1

NCM 218 | CHAPTER 33| Nursing Care of A Family With An Adolescent

Adolescence  blood pressure

 generally defined as the period between ages 13 and up  increases slightly (to 120/70 mmHg) by late
to 20 years adolescence
 time that serves as a transition between childhood and  becomes slightly higher in males than in females bc
becoming a late adolescent more force is necessary to distribute blood to the
early period 13-14 larger male body mass
middle period 15-16  androgen
late period 17-20  stimulates sebaceous glands to extreme activity-->
2020 National Health Goals that relate to adolescent health sometimes resulting in acne
 Reduce the number of adolescents who are obese from a  Apocrine sweat glands
prevalence of 17.9% to 16.1%.  glands present in the axillae and genital area
 Reduce the proportion of high school students engaging in  produce a strong odor in response to emotional
binge drinking from 25.2% to 22.7%. stimulation
 Reduce cigarette use by adolescents from 19.5% to 16%. -  form shortly after puberty
Reduce the rate of smokeless tobacco use by adolescents Teeth
from 8.9% to 6.9%.  second molars--> about 13yo
 Reduce the proportion of adolescents who are offered,  third molars--> between 18-21, may be as early as 14 or
sold, or given an illegal drug on school property from 15
22.7% to 20.4%.  jaw reaches adult size only toward the end of adolescence
 Reduce the proportion of adolescents who report they → adolescents whose third molars erupt before the
rode, during the previous 30 days, with a driver who was lengthening of the jaw is complete--> may experience
drinking alcohol from 28.3% to 25.5%. pain and may need these molars extracted because they
 Reduce the rate of suicide attempts by adolescents from do not fit their jawline
1.9% to 1.7%. Puberty
 Increase the proportion of adolescents who meet current  the time at which an individual first becomes capable of
federal physical activity guidelines for aerobic physical sexual reproduction
activity from 18.4% to 20.2%  usually occurs between the ages of 11-14
Physical Growth  A girl has entered puberty when:
 Adolescents both grow rapidly and mature dramatically:  she begins to menstruate
 during the period from age 13 to 18 to 20 years  a boy enters puberty when:
 The major milestones of physical development in the  he begins to produce spermatozoa
adolescent period  The age of first menstruation in girls is gradually
 onset of puberty at 8 to 12 years of age decreasing from a mean of 13 years to 12.4 years, which is
 cessation of body growth around 16 to 20 years probably related to:
 Girls  more weight gain in girls
 most are 1 to 2 in. (2.4 to 5 cm) taller than boys secondary sexual changes
coming into adolescence  example--> body hair configuration and breast growth
 generally stop growing within 3 years from  characteristics that distinguish the sexes from each other
menarche--> are shorter than boys by the end of but that play no direct part in reproduction
adolescence  Sexual maturity in males and females
 grow 2 to 8 in. (5 to 20 cm) in height  is classified according to Tanner stages
 gain 15 to 55 lb (7 to 25 kg)
 Growth stops with closure of the epiphyseal lines of
the long bones--> about 16-17yo
 Boys
 typically grow about 4 to 12 in. (10 to 30 cm) in
height
 gain about 15 to 65 lb (7 to 30 kg)
 Growth stops with closure of the epiphyseal lines of
the long bones--> about 18-20yo
 adolescents may have insufficient energy and become
fatigued trying to finish the various activities that interest
them
 because the heart and lungs increase in size more
slowly than the rest of the body
 Pulse rate and respiratory rate
 decrease slightly (to 70 beats/min and 20 breaths/min,
respectively)
1This study source was downloaded by 100000897048825 from [Link] on 11-02-2025 [Link] GMT -06:00 shing

