As we talk about child birth we also find that there may be a link between some antidepressant medications and miscarriage. Now we know that there are medications that are not recommended or contraindicated in patients who are pregnant. But in cases where pregnancy is very early on and perhaps in cases where the patient doesn’t even know that they are pregnant, this can cause a problem for patients that are taking medications on a regular basis.
So we need to educate our patients about the medications they take. And if we have a patient who is a child-bearing age, we should advise them on the fact that if they are interested in having children and starting to have children, they should consult with their physician or with their nurse and find out about the medications they’re taking and are they going to be safe if they become pregnant before the pregnancy is discovered. So we need to find out about that.
I did find this article over at health.usnews.com so you can follow up on that particular article just finding out the resources. This is actually a Canadian study that looked at 5,000 women and found that certain antidepressants such as selective serotonin reuptake inhibitors caused the pregnancy to have an increased risk of miscarriage. and certainly when someone has depression issues, we need to find ways to manage that but we may have to switch them to other medications or we may have to talk with those patients and find ways to refer them to perhaps additional behavioral therapies during the pregnancy and nursing period afterward until they are able to safely resume their medications.
And so these are things that we need to be prepared for when patients have a history of depression so be careful, make sure you’re asking that question of your patients if you are in the labor and delivery and maternity care arena. You certainly want to make sure that you are asking questions about history and including their psych history because we need to know if there’s other opportunities or options that can be opened up for these patients if they can no longer take their antidepressants.
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This article has been featured in the news segment of the Nursing Show episode Drowning, Near Drowning and Episode 136
Filed under Blog by on Jun 24th, 2010. Comment. 
This is an article from the UK and this is a look at the 2009 figures for England and Wales and this is reported recently by the office of national statistics for England looking at the fact that the average age of women giving birth has increased and that there are much larger number of older women that are having younger babies obviously. So their children are younger and they’re starting later in life to begin having children. This is something that is unusual an especially for first time mothers.
So they’re looking at a lot of different statistics. The rates for younger women dropped so women under the age of 25 actually dropped during the period of 2008 and 2009 and they also dropped for some of the other younger age groups. However the average age increased for women over the age of 40 by almost 3 percent.
So there is a concern that of course if an older woman is having a child, there may be additional complications, there may be increased need for prenatal care- beyond normal prenatal care. And of course if you have prenatal care, you’re going to be getting those additional services but this is important information to keep in mind and I have a feeling- I haven’t seen statistics in the US on this but I wouldn’t be surprised to find these numbers are increasing in a lot of developed nations as more and more women are engaged in their careers as that change has taken place over the past decades.
That change has encouraged women to be more career focused earlier in life and more family focused as their careers have become established they then can fall back and look at developing their family relationships and that’s something that we should keep in mind and we should be aware of asking those kinds of questions.
We might think that some women are past child-bearing age but we’re seeing more and more frequently women later in life having babies and of course I’m a guy, I have little experience to talk about this but I urge you to get back with me and give me your response. I know we have quite a few labor and delivery and OB nurses out there.
Give me your impressions on what you think about this particular topic. Anecdotally even, have you seen that the age of your patients is increasing and are there any particular issues in nursing care that you have to adjust to deal with this particular change in our patient? So just interested to hear back from you, again nursingshowgmail.com or leave a comment on the website. I’d love to hear back, a response from some of you on this topic.
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This article has been featured in the news segment of the Nursing Show podcast episode Drowning, Near-Drowning Emergencies and Episode 136
Filed under nursing news by on Jun 23rd, 2010. Comment.
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Improved Jaundice Screening Can Protect Newborns
Children of Working Mothers Have Unhealthier Lifestyles
Health Experts Support Tools to Prevent Preterm Birth
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Tip of The Week- Care and Interventions of Newborn Jaundice
Most preterm and almost 50% of full term newborns present with jaundice, a yellow discoloration of the skin and sclera of the eyes. The yellowish hue comes from bilirubin, a substance produced from break down of red blood cells, when it reaches a blood level greater than approximately 2.5 mg/dL. This bilirubin is excreted in the stool via the liver, in the case of infants, this process takes more time resulting to accumulation in the skin. Jaundice appearing about 2-3 days after birth, called physiologic jaundice is normal in newborns,however, interventions like phototherapy should be instituted to help the infant’s body excrete the excess bilirubin.
There are also disorders that can cause bilirubin levels to increase in newborns like blood type incompatibilities, prematurity, polycythemia, etc. If left unresolved, bilirubin may continually increase and cause serious complications such as cerebral palsy, deafness, and kernicterus ( brain damage from very high bilirubin levels).
