Health promotions of adolescents: 12-20 yrs

Question 1

a kid to an adult

Answer 1

Transition from

Question 2

lots ups and downs - stressful; can be very confusing

Answer 2

Hard time -

Question 3

Rapid physical, cognitive, social, and emotional maturation
Adolescent growth spurt (20-25% of total height is achieved during puberty) - 2-3 yr span
Trunk growth most
Size and strength of heart, blood volume, and systolic blood pressure increase - end at adult VS and normal range
Heart rate decreases, RR decreasing, BP increasing
Internal organs nearly double during this time
Adult volume and vital capacity increase - love sports - very close performing at adult levels
Performance capabilities increase - not as gangly - growing into bodies; more muscle growth

Answer 3

Physical development

Question 4

Formal operations period (Piaget)
“Who do I want to be as an adult?”

Answer 4

Formal operations period (Piaget)

Question 5

Abstract thinking
Thinking beyond the present
Hypothetical situations - logically think through things easily; not always; lack life experience; impulsive
Able to evaluate quality of their own thinking
Longer attention spans
Mental manipulation of multiple variables
Concern about others’ thoughts and needs - how actions impact those around me

Answer 5

Abstract thinking

Question 6

Start big questions
Doing things because morals
Questioning who want be

Answer 6

“Who do I want to be as an adult?”

Question 7

Identity vs Role Confusion (Erikson)
Developing a sense of identity
What about our sick adolescents?

Answer 7

Psychosocial development

Question 8

Who going be
Who am I
Impact on the world?
Role confusion: LGBTQ+ and fam not support; not support religious views; parents say going through phase; kids not have support struggle through adulthood with confidence; suicide and depression rate so high when no support and rejected
Common question religion but often come back - explore diff things - freedom explore things and come back on own

Answer 8

Identity vs Role Confusion (Erikson)

Question 9

Group identity (vs. alienation)- middle school - look and be like everyone else otherwise alienate you - bullying issue; not see uniqueness as a +
Individual identity (vs. role diffusion)- high school - realize some differences +; unique and ok; by HS - group friends comfy with and accept you and comfy around them and ok not exactly like
Development of self-concept and body image
Sex-role identity
Emotionality - LOTS EMOTIONS; hormones crazy - up and down
Form a sense of identity, WANT BE totally separate from their parents - tug where parents making rule and kids not want follow them; stricter parent is harder kid push back; little freedoms helpful - build up confidence and shows can make good choices; some independence - help realize make good and safe choices is imp; showing trust and need let go - need know can do things on own and feel that confidence
Look to peers for support

Answer 9

Developing a sense of identity

Question 10

Delayed - rely lot more on parents esp if hospitalized; struggle during time with independence if sick and not at school very much

Answer 10

What about our sick adolescents?

Question 11

Goal: To define identity independently from parental authority
Relationships with parents

Answer 11

Social development

Question 12

Much ambivalence
Intense sociability; intense loneliness
Acceptance by PEERS

Answer 12

Goal: To define identity independently from parental authority

Question 13

Roles change from protection/dependency to mutual affection/equality
Process involves turmoil and ambiguity
Teenager struggles between privileges and responsibilities
Emancipation from parents may begin with rejection of parents by teenagers
Under 18 years parents make your health decisions unless legally emancipated - pregnant, graduate early from HS, military, mental health services, rehab, issues r/t drug use/antidepressants, get married
Given guardian ad lidem - help make decisions to see if competent to make decisions - earliest age typ is 16

Answer 13

Relationships with parents

Question 14

What is the goal of puberty?
Girls
Boys

Answer 14

Reproductive development

Question 15

Reproduction
Body telling you to reproduce after puberty - why sex edu imp - body telling us procreate but mentally not ready
Primary sex characteristics
Secondary sex characteristics
Prepubescence:
Puberty:
Postpubescence:

Answer 15

What is the goal of puberty?

