An adolescent tells the school nurse that she is pregnant. Her last menstrual period was 4 months ago, and she has not yet received any medical care. She smokes but denies any other substance use. Which interventions should the nurse implement? (Select all that apply.)
Encourage smoking cessation.
Arrange for childcare.
Offer nutritional instruction.
Refer for prenatal care.
Teach breastfeeding methods.
Notify her parents.
Correct Answer : A,C,D
A. Encourage smoking cessation:
Smoking during pregnancy can have serious consequences for both the mother and the fetus, such as increased risks of preterm birth, low birth weight, and developmental issues. Encouraging smoking cessation is crucial for improving both maternal and fetal health.
B. Arrange for childcare:
While childcare is an important consideration, it is not an immediate priority at this stage. The focus should be on ensuring the adolescent receives proper prenatal care and support for her health and the health of the baby.
C. Offer nutritional instruction:
Good nutrition is vital for a healthy pregnancy. Offering nutritional instruction helps the adolescent understand how to meet her dietary needs and those of her developing baby, contributing to better pregnancy outcomes.
D. Refer for prenatal care:
Prenatal care is essential for monitoring the health of both the mother and the fetus, providing necessary medical interventions, and offering support. Referring the adolescent for prenatal care is critical for addressing her medical needs throughout her pregnancy.
E. Teach breastfeeding methods:
While teaching breastfeeding methods is important, it is not the most immediate concern. This can be addressed later in the pregnancy or closer to delivery when the adolescent is more prepared to consider breastfeeding.
F. Notify her parents:
Unless the adolescent gives explicit consent or there are concerns for her safety or the safety of the baby, the nurse should maintain confidentiality. In many cases, the decision to notify parents is complex and requires careful consideration of the adolescent's autonomy and legal rights.
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Related Questions
Correct Answer is D
Explanation
A) Obtain a restraining order against the father:
Obtaining a restraining order is a legal action that can be taken to protect the child but is not typically within the scope of the nurse’s immediate responsibilities. This action would involve law enforcement and the legal system rather than being an immediate next step in the healthcare setting. The nurse's role is to report the suspected abuse and ensure that appropriate protective services are involved.
B) Encourage the mother to file a police report:
Encouraging the mother to file a police report is a potential step in addressing the situation, but it should not be the nurse's immediate next action. The nurse's primary responsibility is to ensure that the appropriate child protective services are notified and involved, as they are equipped to handle investigations and interventions in cases of suspected child abuse.
C) Ask the child if his father ever spanks him:
Asking the child about specific forms of discipline, such as spanking, could potentially place the child in a difficult or unsafe position, especially if abuse is suspected. It is not the nurse's role to investigate or interrogate the child directly. Instead, the focus should be on ensuring that the proper authorities are notified to handle the investigation.
D) Refer the family to protective service agencies:
Referring the family to protective service agencies is the most appropriate next step. These agencies are specialized in handling cases of suspected abuse and can provide the necessary intervention and support for the child’s safety and well-being. The nurse's role includes reporting suspected abuse to the appropriate authorities and ensuring that protective services are contacted to investigate and address the situation.
Correct Answer is A
Explanation
A) Review morbidity data for the city's population compiled by the Bureau of Vital Statistics:
This is the most comprehensive and reliable method for identifying the greatest health concern facing the city. Morbidity data provides statistical information on the incidence and prevalence of diseases and health conditions within the population, helping to identify major health issues based on objective data.
B) Conduct a random telephone survey to determine the public's perception about health problems:
While public perception is valuable, it may not accurately reflect the actual health concerns based on prevalence or incidence data. Public surveys can provide insights into perceived issues but are not as reliable for identifying the most pressing health concerns as concrete morbidity data.
C) Call American Medical Association members to determine the most frequently treated diagnoses:
This method might provide insights from a medical perspective but does not offer a complete picture of the health concerns across the entire population. It may also miss out on data from other healthcare providers and public health reports.
D) Survey major hospitals in the area to determine the most common reasons for admissions:
Although hospital admission data is useful, it represents only part of the health picture and may not capture all relevant health concerns in the community. It also does not include outpatient or preventive care data, which are important for a comprehensive health assessment.
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