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Flashcards in Adolescent Health Deck (55):
1

Types of Biologic Maturation During Puberty

Growth in stature
Development of secondary sex characteristics
Achievement of fertility

2

Changes in Body Systems During Puberty

Neuroendocrine axis
Bone size & mineralization
CV system

3

Onset of Puberty

Critical body weight or composition
Leptin for progression of puberty & produced by adipocytes

4

Stage 1 of Sexual Maturity

Preadolescent pubic hair, breast, penis, testes

5

Stage 2 of Sexual Maturity

Pubic hair: sparse, long, lightly pigmented
Breast: bud, breast & papilla elevated, increased areolar diameter
Penis: slight enlargement
Testes: enlarged scrotum, pink, texture roughened

6

Stage 3 of Sexual Maturity

Pubic hair: increased pigmentation, more curly
Breast: enlarged breast & areolar
Penis: increased length
Testes: increased size

7

Stage 4 of Sexual Maturity

Pubic Hair: adult type
Breast: areola & papilla form secondary mound
Penis: glans enlarged, increased breadth
Testes: enlarged, darkened in color

8

Stage 5 of Sexual Maturity

Pubic hair: adult distribution spread to middle thigh
Breast: nipple elevated
Penis: adult size
Testes: adult size

9

What are the "perils" of puberty?

Anemia
Gynecomastia
Acne
Psychological functioning
Musculoskeletal injuries
STI's

10

Define Delayed Puberty

Absence or incomplete development of secondary sexual characteristics by an age at which 95% of children of that sex & culture have initiated sexual maturation

11

Primary Delayed Puberty

Due to hypogonadism and/or defects in their receptors on the membrane of the gonadal cells

12

Secondary Delayed Puberty

Gonads intact
Problem with secretion of LH, FSH, or GnRH
Defects due to hypopituitarism, hypothyroidism, or hyperprolactemia

13

What is Adolescence for?

Exploring their environment
Coping with change
Testing boundaries
Developing independence

14

Primary Values for Adolescents

Freedom
Fun
Friends

15

Goals of Adolescence

Become independent from parents
Develop workable value system
Become comfortable with bodily changes
Build meaningful relationships
Begin establishing economic independence

16

Normal Teen Behaviors

Express opinions
Test limits
Take Risks
Experiment
Develop abstract operations

17

Define Abstract Operations

Widened scope of intellectual activity and an increased capacity for insight

18

Top 5 Causes of Mortality in the Adolescent Population

MVA
Homicide
Suicide
CA
Heart disease

19

Adverse Health Outcomes in the Adolescent Population

Alcohol use
Drug use
Tobacco use
Sex
Sedentary lifestyle

20

Establishing Rapport with Adolescents

Provider must like adolescents
Avoid surrogate parent role
Avoid adolescent role
Act as an interested & caring advocate
Listen carefully and see clues
Instill responsibility

21

Confidentiality in Teens

Critical for teens
Establish parameters of confidentiality
State you will alert parents if suicidal or homicidal thoughts
Attempt to meet with teen alone
Stress responsibility for their health

22

Immunizations for Adolescents

Varicella vaccine
Tdap
Meningococcal vaccine
Gardasil
Hep B
IPV
MMR

23

Screening for Adolescents

HTN
Obesity
Eating disorders
Hyperlipidemia or metabolic syndrome
TB
Abuse
Learning/school problems
Substance use
Depression
Risky sexual behaviors

24

Anticipatory Guidance in Adolescents

Healthy diet: calcium
Safe weight management
Exercise
Minimize TV & video game time
Responsible sexual behaviors
Avoidance of alcohol, tobacco, & other abusable substances
Family involvement

25

What does HEAD stand for in regards to screening adolescents

H: home, habits
E: education, employment, exercise
A: accidents, ambition, activity, abuse
D: drugs, diets, depression
S: sex, suicide, sports, shots

26

Developmentally Oriented Approach to Adolescents

Body image
Peer relationships
Independence
Identity
Sexuality

27

Questions to ask for Body Image in Oriented Approach to Adolescents

Questions or problems with physical changes?
What would you change?
Periods, wet dreams, changes in breasts or pubic hair

28

Questions to Ask for Peer Relationships in Oriented Approach to Adolescents

Best friend?
# close friends?
Activities participate in?
Fun?

