Peds: Adolescent Health & Issues

Question 1

Adolescent Health & Issues: Well Child Checks (WCC)

Answer 1

• *stage appropriate screenings;
• *subjective data (mental/emotional health, school performance, family function, work, stress/anger management/coping skills, injury to self, hobbies, elimination; risk behaviors- caffeine, alcohol, smoking, drugs, sex, gender issues);
• *questions when pt is alone (family relationship/communication, discipline, concerns, strong/weak points, attitude, behaviors);
• *objective data (physical exam, BMI, vitals, tanner staging, pelvic (sexually active/irregular menses), BSE (breast self-exam), TSE (testicular self-exam), check for scoliosis until 2 yrs after PHV (peak ht velocity); observe parent/child interaction;
• **labs- HCT as needed, STI screenings (VDRL, GC, HIV, chlamydia), Pap smear at age 21 or 3 yrs after becoming sexually active, LFT (drug use hx), cholesterol (family hx-parents/grandparents);
• *management- immunization (complete series), meningococcal vac, Tdap, HPV; meds, health promotion with anticipatory guidance, dental assessment q 6 mos;
• *GAP (guidelines for adolescent preventive services by the American Medical Association)

Question 2

Adolescent Health & Issues: Ages

Answer 2

• *adolescence- 12 to 20 yrs of age;
• *three transitional periods:
• –early adolescence: 12-14 years;
• –middle adolescence: 15-17 years;
• –late adolescence: 18-20 years;
• parents are the primary influence of adolescents*

Question 3

Adolescent Health & Issues: Guidelines for Adolescent Preventive Servies by the American Medical Association (GAPS)

Answer 3

**

Question 4

Adolescent Health & Issues: General Strategy to Assessment and Teaching

Answer 4

• *use diagrams/visual aids;
• *structure part of interview alone;
• *watch cues that pt does not want to discuss certain issues;
• *encourage expression of feelings;
• *interview while clothed;
• *recognize that adolescents seek identity, may be rebellious, refine sex roles, try to be independent;
• *HEADS- home, employment/education, activities, drugs, social, sexuality;
• *PACES- parents/peers, accident/alcohol/drugs, cigarettes, emotional issues, school/sexuality;
• *SAFETEENS- sexuality, accident/abuse, emotions (depression/anxiety/suicide), toxins (drugs/alcohol/cigarettes), environment (school/home/friends), exercise, nutrition, shots (immunizations/school performance);

Question 5

Adolescent Health & Issues: Physical Exam Elements

Answer 5

• *secondary sex characteristics develop; dramatic physical change;
• *vision/hearing screen @ each visit (acuity 20/20); hormone surging;
• *vital signs (like adults);
• *physical exam (head to foot);
• *tanner staging- sexual maturity rating (SMR)- average from Tanner stage rates (genital/breast + pubic hair development)

Question 6

Adolescent Health & Issues: Tanner Staging

Answer 6

**

Question 7

Adolescent Health & Issues: Physical Development

Answer 7

**

Question 8

Adolescent Health & Issues: Cognitive Development

Answer 8

**

Question 9

Adolescent Health & Issues: Psychosocial Development

Answer 9

**

Question 10

Adolescent Health & Issues: Anticipatory Guidance

Answer 10

**

Question 11

Adolescent Health & Issues: Common Health Issue-

Eating Disorders

Answer 11

**