A woman tells you she has been teary for most of the 2 weeks since the birth of her baby. Although the infant appears to be cared for appropriately, the mother states that she feels too tired to spend as much time with him as she should. She has lost her appetite and cannot sleep at night. She has been too ashamed to tell anyone before now. The nurse's best response is to:

Correct Answer: C

Rationale: The correct response, option C, is to listen to the woman's feelings carefully and acknowledge that something is wrong. This is the best approach because the woman is exhibiting symptoms of postpartum depression, a serious condition that requires professional intervention. By actively listening and acknowledging her feelings, the nurse can provide support and encourage the woman to seek help from a healthcare provider. Option A is incorrect because dismissing her symptoms as "normal postpartum blues" minimizes the severity of her condition and may prevent her from seeking necessary help. Option B is also incorrect as simply suggesting more rest oversimplifies the complex nature of postpartum depression and does not address the underlying issue. Option D is not appropriate as separating the woman from her baby may exacerbate feelings of guilt and worsen her condition. In an educational context, it is crucial for healthcare providers, especially nurses, to be able to recognize the signs of postpartum depression and provide appropriate support and guidance to women experiencing it. By addressing mental health issues in the postpartum period, healthcare professionals can help prevent long-term consequences for both the mother and the baby.

Correct Answer: B

Rationale: In postpartum care, assessing the fundus is crucial to monitor for uterine atony, a common cause of postpartum hemorrhage. In this scenario, a boggy, elevated, and deviated fundus indicates uterine atony, a condition where the uterus fails to contract effectively after delivery. Option B, a full bladder, is the correct answer as a distended bladder can displace the uterus, preventing it from contracting properly. This can lead to excessive bleeding and delayed involution. Option A, uterine rupture, is unlikely in this case as the fundus would typically be firm and displaced high in the abdomen. Option C, perineal laceration, would not directly cause the fundus to be boggy and elevated. Option D, hematoma, may cause localized pain and swelling but would not typically result in a boggy, elevated fundus. Educationally, understanding the importance of fundal assessment postpartum is crucial for nurses to identify and manage complications promptly. Proper assessment skills help prevent and address postpartum hemorrhage, a leading cause of maternal mortality worldwide. Nurses must be adept at differentiating between normal involution and abnormal findings to provide optimal care for postpartum mothers.

Correct Answer: C

Rationale: The correct answer is C) postpartum depression. Postpartum depression is a common complication that affects many new mothers and can have serious effects on both the mother and the baby. Screening for risk factors such as an infant in the NICU, difficulty in role transition, birth complications, unmet social and physical needs, and lack of partner support is crucial in identifying women who may be at risk for developing postpartum depression. Option A) maladaptive parenting is incorrect because it does not specifically address the mental health aspect of the situation. Option B) psychosis is also incorrect as it is a severe mental disorder characterized by a loss of contact with reality, which is not the primary concern in this scenario. Option D) bipolar disorder is incorrect as it is a mood disorder characterized by fluctuations between depressive and manic episodes, which is not the most likely complication based on the risk factors provided. In an educational context, understanding the risk factors and signs of postpartum depression is essential for healthcare professionals working with new mothers. By recognizing these factors early, nurses can provide appropriate support, referrals, and interventions to help prevent or manage postpartum depression, ultimately improving outcomes for both the mother and the baby.

Correct Answer: D

Rationale: In the context of pharmacology and postpartum complications, it is crucial for nurses to understand the differences between postpartum blues and postpartum depression (PPD) to provide appropriate care and support to new mothers. Option D, "Postpartum blues symptoms include irritability and sadness," is the correct answer. Postpartum blues typically occur within the first few days to weeks after childbirth and are characterized by mild mood swings, tearfulness, irritability, and feelings of being overwhelmed. These symptoms are considered normal and usually resolve on their own without intervention. By recognizing these common signs, nurses can reassure new mothers and provide education on self-care practices. The incorrect options can be explained as follows: A) PPD is less severe and resolves in a few weeks: This statement is incorrect as PPD is a more serious condition that can last for months if left untreated. It requires professional intervention and support to manage effectively. B) Postpartum blues can last up to a year: This is inaccurate as postpartum blues are transient and typically resolve within a few weeks, unlike postpartum depression, which can persist for a longer duration. C) PPD is a normal expectation of postpartum: This is a misleading statement. While it is common for new mothers to experience mood changes postpartum, PPD is not a normal expectation and should be taken seriously and treated promptly to prevent complications. Educationally, understanding the nuances between postpartum blues and PPD equips nurses with the knowledge to provide timely assessments, interventions, and referrals for mothers experiencing postpartum mood disorders. It reinforces the importance of early detection and support in promoting maternal mental health and well-being during the postpartum period.

Correct Answer: A

Rationale: In the context of postpartum care, understanding Rubin's attachment model is crucial for nurses to provide appropriate support to postpartum individuals. The correct answer is A) Taking In. This stage is characterized by the individual being focused on their own physical recovery and depending on others, such as the nurse or partner, for assistance with basic needs. This dependency and passivity are normal as the individual processes the birth experience and adjusts to their new role as a parent. Option B) Taking Hold is focused on gaining confidence and competence in caring for the newborn, which comes after the Taking In stage. Option C) Postpartum Maternal Change and Option D) Attainment of Change do not align with Rubin's stages of attachment and are not relevant to the scenario described. Educationally, understanding the stages of Rubin's attachment model can help nurses anticipate the needs and emotions of postpartum individuals, allowing for more effective and empathetic care. By recognizing which stage a person is in, nurses can tailor their support to provide the appropriate level of assistance and encouragement during this critical period of adjustment.