Adolescent Flashcards
What are 5 examples of motivational interviewing techniques
- open ended questions
- reflective listening
- affirmations
- summary statements
- eliciting change talk
what does harm reduction mean
reducing harm associated with a negative health behavior rather than requiring complete abstinence (methadone programs, sale injection sites, OCP/condoms)
what are 3 approaches to prevent risky behavior
- primary prevention (abstinence)
- behavior reduction (reduce frequency)
- Reducing harm associated with behavior (condom use, STI screening)
what are the most common reasons for hospital admission for adolescents? (2)
unintentional injury
mental health issues
what is a mature minor
decision making based on understanding of individual and ability to foresee consequences of their decision (understand risks/benefit of a treatment)
all competent teens have the right to have health info kept private from others if they wish (excluding issues of safety)
what is the biggest complaint for adolescents who are hospitalized
lack of privacy
- more comfortable on peds ward than adult ward
what are the 5 principles for transition planning?
- adolescent involvement in management of health condition
- adolescent and family understanding of the condition
- understanding of personal potential for activity, education, recreation
- completion of adolescent developmental tasks
- attainment of self esteem and confidence
Goal: uninterrupted, coordinated, developmentally appropriate healthcare before and during transition
start discussion at age 10-12
what are 5 strategies for preparing a teen for transition
- see them without parents for part of appointment
- provide reading material specific to youth medical conditions
- peer support meetings to connect teens
- family/teen education days to discuss transition
- a formal “graduation”
- transition letter explaining what to expect
What percentage of teen pregnancies will have another pregnancy within 2 years?
35%!!
you should provide contraception counseling
List 5 groups that are at risk of unprotected intercourse
social and family difficulties child of a teen mom history of sexual abuse early puberty frequent school absences siblings with teen pregnancies use of tobacco, alcohol or other substances living in group homes, detention centers, street-youth
Are adolescents with chronic health conditons asexual?
NO!! this is a myth
sexual health often overlooked, may even be more sexually active than peers
2x more likely to be sexually abused
What are 6 signs of opioid withdrawal/ 1 for benzo
- depression
- myalgia
- nausea
- chills
- autonomic instability
- diarrhea
- risk of seizures
what are 4 physical consequences of dieting
- nutritional deficiencies
- growth deceleration
- menstrual irregularity
- osteopenia/osteoporosis
what are 5 psychological consequences of dieting?
- distractibility, irritability, fatigue, binge eating
- creating lifelong dysfunctional eating habits
- poorer self esteem
- development of an eating disorder
- may have excess weight gain over time
What are some factors associated with dieting and unhealthy weight control behaviours in teenagers
Individual factors
Female Overweight and obesity Body image dissatisfaction and distortion Low self-esteem Low sense of control over life Psychiatric symptoms: depression and anxiety Vegetarianism Early puberty Family factors
Low family connectedness Absence of positive adult role models Parental dieting Parental endorsement or encouragement to diet Parental criticism of child’s weight Environmental factors
Weight-related teasing Poor involvement in school Peer group endorsement of dieting Involvement in weight-related sports Other factors
Certain chronic illnesses, especially diabetes
Presence of other risk behaviors: smoking, substance use, unprotected sex
what is treatment goal weight
weight needed to support puberty, growth and development, physical activity and psychosocial functioning
- may consider TGW 2kg above weight where periods stopped
- can use BMI 50% for age if growth curve info not available
TGW= MINIMUM weight necessary for overall health
What two groups are associated with higher rates of smoking?
LGBTQ
indigenous children
What are 5 factors impacting the success of teens attempting to quit smoking
nicotine addiction mental health conditions drug and or alcohol use chronic illness family stress peer and family tobacco use overweight or weight preoccupation developmental drive to experiment fear of peer rejection perceived lack of privacy and autonomy
What are 5 factors that increase the success of teens attempting to quit smoking
older teenager male sex teen pregnancy and parenthood scholastic success team sport participation peer and family support for cessation CYP2A6 slow nicotine metabolizer
What is the 5 A’s method for counselling smoking cessation
Ask Advise Assess Assist Arrange
List 5 smoking cessation interventions in youth
Brief counselling Cognitive behavioural therapy Phone or distance counselling Mobile phone interventions Self-help, noninteractive audio-visual materials Nicotine-replacement products (12-18) Bupropion (not for eating d/o or seizure d/o) Varenicline
**e-cigarettes are not recommended
How should a firearm be stored
unloaded, locked and separate from its ammunition
From 2008 to 2012, among adolescents (15- to 19-year-olds), the majority (56%) of firearm deaths were what?
suicide
what are 4 interventions to prevent school shootings
Interventions = remove firearms from home, training for students and teachers to identify and report threats, address bullying in schools, provide mental health services for students.
Cannabis Use Disorder
CUD is defined as a problematic pattern of cannabis use leading to clinically significant impairment in areas of function or distress within a 12-month period
Usually, adolescents experience the following functional impairments: reduced academic performance, truancy, reduced participation and interest in extracurricular activities, withdrawal from their usual peer groups and conflict with family.
Cannabis withdrawal syndrome
CWS is defined by experiencing at least two of five psychological symptoms—irritability, anxiety, depressed mood, sleep disturbance, appetite changes
and at least one of six physical symptoms—abdominal pain, shaking, fever, chills, headache, diaphoresis—after cessation of heavy cannabis use.
Heavy cannabis use is defined as daily or near daily use for at least a few months.
Withdrawal symptoms commonly occur 24 h to 72 h after last use and persist for 1 to 2 weeks. Sleep disturbance is often reported for up to 1 month.
