Perbin J Maata BSN 4A

Rhenee Hinaut RN 2/19/14

Adolescent Pregnancy Etiology: Adolescent pregnancy is a complex issue with many reasons for concern. Kids age 12 14 years old are more likely than other adolescents to have unplanned sexual intercourse. They are more likely to be talked into having into sex. Up to two-thirds of adolescent pregnancies occur in teens age 18 - 19 years old. In many societies, girls may be under pressure to marry and bear children early, or they may have limited educational and employment prospects. In low- and middle-income countries, over 30% of girls marry before they are 18 years of age; around 14% before the age of 15. Moreover, married adolescents are likely to become pregnant and give birth in accordance with social norms. Education, on the other hand, is a major protective factor for early pregnancy: the more years of schooling, the fewer early pregnancies. Birth rates among women with low education are higher than for those with secondary or tertiary education. Some adolescents do not know how to avoid becoming pregnant, or are unable to obtain contraceptives. However, even where contraceptives are widely available, sexually active adolescents are less likely to use contraceptives than adults. In Latin America, Europe and Asia only 42-68% of adolescents who are married or in partnerships use contraceptives. In Africa the rate ranges from 3-49%. There is a lack of sexuality education in many countries. A global coverage measure related to sexuality education estimates that only 36% of young men and 24% of young women aged 15-24 in low- and middle-income countries have comprehensive and correct knowledge of how to prevent HIV. In some situations, adolescent girls may be unable to refuse sex. Sexual violence is widespread and particularly affects adolescent girls. More than one third of girls in some countries report that their first sexual encounter was coerced. Risk factors for adolescent pregnancy include: >Younger age >Poor school performance >Economic disadvantage >Older male partner >Single or teen parents Signs and Symptoms: Pregnancy symptoms include: Abdominal distention Breast enlargement and breast tenderness Light-headedness or actual fainting

Missed period Nausea/vomiting Frequent urination Sudden, intense aversion to certain foods, especially meats or fatty, fried foods Unusual fatigue Unusual mood swings Positive pregnancy test Pathophysiology:
Modifiable Non-Modifiable

Pressure to marry and bear children Education Use contraceptives Lack of sexuality education Unable to refuse sex Low- and middleincome countries

Social norms

Adolescent un-safe sexual intercourse Adolescent pregnancy Abdominal distention Breast enlargement Breast tenderness Light-headedness Fainting Missed period Nausea/vomiting Frequent urination Aversion to certain foods Unusual fatigue Unusual mood swings Positive pregnancy test

Management: All options made available to the pregnant teen should be considered carefully, including abortion, adoption, and raising the child with community or family support. Discussion with the teen may require several visits with a health care provider to explain all options in a nonjudgmental manner and involve the parents or the father of the baby as appropriate. Early and adequate prenatal care, preferably through a program that specializes in teenage pregnancies, ensures a healthier baby. Pregnant teens need to be assessed for smoking, alcohol use, and drug use, and they should be offered support to help them quit.

Adequate nutrition can be encouraged through education and community resources. Appropriate exercise and adequate sleep should also be emphasized. Contraceptive information and services are important after delivery to prevent teens from becoming pregnant again. Pregnant teens and those who have recently given birth should be encouraged and helped to remain in school or reenter educational programs that give them the skills to be better parents, and provide for their child financially and emotionally. Accessible and affordable child care is an important factor in teen mothers continuing school or entering the work force.

Possible NCP: Pregnant adolescents are at risk physically, emotionally, and socially. The impact of adolescent pregnancy on the individual has far-reaching consequences, which may restrict or limit future opportunities for the adolescent and the child(ren). Educational goals may be altered or eliminated, thus limiting potential for a productive life. The client frequently may be of lower socioeconomic status, with the pregnancy perpetuating financial dependence and lowered selfesteem. Statistically, the obstetric hazards for adolescents and their infants include increased mortality and morbidity rates. Therefore, individualized prenatal nursing care for the adolescent client/family/partner that incorporates developmental needs and health education with prenatal needs has the potential to contribute positively to prenatal, intrapartal, and postpartal outcomes. In addition, neonatal outcomes associated with better Apgar scores, lower incidence of resuscitation, and fewer LBW infants can also be expected. *Knowledge deficit [Learning Need], regarding pregnancy process, individual needs, future expectations may be related to lack of information, unfamiliarity with resources, information misinterpretation, lack of interest in learning, developmental stage/cognitive deficit, psychological stressors/absence of support system possibly evidenced by: Request for information, statement of misconception, inaccurate follow-through of instructions, development of complications. The client will be able to participate in learning process, Verbalize understanding of condition. Discuss and adhere to components of adequate prenatal diet. Identify potential teratogens, physiological/psychological aspects of reproduction, pregnancy, labor, and delivery. Evaluate clients age and stage of adolescent development. The age and stage of the adolescent will influence. the approach to teaching because the late adolescent (aged 1720 yr) may be better able to conceptualize, process, and synthesize information than the client in early (aged 1114 yr) or middle (aged 1417 yr) adolescence. Note readiness to learn. Depending on the stage of development, the adolescent is self-focusing. Because of difficulty recognizing the need or importance of learning, the client may not be motivated. Encourage client to explore options regarding outcomes of pregnancy including termination of pregnancy (dependent on stage of gestation), keeping their babies or giving the baby up for adoption. (Note implications of culture on decisions.). Assess clients understanding of female/male anatomy and physiology. Provide appropriate information; correct misconceptions. Assess factors related to high rate of recidivism. Identify community resources and potential support systems. Obtain drug use/abuse history; screen for STDs and for HIV risk behaviors. Provide information about possible negative effects on fetus. (Refer to ND: Injury, risk for fetal [following] and in CP: First Trimester; and CPs: The High-Risk Pregnancy, Prenatal Infection.). Provide information about nutrition, meal planning, and need to avoid empty calories. (Refer to ND: Nutrition: altered, less than body requirements.). Refer client to adolescent clinic for peer support and informational

services, such as prenatal, parenting, and infant care classes. Provide information about importance of establishing individual long-range personal and educational goals for client and her offspring. Refer to appropriate social agencies. Discuss signs of labor. Identify factors that place the adolescent at risk for preterm labor/delivery. Present/discuss available methods of birth control, giving advantages and disadvantages of each. Be realistic and nonjudgmental. Present information appropriate for the adolescents particular developmental stage.

Sources: Nursesreview.org onlymyhealth.com nytimes.com who.int