Chapter 29 - development of the adolescent

Sexual changes ... years in boys: - public hair beings and spreads laterally - scrotum and testes enlarge - scrotum begins to darken

10-13 (early)

Sexual changes ... years in girls: - soft public hair on mons - breast buds appear - menses begin - increased pigmentation on genitalia

10-13 (early)

Adolescence spans the years of transition from childhood to adulthood, which is usually between the ages of ... and ... years.

11 and 20

Immunizations ... years: ○ Tdap - 1 dose (if indicated) ○ HPV - complete 3-dose series

13 - 18

Peak height velocity occurs at about 12 years of age in girls and ... years of age in boys

14

Sexual changes ... years in boys: - coarser pubic hair, growth in scrotum - penis widens, glans penis develops - may see breast development - soft facial hair

14-16 (middle)

Sexual changes ... years in girls: - coarser pubic hair - distribution of pubic hair beyond mons - Areopagus more prominent

14-16 (middle)

Immunizations ... years ○ menACWY (MCV4) ○ MENB 10

16

Sexual changes ... years in boys: - adult like pubic hair - breast tissue disappears - facial hair more coarse and widespread

17-20 (late)

Sexual changes ... years in girls: - adult like public hair and breasts

17-20 (late)

Puberty begins in girls around ... years old and in boys around 10 to 11 years old

9 to 10

Risks of being involved in an unhealthy romantic relationship: ● Imbalance of power in the relationship to the detriment of one of the partners ● Unsafe sexual activity (STIs) ● Unwanted pregnancy ● ...

Dating violence

Piaget stage ... : - moves toward greater abstract thinking and loss egocentric

Formal operation

Erikson stage ... : - focus on body changes - importance of peer culture become primary

Identity VS inferiority

Common substances abused by children and adolescents: ● Marijuana (including synthetic marijuana) ● Alcohol ● Nicotine ● Prescription opiates, sedatives, and analgesics ● Prescription stimulants (Adderall, Concerta, Ritalin) ● Prescription CNS depressants (barbituates, benzothiazides, sleeping aids) ● ... (inhaling fumes from aerosol household products) ● Cocaine, crack ● Heroin

Inhalants

Factors contributing to adolescent violence: ● ... ● Peer or gang pressure ● Poor family functioning ● Limited parental supervision/parents working extended hours outside of the home ● Access to guns and cars ● Drug or alcohol use ● Racism ● Aggression

Low self-esteem

Risk factors for suicide in adolescents: ● Depression or other mental health illness ● Personal or family history of previous suicide attempt ● Poor school performance ● Dysfunctional or disorganized family ● Substance abuse ● Difficulties with sexual identity ● Socially isolated (loner, victim of bullying) ● ... (giving away valued possessions)

Marked changes in behavior

... in opposite/same-sex partners is part of human development occurring in adolescence

Sexual interest

Developmental concerns for the adolescent: ● Changes in body image ● Peer groups ● Violence * ● Suicide* ● Homicide ● ... *

Substance use

At the beginning of this stage, teenagers begin to question ...

The status quo

Safety concerns for adolescents: ● ... injuries ● Internet safety ● Motor vehicle safety (as a driver and as a passenger) ● Avoiding substance abuse ● Firearm safety ● Water safety

Unintentional

... and communication skills continue to develop during middle adolescence

Vocabulary

As they progress to developing their own set of morals, adolescents realize that moral decisions are based on rights, values, and principles that are agreeable to ...

a given society

Assess what the adolescent eats each day with open-ended questions as well as the ... to food at home and outside

access

Integumentary system: skin is thick and tough; sebaceous glands are more active; sweat glands function at ...

adult level

Teens need to learn about these new feelings and how to manage them in an ...

appropriate way

Adolescents also may begin to question their formal religious practices or in some cases ...

cling to them

The adolescent experiences drastic changes in the physical, ... , psychosocial, and psychosexual areas.

