Chapter 10 Adolescents Flashcards
outcomes of this stage of maturity include the development of:
Advanced cognitive abilities
Autonomy
Self-identity
Piaget stages during this age
Age 10–11 years: concrete operations
Age 12 years and older: formal operations
formal operational
Develops analytic thinking
Develops abstract thinking
Shows concern for politics and social issues
Becomes able to think long term and set goals
Compares self with peers
Begins to have some awareness of personal limitations
Becomes able to predict outcomes and consequences
Freud
Age 10–12 years: latency stage
Age 12–18 years: genital stage
erikson
Age 12–18 years: identity versus role confusion
Age 19 years: intimacy versus isolation
Characteristics of adolescent psychology include the following:
Self-conscious
Compares own body with others
Interested in sexuality and gender roles
Emergence of sexual feelings and experimentation
Has a need for privacy
“Tries on” different styles of dress, communication, and personae
Develops personal values Wants to be an adult but still needs the support of the family/caregiver Self-image is dependent on what others think Has mood swings Feels as if “onstage” with others around and paying special attention Believes that he or she is special and unique Has a sense of invincibility Is impulsive Assumes that others have the same perspective Has unrealistic career goals Tests limits and rules Develops a sense of conscience Knows right from wrong Can compromise with others when desired
Measurements
Yearly assessments from 11-21 Height Weight Body mass index Blood pressure Hearing Vision vitals
Cholesterol screening s
once during late adolescence
TB screen
at-risk adolescents, including those who are from countries outside of the United States, who are HIV positive, and who are incarcerated or homeless
General survey
awkwardness normal
Determine developmental history, family composition, and school situation.
Daily fluid requirement
1,500 mL plus 20 mL for every kilogram above 20 kg.
Normal urine output
0.5 to 1 mL/kg/hour.
pain scale
numeric or visual analog scale
indication of school or home avoidance/problems, anxiety and stress, or depression
General somatic complaints without verified diagnostic clinical data
Vitals
Heart rate of 55 to 100 bpm
Respiratory rate of 15 to 20 breaths/minute
Systolic blood pressure less than 120 mm Hg
when performing physical:
Respect privacy.
Inform the adolescent of your actions and explain the rationales.
Focus on the positive aspects of the individual.
Address the adolescent’s concerns directly.
Be cautious about pointing out physical abnormalities.
Examine the genitals last.
Use the correct words for anatomy.
Skin
Hormone changes during puberty cause an increase in sweat secretion and oily skin, especially on the face, back, axillae, breasts, and anus.
acne
self harm
Head
Head reaches adult size during adolescence.
Assess for migraines/stress headaches.
Hair might be brittle and dry if subjected to frequent dyeing or heat styling.
eyes
Visual acuity testing should be done at ages 12 and 15 years
Ears
Hearing testing should be done once between ages 11 and 14, 15 and 17, and 18 and 21 years
mouth
Inspect mouth for ulcers that might indicate inhalant or smokeless tobacco use.
Tooth erosion could indicate that patient has been inducing vomiting.
The third molars (wisdom teeth) erupt between ages 17 and 21 years.
Bruxism, which is teeth grinding, may be present because of stress.
Nose
Piercing
nose may look too large
Cardiovascular
The heart grows in strength and size during adolescence.
Assess for innocent murmurs
Screen for iron-deficiency anemia only if risk assessment is positive
Respiratory
The length and diameter of the lungs increase during adolescence.
Assess for a history of asthma, which is the number one chronic illness in children.
Lungs should sound clear.
Check for signs/symptoms of chronic respiratory issues. Chronic cough that affects sleeping and shortness of breath are the most common. Signs such as barrel chest and clubbed fingers are rarely seen in children.
Gastrointestinal
Assess nutritional status.
Assess constipation/diarrhea/vomiting.
Assess for chronic abdominal pain, which could be an indication of stress/anxiety.
Renal
Assess hydration status.
Assess for enuresis.
Assess signs/symptoms of urinary tract infection, particularly among sexually active adolescents.
Gynecomastia
abnormal breast development in boys.
First gynecological examination
13 and 15 years for external examination only, pelvic examinations are only completed when problems arise such as pain or abnormal bleeding, and Pap tests are no longer conducted until the age of 21 years
