A nurse is attending to a client in labor who is showing late decelerations on the electronic fetal monitor.

What should be the nurse’s initial course of action?

Choice A rationale
Postpartum depression is characterized by severe mood swings, crying too much, difficulty bonding with the baby, withdrawing from family and friends, loss of appetite or eating much more than usual, inability to sleep or sleeping too much, overwhelming tiredness or loss of energy. While some of these symptoms overlap with the ones mentioned in the question, postpartum depression is usually more severe and lasts longer.
Choice B rationale
The letting-go phase is the final phase of maternal adjustment during which the mother moves forward from her existing role to take on a new one as a parent. This phase is characterized by reestablishment of relationships with others, resumption of sexual intimacy, resolution of physical symptoms, and attainment of a new normal. The symptoms mentioned in the question do not align with this phase.
Choice C rationale
Postpartum psychosis is a rare but serious mental health illness that can affect a woman soon after she has a baby. Symptoms can include hallucinations, delusions, a manic mood, a low mood, loss of inhibitions, restlessness, and severe confusion. The symptoms mentioned in the question do not align with this condition.
Choice D rationale
This is the correct answer. Postpartum fatigue is characterized by extreme tiredness that doesn’t get better with rest or sleep. This fatigue can make it difficult for the new mother to care for herself and her baby. The symptoms mentioned in the question - tearfulness, insomnia, lack of appetite, and a feeling of letdown - are all common symptoms of postpartum fatigue.

Choice A rationale
Offering the parent the opportunity to hold their stillborn baby can be a crucial part of the grieving process. It allows the parent to acknowledge the reality of the loss and begin to say goodbye.
Choice B rationale
Telling a grieving parent that “this is for the best” can be perceived as dismissive and insensitive. It’s important to validate the parent’s feelings of loss and grief.
Choice C rationale
Sharing personal experiences of loss can shift the focus away from the grieving parent. It’s more helpful to provide empathetic support and allow the parent to share their feelings.
Choice D rationale
While spiritual support can be helpful for some, it’s not appropriate to assume that every parent will want this. It’s better to ask the parent if they would like to speak with a chaplain or other spiritual advisor.