Question 16

External and internal organs necessary/required for reproduction
Penis

Answer 16

Primary sex characteristics

Question 17

Internal and external: Result of/product of hormonal changes: Voice change, hair growth, breast enlargement, fat deposits
Play no direct role in reproduction

Answer 17

Secondary sex characteristics

Question 18

Period of approximately 2 years before onset of puberty; preliminary physical changes occur

Answer 18

Prepubescence:

Question 19

Development of secondary sex characteristics
During

Answer 19

Puberty:

Question 20

Period of 1 to 2 years after puberty; skeletal growth is complete; reproductive functions become well established

Answer 20

Postpubescence:

Question 21

appearance of breast buds (9-13 years)

Answer 21

Thelarche:

Question 22

growth of pubic hair on mons pubis (2-6 months after thelarche)

Answer 22

Adrenarche:

Question 23

Initial appearance of menstruation (2 years after first pubescent changes)
2 yrs after thelarche
Predict menstruating next couple years

Answer 23

Menarche

Question 24

First pubescent changes: testicular enlargement; thinning, reddening, and increase looseness of the scrotum (9.5-14 years)
Penile enlargement, pubic hair growth, facial hair growth, voice changes (not point out when voice cracks)
Temporary gynecomastia in 1/3 of boys (usually disappears within 2 years) - mens start develop breast tissue; many times often go away; number one cosmetic surgery for me; not always go away

Answer 24

Boys

Question 25

Not know what always triggers puberty but once triggers know what happens
Tell where child is through stage growth and development
Girls
Breast size and development
Pubic hair growth
Boys
Scrotum looseness, redness
Testicular size
Penile length
Pubic hair growth
Stage 1 - prepubescent
Stage 5 - post-pubescent

Answer 25

Tanner stages of development

Question 26

Feelings of confusion are common esp in early adolescence
Teenager are acutely aware of appearance, constantly compare appearance with those of others
Teenagers may try to hide their bodies or advertise them
Blemishes/defects are magnified out of proportion
The right clothes and hairstyle are very important
Poor vs Rich?

Answer 26

Body image and self-concept

Question 27

Not wrap head around that what wear dictates who are
Want latest style
Issues with poor and rich
If not less cool person
School uniforms - shoes, phones, backpacks

Answer 27

Teenager are acutely aware of appearance, constantly compare appearance with those of others

Question 28

Sleep
Activity
Scoliosis
Sex education
Personal care
Vision, hearing
Posture
Body art
Dental Health
piercing/body art/tanning
School and learning problems
Substance abuse/Tobacco use
Stress reduction
Anxiety/Depression
Suicide

Answer 28

Health promotion and screenings

Question 29

8-10 hrs
Staying up late and sleeping in is very normal and expected
Will require more sleep during growth spurts
Base care on age; do not try wake them up

Answer 29

Sleep

Question 30

Monitor for inactivity and overactivity
Very involved in sports and athletics not concerned
Not involved - want them active - not want constant sitting - unhealthy habits - need to move the body

Answer 30

Activity

Question 31

At this point, adolescents may feel physically read for sexual activity; however, they often lack psychological understanding
Adolescents need tools to help navigate relationships and how to handle intimate situations
Being told by body to reproduce
Give tools to make smart decisions to feel safe saying no and give guidance to get out of unstafe situations

Answer 31

Sex education

Question 32

Like to do things
Blow things up
Experiment with things
Listen to loud music - always something in ears

Answer 32

Vision, hearing

Question 33

Continue good habits
Tooth falls - try put back in; put it in milk and get to doc so can put it back in

Answer 33

Dental Health

Question 34

Discuss risk r/t unsafe pracs - infection, transmission; using dirty needles (same needle)
Nothing wrong unless unsafe and unclean manner

Answer 34

piercing/body art/tanning

Question 35

Typ identified in elementary school but not typ MS learning disabilities more apparant

Answer 35

School and learning problems

Question 36

Try all sorts things when adolescents

Answer 36

Substance abuse/Tobacco use

Question 37

Common in age group
Depending on parents; not taken seriously by parents; sometimes think just get over - that is not how it works
As nurse might confide in you - express things - tell fam not care - help them find services; not need parental consent for therapy or antianxiety meds

