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School nurses face ethical and legal challenges while working with teenagers because of issues associated with supporting young pregnant females and disclosing important information to parents. This paper aims to discuss the case of Lucie, a 17-year-old student who has type I diabetes and whose pregnancy test is positive. Furthermore, Lucie needs consultation regarding alcohol consumption when being dependent on insulin. This paper provides the answers to questions on the disclosure of confidential information to parents, the consultation regarding alcohol consumption and insulin, alcohol, and pregnancy, type I diabetes and pregnancy, as well as resources available to pregnant teenagers in Florida.
School Nurses’ Communication with Teenagers and Parents
After conducting a pregnancy test and taking positive results, it is important to inform Lucie regarding a possible pregnancy in the most accurate manner, while accentuating support and respect for the student. Final decisions can be made only after completing the gynecologic examination and taking a blood test. Lucie should be informed that she has a right to decide regarding her pregnancy continuation. It is important to note that school nurses are not prohibited from disclosing information about pregnancy to teenagers’ parents, but they are limited by confidentiality rules (Grubbs, Muro, & Clements, 2016).
Therefore, a nurse should encourage Lucie to inform her parents about her pregnancy and take all necessary assessments under their control. Nurses should act as advocates for students if they think that parents will negatively react to the news.
Diabetes and Alcohol, Pregnancy and Alcohol, Pregnancy and Diabetes
The nurse should inform Lucie about the risks associated with consuming alcohol when being dependent on insulin. Alcohol can provoke changes in blood sugar and cause complications. Although alcohol is not prohibited for individuals with diabetes, its effects can be dangerous for those patients who need insulin and who have a history of hypoglycemia, as it is in the case of Lucie (Azar & Lyons, 2013). Therefore, she should avoid consuming alcohol, even when monitoring her state. If she cannot avoid consuming alcohol, Lucie should have glucose tablets to control blood sugar levels.
While accentuating the fact that Lucie is pregnant, it is important to provide her with brochures that explain the effects of alcohol on pregnancy. The nurse should note that alcohol increases risks of miscarriage and premature birth, as well as further effects on a newborn’s health, including abnormalities. If a female has type I diabetes, pregnancy must be effectively monitored to avoid complications.
This information should be discussed not only with Lucie but also with her parents to make a reasonable decision regarding the pregnancy continuation after taking additional tests. Pregnant females with type I diabetes can require more insulin and control blood sugar levels and hypertension (Azar & Lyons, 2013). Insulin has no effects on a fetus, but high blood sugar can have significant negative effects.
Services for Pregnant Teenagers
After receiving the pregnancy test results, the nurse should provide Lucie with referrals to a gynecologist, a confidential prenatal care center, and specialists of adolescent pregnancy programs. In Florida, pregnant teenagers can use services provided by the Healthy Start program for pregnant females who are at risk of complications and who have certain problems to address.
Additional resources include Florida Medicaid for Pregnant Women, Women’s Resource Center and Medical Clinic, and Orlando Women’s Center. Specialists of the Medicaid program can provide consultation and assistance regarding insurance. Specialists of the Women’s Resource Center and Medical Clinic and Orlando Women’s Center can assist teenagers and their parents in planning the pregnancy continuation or abortion.
Conclusion
In the discussed case, the nurse should follow ethical and legal guidelines regarding the disclosure of information about teenagers’ pregnancy. The case of Lucie is complicated by the fact that she has type I diabetes. Lucie should be informed regarding the effects of alcohol on blood sugar levels and pregnancy, as well as regarding the effects of pregnancy on type I diabetes.
References
Azar, M., & Lyons, T. J. (2013). Management of pregnancy in women with type 1 diabetes. Minerva Endocrinologica, 38(4), 339-349.
Grubbs, L., Muro, J. H., & Clements, K. (2016). School counselors and nurses: Collaborative best practices for maintaining confidentiality with pregnant adolescents. The Practitioner Scholar: Journal of Counseling and Professional Psychology, 5(1), 20-31.
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