Review Postpartum Psychosis

Postpartum Depression > Maternal & Newborn

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Postpartum Psychosis

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Total Questions : 6

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Question 1:

A nurse is caring for a client who has postpartum psychosis.

Which of the following actions is the nurse’s priority?

A. Reinforce the need to take antipsychotics as prescribed B. Ask the client if they have had thoughts of harming themselves or their infant C. Monitor the infant for indications of failure to thrive D. Review the client’s medical record for a history of bipolar disorder.

Answer and Explanation

Choice A:

reinforcing the need to take antipsychotics as prescribed is not the nurse’s priority.

While medication is an important part of treatment for PPP, it is not enough to ensure the safety of the mother and the baby.The nurse should also monitor the patient’s response to medication and report any adverse effects or non-compliance.

Choice B:

Ask the client if they have had thoughts of harming themselves or their infant.This is because postpartum psychosis (PPP) is a serious mental health condition that can affect someone soon after giving birth and can cause psychotic symptoms such as hallucinations and delusions.People with PPP have a much higher risk of harming themselves, dying by suicide or harming their children.

Therefore, the nurse’s priority is to assess the safety of the mother and the baby and intervene if needed.

Choice C:

monitoring the infant for indications of failure to thrive is not the nurse’s priority.

While failure to thrive can be a complication of PPP, it is not as urgent as assessing the risk of harm to the mother and the baby.The nurse should also provide support and education to the mother on how to care for the baby and promote bonding.

Choice D:

Reviewing the client’s medical record for a history of bipolar disorder is not the nurse’s priority.While bipolar disorder is a risk factor for developing PPP, it is not a diagnostic criterion or a determinant of treatment.

The nurse should also collaborate with other members of the multidisciplinary

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Question 2:

A nurse is providing education to a client who has postpartum psychosis and is prescribed lithium.

Which of the following statements by the client indicates understanding of the teaching?

A. “I should drink plenty of fluids while taking this medication.” B. “I should avoid foods that are high in sodium while taking this medication.” C. “I should take this medication with food to prevent stomach upset.” D. “I should stop taking this medication if I experience tremors or nausea.”

Answer and Explanation

Choice A:

“I should drink plenty of fluids while taking this medication.” Lithium can cause dehydration and electrolyte imbalance, so it is important to stay hydrated and maintain a normal sodium intake while taking this medication.Drinking plenty of fluids can also help prevent lithium toxicity, which can cause symptoms such as tremors, nausea, confusion, and seizures.

Choice B:

avoiding foods that are high in sodium while taking lithium can increase the risk of lithium toxicity.Sodium and lithium compete for the same transporters in the kidneys, so low sodium levels can cause more lithium to be reabsorbed and accumulate in the body.Therefore, it is advisable to keep a consistent sodium intake and avoid sudden changes in diet or salt substitutes.

Choice C:

taking lithium with food does not prevent stomach upset.Lithium can cause gastrointestinal side effects such as nausea, vomiting, diarrhea, and abdominal pain regardless of food intake.These side effects may be dose-related and may improve over time or with dose adjustment.Taking lithium with food may slow down its absorption but does not affect its efficacy or tolerability.

Choice D:

stopping lithium abruptly can cause a relapse of postpartum psychosis, which is a severe mental illness that can endanger the lives of the mother and the child.Postpartum psychosis affects 1-2 per 1,000 women and requires immediate hospitalization and treatment.Lithium is a standard treatment option for postpartum psychosis and bipolar disorder, and it can reduce the risk of recurrence by up to 80%.

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Question 3:

A nurse is assessing a client who has postpartum psychosis.

The nurse should expect which of the following manifestations? (Select all that apply.)

A. Paranoia that their infant will be harmed B. Concerns about lack of income to pay bills C. Anxiety about assuming a new role as a parent D. Rapid decline in estrogen and progesterone E. Feeling of inadequacy with the new role as a parent.

Answer and Explanation

Choice A:

Paranoia that their infant will be harmed is a symptom of postpartum psychosis, which is a severe mental illness that can affect a woman after she has a baby.Postpartum psychosis can cause a woman to experience hallucinations, delusions, mood swings, confusion and erratic behavior.

Choice B:

concerns about lack of income to pay bills are not specific to postpartum psychosis.They may be related to other stressors or mental health issues.

Choice C:

anxiety about assuming a new role as a parent is not a symptom of postpartum psychosis.

Choice D:

rapid decline in estrogen and progesterone is not a symptom of postpartum psychosis.

It is a hormonal change that occurs after childbirth and may contribute to mood changes.

Choice E:

feeling of inadequacy with the new role as a parent is not a symptom of postpartum psychosis.

It may be a normal feeling or a sign of postpartum depression or anxiety.

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Question 4:

A nurse is performing a mental status examination on a client who has postpartum psychosis.

Which of the following findings should the nurse report to the provider?

A. The client has difficulty concentrating and remembering recent events B. The client has mood swings and expresses feelings of guilt and worthlessness C. The client has delusions of grandeur and believes they have special powers D. The client has low self-esteem and expresses a lack of interest in their infant

Answer and Explanation

Choice A:

the client has difficulty concentrating and remembering recent events.This is not a symptom of postpartum psychosis, but it could be a sign of postpartum depression or anxiety, which are less severe but more common mental health conditions that can affect new mothers.

Choice B:

the client has mood swings and expresses feelings of guilt and worthlessness.This is also not a symptom of postpartum psychosis, but it could be a sign of postpartum depression or bipolar disorder, which are other mental health conditions that can affect new mothers.

Choice C:

The client has delusions of grandeur and believes they have special powers.This is a symptom of postpartum psychosis, which is a serious mental illness that can affect a woman after she has a baby.Postpartum psychosis can cause a woman to lose touch with reality and experience hallucinations, delusions, mood swings, confusion, and erratic behavior.

Choice D:

the client has low self-esteem and expresses a lack of interest in their infant.This is also not a symptom of postpartum psychosis, but it could be a sign of postpartum depression or attachment disorder, which are other mental health conditions that can affect new mothers.

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Question 5:

A nurse is assessing a client who has postpartum depression.

The nurse should expect which of the following findings? (Select all that apply.)

A. Feelings of inadequacy with the new role as a mother B. Disappointment in the characteristics of the infant C. Rapid decline in estrogen and progesterone D. Anxiety about assuming a new role as a mother E. Paranoia that her infant will be harmed

Answer and Explanation

Choice A:

Feelings of inadequacy with the new role as a mother and anxiety about assuming a new role as a mother are common symptoms of postpartum depression. Postpartum depression is a type of mood disorder that affects some people after giving birth.

Choice B:

disappointment in the characteristics of the infant is not a typical sign of postpartum depression. It may indicate other issues such as unrealistic expectations, lack of bonding or resentment.

Choice C:

rapid decline in estrogen and progesterone is not a symptom but a possible cause of postpartum depression. Hormonal changes after delivery may affect mood and emotions.

Choice D:

Choice E:

paranoia that her infant will be harmed is not a symptom of postpartum depression but a symptom of postpartum psychosis. Postpartum psychosis is a rare and severe form of mood disorder that requires emergency medical attention. Normal ranges for estrogen and progesterone levels vary depending on the stage of pregnancy and postpartum period. Generally, estrogen levels peak at around 36 weeks of pregnancy and drop sharply after delivery. Progesterone levels also peak at around 36 weeks of pregnancy and drop rapidly after delivery.

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Question 6:

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Answer and Explanation

Explanation

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Postpartum Psychosis

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