Answer 37

Anxiety/Depression

Question 38

take all threats of suicide seriously or risk should be serious
Even if think just trying to get attention - talking about it something going on
Get underlying cause

Answer 38

Suicide

Question 39

Annual Flu Vaccine
Meningococcal (additional dose prior to college or communal living) - meningitis

Answer 39

Immunizations

Question 40

Rapid and extensive increase in height, weight, muscle mass, and sexual maturity of adolescence is accompanied by increase nutritional requirements
Caloric and protein requirements are higher than at almost any other time - NEED TO EAT LOT; hope instilled some good habits
Prioritize teaching of eating habits and behaviors

Answer 40

Nutrition

Question 41

Monitor for eating and snacking habits
Ideal have healthy snacks around house - easy grab; fam meals imp
Independent food choices
Start being independent - drive to fast food areas - getting folate in foods esp in grain products; decreased risk of neural tube defect
Obesity
Biggest concern for health
Anorexia - psychologic
Bulimia - psychologic
Binge-eating - psychologic
Multidisciplinary team - therapist and nutritionist; taken seriously

Answer 41

Prioritize teaching of eating habits and behaviors

Question 42

The nurse is caring for an underweight adolescent girl with a diagnosis of anorexia nervosa. Which clinical manifestation will the nurse expect in this client? Select all that apply. One, some, or all responses may be correct.
1. Fatigue
2. Pyrexia
3. Constipation
4. Metabolic alkalosis
5. Extremity edema
6. Heat intolerance
7. Secondary amenorrhea
8. Irritability

Answer 42

Answer: 1, 3, 5, 7, 8
Fatigue results because inadequate nutritional intake results in electrolyte imbalances and decreased RBC
Constipation is associated with reduced gastric mobility as a result of decreased food and fluid intake
Extremity edema can occur due to hypofunction of the liver and subsequent decreased production of albumin, which helps hold fluid in the intravascular space
Pyrexia - fever; adolescents typ cold; lots sweatshirts - no muscle to keep them warm
Secondary amenhorrea - had periods but now stopped; no body fat; can not also sustain another life; no deli meats - get sicker - also prioritize you over health baby - increased risk miscarriage; occurs because of endocrine imbalances resulting from starvation; thought severe starvation damages hypothalamus
Irritability: common with malnutrition
Many of these client have lowered body temp and are intolerant of cold
Bulimia (not anorexia) nervosa clients will present to the client with metabolic alkalosis due to frequent self-induced vomiting

Question 43

INVINCIBLE!
Prefrontal cortex - not fully developed
Motor vehicle- related injuries #1 cause of mortality
Firearms
Sports injuries
Injury Prevention

Answer 43

Injury prevention

Question 44

Nothing happen to them
Death risk increases
Mortality rate increases - mortality and suicide increases

Answer 44

INVINCIBLE!

Question 45

Educate (texting, drinking, seatbelt, passengers)

Answer 45

Motor vehicle- related injuries #1 cause of mortality

Question 46

Concerning
Younger age group - lock it up
Adolescents - can open it and show friends - accidents happen

Answer 46

Firearms

Question 47

Overuse injuries
Permanent damage from injuries
Not care because not thinking about future
Adults make sure resting and caring about bodies

Answer 47

Sports injuries

Question 48

Anticipatory guidance
Teaching parents and child

Answer 48

Injury Prevention

Question 49

The nurse reviews the history to find an adolescent has a tattoo on the neck and piercings on the ear and eyebrow. During the next visit, the nurse finds a new tattoo on the right upper arm and another piercing on the nose. Which intervention will the nurse prioritize in this situation? Select all that apply.
1. Prepare a proper diet plan for the adolescent
2. Instruct the adolescent to get an electrocardiogram
3. Advise the adolescent to perform regular exercises
4. Screen the adolescent for human immunodeficiency virus (HIV)
5. Provide education related to avoiding sunburns
6. Schedule an appointment for administering the hepatitis vaccine
7. Educate on the importance of sleep hygiene
8. Ensure the client is scheduled for a dental examination

Answer 49

Answer: 4, 6
PRIORITIZE