Davao Doctors College, Inc.

College of Allied Health Sciences

Nursing Program

NRG 203: CARE OF MOTHER, CHILD AND ADOLESCENT

(WELL CLIENTS) GROWTH & DEVELOPMENT AN ADOLESCENT
All a Nurse Needs to Know about Maternal and Child Nursing

Getting to Know the Course Instructor

Hello! I am Janeth Rose E. Toledo, and I will be your instructor for

NRG 203: Care of Mother, Child and Adolescent (Well Clients):
Toddler stage. Before we begin, allow me to introduce myself. I am
Ma’am J Rose, a faculty member of the Nursing Program of Davao
Doctors College, Inc. for fifteen years. I garnered my BS Nursing
degree from Tecarro College Foundation Inc., and I earned my
Masters in Nursing-Major in Medical-Surgical Nursing from Liceo de
Cagayan University. I teach the following subjects: Maternal and
Child Nursing, Community Health Nursing, Medical Surgical Nursing,
Nursing Informatics, Health Education, Nutrition and Diet therapy and
GE Filipino 101. I am handling Level II, Level III and Level IV Student
Nurses. It is my responsibility to supervise students in various clinical
areas. I am exposed to different areas such as the Medical-Surgical
wards, OB wards, Pediatrics Ward, Delivery Room, NICU, ICU and ER.

I am handling Level II, Level III, and Level IV Student Nurses. It is expected that much effort both
in their knowledge and skills should be emphasized at these levels. It is my responsibility to
supervise students in various clinical areas. I handle 8-14 students in the ward of their affiliated
hospital. I am exposed to the Medical-Surgical area, OB wards, and Pediatric Ward. Also, I handle
students in special units like the DR, NICU, and ICU.

For this semester, I will be your instructor for NRG 203: Care of Mother, Child, and Adolescent
(Well Clients) – Growth and Development of an Adolescent. I am looking forward to guiding you in
learning this course well. If you want to reach me for any academic-related concerns, you can reach
me through the following:

Contact No: (per request)

Facebook account: J Rose Josue Estavillo
E-mail address: jtoledo@davaodoctors.edu.ph
Consultation hours: Saturday 4:00 – 5:00 PM

Introduction to the Course

The course NRG 203: Care of Mother, Child, and Adolescent: Growth & Development of
Adolescent deals with concepts, principles, theories, and techniques of nursing care management
Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program

of a well adolescent stage. In this course, you are expected to provide nursing care to adolescents
utilizing the nursing process. Presented below are the specific details of this course:

Course Number: NRG 203

Course Credits 9 units (4 units Lecture, 5 units RLE)

306 hours (25.5 hours/week for 12 weeks)

No of Hours (Lab):
If with NRG302 (51 hrs) = 357 hrs (29.75 hours/week for 12 weeks)

Placement: Second-year, First Semester

Prerequisite: NRG 105, NRG 106

Schedule: MTWThF 8-4

GOOGLE CLASSROOM:
Classroom:
CLASS CODE: d2aqsip

Requirements in Completing the RLE Activities

Since most of our sessions for this semester will be delivered through distance/blended learning
activities, the submissions will also be done online. To do this, you need to have access to the
following applications:
1. Microsoft Office/Google Docs
2. Google Classroom
3. Google Meet (or any other teleconferencing app, duly agreed by the whole class)
4. Internet connectivity
Access to a printer and/or scanner is also a plus, but not a requirement.

Daily Activities
Every week, you are expected to follow through with the following deliverables:
November 23 November 24 November 25 November 26 November 27 November 28
(Monday) (Tuesday) (Wednesday) (Thursday) (Friday) (Saturday)
Orientation Submission of Discussion of Discussion of Discussion of Quiz
of the the following: Stepping In; Deep Dive: NCP; Drug
module Stepping In Review of History study; Preparation for
Review of systems and Taking, Related next week’s
Completion Systems Concept Map. Destination readings activity
of Module, Concept Map Check
including Deep Dive Submission of
Assignment History taking NCP, Drug
of Reflection Destination study, and
Time check Related
(Readings) readings
Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program

MODULE 6:
CARE OF MOTHER, CHILD AND ADOLESCENT
(WELL CLIENTS)The Family with an Adolescent

Now that you are done acquainting yourself with the instructor and the course itself, please proceed
to Module 5: CARE OF MOTHER, CHILD & ADOLESCENT (The Family with an Adolescent).

