A child is diagnosed with osteosarcoma.
What is the primary treatment for this condition?

Choice A rationale

While journaling can be a therapeutic outlet, encouraging it as a priority action in this situation could be detrimental. The teen's writings about death and giving away belongings are strong indicators of potential suicidal ideation, which necessitates immediate assessment and intervention for safety rather than emotional expression without prior safety assurance.

Choice B rationale

Giving away personal belongings and writing about death are significant warning signs of suicidal ideation. The nurse's priority action is to immediately assess for suicide risk, determine the level of intent and plan, and initiate appropriate safety measures to prevent harm. This direct intervention is crucial for ensuring the teen's immediate well-being.

Choice C rationale

Notifying the teen's teacher might be a subsequent step in a comprehensive safety plan, but it is not the immediate priority. The teacher's role is to monitor behavior within the school setting, but they are not equipped to perform a comprehensive suicide risk assessment or implement immediate safety measures like a nurse.

Choice D rationale

Providing information on grief support is not the priority action when there are direct indicators of potential suicide risk. While loss can contribute to suicidal thoughts, the immediate concern is the risk to the teen's life, which requires direct assessment for suicidal intent and the implementation of safety protocols, not generalized grief support.

Choice A rationale

Continuous labor support, often provided by doulas or trained birth companions, significantly reduces perceived pain intensity. This is mediated by physiological mechanisms like decreased sympathetic nervous system activation, leading to lower circulating catecholamines, and increased release of endogenous opioids, which naturally mitigate pain signals by binding to mu-opioid receptors in the central nervous system.

Choice B rationale

The presence of a supportive individual during labor fosters a sense of security and control for the birthing person. This psychosocial benefit contributes to a more positive subjective experience, reducing feelings of isolation and fear. Emotional support can lead to increased coping efficacy and a greater sense of satisfaction with the birthing process.

Choice C rationale

Research indicates that continuous labor support is associated with better fetal outcomes, including a reduced incidence of fetal distress and fewer low Apgar scores. This may be attributed to decreased maternal stress hormone levels, which can negatively impact uterine blood flow and oxygen delivery to the fetus, thus promoting a more stable intrauterine environment.

Choice D rationale

Improved client outcomes encompass a range of positive effects, such as reduced rates of medical interventions like epidural anesthesia and cesarean sections. The presence of support often empowers the client to labor more effectively, leading to shorter labor durations and a decreased need for pharmacological pain management, contributing to overall maternal well-being.

Choice E rationale

Increased anxiety is an incorrect benefit. Scientific evidence consistently demonstrates that continuous support during labor actually reduces maternal anxiety and stress levels. The presence of a supportive individual provides emotional reassurance and practical assistance, which helps to alleviate fear and promote a sense of calm during the birthing process.