Psycho-social-cultural aspects of antepartum period-5

Question 1

Ambivalent feelings

Answer 1

common during first trimester, should decrease. Could indicate unresolved conflict if it goes into the third trimester

Question 2

Events that facilitate fetal attachment

Answer 2

Hearing the fetal heartbeat.

● Seeing the fetus move during an ultrasound examination.

● Feeling the fetus kick or move.

Question 3

expected finding from new mom

Answer 3

● Moves from viewing herself as a woman-without-child to a woman-with-child

● Anticipates changes motherhood will bring to her life

● Seeks company of other pregnant women

● Is highly motivated to assume the motherhood role

● Actively prepares for the motherhood role

Question 4

Assessment of the couple’s relationship

Answer 4

The partner’s concern for the woman’s needs during pregnancy.

● The woman’s concerns for her partner’s needs during pregnancy.

● The varying desire for sexual activity among pregnant women.

● The effect pregnancy has on the relationship (e.g., whether it brings them closer together or causes conflict).

● The partner’s adjustment to his or her new role.

Question 5

Prep for labor

Answer 5

attends classes
track pregnancy
mentally rehearse
dreams about labor and birth
realistic expectations of labor and birth.
nesting behavior

Question 6

Prenatal fear of losing control in labor

Answer 6

● The woman’s degree of trust with the medical and nursing staff, her partner, and other support persons.

● The woman’s attitude regarding the use of medication and anesthesia for labor pain management.

Question 7

Prenatal fear of losing self esteem in labor- depends on

Answer 7

Tolerance of self.

Value of self and assertiveness, and decisions about her labor process.

Positive attitude regarding body image and appearance.

Question 8

factors that influence maternal adaptation

Answer 8

parity, maternal age, sexual orientation, single parenting, multiple gestation (twins, triples), socioeconomic factors, cultural beliefs, and history of abuse.

Question 9

older mother risk

Answer 9

miscarriages, fetal chromosomal abnormalities, low birth weight infants, premature births, and multiple births.

Question 10

women over 40

Answer 10

placenta previa, placenta abruptio, caesarean deliveries, preeclampsia, and gestational diabetes.

Question 11

nursing actions 1st trimester

Answer 11

Begin psychosocial assessment at initial contact
Promote pregnancy and birth as a family experience
Assess learning needs.
Offer anticipatory guidance regarding normal developmental stressors of pregnancy
Assess for increased anxieties and fear
Listen, validate, provide reassurance, and teach expected emotional changes.
discuss common phases through which expectant fathers progress through pregnancy.

Question 12

nursing action 2nd trimester

Answer 12

• Encourage verbalization of possible grief process during pregnancy
Discuss normal changes in sexual activity
• Encourage “tuning in” to fetal movements
• Reinforce to partner and family support

Question 13

nursing action 3rd trimester

Answer 13

• Encourage attendance at childbirth classes
• Discuss preparations for birth, parenthood; explore expectations of labor
• Discuss preparations for birth, parenthood; explore expectations of labor
-Refer to appropriate educational materials on parenthood
-If psychosocial complications develop, plan for appropriate referrals
• Help expectant mother identify and use support systems

Question 14

Antenatal Psychosocial Health Assessment

Answer 14

● Social support

● Recent stressful life events

● Couple’s relationship

● Onset of prenatal care

● Plans for prenatal education

● Feelings toward pregnancy after 20 weeks

● Relationship with parents in childhood

● Self-esteem

● History or psychiatric/emotional problems

● Depression in this pregnancy

● Alcohol/drug use

● Family violence

Question 15

Nursing actions- mom

Answer 15

● Assess adaptation to pregnancy at every prenatal visit.
● Identify areas of concern, validate major issues, and make suggestions for possible changes.
● Refer to the appropriate member of the health care team and follow up.
● Establish a trusting relationship
● Assess for the need for psychotropic medications
● Use psychosocial health assessment screening tools

Question 16

Effects of pregnancy on father

Answer 16

● Increased emphasis on his role as provider causes a reevaluation of lifestyle and job or career status.

