NU225 Unit 9 Adolescent PID Care Plan Example

Every Goal Written With Her Privacy in View: A Care Plan for a Composite Sixteen-Year-Old Admitted With Pelvic Inflammatory Disease for Intravenous Antibiotics While Her Parent Knows Only That She Has an Infection

[Student Name]

Purdue University Global

NU225: Pediatric Nursing

Unit 9 Care Plan

[Instructor Name]

[Date]

The patient and family are composite; minors' consent and confidentiality rules differ by state and are bracketed, and treatment follows the provider's orders and current CDC guidance.

Assessment

[Jasmine], composite, 16, presented with three days of lower abdominal pain, fever [38.4] C and vaginal discharge. Pelvic examination by the provider showed cervical motion tenderness. She vomited two doses of oral antibiotics and was admitted for IV treatment. Pain [7] of 10. Pregnancy test negative. Psychosocial history, taken with the parent out of the room and summarized under the HEEADSSS domains (Perry et al., 2022): Home: she, her mother and a brother of 12 share an apartment. Education: eleventh grade, works weekends at a pharmacy. Eating: no concerns. Activities: soccer. Drugs: occasional alcohol at parties, no other substances. Sexuality: one male partner for four months, condoms "sometimes." Suicide and depression: denies; sleeping well. Safety: feels safe at home and with her partner; wears a seatbelt. She consented to her own sexual health care under [state] law and asked that her diagnosis not be shared with her mother. Adolescents are more likely to seek care and answer honestly when confidentiality is assured, and its limits are explained at the start (Ford et al., 2004).

Problem 1: Acute Pain

Goal: pain at or below [3] of 10 within 48 hours, and able to walk to the bathroom without guarding. Interventions: assess pain every [4] hours and after each dose; give analgesics as ordered; offer a heating pad and position of comfort; time assessments to avoid waking her repeatedly. Rationale: pain should ease within about three days of effective treatment; pain that does not improve may signal an abscess and must be reported. Evaluation: pain [2] of 10 by day three.

Problem 2: Risk of Treatment Failure After Discharge

Goal: completes fourteen days of treatment at home. Interventions: confirm with her the oral regimen ordered to complete the course, usually doxycycline with metronidazole after IV treatment (Workowski et al., 2021); teach her to take doxycycline upright with a full glass of water and to avoid lying down for an hour; set phone reminders she chooses; arrange a follow-up visit within 72 hours of discharge and give a clinic number she can call herself. Rationale: fourteen days at home are unsupervised, and missed doses lead to treatment failure and long-term harm, including infertility and chronic pelvic pain.

The hardest part of her treatment happens after she leaves: fourteen days of pills that only she will know she is taking.

Problem 3: Risk of Reinfection

Goal: partner treated and condoms used consistently. Interventions: explain that her partner from the past 60 days needs evaluation and treatment; discuss expedited partner therapy if permitted in [state]; teach that she should avoid sex until both have finished treatment and symptoms are gone; recommend retesting in about three months (Workowski et al., 2021); discuss condom use and other contraception without judgment. Rationale: an untreated partner reinfects her, and repeated infections raise the risk of permanent damage.

Problem 4: Privacy Risk

Goal: her diagnosis is not disclosed without her consent, within the law. Interventions: document her request; note that confidential information should not appear in the parent's view of the patient portal where the system allows; ask the billing office about how the explanation of benefits will be sent; check that her medication bottles and discharge papers show only what she agrees to; give her a private number for the follow-up clinic. Rationale: information can reach a parent through a billing statement, a shared portal account or a pharmacy label, even when no one tells.

Where Confidentiality Ends

She is told at the start that confidentiality has limits: if she discloses abuse, plans to harm herself or others, or is at serious risk, the team must act and may need to involve others. She agreed she would tell her mother she has "a pelvic infection that needs antibiotics," which is true, and the team will support her if she later chooses to say more.

Teaching Checked by Teach-Back

Before discharge she explains back, in her own words, how to take each medicine, why all fourteen days matter, what to tell her partner and which symptoms mean she should call: fever returning, pain getting worse, vomiting her pills or new discharge. Teach-back is done privately, and the written sheet uses plain words she is comfortable keeping in her backpack. She is also given the clinic's text line, since a teenager may text when she would not call.

Supporting the Parent

Her mother is told what she can be told: that Jasmine has an infection being treated with IV antibiotics, how long she will stay, and how to help her rest. The nurse acknowledges the mother's worry and does not imply that anything is hidden from her.

Evaluation at Discharge

Day three: afebrile, pain [2], tolerating oral medication, discharge teaching repeated back accurately, partner notification plan in place, follow-up booked.

References

Ford, C., English, A., & Sigman, G. (2004). Confidential health care for adolescents: Position paper of the Society for Adolescent Medicine. Journal of Adolescent Health, 35(2), 160-167. https://doi.org/10.1016/S1054-139X(04)00086-2

Perry, S. E., Hockenberry, M. J., Cashion, K., Alden, K. R., Olshansky, E., & Lowdermilk, D. L. (2022). Maternal child nursing care (7th ed.). Elsevier.

Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., Muzny, C. A., Park, I., Reno, H., Zenilman, J. M., & Bolan, G. A. (2021). Sexually transmitted infections treatment guidelines, 2021. MMWR Recommendations and Reports, 70(4), 1-187. https://doi.org/10.15585/mmwr.rr7004a1