(4) Monitor intake and output, especially voiding the first 24 hours after a
foley catheral is removed.
Observe lochia flow as ordered.
(6) Monitor fundal muscle tone-gently, according to the same frequency as
checking for lochia.
(7) Assist with breast-feeding as soon as possible (immediately if
desired--there is no reason to refrain).
Encourage maternal-infant bonding as soon as possible.
6-19. POSTPARTAL PSYCHOSIS
Postpartal psychosis is a major psychiatric complication in three of a thousand
pregnant women. Fifteen percent occurs during the prenatal period. Eighty five percent
occurs during postpartal. The causes are unknown but possible precipitating factors
include the birth experience itself, personality traits, hormone withdrawal following
delivery, and fear of the maternal role. Postpartal psychosis usually appears the third
day after delivery.
a. Signs and Symptoms.
Denial of existence of infant.
Delusions regarding the infant.
b. Treatment and Nursing Care.
Close observation and documentation of symptoms.
Protection of the patient and infant.
(3) Counseling - prognosis depends for the most part on the nature of the
underlying psychiatric disorder that is almost always present.