[Link]
2

NCM 218 | CHAPTER 33| Nursing Care of A Family With An Adolescent

4. Becoming uncontrolled by their parents

 If young people do not achieve a sense of identity, they
develop a sense of role confusion or can have little idea
what kind of person they are
Body Image
 Adolescents who developed a strong sense of industry
during their school-age years have learned to solve
problems and are best equipped to adjust to their new
body image.
 Nurses who care for adolescents can do much to educate
them about their bodies and help them to accept the
changes that mark maturity.
Self-Esteem
 Like body image, self -esteem may undergo major
changes during the adolescent years and can be
challenged by all the changes that occur during
adolescence, including:
1. Changes ain one's body and physiologic functioning
2. Changes .in feelings and emotional focus
3. Changes 'in social relationships ( including relationships
with both family and friends)
4. Changes 'in family and school expectations
▪ All of these factors can have an effect on an adolescent's
feelings about himself or herself sometimes resulting in
crisis.
• Body mass increases to adult size. Value System
• Sebaceous glands are activated. ▪ Adolescents develop values through talking to peers. They
• Eccrine sweat glands become fully functional. also need an attentive adult ear , someone who will listen
• Apocrine sweat glands undergo development. to their fears, hopes, dreams, and the pressure they feel
• Body hair is distributed in a characteristic adult-like to be somebody, the pressure Of wanting to do something
pattern. and yet not knowing what or how.
Hormonal Changes Career Decisions
• Hormones: powerful chemical substances secreted by ▪ Part of the feeling of knowing what kind of person you are
endocrine glands & carried through body by bloodstream is knowing what kind of job you can do.
• Hypothalamus: structure in higher portion of brain that ▪ Because of the thousands of opportunities available today
monitors eating, drinking & sex makinq a career decision becomes more and more
• Pituitary gland: important endocrine gland controls difficult.
growth & regulates other glands Emancipation from Parents
• Gonads: sex glands - testes in males & ovaries in female ▪ Emancipation from parents can become a major issue
Two primacy classes of hormones during the middle and late adolescent years for two
• Androgens: male sex hormones reasons. Some parents may not yet be readv for their
• Estrogens: female sex hormones child to be totally independent. and some adolescents
• Testosterone: androgen plays important role in male may not yet be sure they want to be on their own.
pubertal development ▪ They may fight bitterly for a right- for example, to stay out
• Estradiol: estrogen plays important role in female until midnight or later on a weekend- then never use the
pubertal development privilege once they have gained it.
 Developmental task: Identity vs Role confusion Sense of Intimacy
 In the late adolescence, the task is to form a sense of ▪ Once adolescents have achieved a sense of identity in
intimacy or form close relationships with persons of the early or mid-adolescence, they are ready to work on a
opposite as well as the same sex. It is the concentration second developmental task of achieving a sense of
on these two tasks that leads to typical adolescent intimacy (erikson, 1993 The ability to form intimate
behavior relationships is the sense of trust, the first developmental
 The four main areas in which adolescents must make task in infancy.
gains to achieve a sense of identity Cognitive Development
1. Accepting their changed body image ▪ The final stage of cognitive development, the stage of
2. Establishing a value system or what kind of person they formal operational thought begins at the age 12 or 13
want to be years and grows in depth over the adolescent years
3. Making a career decision (piaget, 1969). This step involves the ability to think in
2This study source was downloaded by 100000897048825 from [Link] on 11-02-2025 [Link] GMT -06:00 shing

