2 Peds Adolescent
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| Adolsecents | most medical texts agree adolescence begins at 11-12 and ends at 18-21
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| Early adolescents 10-13 years | rapid growth and development of secondary sex characteristics. Girls often develop 1-2 yrs prior to boys. Avg age of mearche: AA-12.16 years, White-12.88 years. Average weight for first menarche:100lbs
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| Concerns of 10-13 year old | am i normal? privacy conscious, easily embarrassed. Curious about opposite sex, but more comfortable with same sex. iniating abstract reasoning. Need concrete answers to health Q's. Testing of authority. Peers are paramount. Developing own value system.
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| Emergence of sexual feelings and lack of impulse control (need for immediate gratification) is associated with which age of adolescents | 10-13 years old
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| Self-centered focus and decrease in pubertal growth rate is associated with ages | 14-16. Improved comfort with body, increased time on looks. Increased intellectual ability, abstract thinking improvement
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| Difficult parent/child relationships are a key characteristic in teens of this age | 14-16
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| Sexual experimentation, gangs and lots of extracurricular activities are associated with ages | 14-16
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| Feelings of omnipotence and immortality are associated with which ages? | 14-16
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| "emergent adults", less self-centered, improved self-identity, rational and realistic. | ages 17-21. Period of idealism
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| Peer Group Involvement shifts from group to individual relationships | 17-21. interests are more stable
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| what percentage of deaths in adolescents is caused by violent deaths? Injury, homicides, suicides | 76%. Number 1 is MVA
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| Most commonly reported STI | Chlamydia.
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| About ____ million new STI infectiouns occur each year, about ____ of them amoung people ages 15-24 | 19 million, half
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| ___ % of teens will experience depression before they reach adulthood | 20%, 30% of teens with depression also develop a substance abuse problem
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| IN NC Any minor can give effective consent for medical services for the prevention, diagnosis, and treatment of: | Veneral dz, Pregnancy (abortion and sterilization are the exceptions), Abuse of controlled substances/alcohol, Emotional disturbances (except admission to a 24-hr facility)
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| GAPS | Guidelines for Adolescent Preventive Services
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| Heads Home: | Household composition; family dynamics and relationships; living and sleeping arrangements; recent changes.
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| Heads Education: | School attendance, absences, suspensions; ever failed a grade; grades as compared with previous years; attitude toward school; favorite, most difficult, best subjects; special educational needs; future goals.
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| Heads Employmnent: | Ask about employment, working > 20hrs/week associated with negative outcomes, do they have to work to support family.
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| Heads Activities: | What do you do with friends and family for fun? sports participation, church groups or other organized activities.
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| Heads Drugs: | Personal or friends use of tobacco, alcohol, illicit drugs, anabolic steroids; family substance use and attitudes; driving while intoxicated or with someone who was intoxicated; If personal use,CAGE questionnaire.
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| Heads Diet: | body image, dieting, exercise, try to control weight
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| Heads Depression/Suicide: | feeling sad or down, crying, “bored”, sleeping trouble, hurting yourself or others.
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| Heads Sexuality: | Dating? Who? Sexual relationships? How old was partner, how many? What does “safe sex” mean to you?
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| Heads Safety: | Seriously injured? How? Seatbelt use? Safety equipment use. Violence at home, school. Physical or sexual abuse
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| Topics to discuss without parent present | return to
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| PE Essesntials: height, weight, BMI with percentiles, BP, dentition and gums, Skin-acne, scars, piercings, tattoos | thyroid, spine-scoliosis, breasts-Tanner stage, gynecomastia, External genitalia - Tanner stage, lesions if sexually active (self-testicular exam)
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| pelvic exam necessary if: | hx of sexual intercourse, abnormal vaginal discharge, menstrual irregularties (?), Suspicion of anatomic abnormalities, pelvic pain, patient requests.
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| When should you perform a pap smear? | 3 years after onsest of sexual activity OR age 21
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| Conversion Reaction | Psychophysiologic symptom results when anxiety activates the autonomic nervous system. Tachycardia, hyperventilation, vasoconstriction. Anxiety, GI
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| ___ % of 9-12th graders seriously considered suicide in the preceding 12 months | 14.5%
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| Broad Differential for Academic Failure | limited intellecutal abilities, learning disabilities, depression, visual/hearing problems, chronic disease, ADHD, lack of motivation, drug and alcohol
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