QUESTION: "During a home visit on the fifth postpartum day, the client begins to cry and says that she is worried about her ability to care for her baby adequately. She tells the nurse, "I wish I could just get organized-I need 8 hours of sleep!" The nurse determines that she is experiencing which of the following?"
CHOICES
( X ) a.) Taking-in phase of childbearing; she is exhibiting typical signs of adaptation.
( X ) b.) Postpartum blues phase of childbearing; she needs psychological counseling.
( X ) c.) Letting-go phase of childbearing; she needs help to assume the maternal role.
( O ) d.) Taking-hold phase of childbearing; she is feeling inadequate about neonatal care.
RATIONALE: A primipara often has concerns about her ability to care for her infant properly during the taking-hold phase. She is working toward independence and autonomy and wants to be able to perform well in her new role as mother. She needs emotional support, advice on how to manage, reassurance, and reinforcement of appropriate behavior. The taking-in phase occurs from delivery up to about the second to third postpartum day. During this phase, the client is focused on herself and not the neonate. Postpartum blues are evidenced by extreme sadness. However, this client is exhibiting usual behavior associated with the taking-hold phase. Psychological counseling is not warranted. In the letting-go phase, the woman redefines her new role. This phase is extended and continues into the child's growing years. This process requires some grief work and readjustment. NURSING PROCESS STEP: Analysis CLIENT NEEDS CATEGORY: Health promotion and maintenance CLIENT NEEDS SUBCATEGORY: None