[Link]
3

NCM 218 | CHAPTER 33| Nursing Care of A Family With An Adolescent

abstract terms and use the scientific method to arrive at  Parents can, however, encouraqe adolescents to engage
conclusions in healthy patterns of living—primarily through role
Moral and Spiritual Development modeling.
▪ Because adolescents enlarge their thought processes to Dress and Hygiene
include formal reasoning, they are able to respond to the  Adolescents are capable of total self-care and, because of
question, “why is it wrong to steal from your neighbor’s their body awareness, may even be overly conscientious
house?” with “ it would hurt my neighbour by requiring about personal hygiene and appearance.
him to spend money to replace what I stole rather than Sleep
with the immature response of the school age.  Although it is widely believed adults need 8 hours of sleep
PROMOTING ADOLESCENT SAFETY a night some need more and others can adjust to
 Unintentional injuries, most commonly those involving considerably less. Protein synthesis occurs most readily
motor vehicles, are the leading cause of death among during sleep. Because adolescents are buildinq so many
adolescents. new cells, adolescents may need proporfionately more
 Equally dangerous for adolescents are motorcycles, sleep than school -age children during this time.
motorbikes, and motor scooters, which are appealing Exercise
because of their low cost and convenience in parking.  Adolescents need exercise every day both to maintain
 Other common causes of death in adolescents are muscle tone and to provide an outlet for tension.
homicide and self-harm (i.e.,suicide) Vital Signs
Motor Vehicle Temperature: 97.5-98.6 degree F
 Always wear safety gears/protective equipment (e.g. Apical Rate: 55-90 (PR 60-100)
helmet, suits, etc.) Respirations: 12-20 breaths/min
 Take theoretical driving lessons and seminars seriously Blood Pressure: 121/70 mmHg (avearge)
 Do not drink and drive Parental Concerns During the Adolescent Years #1
 Do not take dares Health problems
Firearms ● Hypertension
 Do not play with guns ● Poor posture
 Learn safe gun handling before attempting to clean a gun ● Body piercing and tattoos
or use it ● Fatigue
Promoting Nutritional Health With a Varied Diet ● Menstrual irregularities
Vegetarian Diets ● Acne
 Vegetables contains fewer calories than meat, so the ● Obesity
need to consume larger amounts to achieve adequate Parental Concerns During the Adolescent Years #2
caloric intake Sexuality and sexual activity
Glycogen Loading  STDs
 A procedure used to ensure adequate glycogen to sustain  Pregnancy
energy (mostly used by athletes)  Homosexuality
 Date rape
Promotion of an Adolescent and Family  Stalking
Promoting Adolescent Safety  Hazing or bullying
 Accidents, most commonly those involving motor vehicles Parental Concerns During the Adolescent Years #3
are the leading cause of death among adolescents. ● Substance use disorders
Promoting Nutritional Health for an Adolescent ● Depression and self-injury
 Adolescents may always feel hungry. experiencing If Common Health Problems of an Adolescent
adolescents grow so much growth eating their habits are Poor posture
unsupervised, they tend to eat faddish or quick snack  Many adolescents demonstrate poor posture, a tendency
foods rather than more nutritionally sound ones because to round shoulders and a shambling, slouchy walk. This is
of both hunger and peer pressure. Some adolescents turn due in part to the imbalance of growth, the skeletal
away from the five pyramid food nourished despite their system growing a little more rapidly than the muscles
large intake. attached to it.
Promoting Development of an Adolescent in Daily Activities  Poor posture particularly seems to develop in adolescents
 Maintaining adequate nutrition to support rapid who reach adult height before their peers. They slouch to
adolescent growth is essential to continued healthy appear no taller than anyone around them
development  Girls especially may slouch to diminish the appearance of
 Adequate sleep, hygiene, and exercise are also important their breast size if they are developing more rapidly than
and should become an adolescent's responsibility rather their friends
than the parents'.  This also can occur from carrying backpacks that are too
heavy
Body Piercing and Tattoos
3This study source was downloaded by 100000897048825 from [Link] on 11-02-2025 [Link] GMT -06:00 shing

