Emergency Nursing Care for a Teenage Parturient Using Methamphetamine, Srisatchanalai Hospital: A Case Study

Abstract

This case study examined a teenage parturient using methamphetamine who received services at Srisatchanalai Hospital, Sukhothai Province. The objectives were to assess her health status and formulate nursing diagnoses; to plan and deliver nursing care using the nursing process across four phases (antenatal, emergency, labor, and postpartum with follow-up), with emphasis on the emergency nurse's role in screening, risk assessment, and inter-departmental coordination; and to evaluate nursing outcomes and draw lessons learned. The study was conducted from October 2025 to June 2026, a total of 9 months. The case was selected purposively. Data were collected from medical records, interviews with the patient and her guardian, observation, and physical examination, and analyzed by content analysis based on a risk assessment and screening framework, the nursing process, and the concept of continuity of care and referral system. Trustworthiness was ensured through data triangulation and expert review.

          The case was a 16-year-old Thai primigravida who attended her first antenatal visit at 11+5 weeks of gestation. Her urine amphetamine test was positive, her ASSIST V2 score was 16, she had mild depression (9Q = 7), and a history of a previous suicide attempt; she was referred to the mental health and drug abuse service on the same day. Seven nursing diagnoses covering all phases were identified. She stopped using methamphetamine from the second antenatal visit, and her urine tests were negative from November 17, 2025 until delivery. Her 9Q score decreased from 7 to 3 at the fourth visit, with no recurrence of suicidal ideation. She visited the emergency room once with acute anxiety caused by a family conflict; her symptoms subsided within 35 minutes and she was safely discharged. She had a normal vaginal delivery of a female infant weighing 2,640 g without severe complications. Nursing outcomes were fully achieved for six of seven diagnoses and partially achieved for one (readiness for the maternal role), as she remained worried about child-rearing costs. Key lessons were screening at the first point of entry into the system, continuous cross-departmental care, the emergency nurse acting as a system junction with sensitivity to psychological risk, and non-judgmental care that builds trust.