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S/S perinatal mood disorder
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Mood volatility, loss of control, feeling trapped, heightened anxiety about baby's safety, delayed feelings of lov for baby, depressive mood, sadness, diminished interest in activities, feeling of worthlessness, recurrent thoughts of death/suicid, >12 of edinburgh postnatal depression scal
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Biological risk factors of perinatal mood disorders
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Hx depression, depressive symptoms during pregnancy, family hx of dpression, hx of premenstrual dysphoric disorder (severe PMS), PP blues
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Psychosocial risk factors of perintatal mood disorders
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Lack of social support, poor/no relationship with father of baby, stressful lif evens, primiparitiy, adolescence, certain ethnicities
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PTSD after childbirth
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Traumatic childbirth, emergent cesarean, forcep or vaccum extraction, prolapsd cord. Relive the experience, recurrent nightmares
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PP panic disorder
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Intense fear of harm/harming baby, palpitations, hyperventilation, sweating, chest pain, difficulty caring for or leaving baby
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PP OCD
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Intrusive thoughts/images of severe harm to baby, mother sometimes imagines herself inflicting harm
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Nursing care of PP depression women
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Assess risk factors at admission, administer ediburgh postnatal depression scale evening before discharge, any woman with score >13 given list of resources, instructed to slf readminister EPDS scael at one week after discharge
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PP dpression tx
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Stress reduction, support/help from family friends, support groups, psychotherpay, medications (SSRIs for prophylaxis), estradiol to replace estrogen, light therapy
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PP psychosis symptoms
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Depression, mania, mixed, cycling, suicidal impulses, hallucinations, delusions, delusion-based homicidal/infanticidal impulses, disturbances of consciousness, attention, cognition, perception, fluctuation of symptoms
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PP psychosis risk factors
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Hx schizophrenia, bipolar disorder with psychotic breaks. risk increases with# of prior episodes
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PP psychosis management
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Hospitalize, constant close observation, supervised visits with baby
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PP psychosis tx
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Mood stabilizers, antipsychotics, antidepresssants, benzodiazepines, ECT to reset mood
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PP vital signs
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BP should be be baseline (1st prenatal visit), pulse rate low (decreased volume & cardiac effort, blood loss), elevated temp to 100.4 normal (worry at 101), pain
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PP pain
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Cramping/uterine contractions normal (worse after breast feeding due to release of oxytocin, worse for multiparous because uterus is stretched out). Premedicate with ibuprofen. Perineum/incisional--ice packs
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Involution
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Utuerus returns to normal size/shape, cesarean may go faster.
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