Chapter 10 Caring for Adolescents

Introduction

• Transition from childhood toadulthood

• Adolescence begins at pubertyand lasts through age 18

• Tremendous physical growth,cognitive, emotional, and sexualmaturation

• Emerging feelings ofindependence

• Relating more to peers thanfamily

• Unintentional accidents, injuries, and pregnancies

Developmental Theory

Adolescent period is marked by

- Rapid physical growth- Intellectual curiosity

- Emergence of sexual drives

- Vacillating emotions

Erik Erikson's Theory

Theory of psychosocialdevelopment

- Stage of self-identity versus role confusion

- Navigation through self-awareness and self-understanding

Jean Piaget's Theory

Theory of cognitive development

- Formal operations

- Teen has achieved

• Deductive reasoning

• Propositional thought

• Higher processing of complex information

Adolescent Growth and Development

• Rapid growth

• Use of national growth charts

• Milestones

- Fine motor: manipulatecomplicated objects, highlevel of skill via video game orcomputer, improved hand-eyecoordination/dexterity

- Gross motor: increased endurance, coordination, speed

• Sleep needs

• Development of sex characteristics

Communicating with Teens

Establishing a rapport

Understanding state has laws concerning:

• Provision of assessments

• Distribution or prescriptions of birth control

• Treatment for sexually transmitted infections

Play and Recreation Needs of the Adolescent

Teen preferences

• Peer-related play and recreation

• Independence from family

Nursing care forhospitalized teens

• Distraction

• Play

• Recreation

Health Concerns for the Teenager

• Higher risk based on:

- Poor eating patterns

- African Americans/Hispanic

- High-risk behaviors and choices

- Growing, changing, and maturing bodies

Health Concerns for the Teenager cont

Unintentional injuries

• Poor decisions

• Motor vehicle crashes/ATV

• Homicide, suicide, and violence

Increased emotional reactivity

• Pronounced emotional state

• Exaggerated responses

Nutrition

Risk for nutritional deficiencies

- Rapid growth

- Large appetites

- Consumption of fast foods

• Eating disorders

- Binge-eating

- Bulimia nervosa

- Anorexia nervosa

Anemia

• Symptoms: fatigue, loss of energy, SOB, dizziness, leg cramps, insomnia

• Risk factors

- Iron-poor nutrition

- Heavy menses

- Chronic illnesses

Acne

Hormones increase sebum production

Types

• Inflammatory

• Papules

• Pustules

• Cysts

• Non-inflammatory

• Open comedones (blackheads)

• Closed comedones (whiteheads)

Alcohol and Drug Experimentation

• Harmful drinking

- Risky behaviors

- Significant injuries

• Screening for substance abuse

Mental Health

Depression is contributing factor to:

*Disability

• Illnesses

• Suicide

Conditions that negatively influence health

• Poor self-esteem

• Feeling devalued

• Bullying

• Poverty

• Humiliation

Sexuality

• Sexuality/pregnancy and sexually transmitted infections

- Rate of teen pregnancyand childbirth declined

- Alcohol or drug involvement

- Sexual abuse

Safety Concerns

Hospital or clinic

-Allow independence

-Realistic choices

-Permission to go off floor with parent SW or CLS

Home

-Medications

-Party/alcohol/drugs

-Curfews/limits/boundaries

-Swimming

-Car/driving

-Cleanliness

School

-Sports safety

-Clean equipment

How would you assess?

• Head- shape, circumference

• EENT-Drainage, swelling, PERRLA, MM

• Resp- rate, WOB, retractions, adventitious BS

• Cardiac-murmur, rate, rhythm

• GI-distended, flat, soft, tender

• GU- drainage, odor, pain

• Skin -lesions, bruising, petechia, blisters, redness, edema, rash

• Musculoskeletal-deformity, pain, edema

• Developmental Milestones

vaccines

covid, flu, and maybe 2nd meningcoccol