(30), 1-12. doi:10.1186/s12875-015-0241-x Elsawy, B. & Higgins, K. (2011). The geriatric assessment. American Family Physician, 83 (1), 48-56. Retrieved from Meghan Moore Hello! I chose to interview the 16 year old pregnant white teenager living in an inner-city neighborhood. This can be a tricky situation about gaining trust and providing the best information for the patient. According to the state law where I live, which is Massachusetts, a teenager can consent to medical care without their parents if they are pregnant (FindLaw, 2019). So in this case, if the patient was seeing me alone, this would be within her rights. In the case with adolescents, is can be difficult to gain information from them. It is advised in Seidel's Guide to address the patient first if they are with their parents and do not force the conversation (Ball et al., 2015). Many teenagers are reluctant to talk at first until trust is gained and a relationship is established (Ball et al., 2015). If this patient is going to be seeing me throughout the length of her pregnancy, I want to allow her to feel she is in a safe sharing environment and I am not here to judge her or make her feel less than, she may get that enough from home. The risk assessment instrument I would use would be HEEADSSS and PACES. These are tools used to screen for adolescent issues while also finding out information about her habits and living environment (Ball et al., 2015).
H - home environment E - Education/employment E - Eating habits A - Activities/Ambitions D - Drugs S - Sexuality S - Suicide/Depression S - Safety from injury and violence All of these are very important elements to question, not only for the patient but for the unborn child. I would ask open ended questions such as, what is a normal day in your life like? This would give her a chance to just talk. I have found that when people start to feel comfortable and are able to speak their minds, a lot of information comes out. I also would ask for her to describe her neighborhood as if she were talking to someone from another country? This can give me clues about what kinds of people she may come in contact with on a daily basis. P - Parents/Peers A - Accidents C - Cigarettes E - Emotional Issues S - School The PACES screening could really help me see how her family and friends are responding to her pregnancy. After she has talked about general things like her neighborhood, I can then possible get into more sensitive subjects. I would ask her, Who lives at home with you? How did they react when they found out that you were pregnant? This could go two different ways, she may have a lot of support and be willing to talk about this, or she could have no support and fall into silence. Allow the silence to happen, do not force conversation (Ball et al., 2015). Once I have gathered information about her home life and her activities as a teenager, I need to get information about her as a future mother. This patient requires two distinct assessment views. I need to know her gravidity and parity, menstrual history, gynecological history, past medical and family history (Ball et al., 2015). I wold also
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- Summer '15
- Health care provider, ball