Case Summary
The scenario for a 17-year-old girl brought to a women’s health clinic by her father. The father demands his daughter have a pregnancy test. The girl had not consented and looked worried.
Patient Assessment
The assessment of the patient’s condition will include physical and mental health checks. First, I will ask questions about patient complaints, pain, or other discomfort conditions. The mental health assessment provides questions to identify high-risk behaviors such as sexual behavior, violence, suicidal thoughts, eating disorders, misbehavior, and alcohol or drug use.
I will use the HEEADDSSS psychosocial interview format to assess and gather information (McLean et al., 2023). This format includes a survey about everyday activity in all spheres: home, education, employment, activities, depression, drugs, safety, sexuality, and suicidality. This information will serve as a source for forming a straightforward clinical question and differential diagnosis.
A full assessment of the patient’s condition should include individual interviews with the adolescent and her father and talking with the girl and her father. I ensured that the patient and her father knew the confidentiality requirements during the conversation. These requirements may vary from state to state, but general rules allow teenagers to opt out of having pregnancy tests except medically necessary (surgery, medications).
In addition, adolescents may self-consent for pregnancy, sexually transmitted diseases, and HIV testing (Pampati et al., 2019). The results are confidential but not classified and may be disclosed if the child’s health is threatened. Adolescents should be informed about family planning and sexual behavior, risks, and possible outcomes of neglecting sexual health and pregnancy control.
Applying Evidence-Based Practice Guidelines and Ethical Considerations
I will focus on evidence-based practice guidelines for assessment. Many associations of healthcare professionals caring for minors, including the American College of Obstetricians and Gynecologists, the Society for Adolescent Health and Medicine, the American Academy of Pediatrics, the American Academy of Family Physicians, and the North American Society of Pediatric and Adolescent Gynecology, recognize the importance of confidentiality in the care of adolescents (Pathak & Chou, 2019). The nurse must be wary of the patient’s privacy rights.
The American College of Obstetricians and Gynecologists recommends that there should be time for face-to-face communication between a doctor and an adolescent patient (Rector & Stanley, 2020). More than 40% of adolescents do not discuss sexual behavior with parents or teachers (McKellar & Sillence, 2020). The nurse should provide complete information on these issues.
References
McLean, K., O’Connor, E., Ong, R., Joseph, C., Skinner, R., & Goldfeld, S. (2023). Psychosocial assessment tools for children and young people aged 5–18: A rapid literature review. Journal of Paediatrics and Child Health, 59 (2), 218–228. Web.
McKellar, K., & Sillence, E. (2020). Teenagers, sexual health information, and the digital age. Academic Press.
Pampati, S., Liddon, N., Dittus, P. J., Adkins, S. H., & Steiner, R. J. (2019). Confidentiality matters, but how do we improve implementation in adolescent sexual and reproductive health care? Journal of Adolescent Health, 65(3), 315–322.
Pathak, P. R., & Chou, A. (2019). Confidential care for adolescents in the US Health Care System. Journal of patient-centered research and reviews, 6(1), 46. Web.
Rector, C., & Stanley, M. J. (2020). Community and public health nursing. Lippincott Williams & Wilkins.