2. Disorders affecting psychosocial-cultural functions—postpartum depression/psychosis
   1. General aspects
      1. Can occur in both new parents.
      2. Usually occur within 2 wk of birt
      3. Increased incidence among single parents
      4. Increased incidence among women with history of clinical depression.
      5. Most common symptomatology: affective disorders.
      6. Psychiatric intervention required if prolonged or severe; if underlying cause unresolved; increased risk in subsequent pregnancies.
   2. Etiology— theory: birth of child may emphasize:
      1. Unresolved role conflicts.
      2. Unachieved normal development tasks.
   3. Assessment:
      1. Withdrawal.
      2. Paranoi
      3. Anorexia, sleep disturbance, mood swings.
      4. Depression—may alternate with manic behavior.
      5. Potential for self-injury or child abuse/ neglect.
   4. Analysis/nursing diagnosis:
      1. Ineffective individual coping related to perceived inability to meet role expectations (“mother”) and ambivalence related to dependence/independenc
      2. Self-esteem disturbance and altered role performance related to “femaleness” and reaction to responsibility for care of newborn.
      3. High risk for violence, self-directed or directed at newborn, related to anger or depression.
      4. Ineffective family coping related to lack of support system in early postpartum.
      5. Altered family processes related to psychological stress, interruption of bondin
      6. Altered parenting related to hormonal changes and stress.
   5. Nursing care plan/implementation:
      1. Goal: emotional support.
         1. Encourage verbalization of feelings, fears, anxiety, concerns.
         2. Support positive self-image, feelings of adequacy, self-worth.
         3. 1. 1. 1. Reinforce appropriate comments and behaviors.
                  2. Encourage active participation in self-care, comment on accomplishments.
                  3. Reduce threat to self-image, fear of failur Maintain support, gradually increase tasks.
            2. Goal: safeguard status of mother/newborn.
               1. Unobtrusive, protective environment.
               2. Stay with woman when she is with infant.
            3. Goal: nutrition/hydration.
               1. Encourage selection of favorite foods—to aid security in decision making; counteract anorexia (refusal to eat) by tempting appetit
               2. Push fluids (juices, soft drinks, milkshakes) —to maintain hydration.
            4. Goal: minimize stress, facilitate effective coping. Administer therapeutic medications, as ordere
               1. Schizophrenia—phenothiazines.
               2. Depression—mood elevators.
               3. Manic behaviors—sedatives, tranquilizers.
         4. Evaluation/outcome criteria:
            1. Woman increases interaction with infant.
            2. Woman expresses interest in learning how to care for infant.
            3. Woman evidences no agitation, depression.
            4. Woman actively participates in caring for self and infant.
            5. Woman demonstrates increasing comfort in mothering rol
            6. Woman has positive family interactions.