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Psychiatric Nursing -A Case Study on a Patient with Post Partum Psychosis

Psychiatric Nursing -A Case Study on a Patient with Post Partum Psychosis

Chapter One

Introduction

Mrs. A.N. a middle aged 34 year old unemployed graduate was admitted to the female ward in company of her husband, after a diagnosis of post partum psychosis was made.

She was apparently well during her pregnancy until the delivery of her third child. She was said to have started manifesting some abnormal thinking and behavior few weeks during the post partum period. This, the husband believed, was triggered after receiving the news of the death of the wife’s younger sister in an auto-crash. The reason being that the wife’s younger sister had before accepted to live with Mrs. A.N. to assist her in taking care of her children and other domestic duties but this could no longer hold because of the death.

The reported behaviors include – being withdrawn to self, not talking to anyone, insomnia, feeling paranoid, suspicion, delusion, refusal to eat or eating very little, neglect of self and baby care, among others.

Post partum psychosis, formerly called puerperal psychosis, is a rare but serious heterogeneous group of mood and psychotic disorder following delivery or child birth (Gelder, Harrison and Cowen, 2005). The onset of post partum psychosis constitutes a psychiatric emergency and women with this disorder have the tendency to commit suicide or infanticide than the general population. Gelder et al, further stated that women are more likely to experience psychosis during the periods following childbirth than at any other time in their lives.

Following the admission of Mrs. A.N., appropriate case were instituted with the aim of achieving a positive outcome as can be seen in the write up.

Significance of the Study

  • It will create public awareness on what the condition is all about.
  • This will equip individuals, family members and mental health workers with the basic knowledge on the causes, prevention and management of the condition.
  • It will reduce or eradicate the stigma and misconceptions about post partum psychosis.
  • The knowledge acquired from this study would serve as an important tool for further study on this condition.

Aims and Objectives of the Study

  • To prevent maternal and child morbidity and mortality in relation to post partum psychosis.
  • To prove to the entire public that this condition is preventable, treatable and manageable.
  • To educate individuals, families and the general public on the importance of early detection and prompt management of post partum psychosis.
  • To fulfill this part of the requirement for the award of registered psychiatric nurse certificate (RPN) by the Nursing and Midwifery Council of Nigeria (N&MCN).

Chapter Five

Summary

Post partum psychosis, although a rare psychotic disorder, is a serious condition that requires immediate and emergency action in view of the fact that the well-being of a new born child could be seriously affected and those of other siblings with its antendant suicide and infanticide risks.

However, Mrs. A.N. was admitted in a psychiatric hospital into a female section and all the general and specific care were rendered to both mother and child and proper education of the condition given to both patient and her family members. Thus, she was able to recover quickly from the illness and resumed her normal roles in the family.

This confirmed the fact that early detection with appropriate nursing care, medicare, pharmacological care, education and psychotherapy results in a good prognosis.

Implication for Nursing Practices

Every psychiatric illness requires a specific method of approach and management if quick and appreciable result and recovery is expected.

Holistic care has proved to be the best and effective of rendering nursing care.

For nursing practice to be efficient, team approach and collaborative effort is necessary for achieving good results.

Proper education of patients and family members should be viewed as a necessary component in nursing practice because it equips the client and family members with the appropriate knowledge of managing their health conditions and prevents stigma and corrects misconceptions.

Conclusion  

The management of Mrs. A.N., who was diagnosed of post partum psychosis and her quick response to treatment has proved that correct diagnosis, early treatment, adequate, holistic and team approach is the best form of managing psychiatric conditions and even non-psychiatric conditions.

In addition to the management of Mrs. A.N., she and her family members were properly educated on the condition for possible prevention and early and better management in case it reoccurs in the future.

Recommendation

Nurses should see every contact with patients and their relatives as an opportunity for giving out health education on their health conditions. Post partum psychosis and other mental illnesses that affect women of childbearing age should be incorporated into the antenatal care of mothers.

Government should incorporate psychiatric and mental health education into its health care policy and implement it.

Mother and baby units (MBU) should be constructed in every psychiatric hospital to take care of cases like post partum psychosis.

Everyone should engage in mental health care practices especially those at risk of developing the illness.

Pregnant mothers should be supported by their husbands and other family members during and after delivery.

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