Case Scenario 1:
MJ, age 16 years, is a high school junior who is 59.3 inches tall and weighs 126 lb. He is having increased feelings of discomfort about not fitting in with the other students at school because he has not yet begun sexual maturation. He is a good student and an accomplished violinist in the school orchestra. His father states that he also was a “late bloomer,” but both parents are concerned about MJ’s increasing social withdrawal and seem determined to seek medical intervention for him. The nurse at the clinic assesses the needs and status of MT and his parents.
1) As a nurse what health teaching should you prepare before the parents decide whether to start their son on androgen therapy? The decision is made to prescribe methyltestosterone (Striant) 30 mg twice daily by buccal tablet (held inside the cheek until it dissolves). MT will be on this regimen for 4 months, during which time he is to come to the clinic at monthly intervals. While on therapy, when should MT have x-rays taken? Explain your Answer.
Case Scenario 2:
TA, an older adolescent, was admitted to the hospital for labor induction/augmentation with signs and symptoms of gestational hypertension at 42 weeks’ pregnant (gravida 4, para 1). TA’s mother arrived at the hospital when TA was 8 cm dilated, in time for the late stages of TA’s labor. Her mother remained as TA’s support person throughout the delivery, which occurred at 6:00 AM by vacuum extraction.
TA had a continuous epidural for her labor and delivery. An episiotomy was performed at the time of delivery, and a fourth-degree laceration occurred. A cluster of hemorrhoids was evident. Baby JA, weighing 8 lb 7 oz, had Apgar scores of 7 and 9. The infant is alert and active.
TA lives with her parents and has been going to high school while working part time in an automotive parts store. TA wants to keep her infant and to breastfeed “for at least 3 months.” She plans to finish school and return to work in 6 weeks.
Immediately after the delivery, the nurse conducts an assessment of TA, analyzes the data, and determines and prioritizes TA’s nursing care needs. The same is done for the newborn.
- Identify at least five nursing diagnoses each for the mother and the newborn.
- List the identified nursing diagnoses according to priority.