Exam 1: Well Child: Adolescent

Question 1

Early Adolescence =
Middle Adolescence =
Late Adolescence =

Answer 1

10-13 yo
14-16 yo
17-21 yo

Question 2

Health Supervision Visits how frequent?

Answer 2

Yearly for 10-21 yo

Question 3

Adolescent vital signs

1) HR =
2) RR =
3) Temp =
4) BP =
5) Growth = this is when what begins? coincides with tanner stage?
6) Puberty for
- Girls =
- Boys =
7) For girls include =

Answer 3

1) 55-85
2) 12-18
3) 97.8-98
4) 110-125/65-85
5) Growth spurts coincides with Tanner Stage III*
6) Girls = 9.7-13.5 yo
Boys = 11.7-15.3 yo
7) LMP

Question 4

Ask parent to step out of room to ask =

Answer 4

HEADS

Home
Education
Activites
Disabilities, drugs
Safety, Sexuality, Suicide

Question 5

Confidentiality

1) Varies __ to __
2) In general should keep confidentiality unless concern with _____
3) Providers should help facilitate discussion of ____ with adolescent and parent.

Answer 5

1) State to state
2) SAFETY
- and just let child know you have to tell parent if there’s a safety issue
3) Difficult topics

Question 6

HOME questions (3)

Answer 6

• Who lives at home?
• Do you feel comfortable/safe at home?
• Is there anything going on at home you want to discuss?

Question 7

EDUCATION/EMPLOYMENT questions (5)

Answer 7

• What school, grade?
• Do you like school?
• Do you have friends at school?
• What do you do after school? work/activities
• Work, where do they work? what are the hours?

Question 8

ACTIVITIES questions (1)

Answer 8

• After school activities? sports, music, etc

Question 9

DISABILITIES, DRUGS questions (2)

Answer 9

• When was the last time you used marijuana/alcohol/smoked/etc?
• If they disclose that they use, ask how they feel about it do they want help in decreasing or stopping? (referrals still confidential)

Question 10

SAFETY, SEXUALITY, SUICIDE questions

1) Driving questions
2) Sex questions
3) Depression screening

Answer 10

1) Seatbelt, texting and driving, drinking and driving?
2) Last time you had sex, with who, do you use condoms 100% of time, when was the last time you were tested for HIV? offer test every visit, pre/post counseling
3) If score is concerning then you ask: When do you feel sad, withdrawn, lack of motivation? Have you ever thought of hurting yourself? if yes, immediately refer to mental health

Question 11

Legally, consent of _____ is required before medical care can be provided to a minor

Exceptions include

1) _____ care
2) Tx for all ____ including all reportable contagious diseases
3) Exam and tx for (3)
4) Age and limit varies state to state (typically __ or older)

Answer 11

Parent/guardian

1) Contraceptive
2) STD’s
3) Sexual assault, alcohol/drug problems, mental health
4) 12

Question 12

_____ nutritional needs due to

1) Gain in ___% of adult height
2) Gain in ____% of adult skeletal mas
3) _____ caloric and protein requirements

Answer 12

Increase

1) 20%
2) 50%
3) Maximal

Question 13

Nutritional Problems

1) ____ eating habits
2) ____ meals
3) High ___ snacks of low nutritional value
4) ____ pressure (overeating, purging, restrictive)
5) ____ machines and ___ foods

Answer 13

1) Poor
2) Missed
3) Sugar
4) Peer
5) Vending machines, Fast foods

Question 14

Key Nutritional Concerns

1) 33% of adolescents are _____
2) 5-7% have ________
3) Deficiencies in (3) during adolescent pregnancy

Answer 14

1) overweight
2) IRON DEFICIENCY ANEMIA
3) protein, vitamins, minerals

Question 15

RDA Males

1) _______ calories/day
2) ______ protein/day
3) ___ mg/d of iron/day

Answer 15

1) 2500-3000
2) 45-60
3) 12

Question 16

RDA Females

1) _______ calories/day
2) ______ protein/day
3) ___ mg/d of iron/day

Answer 16

1) 2200
2) 45
3) 15

Question 17

Recommendations

1) Balance intake with _____ to maintain normal growth and development
2) Maintain a healthy w____
3) Eat a ___ variety of nutritious foods
4) Limit ___ fat (butter, lard, margarine)
5) B___/B____ instead of frying foods
6) Use ____ milk instead of fat milk and dairy products should be consumed ____
7) Eat plenty of v_____, l____, f____
8) Eat ___grain cereals, breads, pasta, rice
9) Drink ____ instead of soda, juice
10) Eat meals and snacks ______

Answer 17

1) Physical activity
2) weight
3) wide
4) solid
5) Broil, Bake
6) nonfat, low-fat, daily
7) vegetables, legumes, fruits
8) whole grain
9) water
10) regularly

Question 18

Physical Assessment

1) ___- what is going on during assessment
2) Respect need for _____
3) Give feedback and _____ when possible
4) Use assessment as a time to discover areas for health _____
5) Proceed from ____ to ___
6) Assess for ____*
7) Beginning of _____*
8) Development of secondary ___ characteristics
9) Assess ____ stages

Answer 18

1) Explain
2) Privacy
3) Reassure
4) Education
5) Head-Toe
6) ACNE
7) MENSTRUATION
8) sex
9) Tanner

Question 19

Physical Growth

• Final ___-____% of growth occurs
• Adolescent growth spurt lasts ____ years
• Varies in age of ___, ___, ____

Girls start at ages =
Boys start at ages =

Answer 19

• 20-25%
• 2-3
• Onset, duration, extent

9. 5-14
10. 5-16

Question 20

Tanner Staging is based on what for
Girls =
Boys =

Answer 20

Breast development, Pubic Hair

Penile development, Pubic Hair

Question 21

Maturation Changes in Girls

1) First sign of puberty = ___ changes
2) Rapid increase in h___ and w____
3) Growth of ___ hair
4) Appearance of ____ hair
5) Menstruation starts about __ years from onset of breast changes
6) Abrupt ____ of linear growth

Answer 21

1) Breast changes
2) height, weight
3) pubic
4) axillary
5) 2
6) deceleration

Question 22

Maturation Changes in Boys

1) First sign of puberty = ____ of testes
2) Growth of hair where (3)?
3) Rapid ____ in height
4) V___ changes
5) ______ emissions
6) Abrupt _____ of linear growth

Answer 22

1) enlargement
2) pubic, axillary, facial and body
3) increase
4) Voice
5) Nocturnal
6) Abrupt

Question 23

Sleep Requirements

1) _____ hrs of sleep per night
2) What is released during sleep?
3) Sign of inadequate sleep/ poor sleeping habits =

Answer 23

1) 8.5- 9.5
2) growth hormones
3) excessive daytime sleepiness

Question 24

Oral Health

1) F____ daily, Brush ___ daily
2) Dental visits every ___ months

Caution:

1) Self induced ____ can harm teeth enamel
2) Use of certain ____ can cause ulcers or destroy enamel
3) S____/Chewing T_____ can cause oral ulcers, cancers
4) How to prevent sports oral injuries?

Answer 24

1) Floss, twice
2) 6

1) vomiting
2) drugs
3) smoking, tobacco
4) use of mouth guards

Question 25

Fears of a Hospitalized Adolescent

Answer 25

• Loss of independence
• Loss of identity
• Body image disturbances
• Rejection by others
• Separation from peers, daily lives with peers

Question 26

Nursing Interventions for the Hospitalized Adolescent

Answer 26

• Involve adolescent in plan of care
• Support relationships with family and peers (allow visitation)
• Provide consistent and truthful explanations