Running head: THE FOURTEEEN YEAR OLD MOTHER
The Fourteen Year Old Mother
Ayesha Howard
Old Dominion University
1
THE FOURTEEN YEAR OLD MOTHER
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The Fourteen Year Old Mother
Teen pregnancy continues to be an issue in today’s society. According to the Centers for
Disease Control and Prevention (CDC), about four girls out of every ten will get pregnant before
their twentieth birthday. Though teen pregnancies have declined overall in the United States
when compared to the year 1997, this country continues to be highest when compared to others.
In 2012, CDC calculated a total of 305,388 live births to females ranging from the age of fifteen
to nineteen (“teen pregnancy”). From anyone who is simply observing these statistics would be
outrage, generally coming up with the conclusion that these kids are just senseless and their best
solution is to remain abstinence. However, how many people actually take the time out to talk
with these adolescences? The purpose of this paper is to an in-depth holistic assessment on A.S.
and her family and to analyze their influences. This assessment was done through a private
interview with the patient and her mother as well as data obtained from her medical chart.
Background and Reason for Admission
A.S. is a fourteen year old biracial (African American and Hispanic) female who was
admitted to the hospital after her membranes had spontaneously ruptured, normally known as her
“water breaking.” She is 35 weeks pregnant when her membranes ruptured and was admitted to
the hospital when she was already 6 centimeters dilated. She is unmarried with an eighth grade
education and lives with her mother and two older siblings in a government owned housing
(section 8) within the Norfolk community. During her first prenatal visit, she was diagnosed with
bladder cancer so all of her family, as well as the medical staff is calling her daughter the
“miracle baby” because it would have continued to go unnoticed if she did not get that check-up.
She was previously raped by her father at the age of ten, in which he is now incarcerated
for it; however, he is not the father of her baby, someone in her middle school is. Her father and
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paternal grandfather both have a history of schizophrenia and her mother his hyper-religious. Her
mother has random shouting and singing episodes that was observed throughout the assessment
process. A.S. also looks to her mom before answering any questions as if she was waiting for
approval. It appeared that some of the answers she was giving were coached prior to the
interview. A complete background assessment was done on this young lady and is attached in the
appendix of this paper.
Intrapartal Procedures
She originally came to the hospital when she was 3cm dilated but was sent home on bed
rest. She then came back to the hospital a couple hours later with uncomfortable pain. Once she
was rechecked she was 6/80/+1, which means she was 6cm dilated, her cervix was 80% thinned
out, and her baby was positioned just below her pubic bone. She was towards the end of her Her
physician knew this baby would be coming at any moment now and decided to give the mother
Betamethasone, a corticosteroid, to help speed up the fetus’ lung development. Though she was
almost fully dilated, she was still given Indocin to reduce her contractions in order to give the
Betamethasone time to work. Two bands were placed around the outside of her stomach; one to
monitor the baby’s heart rate and the other to monitor the mother’s contractions. The fetus’ heart
rate was at a steady 145 beats per minute with reassuring acceleration early deceleration. Her
contractions were regular at 3-4 minutes apart with a resting tone of 2 minutes. A.S. did not
receive a spinal epidural anytime during her labor because her mother, in which is the newborn’s
grandmother, wanted her to have a natural experience. The grandmother also did not want her to
have Pitocin, which is a drug to help to stimulate uterine contractions. Since she did not have any
medical interference as of now, she was encouraged walk around her room and moved her hips
from side to side. Also, she stated that her mother encouraged by speaking words of wisdom and
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coaching her throughout this process. Another method of comfort she used was sucking on ice
chips. This helped her body to cool down since she felt that her body was on fire the whole time.
She was receiving Lactated Ringers solution through an intravenous line to maintain her fluid
balance. Since the time she was admitted into the hospital at 6cm, she remained in her first stage
of labor for a total of 2 hours.
