NCLEX · Antepartum, Newborn, and Postpartum Care

A nurse is caring for a client who is 2 hours postpartum. The client reports feeling sad and crying without reason. Which postpartum mood disorder does this MOST likely represent?

  1. A Postpartum psychosis
  2. B Postpartum blues (baby blues) — a very common, self-limiting mood change in the first 2 weeks after birth affecting up to 80% of new mothers
  3. C Postpartum depression
  4. D Postpartum anxiety disorder

Why this is the answer

POSTPARTUM BLUES ('baby blues') is the MOST COMMON postpartum mood change, affecting up to 70-80% of new mothers. Characteristics: onset within 1-3 days after delivery; peaks around day 3-5; resolves on its own within 10-14 days; symptoms include tearfulness, emotional lability, irritability, anxiety, mood swings — often coexisting with happiness about the new baby; does NOT significantly impair functioning. CAUSE: largely attributed to rapid hormonal shifts (dramatic drop in estrogen and progesterone after delivery), combined with sleep deprivation, exhaustion, and emotional adjustment to motherhood. NURSING CARE: reassure that baby blues is NORMAL and TEMPORARY; encourage rest and support; monitor for progression to postpartum depression; validate feelings without reinforcing that something is seriously wrong. POSTPARTUM DEPRESSION (PPD): affects 10-15% of new mothers; onset usually within 4 weeks but can occur anytime in the first year; DOES NOT resolve on its own; symptoms persist longer than 2 weeks and significantly impair functioning; requires treatment (therapy, medication); Edinburgh Postnatal Depression Scale (EPDS) is the primary screening tool. POSTPARTUM PSYCHOSIS: rare (1-2 per 1000); severe psychiatric emergency; symptoms include hallucinations, delusions, disorganized behavior, rapid mood swings, confusion; onset within 1-2 weeks; IMMEDIATE psychiatric referral required; infant safety must be ensured. PN ROLE: screen for mood disorders at postpartum visits using EPDS; provide education; report concerns to RN/provider; support and refer as needed.
Source: NCLEX-PN Test Plan: Health Promotion — Postpartum Care