Marquez, Caren Joy B.

BSN 2B
Case Study 121
L.W., a 20-year-old college student, comes to the university health clinic for a pregnancy test. She has
been sexually active with her boyfriend of 6 months, and her menstrual period is now 2 weeks late. The
pregnancy test is positive. The patient begins to cry, saying, “I don't know what to do.”
1. How will you begin to counsel L.W.?
Pay attention to L.W., give her your entire focus, and recognize what she says to create a safe
environment. To show that you are engaged, use your own body language and gestures. Be open,
honest, and genuine in your response. In a conversation, being an active listener involves recognizing
that the discussion is more about the other person and not about you.

2. What options does a woman experiencing an unplanned pregnancy have?

 continuing the pregnancy and becoming a parent
 terminating the pregnancy (abortion)
 continuing the pregnancy and choosing adoption

3. If your role is to assist her in making a choice, what information will you want L.W. to provide?
In order to help L.W. to make a decision, we must know all the factors to consider such as: her
medical history, her boyfriend’s medical history, cultural background, family history and situation,
financial condition, and her knowledge about pregnancy and newborn care.

4. What are the nurse's moral and ethical obligations in this situation?
As a nurse, it's inculcated in you that you're responsible for all aspects of your patients' care. When it
comes to all aspects of individuality and patient, ethical issues, the use of authority must be
professional. The nurse has the same obligations to self as to others, including the responsibility to
promote health and safety, retain completeness of character and integrity, maintain competence, and
continue personal and professional progress. In this situation, the nurse can share insights and
opinions that can help L.W., but the final decision will be from the patient itself and it must be
respected.

5. L.W. asks you to tell her about abortion. What will you tell her?
“Abortion is a method of terminating a pregnancy. The embryo or fetus, as well as the placenta, are
removed from the uterus using medication or surgery. The choice to terminate a pregnancy
is very personal.  There are pregnancy resource centers where you can receive free pregnancy
confirmation as well as confidential, non-judgmental counseling about your options. You can take
your time and consider things thoroughly. You are not alone, and you don't have to make any
decisions right away.”

6. L.W. wants you to explain the difference between vacuum aspiration and medical abortion.
How would you explain this to her?
“Instead of surgery, a medical abortion uses medicine to end your pregnancy. You'll take two different
medications at different times. The first medicine is generally administered in the doctor's office. The
lining of your uterus will break down as a result of this drug. You'll take the second drug 24 to 48
hours later. Your uterus contracts and empties as a result of this medicine. Rather than taking the
second medication at home, your doctor will usually recommend that you come for a second
appointment. It's possible that you'll need to return for a third and final session to confirm that the
drugs worked and that you're no longer pregnant. You can expect severe cramping after a medical
abortion, which may necessitate the use of over-the-counter or prescription pain relievers, as well as
excessive bleeding and the passing of blood clots. You may get light to severe bleeding for two
weeks in certain situations.

On the other hand, aspiration is the preferred surgical method during the first trimester of pregnancy.
Your doctor will numb and widen your cervix to allow for the insertion of a vacuum tube that will empty
your uterus using suction. You may experience severe cramps and light to heavy bleeding for up to 6-
 8 weeks after the procedure. Surgical abortion is 99% successful, and first-trimester abortions have a
complication rate of less than 1%. Terminating a pregnancy is a difficult choice, but knowing your
choices can help you make the best decision for your health and well-being.”

7. She tells you that she has heard that if a woman has an abortion, she might not be able to get
pregnant again. How would you counsel her?
“It is unlikely that your ability to become pregnant and carry children in the future would be harmed.
Both medicines used in medical abortions have been thoroughly researched and confirmed to be
safe. Complications are exceedingly rare in this procedure.”

8. What types of emotional reactions do women experience after an abortion?

It is normal to have feelings of relief, sadness, regret, or guilt after an abortion. These emotions differ
from one woman to another. Hormonal fluctuations can cause you to be more emotional than normal.
You may feel a range of emotions, including grief, anger, and regret, as well as guilt or relief. If you're
experiencing long-term sadness, guilt, or despair, talk to a supportive family member or friend, a
professional counselor, or your health care provider about your feelings.

9. L.W. wants to know about adoption. What will you tell her?
“Adoption is when you give birth to a child and then choose someone else to raise him. It's a binding
legal arrangement in which you agree to leave your child in the care of another individual or family. 
Many families are hoping to build their families through adoption. An adoption agency can provide
you with information and guidance as you consider your options. It's normal to experience a range of
emotions after placing your child for adoption. Many people who choose adoption are relieved to
know that their child is living with a loving and caring family. They may feel reassured because their
decision helped in providing a decent life for their child.”

10. L.W. asks you if there are any actions she should be doing now to take care of herself. How
will you respond?
“While you're pregnant, you can take care of yourself by maintaining a healthy lifestyle and attending
doctor's appointments. One of the most important things you can do is eat a well-balanced diet.  
Also, before taking any medication, consult your doctor. Some medications, especially those used
during the first three months of pregnancy, might cause birth abnormalities. It is preferable to begin
taking folic acid. You should do this every day. Other vitamins or supplements should only be taken
with your doctor's permission. Don't smoke or hang around with people who do. Smoking increases
your chances of having a miscarriage, giving birth prematurely, having a baby with a low birth weight,
and other health issues. Also, don't take alcoholic beverages. Alcohol use is the leading cause of
preventable birth abnormalities, such as fetal alcohol disorder.”

11. What factors affect carrying a pregnancy to term? L.W. asks you about the importance of
prenatal care. Explain.
“Every pregnancy has its own set of risks. High blood pressure, obesity, diabetes, epilepsy, thyroid
disease, heart or blood disorders, poorly controlled asthma, and infections can increase pregnancy
risks. Complications during pregnancy can be caused by a variety of factors, including your age and
overall health. However, with good prenatal care and support, you may reduce these risks. Prenatal
treatment should be maintained throughout your pregnancy to detect any problems early and
decrease the risk of pregnancy and delivery difficulties. Regular checkups are important during
pregnancy. This continuous care can help you and your baby stay healthy, identify issues early, and
avoid complications during birth.”

12. Finally, L.W. wants to know how long she has to decide
“You should make your decision as soon as possible throughout your pregnancy. If you're expecting a
child, getting medical treatment as soon as possible will help you and your baby stay as healthy as
possible. If you want to stop the pregnancy, an early abortion is the best option.”
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