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OB MH
Mental Health
| Question | Answer |
|---|---|
| During pregnancy, we want the _____ amount of mental health medications necessary to keep mother __ | Minimal; stable |
| Why must we know a mother's Hx of mental illness? | Some medications contraindicated during pg |
| True or false: almost 1/3 of all PP women report their births were traumatic | True |
| Women who develop PTSD r/t birth experience the following: | 1) re-experiencing the event, 2) intrusive thoughts, 3) intrusive thoughts, 4) avoidance of factors associated with event, 5) panic attacks, nightmares, isolation |
| What behaviors may suggest abuse Hx? | 1) obsessively detailed birth plans, 2) trust issues with authority figures, 3) inability to tolerate pelvic/vaginal exams, 4) extreme modesty, 5) dissociation during exams, 6) denial with known Hx |
| In regards to modesty, we must also consider ___ | Cultural/religious issues |
| If a client discloses sexual abuse, we should ____ and let her know she's in a ____ place | Validate; safe |
| Essentially, ____ is at risk when women are depressed | Safety |
| Baby blues is a ____ period that occurs during ____ of PP | Transient; first few days |
| S/sx of baby blues | Tearful, weepy, sleep issues, moody, overwhelmed |
| Baby blues usually resolve in _____ days | 10-14 |
| PP depression's onset is _____. Typically is evident by ____ weeks | Sudden or gradual. Typically evident by 6 weeks. |
| Women with PP depression may need a combination of ______ and meds | Psychotherapy |
| We want to avoid __ because of the cardiac anomalies that develop in the fetus | Paxil |
| ECT therapy may be thought to be ___ for pg to treat major depression | Safe |
| Category ___ may be okay for treating depression during pg | B/C |
| Category L__ okay for mothers | L2-L3 |
| SSRIs are mostly category _____ | C |
| Benzodiazepines are considered category ___, lactation ____- and should be avoided if possible | D; L3-L4 (may give if absolutely need benzo) |
| Lithium and ______ are ______ in pg | Depakote; Contraindicated |
| Single medication at ___ dose is preferable to ____ meds | Higher; multiple |
| ______ is considered an emergency psychiatric condition | PP psychosis |
| Women with bipolar disorder also have increased risk of ____ | PP psychosis |
| ____ are frequent in women with bipolar disorder | Relapses |
| Most common psychiatric disorder is ______ | Anxiety |
| If ___ is untreated, may increase suicide/self-harm and also have increased incidence of infanticide | Schizophrenia |
| PP psychosis involves... | A break from reality, hallucinations with paranoid sx |
| Neonatal effects of SSRI/SNRI drug use during pg include ______ (a syndrome) | Psychotropic withdrawal syndromes |
| S/sx of psychotropic withdrawal syndromes: | Atonia, jitteriness, transient tachypnea, respiratory distress, some sx persisting up to 3 months |
| Partner depression may have a __ onset than maternal | Later |
| ______ is discouraged with breastfeeding | Lithium |
| Trigger "themes" r/t abuse | 1) Control/loss of control, 2) pain/injury/bodily damage/invasion, 3) dependency on partner/caregiver, 4) mistrust of authority figures, 5) shame/being judged over body image/behavior/secretions, 6) exposure |
| Goal of care re: women w/ Hx of abuse | Identify women with this concern, accept/anticipate trigger areas, explain thoroughly, structure so she has control, help her "stay present", praise, support, translate to partner if appropriate |
Created by:
lapio-obgyn
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