Patient Scenario 1:Nursing Care For The Family In Need Of…

Patient Scenario 1:Nursing Care For The Family In Need Of… Patient Scenario 1:Nursing Care For The Family In Need Of Reproductive Life Planning  AN ADOLESCENT IN NEED OF REPRODUCTIVE LIFE COUNSELING Randy Burrows is a 15-year-old boy you see at a pediatric clinic.  CHIEF CONCERN: “I think my girlfriend’s pregnant, but I don’t know why. She told me girls couldn’t get pregnant for the first year after they started their periods especially if they wash with vinegar afterward. She got her first period only 6 months ago so I guess that must not be true. Can she get a morning after pill or something? And what should we do better next time? What if I got a vasectomy?”  HISTORY OF CHIEF CONCERN: Randy has been having sexual relations with a 15-year-old neighbor, Becky, for the last 3 months. They have used no protection because he trusted girlfriend’s knowledge about conception. His girlfriend’s menses is 6 days late, but she has not taken a pregnancy test yet because she tends to have irregular menstrual periods. Although his relationship is monogamous with her, he’s not sure her relationship is monogamous with him.  FAMILY PROFILE: Randy’s family consists of his father (35 years old), a stepmother (about 26 years old), Randy (15 years old), and Scott (4-year-old stepbrother). Randy’s father works as an assistant janitor at the nearby grade school; his stepmother works part-time driving a school bus. They live in a single-story home in a “good” neighborhood. Randy describes the family finances as “okay.”  HISTORY OF PAST ILLNESSES: He had no major illnesses or hospitalizations. Randy broke two front teeth in seventh grade playing hockey; he wears a temporary bridge for this.  HISTORY OF FAMILY ILLNESSES: His maternal grandmother died of breast cancer. His father has Meniere’s disease (inflammation of inner ear so has to avoid salt or gets very dizzy).  DAY HISTORY: Sleep: The client sleeps 7 to 8 hours a night; he has no problems. Nutrition: He eats breakfast at home; lunch in school cafeteria; eats dinner most nights at neighbor’s house because he doesn’t like his stepmother’s vegetarian cooking. Recreation: He plays on high school soccer and softball teams; he has hopes of winning a college softball scholarship. Growth and development: He is a sophomore in high school (age appropriate). He reports marks are “Not great, but okay. I’m going to make it.” When asked where he received his sex education, he laughed and said, “A bad film in school with everyone wearing bell-bottom pants like the Brady Bunch.”  REVIEW OF SYSTEMS: Negative   PHYSICAL EXAMINATION: General appearance: Well-appearing but distressed-appearing adolescent male HEENT: Normocephalic; no palpable lymph nodes; vision and hearing grossly normal; upper central incisors are replaced by an artificial plate; no erosions or irritation present Neck: Full range of motion; thyroid not palpable; midline trachea Chest: Normal heart and lung sounds and rate Abdomen: Soft to palpation; bowel sounds heard in all four quadrants Extremities: Full range of motion; several ecchymotic marks on anterior legs he states are from soccer play Neuro: DTR 2+; normal gait and response to s  Randy’s girlfriend is examined and found she is not pregnant. She is prescribed Ortho-Novum 7/7/7 for birth control. Both she and Randy are counseled regarding safer sex practices, the responsibility that comes with sexual activity, and the necessity for reproductive life planning to prevent pregnancy.    1. Make an NCP for this scenario                                       Health Science Science Nursing NUR 39700

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