Pediatric nursing immunization 800 words due 1/18/2020

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N371Chapter29.pptx

Chapter 29 Growth and Development of the Adolescent

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Physiologic Growth and Development (Adolescent)

Rapid growth occurs with dramatic changes in body size and proportions second only to growth in infancy.

Sexual characteristics and reproductive maturity occur.

Puberty begins in girls around 9 to 10 years old and in boys around 10 to 11 years old.

Adolescents represent varying levels of identity formation.

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Puberty in Adolescent

Girls enter earlier than boys

Girls 9 to 10 years old

Boys 10 to 11 years old

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Physiologic Changes in Adolescence

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 increases in boys and fat deposits increase in girls.

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Organ System Maturation (Adolescent) #1

Neurologic system: growth of myelin sheath enables faster neural processing.

Respiratory system: increase in diameter and length of the lungs; respiratory volume and vital capacity increase.

Cardiovascular system: size and strength of heart increase; systolic blood pressure and heart rate increase.

Gastrointestinal system: full set of permanent teeth; liver, spleen, kidneys, and digestive tract enlarge.

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Organ System Maturation (Adolescent) #2

Musculoskeletal system: ossification of skeletal system is incomplete until late adolescence in boys and occurs earlier in girls; shoulder, chest, and hip breadth increase.

Integumentary system: skin is thick and tough; sebaceous glands are more active; sweat glands function at adult level.

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Motor Skills

Continued development of gross and fine motor skills

Use of computers has greatly increased fine motor skills

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Theories

Erikson’s theory (identity versus role confusion) states that during adolescence teenagers have the task of developing their own sense of identity by revisiting each of the previous stages of development

Piaget’s theory states that the adolescent progresses from a concrete framework of thinking to an abstract one in the formal operational period

Kohlberg’s theory states that adolescents are experiencing the postconventional stage of moral development

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Question #1

The nurse is assessing the cognitive development of an adolescent. Which of the following statements accurately represents a normal finding at this stage?

a. the adolescent progresses from an abstract to a concrete framework of thinking

b. the adolescent develops the ability to think outside the present

c. all adolescents achieve formal operational reasoning at the same time

d. adolescent thinking starts out very introspective and then becomes egocentric

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Answer to Question #1

b. the adolescent develops the ability to think outside the present.

According to Piaget, the adolescent progresses from a concrete framework of thinking to an abstract one. During this period, the adolescent develops the ability to think outside of the present; that is, he or she can incorporate into thinking concepts that do exist as well as concepts that might exist. Not all adolescents achieve formal operational reasoning at the same time. Adolescent thinking starts out egocentric and then becomes very introspective and idealistic.

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Language Skills

Develop and be refined during adolescence and adolescents have improved communication skills, using correct grammar and parts of speech.

Use of slang and how it can affect communication with people other than peers.

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Change in Relationships

Families and parents of adolescents experience changes and conflict that require adjustments and the understanding

The adolescent–family relationship is essential for the nurse when caring for this population

Peer groups play an essential role in the identity of the adolescent

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Question #2

Is the following statement True or False?

The nurse caring for an adolescent should teach the parents to monitor their adolescent’s interaction with peer groups.

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Answer to Question #2

True.

The nurse caring for an adolescent should teach the parents to monitor their adolescent’s interaction with peer groups.

Adolescents who do not have parental or adult supervision and opportunities for conversation with adults may be more susceptible to peer influences and at higher risk for poor peer selections.

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Safety Concerns for Adolescents

Unintentional injuries

Motor vehicle safety

Firearm safety

Water safety

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Nutritional Requirements

Increased due to accelerated growth and sexual maturation

Increased calories, zinc, calcium, iron for growth

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Information Included in Nutritional Assessment for an Adolescent

Evaluation of foods from the different food groups that the adolescent eats each day

The number of times that fast foods, snacks, and other junk food are eaten per week

This assessment will help the nurse to guide the adolescent in making better food choices at home and in fast-food establishments.

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Sexuality and Influence of Dating

Develop an interest in the opposite sex during adolescence related to physical development and body changes, peer group pressure, and curiosity

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Risks of Being Involved in an Unhealthy Romantic Relationship

Dating violence

Risky sexual activity (STIs)

Premature pregnancy

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Areas of Focus to Encourage Growth and Development in the Adolescent

Sports and physical fitness

Learning and participation in school activities

Safety issues

Proper nutrition and healthy eating habits

Healthy sleep and rest

Personal care

Healthy sexual life

Appropriate discipline

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Promoting Proper Hygiene for Adolescents

Encourage frequent bathing and deodorant use.

Encourage washing face two to three times a day.

Discourage squeezing acne lesions and vigorous scrubbing of face.

Encourage frequent shampooing of hair.

Teach care for body piercings and tattoos.

Discourage suntanning.

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Caring for the Hospitalized Adolescent

Provide opportunities for adolescent to maintain independence.

Allow adolescent to participate in decisions.

Encourage socialization with friends through phone, e-mail, and visits when possible.

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Developmental Concerns for the Adolescent

Violence

Suicide

Homicide

Substance use

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Question #3

Is the following statement True or False?

Suicide is the third leading cause of death in adolescents 15 to 19 years of age.

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Answer to Question #3

True.

Suicide is the third leading cause of death in adolescents 15 to 19 years of age.

In a nationwide CDC study, 15% of adolescents surveyed reported that they had seriously considered suicide within the past 12 months, with 11% creating a plan and 7% attempting to take their own life (CDC, 2014a).

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Common Substances Abused by Children and Adolescents

Alcohol and prescribed medications

Hallucinogens, sedatives, analgesics

Anxiolytics

Steroids

Inhalants (inhaling fumes of common household products)

Stimulants, opiates

Various club drugs such as ecstasy, GHB, and LSD

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Topics for Discussion to Discourage Substance Abuse

Short- and long-term effects of alcohol, tobacco, and drugs on health

Risk factors and implications for unintentional injuries and sexual activity

The how and why of chemical dependency

Impact of substance abuse on society

Importance of maintaining a healthy lifestyle

Importance of resisting peer pressure to use drugs and alcohol

Importance of having confidence in teen’s own judgment

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