What are 5 factors that increase of smoking initiation
Older age at time of parental smoking cessation (if parents are ex-smokers)
Low socio-economic status
Peer and family influence, including lack of parental support
Misinformation about the health consequences of smoking
Easy access to tobacco products
Influence of marketing, exposure to tobacco promotions
Previous experimentation
Depression and mental health conditions
Poor school performance
Adverse experiences such as:
emotional, and physical or sexual abuse,
parental separation or divorce,
a household member who is substance abusing, mentally ill or incarcerated
substance abuse
what are the 5 A’s for smoking cessation
5 A’s for smoking cessation
Ask, Advise, Assess, Assist, Arrange
Disease-specific consequences of smoking in adolescents with chronic illnesses
Asthma- Increased frequency and severity of exacerbations, medication use, hospitalization and risk of respiratory arrest
Cystic fibrosis- Increased frequency and severity of bacterial lung infections and hospitalization; accelerated decline in lung function and lower nutritional status
Juvenile idiopathic arthritis- Greater disease severity, higher risks for cardiovascular disease and premature death, and exacerbation of osteopenia
Cancer- Greater risks from several cancer treatments, for respiratory infections when immunosuppressed, and exacerbated mucositis
Sickle cell disease- Increased risk of acute chest syndrome and possible increased risk of stroke
Diabetes mellitus- Accelerated cardiovascular and peripheral vascular disease, including atherosclerosis, retinopathy and nephropathy. Smoking increases the morbidity and mortality of type 1 diabetes by 50% to 75%.
Risks associated with second-hand smoke on children and other household members
Prematurity
Stillbirth
Sudden infant death syndrome (SIDS)
Effects on fetal brain development
Asthma, colds, pneumonia and ear infections (even when parents do not smoke indoors)
Acquired heart disease
Becoming smokers (even when parents tell children not to start)
Long term risks associated with second- hand smoke
Heart disease, chronic obstructive pulmonary disease, lung and other cancers
Infertility
Negative immediate effects of smoking
Bad breath
Yellow teeth
Harder to keep up during active games or sports
Smoking just a few times can get your body hooked so that it is harder to stop
Cigarettes are expensive. Smokers spend money on cigarettes that they could use for more fun things
Tobacco companies use ads to trick you into thinking that smoking is cool and safe
Smoking has long-term effects on health, including several types of cancer and heart attacks
It is illegal to buy cigarettes when you are underage
what are alternate forms of smoked tobacco (4)
cigar- Nicotine content may be up to four times that of a traditional cigarette
hookah- Use of black ‘air-cured’ tobacco
increases risk of esophageal cancer and Increases risk of communicable disease via the shared mouthpiece
bidi- Nicotine content is three to five times that of a traditional cigarette
kretek- Variable nicotine content
what are alternate forms of smokeless tobacco and risks
chewing tobacco- Associated with substantial risks
for gum disease, mouth cancer and oral sores
snuff- Risks similar to chewing tobacco
snus- Nicotine content is two to six times that of a traditional cigarette
dissolvable tobacco- Delivers anywhere from one-half
to three times the nicotine of a traditional cigarette, potential for nicotine toxicity
electronic cigarrette
what are some barriers to health care for street involved youth (5)
Lack of money
lack of transportation
lack of knowledge to access healthcare
Issues with trusting adults and confidentiality concerns
Need for health card or permanent address
HEEADSSS
Home, Education, Eating, Activities, Drugs, Sexuality, Suicide, Safety
Conduct a thorough HEEADSSS assessment, devoting specific attention to:
History of homelessness, current living situation (ie, shelter or housing program) History of domestic violence History of abuse Learning disorders and attention-deficit hyperactivity disorder At-risk behaviours, notably: substance use survival sex unprotected sexual intercourse or unprotected sex Involvement with the justice system: arrests probation recently incarcerated Mental health history Dental health Immunizations
what are important questions to ask on history taking for street involved youth
Do you consider yourself to be homeless or at risk of becoming homeless?
Where do you sleep?
Where does your daily food come from?
Do you feel safe?
Do you know one adult that you can depend on?
How do you get your money?
what are 3 things to ask to screen for a gambling problem?
frequency (at least once per week is threshold);
whether they tend to gamble more than planned (inability to respect personal limits);
behaviours suggesting they are hiding their gambling behaviour from others, such as lying
Health care providers should screen for gambling behaviours. These should be suspected especially when: (6)
parents express concern about their youth’s emotional health
academic performance seems to be suffering
there are sleep problems;
money or possessions in the home go missing or there is criminal activity such as theft
it is known or suspected that the adolescent is misusing substances
family relationships and friendships are impaired
Parental concern, Academic issues, Sleep issues, Missing money in the home, Substance abuse, Impaired social relationships
What are some reasons that children and youth with a disability or chronic health condition are at an increased risk of sexual abuse? (5)
Social isolation can make them more vulnerable to predators
May be seen as ‘asexual’ and not believed when they disclose abuse
Lack of sexual health education
May have weakness or lack of ability to verbally report abuse due to their condition
May tolerate a lesser degree of privacy given their daily needs
5 ways to prevent sexual abuse in children with disability
Screening of employees and volunteers Chaperoning for physical exams Supervised outings Promote patient privacy whenever possible Procedures for reporting suspected abuse
What is the most effective treatment for children and teenagers with AN
family-based treatment
how often should treatment goal weight be reassessed for children with AN
every 3-6 months
what are two of the strongest factors associated with smoking initiation in teens and adolescents
parental smoking
parental nicotine dependence
what are 4 ways to calculate treatment goal weight?
TGW based on prior growth (weight, height and BMI percentiles)
TGW based on weight at same percentile as height percentile
TGW based on median BMI (mBMI) for age
TGW based on menstrual threshold + 2 kg
