Pаrents аre cоncerned thаt their 6-year-оld sоn continues to occasionally wet the bed. What does the nurse explain?
Cаse Overview (I will mаnuаlly grade this) Yоu are wоrking in a primary care clinic. A 16-year-оld female, Maya, presents with her mother for evaluation of severe menstrual cramps. Her mother reports: Missing 1–2 days of school monthly due to pain Increased irritability around menses Recent drop in academic performance You speak with Maya privately. Maya reports: Menarche at 12 Cycles every 28–35 days Severe cramping 1–2 days before menses Pain 8/10 first 2 days Heavy flow first 3 days (pad every 2–3 hours) Headaches and nausea during menses Mood swings and “feeling overwhelmed” Sexually active with one boyfriend Inconsistent condom use No current contraception LMP: 5 weeks ago States: “I don’t think I’m pregnant… probably.” Denies: Fever Vaginal discharge Trauma Assessment Findings: Vital Signs BP: 132/84 HR: 94 BMI: 29 (overweight range) Exam Mild lower abdominal tenderness Acne present Tearful at times Avoids eye contact when discussing sexual activity Screening PHQ-9: 12 (moderate depressive symptoms) Pregnancy test: pending STI screen: ordered I want you to respond to the following questions using the Clinical Judgment Measurement Model (CJMM): RECOGNIZE CUES: I want you to determine developmental Stages: Physical, Psychosocial (Erikson), Cognitive, Moral. Determine 2 Health Problems List 2-3 Risk Factors for this age Document any abnormal assessment findings ANALYZE CUES: For each cue identified, explain why it is clinically significant for this specific patient. How does her development influence her health risks What relationships exist between the cues (if any) What complications could develop if left untreated? PRITORITIZE HYPOTHESES: What is the MOST urgent concern? What has the greatest potential for harm? You must justify your prioritization. GENERATE SOLUTIONS: Develop 2 SMART goals based on your cues and hypotheses. Must be: Specific, Measurable, Achievable, Relevant, and Time-bound. Nothing vague here. You must identify time frame to complete interventions. Example "deAmbra will prevent the mountain of laundry from reaching crisis level for the next 2 months" TAKE ACTION: Provide 2 Nursing interventions for each SMART goal. You will have a total of 4 interventions. Interventions MUST be developmentally appropriate. Example: "deAmbra will complete 1 full load of laundry (wash, dry, fold, and put away) every other day". This is a measurable intervention that will support my goal.