Julia Brown

LW is a 20 year old college student who comes to the university health center for
a pregnancy test. She has been sexually active with her boyfriend for 6 months
and her menstrual period is now "a few" weeks late. The pregnancy test result is
positive. The patient beings to cry and says "I don't know what to do".

1.) How will you begin to counsel LW?

Let her know that she is not alone, and offer her a tissue and water and calm her down.

2.) What information do you need to obtain from LW and why?

Obtain the last date of her period, if the boyfriend is STI free, how many sexual partners
she had, the last STI test she has had, if she has any bleeding disorders or chronic
illnesses.

3.) What options does a woman experiencing pregnancy have?

The woman has many options, she has the options to follow through with the
pregnancy, adoption, and to terminate the pregnancy

4.) If you role is to assist her in making a choice, what information will you want
LW to provide?

My job is to provide her with information about pregnancy, counselings, and financial
resources. If LW wants to terminate the pregnancy, I will provide information about that.

5.) What are the nurse's moral and ethical obligations in this situation?

The obligation I have is to put LW health, well-being, and safety above all.

6.) LW asks you to tell her about elective abortion. What information will you
share?

Elective abortion is when the pregnancy is interupted before the 20th week.

7.) You tell LW about two forms of abortion, medical abortion and vacuum
aspiration. How would you explain the differences to her?

A medical abortion is when the pregnant woman takes a series of medications to

terminate the pregnancy and is most effective during the first 4-9 weeks of gestation.

A vacuum aspiration is when a doctor puts a suction machine into the vagina and uses
suction to empty the uterus.
8.) What are the contraindications to using mifepristone (Mifeprex) for a medical
absorption?

Contradictions include: an ectopic pregnancy, adrenal failure, long-term corticosteroid

use, bleeding disorders, and allergy

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?

Remind her that abotion is a medical treatment and should not impact the ability to get
pregnant in the future

10.) LW asks you "Do you think abortion is killing?" What is you response?

I would say it is a necessary medical treatment for some women, and not give a biased
response

11.) What types of emotional reactions do woman experience after an elective

abortion?

Guilt, as the thought they are ending a life. Fear, about a medical treatment. Confusion

12.) LW wants to know about adoption. What will you tell her?

Adoption is a legal agreement that after birth, the child will be taken care of by another
family or person. I would give her information about adoption agencies

13.) You ask LW if her boyfriend is aware of the possibility she was pregnant. She
tells you that she did not tell him about her late period or her visit to the health
clinic today. She is afraid he will "freak out". How should you respond?

I would ask her if the boyfriend has been abusive in the past. I would tell her that her
emotions are valid, because this was not planned. If the boyfriend has been abusive, I
would contact authorities for her so she is protected.

14.) LW says she is uncertain as to what to do and wants to know how long she
has to decide. How will you respond?

Most doctors do not perform abortions after the 12th week. Only in rare cases will the
doctor assist the abortion.