Term: Third Term, First Semester S.Y. 2020-2021

Dates: Week 5: November 23 to November 28, 2020
Class Schedule: 8 - 4
No. of Hours: 8 hours/meeting

Instructions
Print this worksheet to answer or write your answers on clean white bond papers. Answers must
be handwritten. Do not forget to write your name, year level, and section, and course name on the
upper part of all your submissions. Observe pagination. Once done, take clear pictures of your
written outputs, compile them (in WORD or PDF), and send the compilation to your instructor.

Learning Outcomes:
At the end of this module, you are expected to:
1. Describe normal growth and development and common parental concerns of the
adolescent period.
2. Assess an adolescent for normal growth and development milestones.
3. Review the Anatomical and Physiological changes in an adolescent body.
4. Formulate nursing diagnoses related to adolescent growth and development or common
parental concerns.
5. Use critical thinking to analyze methods of care for the adolescent to be certain care is
family-centered.
6. Identify expected outcomes for nursing care of an adolescent as well as help parents
manage seamless transitions across different healthcare settings.
7. Plan nursing care to meet an adolescent’s growth and development needs.
8. Implement nursing care related to growth and development or special needs of an
adolescent, such as organizing a discussion group on ways to prevent substance use
disorders.
9. Evaluate expected outcomes for achievement and effectiveness of care.
10. Identify areas related to the care of an adolescent that could benefit from additional
nursing research or application of evidence-based practice.
11. Integrate knowledge of adolescent growth and development with the interplay of the
nursing process, and Family Nursing to promote quality maternal and child health
nursing care.

As you start with this module, you are free to consult and coordinate with your assigned clinical
instructor. Be sure to get his/her email address and contact number for collaboration and
assistance. Just keep going, you can do it!
Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program

STEPPING IN

Hello, future nurse!

Welcome to your 5th module. You had your discussion on the process of growth and development
in different stages of life, and the health promotion and disease prevention in the Adolescent period.
Adolescence is generally defined as the period between ages 13 and up to 20 years, a time that
serves as a transition between childhood and becoming a late adolescent. It can be divided into an
early period (13 to 14 years), a middle period (15 to 16 years), and a late period (17 to 20 years).
During all periods, adolescence is defined not so much by chronologic age as by physiologic,
psychological, and sociologic changes. The drastic change in physical appearance and the change
in expectations of others (especially parents) that occur during the period can lead to both emotional
and physical health concerns. Adolescents invariably feel a sense of pressure throughout this
period because they are mature in some respects but still young in others. For example, an
adolescent’s sexual interests are awakening, yet personal or parental pressures discourage sexual
exploration. An adolescent may not feel mature enough to live away from home, yet parents and
teachers may urge the adolescent to apply for an out-of-town college. This duality causes a major
dilemma or conflict for an adolescent, leading to many of the growth and developmental concerns
of the age.

To kick things off, let us start by answering the following questions.

ASSESSMENT: GROWTH AND DEVELOPMENT OF AN ADOLESCENT

Adolescents both grow rapidly and mature dramatically during the period from age 13 to 18 to 20 years.
A. PHYSICAL GROWTH
1. The major milestones of physical development in the adolescent period are the onset of puberty
at age? _______________
2. The cessation of body growth of an adolescent is at around what age? _______________
3. Boys typically grow about _______________ centimeters in height, and gain about
_______________ pounds during their teenage years.
4. Girls grow _______________ centimeters in height, and gain about _______________ pounds.
5. Blood pressure: _______________
6. Pulse Rate: _______________
7. Respiratory Rate: _______________
8. The hormone that stimulates sebaceous glands to extreme activity, sometimes resulting in acne, a
common adolescent skin problem. _______________
9. Which gland produces a strong odor shortly after puberty? ______________
10. Teeth development:
a. Second Molars: _______________ years old.
b. Third Molars (Wisdom tooth): _______________ years old.
11. The time at which an individual first becomes capable of sexual reproduction. _______________
12. A girl has entered puberty when she had her ________________.
13. A boy enters puberty when he begins to produce _______________.
14. These are characteristics that distinguish the sexes from each other but that play no direct part in
the reproduction process. _______________
Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program

15. The end of skeletal growth in male is at age _______________, while for the female is at age
_______________.

Sexual maturity in males and females is classified according to Tanner Stages.

