Question

Scenario:

A 15-year-old female is admitted to the hospital with a concussion after a biking accident. During the admission assessment, the patient confides in the RN that she doesn’t wear a helmet when she rides her bike. A nursing care plan has been developed using the NANDA-I nursing diagnosis Deficient Knowledge related to insufficient information about hazards of biking as evidenced by patient statement, “I don’t wear a helmet when I bike.” The outcome: The patient will verbalize the importance of wearing a helmet when biking before discharge.

Describe safety concerns related to this developmental stage.

Identify three (3) interventions that would help this patient achieve the outcome.

Include your rationale for each intervention.

If the outcome is not met, how will you change the plan of care?

Answer 1

The safety concerns related to adolescence include:

1. Violence: Violence is a leading cause of death in older adolescent males. According to WHO globally, 1 in 10 girls under the age of 20 years report experiencing sexual violence.

2. Alcohol and drugs:Harmful drinking among adolescents is a major concern in many countries. It reduces self-control and increases risky behaviours, such as unsafe sex or dangerous driving. It is a primary cause of injuries (including those due to road traffic accidents), violence (especially by a partner) and premature deaths. Drug use among 15–19 year olds is also an important global concern.

3. Injuries: Unintentional injuries are the leading cause of death and disability among adolescents. In 2015, over 115 000 adolescents died as a result of road traffic accidents. Young drivers need advice on driving safely, while laws that prohibit driving under the influence of alcohol and drugs need to be strictly enforced. Drowning is also a major cause of death among adolescents – 57 000 adolescents, two-thirds of them boys, are estimated to have drowned in 2015, and teaching children and adolescents to swim is an essential intervention to prevent these deaths.

4. Tobacco use: According to WHO, globally, at least 1 in 10 adolescents aged 13 to 15 years uses tobacco, although there are areas where this figure is much higher.

5. Depression and suicide: Depression is the third leading cause of illness and disability among adolescents, and suicide is the third leading cause of death in older adolescents (15–19 years). Violence, poverty, humiliation and feeling devalued can increase the risk of developing mental health problems.Building life skills in children and adolescents and providing them with psychosocial support in schools and other community settings can help promote good mental health.

Interventions:

1. Discuss with the patient the hazards of riding bike without wearing helmet, and the possibility of head injuries, emphasising the serious consequences of head injuries.

Rationale: It is important to teach the patient about the risks involved in not wearing helmet as she has no knowledge regarding those facts.

2. Encourage the patient to open up about possible reasons for not wearing helmet, explore the role of peer pressure.

Rationale: To explore the reasons for not wearing helmet as peer pressure is a common reason.

3. Discuss with the patient ways to overcome peer pressure, supporting her with positive feedback for taking steps towards safety.

Rationale: To find practical ways to deal with peer pressure and positive feedback would encourage her to take safety precautions.

If the outcome is not met, the plan of care can be modified by including parents, determining their attitudes towards safe driving and accordingly​ involving them in reinforcement of safe riding.