You are caring for a 37-year-old female who is pregnant with her second child. Her first pregnancy was traumatic as she experienced a pelvic fracture during delivery causing excruciating pain. The anxiety from this memory plagues her into this pregnancy. She has been prescribed an antidepressant/antianxiety. Her husband is a pharmacist and has attended most visits with the psychiatric-mental health NP for counseling and psychopharmaceutical drug management.
1. What would be your initial approach to assessment and diagnosis with this woman/family?
2. Would you prescribe an antidepressant, and which one?
3. What are possible adverse reactions to placing a woman on antidepressants in the post-partum phase?
4. Explain the pharmacodynamics, pharmacokinetics, contraindications, pregnancy related issues, legal/ethical considerations, testing (if applicable), side effects and relationship to trimester.
5. What would be your plan of care including the strengths and weaknesses of the family functioning and supporting attachment? (Be succinct.) Consider supervision/collaboration/type of psychotherapy or complementary modality you might use.
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