MSc. Nursing

2. Psychological problems related to;
 Menstruation
 Menopause
 Conception, pregnancy, and peurperium

4.  Menstruation is the physical condition that initiates
reproductive preparedness in women.
 Average age- 12 years.

5. A. Premenstrual syndrome
B. Premenstrual dysphoric disorder

7. Premenstrual syndrome is the change in mood, emotions,
physical health, and behavior that can occur between
ovulation and the start of period.

8.  Nearly 48% of women who are of reproductive age.
 About 20% of them, symptoms are severe enough to affect
their regular routines.

9. Emotional and behavioral symptoms
 Anxiety, restlessness, or feeling on edge
 Unusual anger and irritability
 Changes in appetite including increased food cravings
 Sleep disturbances
 Sad/ low mood
 Decreased sex drive
 Impaired memory and concentration.

10. Physical symptoms
 Abdominal bloating
 Cramping
 Sore and swollen breast
 Constipation/ diarrhea
 Body aches
 Unusual sensitivity to light/ sound

11. Cyclic changes in hormones
 Changing levels of estrogen and progesterone
 Leads to anxiety, irritability, and other changes in mood.

12. Chemical changes in brain
 Serotonin and norepinephrine
 Helps in regulating mood, emotions, and behavior.

13. Existing mental health conditions
 Depression/ anxiety
 Family history of PMS can also increase the risk.

14. Life style factors
 Smoking
 Foods high in fat, sugar, and salt
 Lack of regular physical activity
 Lack of sleep

15.  Drink plenty of fluids to ease abdominal bloating
 Balanced diet
 Sugar, salt, caffeine, and alcohol intake should be reduced
 Supplements like folic acid, vit-B6, calcium, and magnesium
 Vitamin- D via natural sunlight
 Adequate sleep
 Exercise, relaxation techniques.

16.  Analgesics- Ibuprofen, Aspirin, or Acetaminophen
 Diuretics- to relieve bloating, sore/ tender breasts
 Heat application

18. Premenstrual dysphoric disorder happens in the week/ two
days before the period starts as, hormone levels begin to
fall after ovulation.
 Happens in the week/ two days before the ovulation.
 Affect 5% women in child bearing age.

19.  An imbalance of the estrogen and progesterone
 Excess estrogen/ a high in estrogen- progesterone ratio
during luteal phase causes symptoms associated with
PMDD.

20.  Breast tenderness/ swelling
 Bloating sensation
 Joint/ muscle pain
 Weight gain
 Headaches

21.  First line treatment- dietary modifications, stress reduction
techniques, exercise, counseling, and education.
 SSRIs- Fluoxetine, Sertaline

23. Menopause is the cessation of menses as a result of the loss
of ovarian follicular function.
 Most symptomatic during this transition period, beginning
a short while before final menstruation called
Perimenopause.

24.  Hot flashes
 Night sweats
 Sleep disturbances
 Vaginal dryness
 Cognitive changes
 Mood swings

26.  Low energy
 Paranoid thinking
 Hostility/ isolation
 Decreased self- esteem
 Insomnia
 Somatic symptoms
 Weight gain
 Decreased sexual interest

27.  Psychosocial therapy
 Education about menopause
 Regular exercises
 Mindfulness techniques
 Yoga
 Dietary modifications

28. Medications
 Antidepressants
 Hormonal therapy- Tibolone (a synthetic steroid with a
mixed hormonal profile).

30.  Limit caffeine intake, alcohol intake, sugar, spicy foods, and
hot drinks.
 Avoid large meals
 Daily vitamin-B complex and 400IU vitamin- E
 Sleeping in a cool room

31.  Antihistamines-
 Water- based lubricants at the time of intercourse
 Relief with vitamin-E suppositories/ low dose estrogen or
testosterone creams.

32.  1000 to 1500mg/ daily Calcium rich diet or taken in the form
of supplement.
 Weight bearing and strength building exercises.

33.  Low- fat, high fiber diet that is rich in fruits, vegetables, and
whole grains.
 Dislipidemic medications

35. Pregnancy is a profoundly personally and social event,
significant for the prospective mother and all the people in
their life.

