Chapter 20 - Transition to Parenthood: Test #4 Material

NUR 390: Maternal, Newborn, and Women's Health; Mississippi College, Mrs. McLendon

what is the period of change and instability for all men and women: adoptive or biologic parents, married or single parent, and lesbian or gay couples?

transition to parenthood

parenting is a process of _____ transition

role

parenting requires _____, _____, and _____ skill

cognitive, affective, and motor

*infant’s well-being and development depends on these components

what are the five factors of the parental process?

1. bonding

2. attachment 

3. proximity 

4. acquaintance

5. claiming process

what is the bonding process?

• early process when parent becomes acquainted with the infant

• occurs through mutually satisfying experiences 

what is the attachment process?

the process by which a parent comes to love and accept a child and a child comes to love and accept a parent

what is the proximity process?

the parents maintain proximity to the infant and responds to the infant’s bids for attention that indicate needs

what is the acquaintance process? 

using eye contact, touching, talking, and exploring to become acquainted with the infant 

what is the claiming process?

identified in terms of “likeness.” for example, little Johnny looks so much like his daddy

what is an assessment of attachment behaviors?

• careful observation of specific behaviors that indicate formation of emotional bonds

• skillful observation and intervening

what 2 factors are included in a skillful observation and intervening?

• enhance parent-infant contact by increasing parent’s awareness of infant responses

• rooming-in

what are the two parent-infant contacts?

• early contact

• extended contact

what does early contact facilitate?

may facilitate the attachment process 

what is an example of early contact?

skin-to-skin immediately after birth

what does skin-to-skin immediately after birth promote?

early and effective breastfeeding. associated with less infant crying, improved thermoregulation, and improved cardiorespiratory stability in late preterm infants

what does extended contact optimize?

family-centered care 

how is extended contact achieved?

• through couplet care

• family is encouraged to participate

the parent-infant relationship is strengthened through _____ responses and abilities

sensual

what are the 4 senses that are used in communication between parent and infant?

• touch

• eye contact “en face” position 

• voice 

• odor

touch varies among _____

cultures

eye contact “en face” position: infant and parent’s faces are ___” apart/same plane

8

voice: infants can distinguish the _____ voice

mother’s

odor: infants can smell their mother’s _____

milk

communication between parent and infant also uses entrainment. what is entrainment?

newborns move in time with the structure of adult speech. they wave their arms, lift their heads, and kick their legs, seemingly “dancing in tune” to a parent’s voice

communication between parent and infant also uses biorhythmicity. what is biorythmicity?

the fetus is in tune with the mother’s natural rhythms such as heartbeat 

communication between parent and infant also uses reciprocity. what is reciprocity?

type of body movement or behavior that provides the observer with cues. the observer or receiver interprets those cues and responds to them. takes several weeks to develop.

communication between parent and infant uses synchrony. what is synchrony?

the “fit” between the infant’s cues and the parent’s response. when parent and infant have a synchronous interaction, it is mutually rewarding

transition to parenthood includes more _____ transition rather than the historical “major life crisis”

developmental 

what are some parental tasks and responsibilities?

• reconcile that actual child with the fantasy/dream child

• become adept in caring for the infant

• establish a place for the newborn within the family

becoming a mother includes learning new _____ and increasing her _____ in herself as she meets new challenges in caring for her child or children

skills; confidence

the “_____” period surrounding the first day or two after birth, characterized by heightened joy and feelings of well-being, is often followed by a “_____” period 

pink; blue

mothers are _____ labile and often cry for no reason

emotionally

postpartum peaks around the 5th day and usually subsides by day ___

10

postpartum blues include what emotional feelings?

• restlessness 

• fatigue 

• let-down feeling 

• insomnia 

• headache 

• anxiety 

• sadness 

• anger 

postpartum blues are usually mild and short-lived, but ___-___% of women experience the more severe disorder termed postpartum depression (PPD)

8-20%

postpartum depression (PPD) is often underreported and undiagnosed. fathers can also have PPD. symptoms can be mild to severe. nurses must include the teaching of symptoms and urge parents to report depressive symptoms promptly.

what is the term used for the father’s absorption, preoccupation, and interest in the infant, sensual responses to the infant, likeness to himself (validating his claim to the infant), and can feel excluded from antenatal appointments and classes?

engrossment 

even the best relationships are often shaken with the addition of a baby

what are the 5 common issues that couples face?

• changes in their relationship with one another

• division of household and infant care responsibilities

• financial concerns

• balancing work and parental responsibilities

• social activities

when should sexual intimacy be resumed after having a child?

2 weeks or 6 weeks depending on delivery 

what is dyspareunia?

vaginal dryness and lacerations

what are 2 things to consider before resuming sexual intimacy?

• chronic fatigue experienced after having a baby

• review preferences for contraception

what is rhythm is infant-parent adjustment?

both parent and infant must be able to interact (en face)

what does the infant’s behavioral repertoire include? (3 factors)

• gazing

• vocalizing

• facial expressions

the parents’ repertoire includes various types of interactive behaviors such as what? (2 factors)

• constantly looking at the infant 

• noting the infant’s response 

what is responsivity?

contingent responses (responsivity) are those that occur within a specific time and are similar in form to a stimulus behavio

various personal and situational factors can influence parent’s responses such as:

• age (i.e. adolescent mother/father or maternal/paternal age older than 35)

• relationships with co-parent and other family members

• lifestyle

• social networks

• socioeconomic conditions

• personal aspirations for the future

• cultural beliefs and practices

• parenting in same-sex couples (lesbian couples and gay couples)

with a visually-impaired parent, how might their parenting might be affected?

• does not have a negative effect on parenting 

• heightened sensitivity to other sensory output 

• skepticism by health care professionals 

• infant will need sensory input from other parent

with a hearing-impaired parent, how might their parenting might be affected?

• mother and partner establish an independent household 

• technologic devices aid in parenting 

• young children acquire sign language readily 

siblings have to assume new positions within the _____ hierarchy?

family

parents’ _____ toward the arrival of the baby can set the stage for other children’s reactions

attitudes 

sibling adaptation also includes… (3 factors)

• reactions manifested in behavioral changes

• involvement in planning and care

• acquaintance behaviors

grandparent adaptation most often associated with _____ (what emotion?)

joy

grandparent adaptation may also feel _____ (what emotion?) due to poor health or geographical distance 

regret 

grandparents are usually eager to _____?

help

*maternal grandmothers are usually called on the most

during grandparent adaptation, intergenerational relationships shift. involvement is dependent on cultural and familial factors.

nursing care for new parents is directed towards… (6 factors)

• helping parents cope with infant care

• role changes

• altered lifestyle

• change in family structure due to new baby

• anticipatory guidance

• care involves the interprofessional health care team during the first few weeks (neonatologists, nurses, social workers, pediatricians, etc.)

early and ongoing assessment and intervention promote positive outcomes for parents, infants, and family members

a 30-year-ld multiparous woman has a boy who is 2 ½ years old and now an infant girl. she tells the nurse, “I don’t know how I’ll ever manage both children when I get home.” which suggestion would best help this woman alleviate sibling rivalry?

a) tell the older child that he is  big boy now and should love his new sister 

b) let the older child stay with his grandparents for the first 6 weeks to allow him to adjust to the newborn

c) ask friends and relatives not to bring gifts to the older sibling because you do not want to spoil him 

d) realize that the regression in habits and behaviors in the older child is a typical reaction and that he needs extra love and attention at this time 

D