Adolescent Health Flashcards by Alicia Daum

Types of Biologic Maturation During Puberty

Growth in stature
Development of secondary sex characteristics
Achievement of fertility

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Changes in Body Systems During Puberty

Neuroendocrine axis
Bone size & mineralization
CV system

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Onset of Puberty

Critical body weight or composition

Leptin for progression of puberty & produced by adipocytes

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Stage 1 of Sexual Maturity

Preadolescent pubic hair, breast, penis, testes

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Stage 2 of Sexual Maturity

Pubic hair: sparse, long, lightly pigmented
Breast: bud, breast & papilla elevated, increased areolar diameter
Penis: slight enlargement
Testes: enlarged scrotum, pink, texture roughened

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Stage 3 of Sexual Maturity

Pubic hair: increased pigmentation, more curly
Breast: enlarged breast & areolar
Penis: increased length
Testes: increased size

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Stage 4 of Sexual Maturity

Pubic Hair: adult type
Breast: areola & papilla form secondary mound
Penis: glans enlarged, increased breadth
Testes: enlarged, darkened in color

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Stage 5 of Sexual Maturity

Pubic hair: adult distribution spread to middle thigh
Breast: nipple elevated
Penis: adult size
Testes: adult size

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What are the “perils” of puberty?

Anemia
Gynecomastia
Acne
Psychological functioning
Musculoskeletal injuries
STI's

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Define Delayed Puberty

Absence or incomplete development of secondary sexual characteristics by an age at which 95% of children of that sex & culture have initiated sexual maturation

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Primary Delayed Puberty

Due to hypogonadism and/or defects in their receptors on the membrane of the gonadal cells

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Secondary Delayed Puberty

Gonads intact
Problem with secretion of LH, FSH, or GnRH
Defects due to hypopituitarism, hypothyroidism, or hyperprolactemia

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What is Adolescence for?

Exploring their environment
Coping with change
Testing boundaries
Developing independence

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Primary Values for Adolescents

Freedom
Fun
Friends

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Goals of Adolescence

Become independent from parents
Develop workable value system
Become comfortable with bodily changes
Build meaningful relationships
Begin establishing economic independence

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Normal Teen Behaviors

Express opinions
Test limits
Take Risks
Experiment
Develop abstract operations

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Define Abstract Operations

Widened scope of intellectual activity and an increased capacity for insight

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Top 5 Causes of Mortality in the Adolescent Population

MVA
Homicide
Suicide
CA
Heart disease

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Adverse Health Outcomes in the Adolescent Population

Alcohol use
Drug use
Tobacco use
Sex
Sedentary lifestyle

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Establishing Rapport with Adolescents

Provider must like adolescents
Avoid surrogate parent role
Avoid adolescent role
Act as an interested &amp; caring advocate
Listen carefully and see clues
Instill responsibility

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Confidentiality in Teens

Critical for teens
Establish parameters of confidentiality
State you will alert parents if suicidal or homicidal thoughts
Attempt to meet with teen alone
Stress responsibility for their health

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Immunizations for Adolescents

Varicella vaccine
Tdap
Meningococcal vaccine
Gardasil
Hep B
IPV
MMR

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Screening for Adolescents

HTN
Obesity
Eating disorders
Hyperlipidemia or metabolic syndrome
TB
Abuse
Learning/school problems
Substance use
Depression
Risky sexual behaviors

Anticipatory Guidance in Adolescents

Healthy diet: calcium
Safe weight management
Exercise
Minimize TV &amp; video game time
Responsible sexual behaviors
Avoidance of alcohol, tobacco, &amp; other abusable substances
Family involvement

What does HEAD stand for in regards to screening adolescents

``` H: home, habits E: education, employment, exercise A: accidents, ambition, activity, abuse D: drugs, diets, depression S: sex, suicide, sports, shots ```

Developmentally Oriented Approach to Adolescents

``` Body image Peer relationships Independence Identity Sexuality ```

Questions to ask for Body Image in Oriented Approach to Adolescents

Questions or problems with physical changes? What would you change? Periods, wet dreams, changes in breasts or pubic hair

Questions to Ask for Peer Relationships in Oriented Approach to Adolescents

Best friend? # close friends? Activities participate in? Fun?

Questions to Ask for Independence in Oriented Approach to Adolescents

Get along with parents? What issues for family arguments? Privacy respected at home?

Questions to Ask for Identity in Oriented Approach to Adolescents

Satisfied with life? Changes in life & why? Working?

Alcohol Abuse in Adolescents

``` When? Where? How much? Parental drinking? DD used? ```

Substance Abuse in Adolescents

``` Hardest to stop when start between 10-15 Easily addicted Cessation aids necessary #1 cause of preventable long term health consequences "Ugly side" to advise teens ```

Illicit Drug Use/Abuse in Adolescents

``` Marijuana Cocaine Opiates Stimulants Hallucinogens ```

Questions to Ask for Sexuality in Oriented Approach to Adolescents

Dating? Serious SO? Questions/concerns about sexual activities, contraception, STIs or pregnancy?

How to get answers of sexuality from teenagers?

``` Open ended questions Range of sexual activity Explicit questions Sexual matters Risk prevention Condoms Oral contraceptives, Depo-Provera, Patch ```

Options for Adolescent Sex Life

``` Dating behavior Heavy petting Masturbation Mutual masturbation Oral sex Vaginal sex Anal sex ```

Sexual Orientation of Adolescents

``` Homosexual Bisexual Transsexual Straight Gay ```

STI's and Adolescents

``` Gonorrhea Syphilis HIV of concern Chlamydia HPV Herpes Trichomonas ```

STIs and Prevention in Adolescents

Abstinence | Condoms

Which STIs do condoms prevent most?

Gonorrhea Chlamydia HIV Trichomonas

Types of Sports Injuries

``` Sprains Fracture/dislocations Lacerations Contusions Head injuries Other injuries Overuse ```

Types of Eating Disorders

Anorexia nervosa | Bulimia nervosa

Eating Disorder Statistics

90-95% female Puberty related Excel in Sports Type A personality

Co-morbid conditions with Eating Disorders

Rape | Depression

Some Reasons for Eating Disorders

``` Lower self esteem Sense of personal ineffectiveness Difficulty with causation, conflict resolution, separation of families "Thin is best" Popular Over concern with bod shape Calorie obsession Age 15-20 ```

Red Flag of Eating Disorders

Weight loss >10% of previous weight in clinic

Consider Anorexia When...

Refusal or inability to maintain weight Intense fear of gaining weight Distortion of perception of body 3 consecutive periods missed

Physical Findings in Anorexia

``` Hypothermia Bradycardia Bradypnea Hypotension BMI below 5th percentile Russell's sign Appear depressed ```

Define Russell's Sign

Erosions of inside of front teeth from vomiting

Define Bulimia Nervosa

Recurrent episodes of binge eating followed by vomiting, laxatives, diuretics, strict dieting 2 binge episodes/week for 3 months

DSM-V Criteria for Anorexia Nervosa

Restriction of energy intake Intense fear of gaining weight Disturbance in one's body weight/shape

Treatment of Eating Disorders

Team approach: pediatrician/internist, nutritionist, counselor Long term plan: intense inpatient with maintenance

Define Emancipated Minor

``` Married Living independently Has children Serves in military Varies by state ```

Define "Mature" Minor

Health provider's assessment of an adolescents maturity to make their own health care decision Generally age 15-16

Title X of the Public Service Health Act

Must provide confidential family planning | Other funds: treatment for other sensitive health needs

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Adolescent Health Flashcards

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