FORUM 5 (for grp 5)- CARE OF AN ADOLESCENT

Care of an Adolescent

Care of an Adolescent

by Edline Aubrey Sarmiento -
Number of replies: 0

HEALTH CARE PLAN

Identified Nursing Problems

Rationale

 

 

Goals of Care

The client will:

 

 

Interventions

 
Ineffective adolescent eating dynamics r/t changes to self-esteem upon entering puberty as evidenced by trying to lose weight Adolescents may feel pressured to lose weight to feel better about themselves. They may try to achieve this goal through poor and harmful nutritional choices. Lack of established healthy eating habits contributes to Ginny’s weight falling below ideal range. 
  • Identify three recommended dietary intakes
  • Report adherence to healthy diet
  • Determine reasons for weight loss
  • Facilitate identification of eating behaviors to be changed
  • Provide information about the health need for weight gain
Imbalanced nutrition: less than body requirements r/t insufficient dietary intake as evidenced by body weight below ideal range An adolescent requires an increased number of calories to support body growth and development. Additionally, women require a high iron intake because of iron depletion with menstruation. Although a weight-loss diet is appropriate during adolescence, it must be supervised to ensure adequate nutrition. Nutritional deficiencies and poor eating habits established during adolescence can have detrimental effects in the long run. Ginny is already underweight, making her vulnerable to various illnesses.
  • Verbalize importance of proper nutrition for her developmental stage
  • Report a 24-hour food recall containing well-balanced meals for a week 
  • Discuss nutritional requirements and patient’s perceptions of recommended diet
  • Assist client in identifying and selecting nutritious meals 
  • Monitor client’s food intake
Interrupted family process r/t changes in family interactions as evidenced by keeping secrets from the parent One of the four main areas in which adolescents must make gains to achieve a sense of identity include becoming emancipated from parents. Attaining emancipation often causes parent-child conflict that may involve restricted actions (ie., engaging in relationships and/or social gatherings) and ineffective communication (ie., keeping secrets). 
  • Identify barriers to communication
  • Report feeling safe and open in discussing feelings with her mother
  • Listen to concerns/feelings of both the patient and her mother
  • Facilitate an open, healthy communication between them
  • Counsel them on effective communication strategies and its importance
Stress overload r/t stressors (attaining high grades for college applications) as evidenced by feelings of stress and self-consciousness on her appearance Transitioning into adulthood involves dealing with various demands (ie., college applications, committed relationships) that necessitate actions which may be challenging for adolescents like Ginny. Such demands may pressure and/or burden Ginny, causing an overwhelming feeling of stress. 
  • Verbalize decrease in stress
  • Utilize rest and relaxation techniques 
  • Assist the patient to identify positive strategies to deal with academic setbacks and negative feelings of self-worth
  • Instruct the patient on the use of relaxation techniques
Risk for situational low self-esteem  Hormonal changes on the onset of puberty leads to an increased oil production that clogs the pores and causes acne. Although some consider acne as merely a cosmetic problem because of its normal occurrence among adolescents, it may actually precipitate significant emotional and psychological effects (ie., poor quality of life, self-esteem, and mood). This is evident in Ginny’s case; having acne makes her more self-conscious.
  • Perform sustainable skincare routine and hygienic practices
  • Maintain healthy grooming habits
  • Verbalize positive self-affirmations
  • Discuss changes caused by puberty, as appropriate
  • Assist patient to separate physical appearance from feelings of personal worth
  • Inspect severity of acne
  • Refer the client, if applicable
 

Anticipated Nursing Problems

Disturbed body image - Constantly worrying about weight and image may lead to an alteration in self-perception. This may interfere with Ginny’s feeling of satisfaction and self-worth.

Ineffective coping - Ginny may develop ineffective coping strategies (ie., unhealthy eating habits, risk-taking activities) if her concerns on her appearance and communication with her mother are not addressed.

 

 

HEALTH EDUCATION PLAN

Topic: Nutrition and Body Image Enrichment

Objectives: 

Client:

  • Identify contributing factors to nutritional deficiencies and underweight status
  • Identify recommended dietary intakes
  • Discuss the health need for weight gain
  • Identify healthy coping strategies
  • Verbalize self-affirmations
  • Verbalize willingness to communicate with her mother
  • Create an appropriate sample meal plan with her mother

Client’s mother:

  • Verbalize willingness for nutritious food preparation
  • Assist in recommended diet adherence
  • Verbalize fostering healthy communication

Content:

  • Nutritional requirements and its importance
  • Recommended dietary intake
  • Healthy eating habits and coping strategies
  • Importance of rest, recreation, and relaxation
  • Role of parental guidance and support 

Materials: 

  • Pen and paper for meal planning
  • Visual aids (Pinggang Pinoy for Adolescents, Food Pyramid Guide) 
  • Infographics on healthy eating habits, activity and rest, grooming and hygiene, and their importance on client’s holistic health, growth, and development

Activities:

  • Lecture/discussion
  • Meal planning

Evaluation:

  • Question and answer
  • Interview
  • Meal plan evaluation

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 References:

Butcher, H. K., Bulechek, G. M., McCloskey Dochterman, J. M., & Wagner, C. (2018). Nursing Interventions Classification (NIC) (7th ed.). Mosby.
Dunn, L. K., O’Neill, J. L., & Feldman, S. R. (2011). Acne in adolescents: quality of life, self-esteem, mood, and psychological disorders. Dermatology Online Journal, 17(1), 1. https://doi.org/10.5070/d34hp8n68p
Herdman, T. H., & Kamitsuru, S. (2017). NANDA International Nursing Diagnoses: Definitions & Classification, 2018-2020 (11th ed.; T. H. Herdman, Ed.). New York, NY: Thieme Medical.
Johnson, M., Bulechek, G. M., McCloskey Dochterman, J. M., Maas, M. L., Moorhead, S., Swanson, E., & Butcher, H. K. (2005). NANDA, NOC and NIC Linkages: Nursing Diagnoses, Outcomes, and Interventions (2nd ed.). Mosby.
Silbert-Flagg, J. & Pillitteri, A. (2018). Maternal & Child Health Nursing: Care of the Childbearing & Childrearing Family (8th ed., pp. 515, 605-614). Wolters Kluwer.
Wahl, R. (1999). Nutrition in the adolescent. Pediatric Annals, 28(2), 107–111. https://doi.org/10.3928/0090-4481-19990201-07