An adolescent tells the school nurse that she is pregnant. Her ...

[futuristic]

An adolescent tells the school nurse that she is pregnant. Her last menstrual period was 4 months ago. She has not received any medical care. She smokes but denies any other substance use. The priority nursing action is to:
 
  a. notify her parents.
  b. refer for prenatal care.
  c. explain the importance of not smoking.
  d. discuss dietary needs for adequate fetal growth.

Question 2

An adolescent asks the nurse what causes primary dysmenorrhea. The nurse's response should be based on which statement?
 
  a. It is an inherited problem.
  b. Excessive estrogen production causes uterine pain.
  c. There is no physiologic cause; it is a psychological reaction.
  d. There is a relation between prostaglandins and uterine contractility.

[Fayaz00962]

Answer to Question 1

ANS: B
Teenage girls and their unborn children are at greater risk for complications during pregnancy and delivery. With improved therapies, the mortality for teenage pregnancy is decreasing, but the morbidity is high. A pregnant teenager needs careful assessment by the nurse to determine the level of social support available to her and possibly her partner. Guidance from the adults in her life would be invaluable, but confidentiality should be maintained. Although it is important to explain the importance of not smoking and to discuss dietary needs for adequate fetal growth, because of her potential for having a high-risk pregnancy, she will need a comprehensive prenatal program to minimize maternal-fetal complications.

Answer to Question 2

ANS: D
The exact etiology of primary dysmenorrhea is debated. Overproduction of uterine prostaglandins has been implicated, as has overproduction of vasopressin. Dysmenorrhea is not known to be inherited. Excessive estrogen has not been implicated in the etiology. It has a physiologic cause. Women with dysmenorrhea have higher prostaglandin levels.