Once she started to transition into the second stage of her labor, her pain became
unbearable. On a pain scale from 1-10, she gave a rating of 10 and her contractions were as hard
as her forehead when measuring the intensity of it. A.S. had a steady heart rate and blood
pressure throughout her pregnancy and delivery; however, her blood pressure began to increase
to 158/86 during the labor. The baby’s early decelerations turned into late decelerations, showing
occasional variability among them. These changes in the baby’s heart rate are due to insufficient
amount of oxygen through the placenta and cord compression. When these changes were
observed, she was already 10cm dilated and ready to push. From start to finish she pushed for a
total of 20minutes before her daughter was born. A.S. had an intact delivery with no episiotomy
or hemorrhages. Her daughter was delivered at 35weeks and 6 days gestation weighing 5 pounds,
10 ounces, and 20 inches long. Her APGAR score was 7 at the one minute marker but decreased
to 4 at the five minute marker. She was having some respiratory distress with cyanosis around
her mouth and nasal flaring. After a complete check by the respiratory therapist, the infant was
then transported to the Special Care Nursery (SCN) down the hall for additional care. A.S. was
sent to the postpartum unit to recover.
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Postpartal Procedures
While in the postpartum unit, a couple of assessments were done on A.S. to see how she
was physically and mentally adjusting to life beyond pregnancy. A common postpartum
assessment known as the BUBBLE HE was conducted to evaluate her physical status. Her
breasts were bilateral in size and tender with touch, colostrum was starting to leak out. Her uterus
was shifted slightly to the right, possible due to a full bladder; she was instructed to urinate.
Regarding her bladder, she did not have any issues voiding on her own. Her last bowel
movement was actually during her birth and her vaginal discharge (lochia) is rubra in color. She
did not have an episiotomy but she was still checked for hemorrhoids, in which she had none. A
homan’s sign was conducted by flexing her foot back to detect any signs of a deep vein
thrombosis; it was negative and caused her no pain. The last aspect of this assessment is to
examine her emotional status. When asked how she felt about being a mother, she only replied
“blessed” and smiled gracefully. She showed no signs of postpartum depression but also could
not answer any question fully unless she received a nod from her mother; which brought up some
suspicion to her nurse. This assessment was repeated every twelve hours at the beginning of a
new nursing shift.
Her blood pressure remained high ranging from 141/89 to158/86. She was being
monitored for possible preeclampsia and was questioned about possible visual changes or
headaches; she denied having both. Her nurse stated that she would collect her blood pressure
again during her next set of vital signs and will call her doctor if it continued to remain high. Her
other vital signs were within normal limits having a pulse at 81bpm, temperature of 98.6 F,
oxygen saturation at 98%, and respirations were at 18.
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Prior to being admitted to the mother-baby unit on the floor, A.S. only got to hold her
baby once before she went to SCN; so there was not a lot of bonding between the new mom and
baby. All the postpartum teaching regarding her self-care as well as the status with the baby was
done in her recovery room. She was taught methods to improve mother-baby bonding while the
infant is in the SCN such as visiting her periodically. She was also advised that touching and
talking to the baby could improve her overall health. A.S wants to breastfeed and plans to pump
until her baby is out of the hospital. As of now, she is taught how to pump and was informed to
not get discouraged too quickly because her breast milk may be delayed coming in, since her
baby was premature. The nurse explained to her that massaging warm water over her breasts
could help stimulate milk production. She also was taught nipple care just in case they were to
crack of get really sore. For the most part, there were little complications in this new mother’s
assessment. However, her blood pressure and emotional status needs to be monitored
continuously.
