Persuasive Outline teen pregnancy

To persuade my audience to support the teaching of sexual education in schools today to prevent teenage pregnancy. Introduction l. It’s Bam and being a 17 year girl tucked away in your bed nice and warm; you hear blood curdling scream from the room next door. No it’s not an intruder it’s your two week old baby ready for his 3rd diaper change. II.

By supporting the teaching of real life situations from sexual choices and education regarding pregnancy prevention, more teenagers will have access to appropriate information to make informed hoicks. Ill. A. Teenage pregnancy is a problem for all involved. It puts a great strain on not only the young mother, but also on her parents who, more often than not, end up with the new baby in their family home, often having to look after it while the baby’s parents are at school if they go back or try to work to support the new child.

As well as the strain on basic tax payers who fund State Assistance funds that several young parents end up on. B. Teen pregnancies in today’s society have become a growing issue and have been brought to the limelight with media attention so it is important o teach our kids the reality of their choices by providing education and real life information regarding their choices. Showing the teens what life is like after the baby is born in real life as opposed to what they imagine and see on TV would create an impact. C.

Teen pregnancies in today’s society have become a growing issue and have been brought to the limelight with media attention so it is important to teach our kids the reality of their choices by providing education and real life information regarding their choice. Showing the teens what life is like after the baby is born in real life as opposed to what they imagine and see on TV would create an impact. A. According to a study in 2008 there is increasing evidence that youth exposure to sexual “content on television shapes sexual attitudes and behavior in a manner that may influence reproductive health outcomes” (1) 1 .

Today it is hard to find a person who hasn’t seen or at least heard of the TV shows, 16 and Pregnant or Teen Mom, which puts a positive spin on teen pregnancy, but what the teens that are obsessed with these shows don’t think about is not every situation has the same outcome as in these shows. A. Adolescents who are exposed to more sexual content in the media, ND who perceive greater support from the media for teen sexual behavior, report greater intentions to engage in sexual intercourse and more sexual activity.

Mass media are an important context for adolescents’ sexual colonization, and media influences should be considered in research and interventions with early adolescents to reduce sexual activity. (2) Ill. When we have more comprehensive education available to the teenagers, they will be able to see what consequences their choices would have on not only their futures but can see how their choices would impact all of those around them. With he right information given to them they will be able to make more informed A.

Abstinence only sexual education programs are not effective in preventing teenage pregnancy. In fact there is not any proof that it is any kind of deterrent for any sexual activity. There are several theories that when Youth are told “not” to do something it pushes them into doing it faster. B. Evaluations of comprehensive sex education programs show that these programs can help youth delay onset of sexual activity, reduce the frequency of sexual activity, reduce number of sexual partners, and increase condom and contraceptive use.

Importantly, the evidence shows youth who receive comprehensive sex education are NOT more likely to become sexually active, increase sexual activity, or experience negative sexual health outcomes Conclusion parents are at school if they go back or while they try to work to support the new child. As well as the strain on basic tax payers who fund State Assistance funds that several young parents end up on. B. Teen pregnancies in today’s society have become a growing issue and have been their choices. Showing the teens what life is like after the baby is born in real life as opposed to what they imagine and see on TV would create an impact.

C. When we have more comprehensive education available to the teenagers, they will be able to see what consequences their choices would have on not only their futures but can see how their choices would impact all of those around them. With the right information given to them they will be able to make more informed decisions which will let them have better careers, and society will benefit as a whole. II. I know that I am asking you to think about a topic that for a lot of people is a Taboo subject and there are some of you out there that don’t see any problems at all with the way things are now.

Just imagine that it is your child, or family member that is thinking how much fun it would be to have a baby Just like Magic from Teen Mom, wouldn’t you want to have her taught that yes babies are fun but they are also work. They are not accessories like Coach Purse that when you are done you can put away. A child is a lifetime responsibility. I would hope that you will support the education of real life choices. Ill. I’m not saying that if we tell every single teenager out there that babies are bad and you have to wait then they will.

Early pregnancy

Early pregnancy is considered “socially problematic” such as : broken families, discrimination and some teenagers feel they all alone. In addition, people believes that being pregnant in an early age are at the high risk for poor health outcomes during pregnancy such as checkups ,vitamins and even exercise and it is a result of being a child mother because they are young not to know what the right things to do.

And even in the child birth she didn’t know how to are with her baby because she’s too young. And in the process of growing up of her child most of them does not able to teach a good attitude to their child because even them their parents haven’t teach them well so the history repeat itself. But in the other way around some child mother care, teach and give their all attention to their baby because they don’t want that their baby would be same after them. What Age they considered as early pregnancy? It is 15 years old and below.

Because it have a high rate of infant mortality which is 13 overlook live births, very low birthright =24 and very preterm delivery = 43. Compare to 16-19 years old infant mortality = 8, very low birthright = 15 and very preterm delivery = 22. So this analysis signified that 1 5 years old and below considered early pregnancy. Background Why did I choose this topic? Is that I think that discussing this one is the best thing to do to open the mind of those teenager not to do premarital sex which will result a “Early Pregnancy’.

Another reason is to explain what is the cause and effect factors of early pregnancy. Some may don’t really care about this topic, but for me this is important. Because our population is increasing while our economic is decreasing and it was so alarming. Another reason why should I have to discuss this is to enlighten the mind of those woman to enjoy their teen years and also single life. Then to avoid her to big responsibilities she cannot take. And to avoid destroying a lot of woman’s future.

Focus paper: teenage pregnancy

V raising a baby and they think “hey I can do that. ” Then reality kicks in and it is nothing like how it was on T. V. There are many issues among teens in the United States, but the focus on this paper is going to be following teenage pregnancy. In today’s society when someone hears that a young girl is pregnant they automatically think she was sleeping around. People Jump to the conclusions and they don’t take time to realize there are many other causes for teenage pregnancy than the girl sleeping around. The reality of it is there are actually five major causes o teenage pregnancy.

Peer pressure, underage drinking, clamoring teen pregnancy, lack of knowledge and sexual rape are the five major causes of teenage pregnancy. Peer pressure is a cause for almost anything involving teenagers; whether it be for drugs, drinking or sex. Teenagers often feel pressure to make friends and fit in. Many times these teens let their friends influence their decision to have sex even when they do not fully understand the consequences. Teenagers have sex as a way to appear cool and to fit in, but in some cases the end result is an unplanned teen pregnancy.

According to the Kaiser Family Foundation states that more than 29 percent of pregnant teens reported that they felt pressured to have sex, and 33 percent of pregnant teens stated that they felt that they were not ready for a sexual relationship, but proceeded anyway. When peer pressure is involved to have sex that usually means that drinking is involved as well. Underage drinking is another cause that leads to teenage pregnancy. Teen drinking can cause an unexpected pregnancy, according to the website Love to Know. Many teens experiment with drugs and alcohol.

Drinking lowers a ten’s ability to control her impulses, contributing to 75 percent of pregnancies that occur between the ages 14 and 21 . Approximately 91 percent of pregnant teens reported that although they were drinking at the time, they did not originally plan to have sex when they conceived. Peer pressure and underage drinking go hand in hand with teenage pregnancies. One leads to another which causes an unexpected pregnancy. Out of the other three causes clamoring teenage pregnancy and lack of knowledge also go together. The movie industry and the media contribute to teenage pregnancy by clamoring teen pregnancy in movies.

Movies that show teen pregnancy as something to be desired encourage teens to engage in reckless sexual activity, according to Abs’s “Good Morning America. ” During adolescence, teens become more focused on their appearance and how people view them. Teens see on T. V that there same age are having cute little babies so they go out and have sex without being fully educated in what that really is. Teenagers who are uneducated about sex are more likely to have an unintended pregnancy. Some teens do not fully understand the biological and emotional aspects associated with having sex, according to

Tailored. Co. UK. Many times, teens do not have the knowledge needed to make informed and responsible decisions about whether or not to engage in sexual activity that can alter their life. Social media is not helping teenage pregnancy it is only causing young girls to go out and try it. The last and final cause for teenage pregnancy is rape. Teens can become pregnant as a result of sexual abuse or rape. The Stomacher Institute states that between 43 and 62 percent of teens acknowledge that they were impregnated by an adult male, and two-thirds report hat their babies’ fathers are as old as 27.

Approximately 5 percent of all teen births are the result of a rape. People in society need to realize that teenage pregnancy is a big issue today. Many of these young girls don’t finish high school. Teen pregnancy greatly affects education. Only 51% of teen moms have a high school diploma. The number for those who didn’t have a teen birth is closer to 89%. Parenthood is the leading cause for teen girls dropping out of school. Teen moms are extremely unlikely to go to college. Only about 2% of young teen moms ever get a higher education degree.

Statistics show that In the United States, there are nearly 750,000 teen pregnancies each year, that’s about 2000 a day! . It’s estimated that about half of Latin and African American teenagers will be pregnant at least once before they’re 20. Raising a baby can cost up to $10,000 in the first year alone. About 80% of teen fathers don’t marry the mom. They also contribute very little to raising the baby. On average, teen dads pay less than $800 a year on child support. Teenage pregnancy is an issue Just like drug use and alcohol abuse that needs to be looked into.

