Adolescent Health Issues Flashcards
Adolescence: ____ through 20 years of age
12
Adolescence is a bridge from school age to ______
adulthood
_____ adolescence is 12 to 14 years?
Early
______ adolescence is 15 to 17 years?
Middle
____ adolescence is 18 to 20 years?
Late
The physical finding of adolescence:
a) This is a rapid change in the _____, skeletal, muscular, and cardiovascular systems
b) Secondary sexual characteristic development
c) Peak height velocity (PHV)- growth spurt
reproductive
The cognitive aspect of adolescence:
a) Sense of _______
b) Narcissism
identify
Well, Child Check (WCC) is composed of several components:
a) elimination (laxatives, diuretics)
b) developmental
c) Risk factors/ behaviors
d) _____ activities and reproductive issues: gender issues
e) Concerns and worries: current and recent stressors
f) Specific questions to ask when alone with parents
Sexual
Development of WCC include:
a) Mental/ emotional health
b) _____ performance and attendance; friends and relationships
c) Family functioning
d) hobbies and activities
e) work
f) stress, anger management, and coping skills
g) Injury to self or others
School
Adolescent Health of specific questions to ask when alone with parents:
a) Family _________ patterns and relationship
b) description of adolescent’s strong and weak points, attitudes, and behavior
c) discipline practices and response
d) specific concerns and worries about the adolescent
communication
Adolescent Health Objective date Physical examination:
Observation of the parent/adolescent interactions
1) Is the parent supportive of the adolescent?
2) Does the parent allow the adolescent to ____ questions?
answer
Physical examination includes:
1) Observe the parent/adolescent interactions
2) _______ ____ ____ (BMI)
3) Assessment for scoliosis
4) Tanner staging
5) Observe for STIs
6) Pelvic exam
7) Breast self exam (BSE)
8) Testicular self-exam (TSE)
Body Mass Index
Adolescence look for scoliosis (( until ___ years after PHV (Peak height velocity))
2
Ankylosis _____ symptoms often appear in early adulthood, caused by reduced flexibility of the spine and hunched forward curvature
Spondylitis
In adolescents with pelvic exams if sexually active you will see what?
irregular menses
What laboratory get from adolescents?
1) ______ as needed
2) Syphilis test (______), gonorrhea test (GC), chlamydia, and human immunodeficiency virus (HIV) if sexually active or history of sexual abuse
1) Hematocrit
2) VDRL ( Venereal disease research laboratory)
Pap smear if a pelvic exam is performed, begin at age ____
21
_______ function test if history of drug usage
Liver
_____ if indicated (family history dyslipidemia or premature cardiac disease (biological parents and or grandparents with cardiac event ( such as an MI) Prior to the age of ___ years
Cholesterol
55 years
Immunization with adolescents (completion of vaccine series):
a) Meningococcal vaccine
b) ______
c) Human Papillomavirus (HPV)
Tdap
Dental assessment and cleaning in adolescent every ____ months
6
The interview of the adolescent may use ____ and visuals
diagrams
May need to structure part of the _____ alone
interview
May not want to ____ in front of parent
talk
Encourage teenager for expression of ____ and concerns
feelings
Interview the adolescent while _____ clothed
fully
Maximize the interview:
a) adolescent is ________ seeking
b) Maybe rebellious
c) is often _______
d) is refining sex role and sexuality
e) trying to be independent
a) identity
c) inflexible
General Strategy for adolescent interview
a) ______
b) PACES
c) SAFETEENS
d) CRAFFT
a) HEADSS
HEADSS format
a) ________ environment
b) Emplyment and education
c) Activities
d) Drugs
e) Social
f) Sexuality
Home
PACES format
a) Parents, peers
b) _____________
c) Cigarettes
d) Emotional issues
e) School; sexuality
b) Accident, alcohol/drugs
SAFETEENS format
a) Sexuality
b) Accident, abuse
c) firearms, homicide
d) ________ (suicide/ depression)
e) Toxins (tobacco/alcohol, others)
f) environment ( school, home, friends)
g) exercise
h) nutrition
i) shots ( immunization status and school performance)
d) emotions
CRAFFT screening tool
a) Have you ever ridden in a ____ driven by someone (including yourself) using alcohol/drugs?
b) Do you ever use alcohol/drug to Relax, feel better, or fit in?
c) Do you ever use alcohol/drugs while you are Alone
d) Do you ever Forget things you did while using alcohol/drugs?
e) Do family or ** Friends** ever tell you that you should cut down on alcohol/drug use?
f) Have you gotten into Trouble while using alcohol /drugs?
