Adolescents Flashcards
Confidentiality
- Must interview children 10+ with suspected SA alone
- All teens must be seen alone
- Exceptions - risk of harm to self or others
- Reassure parent you are not encouraging secrecy or lying
Who can consent to all of their own healthcare?
Pregnant minors Minors who are parents Married minors Emancipated minors Sometimes, mature minors
Types of HC minors can consent to
-Reproductive health
-Most mental health
ETOH and drug abuse
Sexual assault eval and tx
Emancipated minors
- Parents renounce rights via PINS petition
- No statue or procedure
- Also married, armed services, economically independent
- Must move out and be economically independent
Mature minors
- Mature and informed enough to give consent
- No formal process- health care provider designation
Can you guarantee confidentially 100%?
No - Medical Insurance
Parents see codes until 18
Tweak codes if needed
Talking to parents
- Good medical hx
- Prepare for hostility
- Paradignm shift from peditrics
Virgin exam
- Not definitive
- Hymens are variable
- Straddle injuries
- Cannot be used in court
Statutory rape
-Cannot consent under 11
-No one 18+ can have sex with anyone under 13
If at least 13 and
Teen Intellectual Development
Concrete thinkers, no gray area, cannot predict consequences
Teen emotional Development
Asserting independence, acting out
Teen Social Development
Focus is outside the family
HEADS
Home, Education, Activates, Drugs, Sex
Adolescent Risks
Sexual Abuse, identity confusion, excessive risks, drug or ETOH, Psych - ED, Depression, anxiety, addiction
STI screening for teens
- CT yearly
- GC yearly
- First pap 21
- Not recommended (syph, trich, BV, HSV, HPV, HEP B/C)
- More for YMSM, pregnant