29

Questions to Ask for Independence in Oriented Approach to Adolescents

Get along with parents?
What issues for family arguments?
Privacy respected at home?

30

Questions to Ask for Identity in Oriented Approach to Adolescents

Satisfied with life?
Changes in life & why?
Working?

31

Alcohol Abuse in Adolescents

When?
Where?
How much?
Parental drinking?
DD used?

32

Substance Abuse in Adolescents

Hardest to stop when start between 10-15
Easily addicted
Cessation aids necessary
#1 cause of preventable long term health consequences
"Ugly side" to advise teens

33

Illicit Drug Use/Abuse in Adolescents

Marijuana
Cocaine
Opiates
Stimulants
Hallucinogens

34

Questions to Ask for Sexuality in Oriented Approach to Adolescents

Dating?
Serious SO?
Questions/concerns about sexual activities, contraception, STIs or pregnancy?

35

How to get answers of sexuality from teenagers?

Open ended questions
Range of sexual activity
Explicit questions
Sexual matters
Risk prevention
Condoms
Oral contraceptives, Depo-Provera, Patch

36

Options for Adolescent Sex Life

Dating behavior
Heavy petting
Masturbation
Mutual masturbation
Oral sex
Vaginal sex
Anal sex

37

Sexual Orientation of Adolescents

Homosexual
Bisexual
Transsexual
Straight
Gay

38

STI's and Adolescents

Gonorrhea
Syphilis
HIV of concern
Chlamydia
HPV
Herpes
Trichomonas

39

STIs and Prevention in Adolescents

Abstinence
Condoms

40

Which STIs do condoms prevent most?

Gonorrhea
Chlamydia
HIV
Trichomonas

41

Types of Sports Injuries

Sprains
Fracture/dislocations
Lacerations
Contusions
Head injuries
Other injuries
Overuse

42

Types of Eating Disorders

Anorexia nervosa
Bulimia nervosa

43

Eating Disorder Statistics

90-95% female
Puberty related
Excel in Sports
Type A personality

44

Co-morbid conditions with Eating Disorders

Rape
Depression

45

Some Reasons for Eating Disorders

Lower self esteem
Sense of personal ineffectiveness
Difficulty with causation, conflict resolution, separation of families
"Thin is best"
Popular
Over concern with bod shape
Calorie obsession
Age 15-20

46

Red Flag of Eating Disorders

Weight loss >10% of previous weight in clinic

47

Consider Anorexia When...

Refusal or inability to maintain weight
Intense fear of gaining weight
Distortion of perception of body
3 consecutive periods missed

48

Physical Findings in Anorexia

Hypothermia
Bradycardia
Bradypnea
Hypotension
BMI below 5th percentile
Russell's sign
Appear depressed

49

Define Russell's Sign

Erosions of inside of front teeth from vomiting

50

Define Bulimia Nervosa

Recurrent episodes of binge eating followed by vomiting, laxatives, diuretics, strict dieting
2 binge episodes/week for 3 months

51

DSM-V Criteria for Anorexia Nervosa

Restriction of energy intake
Intense fear of gaining weight
Disturbance in one's body weight/shape

52

Treatment of Eating Disorders

Team approach: pediatrician/internist, nutritionist, counselor
Long term plan: intense inpatient with maintenance

53

Define Emancipated Minor

Married
Living independently
Has children
Serves in military
Varies by state

54

Define "Mature" Minor

Health provider's assessment of an adolescents maturity to make their own health care decision
Generally age 15-16

55

Title X of the Public Service Health Act

Must provide confidential family planning
Other funds: treatment for other sensitive health needs