Felicia Walker Is A 14-Year-Old Female Who Presents To Your ✓ Solved
Felicia Walker is a 14-year-old female who presents to your school
Felicia Walker is a 14-year-old female who presents to your school-based teen clinic. She is complaining of daily stomachaches for the past several weeks. She states that she has been complaining about them but everyone tells her it's just stress from moving and it will get better after she makes some friends. Felicia is new to your school this year and her record notes that she frequently misses her first class of the day. She lives with her aunt and uncle, who are her legal guardians. You ask her more information such as her living arrangements, how things were at her previous school, whether she likes this school.
Felicia states that if she eats something it is better, but if she gets hungry it's worse. As you discuss her symptoms more, she relates that she is often late in the morning because she's been so tired recently. She states she's feeling better and doesn't want to miss her next class. Your next step is to ask her to come back another time to discuss her symptoms and issues further with her since she's opening up.
Felicia comes back during her lunch break. You find out that she is also worried because she has not had her period since moving in with her aunt and uncle 3 months ago. She likes living with them but they are very religious and are at church three or four times a week. As you talk with her more, you find she was removed from her mother's care due to drug use, and her mother's boyfriend was found to have drugs in the home. She says she's glad to be away from him because he's a "pig." You ask Felicia why she called her mother's boyfriend a pig, and she explains that he smells like one. Upon further discussion, she tells you that he would come into her room at night and touch her. She is reluctant to go further with this conversation and starts crying. To gain more information, you reflect on and clarify what she has told you, and you ask if this is one reason she is concerned about stomachaches and missed periods.
Upon additional questioning, Felicia says she is concerned that's why she hasn't gotten her period and just thinking about it makes her nauseous. She says she can't sleep at night because she thinks her aunt and uncle won't want her if they know. You do a urine pregnancy test and the result comes back positive. She states she doesn't want this baby in her. You find out that the mother's boyfriend is 40 years old, and Felicia feels safer now that she's in a different city than him.
Considering these factors, you also need to address ethical dilemmas and the laws regarding mandated reporting and a teen's autonomy in making reproductive health choices.
Ethical Considerations in Mandated Reporting
As a mandated reporter, your primary responsibility is to protect Felicia's welfare. This includes reporting any suspicions of abuse or neglect to the appropriate authorities. The implications of this case are profound. Felicia's experience of sexual abuse from her mother's boyfriend poses significant ethical and legal challenges that must be navigated carefully (Gilbert, 2012).
Psychological Issues
Felicia's psychological state raises concerns. She is experiencing stress, anxiety, and fear of abandonment from her aunt and uncle. These psychological factors can exacerbate her physical symptoms, including stomachaches and the delay in her menstrual cycle (McLean, 2018). Addressing her mental health is crucial in her treatment plan.
Physical Issues
Physically, Felicia's daily stomachaches and missed periods are manifesting symptoms that might connect to her psychological trauma and stress. The positive pregnancy test adds a layer of complexity, necessitating discussions around her reproductive rights and the implications of her situation (American College of Obstetricians and Gynecologists, 2021).
Financial Issues
Financial considerations are also crucial, particularly regarding her access to healthcare and potential pregnancy termination services. Difficulty in affording these services can influence her decision-making process regarding the pregnancy (Freedman et al., 2016).
Differential Diagnosis
The differential diagnosis should include anxiety disorder, gastrointestinal issues like irritable bowel syndrome (IBS), pregnancy complications, and potential post-traumatic stress disorder (PTSD) related to the sexual abuse she experienced (Lindley, 2019). The choice of diagnosis will focus on correlating the physical symptoms with her emotional and psychological distress.
Treatment Plan
1. Psychological Support: Felicia should be referred to a trauma-informed therapist specializing in adolescent trauma and abuse. This can create a safe space for her to explore her feelings in depth (Harris, 2020).
2. Medical Care: Immediate medical evaluation for her pregnancy to discuss options, including prenatal care or potential termination, which must be done considering her legal rights and health. In many states, minors have the right to seek health care without parental consent, which may allow her to make autonomous decisions regarding her pregnancy (Gonzalez et al., 2020).
3. Family Therapy: Engaging her aunt and uncle in this process could facilitate constructive dialogue regarding her fears and reinforce their support system while remaining sensitive to their religious beliefs.
4. Health Education: Providing information on reproductive health, her rights as a minor, and available resources. Ensuring she understands her options is key to empowering her during this difficult time.
Conclusion
Felicia's case demonstrates the complex interplay of legal, ethical, physical, and psychological issues when addressing adolescent health concerns. As a healthcare provider, it is crucial to navigate these aspects delicately, ensuring Felicia feels supported and safe while also adhering to legal obligations as a mandated reporter.
References
- American College of Obstetricians and Gynecologists. (2021). Care of Adolescent Female Patients. Obstetrics & Gynecology.
- Freedman, R. L., et al. (2016). Economic Factors Affecting Adolescent Women’s Access to Abortion Services. Journal of Health Economics.
- Gilbert, R. (2012). The Role of Mandated Reporting in Child Protection. Child Abuse & Neglect.
- Gonzalez, R., et al. (2020). Legal Rights of Minors in Reproductive Health Decisions. Health and Human Rights Journal.
- Harris, M. (2020). Addressing Trauma in Adolescents: Creating Safe Spaces. Journal of Adolescent Health.
- Lindley, L. (2019). Managing Anxiety and Stress in Pediatric Patients. Pediatrics.
- McLean, C. P. (2018). The Psychological Impact of Physical Symptoms Among Adolescents. Pediatric Anxiety Journal.
- National Institute of Mental Health. (2021). Anxiety Disorders in Adolescents. NIMH.
- Office on Women's Health. (2019). The Importance of Reproductive Health Access for Teens. U.S. Department of Health & Human Services.
- World Health Organization. (2020). Guidelines for Adolescent Health Services. WHO.