session 12 Adolescent needs, Ethical and legal considerations

Question 1

Explain where and how the acronym HEEADSS is used

Answer 1

It is used in the adolescent interveiw
Home - where do they live and who with, do they feel safe there?
Education and employment - are they at school or work and how is that going for them, do they go everyday (?bullying)
Eating- what do they like or not like about their body, have they been dieting in the last year, what do they think is a healthy diet
Activities- what do they like doing?, what is a usual day for them, do they spend alot of time alone?
Drugs-do they drink, smoke or tried drugs - what do you like about it/ don’t like?
Sexuality - are they in a relationship, do they identify as straight or bisexual/gay/lesbian
Suicide and Depression-do they ever feel sad or down more than usual, ? trouble sleeping, have they ever tried to hurt themselves (cutting) to feel better, have they thougth they would be better off dead?
Safety-have they been seriously injured, do they use safety equipment for sports/hobbies, is there any violence in their neighbourhood,school, home?

Question 2

Do adolescents have the rigth to confidentiality when disclosing information with health professionals

Answer 2

Yes - except if they intend to self-harm/committ suicide or harm others
risk committing a criminal act
if they are being abused physically or sexually.

Question 3

Can an adolescent consent and at what age can they give consent?
can they refuse treatment?

Answer 3

Yes - a mature minor can consent
Yes they can refuse treatment
3 R’s - refusal = are they capable of making the decision
restrain= only on a locked ward can a person be restrained
restrict= call the police if they leave

Question 4

what are the mental health conditions that are prevalent in teh adolescent population

Answer 4

depression
self harm
suicide
anorexia

Question 5

discuss Depression traits

Answer 5

Behavioural changes- withdrawn, substance use
cognitive changes - neg thoughts, decreased concentration, thoughts of death/suicide
Communication changes - unlikely to initiate changes
Mood changes - isolation, hopelessness
Alterations in physical functioning - sleep disturbances, disturbed appetite, fatique

Question 6

Discuss self harming traits and management

Answer 6

Coping mechanism
common among you people - cutting, picking at wounds
response to intense emotional pain, or a sense of being overwhelmed by negative thoughts
not necessarily a sign of suicide
misconception for attention seeking
Just listening is a huge step in recovery

Question 7

discuss nursing management of suicidal ideation

Answer 7

always take expression of wish to die seriously
provide safe environment
report

Question 8

discuss suicidal ideation and what are the 7 warnings of suicide

Answer 8

1. making direct and indirect threats about suicide
2. dramatic changes in personality and appearance
3. changes in eating or sleeping habits
4. a dramatic drop in performance at school or work
5. feelings of guilt or low self esteem
6. saying goodbye and giving personal belongings away
7. withdrawing from family and friends

Question 9

discuss anorexia traits

Answer 9

severe starvation
dramatic weight loss
may involve purging behaviours
high body distortion
chronic disease

Question 10

what is the nursing diagnosis for anorexia

Answer 10

disturbed body image
chronic low self esteem
disturbed sleep pattern
disturbed thought processes
social isolation
impaired social interaction
ineffective coping mechanisms
ineffective role performance

Question 11

what is the nursing care for anorexia

Answer 11

nursing 1 to 1 care
daily weights early in the morning
high caloric feed up
nurses need to offer distraction

Question 12

what is the nursing management of self harming

Answer 12

attend to cuts
listening to the child is a huge step in recovery
refer to psych, or social worker for review

Question 13

Identify the risk factors for child abuse and neglect

Answer 13

Child Factors 
- younger than 4 yrs old
children with a disability
children with poor sleeping patterns
altered child parent attachment
aboriginal/ torres strait islander descent

Family characteristics
hx of abuse or neglect of another child in the family
absence of social supports/isolation
parental mental illness, depression, anxiety
parental chronic illness
parental substance abuse
poor parent child attachment
parental hx of poor impulse control
at risk family structure (single parents, separated parents, parental conflict)

Question 14

define types of child abuse

Answer 14

physical abuse - non accidental bodily injury
psychological abuse - regular lack of attention to childs needs
shaken baby syndrome - violent shaking of the baby
sexual abuse - sexual penetration, inappropriate touching, exposure to sexual acts, exposure to pornographic materials.

Question 15

what is the legislation in WA for child sexual abuse and how what is the process for mandatory reporting

Answer 15

It is a legal requirement in WA for doctors, nurses, midwifes, teachers and police officers to report all reasonalble beilefs of child sexual abuse, of children under the age of 18, to the department of child protection.
Report as soon as possible after forming the belief that sexual abuse is happening. Reporters do not have to prove that a child is being abused, only have a beleif is grounds enough for investigation. The reports can be recieved 24hrs day/ 7 days a week.