Psychological adjustment / Education & Counseling Flashcards Preview

Nursing - obstetric component > Psychological adjustment / Education & Counseling > Flashcards

Flashcards in Psychological adjustment / Education & Counseling Deck (13)
Loading flashcards...

Psychological Development

Pregnancy is a crisis; ends with birth
Transitional period; life pre- & post-baby
Women are emotionally labile ( hormones)
Women are vulnerable
Sequence of specific psych. processes


1st TM: Period of Adjustment

1. Feelings of disbelief & ambivalence, even if planned
2. Baby doesn’t seem “real”; rejection

3. 1st TM discomforts (N/V)
4. Weight gain significant issue
5. Baby is a “secret”
6. Libido usually decreases


2nd TM: Period of Radiant Health

1. Free from discomforts
2. Quickening occurs
3. Very introspective
4. Task: developing mothering identity
-  Transition from care receiver to care-giver
- Can be guilt-producing
Can’t hide pregnancy
5. Libido increases 
Sexual Activity Can Continue Throughout Pregnancy! Woo hoo! Yeah, baby,

* don't blow air into vagina - air embolism 


3rd TM: Period of Watchful Waiting

1. Eager for NB’s arrival
2. Active, visible preparation for CB & parenthood
3. Fears surface ( dreams : monster; misplacing baby) 
4. Anticipatory grief process ( loss of baby from body; loss of attention ) 
5. Physically uncomfortable
6. Libido decreases


Father of the Baby: The FOB

1. Pregnancy also stressful
2. Initial pride in virility; also many ambivalent feelings
3. Must establish fatherhood role
4. Easier if share pregnancy & delivery with partner
5. Couvade: identifies with woman’s pregnancy
- N/V, fatigue, weight gain
 - Normal & temporary


Intimate Partner Violence

36% American women physically or sexually abused at some point
>300,000 incidences abuse during pregnancy each year
Abuse may begin or worsen in pregnancy ( breast, belly, genitals) 
Abuse occurs across all races equally
Homicide leading cause of death for pregnant women


Intimate Partner Violence

All women should be screened at every prenatal visit
Cycle of violence:
1. Tension building (verbal or minor battery)
2. Acute battering (discharge of tension)
3. Reconcilliation (honeymoon) phase


Signs of abuse:

1. Delay in seeking prenatal care
2. Unexplained bruising to breasts or abdomen
3. Continued use of harmful substances
4. Reoccurring psychosomatic illnesses
5. Lack of attendance at prenatal education classes


Intimate Partner Violence
Immediate effects on pregnancy:

1. Blunt trauma to abdomen
2. Placental abruption
3. Uterine rupture
4. Preterm labor
5. Miscarriage/stillbirth
6. Premature rupture of the membranes
7. Effects in labor:
-  Some studies suggest prolonged labor
-  Can trigger significant reactions ( check cervix - no fingers in vagina) 


Intimate Partner Violence
Barriers to getting help

1. Embarrassment & shame
2. Lack knowledge of $ & housing alternatives
3. Fear of reprisal from partner & others
Local resources:
Ohio Domestic Violence Network

*if suspected - do not write number and give to woman ; She has to take initiative 


Exercise in Pregnancy

1. Start slowly; relax, stretch
2. Listen to body
- Signs of low O2 - can walk and talk at the same time 
3. Comfortable clothing; supportive footwear
4. Take breaks, drink water

5. Don’t exercise in hot weather
6. Avoid contact sports

7. Joints are lax, center of gravity changes; increased risk for falls/injury
8. Tone upper body & abdomen ( triceps)
9. Avoid lying flat on back ( Vena Cava syndrome)
10. Always “cool down”
11. Eat a healthy diet


Travel During Pregnancy

1. Always “buckle up”
2. Lap belt low on abdomen
3. Keep air bags turned on
4. Hold on if walking in aisles
5. Take short breaks & walks; keep blood circulating
6. Limit travel time to 5-6 hours; have snacks
7. Air travel usually allowed through 8th month
8. Immunizations, disease risk, diarrheal diseases
9. Access to care