• change in role
• struggle to feel relevant
• without models for fatherhood
• pregnancy like symptoms

Question 17

couvade syndrome

Answer 17

partner experiencing pregnancy symptoms

Question 18

The announcement phase

Answer 18

reaction to pregnancy

Question 19

The moratorium phase

Answer 19

appear to put conscious thought of the pregnancy aside for some time

Question 20

The focusing phase

Answer 20

Men will be actively involved in the pregnancy and their relationship with the child.

Question 21

Nursing action- dad

Answer 21

-explore response
-reassure ambivalence
-reassure pregnancy like symptoms
-encourage involvement
● Encourage the man to negotiate his role in labor with his partner.

● Explore his attitudes and expectations of pregnancy, childbirth, and parenting.

Question 22

Sexuality in pregnancy by trimester

Answer 22

● During the first trimester, fatigue, nausea, and breast tenderness may affect sexual desire.

● During the second trimester, desire may increase as a result of increased sense of well-being and the pelvic congestion associated with this time in pregnancy.

● During the third trimester, sexual interest may once again decrease as the enlarging abdomen creates feelings of awkwardness and bulk.

Question 23

Nursing action- sexuality

Answer 23

• Discuss fears and concerns related to sexual activity.
• Encourage communication between partners and discuss possible changes with couples.
• ask about it to open the conversation

Question 24

sibling adaptation by age

Answer 24

● Children younger than 2 are usually unaware of the pregnancy
● Children from 2 to 4 years of age may respond to the obvious changes in their mother’s body but may not remember from month to month
● Children aged 4 to 5 often enjoy listening to the fetal heartbeat and may show interest in the development of the fetus.
-School-age children (6 to 12) are usually enthusiastic and keenly interested in the details of pregnancy and birth
● Adolescent responses to pregnancy vary according to developmental level.

Question 25

mental health difficulties with pregnancy adaptation

Answer 25

● Difficulty with taking on the maternal role, making the necessary transitions to parenthood, and mourning losses associated with the time before pregnancy
● Prenatal depression, maternal stress, and anxiety
● Rates of serious mental illness (MI) during pregnancy
● When assessing mood, emotional states, and anxiety, the nurse should consider these aspects: frequency, duration, intensity, and source

Question 26

mental health nursing actions

Answer 26

assess adaption 
assess support/coping
assess mood
discuss expectations
identify areas of concern
referrals
establish relationship

Question 27

psychosocial adaptations to pregnancy complications

Answer 27

• pregnant woman may distance herself emotionally from the fetus
• Disequilibrium, feelings of powerlessness, increased anxiety and fear, and a sense of loss are all responses to the news of a pregnancy complication.

Question 28

Response to pregnancy complications depends on:

Answer 28

● Pregnancy condition.

● Perceived threat to mother or fetus.

● Coping skills.

● Available support.

Question 29

avoid crisis

Answer 29

Having a realistic perception of the event, adequate situational support, and positive coping mechanisms

Question 30

increase the risk of crisis

Answer 30

Poor self-esteem, lack of confidence in the mothering role, and an inability to communicate concerns to health care providers and close unsupportive family members

Question 31

Nursing actions for women with complications

Answer 31

Provide frequent and clear explanations
let her ask questions
asses and encourage support
support coping mechanisms
referrals

Question 32

types of support

Answer 32

material-practical help
emotional
informational
comparison-similar situation
spiritual

Question 33

social support benefits

Answer 33

● Attachment to infant and improved interactions with infant

● Compliance with health care regimen

● Improved functional status

● Improved coping with changes related to pregnancy

● Increased acceptance of new role in life

● Increased incidence of breastfeeding

● Reduced physical symptoms

● Reduced loneliness

● Reduced feelings of stress or a sense of concern

● Reduced postpartum depression

● Satisfaction with intimate relationships

Question 34

nursing action- cultural care

Answer 34

enhance communication
emphasize woman's strengths
respect practices
work with woman to change practice if harmful
accommodate practices as appropriate
identify family

Question 35

midwives

Answer 35

Nurse-midwives are RNs with advanced training in care of obstetric patients.
Lay midwives- self taught to formal training
Direct-entry midwives are trained in midwifery schools or universities as a profession distinct from nursing.