There is no way to stop teenage pregnancy. Talking to teens about it is not going to stop them when they are at a party and alcohol is involved. Instead contraception’s should be provided in public bathrooms, schools and encouraged to be available at home. Many believe that providing protection in schools will only encourage teens to have sex. Reality is they are going to have it whether there is protection or not, so why not provide them the right choice of using protection. Maybe if protection is provided there will be less unexpected pregnancies in the United States.

Microscopic examination

Malaria is typically diagnosed by the microscopic examination of blood using blood films, or with antigen-based rapid diagnostic tests. Malaria infection develops via two phases: en that involves the liver (creditworthy phase), and one that involves red blood cells, or erythrocytes (erythrocytes phase). Core Nurses roles in preventing and managing malaria in pregnancy involves provision of care directed at bite Prevention/ Vector control, Education and community participation, Prophylaxis and Medical treatment.

However the nurse plays important roles in providing supportive care and symptomatic treatment, such as tepid sponging for fever, health education regarding personal protection, prevention of malaria and compliance with treatment, ordinates care, psychosocial support by encouraging the patient and giving comfort and generating community participation. Malaria prevention and control during pregnancy require a three-pronged nursing approach: Focused Antenatal care &Health Education, effective case management of malaria infections, use of insecticide-treated bed nets and intermittent preventive treatment in area of stable transmission.

Malaria in pregnancy is an obstetric, social and medical problem requiring multidisciplinary and multidimensional solution. Pregnant women constitute the main adult risk group for malaria and 80% of deaths due to malaria in Africa occur in pregnant women and children below 5 years. Malaria in pregnancy is a Priority Area in Roll Back Malaria strategy. Malaria and pregnancy are mutually aggravating conditions. The physiological changes of pregnancy and the pathological changes due to malaria have a synergistic effect on the course of each other, thus making the life difficult for the mother, the child and the treating physician.

P. Follicular malaria can run a turbulent and dramatic course in pregnant women. The non- immune, prim-gravid are usually the most affected. In pregnant women the morbidity due to malaria includes anemia, fever illness, hypoglycemia, cerebral malaria, pulmonary edema, puerperal sepsis and mortality can occur from severe malaria and hemorrhage. The problems in the new born include low birth weight, prematurely, malaria illness and mortality. Malaria in pregnancy is a major cause of maternal morbidity worldwide and leads to poor birth outcomes.

Pregnant women are more prone to complications of malaria infection than non-gravid women. Pregnant women are more susceptible than the general population to malaria: they re more likely to become infected, suffer a recurrence, develop severe complications and to die from the disease. Malaria contributes very significantly to maternal and fetal mortality – with at least 10,000 maternal deaths per annum attributable in sub- Sahara Africa (Meghan D. ,et al 2007). Five species of Plasmid can infect and be transmitted by humans. The vast majority of deaths are caused by P. Logically and P. Visa, while P. Oval, and P. Malarial cause a generally milder form of malaria that is rarely fatal. The economic species P. Knowles, prevalent in Southeast Asia, causes alarm in macaques but can also cause severe infections in humans. Malaria is common in tropical and subtropical regions because rainfall, warm temperatures, and stagnant waters provide an environment ideal for mosquito larvae. Malaria is typically diagnosed by the microscopic examination of blood using blood films, or with antigen-based rapid diagnostic tests.

Modern techniques that use the polymerase chain reaction to detect the parasite’s DNA have also been developed, but these are not widely used in malaria-endemic areas due to their cost and complexity. The disease is widespread in tropical and subtropical regions in a broad and around the equator, including much of Sub-Sahara Africa, Asia, and the Americas. The World Health Organization estimates that in 2010, there will be 219 million documented cases of malaria. That year, the disease killed between 660,000 – 1. 2 million people, many of whom were children in Africa(WHO, 2000).

The actual number of deaths is not known with certainty, data is unavailable in many rural areas, and many cases are undocumented.. The life cycle of malaria parasite mosquito causes an infection by a bite. First, sportiest enter the bloodstream, and migrate to the liver. They infect liver cells, where they multiply into mortises, rupture the liver cells, and return to the bloodstream. Then, the mortises infect red blood cells, where they develop into ring forms, trapezoids and consists that in turn produce further mortises.

Sexual forms are also produced, which, if taken up by a mosquito, will infect the insect and continue the life cycle. In the life cycle of Plasmid, a female Anopheles mosquito (the definitive host) transmits a motile infective form (called the sportiest) to a vertebrate host such as a human (the secondary host), thus acting as a transmission vector. A sportiest travels through the blood vessels to liver cells (hypotheses), where it reproduces asexually (tissue schmoozing), producing thousands of mortises.

These infect new red blood cells and initiate a series of asexual multiplication cycles (blood schmoozing) that produce 8 to 24 new infective mortises, at which point the cells burst and the infective cycle begins anew. Other mortises develop into immature gamesters, which are the precursors of male and female gametes. When a fertilized mosquito bites an infected person, gamesters are taken up with the blood and mature in the mosquito gut. The male and female gamesters fuse and form a continent-?a fertilized, motile zygote.

Kookiness develop into new sportiest that migrate to the insect’s salivary glands, ready to infect a new vertebrate host. The sportiest are injected into the skin, in the saliva, when the mosquito takes a subsequent blood meal. Only female mosquitoes feed on blood; male mosquitoes feed on plant nectar, and thus do not transmit the disease. The females of the Anopheles genus of mosquito prefer to feed at night. They usually start searching for a meal at dusk, and will continue throughout the night until taking a meal. Malaria parasites can also be transmitted by blood transfusions, although this is rare.

Signs and Symptoms The common signs and symptoms of malaria typically begin 8-25 days following infection and they include headache, —-Hemoglobin in urine fever and shivering, —Convulsions —-Bitter taste in the mouth, Nausea and vomiting, joint pain, —-Anorexia hemolytic anemia, –Malaise jaundice, The classic symptom of malaria is paroxysm-?a cyclical occurrence of sudden coldness followed by shivering and then fever and sweating, occurring every two days (tertian fever) in P. Visa and P. Vale infections, and every three days (quarter fever) for P. Larvae. P. Follicular infection can cause recurrent fever every 36-48 hours or a less pronounced and almost continuous fever. Pathologically Malaria infection develops via two phases: one that involves the liver (creditworthy phase), and one that involves red blood cells, or erythrocytes (erythrocytes phase). When an infected mosquito pierces a person’s skin to take a blood meal, sportiest in the mosquito’s saliva enter the bloodstream and migrate to the liver where they infect hypotheses, multiplying asexually and asymptomatically for a period of 8-30 says.

After a potential dormant period in the liver, these organisms differentiate to yield thousands of mortises, which, following rupture of their host cells, escape into the blood and infect red blood cells to begin the erythrocytes stage of the life cycle. The parasite escapes from the liver undetected by wrapping itself in the cell membrane of the infected host liver cell. Within the red blood cells, the parasites multiply further, again asexually, periodically breaking out of their host cells to invade fresh red blood cells. Several such amplification cycles occur.

Thus, classical descriptions of waves of fever arise from simultaneous waves of mortises escaping and infecting red blood cells. Some P. Visa sportiest do not immediately develop into creditworthy-phase mortises, but instead produce hypnotizes that remain dormant for periods ranging from several months (7-10 months is typical) to several years. After a period of dormancy, they reactivate and produce mortises. Hypnotizes are responsible for long incubation and late relapses in P. Visa infections, although their existence in P. Oval is uncertain.

The parasite is relatively retorted from attack by the body’s immune system because for most of its human life cycle it resides within the liver and blood cells and is relatively invisible to immune surveillance. However, circulating infected blood cells are destroyed in the spleen. To avoid this fate, the P. Follicular parasite displays adhesive proteins on the surface of the infected blood cells, causing the blood cells to stick to the walls of small blood vessels, thereby sequestering the parasite from passage through the general circulation and the spleen. The blockage of the macrostructure causes symptoms such as in placental malaria.

Sequestered red blood cells can breach the blood-brain barrier and cause cerebral malaria. Investigations Diagnosis of Follicular malaria in pregnancy can be particularly difficult due to placental sequestration of parasites – Thick and thin films for malarial parasites should be examined and the degree of parasites determined. Parasites may not be detectable on peripheral blood films. Full Blood Count(BBC), Urea (U), blood glucose and Liver Function Tests (Lefts) including blurring levels should also be checked. Chest X-Ray may reveal cases of pulmonary edema. Polymerase chain reaction tests are available.

Intermittent preventive treatment OPT). Long lasting insecticide treated nets (Lens). ASS Others are Evidence-based, goal-directed actions Individualized, woman-centered care ‘V. Regular& appropriate use of Early detection and treatment of problems and complications Prevention of complications and disease Quality vs.. Quantity of visits Care by skilled Nurses and health promotion Birth preparedness & complication readiness Nurses role in focused antenatal care & health education In line with WHO recommendations, the nurse applies focused Antenatal Care (FAN) which is the approach used to provide services at the NC clinic.

