Adolescents

age range

13-20 years old

puberty

period of rapid physical, cognitive, social and emotional growth

what is girls puberty based on

breast changes and pubic hair

initial indication of puberty for girls 

breast buds between 8 and 13 years old, begin pubic hair growth which occurs 2-6 months after breast buds 

when does menarche (1st period) start

2 years after starting prepubescent changes

what is boys’ puberty based on

size and shape of penis, scrotum and pubic hair

initial indication of boys’ puberty

testicular enlargement accompanied by redness thinning increase looseness of the scrotum between 9.5 and 14 years old 

early puberty characteristics in boys

initial visual of pubic hair, penile enlargement along with early voice changes, increase muscularity, early facial hair, gynecomastia 

gynecomastia

breast enlargement and tenderness, common, occurs in 70% of boys, goes away within 2 years, may surpass 2 years if obese 

late puberty in boys 

increase length and width of penis, first ejaculation, axillary hair, facial hair extends to anterior neck, last voice change 

height

last 20-25% of height is achieved within a 24 to 26th month period, rapid growth

girls’ growth 

growth spurt occurs between 9.5-14.5 years, gain 2-8 inches, gain 15.5-55 lbs 

boys’ growth

growth spurt occurs between 10.5-16 years, gain 4-12 inches, gain 15.5-66 lbs 

response to puberty

compare themselves to peers and what they see on media

how should a nurse base the healthcare interventions on the teen

provide teaching that are appropriate for the teen chronological and cognitive development

developmental stage

identity vs role confusion

challenge of development stage

group identity and personal identity

what should they resolve first before knowing to answer of who they are in relation to family and society 

resolve questions about the relationship within their group 

how can a peer group help the adolescent

helps establish a difference in themselves and their parents

self concept

consider relationships they have developed in the past and reflect where they want to go with the relationships in the future 

process of self concept and what is it accompanied by

takes time, accompanied by confusion depression and  discouragement 

body image

no longer familiar with this body, uncomfortable with new body

reactions to body image 

try to hide, flaunt their new body 

relationship with parents

changes from a protective dependecy to a mutual affection and equality, confide less in their parents 

what does the process of the change in relationship result in 

turmoil and ambiguity

what happens when a teen asserts their independence

results in conflict in the home, spend more time with peers than family 

relationship with parents education

work together to establish new relationship, it is important to their personnel and health related decision making 

relationship with peers

peer groups are a strong support to teen, school and social connectedness is accomplished through school completion

what are the benefits of peer groups for adolescents 

provides a sense of belonging and feeling of strength and power 

school connectedness association

positive mood and decreased high risk behavior, cliques are formed in school 

clique characterisitcs

informal and smaller

interests and activities

switch from personal centered to peer centered, leisure activities

what does leisure activities assist with

social physcial and cognitive development, learn to set priorities and structure their time

interventions for interest and activities 

help them prioritize their time effectively 

emotional well being

unpredictable mood swings, wide range, doesn’t take a lot to set teen off, learn to control emotions, approach problems in a calm rational manner 

what happens once teen emotions are under control

retreat to think about what happened in an attempt to control their emotions 

nutrition

rapid increase need for nutrition, caloric intake should be individualized, nutrient counseling

what is caloric intake based on

level of activity

nutrient counseling

focus on nutrient dense foods and avoid empty calories

nutritional risk for girls with heavy menses

risk of developing iron deficiency

problem with skipping breastfast or eating a poor breakfast 

choose snacks on availability and not of nutritional value 

physical fittnes

high school PE helps with physical exercise needs, participate in sports and dance 

stats on students participation in activity

50% participate in activity that makes them breathe hard and sweat for at least 20 min three or more times a week 

sleep/rest 

9 hours, sleep deprivation can negatively impact physical and mental health

interventions of sleep

help balance and prioritize

what can sleep deprivation lead to

obesity, depression, somatic complaints, fatigue, difficulty with concentration 

dental health

develop less dental carries, regular dentist vists every 6 months, seek corrective oraldontia early, wisdome teeth removal 

personal care

open about it, deodorant to control sweat and odor, wash hair everyday, provide hair removal and cosmetic information 

education of personal care

body positivity and what they can do as personal care

sex education

discussion on intercourse, alternate methods of sexual satisfaction, STD, resist peer pressure, safe sex, clarification of their personal values, provide accurate and unbiased information 

where should you give sex education

in a setting where they feel comfortable enough to ask questions