Adolescents Flashcards
What is considered adolescents?
Begins at age 10-12
Ends between ages 18-21
period of development
What are the top 5 causes of death in teenagers?
Accidents (MVC is MC) homicide suicide CA heart disease
PREVENTABLE
What is puberty?
biologic process in which a child becomes an adult
Secondary sexual characteristics
Increase to adult size
Reproductive capacity
Puberty growth spurt in girls v. boys?
begins nearly 2yrs earlier in girls than boys
girls reach peak velocity: 11.5-12
boys between 13.5-14
What is considered early adolescence?
10-13y/o
limited thought to future
feels awkward about self & body
desire for independence
moodiness
greater interest in privacy
What is considered middle adolescence?
14-16 y/o
greater capacity for setting goals
intense self involvement
drive for independence
feelings of love & passion
what is considered late adolescence?
> 17
ability to think ideas through
firmer sense of self identity
development of more serious relationships
Tanner stage 1 in girls?
no breast development (elevation of papilla only)
no pubic hair
Tanner stage 2 in girls?
elevation of breast & papilla as small mound areola diameter enlarge (9.8)
sparse long pigmented hair along labia majora (10.5)
When does menses typically begin?
2-2½ yr after pubarche/thelarche (during stage 3-4)
Is the first menstrual bleed associated w/ ovulation?
NO
typically is caused solely by the effects of estradiol on the endometrial lining
What is the first visible sign of puberty in boys?
around 9-10
enlarged scrotum, pink, texture altered
Spermarche in boys?
1st sperm production; around stage 4-5 (14-15 yo)
What are some developmentally appropriate behaviors in adolescents?
Bids for autonomy: avoiding family activities, demanding privacy, ↑ argumentativeness
Bewilderment & dysphoria at start of middle school
Risk-taking limited in early adolescence
What are some concerning behaviors in adolescents?
Extreme withdrawal or antagonism
Continued failure to adapt several weeks-months later
Escalation of risk-taking behaviors
What is the MC of reason for adolescents not seeking care?
“not wanting to tell parents”
other reasons: reluctant to admit their behaviors, access to health care
In general: minor can be given care only if parent consents or is a medical emergency, what are some reasons that a minor may consent?
Minor is emancipated, married or homeless
Care relates to STI, rape & minor is 12 or older, substance abuse & minor is 12 or older, alcoholism, HIV testing
Tx for chemical dependency in adolescence?
Minor can apply for tx at a substance abuse facility
Parents / guardians must be notified once admitted for treatment
A pt > 12 yo under the influence of a substance (including withdrawal) is considered a medical emergency and consent is implied
Adolescent mental health tx?
Inpt tx requires parental consent
outpt tx: laws vague
Can adolescents consent to abortion in AZ?
NO
exceptions: pt is emancipated, judge authorizes, pregnancy is the result of inappropriate sexual misconduct, pregnancy is harmful to pts health
What are some situations that require disclosure by law?
abuse
SI
HI
STIs-public health deparments
What is included in HEADSSS assessment?
Home Education/exercise Activities/employment Drugs Suicidality Sex Safety
What is the largest, preventable and most costly public health problem in the US?
adolescent substance use
What are some risk factors for substance use?
+FH of substance use disorder
Adverse childhood events (abuse, neglect, trauma)
Co-occurring mental health problems
Peer victimization or bullying
Engaging in other risk behaviors
What are some Cultural/environmental factors play critical role in adolescent substance use?
parental influences
media
availability
Tx of depression?
Refer to pediatric behavioral health
Psychotherapy
Pharmacotherapy
-Fluoxetine (Prozac)-SSRI approved for kids over 8
S/s of anorexia nervosa?
Decreased body temp,
Bradycardia
Dizziness/lightheadedness
Decreased peripheral circulation
Thin hair and nails
Dry skin
Early satiety
Depression
s/s of bulimia nervosa?
abd pain, early satiety, diarrhea/constiption, parotid pain/enlargement
depression dehydration, OH
tooth enamel loss, dental carries, bruising, thickening along joints of the fingers
What is considered binge eating disorder?
1 x week x 3 mos
