M8,11,12: Mood, Breast & Pelvic Health, Loss Flashcards
What is postpartum depression?
Clinical depression
Categorized by DSM-5 as major depressive disorder with peripartum onset
What are screening tools for PPD?
Postpartum Depression Screening Scale (PDSS)
Edinburgh Postnatal Depression Scale (EPDS): score of above 12 = PPD
What is the treatment for PPD?
individual or group psychotherapy, antidepressants, or a combination of both
Risk factors for PPD
- History of major depression
- Depression during pregnancy
- History of postpartum depression or bipolar illness (recurrence rates are ≥ 20%)
- Stressful life events
- Primiparity
- Ambivalence about maintaining the pregnancy
- Occurrence of postpartum blues
- Lack of social support
- Lack of a stable and supportive relationship with parents (especially her father, as a child) or partner
- The woman’s dissatisfaction with herself, including body image problems and eating disorders
- Complications of delivery
- Loss of newborn
- Age (adolescence increases risk).
what are signs of depression?
anxiety, irritability, poor concentration, forgetfulness, sleeping difficulties, appetite change, fatigue, and tearfulness
listen for statements indicating feelings of failure and self-accusation
what is postpartum psychosis?
postpartum mood episodes with psychotic features
Is postpartum psychosis emergent?
yes, due to risk of infanticide or suicide
What is the treatment for postpartum psychosis?
directed at the specific type of psychotic symptoms displayed
may include lithium, antipsychotics, or electroconvulsive therapy in combination with psychotherapy, removal of the baby, and social support
What are symptoms of postpartum psychosis?
- Sleep disturbances—the woman is unable to sleep, even when her baby is sleeping
- Depersonalization—seemingly unaware of or distant from the immediate environment and individuals within it
- Confusion; irrational or disorganized thinking; bizarre behaviors
- Hallucinations; delusions
- Psychomotor disturbances—stupor or agitated state sometimes accompanied by rapid and incoherent speech.
What are the risk factors for postpartum psychosis?
- previous postpartum psychosis
- history of bipolar disorder
- Family history of postpartum psychosis and bipolar disorder have also been found to increase the risk
What is swansons caring theory?
outlines five caring processes: knowing, being with, doing for, enabling, and maintaining belief
Which process of caring theory: attempting to understand the event as it has meaning in the life of the parents
knowing
Which process of caring theory: nurse’s ability to reach beyond professionalism and give of herself or himself as a human being
being with
Which process of caring theory: means that nurse does for the parents as she or he would have things done for her or him in the same situation
Doing for
Which process of caring theory: facilitation of the parents’ passage through life transitions and unfamiliar events
enabling
which process of caring theory: believing in the parents’ capacity to get through the event and face a future with meaning.
maintaining belief
What does RESPONDING model stand for?
-Recognition and validation of the loss
-Emotional availability
-Spiritual and cultural accommodation
-Physical presence
-Open communication
-Normalization of grief reactions
-Decision-making assistance
-Interprofessional involvement
-Nonjudgmental attitude
- Genuine caring
How can you actualize loss?
offer as many quality mementos as possible, such as pictures and hand- or footprint molds and cards
What should you do if patient denies remembrance box?
common for the hospital to retain these items for a specific period of time in case they change their minds
What are the development tasks of pregnancy: reva rubin
- Seeking safe passage through pregnancy labor and birth
- Seeking of Acceptance of child from others
- binding in
-Learning to give oneself on behalf of one’s child
Describe Reva Rubin stage: Seeking safe passage through pregnancy labor and birth
- Feels concern for her unborn child and herself
- Seek care, knowledge, observation, discussion
- Self-care activities: diet, exercise, alcohol
Describe Reva Rubin stage: Seeking of Acceptance of child from others
- Alters in womans primary support group, family, and other groups
- Partner is most important figure: influence completion of maternal tasks and formation of maternal identity
Which stage of reva rubin is this:
- Quickening (perceived fetal movements): child becomes real
- Develop bonds of attachment
- seeking of commitment & acceptance of self as mother to child
Binding in
Describe Reva rubin: Learning to give oneself on behalf of one’s child
- Develop capacity for self-denial and learns to delay immediate personal gratification to meet need of another
- Baby showers and baby gifts are acts of giving that help mother’s self-esteem
Also helps acknowledge separateness and needs of coming baby
