teen pregnancy and family denial

[pedspnp]

This is my first month as a PNP and yesterday I had a 17 year old in who was complaining of lower back pain, that radiated to her leg, hmm I thought could be sciatica which is not unheard of in this age group but not common, could be a UTI, or Pylonephritis or a number of other things, I know in school we are told to look for the most obvious cause, but something told me to ask" any possibility you are pregnant the guardian replied no she does not go any where,but school the pt also denied the possibility of pregnancy, since I was running a UA I had the nurse run a pregnancy test well the test came back positive, since the girl was a minor i had her come to the office to discuss the results when i told her she was pregnant she replied how did that happen, my response was well are you sexually active she replied not since last year , come to find out last year was December and had no idea when her last period was, she decided to tell the guardian with me present, the guardians response was that is not possible she does not go any where but to school, by this time i am thinking oh now what, so i decided to have a quantitative HCG done explaining there was always a possibility of a false positive, they still insisted that there was no way she was pregnant, well they left and had the HCG done, which was positive, they then still insisted that she was not pregnant, went to the er and had an ultrasound done which indeed confirmed the pregnancy and also a ovarian cyst, I am so glad i acted on my gut, my supervising MD felt i should just treat her for a sciatica and follow up when I told my supervising MD she was like wow good call it made me feel good but I feel so sorry for that patient I hope she gets the prenatal care she needs :redbeathe

[traumaRUs, MSN, APRN]

This is always a touchy subject. I've had to tell girls too that they were pregnant (I work prn in an ER) and rarely is it a joyful experience. I do leave the girls with written material about prenatal care and resources in our area for prenatal care, assistance with clothing, etc..

I think you did the right thing.

[BabyLady, BSN, RN]

Many my disagree with this, but I would follow-up with the patient and if they are still in denial, I would wager that a social services consult may be necessary to make sure she is able to accept that she is pregnant and that her family does too.

Our county does an automatic social services consult on all teen pregnancies...just to make sure it wasn't a case of rape, statutory rape, abuse in the home and that the baby is being taken care of....not so much a case of ongoing monitoring like you would find in a possible neglect case, etc.

[txspadequeenRN, BSN, RN]

parents need to wake up...i got my wake up call when i too thought my child was not sexually active ...then i got the call from school telling me that she was caught in the bathroom at school having sex...my daughter was not pregnant thank the good lord....i hope the girl gets the care she needs and this experience will show others that they need to open their eyes at all the possibilities.....