Chapter 29 - Growth & Development of the Adolescents

Social Development

(Friends are huge) - goal is to define one's identity independently from parental authority - much ambivalence - intense sociability; intense loneliness - acceptance by peers

Adolescent Sexuality

*Sexuality education & guidance*(teach to be safe) - media influences - knowledge from peers, TV, movies, magazines - need factual information, presentation based on developmental maturity & ability to ask questions - role modeling

Health Promotion - Injury Prevention

- Motor vehicle crashes # 1 cause of serious and fatal injuries in teens

Psychosocial Development Middle = 15 - 17 Yrs

- peer groups conformity - conflict with parents

Health Promotion - Personal Care

- piercing (make sure place is clean, look for infections) - tattoos - tanning - sexual activity

Adolescent Growth & Development

- transition between childhood & adulthood - rapid physical, cognitive, social, and emotional maturation - generally defined as beginning with the onset of puberty & ending with the cessation of body growth at 18 to 20 yrs (going from dependent to independent)

Common Developmental Concerns - Adolescence

- violence - substance use - suicide (3rd leading cause of death in youth 10-24 yrs old *risk* (prom & back to school) - responds to teens better

Erikson Stage

Sense of Identity vs. Role Confusion - development of personal identity - sex role identity

Suicide

Suicide is a solution when there does not appear to be any other solution. Helping an adolescent learn better problem solving can help prevent a second attempt.

What exercise recommendation should nurses give to adolescents?

The U.S. Department of Health and Human Services recommends that adolescents participate in 60 minutes of moderate to vigorous physical activity each day

True adolescence is said to begin when what occurs?

True adolescence begins with the onset of menstruation in the female and the production of sperm in the male.

Which action would provide an indication that an adolescent's parents understand their daughter's need for increased independence?

- Telling you that they are encouraging their daughter in her search for an after-school job (Encouraging adolescents to separate from parents, not to continue to rely on them, can be difficult for parents because it involves allowing adolescents to face and solve problems instead of having them solved for them.)

Health Promotion for Adolescent & Family

- assumption of responsibility for health - assess for risk factors - immunizations - nutrition - eating habits & behaviors - healthy lifestyle habits - dental health - sleep & rest - exercise & activity (HPV - 3 doses - age 12)

Psychosocial Development Early = 11 - 14 Yrs

- body image - same sex friends

Development of Self-Concept & Body Image

- feelings of confusion in early adolescence - acute awareness of appearance, comparison of appearance with others - blemishes & defects are magnified out of proportion - Matures to self-concept based on uniqueness & individuality

Piaget: Cognitive Development

- formal operation period - abstract thinking : think beyond present : mental manipulation of multiple variables : concerned about others' thoughts & needs

Psychosocial Development Late = 18 - 21 Yrs

- less conflict

Anticipatory Guidance - Care of Families

- parents need support & guidance - information needs regarding developmental changes & process of gaining independence - help "letting go" & promoting independence (help let them become their own person)

Relationships with Peers

- peers assume an increasingly significant role in adolescence (best friend) - peers provide a sense of belonging & a feeling of strength & power - peers form transitional world between dependence & autonomy - role of social media & advanced technology

Responses to Puberty

- responses differ depending on the stage of development : curiosity in early adolescence : concerns with "Am I normal?" : concerns for late-maturing teens : concepts of "perfect body" achievement

Relationships with Parents

- roles change from "protection-dependency" to "mutual affection & equality" - process involves turmoil & ambiguity - struggle of privileges & responsibility - emancipation from parents may begin with the rejection of parents by the adolescent

Spiritual Development

- some may question the values & beliefs of the family - capable of understanding abstract concepts & interpreting analogies & symbols - may fear that others will not understand their feelings - tendency for introspection & emotional intensity

The nurse is performing a health surveillance visit with a 12-year-old boy. Which characteristic suggests the boy has entered adolescence?

Experiences frequent mood changes (If the boy has just entered adolescence, he is likely to exhibit frequent mood changes. A growing interest in attracting girls' attention and understanding that actions have consequences are typical of the middle stage of adolescence. Feeling secure with his body image does not occur until late adolescence.)