NU 330 > Chapter 5 > Flashcards

Chapter 5 Flashcards

(54 cards)

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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

23
Q

symptoms of baby blues

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A

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

24
Q

cause of baby blues

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A

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

25
how long does baby blues last?
lasts 2 days to 2 weeks
26
contributing factors to baby blues
- extreme sleep deprivation - fatigue
27
perinatal depression symptoms
- 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
anxiety symptoms
- 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
OCD is characterized by
intrusive, troubling thoughts (obsessions) and repetitive, ritualistic behaviors (compulsions) which are time consuming, cause significant distress and impair functioning
30
classic OCD symptoms
- cleaning - checking - counting - ordering - obsession with germs and cleanliness - checking on baby - hypervigilance
31
what are the components of the "OCD cycle"
obsessions, anxiety, compulsions, relief
32
prevalence of OCD
- general population: 1.08% - pregnant women: 2.07% - postpartum women: 2.43%
33
incidence of OCD (in pregnancy/postpartum)
- in pregnancy: 2.1-13.7% - in postpartum: 2.3-15.2%
34
___ and ___ are associated with the onset of OCD
pregnancy and postpartum **more frequently than other life events
35
risk factors associated with postpartum OCD
- 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
OCD % prevalence: primiparity vs multiparity
primi: 6.57% multi: 1.8%
37
what is PTSD?
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
symptoms of PTSD
- intrusive re-experiencing of a post traumatic event - isolation from family and friends - "emotional numbing" - hyperarousal/hypervigilance - avoidance
39
are postpartum blues and baby blues the same thing or different?
same thing, different names
40
postpartum PTSD themes
- perception of lack of caring - poor communication - feeling of powerlessness - do the ends justify the means
41
PTSD theme: perception of lack of caring
- feeling abandoned - stripped of dignity - lack of support or reassurance
42
PTSD theme: poor communication
- moms felt invincible
43
PTSD theme: feeling of powerlessness
- betrayal of trust - didn't feel protected by staff
44
PTSD theme: do the ends justify the means?
healthy baby justified traumatic delivery? - healthy mommy, healthy baby
45
PTSD in NICU parents: risk factors
- neonatal complications - lower gestational age - greater length of stay in NICU - stillbirth
46
PTSD treatments
- EMD (eye movement) - CBT (cognitive behavioral therapy)
47
prominent symptoms of PTSD in NICU parents
- intrusive memories of infant's hospitalization - avoidance of childbirth reminders
48
types of birth trauma
- 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
onset of psychosis
usually within first 3 weeks after delivery
50
postpartum psychosis symptoms
- 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
postpartum depression in dads is ____ as common as adult male population in the US
twice
52
dads with depression symptoms
- initial high after gives way to depression - irritable - agression - hostility - distancing or "checking out" - not very likely to show sadness
53
factors that would exacerbate PMADs
- 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
treatment options for PMADs
- medical evaluation and treatment - social support and practical help - new parent classes and groups - mental health counseling
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