Adolescents

CH 7 AGE 12- 20
Adolescents
● Maturing emotionally, physically and moving
toward adulthood

● Body image is critical, anything that interferes with

can interfere with development BUT time when
acne, braces, vision issues naturally occur

● Look like adults but don’t have the judgement to

act in society as adults
 Adolescents
● Strongly influenced by friends

● Roller coaster emotions

● Intense interest in romantic relationships

● Erikson: Identity vs Role Confusion

● View themselves as invinciable

Physical Development
● Females

Grow 2-8 inches and gain 15.5-55 lbs

Stop growing 2 - 2.5 years after the beginning of their periods

● Males

Grow 4 - 12 inches and gain 15.5 - 66 lb

Stop growing around 19 - 20 years old

Physical Development
● Growth spurt for girls begins earlier and is shorter

● Boys grow slower and steadier rate

● Girls sexual maturation : breasts, pubic hair, axillary hair,

period

● Boys: Tetsical enlargement, pubic hair, penile enlargement,

axillary hair, facial hair, vocal change
Cognitive Development
● Piaget formal operations

● Can think in abstracts and hypotheticals

● Can evaluate the quality of their own thinking

● Can see how actions of an individual influence others

● Can think beyond current circumstances

Psychosocial Development
● Erikson: Identity vs Role Confusion

● Will try out being different people in order to

develop their own personal identity and be able
to view themselves as completely unique
individuals

● Peer group largely influences behavior

Sexuality
● Develop close same sex relationships, can sometimes
involve experimentation driven by curiosity

● Transition from friendships to relationships

● Both sexes need to be taught what is happening with the

other sex during this time

● They need to receive accurate, honest information

Sexuality
● Need to be prepared for beginning of period and
nocturnal emissions

● Need a good foundation in sex education which

should start in the home ; good sex ed can reduce
rate of HIV infections

● Need to understand the importance of regular exams:

Testicular cancer is one the most common cancers in
men age 15 - 34 years
Sexuality
● Need safe sex info and how to prevent STI’s

● Need to be asked their preferred pronouns

● Risk of bullying, physical/sexual violence, substance abuse,

and suicidal behaviors, STI’s for those that identify LGBTQIA

● Need sensitive non judgemental care

Autonomy
● Independent decision making regarding relationships…BUT
caregivers can/may need to place limits

● Can spend time with AFTER homework etc..

● May accept or reject traditional beliefs of family in regards to

religion/culture

● Will see themselves in relation to likeness with peers early on

then start to see themselves more in terms of their own
unique characteristics
Body Image
● Image established during this time tends to carry on through life

● Intensely important, do not want to look different yet the time of life
where bodies change and get braces, glasses, acne, and everyone
develops differently and at individual times

● Any lack of perceived inadequacy leads to stress; EX: boy goes through
growth spurt later…shorter than friends…stress when they don’t feel
they live up to expected stereotype

● Seeing body as attractive and well functioning attributes to self esteem;

feeling different can detract from that even though they are healthy
Age Appropriate Activities
● Non violent video games

● Nonviolent music

● Sports

● Movies

● Reading
Health Screening
● Scoliosis

● Annual height,weight BMI :( …..BP checks

● Hemoglobin, hematocrit, lipids

● STI screenings
Nutrition
● Rapid growth and high metabolism increase food needs

● Need additional CA+, Iron, Protein, Zinc; often deficient in CA+

(rapid bone growth need more) and iron

● Overeating and undereating can occur

Obesity
Anorexia Nervosa
Bulimia
Nutrition
● Alternate Diets

Vegetarian diets
Vegan
Lacto-Ovo Vegetarian

● Fad Diets, Food Challenges

Sleep and Rest
● Need about 9 hours of sleep

● Stay up late, sleep later and more often during the day
Dental Health
● Checkups every 6 mos

● Dental malocclusion (improper alignment) common; hence braces

● Should brush after meals and snacks and bedtime

● Flossing
Family Teaching
● Can be difficult time for adolescent and caregivers

● Balance between letting them make their own decisions and

safeguarding them

● Issues: sexuality, substance abuse, accidents, discipline, volatile

emotions

● Caregivers may need anticipatory guidance

Injury Prevention
● Alcohol most commonly abused substance

● Need drivers ed class, emphasis on seat belt use, no texting while

driving, no substances when driving

● Stress can lead to depression, suicide, and conduct disorders

● Emotional ups and downs can lead to depression, academic and

social pressures can increase that
Injury Prevention
● Teens need to be monitored for self harm S/S
Lack of interest, social isolation, disturbances in
sleep/appetite,
Expression of suicidal thoughts

● Discuss bullying, cyberbullying

● Computer safety, sexual predators

● Need to be taught how to resolve conflict non violently

 Adolescent in Healthcare Facility
● If admitted usually related to major health problem

● Have to cope with stress of hospitalization, possible dramatic

alteration in body image, interruption to search for identity

● Fears loss on control and loss of privacy

● Need to be able to stay in touch with peers, wear own clothes,

makeup, hair as much as possible

● Encourage maximum participation in self care