a) Car
_______ in males may be caused by marijuana intake, anabolic steroids, alcohol, antidepressants, among others.
Gynecomastia
Vision and hearing screen at each visit
a) Visual acuity: ______; may alter with hormone surging
20/20
____ ___ each adolescent visit
Vital signs
Physical exam proceeds from ____ to ____
head to foot
___ ____ ____ (SMR) is obtained by taking the average from both Tanner stage rates (genital/breast + public hair development)
Sexual maturity rating
Secondary characteristics of a boy:
1) ______
2) Enlargement of scrotum and testes: scrotum roughens and reddens
3) Penis elongates
4) Penis enlarges in breadth and development of glans; rugae appear
Preadolescent testes, scrotum, penis
Breast Development in Girls:
1) Preadolescent breast
2) Breast buds with areolar _______
3) Breast enlargement with separate nipple contour
4) Areola and nipple project as a secondary mound
5) Alt breast: Areola recedes, nipple retracts
2) enlargement
Pubic Hair: For Males in females
1) Preadolescent
2) _____, pale, fine
3) Darker, increased amount, curlier
4) Adult in character but not as voluminous
5) Adult pattern
2) Sparse
____ reached: associated with Tanner staging
PHV
Progresses from “long and ___” to adult appearance (musculoskeletal development)
gangly
Female menses” _____ between breast development stages 3 to 4; predominantly at sage 4
Menarche
Males begin _____ emissions; spermarche occurs shortly after genial stage 3
nocturnal
The onset of puberty before age ____ in girls and 9 in boys is precocious puberty
8
Cognitive Development: Adolescent
1) Erikson’s identity vs. role confession stage
2) _______ abstract thinking stage
a) Cognitive ability progresses to adulthood
b) Younger adolescent daydreams; trouble staying
focused
3) As Adolescence progresses, becomes creative
4) Enjoys intellectual challenge
5) Use humor and formal thought
Piaget’s
Psychosocial development _____ ______: Adolescent
a) conforms to peer groups
b) characterized by parent/child conflict
c) expressed anger
Younger adolescence
Psychosocial development _____ _____: Adolescent
a) Less emotionally labile
b) continues to develop independence
c) re-established rapport with parents
d) more interested in the opposite sex
e) a better sense of self-esteem, confidence
Older adolescence
_______ guidance with adolescent partners remain as the primary influence.
Anticipatory
Discipline: Adolescent
a) _______ is essential; allow some flexibility on less important issues
b) Adults must be role models
Negotiation
Developmental Discussion/Guidance in adolescent
a) Parents remain as the primary influence
b) Discipline
c) _______ honesty
d) respect need for privacy
e) Be aware of television programming and internet activity
f) Expect histrionics in young adolescents
Reinforce
Nutrition/ feeding in adolescence:
a) nutritional requirements are _____ than adults
b) minimize “ junk food”
c) encourage regular meals
d) monitor ______ diets
e) discuss dieting
a) higher
d) vegetarian
Dental Health: Adolescent
a) Brushing after ______ and before bed
b) dental cleaning every 6 months
c) Encourage flossing
meals
Sexuality: Adolescent
a) Increased interest in the opposite sex
b) Established communication about sexually transmitted infections and HIV/AIDS
c) Prepare for body changes, ______, or nocturnal emissions
d) Give accurate information about sex, disease prevention, and pregnancy preventions
e) Gender identify issues
Menstruation
Preventive Health issues:
a) Mental Health (____ ___ ___)
b) Gange activity
depression and suicide
Developmental Warning sings: Adolescence
a) CHange in school performance, friendships, sleeping, or eating
b) Apparent ______ changes
c) Difficulty accepting failure
d) talk of suicide
e) withdrawal from friends or family
b) personality
_____ ___ is characterized by eating disturbances, weight loss, and refusal to maintain body weight at 85% of expected weight for height; amenorrhea ensues
Anorexia Nervosa
____ ___ is characterized by episodic binge and purge episodes
Bulimia nervosa
Nervosa cause is not clearly defined but is believed to arise from familial issues, social pressure ____ self-esteem, and a desire for control
low
Peak incidences are at age __ to 18 years for Nervosa?
14
Overall, mortality is as high as ___% as a combination of suicide and consequential death with Nervosa
10%
Signs and symptoms of Nervosa are:
a) weight loss
b) ______
c) amenorrhea
d) dry skin
e) constipation
f) low vital signs
g) lanugo
h) evidence of self- induced vomiting (tooth enamel erosion)
i) Changes in gums and erosions of tooth enamel
j) _____ sign: bruising knuckles
k) Nail discoloration
b) Anemia
J) Russell’s
Differential Diagnosis for eating disorder in an adolescent:
a) Organic disease-producing weight loss
b) _______
c) depression
d) substance abuse
Pregnancy
< 20% below ideal body weight
Mild malnutrition
< 30 % below IBW
Severe malutrition
<20 % to 30%, below IBW
Moderate malnutrition
Management of eating disorder involves?
a) _______ management
b) Behavior modification
c) Psychotherapy
d) may need hospitalization
Interdisciplinary