The FAN approach is a personalized service that emphasizes the pregnant woman’s overall health, preparation for childbirth and readiness for complications. The main principles of focused Antenatal Care are; Family-centered care Quality, rather than quantity of visits Care by skilled providers The Nurses educates every pregnant woman the importance of consistent attendance at least four scheduled visits to NC as follows; 1st visit; before 16 weeks 2nd visit; 16 to< 28weeks 3rd visit; 28 to < 32weeks 4th visits; 32 to 40weeks

During the visits, the nurse gets the opportunity to assess and evaluate the health of the pregnant woman and also provide herewith regular malaria prevention and treatment intervention skills. Nurses Role in the application of Intermittent Preventive treatment Intermittent Preventive Treatment (PIT) is the use of antibacterial medicine given in treatment doses at predetermined intervals after quickening and in order to clear a presumed burden of parasites.

Currently, the recommended medication of choice for PIT is Sulfanilamide-predetermine (SP) (Guitar G. M. , Elder J. M. , 2005). The Nurses role in he use of intermittent preventive treatment includes– The Nurse educates the pregnant women on the benefit of Sulfanilamide as follows; A good safety profile. Effectiveness in administration I. E. One dose regimen. Simple dosage regimen that promotes better treatment completion. The Nurse makes sure that all pregnant women who report to the antenatal clinic should be targeted for ‘OPT.

The Nurse ensures that SP is taken as a single dose of 3 tablets, each containing MGM sulfanilamide madding of predetermine, at scheduled NC visits after quickening (when the mother can perceive fetal events) and not less than one month after the first dose. The Nurse encourages the pregnant women to receive at least 3 doses of SP as PIT during a pregnancy carried to them. The Nurses also assesses, monitors and ensures that pregnant women who are HIVE positive and those on routine (daily) co-territorial as well as pregnant women who are allergic to sylphs-containing drugs SHOULD NOT be given SP as ‘OPT.

The Nurse directly observes compliance of each SP dosing throughout therapy possibly at antenatal visits. The Nurse advocates that SP should be provided as part of a comprehensive antenatal package with other components such as mathematics and anti-Wilhelmina to control malaria and anemia. The Nurse also ensures that pregnant women with malaria disease (symptomatic malaria) are tested and treated promptly with high priority according to the national treatment guidelines. DOSAGE OF SP The 3 doses of SP shall be given at least one month apart. L. SST Dose; after quickening (first fetal movement usually after sixteen weeks). II. 2nd Dose; At least one month after the first dose. Ill. 3rd Dose; At least one month after the second dose. Nurses Role in the use of long lasting insecticide treated nets (LOINS). LOINS is a type f net with insecticide embedded into the fiber of the net in such a way that the insecticide is able to maintain its effect on average for about three years of following 20 washes. Lens can be of different shapes, sizes and colors, depending on the type available the net is giving I or shared to the pregnant women in the Clinic.

During antenatal teaching the nurse teaches the pregnant women the advantages of using Lens to include: 1) Protection against Malaria. 2) Kills and repel mosquitoes. 3) Reduce number of mosquitoes in [outside net. 4) Kill other insect’s e. G. Lice, roaches, and bedbug. ) Safe for pregnant women, young children and infants. Also the nurse re-emphasizes that regular and appropriate use of Lens is a very effective method of reducing human vector contact by; a. Creating a physical barrier. B. Killing vector mosquitoes if they land on Lens. C.

Repelling them. The Nurse plays a pivotal role in teaching the appropriate use of Lens by a pregnant woman and the benefits of such the woman and her family. This teaching is made available by the nurse during antenatal meetings with the pregnant women and family members. Studies indicate that women who were protected by Lens every eight in their first pregnancies delivered approximately% fewer babies who were either small for gestational age or both prematurely than women who were not protected Lens(Gamble C. , Awkward J. P. , terrible F. O. 2006).

The Nurse also educates the pregnant women on how to take care of their immediate environments by; a) Making sure that there is no stagnant water around their living homes. B) Clearing bushes around their house. C) Provision of nets on their doors and windows. The nurse visits homes of her clients in other to make sure that these mothers implements what they are thought in the ante natal clinic. Also the nurse arranges for health talk in the communities with the aid of the stake holders to create awareness and advocate for the distribution of long lasting treated insecticide nets (Lens) to the pregnant mothers in the village.

Critical thinking in Nursing Pregnant women with Malaria Critical thinking required while nursing pregnant women with malaria involves care that is energetic, anticipatory and careful. Energetic: Don’t waste any time. It is better to admit all cases of Plasmid Follicular malaria. Assess severity- General condition, pallor, Jaundice, Blood Pressure, temperature, hemoglobin, Parasite count, Serum Blurring, Serum creating, Blood sugar. Anticipatory: The Nurse should always be looking for any complications by regular monitoring. Monitor maternal and fetal vital parameters 2 hourly.

Random Blood Sugar 4-6 hourly; hemoglobin and parasite count 12 hourly; S. creating; S. blurring and Intake / Output chart daily. Careful: The nurse must be careful and applying cognitive thinking during the discharge of her duty keeping in minds the risk of negligence and other issues such as: – The physiologic changes of pregnancy pose special problems in management of malaria. Certain drugs are contraindicated in pregnancy or may cause more severe adverse effects. All these factors should be taken into consideration while treating these patients.

Administer drugs according to severity of the disease/ sensitivity pattern in the locality Avoid drugs that are contraindicated. Avoid over / under dosing of drugs Avoid fluid overload / dehydration Maintain adequate intake of calories. Nursing Management of a Pregnant woman with Malaria requiring admission Make a rapid clinical assessment with special attention to level of consciousness, Temperature, blood pressure, rate and depth of respiration and pallor. Admit patient to an intensive care unit if this is available.

Ensure the pregnant mother is admitted in a well-made bed and put in a comfortable position (lateral). Take patient history especially that of pregnancy and document. Explain all procedures to the patient and plan care with her and reassure her family members. Inquire and listen to complaints from the family members and patient. Alleys fears and involve them in care. Patient blood sample should be collected and sent to the laboratory for parasitological confirmation of malaria at the recommendation of the physician or make a blood film and start treatment as required.

Ensure meticulous nursing care. This can be life-saving, especially for the unconscious patient. Maintain a clear airway. Nurse the patient in the lateral or semi-prone position to avoid aspiration of fluid and possible occlusion of blood vessels. Insert a instigators tube and suck out the stomach contents to minimize the risk of aspiration pneumonia. Aspiration pneumonia is a potentially fatal complication that must be dealt with immediately. Turn the patient every 2 hours. Do not allow the patient to lie in a wet bed. Pay particular attention to pressure points.

Keep a careful record of fluid intake and output. If this is not possible, weigh the patient daily in order to calculate the approximate fluid balance. Note any appearance of black urine (hemoglobin’s). Check the speed of infusion of fluids frequently. Too fast or too slow an infusion can be dangerous. Monitor the temperature, pulse, respiration, blood pressure and fetal heart rate. These observations should be made at least every 4 hours. Report changes in the level of consciousness, occurrence of convulsions or changes in behavior of the patient immediately.

All such changes suggest developments that require additional management. If the temperature rises above 38 co, remove the patient’s clothes, fan patient and tepid sponge intermittently. Give prescribed antipathetic drug e. G. Tablet -Perpetrator. Give antibacterial chemotherapy intravenously if prescribed. If intravenous infusion is not possible, an appropriate medication may be given intramuscularly. Suppository formulations or oral treatment should be substituted as soon as reliably possible (once patient can swallow and retain tablets).

Calculate doses as MGM/keg of body weight. Therefore, weigh the patient. Provide good nursing care including daily grooming, oral care, and bed thing, and serving of patient bed-pan when needed and maintain privacy throughout care. This is vital, especially if the patient is unconscious. Pay careful attention to fluid balance, if fluids are being given intravenously, in order to avoid over- and under-hydration. Make a rapid initial check of the blood glucose level, and monitor frequently for hypoglycemia. Monitor patient and look for any complication associated with pregnancy.

Observe and record urine outputs and look for the appearance of black urine (hemoglobin’s) or Algeria which may indicate acute renal failure. Monitor the core temperature, fetal heart rate, respiratory rate and depth, blood pressure, level of consciousness and other vital signs regularly. These observations will allow you to identify the late onset of important complications such as fetal distress, maternal distress, hypoglycemia, metabolic acidosis, pulmonary, edema and shock. More sophisticated monitoring (e. G. Assortment of arterial pH, blood gases, and central venous pressure) may be useful if complications develop, and will depend on the local availability of equipment, experience and skills. Nursing Management of a Pregnant Woman with Malaria in Labor: The Nurse advocates that pregnant women with severe malaria are better managed in an intensive care unit The Nurse should be in the know that Follicular malaria induces uterine contractions, resulting in premature labor and as such be watchful. The frequency and intensity of contractions appear to be related to the height of the fever.