36. A. Postpartum blues/ ‘Baby blues’
B. Birth- related PTSD
C. Post- partum depression
D. Post- partum psychosis
E. Perinatal OCD

38. Post partum bleus is very common but self- limited condition
that begins shortly after childbirth and can present with a
variety of symptoms such as mood swings, irritability, and
restlessness.
 Also known as ‘Maternity bleus’

39. Up to 85% of new mothers are affected by post partum bleus
with symptoms starting with a few days after child birth;
and lasting up to 2 weeks in duration.

40. Symptoms of post partum bleus can vary significantly from
one individual to the another, and from one pregnancy to
another.
 Symptoms that are mild and less disruptive to their daily
functioning.

41.  Crying “for no reason”
 Mood swings and irritability
 Anxiety
 Questioning one’s ability to care for the baby
 Difficulty making choice
 Loss of appetite
 Sleep disturbances
 Fatigue

42.  Onset- generally begins within a few days of child birth
and often peak by day 4 or 5.
 Duration- may lasts few days up to 2 weeks. If symptoms
lasts more than 2 weeks, must be evaluated for postpartum
depression.

43.  Not been clearly established
 Intersection of significant biological and psychosocial
changes that occur with childbirth.

44.  Fatigue after labour and delivery
 Caring for newborn that requires 24/7 attention
 Sleep deprivation
 Lack of support from family members
 Marital/ relationship strain
 Changes in home and work routines.

45.  Financial stress
 Unrealistic expectations of self
 Societal or cultural pressure
 Anger, loss, or guilt especially for parents of premature/
sick infants.

46. • Getting enough sleep
• Take time to relax and do activities that’s bring joy
• Ask help from family and friends
• Reaching out to other new parents
• Reassure that symptoms are very common and will resolve
on their own.

48. Birth- related PTSD is a type of anxiety disorder, also known
as ‘Birth trauma’ may experience during labour or child
birth due to traumatic events.
 Also known as Post- natal PTSD.

49.  A difficult labour with a long and painful delivery.
 An unplanned CS section
 Other shocking, unexpected and traumatic experiences
during child birth.

50. Relieving aspects of trauma
 Vivid flashbacks
 Intrusive thoughts and images
 Nightmares
 Physical sensations such as pain, sweating, nausea, or
trembling.

51. Alertness/ feeling on edge
 Panicking when reminded of the trauma
 Being easily upset or angry
 Extreme alertness/ Hyper vigilance
 Irritability or aggressive behavior
 Self destructive/ reckless behavior
 Symptoms of anxiety

52. Avoiding feelings/ memories
 Avoiding situations that reminds of trauma
 Being unable to remind that details of what happened.
 Feeling emotionally numb/ detached from the baby
 Being unable to express affection.

53. Difficult beliefs and feelings
 Feeling like can’t trust anyone and nobody understands
 Blaming by self for what happened
 Overwhelming feelings of anger, sadness, guilt, or shame.

54. Psychotherapy
Trauma- focused CBT
 Helps to assist in better understanding, coping with
processing emotions and memories tied to traumatic
experiences.

55. Eye movement desensitization& reprocessing (EMDR)
 Therapist guides to make rhythmic eye movements while
recalling the traumatic event.
 Aim is to help in processing traumatic events, and speed up
readjustment and recovery.

56. Medication is not normally offered to treat PTSD; but there
are few related reasons for prescribing medication;
 Anxiety
 Depression
 To feel more stable and able to care for the baby.

57.  Get to know the triggers
 Confide in someone
 Give self time
 Try peer group support
 Look after your physical health

59. Post partum psychosis is a reversible- but severe- mental
health condition that affects people after they give birth.

60.  Can affect anyone who recently give birth.
 While it usually happens within several days of giving birth,
it can happen up to 6 weeks later.
 It affects 0.089 and 2.6 out of every 1000 live births.

61.  History of mental health conditions
 Number of pregnancies
 Sleep deprivation
 Hormone changes
 Other medical conditions like autoimmune and
inflammatory diseases, electrolyte imbalances, vitamin
deficiencies, thyroid disorders, etc.

