1100: The client gave birth four weeks ago via cesarean section. The infant was term and had no complications. The client denies any pain and reports no fever, vaginal discharge, nausea, or vomiting. The incision was approximated with no erythema. The client was avoidant when discussing the infant, and when asked directly, the client became tearful, saying, "It has been rough, and I am not sure I can take it." The symptoms started eight days postpartum and have been persistent. The client reports sleeping more, eating less, and not feeling 'attached' to the infant, which has caused her subsequent feelings of guilt. The client denies any hallucinations, suicidal ideations, or wanting to harm any individual. She denies any thoughts of wanting to harm the infant but worries that she is inadequate. The client's partner says she has been periodically despondent and has occasional bouts of anxiety that tend to occur right before she breastfeeds. After noticing his wife's behavior, the client's partner has stayed home from work to look after the infant. Both report that she has been breastfeeding the infant regularly, without delay, which makes the client feel guilty that she does not have more of a bond with the infant. T 98° F (36.7° C) P 88 RR 16 BP 119/89. Pulse oximetry reading 98% on room air. The infant was present during the assessment and had a normal appearance, well nourished—full range of motion in all extremities with occasional crying but stopped once held.