A patient in the clinic expresses reluctance to celebrate her ...

[crobinson2013]

A patient in the clinic expresses reluctance to celebrate her 80th birthday stating, It's terrible to grow old. I don't enjoy life any more, and I don't want anything that reminds me how old I am.
 
  How would you respond?

Question 2

A mother brings her 14-year-old daughter into the pediatric clinic for a routine physical prior to beginning high school. The adolescent has gained a significant amount of weight since her last visit.
 
  a. The client's mother expresses concern regarding her daughter's weight gain. What questions should the nurse ask of the client to determine possible contributing factors?
  b. You ask the mother to leave the room for the physical exam. The adolescent asks if you can prescribe birth control for her. What information would you give to the client?

[pallen55]

Answer to Question 1

- Begin by exploring more in-depth with the patient about why she feels this way. There is not enough information in the scenario to formulate a full response. Is this how she feels at this moment, or do her statements reflect how she has been feeling about her life for some time? Is there something that triggered these feelings? What is it about growing old that she dislikes or fears? Are chronic symptoms such as pain and fatigue interfering with her enjoyment of life? As you discover more about the patient's feelings and beliefs about her life situation, you can develop an approach that is tailored to her individual needs.
- Help the patient explore what is positive about getting older and reasons to celebrate her life. Possible advantages of growing older might include wisdom gained through years of experience; opportunity to establish a lasting legacy with younger generations; more time to enjoy life and accomplish life goals; and having family or friends.

Answer to Question 2

- A nursing assessment of the adolescent's diet and exercise patterns
- Assessment for type 2 diabetes

b.
(should the patient's age be part of the discussion? Are there issues about birth control counseling for minors without their parents' consent?)
- The nurse should assess the client's sexual risk behaviors, by asking about sexual activity and use of other contraceptives.
- The nurse should impart information regarding sexually transmitted infections and pregnancy.
- The nurse should also determine if the client's weight gain is due to pregnancy, by discussing the client's menstrual cycle and obtaining an order for a pregnancy test.

[crobinson2013]

Gracias!

[T4T]

TYSM