The Nurse monitors for fetal distress, documents and report findings as often as possible reduce chances of such going unrecognized. The Nurse through regular monitoring of uterine contractions and fetal heart rate may reveal asymptomatic labor and fetal tachycardia, brickyard or late deceleration in elation to uterine contractions, indicating fetal distress. The Nurse applies adequate nursing skills to rapidly bring the temperature under control, by tepid sponging and the use of prescribed anti-paretic like Perpetrator etc. The Nurse applies careful fluid management as a crucial nursing management.

Dehydration as well as fluid overload should be avoided, because both could be detrimental to the mother and/or the fetus. The Nurse therefore ensures adequate monitoring of intake and output chats and subsequently comparing data to ensure no fluid imbalance. In cases of err high parasite, the nurse advocates for exchange transfusion and monitoring of administration of blood products and subsequent reactions. The nurse also ensures that aseptic technique and proper screening of blood products are put in place throughout patient admission.

If the situation demands, the nurse calls the attention of Gynecologist for possible induction of labor. Once the patient is in labor, the nurse should monitor for fetal or maternal distress which may indicate the need to shorten the 2nd stage by forceps or vacuum extraction, if possible a caesarian section. Documentation of findings and reporting of such is very crucial to the nursing care of pregnant woman with malaria in labor. If caesarian section is considered, the nurse notifies the colleagues who will be taking over and also prepares patient and theatre for the procedure and assist throughout the process.

Drug Use During Pregnancy

The use of tobacco during pregnancy has adverse prenatal uniqueness and these consequences can extend far beyond the prenatal period (Washrag, 2002). Antisocial behavior is defined as a chronic violation of social norms and rules which can have both violent and nonviolent manifestations. This antisocial behavior can end up being categorized as a mental disorder. Exposure during pregnancy may play a casual role in the onset of severe antisocial behavior via dermatological effects on the fetus (Washrag, 2002).

A teratology is the name for any substance that crosses the placenta to harm the fetus. Exposure to tobacco institution during fetal development and via environmental tobacco smoke exposure is known as the most hazardous of a child’s environmental exposure (Diffract, 2004). Children exposed to environmental tobacco smoke (TEST) in the home increases the incidence of middle ear disease, asthma, bronchitis, and pneumonia; just to name a few. Hospitalizing for respiratory illness is far more likely for children of smokers than those who are not.

The use of cocaine during pregnancy is linked to miscarriage, growth retardation, and learning and behavior problems (Belles, peg 51). Cocaine exposed infants were about a week younger, measured shorter, weighed less, and had a head circumference smaller than unexposed infants. Central and autonomic nervous system symptoms, as well as infection, were more frequent (but not always) with infants that were exposed to cocaine in utter (Bauer, 2005).

Though long-term effects of cocaine usage while pregnant are almost nonexistent in children of mothers who used cocaine. According to Growth, Development, and Behavior in Early Childhood Following Prenatal Cocaine Exposure there was no consistent negative association between prenatal cocaine exposure and hysterical growth, developmental test scores or receptive or expressive language. Prenatal cocaine exposure without concurrent opiate exposure has not been shown to be an independent risk factor for sudden infant death syndrome (Frank, 2001).

In my personal experience, I have seen quite a few pregnant women smoke or use other recreational drugs. I have also seen them give birth to extremely healthy children. I can admit to smoking while I was pregnant, but it was maybe a cigarette every few days. Now, I can see having major issues when the mother smokes a pack a day and s constantly around smokers. But, as a non-habitual smoker, my son, who is two, is bright, sweet, and has absolutely no health issues.

Illicit Drug Use During Pregnancy

Drug exploitation in pregnancy is an elaborate public health problem with conceivably serious conflicting effects for the mother, the fetus and spreading to the developing child. When a mother becomes pregnant, it is important to her baby’s health that she has a healthy lifestyle. This includes eating plenty of nourishing foods, getting a decent amount of rest and exercising normally. For a pregnant woman, pregnancy substance abuse is twice as dangerous because not only is it effecting her, its also affecting the baby that’s inside of her.

Drugs may harm her own health, which will intervene with her ability to support the pregnancy; also some drugs can directly reduce prenatal development. All illegal drugs pose a danger to pregnant woman, Even legal substances such as tobacco, alcohol, and prescription drugs are dangerous to woman that are expecting. As many as one in ten babies may be born to woman that use illegal and prescription drugs while being pregnant. ( Kale, Being; 2009) Alcohol consumption and illegal drug abuse is intensely rosaceous during pregnancy and therefore pregnant woman should admire their value to their child and never exploit them.

Studies shown in 2008 that the amount of babies born to drug addicted mothers has almost doubled since 2003. Pregnant mothers have been using drugs during pregnancy for decades without knowing the effects it can have on their child. Even though many people assume that illicit drugs used by pregnant mothers cause no harm to the fetus there have been studies shown otherwise. If a mother uses cocaine in the early stages of pregnancy it can increase the risk of a miscarriage, when it is seed later in pregnancy cocaine usage can lead to muscle spasm, feeding difficulties and sleeplessness.

Cocaine has many street names such as crack, blow, snow, and coke. It is highly addictive and it is a central nervous system stimulant. Cocaine comes from a plant that has been used for thousands of years in the most parts of the world, it comes from the coca leaf and it is the most dangerous stimulants of the natural origin. The drug can be injected, snorted, or smoked. It increases the addicts blood pressure, body temperature and heart rate. The risks that cocaine may cause o a pregnant woman are respiratory failure, heart attacks, nausea, seizures and also abdominal pain.

Sudden death may also occur to first time users, because the body is not use to the adrenalin the drug is giving it. When a pregnant woman uses cocaine it crosses through the placenta and circulates through the fetus body, fetus eliminate cocaine from their bodies more slowly then adults do. In assertive rare chances perennial cerebral infraction associated with cocaine use has also been known to happen, this drug decreases uttering blood flow and increases maternal blood pressure. When placental abortion happens it can lead to preterm birth, severe bleeding and even a fatal death.

Studies show that woman who use cocaine during pregnancy are at least twice and likely as other woman to have a premature baby, since cocaine cuts the flow of nutrients and oxygen to the fetus, the baby may be much smaller at birth than it would be otherwise. Physically cocaine exposed babies tend to have smaller head which indicates a smaller brain. Post pregnancy babies of woman who use cocaine regularly during pregnancy are between three and six times more likely to be born at a low birth weight, less than 5. Mounds than babies who do not use the drug. Pre-mature birth is caused by low birth weight and can be caused by poor growth before birth. Low-birth weight babies are 20 times more likely to die in their first month than normal weight babies are. The babies that actually survive are at an increased risk of lifelong disabilities such as mental retardation, cerebral palsy, visual and hearing impairment. In the USA, the 2004 Survey on Drug Use and Health showed that 5% of American women reported the use of an illicit drug during pregnancy.

In the I-J, national estimates for pregnant drug seers are lacking, but studies report that approximately a third of drug users in treatment are female and over 90% of these women are of childbearing age (15-39 years of age). A study comparing the profiles of pregnant drug users presenting to a perennial addictions service in London (I-J) found illicit heroin use (38%), followed by cocaine use (24%) as primary drugs of abuse, with poly substance use common. (Rasher Unworthy Managua, MD; 2011) Pregnancy should be taken seriously and one should implement a healthy lifestyle to keep them and their unborn child safe.

A pregnant woman’s lifestyle habits as well as her partner’s can severely affect the health of their unborn baby. If the pregnant woman and her spouse have already taken these actions into consideration it should be continued throughout the entire pregnancy. It is never too late for a pregnant woman to start thinking about making behavioral changes or having withdrawals. Staying acting during pregnancy can only have a positive effect on the baby and the expecting mother with providing her feeling more energy and developing a healthy lifestyle. References Babysitter Medical Advisory Board (2014, July).

Medicalisation of pregnancy

From the initial pronouncement by the GAP that a woman is pregnant to the regular scans and antenatal process pregnant women are expected to participate in, pregnancy has been redefined as a potential risky process requiring medical surveillance. Explain this statement using sociological concepts including metallization and consider the advantages and disadvantages of this approach to pregnancy.

The metallization of pregnancy and childbirth has changed from something that was previously the most natural process into an extremely risky process, so why is his and what does the term metallization actually mean when applied to the pregnancy process? This following assignment will discuss the definition of metallization, medical social control and how it applies to the risk of pregnancy and childbirth. It will explore the history of pregnancy procedures and discuss the current processes of pregnancy from the initial pronouncement to the expectations of the pregnant woman throughout the pregnancy term.

The assignment will also discuss the sociological concepts and theories, including the advantages and sedateness of the metallization of pregnancy. There are many definitions of metallization but according to Conrad (1992) “metallization describes a process by which medicinal problems become defined and treated as medical problems, usually in terms of illnesses or disorders” – pregnancy and childbirth is a prime example of this definition.