[Link]
4

NCM 218 | CHAPTER 33| Nursing Care of A Family With An Adolescent

 Body piercing and tattoos are becoming a mark of  Most overweight adolescents have obese parents,
adolescence. Both sexes have ears, lips, chins, navels, and suggesting that both inheritance and environment play a
breasts pierced and filled with ear rings, or tattoos applied part in the development of adolescent obesity.
to arms, legs, or their central body.  Most obese adolescents continue to be obese adults. It
 These acts have become a way for adolescents to make a can be difficult for adolescents to learn to like themselves
statement I am different from you"). Be certain they know (achieve a sense of identity) if they do not like their
the symptoms of •infection at a piercing or tattoo site reflection in a mirror.
( redness, warmness, drainage, swelling, mild pain) and to Hypertension
report these to a healthcare provider if they occur.  Hypertension is present if blood pressure is above 95th
Fatigue percentile, or 127/81 mmHg for 16 y/o girls and 131/81
 So many adolescents comment they feel fatigued to some for 16 y/o boys for two consecutive readings in different
degree that this can be considered normal for the age settings.
group.  all children older than 3 years of age should have their
 Because fatigue may be a beginninq symptom of disease, blood pressure routinely
however , it is important to be investigated as a legitimate Concerns Regarding Sexuality and Sexual Activity
concern and not underestimated. Sexually Transmitted Diseases
 Assess an adolescent’s diet, sleep patterns, and activity Teenagers tend to believe that:
schedules, because all can contribute greatly to fatigue. ●Sexually transmitted diseases (STD) always happen to
Menstrual Irregularities someone else.
 Menstrual irregularities can be a major health concern of STDs Can be easily cured without any harm done
adolescent girls as they learn to adjust to their individual ●STDs are too horrible for a nice young person to
body cycles. even hear about.
 Dysmenorrhea is painful menstruation, it was thought to Eating disorder
be mainly psychological, needing no treatment other than ● Eating disorder are complex, involving genetic, inheritance,
reassurance that it was a normal phenomenon and physiological factors, cognitive factors and environmental
something women should endure. experiences
 Today, it is known that the pain is caused by the release of ● Anorexia nervosa: is disorder that involve voluntary refusal to
prostaglandins in response to tissue destruction during eat, accompanied by severe loss of body weight without an
the ischemic phase of the menstrual cycle. Prostaglandins organic cause
release causes smooth muscle contraction in the uterus ● Bulimia: individuals consistently follow binge and purge
 Dysmenorrhea can also be a symptom of an underlying eating patterns (episodes of binge eating followed by
illness such as PID, uterine myomas (tumors) or self inducing vomiting
endometriosis (abnormal formation of endometrial tissue) Stalking
Management of dysmenorrhea  refers to repetitive, intrusive, and unwanted action such
1 .Warm bath as constant and threatening pursuit directed at an
2. Heating pads applied to abdomen individual to gain attention
3. Exercise CONCERNS REGARDING HAZING OR BULLYING
4. Good posture Hazing
5. Mild analgesic  Is a form of organized bullying refers to demeaning or
6. Diuretics to relieve fluid retention humiliating rituals that prospective members have to
7. Psychotherapy undergo to join sororities, fraternities, or adolescent
Acne gangs
 Acne is a self -limiting inflammatory disease that involves Substance abuse:
te sebaceous g an s a empty into hair shafts ( the  refers to the use of chemicals to improve a mental state
pilosebaceous unit mainly of the face and shoulders. or induce euphoria,
 It is the most common skin disorder of adolescence,  This is so common among adolescents that as many as
occurrinq slightly more frequently in boys than girls. The 50% of high school seniors report having experimented
peak age for the lesions to occur in girls is 4 to 17 years: with some form of drug use occurs in adolescence from a
for boys, 16 to 19 years. desire to expand consciousness or to feel more confident
 Although not proven, genetic factors may play a part in and mature
their development Cigarette smoking may also increase  It also can be a response to peer pressure or a form of
the number of Inflammatory lesions. adolescent rebellion. This type of rebellion is more
Therapeutic Management emotionally charged than acts such as staying out late or
 The goal of therapy for acne is threefold: (1) decrease wearing clothing other than those approved by parents,
sebum formation, (2) prevent comedones, and (3) control because it is not only harmful but also illegal.
bacterial proliferation. Types of Abused Substances
Obesity Prescription and Over-the-Counter Drugs

4This study source was downloaded by 100000897048825 from [Link] on 11-02-2025 [Link] GMT -06:00 shing

