health clinic for a pregnancy test
L.W., a 20-year-old college student, comes to the university health clinic for a pregnancy test. She has been sexually active with her boyfriend of 6 months, and her menstrual period is now “a few” weeks late. The pregnancy test result is positive. The patient begins to cry, saying, “I don’t know what to do.”
1. How will you begin to counsel L.W.?
2. What information do you need to obtain from L.W. and why?
3. What options does a woman experiencing a pregnancy have?
4. If your role is to assist her in making a choice, what information will you want L.W. to provide?
5. What are the nurse’s moral and ethical obligations in this situation?
6. L.W. asks you to tell her about abortion. What will you tell her?
7. You tell L.W. there are two types of abortions, vacuum aspiration and medical abortion. How would you explain the difference to her?
8. What are the contraindications to using mifepristone (Mifeprex) for a medical abortion?
9. She tells you that she has heard that if a woman has an abortion, she might not be able to get pregnant again. How would you counsel her?
10. L.W. asks you, “Do you think abortion is killing?” What is your best response?
a. “Good question. What do you think about it?”
b. “A lot of people think this is what an abortion is.”
c. “Absolutely not. What happens with pregnancy is a woman’s choice.”
d. “I am not able to answer that question. Are you uncertain about abortion as an option?”
11. What types of emotional reactions do women experience after an abortion?
12. L.W. wants to know about adoption. What will you tell her?
13. You ask L.W. if her boyfriend is aware of the possibility, she was pregnant. She tells you that she did not tell him about her period being late or her visit to the clinic today. She asks you if she should tell him because she is afraid, he will “freak out.” How should you respond?
14. L.W. says she is uncertain as to what to do and wants to know how long she has to decide. How will you respond?
15. L.W. declines an examination and says she needs to “think about all this.” She does make an appointment to return in 1 week. What teaching do you need to provide L.W. about how to care for herself in the meantime? How will you respond?