Case Analysis
Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) is a
nonprofit membership organization that promotes women and newborn’s health. This
organization sets standards that are important for nurses to follow in order to provide their
patient the best care. The first standard used for A.S. is assessment in which nurses are required
to collect data about mother and baby to assist with care (AWHONN, 2009). This standard was
met for all aspects of her birthing experience. A perfect example of this is when she found out
she had bladder cancer. She was coming in for care with her pregnancy and the healthcare team
did further assessments to examine other parts of her body. If they did not do a thorough check
during her visit, her cancer would have not been detected and potential complications could have
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emerged much quickly. Standard VIII: Education is another one that was met by the patient’s
nurses. She was taught mild stones she should observe in her newborn while she is in the SCN,
such as first getting off the SPAP, then nasal cannula, and finally being able to breathe on her
own. She was also taught how to pump her milk for her baby and the benefits of it. She was also
advised not to worry so much if her milk did not come in immediately since her baby was
premature. The last standard that was met was X: Ethics. Due to her age, people may make
judgments on getting pregnant so young. Some healthcare workers tend to let it interfere with
their care for their patient. However, her nurses treated her with a great amount of respect as if
she was an adult who had planned her pregnancy.
Nursing Diagnosis
The priority nursing diagnosis for this fourteen year old mother is deficient knowledge
related to young parental age. Though she was successful in physically caring for her child does
not mean that she is mentally prepared to do it as well. She still has the mindset as a young
teenager and needs guidance when it comes to motherhood. During her interview when she was
asked simply questions, she seemed to have a hard time answering. For instance, when asked
what her race was, she said she did not know and her mother answered the question for her.
Also, she expressed no reality concept of what challenges and general changes that lay ahead for
her. She believes that everything will work out in due time and that taking care of a child is easy.
She plans on going back to school in two weeks as if nothing in her life has changed. She also
believes her baby’s father will come back into their lives as soon as he sees the child. Patient
education is the best intervention a nurse can provide for this young female. She needs to be
taught how to breastfeed since she is interested in it, signs and symptoms of when her baby is in
distress or hungry. She also needs to be taught what to expect regarding her own body changes
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and what is normal and what is not. Community resources should be provided to her before
discharge for places she could go even if she just needed emotional support. Her nurse should
also provide options to help her in preventing another unexpected pregnancy. According to a
nursing research article, females who have a history of rape or neglect in their childhood have a
higher risk of becoming teen parents. By providing then positive support and education can help
decrease their chances of repeating this act again (DeSocio, Holland, Kitzman, & Cole, 2013).
After educating her on the importance of birth control, A.S. decided to get the implantation form.
Another nursing diagnosis that is more directed towards her daughter is ineffective
breathing pattern due to the use of a continuous positive airway pressure machine (CPAP). This
machine is used by increasing air pressure in one’s throat to prevent the airway from collapsing
after every breath. Her daughter was showing some respiratory distress shortly after the delivery
and was sent to SCN for additional monitoring. The major nursing intervention needed is to
continuously check for skin break down and make sure that it is in placed correctly. Skin injury
was higher in premature infants who were smaller in physical size; the impact of it also was
determined by the duration of the therapy as well (Newnam, McGrath, Estes, Jallo, Salyer, &
Bass, 2013). Providing skin care can help decrease their risk for skin breakdown. A positive
outcome that has occurred so far with this infant is that her level of oxygen decreased a liter
during the time of this interview.
The last nursing diagnosis that is associated with this patient is risk for decrease cardiac
output related to preeclampsia symptoms. After her delivery, her blood pressure began to spike
up and remained there. She was evaluated for preeclampsia but denied having burry vision or
headaches. Her nurse needs to monitor or record her blood pressure every four hours to see if
there are any changes with it. If it continuous to remain high, further actions needs to be taken
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such as being put on magnesium sulfate. A further follow up needs to be done to determine the
outcome of this medical event.
Risk Factor
The biggest factor this new mother is at risk for is postpartum depression (PPD) due to a
variety of different reasons. The first and most significant reason why she could develop PPD is
because she has already had a previous encounter with depression. Normally, if a person has had
a history of it before, than it will not be difficult for them to fall into it again. She also was raped
by her father at the age of nine in their family home at the time. Before this incident, she
admitted that their bond was very close in which she could tell him about anything. In addition to
that traumatic event in her life, she was diagnosed with bladder cancer during her first prenatal
visit. She is in the early stages of this cancer in which treatment is still an option. Lastly, the
simple fact of having a baby at such a young age can play a major part. According to a literature
review, PPD is significantly higher in adolescents when compared to adults; even the adults who
are from a low resources background. Their risk is the highest at prenatal and six months after
delivery, however they are known to have consistent symptoms throughout their pregnancy
(Kleiber & Dimidjian, 2014). Due to her adolescent age and previous traumatic events that has
happened in her life, there is no doubt that she could develop this disorder, even if it is short
term.
