adolescents Flashcards
Adolescent definition.
Bridge b/t childhood and adulthood
-ages. 10-20
early. 10-13
middle 14-17
late 18-20
Females grow an average of how many in after menarche?
2-3inches
Interview process with adolescents
-Establish trust
-diagrams and visual
-structure part of the interview alone
-be alert for cues that the adolescent doesn’t want to discuss certain. issues in front of parents
-HIPAAm adolescents right to privacy from parents regarding contraceptions and sexual activity
-encouraged to express feelings and concerns
-fully dressed
-HEADSS assessment for the adolescent
-Home, (living situation, who, where, how many rooms)
-Education and employment, (school. performance, empty,memt Hx)
-Activities, (church, hobbies, TV)
-Drugs, (personal use, family Hx)
-Sexuality, (orientation, pregnancy/. abortion, STIs)
-Suicide/ Depression, (any sleep disorder, appetite changes, Hx of suicide)
CRAFT screening tool for adolescents
Screen for alcohol, drugs use
-CAR
-RELAX
-ALONE
-FORGET
-FRIENDS
-TROUBLE
-have you ever. ridden in a car drive. ny someone or yourself using drugs/alcochol
-Do you. use drugs to relax
-do you do drugs alone
-do you. ever forget things when using drugs
-do family or friends. ever tell you to cut down on drugs
-have you gotten into trouble while using drugs and alcohol
Vaccinations for adolescent
Meningococcal Vaccine (series of two shots)
Tdap
HPB (boys and girls)
Dental assessment for adolescents
-cleanings every 6 months.
-encourage flossing
-brush after meals and before bed
Adolescent visual acuity
20/20
may alter with hormone surging
Adolescents Vital Signs
Vitals at each visit
Pulse: 55-85
Respiration: 12-18
BP: systolic 110-124
BP: diastolic 70-79
Assessment of the adolescent for scoliosis
Females: once at age 10 and once at age 12years
Males: once b/t 13 and 14years
-use Adams bend over exam
Laboratory test for adolescent
-Hematocrit: good for heavy periods
-Syphilis test: VDRL or RPR, gonorrhea (GC)/ Chlamydia (CT) from all sites (oral, anal, vaginal) and HIV if sexually active or Hx of sexual abuse
-Pap smears: begin at 21years of age
-Liver function test if Hx of drug use: street drugs and anabolic steroids
-Cholesterol if indicated: once at age 9-11 and again at age 17-21 years
(additional screening if DM, oversight/obese, family Hx of dyslipidemia and cardiac disease)
Adolescent male may experience gynecomastia if?
-marijuana intake
-anabolic steroid use
-alcohol
-antidepressants
Adolescents taught self-exam of what?
-testicular self exam
(perform return demonstration)
-takes 2 min
Tanner stages for boys
1-preadolescents tests, scotum, penis, - BABY
2-enlargement of scrotum and testes, scrotum roughens and redness
3- PENIS ELONGATES
4-Penis enlarges in breadth and development of glans, rug appear
5-adult shape and appearance- ADULT
Tanner stages for Girls
1-Preadolescent breast, -BABY
2-Breast buds with areolar enlargement
3 BREAST ENLARGEMENT WITHOUT SEPARATE NIPPLE CONTOUR
4-Areola and nipple project as secondary mound
5-Adult breast, areola recedes, nipple retracts -ADULT
Tanner stages, pubic hair
- preadolescent -BABY
- SParse, pale, fine
- DARKER, INCREASED AMOUNT, CURLIER
- Adult in character but not as voluminous
- Adult pattern -ADULT
Female monarch and which tanner stage?
Menarche 2-3 years after start of breast stage 2
Males begin nocturnal emissions and spermacch at which tanner stage?
Genital stage 4
onset of puberty before age 8 in female and before age 9 in males ?
Precocious Puberty
Cognitive theorist for adolescents
Erik Erikson
Identity vs Role confusion
ages 12-18y
Jean Piaget
Formal Operational (abstract thinking)
ages 12 and up
How to discipline an adolescent
Negotiation is essential
adults must be role models
Nutrition of the adolescent
-higher requirements than adults
-minimize junk food
-encourage regular meals
-monitor vegetarian diets
-discuss diets
Prevention health issues for the adolescents
-mental health (depression and suicide)
-Gang activity
Adolescents eating disorders
chronic disturbances in eating patterns accompanied by distorted body image
-anorexia nervosa
fear of wt gain, distorted body image, distorted ideas about food, FOOD RESTRICTION leading to wt loss.
-Bulimia Nervosa
episodic binge and purge
Major S/S of adolescent eating disorders
Russell’s sign: bruised knuckles (bulimia Nervosa)
r/o organic issues for eating disorders which are?
-organic disease producing wt loss
-pregnancy
-depression
-substance abuse
