PEDS CHAPTER 29
when communicating with a teen how should you speak to them?
-allow them time to speak -respectfully -face-to-face (this shows engagement with the person and respect) -ask open-ended questions -make your message clear to them -be honest -clearly state expectations
how can you give an adolescent thats hospitalized a sense of independence?
-allow them to participate in decisions -identify any knowledge self-care deficits and provide resources
sexually active teens must have access to what?
-contraceptives
if the adolescent has limited parental supervision or poor family functioning what does it put that child at risk for ?
-contribution to adolescent violence
During adolescent years internet safety is important why?
-cyberbullying -sex trafficking
what are some other risk factors of suicide in adolescents?
-depression or other mental health illness -substance abuse -difficulties with sexual identity (fear of not being accepted by others) - socially isolated (victim of bullying) -incarceration
how would you promote proper hygiene in an adolescent?
-encourage frequent bathing and deodorant use -encourage face washing 2-3 times a day -avoid squeezing acne lesions -frequent hair shampooing -hygienic care for body piercings and tattoos -encourage sunscreen use
what should an adolescent be allowed to do during hospitalization to keep socialization involved?
-encourage socializing with their friends through phone, email, and visits when possible
what water safety is important for adolescents?
-learn to swim -avoid swimming alone if possible -wear a life jacket when on a boat (law) -make sure there is enough water to support diving
what factor involving self-image of an adolescent can be a contributing factor to adolescent violence?
-low self-esteem -history of victimization
common substances abused by children and adolescents
-marijuana (including synthetic) -alcohol -nicotine -prescription opiates -prescription stimulants (adderall, concerta, ritalin) -barbituates, benzothiazides, sleeping aids -bath salts -hallucinogens -inhalants (fumes from household products, spray paint) -cocaine, crack -heroin
what are other factors that contribute to adolescent violence?
-peer or gang pressure -access to guns and cars -drug or alcohol use -racism -aggression -lower socioeconomic class -less than optimal housing situation
what are other areas adolescents should focus on to encourage growth and development
-personal care -healthy sleep -healthy sexual life -appropriate discipline -mental health resources (important)
what are some risk factors involving the adolescents family that can increase suicide ?
-personal or family history of previous suicide attempt -dysfunctional or disorganized family
how do peers influence during adolescence ?
-play essential role in identity -provide opportunities to learn differences -provides someone to share their problems with -creates stability in times of stress and transition -sources of information and social reinforcement (behaviors, roles) -can be positive or negative
teens needs to know about these new feelings and how to manage them appropriately; is a part of human development occurring in adolescence
-sexual interest in opposite/same-sex partners
why should substance abuse be discussed and discouraged with an adolescent?
-short/long term effects of substance use on health, relationships, and school performance -risk for unintentional injuries -unwanted sexual activity -the how and why of chemical dependency -impact of substance abuse on society -importance of resisting peer pressure -importance of teen's own judgement -importance of maintaining a healthy lifestyle
what should an adolescent be taught about firearm safety?
-should take firearm safety class -do not point guns at people
when teens started making groups of friends, and start experiencing things like drugs what would a parent be worried about ?
-substance abuse
name three risk of being involved in an unhealthy romantic relationship
-unsafe sexual activity (STI's) -unwanted pregnancy -dating violence
when the adolescent is old enough to drive a motor vehicle what are some things that are important for them to know?
-wear a seatbelt at all times (EVERYONE in the vehicle) -do not drive or ride with anyone impaired -limit passengers to decrease distractions
At what age does puberty begin in boys?
10-11 years
At what age does puberty begin in girls?
9-10 years old
The nurse has determined that an 8-year-old girl is at risk for being overweight. Which intervention would be a priority prior to developing the care plan?
A. Determining the need for additional caloric intake B. Asking the parents who they want to work with the child C. Interviewing the parents about their eating habits D. Discussing the influence of peers on the child's diet (C)
The nurse is caring for a premature baby in the NICU. The mother reports that the infant's normally happy and outgoing 5-year-old sister is acting sad and withdrawn. The nurse understands that due to her developmental stage, the girl is at risk of what happening?
A. Harming the baby B. Viewing her baby sister's illness as her fault C. Experiencing clinical depression D. Creating an imaginary friend to cope with the situation (B)
The nurse is assessing the psychosocial development of a preschooler. What are normal activities characteristic of the preschooler? Select all that apply.
A. Plans activities and makes up games B. Initiates activities with others C. Acts out roles of other people D. Engages in parallel play with peers E. Classifies or groups objects by their common elements F. Understands relationships among objects (A,B,C)
When describing the various changes that occur in organ systems during adolescence, what would the nurse include?
A. Significant increase in brain size B. Ossification completed later in girls C. Decrease in heart rate D. Decrease in activity of sebaceous glands (C)
The school nurse is conducting a seminar for parents of adolescents on how to communicate with teenagers. Which guidelines might the nurse recommend? Select all that apply.
A. Talk face to face and be aware of body language. B. Ask questions to see why he or she feels that way. C. Do not give praise unless the adolescent deserves it. D. Speak to your child as an authority figure, not an equal. E. Don't admit that you make mistakes. F. Don't pretend you know all the answers. (A,B,F)
what are physical changes that can occur in male and females related to sweat glands?
apocrine glands (sweat glands) activate in the axilla (underarms) and genital areas
What is the the first sign of puberty in females?
breast budding (also known as thelarche)
what physical change can occur involving the skin?
due to increased sebaceous gland secretion may lead to acne
why should adolescents engage in sports and physical fitness ?
encourages growth and development
what are other physical changes that can occur in both male and female adolescence dealing with bone development?
growth plates at the end of long bones begin to close and limbs can elongate disproportionally (making them look "leggy")
what other physical change can occur in females?
hips widen
Involving hair development during development of the adolescent what occurs?
increase in body hair
During the development of hair in the male adolescent where does it begin?
pubic hair begins and spreads laterally
where does hair growth begin for females during the development of the adolescent?
soft pubic hair begins on the mons
What is the first sign of puberty in boys?
testicular enlargement
what is the leading cause of death in adolescents?
unintentional injuries
What other physical changes occur in males?
voice deepens and shoulders widen