62.  Hallucinations
 Delusions- persecutory, control, or somatic delusions
Other symptoms;
 Mood changes
 Disorganized thinking/ behavior
 Insomnia
 Irritability/ agitation
 Thoughts of self harm/ harm to others.

63. TYPES OF POST PARTUM PSYCHOSIS
 Depressive
 Manic
 Atypical/ Mixed

64.  Antipsychotic medications
 Anticonvulsants
 Mood stabilizers- Lithium
 ECT

66. Perinatal OCD during pregnancy or after giving birth (in the
first tear) is a set of obsessions and compulsions that may
experience are likely to relate to the feelings about being a
parent and baby.

67.  Intrusive thoughts about hurting baby, during or after
pregnancy.
 Disturbing thoughts of sexually abusing child
 Fear of being responsible for giving a serious disease to the
child
 Fear of making wrong decisions- eg; about vaccinations/
medical treatment.

68.  Avoiding changing soiled nappies
 Keeping baby away from other people
 Constant checking on the baby- eg; waking them up when
they’re asleep to check on them.
 Going over what happened each day to reassure that they
haven’t harmed baby.

69. Psychotherapy
 Cognitive behavioral therapy (CBT)
 Exposure and response prevention- helps to understand
how OCD works and what all are needed to overcome it.

70. Medications
 Antidepressants- SSRIs
Other therapies;
 Interpersonal therapy
 mindfulness

72. I. Pre- marital counseling
II. Marital counseling
III. Genetic counseling

74. Premarital counseling is a type of advice that helps couples
prepare for marriage.
 Premarital counseling can help ensure that both spouses
would have a strong, healthy relationship — giving them a
better chance for a stable and satisfying marriage.

75. Premarital counseling addresses issues such as finances,
affection and sexuality, family of origin, strength and
issues, spiritual beliefs and values.

76. i. Discuss expectations around marriage
ii. Practice healthy communication
iii. Learn conflict reduction
iv. Discuss values and needs
v. Explore family of origin patterns
vi. Address challenging topics

77. A. Gottman method
B. Emotionally focused therapy
C. Psychodynamic couples therapy

79. Marital counseling, also called as couples therapy, marriage
and family therapy is a type of psychotherapy, that focuses
on improving communication and conflict resolution skills.

80.  To identify and maintain what’s going well in the couples’
relationship.
 To identify what is damaging the relationship.
 It helps to deepen intimacy and connection
 It helps to promote self- awareness and personal growth in
couples.

81.  Extra- marital affairs, loss of sexual attraction, gradual
disintegration of communication and caring.
 Couple with lack of intimacy and wants to improve their
sexual relationship.
 Parents to cooperate more effectively in parenting their
children.

82.  Couple who wait too long before seeking help.
 Marriages with one spouse is set on divorce.
 Marriages with one partner is addicted to alcohol, drugs or
pornography.
 Marriages with one partner showing up to sessions but not
invested in the work.

84. Genetic counseling is a communication process, which deals
with human problems associated with the risk of
occurrence of a genetic disorder in a family.

85.  Provide information about inherited disease
 Reassure people who concerned that their child may inherit
a particular disorder, that the disorder will not occur.
 Allow people who are affected by inherited disease to
make informed choice about future production.
 Offer skilled support to people who are affected by genetic
disorders.

87.  For women who are above 35, and pregnant
 Increased risk for mental retardation and birth defects.

88.  Parents of child with features of an inherited condition
 Any child who is born with more than one defects, mental
retardation, or dysmorphic features.

89.  When a person in the family decided to be tested for the
presence of a known genetic condition.
 When an adult exhibiting symptoms of an inherited
condition.
 Where there is a new diagnosis of someone with an adult
onset of disorder in the family.

90.  Guiding a woman or couple through prenatal diagnosis.
 Helping parents make decisions in regards to abnormal
diagnostic results.
 Assisting parents who have had a child with a defect to
locate needed services and support.
 Providing support to family deal with the emotional impact
of a birth defect.