adolescent growth and development powerpoint
- 1. Adolescent Growth and Development • Spans ages 11–21 years • Dramatic changes in size and appearance • Pace of physical growth is second only to that in infancy • Reaches full adult height • Marked by important psychological changes • Primary and secondary sexual characteristics are acquired
- 2. Lesson Outcomes 1. Review physical, psychosocial, cognitive and emotional development of the adolescent. 2. Identify communication techniques to use with adolescents 3. Explore the influence of peers on the adolescent. 4. Discuss safety concerns for the adolescent, including teen violence, dating violence, substance abuse and suicide risk 5. Create a teaching plan for good hygiene for teens. 6. Identify strategies for caring for a hospitalized adolescent.
- 3. Physical Growth and Development • Girls experience budding of breasts, pubic hair. Growth in height ceases 2–2 1/2 years after menarche. Fat deposits increase. Secretion of estrogen in girls stimulates physical sexual changes Hips widen in females • Boys experience testicular and penile enlargement. Growth in height is slower than girls and ceases between 18 and 20 years of age. Muscle mass increases. testosterone in boys stimulates physical sexual changes shoulders widen in males • Peak height velocity occurs at about 12 years of age in girls and 14 years of age in boys • Growth plates at the end of long bones begin to close • Physical development, hormonal changes, and sexual maturation occur during puberty Skin changes related to increased sebaceous gland secretions may lead to skin eruptions (acne) Apocrine glands (sweat glands) activate in axilla and genital areas Increase in body hair Voice deepens (most dramatic in males) Limbs elongate disproportionately (may look “leggy”) • Neurologic system: growth of myelin sheath enables faster neural processing; cognitive growth increases • Respiratory system: increase in diameter and length of the lungs; respiratory volume and vital capacity increase
- 4. Physical Growth and Development • Cardiovascular system: size and strength of heart increases; systolic blood pressure increases and heart rate decreases • Gastrointestinal system: full set of permanent teeth; liver, spleen, kidneys, and digestive tract enlarge • Musculoskeletal system: linear growth is not complete until late adolescence in boys and occurs earlier in girls; growth plates (which promote linear growth) begin to close at puberty. Adult height is attained when growth plates have closed in late adolescence • Integumentary system: skin is thick and tough; sebaceous glands are more active; sweat glands function at adult level
- 5. Tanner Stages of Adolescent Sexual Development Sexual Maturity Rating – describes five distinct stages of sexual development based in breast and pubic hair development in girls and genital and pubic hair development in boys. This also includes approximate age ranges for early, middle, and late puberty. See pgs. 422-423 for Tanner Stages Stage 1 - no signs of puberty Stage 2 - Early Puberty- 10 – 11.5 years old Stage 3 - Middle Puberty- 11.5 – 13 years old Stage 4 - Late Puberty- 14.5 -16.5 Stage 5 - Adult
- 6. Motor Development • Engages in various forms of motor activity • Aerobic exercise • Team sports • Dance • Provides an opportunity for competition, teamwork, and social relationships • Large muscle mass increases in adolescents. • Coordination of gross and fine muscle groups improves.
- 8. Sensory Development Eyes and ears are fully developed. Exception of refraction errors Minor infections Myopia occurs in early adolescence. Eye injuries are common. Protective equipment should be worn during athletics.
- 9. Psychologic / Cognitive Development
- 10. Cognitive Development Cognitive thinking during adolescence moves from concrete to abstract reasoning. Formal operations characterizes the last stage of cognitive development (Piaget). Inductive and deductive reasoning Ability to connect the separate events Understanding of consequences Understanding of complex concepts using analytical methods
- 11. Cognitive Development: Piaget • Formal operations period • Abstract thinking • Think beyond present • Mental manipulation of multiple variables • Concerned about others’ thoughts and needs
- 12. Psychological Development Early adolescents (11–14 years) Intense feelings about body image Quite egocentric May move from obedience to rebellion Believe everyone is critical of them Audience conscious (Elkind) Bad things only happen to others.
- 13. Psychological Development Middle adolescence (15–17 years) Most frustrating period of adolescent development Teen becomes introspective and narcissistic. Testing of limits, withdrawal, rebellion Extreme interest in the opposite sex Vocational exploration Interest in gangs
- 14. Psychological Development Late adolescence (18–21 years) Ability to think abstractly Conceptualize verbally and express thoughts and feelings Conformity becomes less important. Self-esteem increases, and they can resist peer pressure. Emancipation (leaving home) Social relationships are more mature.
- 15. Psychosocial Development Erikson’s theory: Identity vs Role Confusion Ages 12 – 18 years • Rapid and marked physical changes • Preoccupation with physical appearance • Examines and redefines self, family, peer group, and community • Peer group very important • Success = confidence in self and identity; optimistic • Fails = develops role confusion and pessimism
- 16. Psychosocial Development • Identity formation - The acquisition of psychosocial, sexual, and vocational identity • Will begin to experiment with new roles outside the family unit
- 17. Language Development Able to express themselves verbally Adolescents who read are more articulate and have a broader vocabulary. Self-confidence plays a significant role in verbal expression. Social media has contributed to abbreviated communication. Communication with a teen can be challenging.
- 18. Parent – Teen Communication Parents should be guided towards authoritative parenting in which authority is used to guide the adolescent while allowing developmentally appropriate levels of freedom and providing clear, consistent messages regarding expectations.
