Assessments
What will you assess under "individual client assessment"?
Mental health assessment, Physical assessment, Pain & pain control, Understanding of what happened, Life stressors
What determinants of health are relevant to this scenario?
Income, Social exclusion, Education, Employment, Social safety net, Health services.
Who or where may Emma experience judgment and prejudice from?
At school (peers, friends, teachers), other family members, Health care providers.
Where/how could the nurse demonstrate leadership in this scenario?
What does leadership mean in this context?
Advocate to destigmatize teen pregnancy, Promote healthy pregnancy & parenting for teen parents.
Understanding how teen parents feel & advocate on their behalf.
How does a CHN show the standard of access & equity?
Treating client as any new mother and navigating resources that are accessible to her and meets her needs.
What will you assess under "family assessment"?
Who is part of her support system, Friends, What is happening with the father of the baby & his family.
Do these determinants work in isolation or interact with other determinants?
These determinants interact together to create Emma's health status, Income plays a major role in everyone's lives (those with lower incomes have a lower quality of health).
How can relying on the parents too much create a challenge?
Overburden them by making them sacrifice time and expecting them to earn money for the family.
Who should be involved in this situation? (Individuals, agencies, Resource)
Support group for teen parents (can be in person or online), Pregnant & parenting programs, Counselling.
How does a CHN show professional responsibility and accountability?
Respecting confidentiality on client, understanding the needs of client, and referring to relevant resources.
What will you assess under "community assessment"?
Any community centers/programs for pregnant teenagers, Any support from school for her situation/any accommodations (if she goes back), For the future→ any daycares or schools in the area, Access to hospitals, doctors office, walk in clinic (if she or the baby is sick).
How do these determinants affect the scenario?
These determinants make it more difficult for Emma in the future, May cause unnecessary stress, Her parents will not be able to support her of her whole life (she eventually needs to develop her own skills to support herself & her child).
How does the stigma around teen pregnancy impact Emma?
May be socially isolated, have difficulty trusting others, and have a fear of being shamed/judged.
What might be the challenges of having other individuals involved? How can the community nurse best work with these partners?
Others may judged her & make her feel like she is incompetent or a bad mother, Others may label her parents as "bad" because they "allowed" this to happen.
The CHN needs to see if the client is willing to interact with other, The CHN will work together with others in order to provide client-centered care.
If Emma is unwilling to learn about other parenting styles/tips, how may you address that?
Inform her of benefits, do not force anything on her, encourage her to seek for help when needed.
What assessment should be done for the MOM after a c-section ?
Assess for blood clots, Hemorrhaging, Injury (to internal organs), Wound healing (approximation, redness, infection, intact sutures ), BP, Respirations, Pulse, Pain level, Medications administered).
What ethical issues may arise & how can the nurse address them?
ISSUES: Abortion (Jake pushed for an abortion, Doctors may push for an abortion due to her age, is abortion ethical or not?), Judgment & stigma from staff.
SOLUTIONS: Provide Emma with her options & allow her to make her own decision, be non-judgmental, don't be biased
How does Emma's acceptance of motherhood responsibilities positively impact the scenario?
Looks after health of baby by taking prenatal vitamins and going to prenatal check-ups.
What is the role of the nurse within the interprofessional team?
To advocate on behalf of the client (taking their preferences into account), Not reflecting biases or assumptions, Connection the interprofessional team together, Providing client-centerer care, Creating a supportive environment, Encouraging healthy behaviours.
How can a CHN address the issue of Emma's fear of being judged?
Without reflecting own biases, let Emma know she is not alone and you are here to support her.
What assessment should be done for the BABY after a c-section ?
Assess respiratory status (transient tachypnea, need for suctioning, need for resuscitation), Injury (from surgical procedure), Activity (muscle tone), Pulse, Grimace, Appearance (skin colour), Respiration.
What issues of social justice & equity are relevant to this scenario?
Due to her age, Emma may be treated differently by staff at the hospital, her peers at school, in public places, She faces social stigma & exclusion, Judgment that she is incapable to be a "good mom" because of her age
How can having a supportive family positively impact the scenario?
Gives Emma emotional support, helps with caring for child, and may allow Emma to return to school.
What community health nursing competencies/standards are relevant to this scenario?
Health promotion, Professional relationships, Access & equity, Professional responsibility & Accountability.
What nursing and health promotion strategies can be used in this scenario?
Education on mother and baby health (prevent SIDS), parenting (communication), encouraging mother to talk about feelings.