1. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 33 Nursing Care of a Family With an Adolescent

2. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Development of the Adolescent Assessment- HR=70; R=20; BP=120/70 Boys grow 4-12” & gain 15-65 lbs Girls grow 2-8” & gain 15-55 lbs. Growth stops with the closure of epiphyseal lines of long bones. Girls=16-17; Boys=18- 20

3. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Growth and Development of an Adolescent Physical growth –Teeth –Puberty –Secondary sex changes -Tanner-917-919

4. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Growth and Development of an Adolescent (cont’d) Developmental milestones Play or recreation

5. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Growth and Development of an Adolescent (cont’d) Emotional development –Developmental task: Identity vs. Role Confusion Body image Self-esteem Value system

6. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Growth and Development of an Adolescent (cont’d) Emotional development –Developmental task: Identity vs. Role Confusion Career decisions Emancipation Sense of intimacy –Socialization

7. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Growth and Development of an Adolescent (cont’d) Cognitive development Moral, spiritual development

8. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Promotion (cont’d) Safety Nutritional health –Recommended dietary reference intakes –Varied diets Vegetarian Glycogen loading

9. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Promotion (cont’d) Daily activities –Dress, hygiene –Care of teeth –Sleep –Exercise

10. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Promotion (cont’d) Healthy family functioning Common health problems –Hypertension –Poor posture –Body piercing, tattoos –Fatigue

11. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Promotion (cont’d) Common health problems –Menstrual irregularities –Acne Assessment Therapeutic management External medication Systemic medication

12. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Promotion (cont’d) Common health problems –Obesity –Sexuality, sexual activity –Stalking –Hazing

13. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Promotion (cont’d) Substance abuse –Types Tobacco Alcohol Anabolic steroids Marijuana

14. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Promotion (cont’d) Substance abuse –Types Amphetamines Cocaine Hallucinogens Opiates Box-33-4-939; 33-10; 33-11

15. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Promotion (cont’d) Assessment of substance abuse Attempted suicide –Assessment Runaways

16. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Promotion (cont’d) Concerns of physically challenged or chronically ill –Nutrition

17. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Question The parents of an adolescent boy are concerned about the amount of sleep he seems to require. What advice would you give them? A.“As long as he seems otherwise well, this sounds like a typical teenager.” B.“Adolescents only need 8 hours of sleep a night; anything over this is excessive.” C.“Your son is probably engaged in too many activities and is wearing himself out.” D.“Your son may be taking drugs; the side effect of many drugs is to cause sleepiness.”

18. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer A. “As long as he seems otherwise well, this sounds like a typical teenager.” Rationale: Many teenagers feel fatigued from a combination of quick-food diets, many activities, and a rapid growth spurt.

19. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Question The nurse working with adolescents should be aware that the most widely used drug among adolescents is A.alcohol. B.heroin. C.cocaine. D.speed.

20. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer A. Alcohol Rationale: Alcohol is the most abused drug among adolescents because it is often readily available and is inexpensive compared to other drugs.

21. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Question When encouraging an adolescent who is hospitalized and physically challenged or chronically ill to develop and maintain a sense of identity, you would A.provide the opportunity for individual decision making. B.provide physical comfort to the individual. C.ask the parents what the adolescent is capable of doing. D.provide care until the adolescent insists on being independent.

22. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer A. Provide the opportunity for individual decision making. Rationale: Knowing who you are includes how to make decisions to advance your welfare. Providing opportunities to do this is important.