[Link]
 5

NCM 218 | CHAPTER 33| Nursing Care of A Family With An Adolescent

 Adolescents who use drugs this way can easily overdose  Can be extremely dangerous, there is a tendency to
because they are unaware of usual drugs this is called decrease one's respiratory rate
pharming Cocaine
 Ex. Sedatives, pain medication, ketamine, or cough syrup  One of the most popular drugs of abuse for late
 Methylphenidate (Ritalin) - is a drug frequently prescribe adolescents
for attention deficit hyperactivity disorder  It is combined with heroin
 Mephedrone - commonly called "bath salts" a stimulants Produces Physical Effects
that creates an enjoyable high  Increased pulse rate,
Alcohol  respiratory rate,
 Alcohol use cannot be taken lightly, it can cause disease  increased temperature,
such as cirrhosis and is linked to destructive behaviors  increased blood pressure,
such as addiction, depression and vulnerability to date  decreased appetite
rape
Tobacco Psychological Effects
 Adolescents usually begin smoking because the habit - Euphoria
conveys a stamp of maturity - Excitement
 Chewing tobacco it can cause gingival recession and lip - Restlessness
and mouth cancer - Possible hallucinations
PERFORMANCE ENHANCING SUBSTANCE USE DISORDER •During pregnancy it can cause separation of the placenta with
Anabolic Steroids potential fetal and maternal death
 are derivatives of the natural hormone testosterone. CONCERNS REGARDING DEPRESSION AND SELF-INJURY
These substances have side effects of euphoria and •Self-injury includes a range of self-destructive actions from
lessened fatigue, which make them doubly appealing cutting to suicide, the planned intent to end one's life.
 Athletes using them and paying vigorous sports can die •Cutting is found more frequently in girls than boys and can
from ventricular hypertrophy begin as early as grade school
Human Growth Hormone Homeless Runaway Youth
 is a second drug used to enhance athletic performance •A runaway is commonly defined as an adolescent between
Marijuana the ages of 10 and 17 years who has been absent from home at
 Cannabis sativa is the most frequently abused illicit least overnight without permission of a parents or
substance next to alcohol used by adolescents guardian.
Physical and Psychological Effects •Stress factors such as family, unemployment,
- Euphoria alcoholism,sexual maltreatment, incest, attempted
- Sense of well being suicide,poverty are frequent characteristics in their families
- Temporary impairment of coordination Common health reasons for which runaway adolescents are
- Rapid mood swing seen at healthcare facilities are:
- Decreased attention span •Sexually Transmitted Diseases,
- Loss of memory for recent event •Including HIV and AIDS,
•Rape Pregnancy,
Long Term Side Effects •Substance Use Disorders,
- Pulmonary Disorder •Hepatitis and Vaginitis.
- Lack of Sperm Formation A Physically Challenged or Ill Adolescent
Amphetamines •Achieving a sense of identity may be difficult for adolescents
- group of drugs used in the treatment of hyperactivity and who have a chronic illness or other challenges.
narcolepsy •Adults who are chronically ill are likely to be difficult to be as
- Called "uppers" or"speed" independent as they would like to be. They are at high risk of
- Some side effects: aggressive or demanding behavior, drug use disorder or self injury
paranoia, extreme restlessness •Adolescents who are not fully mobile must be mindful of their
-Chronic methamphetamine abuse result in destruction of overall consumption of calories because they may become
teeth enamel or blackened obese as growth needs decrease at the end of adolescence.
Hallucinogens
- Drugs used by adolescents are lysergic acid diethylamide (LSD)
dimethyltryptamine (DMT)
Methaqualone (Quaalude)
- This drugs gives users feelings of euphoria, pleasure, distorted
time and sensory perception
Opiates
 Opiates include drugs such as heroin, meperidine and
morphine.
5This study source was downloaded by 100000897048825 from [Link] on 11-02-2025 [Link] GMT -06:00 shing

[Link]
Powered by TCPDF ([Link])