A preteen girl has come to the school nurse, crying.

After
calming the girl down, the nurse discovered she has started her
period.

Question 1: How should the nurse approach this?

1. Educate the girl about what a period is and how often

period come.
2. Console her by saying that it is a quiet normal that happens
to every girl.
3. Counsel her about what are the changes that may happens
to her body.
4. Teach her how to use and dispose the pads or tampons.
5. Tell her to keep track of her periods by using any app or
calender or dairy.
6. Explain to her that periods are the most significant
milestone of a female life.

Question 2: The child finally admits she does not want to be

a girl but feels she should be a boy. What should the nurse
do?

1. Ask the child to tell you more about this.

2. Proform a  mental status examination. 
3. Find out her likes and dislikes of being a girl as oppose to
being a boy. 
4. If her decision was related to her period explain to her that
it is normal to feel like this sometimes most woman want
to have a change of heart when they experience their
periods due to the signs and sumptoms that comes with it
and most times its as a result of mood swings . 
5. Share personal experience of when you also had the same
thought and what you have become since that thought. 
 6. Explain to her the beauty of being a woman. Try to tell her
that being a girl is a blessing. Try to explore everything
she have. Try to get her understand of what girls as oppose
to boys body parts and role they play; motherhood, unique
beauty, long hair everything.
7. Acknowledge how her existence in this world was a result
of her mom having her first period and the same for
everyone else.
8. Illustrate using diagram the changes in puberty a girl might
have. 
9. Educate the girl and her family especially mother about
her issues and concerns regarding being a girl.
10. The girl may be emotionally unstable or in a shock of
her first period. But it is quet common thing and is not a
major issue.
11. She might come through a range of physical
symptoms like sore breast and pimples. Period pain we can
suggest a pain reliever or educate on the use of a hot water
bag on her tummy.
12. Explain to her that there may be mood changes seen
before or during periods.
13. Encourage the family to give her more privacy and
space around this time is better to deal.

Question 3: What nursing diagnoses might the nurse use in

this case?

1. Anxiety related to fear of unknown process.

2. Difficient knowledge related to lack of exposure
3. Pain relating to uterine cramping from mentruation
4. Disturb body image related to early development of
secondary sex characteristics 
5. Health seeking behavior related to learning responsible
sexual practices. 
6. Fear related to the uncertainty of menstrual process
7. Coping ineffective related to changes in physiology of the
body
8. Disturbed personal identity uncertainty of stages of growth
or development