Along with metallization came medical social control and Conrad (1979) states there are four main types of medical social control, these are: medical ideology, medical collaboration, medical technology and medical surveillance. Whilst the risks of pregnancy and childbirth may fall under all four of these types of social control, the main control would be medical surveillance along with medical technology. Conrad: 1992) The most important change within pregnancy and childbirth is the transition from the private sphere (giving birth at home) to the public sphere of the hospital. (Symons & Hunt: 1996) Initially, midwives were UN-qualified women whose experience was based purely on their own childbirth and what they had learned from other women. Perceptions of midwives varied from being old, drunken, unclean omen to conscientious, clean kept and caring women. Kent: 2000) Depending on wealth, women in the nineteenth century would encounter different types of midwives. For those that were poor, lay midwives or handymen would be present at the birth however, often these classes of women would receive their treatment in hospitals where there was no charge for treatment but meant obstetricians were free to carry out treatments or operations enabling them to develop their own skills and knowledge (Kent: 2000) Middle class women would receive more expensive medical care (Kent: 2000)

According to Leap and Hunter (1993) during the late nineteenth century a group of women set up a campaign to enable the training and practice of midwives which led to the 1902 Midwives Act. Prior to the introduction of this Act, eight attempts to upgrade the role of midwife had failed. The introduction of the act meant that it was illegal for any untrained person to attend a birth other than if instructed by a doctor and it was a statutory responsibility for a midwife to attend. Kent: 2000) Hospital births began to increase prior to the Second World War and the introduction of the National Health Service in 1946 saw a massive increase in maternity beds which was free to all. (Kent: 2000) Feminist’s theory of the metallization of childbirth defined the process as an’ expression of patriarchal power’ and feminists such as Donnish and Oakley would argue that this meant that women were now subjected to male power.

Oakley in particular sees the move of childbirth into a male area as robbing women of autonomy and losing control of their own bodies (Symons & Hunt: 1996) As documented by Hunt in 2005, Ivan Illicit critiqued that pregnancy, which was once such a natural process was now ruled by the male profession. Metallization of this process was apparent due to the mass increase in hospital births. In 1927 only fifteen per cent of births took place in hospital where in 1980 an astonishing ninety eight per cent of births were hospitalized. Hunt: 2005) Nowadays, pregnant women have very little say throughout their pregnancy and focus on the fetus has become more important than the actual mother who loses her own identity whilst carrying the unborn child. Women are expected to conform to the guidelines set by Doctors with regards to factors such as diet: what we can or Anton eat, exercise, alcohol consumption and smoking. These factors create or identify categories such as: good mother (for those who follow guidelines) and bad mother (for those who choose to ignore said guidelines) and in which society is only too quick to Judge.

From the first confirmation by the General Practitioner that the woman is pregnant, she is immediately put under ‘surveillance’ for the remainder of her pregnancy period. The pregnant woman must attend regular scans and routine appointments with both her midwife and also with obstetricians whilst monitoring err behavior. She is also likely to undergo physical examinations and possibly genetic tests, will have blood tests and receive visits from a Health Visitor.

So for example: the woman’s diet, if the woman has a higher than normal Body Mass Index, she may well be referred to an obstetrician who specializes in that area of practice. The more intervention involved the more likelihood that some form of intervention is needed throughout pregnancy and labor however what we must question is: is this amount of surveillance or interference at all beneficial or even necessary. Risks can occur during every pregnancy and there are many factors that contribute to the risks such as: age, weight or previous pregnancies.

Risks during pregnancy can often be magnified if the woman already suffers from chronic conditions such as high blood pressure, heart disease, diabetes or kidney problems which would require additional pre-natal care. (Medicine plus: 2013) Pre-natal care is monitored very closely with routine check-ups to the midwife occurring approximately once a month at the start of the pregnancy. The closer the birth date approaches, the closer the sits to the midwife. The midwife will give advice on physical activity and diet to try and make the pregnancy as healthy as possible.

She will also perform many checks throughout this period such as checking bloods (for lack of iron) or to check the woman’s blood type as depending on the type of blood, further intervention may be needed, checking of blood pressure and weight and also measuring the size of the baby (again depending on size of baby further intervention such as growth scans be may needed if baby is measuring too big or too small to the ‘norm’. All of these actors can contribute to the risky process of pregnancy and birth. (Medicine plus: 2013) There is a huge on-going debate as to whether or not hospital births are more beneficial than home births.

Whilst there are many advantages towards the metallization of pregnancy that suggests it is such as: knowing that you are in the safest place in case of any emergencies during labor especially if the pregnancy is classed as ‘higher risk can make the woman feel at ease. Depending on the hospital and area (for example large teaching hospitals) will have up to date medical equipment and most likely have a Doctor on-call at all times (Milk & Mud: 2013) Hospitals will provide very high levels of support for the new born child I. : neo-natal units and specialized care units, increased availability of pain relief and medication (whereas this may be limited in the home environment) (Milk & Mud: 2013) However, for all the advantages there are Just as many disadvantages that suggest hospital births are not necessarily in the best interest of the patient. Hospitals are governed by rules and therefore expect their patients to conform to these rules. Milk & Mud: 2013) Most, if not, all hospital births will experience some sort of intervention.

Every hospital has their own guidelines or policies as to how long a ‘healthy labor should last therefore women in labor may be encouraged to speed up their delivery with the intervention of drugs (Babysitter: 2013) Forms of intervention may also take place if the labor is not going to plan or according to text book standards. Whilst in hospital, women will be more at risk of infections such as MRS. and may find themselves subject to UN-necessary routine and procedures even f their pregnancy is classed as low risk.

They will have less privacy than if giving birth at home and will not receive the personal one-to-one care as would be applied at home, this may be due to staff shortages or change-over of shifts (Milk & Mud: We can see by figures produced Just how much the shift from home to hospital births have increased. In the beginning of the sass’s, almost ninety nine per cent of births took place in the home however by the sass’s, only approximately thirty per cent now took place in the home. (NC: 2008) So why is this?

National Childbirth Trust, a hearty founded in 1956, was initially set up to promote and understand the system of natural childbirth. The charity would argue that home births are perfectly safe for healthy women situated in the ‘low risk category and that there is no evidence to suggest otherwise (NC; 2012) The charity policy has eleven factors, the first being that ‘all parents should be able to choose a place to give birth that they feel is right for them and their baby. They also believe that parents need up to date evidence to enable them to make a suitable decision for their place of birth. NC: 2008) In 1970 he Peel Report was published. The report gave a negative perception on home births giving the impression that home births were less advanced than hospital births but there was no evidence to back this up. The report was challenged due to lack of evidence and twenty two years later, was proven to be incorrect. (NC: 2008) It was the Government’s Policy to increase women’s choices of places of birth and that from 2009, home births would be guaranteed (NC: 2008) However, we know that this is not necessarily the case and that home births can very much depend on circumstances and resources I. , location, midwife availability and medical attention required to name a few . (NC: 2008) It is evident by looking at documentation produced by interest groups such as The National Childbirth Trust that pregnant women may not have as much choice in the place of their child’s birth as is lead to believe by the Government and that more information needs to be distributed effectively to enable this to happen. While it is lead to believe that pregnant women now have more choice throughout this period, are we mislead by what we believe is choice when in fact we are still Ewing controlled ?

Pregnancy and Abortion

Abortion is wrong and unjust husbands of women throughout the world obtain abortions every year. The decision to have an abortion is life altering and can have an enormous impact on a woman’s future health and well being. The reasons for having an abortion vary from woman to woman. The fact that a woman has even had to consider having an abortion can be in and of itself very disturbing emotionally. Some women experience a tremendous sense of relief, while others may have feelings of guilt, anger or profound sadness.

For most women these feelings radically improve and cease to be after a short period of time; however, for a small percentage, they may become much more pronounced or serious and for a far longer period of time. The more certain a woman is about her decision to terminate her pregnancy, the less her chances will be of developing emotional or psychological problems. The same holds true for women who have friends and/or family to provide support before, during and after this emotionally trying time.

Emotional problems following an abortion tend to be more prevalent among women ho have been previously diagnosed with depression, anxiety disorders or other mental health issues. Also noted at higher risk of developing depression are teenagers, separated or divorced women, and women with a history of more than one abortion. It is not unusual for a woman to experience a range of often contradictory emotions after having an abortion, Just as It would not be unusual for a woman who carried her unintended pregnancy to term. There Is no “right” way to feel after an abortion.

Feelings of happiness, sadness, anxiety grief or relief are common. Providing women with an outlet for discussing their feelings Is the first step toward the process of achieving emotional well being following an abortion. Ads by Google Most experts agree that the negative feelings a woman may have after an abortion may be due to a negative reaction by her partner, friends or family members, who might Judge her negatively for having an abortion or for even becoming pregnant In the first place. Research studies Indicate that emotional responses to legally Induced abortion are largely positive.

They also Indicate that emotional problems resulting room abortion are rare and less frequent than those following childbirth. Most studies In the last 25 years have found abortion to be a relatively benign procedure In terms of emotional effect except when pre-abortion emotional problems exist or when a wanted pregnancy Is terminated, such as after diagnostic genetic testing. While most abortion providers offer post abortion counseling or counseling referral sources, Pregnancy and Abortion By libidinal emotions after having an abortion, Just as it would not be unusual for a woman who carried her unintended pregnancy to term.

