QUESTION: "When visiting a family planning clinic, an 18-year-old nulligravida states that she and her fiance are planning their wedding but "don't want to become pregnant for at least 1 year." When planning to provide preconception counseling to the client, which of the following should the nurse do first before beginning the counseling?"
( O ) a.) Obtain a sexual history from the client in a private setting.
( X ) b.) Have the client and her partner undergo a complete physical examination.
( X ) c.) Ask the client to return to the clinic with her fiance in 1 week.
( X ) d.) Determine if the client has a history of genetic abnormalities.
RATIONALE: Before providing preconception counseling, the nurse must first obtain a sexual history from the client to determine the client's usual habits and needs. Only after the necessary information has been collected can the data be analyzed and plans formulated, implemented, and evaluated. Although a complete physical examination of the client and her partner may be warranted, this can be done later. At this point, involving the client's partner is not necessary. Asking the client to return in 1 week is inappropriate because it ignores the client's desire and need for information. At this point, involving the client's partner is not necessary. There is no need to discuss a history of genetic abnormalities until after the sexual history has been obtained. The client's sexual history is the priority. Once this obtained, further information can be collected about other pertinent aspects of the client's history. NURSING PROCESS STEP: Implementation CLIENT NEEDS CATEGORY: Health promotion and maintenance CLIENT NEEDS SUBCATEGORY: None
