mood and anxiety disorders are

Answer 45

(1) therapy (2) medication (3) lifestyle changes (4) integrative therapies