cognitive

Sexually active teens must have access to ...

contraceptives

Because of this period of rapid growth spurts, teenagers may experience times of decreased ... and have a diminished ability to perform previously learned skills, which can be worrisome for the teenager.

coordination

Respiratory system: increase in ... of the lungs; respiratory volume and vital capacity increase

diameter and length

Cognitive and ... development are dramatic

emotional

The majority of their choices are based on ... while they are questioning societal standards.

emotions

Gastrointestinal system: full set of permanent teeth; liver, spleen, kidneys, and digestive tract ...

enlarge

Ways to improve communication with teens: ● Be honest; don't be afraid to say you don't know ● Be liberal with praise; acknowledge effort ● Solicit the teen's input in decision making as often as possible ● Clearly state ... and set limits fairly

expectations

Engage the teen in identifying healthy ...

fast food options

Muscle mass increase in boys and ... increase in girls

fat deposits

Assess teen's knowledge about nutritional content of his or her ...

favorite foods

Adolescents have improved communication skills, using correct ... and parts of speech

grammar

Adult height is attained when ... have closed in late adolescence

growth plates

Physical development, ... changes, and sexual maturation occur during puberty

hormonal

Adolescents represent varying levels of ...

identity formation

Rapid physical growth in body size and proportions second only to growth in ...

infancy

By ... language skills are comparable to those of adult

late adolescence,

Caring for the hospital adolescent: ● Provide opportunities for adolescent to ... ● Encourage adolescent to participate in decisions ● Encourage socialization with friends through phone, e-mail, and visits when possible ● Identify any knowledge self-care deficits and provide resources

maintain independence

Neurologic system: growth of ... enables faster neural processing; cognitive growth increases

myelin sheath

Provide education to the teen regarding ... of favorite foods and suggest better alternatives for those with lower nutritional value

nutritional value

Ways to improve communication with teens: ● Allow sufficient time for conversation ● Speak respectfully as you would to a colleague ● Talk face to face; be aware of body language (yours and the teen's) ● Ask ... questions to clarify and promote understanding ● Choose words carefully so that message and intent are clear

open-ended

There is some ... between late school age and adolescence.

overlap

Emphasize the role of ... in maintaining healthy weight; provide healthy physical activity options not related to sports (60 minutes per day is recommended)

physical activity

Secretion of estrogen in girls and testosterone in boys stimulates ...

physical sexual changes

Inquire about the ... from the different food groups

preferences

Musculoskeletal system: linear growth is not complete until late adolescence in boys and occurs earlier in girls; growth plates (which promote linear growth) begin to close at ...

puberty

Language skills continue to develop and be ... during adolescence

refined

Sexual characteristics and ... maturity occur

reproductive

However, the usage of colloquial speech (...) increases, causing communication with people other than peers to be difficult at times.

slang

Promoting proper hygiene for adolescents: ● Encourage frequent bathing and deodorant use ● Encourage washing face two to three times a day ● Discourage ... and vigorous scrubbing of face ● Encourage frequent shampooing of hair ● Teach hygienic care for body piercings and tattoos ● Encourage sunscreen use; discourage artificial sun-tanning (tanning salons, chemical tans)

squeezing acne lesions

Cardiovascular system: size and strength of heart increases; ... blood pressure increases and heart rate decreases

systolic

Topics for discussion to discourage substance abuse: ● Short- and long-term effects of alcohol, tobacco, and drugs on health, relationships, and school performance ● Risk factors and implications for unintentional injuries and unsafe/unwanted sexual activity ● Importance of maintaining a healthy lifestyle ● Importance of resisting peer pressure to use drugs and alcohol ● Importance of having confidence in ...

teen's own judgment

During adolescence, the ... refines and continues to develop his or her gross and fine motor skills.

teenager

It is during the adolescent years that teenagers develop their own set of ... and ...

values and morals

Ask the number of times that fast foods, snacks, and other lower nutrition value foods are eaten per ...

week