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Puberty & Adolescence
Life Span - Lecture 6Chapter 10
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Puberty / Pre-adolescence
• Rapid growth• @ 2 yrs to complete• 2nd sex characteristics
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Factors that influence Puberty
• Heredity• Climate• Nutrition• Gender• Socioeconomic status
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4 Major Changes - Puberty
1. Rapid growth2. Δ body proportions3. 1o sex characteristics4. 2o sex characteristics
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Puberty Frustrations
• Independence / supervision• Appearance / body changes• Peer acceptance / peer frustration• Academic success / h workload• Adult behavior / child behavior• h schedule / need for h sleep
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Adolescence• Begins– Sexual maturity
• Ends– Cessation of growth
emotional maturity
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Characteristics of Adolescence
• Volatile emotions• Insecurities• Introspection• Experimentation• Testing values
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Puberty: Height & Weight
• Rapid Growth• Girls before Guys– Feet 1st
• Height– h 20 – 25%
• Weight– h 15 – 60 lbs
• Disproportionate
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Puberty: Development of Sex
• 1o sex characteristics– Gonads
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Puberty: Male
• Testes• Scrotum• Sperm• Testosterone• Ejaculation• Penis
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Puberty: Female
• Ovaries• Ova• Estrogen• Progesterone• Menarche• Menopause
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Puberty: Development of Sex
• 2o sex characteristics– Pubic hair– Axillary hair – Sebaceous glands
• oil
– Apocrine glands• sweat
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Body Changes: Puberty
Male ♂• Penis• Erections• Wet dreams• Voice changes
Female ♀ • Breasts• Menstruation• Cramps• Pregnancy• Hygiene
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Body Changes: Puberty
Male ♂• 10 – 11
– Gonad growth– Pubic hair
• 12-13– Growth spurt
• 13-15– 2o hair– Ejaculation– Voice deepens
Female ♀ • 10-11
– Growth spurt– Breast– Pubic hair
• 11-14– Menarche
• 12 – 13– 2o hair
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Adolescence: Height & Weight
• Slows after puberty• ♀– 16 - 17
• ♂– 18 – 20
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Muscle & Bone development
• h strength• h endurance• h size
• Sore• Awkward• Scoliosis– “lateral curvature of the
spine”
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Respiratory System G&D
• h Lung size, weight• i rate• h performance
• Nurse intervention– EXERCISE!!!
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GI System G&D
• h size & capacity
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Teeth: G&D
• 12yrs– 2nd molars
• 14 – 25 yrs– 3rd molars– “Wisdom teeth”
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Vital Signs
• Pulse– 60-90
• Resp– 16 – 24
• Nursing intervention– EXERCISE!!!
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Motor Development• Rapid growth Clumsy • *Eye-hand coordination
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Sexual Development
• Comparisons• Masturbation• Sexual activity• Education
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STD’s
• h• Prevention education
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Teen pregnancy
“The pregnant adolescent has twice the mortality rate
of a non-adolescent pregnant woman.”
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Teen Pregnancy
• What are the “down-sides” of teenage pregnancy?
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Rape
• h• Stranger• Date-rape
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Psychosocial Development: Behavior
Behavior• Rebellious
Parental Response• Overlook• Avoid confrontation• Be tolerant• “Pick your battles”• Avoid seeing behavior as a
rejection of parental love
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Psychosocial Development: Behavior
Behavior• Need for privacy
Parental Response• Own space• Understanding• Offer help – step back• Open communication
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Psychosocial Development: Behavior
Behavior• Dishonesty
Parental Response• Don’t overreact• Reinforce reality• Be consistent
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Psychosocial Development: Behavior
Behavior• Responsibility
Parental Response• Listen• Expect uneven maturity• Enc. decision making &
responsibility• Set reasonable rules
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Psychosocial Development: Behavior
Behavior• Curfews
Parental Response• Allow unexpected delays• Enc phone contact• Set example• Socialize at home
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Psychosocial Development: Behavior
Behavior• Friends
Parental Response• Accept \ criticism• Get to know them• Avoid showing disapproval
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Psychosocial development: Puberty
• Attitude– Happy negative
• h self-consciousness• Self-doubt• h time alone (room) • Find new peers
• Antagonism
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Psychosocial Development: Adolescence
• Explore own values– Test them
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• Ambivalence– Two opposing feelings at
the same time
• Mood swings
• Love / hate family• Freedom/supervision• Wanting to be part of a
group / wanting to be alone
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• Emotions– Expressed feelings
behavior
• Mood swings– Anger– Fears– Worries– Jealousy– Envy– Happiness
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• Boredom– Daydreaming
• Humor– “Biting”
• Work / employment
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Age 13 - 14
• Hide feelings• Negative & hostile• Narrow perspective– compromise
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Ages 15 - 16• i self absorption• h compromise• h independent thinking– Discuss– Debate
• Experimenting– h risk taking– h adventure
• Dating
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Age 17 -19• Serious• Idealistic• h Stress• Relationships– Family– “boy-friend” /“girl-friend”– Peers
• Career
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Discipline
• Clear rules• Set rules – Dating– Curfew
• Open communication• Be realistic• Be available• Listen!
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Cognitive Development
• Concrete thinking (with training) formal operational– Logical– Scientific reasoning– Problem solving– Look at all possibilities
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Moral Development
• “Cognitive development is a prerequisite for moral reasoning”
• Conventional Level– Follow rules– Show concern for others– Want to be trusted
• BEGIN TO QUESTION EVERYTHING• Post conventional
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Communication
• Verbal communication
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Nutrition
• Caloric intake– ♀
• 2,600 / day
– ♂• 3,000 / day
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Key nutrients
• Protein– 15%
• Calcium• Iron
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Sleep & Rest
• h need for sleep– 8 hours
• Affects of poor sleep– Irritable– I school performance– i concentration– h stress– h susceptibility to illness– Auto accidents
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University of Chicago Medical Center October 23, 1999 The Lancet.
• “Chronic sleep loss can reduce the capacity of even young adults to perform basic metabolic functions, such as processing and storing carbohydrates or regulating hormone secretion… Cutting back from the standard eight down to four hours of sleep each night produced striking changes in glucose tolerance and endocrine function--changes that resembled the effects of advanced age or the early stages of diabetes--after less than one week.”
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Anorexia Nervosa
• Eating + emotional disorder
• Willful starvation• < minimum body weight• Fear of weight gain• Extreme dieting
– Diet pills– Laxatives– Ipecac
• Excessive exercise
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Bulimia
• Binge & purge• loss of control
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Safety
• MVA– Driving– Independence– Poor judgment– Don’t drink and drive
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Safety
• Sporting activities– Pre-sport physicals– Protective equipment
• ♂– Football– Hockey
• ♀– gymnastics
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Safety
• Firearms– Storage– Training
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Health Promotion
• nutrition patterns = health level
• Annual physical• Vision & hearing• √ Height & weight
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Depression• “Prolonged feeling of
sadness and unworthiness”
• h d/t long period of…– Self reflection
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S&S of Depression in Adolescence
• Crying• Insomnia• Eating disorders• Social isolation• Acting out• Hopelessness• Physical symptoms• Loss of interest in
appearance• Giving away things
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Contributing Factors to Adolescent suicide
• Depression• Low self-esteem• Poor impulse control• Substance abuse• Emotional isolation
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Depression/suicide: Nursing interventions
• Assess for clues• Listen carefully• Do not undervalue
emotions!• Ask if they are thinking
about suicide• Do they have a plan?• Constant supervision
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Substance Abuse
• How to know• http://www.youtube.com/watch?feat
ure=player_detailpage&v=RkgZujOQSFU