Chapter 7 Pediatriacs

In helping parents anticipate puberty in their daughter, the nurse explains that a first sign will be the appearance of ________________________.

Breast buds

A 17-year-old girl needs to increase her iron intake but is concerned about weight gain. The nurse will suggest which of the following?

Chicken, whole-wheat bread, watermelon Chicken, whole-wheat bread and watermelon are all foods high in iron. The calorie content will not promote weight gain. All the other options do not include good sources of iron but are nutritious foods. Calorie content is also acceptable.

What exercise recommendation should nurses give to adolescents?

Engage in aerobic exercise at least 30 minutes each day four times per week. Aerobic exercise 30 minutes daily four times weekly is adequate but even better if done daily. The other recommendations lack adequate activity or specificity.

A 14-year-old girl arrives at the nurse's office carrying a tooth knocked out in gym. The nurse knows, prior to dental care, the action that will best preserve the tooth is:

Reinsert the tooth into the socket. If reinserting the tooth is possible, it will be preserved until the teen can get to the dentist. The other options for caring for the tooth are incorrect. If replacing it in the socket is not possible, placing it in cool milk or in normal saline for transport to the dentist is suggested.

Nurses work to prevent tobacco use by teens because: Select all that apply.

Smoking is associated with fighting and unprotected sex. Smokeless tobacco damages gums and teeth. Teens who smoke are more likely to use alcohol and drugs. Tobacco use is addicting (nicotine). Smoking damages the respiratory system. All the options are true and represent reasons nurses work to help teens resist tobacco use.

In helping parents anticipate puberty in their son, the nurse explains that a first sign will be _______________________________.

Testicular enlargement

The nurse is planning to talk to a 12r-year-old boy who says, "I am too short! Girls are taller than I am. Guess I won't be playing basketball." What points of information will the nurse share? Select all that apply.

"You could add as much as 12 inches to your height before you stop growing." There are a lot of size differences in your age group now because everyone enters puberty and grows at slightly different times than others." "Girls begin to grow rapidly at a younger age than boys do. Boys start later and grow longer." The information about girls growing faster than boys, about differences in size within his age group, and about his growth potential is accurate and addresses concerns implied in his comments to the nurse. Most boys' growth spurts begin near 14 years, not 12r. Height should be doubled at 2 years to predict adult size. The growth control and basketball remarks minimize his concerns and provide no information.

The mother of a 15-year-old boy expresses sadness to the nurse that her son is "much more connected to his friends than his family." What understanding would benefit this parent? (Select all that apply.)

Adolescents need parental support and guidance as they move toward greater peer involvement. Peers can be positive or negative influences. Peers provide opportunity to learn and practice social roles. Peers are needed for emotional security while stepping away from family. All the statements are true regarding the role peers play in an adolescent's life. The mother may better understand the appeal of the peers.

For reasons of anticipatory guidance, nurses should be aware that menarche appears earlier in some ethnic groups than others. In which ethnic group is menarche likely to appear first?

African-American Menarche begins, on average, at 12.06 years in African-American girls, 12.25 years in Mexican-American girls, and 12.55 years in Caucasians.

The nurse is talking with parents of a depressed 16-year-old boy. Which question is of most importance?

Is there a gun in your home? He may be at risk for suicide. Firearm-related suicides have been responsible for a large number of the suicide deaths in 15- to 19-year-olds nationwide. All the other questions assess for depression and do not protect against suicide.

What anticipatory guidance can the nurse provide the girl who has noted the development of breast buds?

Menarche should follow in about 2 years. Menarche usually follows within 2 years of the first signs of breast development. Peak height velocity (PVH) in girls occurs 6 to 12 months following menarche. It does not follow immediately. Breast development progresses through several stages and will not be complete until late puberty. Adult height is not reached at the time of menarche but about 6 to 12 months following menarche.

Nurses should provide anticipatory guidance to males to prepare them for what particular pubertal change in late adolescence?

Nocturnal emissions This involuntary ejaculation during the night can be disturbing to the adolescent male who has little or no understanding of what is happening in his body. Lengthening of the penis begins to occur in early adolescence as does reddening of the scrotum. Breast enlargement occurs in some males in middle adolescence and resolves in late adolescence.

Parents comment that their son seemed more coordinated on the basketball floor at 12 years than he does now at 14. The nurse can include what information in the response?

Uneven growth of soft tissues and bones during growth spurts can cause decreased coordination for boys. The age of 14 years is usually the time of peak height velocity (PHV). Mental focus and reaction to adult authority are not causes of poor coordination. Gains in hand:eye coordination are made during puberty and become precise by late adolescence.

The high school soccer coach asks the nurse how soft tissue ankle injuries to the players might be prevented. The nurse's main recommendation is:

Use semi-rigid ankle orthoses. Research validated that use of semi-rigid orthoses reduced the risk of injury. Ankle conditioning and strength training as well as exercises to improve coordination and proprioception may be helpful and are encouraged. High-top shoes provide some ankle protection and should be worn.

With summer approaching, the nurse discusses sun safety with a group of teen girls. Which suggestion is most likely to be followed?

Wear sunglasses. Sunglasses can be a fashion statement and are likely to be accepted. The other pieces of advice are less appealing to adolescents who link a tan body to beauty. Unfortunately sun exposure is cumulative over a lifetime, and much of it occurs in youth making protecting young skin important.