Infants receiving phototherapy, the first line intervention for jaundice, requires special attention to avoid chilling or burning of the skin. Intake and output should be monitored and carefully documented, including continuous assessment for skin breakdown and bilirubin lab values should always be updated. Serum bilirubin levels above 25 mg/dL or higher at any time is a medical emergency and the infant should be evaluated immediately for exchange transfusion.
For more on nursing care of newborn jaundice, follow links below
Newborn Jaundice by NIH Medline
eMedicine Article on Newborn Jaundice
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Filed under nursing show podcasts, pediatrics for nurses by on Nov 6th, 2009. 1 Comment.
The National Association of Pediatric Nurse Practitioners (NAPNAP) released a strong statement against a recent article negating the benefits of breastfeeding that was published in the magazine The Atlantic.
In this article, the mother of three cited lack of any credible evidence that she could find to support the strong push by medical educators, nurses, and breast feeding advocates for mothers to breast feed their children. She said she found no evidence of any benefit over other methods of feeding.
The American Academy of Pediatrics (AAP) came out very strongly against this article and the subsequent news coverage. The pediatricians cited their 2005 position statement supporting breastfeeding. That statement includes references to over 200 peer reviewed studies supporting the benefits of breastfeeding over other methods of feeding.
The National Association of Pediatric Nurse Practitioners (NAPNAP) joined the AAP in the strong resonse to the article by releasing their own strong affirmation of the benefits of breastfeeding. “NAPNAP is committed to educating families and health care providers about the importance of breastfeeding and its impact on children’s health,” said NAPNAP President Linda L. Lindeke, PhD, RN, CPNP. “We stand with the AAP’s statements in response to the recent controversy and the scientific evidence that supports breastfeeding.”
Breastfeeding has been shown to provide numerous benefits to newborn infant including (but not limited to) immune system protections, reduced chances of obesity later in life, and better nutritional content suited to the infants life stages.
Here are some additional resources on the topic of breastfeeding for nurses and nursing students:
NAPNAP page on Breastfeeding Education
NIH Medline Links Page for Breast Feeding
Filed under pediatrics for nurses by on Mar 28th, 2009. Comment.
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Nursing News –
Medically Unnecessary Procedures Drive Rising Childbirth CostsReport Reveals
Registered Nurses Least Satisfied in Hospital Setting
Nursing ranks as No. 3 major in the country
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Tip of the Week — APGAR Score for Nurses
American Academy of Pediatrics (journal article pdf)
Apgar Score: Test and Procedure History on MedicineNet.com
What Is the Apgar Score? (a patient resource from Kidshealth.org)
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Filed under nursing show podcasts by on Oct 17th, 2008. 4 Comments.
A newly released study of 2.8 million babies born between 1995 and 2000 ties some newborn risks including low birth weight and mortality to having a father younger than age 20.
The interesting part of this study is that it focuses on the father and not the mother. The study allowed for women in peak child bearing years between 20 and 30 in order to remove the associated risk factors for teen mothers. Most of the fathers were in their 20s or 30s but 28,000 of them were younger than age 20.
It was this younger age group that seemed to comprise a surprising number of higher risk newborns when compared to the others. The researchers don’t look at overall socio-economic group or other outside factors but they do say that this may indicate that there is a biological impact based on the father’s youth as well as with the mother.
Filed under pediatrics for nurses by on Feb 13th, 2008. Comment.
Breastfeeding by new mothers is sometimes a trying activity. Even after successfully nursing one baby, difficulty can arise with later children (I know — my wife had trouble feeding our third and for a long time blamed herself for subsequent failure to thrive that was related to other medical issues).
It falls to the nurse in the maternity units to start moms off on the right (foot?). Patient education, finding the right accommodations to facilitate success, and emotional support are all important parts of the picture.
This article on anxious mothers and breastfeeding provides a good picture of why this may be one of the most important nursing activities on the maternity unit and beyond in the pediatric practice. The study looked at 28,000 new mothers both immediately post-partum and 6 months later.
The researchers found that anxiety over whether they produced enough milk and overall depression had a profound impact on success and whether the mothers eventually supplemented with, or switched entirely to formula feedings.
If you work on a unit that comes in contact with new mothers, what steps can you take to improve the mother’s confidence in her ability to provide food for her baby via breast milk?
You can leave your thoughts and comments here at the comments link below or email me here at comments@nursingshow.com.
Filed under nursing education, pediatrics for nurses by on Jan 26th, 2008. 1 Comment.
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