Exam (elaborations)
N4312 Perinatal Mental Health
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N4312 Perinatal Mental Health
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N4312 Perinatal Mental Healthpsychiatric disorders that occur during antepartum period - ANS-Depression, psychosis,
bipolar disorder, panic disorder, PTSD, OCD
psychiatric disorders that occur during the postpartum period - ANS-"baby blues",
depression, panic disorder, bipolar disorder, PTSD, psychosis
nursing care in promotion of optimal perinatal mental health - ANS-Preventative
education r/t depression prior to, during, and after pregnancy; Listen to women, advise,
observe for behavioral changes, screen, invite/involve family and/or partner
Psychology of pregnancy - ANS-developmental crisis upheaval, followed by positive
resolution (intensification of unresolved family issues; increase in self esteem and self
absorption; "protector of fetus")
Depression in Pregnancy: etiology - ANS-often unclear (r/t hormonal shifts,
neuroendocrine changes, psychosocial adjustments, etc.); continuation of pre-pregnant
disease or new-onset with pregnancy
Depression in Pregnancy: risk factors - ANS-race/ethnicity, marital instability, single,
poor support, adverse life events, unplanned pregnancy, ambivalence towards
pregnancy, low SES, personal/family hx of depression, discontinuing or decreasing
antidepressants
Depression in Pregnancy: effects - ANS-pain/suffering ("robbed of the joy"), family
discord, poor nutrition -> weight loss/gain, ATOD use, impaired judgement ->
noncompliant with prenatal care -> low birth weight and/or PTL(B), anxiety, insomnia,
psychosis, PPD, impaired maternal-infant bonding, suicidal ideation
Depression in Pregnancy: Screening - ANS-screen early! Ask "how have you been
feeling" or "how are you___" or "Do you feel ___"; PHQ-9 in clinic (must notify findings)
Depression in Pregnancy: Treatment - ANS-1) recognition 2) cognitive therapy 3)
antidepressant medications in tandem with cognitive therapy
Depression in Pregnancy: Medications - ANS-SSRIs (low risk for baby); Paxil (risk of
congenital heart defects); Multidrug management via psychiatrist (may taper off and
restart if desired)
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