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

Identified Nursing Problems

Rationale

Goals of Care

The client will:

Interventions

The nurse will:

Ineffective adolescent eating dynamics related to changes to self-esteem as evidenced by trying to lose weight

For client Ginny, she may be experiencing peer pressure which may lead her to prefer low-calorie and harmful diets just to gain attention or please her peers. Such mindset may lead her to developing an eating disorder, such as bulimia or anorexia nervosa, that is more common on adolescent females than males. Lack of understanding regarding proper weight-loss diet and healthy eating patterns may have contributed to Ginny’s low weight and BMI.

• Discuss different healthy eating habits to establish her growth and development
• Report adherence to a healthy, balanced, and calorie-sufficient diet
  • Determine the reasons on for weight loss
  • Discuss the 2 appropriate diets to which she can choose to promote nutritional health for adolescents
  • Identify and discuss some of her eating habits that is needed to be modified.
  • Emphasize the importance and need of nutrition and weight gain during the adolescence period

• Determine the reasons on for weight loss
• Discuss the 2 appropriate diets to which she can choose to promote nutritional health for adolescents
• Identify and discuss some of her eating habits that is needed to be modified.
• Emphasize the importance and need of nutrition and weight gain during the adolescence period

Imbalanced nutrition: less than body requirements related to improper dietary pattern as evidenced by underweight (BMI < 5^th percentile)

Ginny is underweight, which can be attributed to her eating habits. One must note that during adolescence, there is an increased needed calorie to support rapid body growth. Specifically, females, like Ginny, must have high iron intake as this is lost during menstruation. She must also take foods high in calcium and vitamin D and also do physical exercises as this is necessary for her rapid skeletal growth. She must also take zinc-filled foods to facilitate sexual maturation and final body growth.

• Report her 24-hour food recall that adheres to an appropriate dietary habit based on her age, sex, and development
  • Assist the client in formulating a daily and appropriate nutritional dietary pattern
  • Determine the food preferences of the client
  • Conduct health teaching regarding different required nutrients for adolescent’s body and the implication of underweight

• Assist the client in formulating a daily and appropriate nutritional dietary pattern
• Determine the food preferences of the client
• Conduct health teaching regarding different required nutrients for adolescent’s body and the implication of underweight

Stress overload related to preparation for college application and acne breakout as evidenced by feelings of stress and extra conscious about self-appearance.

Adolescence is a period where heightened stress is caused by physical maturation (mind and body), peer interactions, and brain development. Moreover, stress could also be brought by career decision such as applying for college. These said factors may cause Ginny to experience overwhelming feeling of stress that poses challenge during her adolescence period. It is important that various stress issues must be addressed since she may be at risk for activities like substance abuse, alcoholism, and suicide.

• Select appropriate rest and relaxation techniques to alleviate stress
• Select appropriate coping mechanisms that would best deal with her stress and its corresponding stressors
  • Conduct health teaching regarding different relaxation techniques to deal with stressors
  • Refer to the physician for acne breakout treatment program, if necessary.

• Conduct health teaching regarding different relaxation techniques to deal with stressors
• Refer to the physician for acne breakout treatment program, if necessary.

Ineffective Relationship related to inability to effectively communicate as evidenced by having hard time talking with Ginny

During adolescence, they tend to spend more time interacting with their peers via face to face or electronic media. Conflict may arise if parents disapprove the number of hours spent towards friends as they prevent important hours wasted. Parents should note that talking is a major way of learning about values and responsibilities. Meanwhile, adolescents must always update their parents to what, when, or wherever they are. There should be a balance in roles and responsibilities to maintain parent-child relationship.

• Improve open communication to her parents by updating at least once a day

The parent will:

• Report adherence towards promoting independence to child by providing her freedom and responsibility
• Encourage information sharing by listening to what the child say and feel.
• Encourage healthy communication to improve parent-child relationship through showing care and understanding
• Educate both the parent and child by helping them understand the changing individual roles and responsibilities, especially on adolescence period.

• Encourage healthy communication to improve parent-child relationship through showing care and understanding
• Educate both the parent and child by helping them understand the changing individual roles and responsibilities, especially on adolescence period.

Anticipated Nursing Problems

1. Disturbed body image – If Ginny is constantly stressed with her grades, college application, and pimple breakout, this may eventually lead to questioning her physical self and may paint a different mental picture of self.
2. Ineffective coping – Since Ginny is underweight and stressed with her academics and pimples, she may have developed negative coping mechanisms. This includes unhealthy eating habits and spending longer hours with friends to release negative emotions via alcoholism, etc.
3. Risk for injury – Ginny may have been avoiding peer pressure, which is why she spends more time with friends. With that, she may engage in drugs, alcoholism, and sexual activities. This may pose risk in contracting STDs and inflicting self-harm if the parent is not aware of the child’s circle.