Emergency department

QUESTION Momo is a registered nurse working in the emergency department of a hospital operated by Queensland Health. A teenager named Olivia presented at the hospital with her mother. Olivia is 17 years old and will turn 18 in two months. When Momo assessed Olivia, she noted that Olivia had an elevated body temperature and a suspected urinary tract infection. Olivia’s mother consented to a urine test. It was determined that Olivia should remain at the hospital for further observation and treatment for her urinary tract infection. Olivia’s mother then left, apologising that she had to leave for the day to go to work. The results of the urine test also revealed that Olivia was pregnant. Momo asked the Olivia if she knew she was pregnant and she responded that she did not. After speaking with Olivia about the pregnancy, Momo noted that Olivia is a mature and thoughtful young woman and that she seems to fully understand her options in terms of continuing with the pregnancy or seeking a termination. When Momo asked Olivia about the baby’s father, Olivia looked embarrassed, became very upset and said it is a boy from school. Momo suggests that she tell Olivia’s parents and, together, they can work out how things should progress, but Olivia looks horrified and refuses. When Momo asks why, Olivia says: If you tell Mum, she will just cry. And Dad will kill me. Look what he did when I broke a glass the other night! It doesn’t matter anyway; the pregnancy won’t be a problem much longer. Olivia lifted her shirt sleeve to reveal a nasty haematoma on the inside of her arm. Momo also noticed some swelling around Olivia’s left eye. When she asked how she hurt her eye, Olivia just shrugged and put her head in her hands and said please don’t tell anyone. Momo is very concerned about Olivia’s welfare. Momo is unsure whether she should raise Olivia’s pregnancy with her mother and whether she should take any further action about Olivia’s bruising.

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