Postpartum Affective Disorder UNFOLDING Reasoning

Brittany Horton, 28-year-old female Primary Concept Mood and Affect Interrelated Concepts (In order of emphasis) • Stress • Coping • Clinical Judgment • Patient Education • Communication • Collaboration NCLEX Client Need Categories Percentage of Items from Each Category/Subcategory Covered in Case Study Safe and Effective Care Environment • Management of Care 17-23% ✓ • Safety and Infection Control 9-15% Health Promotion and Maintenance 6-12% ✓ Psychosocial Integrity 6-12% ✓ Physiological Integrity • Basic Care and Comfort 6-12% ✓ • Pharmacological and Parenteral Therapies 12-18% ✓ • Reduction of Risk Potential 9-15% ✓ • Physiological Adaptation 11-17% ✓ History of Present Problem: Brittany Horton is a 28-year-old female, G1 P1, who delivered baby boy Mitchell 36 hours ago via primary cesarean section due to breech presentation. Brittany was 39 3/7 weeks gestation and had an uneventful pregnancy. Brittany’s blood type is B+ and she is GBS negative. Brittany weighs 190 pounds (86.1 kg) and has a pre-pregnancy BMI of 32.6. Brittany gets out of bed independently but lets the nurses or her significant other do most of the care for Mitchell. Her Foley catheter was removed 12 hours ago and she is voiding without difficulty. She is using hydrocodone bitartrate and acetaminophen (Norco) 5/325 mg and Ibuprofen 600 mg as needed for pain and states her pain is well controlled. Her significant other, Mark, is at the bedside and is helping care for Mitchell so Brittany can rest. Personal/Social History: Brittany and Mark have been together for four years and are planning to get married in six months. Mark is a loan officer at a local bank. Brittany is attending college and not working outside the home. She is worried about the extra expense of a new baby and is considering getting a job. Brittany’s family lives an hour away, and Mark’s family lives three hours away. Brittany has a history of depression and quit taking Sertraline when she became pregnant. What data from the histories are RELEVANT and must be interpreted as clinically