Respond to the posts and provide additional insight that might be useful and appropriate for the issue addressed. Use your learning resources and/or evidence from the literature to support your position
Post:
The case study I chose was case study number two, with the 14-year-old female who presented to the school clinic with an upset stomach. As the case study progressed you learned that this 14-year-old was sexually assaulted by her mother’s boyfriend and is pregnant, the aunt and uncle she lives with has no idea what happened. The aunt and uncle are very religious, and the 14-year-old is afraid they will not want her if they learn what happened. My differential diagnosis is O09.619 “Supervision of young primigravida, unspecified trimester”. I chose this differential diagnosis because while she disclosed, she was raped by her mother’s boyfriend she is more concerned with possibly being pregnant and not wanting it.
The treatment plan for this patient would be to get her counseling for the rape and the pregnancy. Also, having a counselor help disclose this information to her aunt and uncle. The next step in the treatment plan would be to lay out the options for the patient regarding abortion, adoption, and keeping the baby. I live in Florida do abortion is legal until 24 weeks gestation if there is a physician saying it is medically necessary. In Florida we have the “Parental Notice of and Consent for Abortion Act”, this law requires a minor to have the consent of a parent of guardian be obtained prior to a physician conducting an abortion (Online Sunshine, 2022). If the patient decides to keep the baby, I will start her on a PO daily prenatal vitamin.
Mandatory reporting includes physical, sexual, emotional abuse, physical, educational, and emotional neglect and those who are required to report are healthcare workers, educational employees, social workers, religious leaders, CPS employees, criminal justice and other governmental employees (Liu & Vaughn, 2018). The main issue people run into when it comes to mandatory reporting is the inconsistences in what qualifies are abuse or neglect. This causes false arrest and real cases to not be investigated properly. If you are unsure of what to do, refer to your state laws about mandatory reporting and it will outline what is expected and what qualifies, that is the best practice guidelines. Also, nurses have a fear of making mistakes and have difficulty sharing information regarding child abuse situations (Lines, et al., 2020). If the child has opened up to you to report the abuse, it makes it difficult to share that information because you were a trusted confidant, but you are having to break that trust to do the mandated reporting.
There are ethical issues within this case study because it mentioned not wanting to be pregnant and abortion is a sensitive subject for many people, including healthcare workers. Also, you are trying to earn this patient trust but as a mandatory reporter you are going to have to break that trust and tell someone. By breaking that trust you can cause more psychological issues. As far as finance issues you must think of the strain on the Medicaid system an unwanted pregnancy will bring, also for the aunt and uncle who have taken this patient in.
References
Lines, L., Grant, J., & Hutton, A. (2020). Nurses’ perceptions of systems and hierarchies shaping their responses to child abuse and neglect. Nursing Inquiry, 27(2). https://doi.org/10.1111/nin.12342
Liu, B., & Vaughn, M. S. (2019). Legal and policy issues from the united states and internationally about mandatory reporting of child abuse. International Journal of Law and Psychiatry, 64, 219–229. https://doi.org/10.1016/j.ijlp.2019.03.007
Online Sunshine. (2022). Statutes & constitution. Official Internet Site of the Florida Legislature. http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute
Original topic :
Review the interactive case studies in this week’s Learning Resources. Select one of the cases to prepare your discussion post. Your post should address the following:
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Summary of your chosen case study
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What is your differential diagnosis?
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Why did you make this diagnosis decision?
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What is your treatment plan?
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What evidence-based research can you provide to support your decision (choice for differential diagnosis and plan/intervention)?
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What resources did you use to meet your best practice guidelines?
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Address the ethical dilemmas and/or other issues for your case study:
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Ethical issues
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Psychological issues
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Physical issues
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Financial issues
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