Health Problems of the Adolescent

Question 1

Acne

Answer 1

-More than 50% affected
-Etiology: Familial aspect, Hormonal influence, Other influences
-Psychosocial ramifications: elf-esteem issues
-Pathophysiology: Involves hair follicle and sebaceous glands, Comedogenesis
-Therapeutic management: General measures/overall health, Medications, Nursing considerations

Question 2

Health problems of the male reproductive systems

Answer 2

-Penile problems: Uncorrected congenital problems, HPV, Trauma
-Testicular tumors: Usually malignant, Testicular cancer accounts for 7% of malignancies in males ages 15 to 34, Testicular self-examination (TSE)
-Testicular torsion: Partial or complete venous occlusion with rotation of testicle, Occurrence—1 in 4000 males, Peak onset—age 1, Surgical emergency to prevent necrosis
-Epididymitis: Presentation—pain, redness, and swelling
-Treatment—analgesics, antibiotics, and supportive care

Question 3

Health problems of the female reproductive system

Answer 3

-Timing of initial pelvic exam controversial: Gynecological Examination –> initial visit between 13 & 15 years of age, General exam, visual breast exam, external pelvic & education
-Effective urine-based STI screening
-Menstrual disorders: Primary amenorrhea—no menses by age 17, Secondary amenorrhea—no menses for
-Six months in previously menstruating female: Irregular menses common in adolescence

Question 4

Dysmenorrhea

Answer 4

-Primary dysmenorrhea: the cramping pain that comes before or during a period
-Secondary dysmenorrhea: caused by a disorder in the reproductive organs
-Therapeutic management: NSAIDs, Estrogen therapy, Oral contraceptives, Dietary changes, Exercises, comfort measures

Question 5

Endometriosis

Answer 5

-Definition: presence of endometrial glands and stroma outside the normal intrauterine endometrial activity
-Etiology unclear, familial tendencies
-Tx: medial, surgical, pharmacologic suppression

Question 6

STI/STDs

Answer 6

-Major cause of morbidity during adolescence and young adulthood
-Strong relationship between STDs and infertility
-Transmission and follow-up of contacts

Question 7

Types of STI/STD

Answer 7

-Chlamydia
-Gonorrhea
-Syphilis
-Gonorrhea
-Pelvic inflammatory disease (PID)
-Human papillomavirus
-Hepatitis B virus (HBV): immunization, Series begun at birth, Series of three IM injections, Goal to target children before onset of high-risk behaviors

Question 8

HIV and AIDS

Answer 8

-Time lag between infection with HIV and
development of clinical AIDS
-Transmission
-Screening and diagnosis: Counseling for testing
-Therapeutic management: Follow-up of sexual contacts, Pregnancy and HIV
-Adolescent perception of risk of AIDS

Question 9

Adolescent pregnancy

Answer 9

-Rates of teen pregnancy in United States: In 2022, the teenage birth rate fell to 13.5 per 1,000 girls aged 15 to 19, the lowest on record
-Physiologic aspects
-Medical aspects: Diagnosis, Complications, Nutritional needs
-Nursing care management
-Infants of adolescent mothers: Higher risk of prematurity, Higher incidence of low birth weight, Potential for developmental delay, Cumulative risk factors for infant

Question 10

Anorexia and bulimia nervosa

Answer 10

-Anorexia (AN): social, psychologic, behavioral, cultural, physiologic components characterized by distorted body image
-Bulimia (BN) is characterized by repeated episodes of binge eating followed by inappropriate compensatory behaviors

Question 11

Anorexia s/s

Answer 11

-Severe weight loss
-Altered metabolic activity: amenorrhea, brady, decreased BP, hypothermia, cold intolerance, dry skin, brittle hair and nails, appearances of lanugo

Question 12

Therapeutic management of anorexia nervosa

Answer 12

-Nutrition therapy: IV and tube feedings, monitor cardiovascular status
-Psychotherapy
-Pharmacologic therapy: results have been disappointing

Question 13

Bulimia definition

Answer 13

-Eating disorder characterized by binge eating
-May be followed by purging behaviors: laxative abuse, self-induced vomiting, diuretic abuse, rigorous exercise regimens
-Up to 8+ cycles per day

Question 14

Bulimia s/s

Answer 14

-Weight may be normal or slightly above normal
-Weight may be low (bulimarexia)
-Tooth erosion, esophageal damage, other GI concerns
-Psychological issues: self-deprecating thoughts, depressed mood, hx of unsuccessful dieting, overweight in childhood, low impulse control

Question 15

Nursing care of anorexia and bulimia

Answer 15

-History and physical assessment accuracy
-Inpatient care: Assessment of fluid and electrolytes, Cardiac assessment, Nutritional assessment and avoiding trigger foods, Collaboration with team members, Provision of trusting relationship and support to patient and family
-Diet
-Behavioral therapy

Question 16

Rape and sexual assault

Answer 16

-Sexual assault nurse examiners (SANEs)
-Dx eval: obtain account of incident, be sensitive to victim’s emotional status, collect physical evidence (vaginal secretions for evidence of sperm, blood, DNA; GC culture to rule out preexisting condition; HIV testing)

Question 17

Substance ab

Answer 17

-Tobacco: Cigarettes, smokeless tobacco, Chewing tobacco, Second-hand smoke
-Alcohol
-Marijuana
-Cocaine
-Narcotics
-Mind-altering drugs

Question 18

Nursing care for drug abuse

Answer 18

-Screening tools and assessment: CRAFFT questionnaire
-Acute care: toxic effects, managing withdrawal symptoms, support pt and family
-Long term management: rehabilitation, family support, prevention

Question 19

Self-harm

Answer 19

-Self injury
-Etiology varies
-Dx eval: physical exam
-Nursing alert (1-800-DONT-CUT)

Question 20

Suicide

Answer 20

-Etiology varies
-Methods: Firearms, Hanging, Overdose,
-Motivation
-Evaluation and therapeutic management: Immediate action during threat, Medications for depression
-Nursing care management – keep them safe!