Reference no: EM133856203

Assignment:

Case Study 1: An Adolescent Couple with HIV

Alexa was a senior in high school, aged 17 years, and had been an A student her whole school life. Her goal was to earn a bachelor's degree in science and one day attend medical school. For the past 3 years, she has dated only Robert, aged 20 years, and he was already attending a nearby university. Robert had plans to be an accountant. They are planning on marriage at some point in time, which led them to having unprotected sex on a regular basis. Alexa took oral contraceptives to prevent pregnancy, so she did not worry about becoming pregnant. However, Alexa began to get sick with intermittent flulike signs and symptoms, such as no appetite, weight loss, nausea and diarrhea, and other mysterious symptoms. She finally went to her physician and received a diagnosis of HIV. She was shocked! She had never had sex with anyone but Robert, and to her knowledge she had not acquired HIV by other means. Robert did not look sick, and she had never doubted his faithfulness to her until now. After confronting him, she found out that he had been getting high on drugs and having risky, unprotected group sex with both genders. Although he too had been having symptoms, he had not yet been diagnosed with HIV when Alexa confronted him. He later received a diagnosis of HIV.

Questions for Case Study 2:

Review the chapter content.

1. You are the nurse in the clinic on the day Alexa finds out she has HIV. She remains in the clinic for more than an hour with you while you try to support and console her. You have had formal HIV counseling training, so you apply your skills as you communicate with her. Several weeks later, after Alexa is more composed and has had time to think about her situation, she drops by the clinic and wants to talk with you on a more personal basis. She needs comforting. What approaches will you use with Alexa? Please explore how to use and apply the nursing ethical competencies to help Alexa. Be specific with your approaches and rationales.

2. You realize that emotional support and possibly spiritual support are important to adolescent development. What nursing approaches could you use to offer support to Alexa? Be very specific. In doing so, encourage her to think about her life goals with or without Robert, her medical future, and her future in general. Imagine what you might say to her and do for her. Imagine a supportive conversation you might have with her.

3. Consider an additional activity of role-playing with classmates for this or another scenario.

Case Study 3: Hannah's Secret

Hannah, aged 13 years, overheard some of her friends in the hall at school talking about her big build and weight. Hannah was devastated! According to the family physician and her family, she was a normal weight and size for a girl her age. She looked at herself in the mirror many times, each time with more and more disgust. She began receiving harassing instant messages from people she did not recognize. These remarks by her friends bothered her so much that Hannah began thinking about how she could lose weight. She was terrified at what her classmates thought about her, and she thought of not fitting in or losing her friends. Over the course of a few days, she became so obsessed with her weight that she began visiting various Ana websites, such as Thin Intentions Forever and Ana Boot Camp. She found great comfort in knowing that many girls her age were having similar feelings about themselves. The websites and people commenting on blogs encouraged her to lose weight. Hannah first began cutting out all desserts, all milk products, and all fats from her diet.

Later, she progressed to eating only green salads, tiny servings of meat, and water. She increased her exercise to at least 1 hour of full aerobics every day. She lost considerable weight. Everyone mentioned her weight loss to her, which encouraged her to continue. Not knowing Hannah's secret, her parents appeared proud of her new healthy eating pattern and exercise program, and therefore, they did not worry until later when people started commenting on her extreme weight loss and unhealthy appearance. Hannah discovered she could not stop her new eating and exercise ritual, nor did she want to. A couple of Hannah's friends discussed their concern with Hannah's mother. Her mother took her to the family physician. After the physician diagnosed her with anorexia nervosa, the nurse provided them with resources for recovery and support.

Questions for Case Study 4:

Review the content and statistics related to eating disorders, trust, and limits of confidentiality in the chapter. Then, search websites such as Ana Boot Camp and Thin Intentions, as well as those websites that provide recovery guidelines and support for anorexia nervosa.

1. Adolescents engaging in risky behaviors tend to keep it hidden from others as long as possible. As a school nurse, what strategies would you implement to monitor signs of eating disorders?

2. Explore the limits of confidentiality for an adolescent. As a school nurse, what ethical considerations would you face?

3. What online information did you discover about the recovery and support site? How would you incorporate some of the information in your strategies?