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M , 15 years of age, is 6 months pregnant, She states that she does not know “for sure” who the father is

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M , 15 years of age, is 6 months pregnant, She states that she does not know “for sure” who the father is. She comes to your clinic for her first prenatal visit. She says that she never uses condoms and has had two previous abortions. She acknowledges that she drinks alcohol (“only a few beers a day”) and “smokes weed once in a while.” Her weight is well below that expected for her height. She has a constant, hacking, and productive cough. She smokes two packs of cigarettes and drinks four to five cups of coffee each day. She has recently been living at the Salvation Army shelter in their “special needs” area. She has no contact with her family and does not know what immunizations she had as a child. She wants to have “a healthy baby” and plans to keep her child. She refuses to discuss chemical dependency treatment. What implications do alcohol, marijuana, and tobacco use have for M.’s general health and for that of her fetus? What are the social implications of her age and lifestyle? Describe your approach to this client. What nursing measures should you perform? What medical, laboratory, and other examinations or tests would you expect to be ordered? What disorders would you expect to be ruled out? What are the nurse’s legal obligations? What services could you offer to assist M. to learn parenting skills? What community resources might be available to assist with housing, medical care, education, financial support, and other needs for M. and her baby in your community? What is your personal reaction to this situation?