HEALTH PROMOTION &

HEALTH PROBLEMS ADOLESCENCE

Presented by

Angelique White-Williams, DNS, APRN-CNS, CCHC

PROMOTING OPTIMUM GROWTH AND DEVELOPMENT

Complex interplay of biologic, cognitive, psychologic, and social change, perhaps more so than at any other time of life

Change on multiple levelsBiologic maturationCognitive developmentPsychologic development

Adolescence

Early—ages 11 to 14 Middle—ages 15 to 17 Late—ages 18 to 20

Transition into Adulthood

Changes in Reproductive Hormones Females

Menarche (average age 12)Ovulation

MalesChange in penis size & function

Physiologic Changes

Growth spurts Heart, blood volume, and systolic BP

increase in size and strength Heart rate decreases Respiratory vital capacity increases

Adolescent Conceptions of Self

Adolescent egocentrism Self-absorption Health-related beliefs

Imaginary audience (everyone is watching)Personal fable (won’t happen to me)

Adolescence

Moral DevelopmentMoral reasoning r/t principles

Spiritual DevelopmentExamine spiritual beliefs & ideas

Psychosocial DevelopmentIdentify achievementSocial forces shape sense of self

Sexuality

Hormonal, physical, cognitive, and social changes affect sexual development

Body image Sexual identity Sexual orientation

Romantic Relationships Are Important During Adolescence

The Peer Group Influences Adolescent Development

Work versus School

Impact the life of adolescent Positive or negative May encourage development of

intellectual and social skills, autonomy May result in decreased interest in

school, fewer extracurricular activities, and poorer grades

Technology as a Social Environment

Internet chatrooms and social networking sites have created “virtual” communities

Try out identities and interpersonal skills with wider network of people

Anonymity Risks

Health Concerns of Adolescence

Parenting and family adjustment Psychosocial adjustment Intentional and unintentional injury Dietary habits, eating disorders, and

obesity Physical fitness

Health Concerns of Adolescence— cont’d Sexual behavior, STDs, and unintended

pregnancy Use of tobacco, alcohol, and other

substances Depression and suicide Physical, sexual, and emotional abuse

Health Promotion Among Special Groups of Adolescents Adolescents of color Gay, lesbian, and bisexual adolescents Rural adolescents

Acne More than 50% of adolescents affected Etiology

HereditaryHormonal influenceOther influences (Diet, hygiene)

Psychosocial ramificationsSelf-esteem issues

Acne—cont’d

PathophysiologyInvolves hair follicle and sebaceous glands

Therapeutic managementGeneral measures/overall healthMedicationsNursing considerations

Menstrual Disorders Primary amenorrhea—no menses by

age 17 Secondary amenorrhea—no menses for

6 months in previously menstruating female

Irregular menses common in adolescence

Dysmenorrhea

Adolescent Pregnancy

Rates of teen pregnancy in United States

Physiologic aspects Pregnancy risks associated with teen

pregnancy Nutritional needs

Infants of Adolescent Mothers Higher risk of prematurity Higher incidence of low birth weight Potential for developmental delay

Social and Economic Effects of Teen Pregnancy School/education disruption Social relationship deprivation Statistical risk of poverty Emotional effect on infant and parents

Adolescent Fathers

Changing social expectations Emotional effects

Adolescent Abortion

Counseling Associated risks

Other Health Concerns

Contraception Rape STDs Gonorrhea Chlamydia HIV/AIDS

Nursing Diagnosis

Health-seeking behaviors r/t normal growth & development

Self-esteem disturbance r/t facial acne Pain r/t uterine cramping from

menstruation Risk for injury r/t peer pressure to use

alcohol/drugs Anxiety r/t fear of contracting STD

Implementation

Communication Health teaching Involve other teens

Summary

Complex patient. Don’t underestimate family influence but

peer influence is greater. Acceptance and honesty is important. Communication & health teaching

important to enhance health promotion.