Age Specific Competencies: Adolescences

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Age Specific Competencies Adolescences

• ENS Derrick James LeBeau

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Overall Objective

• You will be able to demonstrate a basic knowledge
  of care requirements for the adolescence patient.

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Learning Objectives

• Stages of adolescence
• Legal issues
• Interview structures
• Health concerns
• Pain assessment
• Diet
• Skin problems

• Sleep patterns
• Self-concepts
• Key relationships
• Reproduction/Sex
• Moral reasoning
• Stress
• Coping patterns

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White Flags
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Stages of Adolescence

• Early Adolescence 12-15 yrs a time for
  self-conciseness.
• Middle Adolescence 15-18yrs interest in
  opposite sex, sex role expectations.
• Late Adolescence 18-22 education, career,
  marriage, children, and life-style.

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Common Health Concerns

• Accidents
• Nutritional disorders
• Acne
• Pregnancy
• STDs
• Stress coping problems

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Key Concept

• When speaking to Adolescence, address questions
  to the adolescence.
• Ask them if they want the parents/caregivers to
  present during interviews.

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Physiological Developments

• Cardiac
• Pulmonary
• Neurological
• Respirations
• Pulse
• Blood Pressure

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Physiological Developments

• Muscle growth rate increases.
• Growth in Stature stops around 20 for men/17 for
  women.
• Scoliosis.

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Chronic Illnesses

• Foster feelings of security and independence.
• Behavior problems can be lessened when patients
  are able to verbalize their feelings.
• Can be prone to depression and feeling rejected.

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Pain Assessment

• Pain assessment is important in all patients.
• Adolescence can understand and relate pain.
• Limited life exp limits the ability to cope with
  pain.

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Pain Assessment

• Address questions to adolescence.
• Observe muscle tension, stiffness, increased
  heart rate, BP, or respiratory rate.
• Scale (0-10) can be used for adolescence, ages 12
  and older.
• Observe for withdraw.

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Nutrition for the Adolescence

• Interview for diet history.
• Perform physical assessment to assess for
  problems with nutrition.
• Malnutrition.

• Height and Weight.
• Body stature scales.

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Nutrition continued

• Fail to maintain an appropriate diet.
• Preoccupation with activities.
• Peer influence.
• Advertising influence (TV, magazines, movies).

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Nutrition Continued

• Follow fad diets.
• Skipping meals.
• Fast-food consumption.
• Self-esteem/self-image.
• Age should be appropriate to weight.

• These factors often lead to disorders
• Anorexia
• Bulimia
• Steroid abuse

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Elimination Patterns

• Same as adults
• Important for the patient to understand their
  own elimination pattern.
• Should be aware of any changes.

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Adolescence Skin

• Sweat glands
• Hair follicles
• Acne
• Perspiration
• Body odor

• Skin irritation due to commercial skin products.
• Myths chocolate, nuts, fatty foods.
• Heat, humidity, sweat can lead to acne.
• Dont pick or squeeze.

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Activity and Exercise

• Motor function matures.
• Social interaction.
• Enhances feelings of self-worth.
• Can also increase the chances of physical injury.

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Cognitive Development

• Vision, hearing, and taste mature.
• Adolescence become less self-centered.
• Give special attention to school and work
  performance.

• Cognitive development is nearly complete.
• Caregivers should be honest and straightforward.
• Establish reasonable limits of behavior.

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Sleep and Rest

• Increases in sleep due to rate of physical
  growth.
• Late awakenings on weekends/day naps not
  unusual.
• Average hours of sleep 6-9hrs.

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Self-Concept/Self-Perception

• Describes a clients self-concept pattern.
• Body image.
• Self-worth.

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Development Is Influenced By

• Actions and reactions to parents/peers.
• Moral development.
• Emotions.

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Problems If Not Developed

• Failure to become independent and responsible.
• Having friends.
• If self concept is not developed, self-esteem
  could be threatened.

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Roles and Relationships
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Roles and Relationships

• Dynamics of family members.
• Who fulfills the need for nurturing, helping, and
  protecting.
• Peer support teams, key clubs, band, or even
  gangs.

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Important Relationships

• Peer groups
• Opposite sex relationships
• Independence from parents/maintaining affection

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Conflicts In Relationships

• An adolescence need to express his/her own
  identity.
• Driving the car.
• Dating.
• Smoking.
• Choices of friends.
• Homework habits.

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Reproduction and Sexuality
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Sexuality and Reproduction

• Sexuality and reproduction are evaluated in
  adolescence to determine
• Parental teaching needs
• Sexual development
• Sexual myths

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Educational Needs Sexuality

• Parents may or may not be able to meet these
  needs.
• Inquire if those needs are meet.
• Educate the client about intercourse, pregnancy,
  contraception, STDs.

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Coping and Stress

• Common stressors associated with stages of
  adolescence
• The adolescences perception of stresses.
• Behaviors associated with coping and responding
  with stress.
• Support systems during times of stress.

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Most Common Stressors

• Poor self-esteem
• Developmental tasks
• Physical/emotional changes
• Achievement
• Leaving home

• Peer relationships
• Heterosexual relationships
• Sexual awareness
• Career choices
• Parenting

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Stress Response

• Drug Abuse may be used to help deal with stress.
• Alcohol/Tobacco
• Suicide third leading cause of death in
  adolescence.
• Drug overdose, self inflicting gun-shot wounds,
  carbon monoxide poising.

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Moral Development

• Values utilized in decision making, and persist
  over a long period of time.
• Beliefs based of more faith than fact,
  represents a personal confidence in the validity
  of some idea, person, or object.

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Moral Development

• Spirituality a component of values and beliefs.
• Culture is socially inherited, and represents a
  complex system of values, beliefs, customs,
  rituals, taboos and norms shared by a group of
  people.

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Interventions

• Speak directly to the adolescence
• Encourage questions about fear
• Involve in decision making and planning
• May be resistance
• Allow for sense of control

• Plan for mobility and functional needs
• Identify social influences in relation to diet
• Allow for spiritual and religious beliefs
• Use equipment specific for size

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Key Points

• Health Concerns
• Nutrition
• Sleep and Rest
• Self-Concept
• Self-Perception
• Sexuality
• Stress

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Questions?