Pathophysiology of Postpartum Depression
When depression continues after the “baby blues” phase, which is two weeks after
delivery, it is then considered postpartum depression (PPD). This type of depression is usually
the result of a combination of things ranging from hormonal changes, general fatigue,
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psychological and physical adjustments to motherhood (Katon, Russo, & Gavin, 2014). There
are three hormones that increase tremendously towards the end of the pregnancy then rapidly
drops during delivery; they are progesterone, estrogen, and cortisol. These hormones play a
major part in psychoactive effects, especially in women who were already emotionally unstable.
Also, PPD has been linked to the development of thyroid autoantibodies during pregnancy.
In order to understand their origin, it is significant to differentiate the various types of
mood disorder. Going through the birthing process can trigger the “baby blues” phase which
consists of crying, temporary psychosis, and slight hypomania. A major risk factor for the
postpartum psychosis is a family history of hysterical depression. People who are genetically
vulnerable to a puerperal trigger demonstrate this type of depression as well. If not properly dealt
with, “baby blues” can lead to PPD, which can be presented by the same symptoms (Glover &
Kammerer, 2004).
Presenting Symptoms
Though she was recently diagnosed with bladder cancer, she is not showing many signs
or symptoms except for discolored urine and frequent urination. Her urine has an orange tent
because of the presence of blood, which is generally the first sign of bladder cancer. Even though
polyuria is a symptom of this cancer, it can be difficult to detect because this is also a common
symptom of pregnancy. However, she did display more potential signs and symptoms for
postpartum depression. While her mother was in her room, she made sure to answer every
question carefully as if it was already scripted out for her to say. She would then look to her
mother with a look for approval. Though this did bring some suspicion, she could be acting like
this because she is still a child; just because she has a child does not mean she has mentally
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developed fully. Children her age are still looking towards their parents for guidance. However,
when her mother stepped out the room, her answers began to change some.
When her mother left, her look on her face was a sign of relief and she began to elaborate
a little more. She has posttraumatic stress disorder that has affected her life since she was raped
by her father four years ago. Though her father is in prison, she states that she is still haunted by
that event and occasionally goes to counseling for it. She also said that she was looking for love
to replace her thoughts of what her father did, in which she thought she found in her daughter’s
father. Their plan was to raise this child together but lately he has been very distant and was not
there for the birth. Though she states that she really does love her daughter, she also has some
resentment towards her as well. She mainly visits the baby in the SCN because her mother wants
to.
Medical Treatment
Antidepressants are useful in relieving depressive behavior and have been proven to treat
PPD. If the mother is breastfeeding, in which A.S. plans to, she should be reminded that any
medication she takes will be directly transferred to her daughter. However, there are some
antidepressants that have a lower risk for side effects towards the baby; it is important to discuss
that option with her doctor. Though this may sound like an easy solution to PPD, adhering to the
medication is a major barrier towards its success. Educating the patient is the most important
intervention a nurse could do. According to a systematic review, a study was conducted to
determine the impact of education on the adherence of antidepressants. The nurses used return
demonstration, games, and videos helped the participants obtain more information about their
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medications and encouraged them to stick to it. A telephone follow up was done a month after
the study and most of them were still consistent with it (Chong, Aslani, &Chen, 2011).