There is no “right” way to feel after an Providing women with an outlet for discussing their feelings is the first step toward might Judge her negatively for having an abortion or for even becoming pregnant in the first place. Research studies indicate that emotional responses to legally induced abortion are largely positive. They also indicate that emotional problems resulting studies in the last 25 years have found abortion to be a relatively benign procedure in terms of emotional effect except when pre-abortion emotional problems exist or when a wanted pregnancy is terminated, such as after diagnostic genetic testing.

Multifetal pregnancy reduction

Relatively recent developments in assisting reproductive technology have increased the occurrence of multiple fetal gestation with fertility treatment (Exploitable, 2013). Multiple birth pregnancy is not always welcomed by parents or physicians. The risk of prematurely and low birth weight increases with multilateral pregnancy. In this case, the perennial practitioner has ethical obligations to both the pregnant and fetal patients (Coherence & McCullough, 2013). Clinical circumstances may generate offering the procedure of multilateral pregnancy reduction (MIFF) in the process of informed consent to ensure autonomy.

Some may argue that this is not the termination of a pregnancy, but is a procedure to ensure successful continuation of the pregnancy (Exploitable, 2013). Grant & Ballard (2011) suggest some may view the Issue as Immoral; as tampering with nature. Issues Surrounding Multilateral Pregnancy Reduction A multilateral pregnancy reduction involves a flirts-trimester or early second-trimester procedure for reducing by one or more the total number of fetus in a multilateral pregnancy (American College of Obstetricians and Gynecologist, 2013).

The procedure is most often performed in higher order pregnancies that include three or ore fetus. Reduction decreases 3 maternal risks and Increases the chance of at least one live birth. There are many ethical complexities involving continuing or reducing a high order pregnancy. In multilateral pregnancy reaction, ten Tutees to De reach are chosen oases on technical considerations (American College of Obstetricians and Gynecologist, 2013). For instance, the fetus that are the most accessible to intervention (potassium chloride injection) are usually chosen.

Selective reduction is an additional controversial ethical issue, that involves choosing fetus for reduction based on heir health, gender, or anomalies after chronic villous sampling, amniocentesis or ultrasound. Screening for the explicit purpose of sex selection for social reasons is not appropriate. However, information should not be withheld from parents if they request it. Reduction to a singleton pregnancy from a twin or greater pregnancy remains controversial and some physicians may offer this option depending upon the woman’s circumstances and her values.

To ensure the principle of autonomy, the decision ultimately rests with the parents of the fetus. Benefits and Risks Associated with Higher-order Pregnancies and MIFF Maternal kiss associated with multilateral pregnancy are the increased incidence of (a) hypertension, (b) proclaims, (c) gestational diabetes, and (d) postpartum hemorrhage (American College of Obstetrics & Gynecologist, 2013). Additional complications may include maternal depression, severe parenting stress, child abuse, and an increased divorce rate.

Significant medical costs and adverse economic consequences are associated with multiple pregnancy. Infants born to multiple pregnancy may have an increased risk of prematurely, low birthright, cerebral palsy, learning disabilities, delayed language development, behavioral difficulties, chronic Eng disease, and death. 4 The intention of MIFF is to decrease the maternal and infant risks associated with multiple fetal pregnancies (American College of Obstetrics & Gynecologist, 2013). There are risks related to the procedure of MIFF and long-term effects.

A woman may have adverse outcomes from the procedure including; bleeding, infection, or even loss of more than the reduced fetus including spontaneous abortion of the entire pregnancy. Couples may experience sadness, grief, or depression for months or years to come (Attaining Fertility, 2014). After reduction, the pregnancy may still exult in premature birth, low birthright and associated complications (American College of Obstetrics & Gynecologist, 2013). Ethical Dilemma Mrs.. C. , a 39 year-old fertility and peregrination patient is 10 weeks pregnant.

After many miscarriages and several cycles of assisted reproduction, Mrs.. C. And her husband are thrilled to be expecting their first child. They have been counseled it is likely they will have a multiple gestation with triplets or greater. The parents find out today they are expecting septets and the physician and advanced practice nurse are consulting with the couple about the pregnancy. Included is a discussion regarding the risks and benefits of multilateral gestation. The physician feels it is necessary to offer the option of selective reduction to the woman and her husband.

The physician recommends selective reduction to the woman and her husband to preserve ten Neal AT Mrs.. C. Ana some AT ten Tutees. He extols ten Detentes AT ten procedure while minimizing the risks of losing the pregnancy. Initially, Mr.. & Mrs.. C. Recoil in horror at the thought of terminating even one of the babies they have worked so hard for. Mrs.. C. Asks the certified nurse midwife (CNN) about selective reduction. The CNN has strong beliefs about informed consent, patient autonomy, and termination of life. Additionally, she feels that the physician has made a recommendation and not 5 provided sufficient information.

She examines the context of the dilemma, her professional responsibilities, scope of practice, and her personal beliefs to determine what actions she should take in communicating with the physician and couple and in decision-making. The CNN is experiencing moral distress. There are several ethical and legal reasoning constructs that the CNN must consider before arriving at a decision on how to act in this case. In-depth knowledge and details of the process of reasoning hopefully will assist the CNN in resolution of the moral dilemma presented.

Critically thinking about how the law would be applied in this case is important. Identification, evaluation, and application of the ethical principles of the case are equally necessary. Legal Reasoning Constructs Girdled (1984) suggests that legal reasoning constructs are principles involved in determination of how the law is applied in a legal decision. It also includes how a decision is reached when there are insufficient preexisting cases to pave the way. Interpretation, coherence, logic, case law, and legal analysis are the main principles in legal reasoning constructs.

Each principle will be discussed in the following paragraphs. Interpretation in Legal Reasoning Girdled (1984) suggests when the law is clear on a subject, relevant rules can be applied in a logical manner. Legal reasoning focuses on how one develops a sense of legal consciousness and evaluate the appropriateness of formal rules in society (Moon, 2013). It assists in differentiating what is right and what one should do. It can aid in decision making when a practitioner may want to act in one way; however, loud find themselves making the wrong decision.

Legal reasoning is also a method of addressing a legal issue by arguing the existing rules among all interested parties (Peterson, n. D. ). It may exist in two forms (a) application of the 6 rules to cases, and (b) legislative drafting. Application of legal reasoning may involve dealing with the interpretation of written law (statutes) or customary law (past practices that now define an essential mode of conduct). Finally, Endicott (2011) suggests Tanat Interpretation In legal reasoning Is Titling rotational support Tort legal conclusions. Coherence in Legal Reasoning

Coherence in legal reasoning refers to the ability to know exactly what the law states (Moon, 2013). It is the degree to which a case follows established law (Levelness, 1984). Additionally, it may be a condition for legal Justification (Berate, 2009). It is a measure of how a ruling falls in line with the fundamental principles of a legal system. Coherence requires consistency, comprehensiveness, and completeness. It may serve as a normative criterion in following the spirit of the law. Coherence places emphasis on the past and the obligation to remain within former legal decisions.

Logic in Legal Reasoning Logic in legal reasoning is the ability to view clearly what the law is and how the law works (Moon, 2013). The rules of law apply in that similar cases are decided comparably. Individual cases should be decided on their own merits and the decision making process must comply with applicable rules and procedures of evidence. To achieve the rules of law, one must articulate and evaluate the elements of legal reasoning (Walker, 2007). This type of reasoning is involved in interpreting constitutions, statutes, and regulations.

Legal reasoning uses the concept of syllogism (Ramee, 2002). This consists of three parts (a) major premise – states a general rule, (b) minor premise – makes a factual assertion, and (c) conclusion – applies the facts to the law. A syllogism must be a logical, valid statement; it is impossible for premises to be true and the conclusion to be false. 7 Case Law Legal reasoning may involve analysis directly from prior cases at hand (Tellurium, 2012). Case law establishes a precedent for future cases to follow (Lament, 2014).

Precedent is a prominent feature of legal reasoning. It occurs when an earlier decision is followed in a later case when similarity exists. Lament (2014) suggests precedents are legally significant and should be understood as (a) laying down rules, (b) the application of underlying principles, and (c) as a decision on the balance of reason. Case law is often referred to as common law (Laws. Com, 2013). Legal Analysis Legal analysis refers to a statement by a court, Judge, or other legal authority as to the legality or illegality of an action, condition, or intent (U.

S. Legal, 2014). It is critical examination of the legal issues present in a case and there are four steps (a) identify the issue or legal question, (b) using enacted law, case or common law, or a ambition helps provide an understanding of what applies to the case at hand, (c) a decision is made on how the law applies to the legal question or issues asked in the first place, and (d) an objective conclusion or summary is made. The most pertinent law, case, or statute is discovered in an analysis that applies to the particular case.

