NUR 678 Exam 2 Questions With Complete Solutions
Postpartum Thyroiditis - Pharmacological Treatment
Levothyroxine (T4)- treats hypothyroidism
Propranolol 10-40mg q6-8h is used for cardiac symptoms. p601
Postpartum urinary tract infection (UTI) - Risk factors
-C-section
-tocolocytic therapy - drugs that are used to delay delivery for a
short time (up to 48hrs)-induction of labor
-renal disease
-preeclampsia p601
Postpartum urinary tract infection (UTI) - Pharmacological
treatment
Trimethoprim/sulfamethoxazole (Bactrim)- 1tab q12h for 3 to 5
days
Nitrofurantoin (Macrobid)-100mg tab q12h 3 to 5 days
Acute appendicitis
In pregnancy and the puerperium, the appendix is atypical
positioned.
Acute appendicitis subjective data
May report a loss of appetite, abdominal distention, and
abdominal pain. p603
Acute appendicitis objective data
,pt may be distressed, pain, vital signs within normal limits, may
have a temp. No guarding or rigidity due to appendix not being
in its usual location while pregnant p603
maternity blues
A brief and relatively mild state of depression often experienced
by mothers 2 or 4 days postpartum and can last up to 2 weeks.
maternity blues subjective data
Pt reports weeping, often alternating periods of elation,
irritability, anxiety, disturbances in sleep pattern, and fatigue
p604
Postpartum depression subjective data
lowered moods, irritability, fatigue, feelings of worthlessness
Symptoms are similar to those of maternity blues but without
periods of elation.
Postpartum Psychosis phases
Manic phase-Racing thoughts hyperactivity, and mood swings
Delirious state- confusion, dissociative episodes w/ confusion or
hostility, and anxiety
Psychotic depression-suicidal tendencies, desire to harm infant
or others, psychomotor retardation, and prominent delusions that
are often related to infant p 605
Screening instruments for postpartum psychiatric disturbances
,TSH levels
Edinburgh postpartum depression scale (EPDS)-10 statements
Postpartum depression screening scale (PDSS)- 35 items p605
Psychosocial intervention for postpartum depression
frequent assessments of postpartum women the first 28 days
after discharge and 6 to 8 weeks postpartum p606
postpartum depression pharmacological treatments
SSRIs
Sertraline (zoloft)- 25 mg tab daily for 1 week then increase to
50mg daily (okay for nursing infants)
Paroxitine (Paxil)- 10 mg tab daily increase up to 50 mg daily
(minimal effects to nursing infants, but adverse effect for infants
in utero)
Citalopram (Celexa)-not first choice for breastfeeding mothers
p607
Postpartum post-traumatic stress disorder
prevalence 5%
Risks factors- include an increased fear of the birth process or
anxiety related to the birth process, a traumatic or prolonged
labor and or delivery, poor communication by labor attendants
or other perceived lack of attentiveness, use of medication that
alters consciousness during labor or delivery, and poor social
support p 608
early discharge
Hospital stay 48 hrs for vaginal delivery and 96 for c-section
, Neonatal assessment
Appropriate for gestational age
Vital signs within normal limits
Feeding successfully
Making transition from fetal to neonatal life
Passed urine and stool
Mother able to care for infant p608/612
Maternal Assessment physical examination
-General appearance and vital signs
-breast health and care
-Abdomen and musculoskeletal system
-Genitalia and reproductive organs p611
Infant weight gain since hospital discharge
5 to 10 % of birth weight may be lost by both bottle fed and
breast infants, but newborn should return to or exceed weight by
week 2 of life p612
Rubin's theory of maternal-infant bonding
Begins with pregnancy as the result of fetal movement &
maternal fantasies about the infant.
Phases Taking in, taking hold, letting go p612
Adjusting to parenting Theories
-Rubin's theory of maternal-infant bonding
-Kathryn Barnard model for attachment and parenting
Postpartum Thyroiditis - Pharmacological Treatment
Levothyroxine (T4)- treats hypothyroidism
Propranolol 10-40mg q6-8h is used for cardiac symptoms. p601
Postpartum urinary tract infection (UTI) - Risk factors
-C-section
-tocolocytic therapy - drugs that are used to delay delivery for a
short time (up to 48hrs)-induction of labor
-renal disease
-preeclampsia p601
Postpartum urinary tract infection (UTI) - Pharmacological
treatment
Trimethoprim/sulfamethoxazole (Bactrim)- 1tab q12h for 3 to 5
days
Nitrofurantoin (Macrobid)-100mg tab q12h 3 to 5 days
Acute appendicitis
In pregnancy and the puerperium, the appendix is atypical
positioned.
Acute appendicitis subjective data
May report a loss of appetite, abdominal distention, and
abdominal pain. p603
Acute appendicitis objective data
,pt may be distressed, pain, vital signs within normal limits, may
have a temp. No guarding or rigidity due to appendix not being
in its usual location while pregnant p603
maternity blues
A brief and relatively mild state of depression often experienced
by mothers 2 or 4 days postpartum and can last up to 2 weeks.
maternity blues subjective data
Pt reports weeping, often alternating periods of elation,
irritability, anxiety, disturbances in sleep pattern, and fatigue
p604
Postpartum depression subjective data
lowered moods, irritability, fatigue, feelings of worthlessness
Symptoms are similar to those of maternity blues but without
periods of elation.
Postpartum Psychosis phases
Manic phase-Racing thoughts hyperactivity, and mood swings
Delirious state- confusion, dissociative episodes w/ confusion or
hostility, and anxiety
Psychotic depression-suicidal tendencies, desire to harm infant
or others, psychomotor retardation, and prominent delusions that
are often related to infant p 605
Screening instruments for postpartum psychiatric disturbances
,TSH levels
Edinburgh postpartum depression scale (EPDS)-10 statements
Postpartum depression screening scale (PDSS)- 35 items p605
Psychosocial intervention for postpartum depression
frequent assessments of postpartum women the first 28 days
after discharge and 6 to 8 weeks postpartum p606
postpartum depression pharmacological treatments
SSRIs
Sertraline (zoloft)- 25 mg tab daily for 1 week then increase to
50mg daily (okay for nursing infants)
Paroxitine (Paxil)- 10 mg tab daily increase up to 50 mg daily
(minimal effects to nursing infants, but adverse effect for infants
in utero)
Citalopram (Celexa)-not first choice for breastfeeding mothers
p607
Postpartum post-traumatic stress disorder
prevalence 5%
Risks factors- include an increased fear of the birth process or
anxiety related to the birth process, a traumatic or prolonged
labor and or delivery, poor communication by labor attendants
or other perceived lack of attentiveness, use of medication that
alters consciousness during labor or delivery, and poor social
support p 608
early discharge
Hospital stay 48 hrs for vaginal delivery and 96 for c-section
, Neonatal assessment
Appropriate for gestational age
Vital signs within normal limits
Feeding successfully
Making transition from fetal to neonatal life
Passed urine and stool
Mother able to care for infant p608/612
Maternal Assessment physical examination
-General appearance and vital signs
-breast health and care
-Abdomen and musculoskeletal system
-Genitalia and reproductive organs p611
Infant weight gain since hospital discharge
5 to 10 % of birth weight may be lost by both bottle fed and
breast infants, but newborn should return to or exceed weight by
week 2 of life p612
Rubin's theory of maternal-infant bonding
Begins with pregnancy as the result of fetal movement &
maternal fantasies about the infant.
Phases Taking in, taking hold, letting go p612
Adjusting to parenting Theories
-Rubin's theory of maternal-infant bonding
-Kathryn Barnard model for attachment and parenting