Hormone therapy is another treatment offered for postpartum depression. By taking extra
estrogen, it can help counteract the dramatic decrease affect it does during childbirth. However,
this methods effectiveness is still being researched. Nurses need to monitor for thromboembolic
disease and abnormal uterine bleeding because an increase in estrogen can cause both of these
factors. Instruct the patient to report chest pain, unusual swelling, SOB, and excessive bleeding
in urine (Bulechek, Butcher, Dochterman, & Wagner, 2013). For the psychosis that can occur
with this type of depression, electroconvulsive therapy (ECT) is recommended when medication
has failed. Electrical currents that resemble the ones occurring during a seizure are sent in small
amounts to the individual’s brain; this reduces depression symptoms. It is important for the nurse
to teach the patient what to expect during the ECT and to provide ultimate safety just in case a
seizure was to occur. Throughout the procedure, blood pressure is important to monitor because
it is the main thing that is affected (Chong, Aslani, &Chen, 2011). Though medical options are
available, it is highly advised to use psychotherapy as a source of treatment for postpartum
depression.
Conclusion
A.S is a fourteen year old female who has just given birth to her first child. Her daughter,
who was born at 35 weeks gestation, is currently in the Special Care Nursery (SCN) due to
respiratory distress. She is currently unmarried with an 8th grade education and lives in a low
income community with her mother and siblings. She was diagnosed with bladder cancer during
her first prenatal visit and is at risk for postpartum depression. For the most part, her birthing
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process went well without any major complications; however, she still needs to be monitored for
potential preeclampsia. There are many interventions and teachings her nurse can give to her to
help with her transition into motherhood. This could be done by following AWHONN standards
to provide her the best care. Though she is still an adolescent, with the help of the health team
and her family, she can develop into a wonderful mother.
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References
Association of Women's Health, Obstetric, and Neonatal Nurses. (2009). AWHONN lifelines.
Philadelphia, PA: Lippincott-Raven Publishers.
Bulechek, G. M., Butcher, H. K., Dochterman, J. M., & Wagner, C. (Eds.). (2013). Nursing
Interventions Classification (NIC) 6: Nursing Interventions Classification (NIC). Elsevier
Health Sciences.
Centers for Disease Control and Prevention. (2012).Teen Pregnancy. Retrieved from
http://www.cdc.gov/teenpregnancy/
Chong, W. W., Aslani, P., & Chen, T. F. (2011). Effectiveness of interventions to improve
antidepressant medication adherence: a systematic review. International journal of
clinical practice, 65(9), 954-975. DOI: 10.1111/j.1742-1241.2011.02746.x
DeSocio, J. E., Holland, M. L., Kitzman, H. J., & Cole, R. E. (2013). The influence of social‐
developmental context and nurse visitation intervention on self‐agency change in
unmarried adolescent mothers. Research in nursing & health, 36(2), 158-170. DOI:
10.1002/nur.21525
Glover, V., & Kammerer, M. (2004). The Biology and Pathophysiology of Peripartum
Psychiatric Disorders. Primary Psychiatry.
Katon, W., Russo, J., & Gavin, A. (2014). Predictors of Postpartum Depression. Journal of
Women's Health, 23(9), 753-759. doi:10.1089/jwh.2014.4824.
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Kleiber, B. V., & Dimidjian, S. (2014). Postpartum Depression Among Adolescent Mothers: A
Comprehensive Review of Prevalence, Course, Correlates, Consequences, and
Interventions. Clinical Psychology: Science and Practice, 21(1), 48-66.
DOI: 10.1111/cpsp.12055
Newnam, K. M., McGrath, J. M., Estes, T., Jallo, N., Salyer, J., & Bass, W. T. (2013). An
Integrative Review of Skin Breakdown in the Preterm Infant Associated with Nasal
Continuous Positive Airway Pressure. Journal of Obstetric, Gynecologic, & Neonatal
Nursing, 42(5), 508-516. DOI: 10.1111/1552-6909.12233
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Appendix
CASE STUDY CLIENT ASSESSMENT
Prenatal Course History
Age:
14 years old
Ethnicity/Cultural Background
Biracial (mother is Hispanic and father is African American)
Single/Married/Committed
Relationship/Sexual Preference
Educational Level
Single/ straight
Occupation
Full time student
GTPAL
G1T1P1A0L1
Past Pregnancies
none
Dates of Delivery
Outcomes (SVD or C/S)
Risk factors
Current Status of children
8th grade (current grade)
-
-
LMP/EDC (EDD)
Planned pregnancy?