Ethical Reasoning Constructs Ethical reasoning is the cognitive process involved in the analysis of an important tentacle Issue (Valentine & Bateman, 2 ) I nee TLS step In ten process AT tentacle reasoning is to identify the ethical issue present. The situation is then evaluated wrought different moral frameworks and an ethical Judgment is formulated. The reasoning from this process leads to ethical behavioral 8 intentions. The behavior is then performed and that reinforces the previous steps of ethical reasoning.

The Function of Ethical Reasoning Elder & Paul (2011) suggest the function of ethical reasoning is to critically think about acts that benefit others and acts that harm others. It is a way to set aside and distinguish other domains of thought such as religion, law, and social conventions. Recognizing that an issue has ethical components can form the basis for moral awareness (Valentine & Bateman, 2011). Moral awareness is when one recognizes that their potential decisions may impact the interests, welfare, or expectations of the self or others in a manner that may conflict with one or more ethical principles.

The Problem of Pseudo-Ethics At times in healthcare, there are dilemmas that initially that appear to be ethical issues; however on closer examination are more about communication and frustration. These dilemmas have been misclassified as “ethical issues” (The American Association of Neurosurgeons, n. D. ) reports that many hospital ethics committees are reviewing issues that are not truly ethical in nature. Contentious situations have been classified erroneously as ethical for the purpose of the ethical committee review.

They suggest that reframing an issue as ethical does not uncover the essence of the problem. It is difficult to apply ethical methodology to non-ethical issues. The Elements of Ethical Reasoning Paul & Elder (2006) list the following elements of ethical reasoning (a) “define the purpose, (b) raise questions, (c) use information, (d) utilize concepts, (e) make interpretation and inference, (f) make assumptions, (g) generate implications and consequences, and (h) embodies a 9 point of view’ (p. 14).

The authors suggest if one understands these concepts, they are better equipped to analyze ethical reasoning and follow the ethical implications of their decisions. The Logic of Ethical Reasoning Elder & Paul (2011) propose that ethical reasoning must be developed to overcome the human natural tendencies towards egotism, prejudice, self-justification, and self- exceptional. Humans need to unearths Tanat tenet Demeanor NAS consequences Tort others and natural tendencies can be resisted through the development of the ethical thought of fair-mindedness, honesty, integrity, self-knowledge and genuine concern for the welfare of others.

If a person applies the elements of ethical reasoning, they will be able to ethically analyze a situation and determine appropriate behavior and action. The Advantages and Disadvantages of Ethical Reasoning Slouching (2008) suggests that principle based approaches to ethical reasoning have several advantages including they are adaptive to new situations, offer practical solutions to ethical problems, have explanatory power, and are enduring. They also have the advantage of unavailability’s in certain fields such as bioethics.

Ethical reasoning can also be combined with a coherence model of Justification. The author ports limitations to ethical reasoning based on principles. Critics argue they do not provide an action guide or an adequate philosophical theory. Some feel that the existing principles and rules are imperfect, and coherence between the principles and rules will lead to imperfect ethical decisions. Differences between Legal and Ethical Reasoning ethical issue (Valentine & Bateman, 2011). Legal reasoning is the determination of how the law is applied in a legal decision (Girdled, 1984).

Legal reasoning may also be how one develops a 10 sense of legal consciousness and evaluates the rules of society (Moon, 2013). Moral deliberation uses the insights of various perspectives to clarify the ethical meaning in a situation; whereas, legal reasoning involves the foundation of enforceable law and court interpretation of application. Resolution of the Ethical Dilemma There are many ethical complexities involving continuation or reduction of a high order pregnancy (American College of Obstetricians and Gynecologist, 2013).

One could view the dilemma through the lens of the unreduced fetus and center their argument on maximizing benefits for the surviving fetus after a MIFF (Ralston, 2011). This utilitarian resolution may be termed “lifeboat ethics”, where one or more is sacrificed for the good of the others. An ethical and legal discussion of the issues involved in this particular case; however, is much more complicated. The ethical issues surrounding multilateral pregnancy reduction (MIFF) are controversial and consist of varying shades of gray (Ralston, 2011). Aligning the interests of all the fetus and the mother is simply not possible.

Evans & Bruit (2010) argue that all involved in MIFF may struggle to reconcile the potentially oppositional elements of religious beliefs and the risks associated with Geiger-level pregnancies. Ethical Justification for choices and actions are based on the principles of informed consent, autonomy, beneficence, and malefaction (Simmons, 2 2) All AT tense principles are consolable In ten case Ana seclusion- making on the part of the advanced practice nurse, the physician, and the pregnant couple rests on a balance of the principles. Perhaps the most important principle in the case is that of informed consent.

Receiving and understanding information forms the basis for informed consent and allows the couple to make an autonomous decision (Demotion, et al. , 2011). The principle of autonomy will be violated if the physician 11 and/or CNN do not provide information (Grant & Ballard, 2011). Respect for autonomy in this case is the principle that the couple must balance the relative importance of the medical, ethical, religious, and socioeconomic components and choose the best course of action for their unique situation (American College of Obstetricians & Gynecologist, 2013).

As previously noted, to ensure the principle of autonomy, the decision ultimately rests with the parents of the fetus. The probability of specific adverse outcomes should be discussed, and it is the physician’s ethical and legal obligation to provide adequate information regarding diagnosis, prognosis, and alternative treatment choices, including the option of no treatment (American College of Obstetrics and Gynecologist, 2013; Grant & Ballard, 2011).

Beneficence would be providing benefit to the woman and the remaining fetus for a successful pregnancy. Malefaction is more problematic in this case, as some of the fetus would need to be harmed to help the mother and the remaining fetus. Justice would be concerned with the costs associated with prematurely and the quality of life of the infants if premature or disabled. One could also argue that justice could be applied in the case of which fetus will be spared during the procedure and how the costs of health care are distributed.

Standard of Care and Scope of Practice Issues The advanced practice nurse practicing in the area of women’s health or nurse- midwifery may practice in a diverse range of settings, including obstetrician or maternal-fetal medicine offices (American College of Nurse-Midwives, 2011). Contained within the scope of practice statement of the American College of Nurse- Midwives (CACM) is the provision to form a partnership with women and their implies in a shared decision-making model. This includes listening, providing information, guidance, and counseling.

The standards of practice for nursemaid’s care include the support of individual rights and self-determination within the 12 boundaries of safety. This standard addresses autonomy and beneficence. The provision of information in the context of current science is necessary for the woman to provoke Motormen consent. Cams are required to provoke retell to toner providers if necessary when the care required is out of the scope of practice for the CNN (CACM, 2011). Ethical and Legal Principles Involved in the Case The principle of autonomy may be violated if the CNN does not provide information.

Grant & Ballard (2011) suggest that autonomy forms the basis for informed consent. Demotion, Pips, Pintos, & Dollar (2011) argue that having information is not the same as understanding the information and may be problematic in informed consent. Furthermore, autonomy depends on (a) liberty – lack of coercion, (b) agency – the capacity to understand relevant information, consider options, evaluate risks and benefits, to make and communicate a decision, and (c) having the information accessory to make a decision.

The physician in the scenario is responsible for initially explaining the risks and benefits of the procedure and the effects on the current pregnancy (Grant & Ballard, 2011). If the CNN interprets the professional moral duty to the patient, then she has the responsibility to ensure that the patient has all of the information and understands it in order to give informed consent for the procedure. CACM (2011) clearly delineates the scope of practice for the CNN and certified midwife (CM). Included in the scope of practice are the services, education and core impenitence required for midwifery practice.

This is presented in a document entitled Definition of Midwifery and Scope of Practice for Certified Nurse-Midwives and Certified Midwives. Suppers (2004) suggests an advanced practice nurse must also consult their state law for a source of authority for professional practice. Therefore, the state Nurse Practice Act also specifies the scope of practice. 13 In the case scenario, the advanced practice nurse is practicing in collaboration with the physician, and is not in independent practice.

According to Grant & Ballard 201 1), the CNN is practicing in a collaborative manner with the physician in this case, and the physician is responsible for providing informed consent. Treating a woman with a complex multiple gestation is out of the scope of practice of the CNN and necessitates a referral (American College of Nurse-Midwives, 2011). However; in this case, as a CNN she has a duty to listen to concerns and provide information and support. At this point, the CNN should not make suggestions for care or provide counsel. Her main purpose is to provide information in addition to what the physician has provided.

Three Recommendations to Resolve Moral Distress The use of an ethical decision making model allows the advanced practice nurse to examine all of the relevant aspects of an ethical dilemma (Park, 2012). This provides a comprehensive review process of (a) identifying the ethical problem, (b) collecting additional information to identify the problem an formulate solutions, (c) develop alternatives for comparison, (d) select the best alternatives and Justification, (e) develop practical, diverse ways to implement the ethical decisions and actions, and (f) evaluate ten erects Ana strategies to prevent a Torture salary occurrence.

