Postpartum Depression-Case Study The client is a 19-year-old woman who returned home from the hospital yesterday with her newborn baby boy who is now 2 days old. The baby weighed 7 lbs, I oz at birth. His Apgar scores were 8 and 10. The client had a 12-hour labor and an uncomplicated vaginal delivery. During her admission to the hospital. The client decided to breastfeed and did well with the support and encouragement from her nurses. She was attentive to all teaching while in the hospital, but she frequently voiced concern about having to care for her newborn by herself. Because of a recent move, the client has few friends and no family members within the area who can offer emotional support or education regarding her newborn. Neither her parents nor her husband’s parents are able to visit or offer assistance at this time. The client works long hours as manager of a fast-food restaurant and will only be available at night to help care for the baby. The client’s health insurance carrier allows for a home health nurse visit within the first week following hospital discharge; therefore, a murse has been assigned to visit the client at home. Upon arrival at the client’s home on her fourth postpartum day, the murse notes that the apartment is cluttered and needs to be cleaned. The client appears disheveled and is sobbing. She states that she hasn’t slept since coming home, she feels exhausted, and she can’t take it anymore. She adds that the baby has finally stopped crying, for which she is relieved and grateful. The client states that if she had known that motherhood was going to be this difficult, she would never have had the baby. She feels she is a poor mother and incapable of caring for the baby. The nurse notes that the client is pale but her vital signs are stable. She states that she passed a large clot yesterday but her drainage is decreasing. Her fundus has receded to approximately 3 cm above the pubic bone. She adds that she has little appetite and has had two episodes of diarrhea during the past day. She further states that she misses her family and friends The baby, who is now 4 days old, is in a small room off the client’s bedroom in a crib. The client reluctantly allows the murse to examine the baby, stating that she fears he will awaken. The nurse notes that the baby has excoriated buttocks, his skin is dry, and he is lying quietly in bed. The client states that she has tried to breastfeed him, but he keeps falling asleep. His rectal temperature is 102F, his apical heart rate is 180 beats per minute (bpm), and his respirations are 45 breaths per minute. His sclera is yellowish in color, and his slightly sunken. He weighs 6 lbs., a decrease of 17 oz. from his hospital fontanelles are discharge weight. Discussion Questions what conclusions can you draw about the clientr’s mental and emotional status? 1 a Cluster the subjective and objective data into related categories. b. On the basis of your data clusters, identify actual and potential problems. Consider the client’s physical symptoms of fatigue, loss of appetite, diarrhea, and so on Consider her psychosocial symptoms, such as feeling inadequate, wanting. c. How are childbirth and postpartal depression related? 2. Research the topic of postpartal depression. Explain the client’s behavior on the basis of your findings. Discuss the hormonal shifts that occur following childbirth and the effect of a b. those shifts on the client’s mood. 3. At what point can postpartum depression become postpartum psychosis? Research the condition of postpartum psychosis. Compare the clinical manifestations of postpartum depression with postpartum psychosis. c a. b. Consider the time at which both conditions may occur and the length of time they typically persist What can you infer about the newborn’s physical status? 4 Describe the normal physical findings for a 4-day-old infant. b. Compare the client’s newborn data with that of a normal newborn. Decide a. which data are abnormal and what the abnormal data imply about the newborn’s status. c. Consider the newborn’s weight, sunken fontanelles, lethargy, temperature, and so on 5. Considering the assessment data on both the client and her newborn, what should you do first? Review the significance of the newborn’s physical findings. b. Research the importance of adequate fluid balance in a newbon. c. Using the life-preservation framework or another vehicle, prioritize both the a. needs of the client and her newbom d. Decide which action to take first on the basis of your prioritization. 6. What is the most likely prognosis for the client given your understanding of postpartum depression? On the basis of your research on postpartum depression and the client’s current living situation, predict the outcome of the client’s depression. b. Identify factors that can help clients overcome postpartum depression or a. perpetuate the condition. Discuss the need for immediate intervention to increase her chances for a full C recovery 7. What attitude and cognitive critical thinking skills did you use to address this case? And give the definition of your skill.