CNM Certified Nurse Midwife

Category - Postpartum

A nurse midwife is managing the care of a postpartum client who gave birth to a baby girl two months ago. On assessment, the client informs the nurse midwife that she is hearing voices and that she constantly feels empty. She has a history of clinical depression. Which of the following is the priority action of the nurse midwife?
  1. Offer compassion.
  2. Protect the client and child from injury.
  3. Consider counseling for the client.
  4. Administer antidepressants.
Explanation
Answer: B - The client has postpartum psychosis, which is manifested by feelings of depression and hallucinations. A history of clinical depression increases a woman’s risk for postpartum psychosis. The priority action of the nurse is to protect the client and child from injury. In addition to suicide ideation, it is not uncommon for women with this condition to have the urge to hurt their babies. The nurse midwife must be alert when a client reveals this information. Offering compassion is more appropriate for clients with postpartum blues. Counseling is usually recommended to client with postpartum depression.
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