Additional recommendations are made to assist the CNN is resolving moral distress; both in the case and future situations. The second recommendation is improving skillful, assertive communication to foster the nurse-physician relationship (Lachrymal, 2010). This may assist all professionals in problem-solving for ethical situations and practice. The third recommendation is specific ethics education (Lachrymal, 2010). Ethics education is also suggested for all professionals involved in the case to raise awareness of 14 potential distressing situations and understand the relevant principles and application of them.

Changing the environment to remove barriers to the CNN acting in what she deems a moral manner may be helpful for all disciplines involved (Radian, 2011). Implement an Ethical Decision Making Model The J. PLUS Decision Making Model is utilized to apply to the ethical dilemmas presented in the case scenario (Jehovah, n. D. ). The PLUS is applied at several steps of the decision-making process and stands for P – polices, L – legal, U – universal and S – Self. The questions the CNN needs to ask herself are (a) Is this consistent with my organization’s policies, procedures, and guidelines? B) Is it acceptable under the applicable laws and regulations? (c) Does it conform to universal values/principles my organization has adopted? And (d) Does it satisfy my personal definition of good, right, and fair? The model includes six steps to ethical decision making: Step 1: Define the problem PLUS Step 2: Identify alternatives Step 3: Evaluate the alternatives PLUS Step 4: Make the decision Step 5: Implement the decision Step 6: Evaluate the decision PLUS (Jehovah, n. D. ).

Applying the model to the case scenario, the CNN considers all of the following for the PLUS step of the decision making model scope of practice information and core nets of midwifery as specified in the (a) Definition of Midwifery and Scope of Practice for Certified Nurse-Midwives and Certified Midwives, (b) Standards for the Practice of Midwifery, (c) the Midwifery Code of Ethics (d) state Nurse Practice acts, (e) the ethical principles of autonomy, 15 informed consent, beneficence, and malfunctioned (American College of Nurse Midwives [CACM], 2012).

I nee TLS Ana Tremors reticence to consult Tort Loretta would De ten American College of Nurse-Midwives (CACM) Vision, Mission & Core Values Statement (American College of Nurse-Midwives, 2012). This statement specifically speaks to the core values of (a) excellence, (b) evidence-based care, (c) formal education, (d) inclusiveness, (e) woman-centered care, (f) primary care, (g) partnership, (h) advocacy, and (I) global outreach. Of particular importance, the core values of partnership and advocacy speak to the advocacy role of the CNN.

CACM (2012) states the nurse- midwife “acts to amplify the voice of women on health issues” and to form a partnership with women and their families in a shared decision-making model. This includes listening, providing information, guidance, and counseling. As a CNN, one must also follow the Standards of Practice for Midwifery as presented by the CACM (2011). The CACM also has a formal Code of Ethics (Center for the Study of Ethics in the Professions at IT, 2011). The code points out the professional moral obligations of the CNN.

It specifies that decision-making is a shared, ongoing process with the woman, and the process considers cultural diversity, individual autonomy, and legal responsibilities. It includes nondiscrimination, confidentiality, and protection of clients from harm in the instance of unethical or incompetent practice. Once the CNN has considered the PLUS components, it is appropriate to apply the steps of the J. PLUS Model of Decision Making. The first of six steps is to define the problem. In the case, the couple’s right to informed consent and autonomy has been violated.

In addition, the physician has not provided the couple with all of the relevant information and has minimized the risks. Full disclosure of the information from both practitioner’s scope of practice and duty to the 16 patients is necessary (American College of Nurse Midwives, 2012; American College of Obstetricians and Gynecologist, 2013). Step two is concerned with identifying the alternatives. Essentially there are three alternatives in this situation; the physician discloses the information, the CNN discloses the information, or no further information is given to the couple.

Nondisclosure of the information is not an option in this case as it is necessary for the couple to possess relevant and current scientific information to make an informed decision (American College of Nurse Midwives, 2012; American College of Obstetricians and Gynecologist, 2013). The third step of the model is to evaluate the alternatives. The physician is responsible for providing information for informed consent (Grant & Ballard, 2011).

Causes of Teenage Pregnancy

As a result, she has an unwanted pregnancy. She is angry with her mother because she didn’t do anything to protect her. People In society are misjudging her. Yah-yah is frustrated and on the verge of seclude. Teenage pregnancy has been a phenomenon since biblical ages. Dry. Michelle Golden stated, The united States has the highest teen pregnancy rate In the industrialized world. There are 750,000 teen pregnancies annually. The Caribbean has not escaped this plague.

A study done by a fourth year medical student at the university of the West Indies reported that pregnant unmarried teenagers form the biggest single social problem in Jamaica. From the study it was concluded that teenagers were responsible for 16% of the total births in Jamaica, I. E. For some 9,300 babies. There are many factors contributing to the high incidence of early pregnancy: (1) Lack of Parenting Guidance; (2)Lack of basic education; (3) Inadequate knowledge about safe sex (4) Exploitation by older men. Firstly, the root cause of teenage arrogance is the lack of parenting guidance.

Often times, parents do not permit their children to talk about sex. Also some parents go far as providing their children with false Information about sex. For instance, the child may ask “Where do babies come from? ‘ The mother may reply, “Babies come from the sky. ” The lack of parenting guidance In relation to educating their children about sex was Illustrated In a study conducted in Jamaica by S. S Goode. Goode found that only 45% of his sample claimed to have had any sex education at home. S. S Goode also contended that mom girls was so eager to obtain information that they read books.

One girl reported that her mother explained to her about menstrual cycle, after it had begun. It is important to note, that information about sex is gathered outside the home by children. Sources where information are gathered includes book, magazines, and the cinema, discussion with friends or overhearing adult conversations. In S. S Goodness study it was stated that nearly one-third were of the opinion that school was the proper place for providing sex education but the majority however was In the favor of mom. The present relationship between parents and children do not provide adequate Information about sex.

Thus, children are experimenting with sex without being aware of the likely implications. Secondly, lack of basic education may lead to teenage pregnancy. Shirley Clarke interviewed a total of 40 teenaged unmarried mothers between the ages of 14 and 20. Though all of the girls questioned by Clarke had attended primary school at some time, the majority had left school, mainly for economic reasons. Only 17% had attempted to extend their education. The lack of a DOD basic education makes these girls venerable as they may become dependent on older men to satisfy their economic needs.

In many instances, the older man expect a returned “favor” from the girls. As a result, the girl may become pregnant. The lack of a good basic educations means that adolescents have not had the benefits of school influences In helping them to develop other moral values. Also they have acquired few Interest to fill their leisure time. The girls In Clarke sample reported few Interests. Clarke stated that reading, sewing and going to the cinema appeared to be Nell mall occupations. 2 gave sleeping as one AT tenet noodles.

In most Instances, girls who has experienced pregnancy are unable to attract Jobs because they lack the basic qualifications. Thus, the unemployment rate continues to be high among this group. Additionally, in America, more than half of the nation’s high school students have sex, reported the center for disease control in 1992. An increase in the number of sexually active teens appears with each grade: 40 percent at grade 1 1, and 72 percent at grade 12. Nineteen percent of all high school students and 29 percent of noirs reported having had four or more sexual partners.

The reports of sexually active teens is quite alarming but however what is more alarming is that most adolescents do not know about safe sex. As a result, they probably have no access to traditional methods of preventing unwanted pregnancies. Furthermore, another leading cause of teenage pregnancy is sexual exploitation by older men, as you saw in the skit. Rape and sexual exploitation causes unwanted early pregnancies. In Grenade, forty five percent of households are female headed, in cases, teenage girls vying in these households may desire a male figure to show them love in absence of their fathers.

As a result, teenage girls dating older men are more likely to become pregnant before they reach womanhood. Lastly, by nature humans are sexual beings, as a result, we tend to sexually express ourselves through the medium of sex. Therefore, it is important that social institutions such as the family, the church, the education system, the law system et al, take actions to prevent teenage pregnancy. Parents or Guardians should not evade their children from participating in sexual concussions. They should try as much as possible to impart information concerning sex to their children.

The education system should take the task upon themselves to provide sex educate to students. The church is one of the oldest institutions in society and its function has declined in recent times. With society becoming more secularists it is important for the church to develop new strategies to appeal to adolescents about controlling their sexually urges (the ideal of premarital chastity is not fully accepted by adolescences) instead of Just preaching summons about the immorality of having sex before marriage.

Today, Planned Parenthood advocates wants the removal of laws requiring parental consent as notification for girls under the age of eighteen to have an abortion. This step may not be the best solution as a Christopher Health and Development study revealed Forty-one percent of women had become pregnant on at least one occasion prior to age 25, with 14. 6% having an abortion. Those having an abortion had elevated rates of subsequent mental health problems including depression, anxiety, suicidal behaviors and substance use crosiers.

Many people hold the perception that giving adolescents contraceptives encourages them to have sex but the numbers of teens having sex without contraceptives is alarming as you heard earlier, as a result, the legal system should implement laws to allow parents to give their children contraceptives to not only prevent unwanted pregnancies but also Studs. In closing, we hear the proverb the youths are the future of tomorrow’, therefore the traditional institutions needs to curb the phenomenon of teenage pregnancy, as it can Jeopardize social order in society.