Peds Chapter 16
Define adolescence
"to grow into maturity" Generally regarded as the psychological, social, and maturational process initiated by the pubertal changes.
Adolescents are in which of Kohlberg's stages of moral development?
Conventional level Morality is determined by social norms
When does the final 20% to 25% increase in growth occur?
During puberty For girls - 9 ½ to 14 ½ years of age For boys - 10 ½ to 16 years of age
What is stage 3 development on breasts in girls?
Further enlargement of breast and areola with no separation of their contours
What makes adolescents prone to injuries?
Propensity for risk-taking behavior PLUS Feelings of indestructibility
What is stage 2 development on breasts in girls?
Pubertal Breast bud stage Small area of elevation around papilla Enlargement of areolar diameter
When is postpubescence and how is it characterized?
1-2 year after puberty Skeletal growth is complete Reproduction functions become well established
When is prepubescence and how is it characterized?
2 years immediately before puberty Preliminary physical changes that lead to sexual maturity
When does ovulation normally begin?
6 to 14 months after menarche
What is thelarche and when does it occur?
Appearance of breast buds Occurs in girls between 8 and 13 years of age
What are some areas of stress in adolescence?
Body image Sexuality conflicts Scholastic pressures Competitive pressures Relationships with parents Relationships with siblings Relationships with peers Finances Decisions about present and future roles Career planning Ideologic conflicts
What is the usual sequence of maturational changes in girls?
Breast changes Rapid increase in height and weight Growth of pubic hair Appearance of axillary hair Menstruation (begins 2 yrs. after first sign of breast) Decline in height growth.
What are the three distinct subphases of adolescence?
Early adolescence - age 11-14 Middle adolescence - 15-17 Late adolescence - 18-20
What is the usual sequence of maturational changes in boys?
Enlargement of testicles Growth of pubic hair, axillary hair, hair on upper lip, hair on face and everywhere else on the body (facial hair usually appears 2 years after the first sign of pubic hair) Rapid increase in height Changes in the larynx and consequently the voice Nocturnal emission Decline in height growth
When does the adolescent growth spurt cease?
For girls - 2 to 2 ½ years after menarche For boys - 18 to 20 years of age
What is the average height and weight gain during adolescent growth spurt?
For girls - 5 to 20 cm (2-8 inches) and 7 to 25 kg (15.5-55 lbs) For boys - 10 to 30 cm (4-12 inches) and 7 to 30 kg (15.5-66 lbs)
Adolescents are in which of Piaget's stages of development?
Fourth and last stage Period of formal operations Capacity for abstract thinking No longer restricted to the real and actual, now concerned with the impossible
What is adrenarche and when does it occur?
Growth of pubic hair on the mons pubis Approximately 2 to 6 months after thelarche
What is stage 5 growth of pubic hair in girls?
Hair adult in quantity, type, and patter with spread to inner aspect of thighs
What is stage 3 growth of pubic hair in girls?
Hair darker, coarser, and curly and spread sparsely over entire pubis in the typical female triangle
Adolescents are in which of Erikson's stages of development?
Identity versus Alienation See themselves as distinct individuals, somehow unique and separate from every other individual Goal is to attain autonomy from parents and develop a personal identity If goal is not achieved, will develop role diffusion (confusion)
What is pubertal delay for girls?
If breast development has not occurred by age 13 years or if menarche has not occurred within 4 years of onset of breast development.
What is stage 4 of secondary sex characteristics and genital development in boys?
Increased size of penis with growth in diameter and development of glans Glans larger and broader Scrotum darker Pubic hair more abundant with curling but restricted to pubic area
What is menarche and when does it occur?
Initial appearance of menstruation Occurs about 2 years after the appearance of the first pubescent changes (approximately 9 months after peak height and 3 months after peak weight) Average age is 12 years, 4 months (10 ½ to 15 years of age)
What is stage 3 of secondary sex characteristics and genital development in boys?
Initial enlargement of penis, mainly in length Testes and scrotum further enlarged Hair darker, coarser, and curly and spread sparsely over entire pubis
What is stage 2 of secondary sex characteristics and genital development in boys?
Initial enlargement of scrotum and testes Reddening and textural changes of scrotal skin Sparse growth of long, straight, downy, and slightly pigmented hair at base of penis
What is stage 5 development on breasts in girls?
Mature configuration Projection of papilla only caused by recession of areola into general coutour
What is stage 1 growth of pubic hair in girls?
No pubic hair; essentially the same as during childhood No distinction between hair on pubis and over the abdomen
What is stage 1 of secondary sex characteristics and genital development in boys?
No pubic hair; essentially the same as during childhood No distinction between hair on pubis and over the abdomen
What is the greatest single cause of death in the adolescent age group?
Physical injuries Claim more lives than all other causes combined! Most vulnerable age groups is 15 to 24 years, when accidental injuries account for about 60% of deaths in boys and 40% of deaths in girls
What is stage 1 development of breasts in girls?
Prepubertal Elevation of the papilla only
What is stage 4 development on breasts in girls?
Projection of areola and papilla to form a secondary mound May no occur in all girls
What is stage 4 growth of pubic hair in girls?
Pubic hair denser, curled, and adult in distinction but less abundant and restricted to the pubic area
What is stage 2 growth of pubic hair in girls?
Sparse growth of long, straight, downy, and slightly pigmented hair extending along labia Between stages 2 and 3 begins to appear on pubis
What is gynecomastia and when does it occur?
Temporary breast enlargement in boys Common during mid puberty Occurs in 1/3 of boys Disappears within two years
What is stage 5 of secondary sex characteristics and genital development in boys?
Testes, scrotum, and penis adult in size and shape Hair adult in quantity and type with spread to inner surface of thighs
What are the first pubescent changes in boys and when do they occur?
Testicular enlargement Thinning, reddening, and increased looseness of the scrotum Between 9 ½ and 14 years of age
Define puberty
The maturational, hormonal, and growth process that occurs when the reproductive organs begin to function and the secondary sex characteristics develop (voice alterations, development of facial and pubertal hair, fat deposits). When sexual maturity is achieved, marked by the first menstrual flow in girls but by less obvious indications in boys.
What is pubertal delay for boys?
When no enlargement of the testes or scrotal change by 13 ½ to 14 If genital growth is not complete 4 years after the testicles begin to enlarge
What is the difference, in relation to thelarche, between girls of different races?
White girls - 10 years of age (8 to 12.75 years of age) Black girls - 8 years of age (7 to 11 years of age) Hispanic girls - somewhere between the two above