Prenatal Care
(Where, when started, number
of visits)
Number of
ultrasounds/significant findings
Other testing
Nutrition/Vitamins (any
changes with pregnancy
Gynecological History
Menarche (onset, duration and
frequency), PAP smears,
(problems or procedures?),
sexual partners, history of rape
or abuse. Birth control use.
Medical or Surgical History
November 12, 1014
SVD
Father and paternal grandfather have schizophrenia; Mother has
HTN and maternal grandmother has DM. Patient has asthma that
is maintained with an inhaler and history of depression
Child is currently in SCN on breathing treatment
LMP: March 13, 2014
EDD: December 20, 2014
no
Started April 28 at SNGH, about 40 visits total due her high risk condition
12 ultrasounds; bladder cancer discovered on first visit and chlamydia was
detected
General prenatal vitamins that were prescribed
Menarche: first appeared at the age of 11, normally last for 5 days, has not
received a pap smear due to young age. Admitted to one partner originally
(which is the baby’s father who is not in their life anymore) but later
confessed she was raped by her father at the age of 10 (he is now
incarcerated)
She was only using condoms originally but mow she is getting the
implantation rod placed in her arm
Biopsy of bladder and tonsils removed
THE FOURTEEN YEAR OLD MOTHER
Any traumas?
Surgeries
Normal childhood diseases?
Psychological History
History of psychological
illnesses?
History of Postpartum
Depression?
Evidence of Bonding?
Social/Cultural Factors
Health insurance
Living quarters
Religious or spiritual beliefs
Support System
Community Resources
-
-
17
Currently not present; only happiness and gratitude for child. Has
no concept of reality right now just believes that “everything will
work itself out.” Sad that baby is in SNC and will not be
discharged with her
History of PSTD due to rape
Yes; visits baby periodically within the day. Smiles and excited
when around baby
Edge Park House
Section 8 housing currently with mom, sister and brother (mother
is remarried)
Devoted Christian
Mother is major support system; on WIC and CHIP, in which they
have assisted with clothes and diapers for newborn (currently still
does not have crib or car seat)
Intrapartal Course
Initial Assessment
Pt originally came to department at 3cm dilated and SROM. She was sent
Vital signs
back home on bed rest
SVE/SROM/Bleeding/Problems
Fetal Monitoring
External or Internal or Both
- EFM
FHR Baseline
- Baseline 145bpm
Reactive/Nonreactive
- Reactive initially then became nonreactive
Accels
Positive accelerations
Early/Late/Variable Decels?
- Multiple variable and late decels
Risk factors associated with this
- Bladder cancer
pregnancy?
Neonatal Course
Delivery Summary
Gestational age at delivery
SVD or C/S
Forceps or Vacuum
Sex, Length/Weight
Apgar score
Resuscitation
(Blow by Oxygen/stimulation/
chest compressions?)
