N13 - Maternal and Child Nursing 2nd Semester AY 2021-2022

Identified Nursing Problems

Rationale

Goals of Care

The client will:

Interventions

Ineffective adolescent eating dynamics related to changes to self-esteem upon entering puberty as evidenced by undereating.

Having low self-esteem is very common among adolescents, especially girls. This can affect most of their behaviors including eating dynamics which can eventually damage health. As early as now, it is important to correct this to ensure that the client has sufficient energy and nutrients needed to build relationships, achieve goals, and assume responsibility, all of which are important during this stage of development.

• Discuss the need for healthy eating concerning age and development.
• Explore personal factors that cause low self-esteem.
• Verbalize self-acceptance and confidence to improve self-esteem.

• Explain the relation and importance of nutrition to optimal adolescent development.
• Assist the client in identifying the factors that cause or trigger low self-esteem.
• Appraise the client’s adjustment to changes in body image.

Imbalanced nutrition: less than body requirements related to insufficient dietary intake as evidenced by BMI below the 5th percentile.

Ginny is underweight which means that the body does not receive sufficient nutrients to meet the demands of the rapidly growing adolescent. This may have several health impacts such as malnutrition, fatigue, and even vulnerability to infections such as acne breakout.

• Adhere to the meal plan and recommended nutritional requirements appropriate for age, sex, and development.

• Provide health teaching regarding the nutrient requirements of the body and the impacts of being underweight.
• Determine the patient’s food preferences.
• Create a meal plan with a high caloric intake and from a wide variety of choices.

Stress overload related to stressors as evidenced by the feeling of pressure from preparation for college application and acne breakout.

Adolescence serves as a transition between childhood and becoming a late adolescent. Making a career decision and establishing a positive body image are both crucial during this period. Thus, any factors that may hinder them from achieving this may cause stress. In the case of Ginny, there may be constant pressure from the environment to always excel or appear “perfect/popular” leading to stress.

• Choose effective coping mechanisms to manage and control stressors.
• Explain the causes of acne, and its relation to puberty using her own words.
• Maintain healthy eating and proper hygiene every day.

• Provide counseling regarding effective coping techniques which the client can use to manage and control stressors.
• Discuss the disease process of acne development at its prevalence in adolescence.
• Teach proper nutrition and hygienic practices to prevent acne development and to enhance body image.
• Refer to a physician to provide a treatment regimen for acne breakout, if necessary.

Ineffective Relationship related to ineffective communication skills as evidenced by dissatisfaction with information sharing.

Although children from this age usually spend more time with their friends than family, the parent-child relationship must not suffer. Children should always update their parents regarding their activities and experiences, while parents on the other hand should balance giving their children both freedom and responsibility.

• Maintain open communication with parents at least once a day.

 The parent will:

• Promote appropriate independence characterized by a balance between providing freedom and responsibility.
• Encourage information sharing by validating the adolescent’s feelings and emotions.

• Encourage healthy communication between parents and adolescents characterized by respect and understanding.
• Help the adolescent and parent understand how difficult it is to manage the changing individual roles and responsibilities.

Anticipated Nursing Problems

1. Risk for injury. This may result from peer pressure to use alcohol, drugs, and other risk-taking behaviors including acquiring a disease from unprotected sex, especially if the parent is now aware of her child’s circle.

2. Ineffective Coping. If the stressors are not resolved through the establishment of effective coping mechanisms, Ginny may have difficulty managing further stress.

3. Disturbed Body Image. This may happen if Ginny is not able to effectively cope with stress and further changes (physical and emotional) during adolescence.