- 19. Moral and Spiritual Development Develops a respect for law and a society- maintaining orientation (Kohlberg). Questions the values of family and society Integrates experiences and beliefs into a personal moral framework Spirituality has a positive effect on health- related quality of life in adolescence.
- 20. Assessment of the Adolescent • Prefer a straight-forward approach. Be careful not to appear condescending. • Show concern for adolescent’s perspective. Ex. “First, I’d like to talk about your main concerns” • Begin with less sensitive issues and proceed to more sensitive ones. • Have an open dialog regarding who should be present during the exam (usually without parents present) • Parents should be able to talk with nurse regarding concerns • Provide a gown for the adolescent to wear during exam and be sure to allow for modesty • Perform head to toe exam, including examination of genitals. Allow the teen to ask any questions.
- 21. The Adolescent’s Reaction to Hospitalization/Illness • Loss of independence • Loss of identity • Body image disturbance • Rejection by others • Separation from peers is a source of anxiety • Physical appearance is important to their identity perception • May act due to loss of control: anger, withdrawal, uncooperativeness, power struggles, etc. • Reluctant to ask questions, questions competency of others • Personal Fable – nothing can harm them. This results in risk taking and noncompliance
- 22. Health Promotion Hygiene In general, teens are meticulous about personal hygiene Acne Dental care Cavities decrease Third molars (wisdom teeth) may erupt Gingivitis, malocclusion, and trauma to the mouth
- 23. Health Promotion Sleep and rest Shows a propensity for staying up late Difficulty waking up in the morning 6–8 hours sleep during the week; 12 on weekends Exercise and activity Involvement in many activities Ideal time to promote physical fitness
- 24. Nutrition in Adolescence • Peer pressure; growing wish for independence from family in food choices • Low cost/convenience/easy access of fast foods • Family culture relating to food and mealtime rituals • Lack of time/opportunities for family meals (busy schedules) • Growing wish for independence in food choices
- 25. Safety • Injuries claim more lives during adolescence than all other causes of death combined. Car safety Alcohol use and motor vehicle crashes Water safety Suicide Violence toward others Firearms
- 26. Risk for Violence Factors that contribute to violence: • Low socioeconomic status • Crowded urban housing • Single-parent family/limited supervision • History of family violence/abuse • Access to guns • Peer pressure or gang involvement • Limited education • Racism • Drug or alcohol use • Low self esteem/hopelessness about the future • Aggression
- 27. Adolescent Suicide Risks • Depression or other mental health illness • Personal or family history of previous suicide attempt • Poor school performance • Dysfunctional or disorganized family • Substance abuse • Difficulties with sexual identity • Socially isolated (loner, victim of bullying) • Marked changes in behavior (giving away valued possessions) http://www.nbcnews.com/news/us-news/teen-accused-coercing-boyfriend-kill -himself-sent-texts-grieving-mother-n768866
- 28. Selected Issues Related to the Adolescent Risk-taking behavior is considered normal. Body piercing Tattoos Tanning Sexual activity Relationship violence Teen pregnancy Sexually transmitted diseases (STDs)
- 29. Factors to Consider in Selecting Adolescent Contraceptives • Sexual interest in opposite/same-sex partners is part of human development occurring in adolescence • Teens need to learn about these new feelings and how to manage them in an appropriate way • Conversations about sexual activity and health should be ongoing and built upon candor and trust • Parents may need support in these conversations • Navigating romantic relationships is an important developmental task for adolescents • Sexually active teens must have access to contraceptives
- 30. Consent in Pediatrics Minors needing emergency treatment • The emergency treatment exception allows health care providers to treat minors in emergency or life- threatening situations when a parent or guardian can’t be reached to give consent. • The legal definition of an emergency medical condition is any condition that threatens the loss, impairment, or serious dysfunction of life or limb or causes severe pain. • This exception is based not on the minor’s autonomy but on the need to maintain the minor’s health and well-being. This exception protects you and other healthcare providers from assault and battery charges that often stem from providing treatment to someone without consent. Smith, PhD, JD, RN, M. H. (2017, October 13). What you must know about minors and informed consent. Retrieved May 16, 2018, from https://www.americannursetoday.com/what-you-must-know-about-minors-and- informed-consent/
- 31. Consent in Pediatrics – Clinical Exceptions • Diagnosis and treatment of STI • Contraceptive services • Prenatal services • Diagnosis and management of substance use/abuse • Limited mental health treatment • In the state of KY, girls under 18 who aren’t married or otherwise emancipated must get the written informed consent with a 24-hour waiting period of one parent or guardian, except when a medical emergency requires an abortion. A girl can also go to court to ask the judge to waive the parental consent requirement.
- 32. The End
Editor's Notes
- #3: Secretion of estrogen in girls and testosterone in boys stimulates physical sexual changes Physical development, hormonal changes, and sexual maturation occur during puberty Peak height velocity occurs at about 12 years of age in girls and 14 years of age in boys Muscle mass increase in boys and fat deposits increase in girls
- #5: Knowledge of Tanner staging is important for RNs to assess normal growth and development and provide adolescents and their parents with anticipatory guidance regarding sexual development. However, nurses must remember that sexual maturation and physical development are highly variable and that Tanner stages may overlap one another. Stage 1 and 2 often occur in the school-age child Stages 3 – 5 occur in the adolescent