Risk Factors
Bladder Cancer
-
Intact delivery
SDV
No forceps or vacuums
-
Female, 20inches, 5lb 10oz
APGAR: 1min-7; 5min-4
Demonstrated respiratory distress; on CPAP
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18
Pregnancy
Postpartum
O-
O-
Immune
Immune
Negative
Negative
Negative
Negative
Negative
Negative
Negative
Negative
positive
negative
Negative
Negative
132mg/dL
122mg/dL
n/a
n/a
n/a
n/a
8.7k/ul
9.4k/ul
3.44 m/ul
3.98m/ul
35.3%
36.1%
12.6g/dL
12.6g/dL
abnormal
negative
Medications
Action
Colace
Stool softener
Percocet
For pain relief
Common side effects
A bitter taste, throat irritation,
diarrhea, skin rash
Dizziness, vomiting, constipation,
upset stomach, drowsiness
rare
Lanolin
Nipple pain or irritation
Motrin
Minor pain relief
Laboratory Findings
Blood type
Rubella titer
VDRL/RPR (Syphilis)
HBsAg (Hep B)
GBS (Group B Strep)
HIV
Chlamydia
GC (Gonorrhea)
Glucose Screening
Liver Enzymes (PIH)
Uric Acid (PIH)
WBC
RBC
Hct
Hgb
Urinalysis
Constipation, mild heartburn, and
upset stomach
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19
Case Study Grading Rubric
Grading Criteria
(Use these as your headings)
Point
Value
Introduction
5
Purpose of Assignment
Brief Patient Background
Reason for Admission
Intrapartal Procedures
10
Discuss any invasive or noninvasive procedures during the
intrapartum period such as:
AROM/SROM/Amnioinfusion/
Significant Lab Values/IV
access/Fluid Maintenance/Fluid
Bolus/Epidural/Foley/Oxygen/
Position Changes/ Episiotomy/
Comfort Measures/ Teaching/
Focused assessments to include
baseline FHR with periodic
changes (accels/decels);
contraction frequency/intensity;
labor progress through first stage
with phases/second stage/third
stage.
Postpartal Procedures
Discuss any invasive or noninvasive procedures during the
postpartum period such as:
Fundal Massage/Fluid
Maintenance/Foley/Episotomy or
LacerationRepair/Focused
Assessments/Hemorrhage control/
Promotion of Maternal and
Newborn Bonding/ Teaching/
Comfort Measures/ Promotion of
Breastfeeding
10
Points
Given
Comments
THE FOURTEEN YEAR OLD MOTHER
Case Analysis
20
Does the care provided conform to
the current standards of care? Why
or why not? Were the client’s
needs met? Do not restate the
AWHONN standards but
identify specific examples of how
the standard was met. You must
cite AWHONN Standards of Care
in your Bibliography. Look up
APA format for this as there is no
author.
Identify and prioritize at least 3
nursing diagnoses.
Include contributing factors and
evidence to support, nursing
interventions and outcomes/with
evaluation.
Current Literature
10
Select two (2) current references
from nursing journals to support
your nursing interventions. Both
articles must be from nursing
journals. One article must be
research. Current articles are from
within the last five years.
Submit articles with case study
Risk Factor
Select one risk factor for your
client and discuss the reason you
choose this risk factor, i.e.,
significance to patient health.
Pathophysiology
See your clinical instructor if your
client had no identifiable
pathophysiology to determine an
appropriate topic for this section.
5
20
THE FOURTEEN YEAR OLD MOTHER
Pathophysiology
10
Discuss the pathophysiological
processes that occur or could occur
with the risk factor you chose.
Presenting Symptoms
5
Identify presenting symptoms of
your client. In addition, include
typical signs and symptoms for this
risk factor.
Treatments:
5
Discuss all standard medical
treatments and nursing
interventions, including patient
education.
Grammar/Syntax
APA format including citations
and bibliography
10
Grading Rubric attached
There is an example of a correct
APA format paper on blackboard.
If you have questions or would like
assistance with editing or input,
you may ask your clinical
instructor for help or the clinical
coordinator during class time
(Linda Bennington, Phd,RN).
Appendix
10
Attach Case study client assessment
Be sure it is accurate and thorough
to include medications, side effects
and purpose, and include significant
lab values.
Total Points:
Honor Code:
100
21
THE FOURTEEN YEAR OLD MOTHER
22
"We, the students of Old Dominion University, aspire to be honest and forthright in our
academic endeavors. Therefore, we will practice honesty and integrity and be guided by the
tenets of the Monarch Creed. We will meet the challenge to be beyond reproach in our actions
and our words. We will conduct ourselves in a manner that commands the dignity and respect
that we also give to others."
Honor Pledge
"I pledge to support the Honor System of Old Dominion University. I will refrain from any form
of academic dishonesty or deception, such as cheating or plagiarism. I am aware that as a
member of the academic community, it is my responsibility to turn in all suspected violators of
the Honor Code. I will report to a hearing if summoned."
SIGNATURE: ____Ayesha Howard_________