A. Cite the Tanner stages of female sexual development:
Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program

Tanner Stage Breasts Pubic Hair

Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program

B. Stages of male genital growth:

Tanner Stage Genital and Pubic Hair Development

Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program

B. EMOTIONAL DEVELOPMENT

1. Developmental task according to Erik Erikson:

Approximate Age Period Psychological Virtue Developed

Task/Crisis

2. What are the four main areas in which adolescents must make gains to achieve a sense of identity?
a. _______________________________________
b. _______________________________________
c. _______________________________________
d. _______________________________________
3. Developed when young people do not achieve a sense of identity and they can have little idea what
kind of person they are. ______________________________
4. Describe the Socialization of the following age:
a. 13 years old:
________________________________________________________________________________
________________________________________________________________________________
b. 14 years old:

________________________________________________________________________________
________________________________________________________________________________
c. 15 years old:
________________________________________________________________________________
________________________________________________________________________________
d. 16 years old:
________________________________________________________________________________
________________________________________________________________________________
e. 17 years old:
________________________________________________________________________________
________________________________________________________________________________
 Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program

C. CONCEPT MAP OF THE GROWTH & DEVELOPMENT OF AN ADOLESCENT

Instruction: Trace the milestones development of the Adolescent stage from 13-20 years old.
Follow the diagram below:

Patient
Information
(Name, Age, Present
complaint)

Physical Developmental Emotional Cognitive Management by

Growth Milestone Development Development Areas of Concern:

˃Common Health
Secondary Sex Problem
Play & Early Late Developmental
Characteristics -HPN
Recreation Adolescent Adolescent Task -Poor Posture
Developmental Developmental -Body Piercing and
Task Task Tattoos
-Fatigue
-Acne
-Obesity
˃Sexuality/ Sexual
Nutritional Activity
Health Daily Healthy Family
˃Hazing & Bullying
Promotion Health Activities Functioning
˃Substance Abuse
Promotion
˃Depression & Self-
Injury
-Suicide
Safety Diet Dress, Hygiene,
Care of self,
Sleep, Exercise,
Sun Exposure

Developed: Early Adolescent = Identity vs. Role Confusion

Late Adolescent = Intimacy vs. Isolation

Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program

You are now ready to meet your patient for this clinical experience.

DEEP DIVE
A Case Study on the Concept of Growth & Development of an Adolescent

Adolescence is like a roller coaster ride; there are all of these unexpected twists and turns, hills
that are greatly anticipated, and then drop‐offs that will take a person’s breath away. It can be
exciting and scary all at the same time. Like Adolescence, people may take the same roller coaster
ride; however, each individual’s experience and interpretation of the ride is different. Adolescence
is a period of development marked by biological changes, new experiences, and new developmental
tasks.

Jayson was born on June 23, 2003, in Digos City. His father, Swinson, 45 years old, is a salesman
whiles his mother, Robilyn, 39 years old, a housewife. He had 2 siblings, Peree, 13 years old, and
Belle 7 years old. He was their firstborn and only son of the family. Jayson weighs 175 pounds, and
his body structure would most likely resemble an endomorphic type. Like all teenager, Jayson loves
to eat faddish or quick snack foods which usually consists of oily and sweet foods rather than eating
nutritionally balanced meals. He chooses buttered chicken, pizza, fries, and pasta over vegetable
menus cooked by his mother. He seldom eats fruits but his preferences are always apple and
grapes. Most of the time, his mother reprimanded him for eating fast food once a week. Although
he does unhealthy eating choices, he occasionally does exercise.

At his age, Jayson has developed many pubertal characteristics such as more detectable voice
changes, and the growth of facial hair occurred. He could not recall the exact age but reported that
experiencing his growth spurt and noticed a detectable change in his voice at about age 13, and
began to develop facial hair at age 15. Jayson recently completed his junior year in high school.
He said his favorite thing about school was socializing, and his least favorite was all the work.
Despite his feelings about school, he makes good grades. He excelled in academics throughout his
schooling. He was awarded certificates of achievement in Honors for math and science subject. He
plans to go to college and potentially see himself pursuing a career in engineering. He has stated
that his friends are an important aspect of his life. He says most of his friends are also active in
sports. When asked about peer pressure, he did not seem as if it were a difficult issue. He reports
Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program

that he does begin to accompany his friends to a party without telling his mom. Some of his friends
tried smoking and drinking socially as he stated.

You meet Jayson in an adolescent clinic because he complains of a headache and cold after his
class. You observed that he has numerous acne lesions on his forehead and cheeks. Jayson was
an active member of the chess team in their school. He was truly an expert in mind-boggle games
and would like to be a challenge when he plays with it. His parents tell you Jayson seemed
depressed after his girlfriend broke up with him a few weeks ago. After the break-up, they did not
see him play chess, but now they observed that Jayson seems happy again. For a start, Jayson is
prepping to get involved in a physical sport which he appreciated more likely because he is a fan
of Stephen Curry from the Golden State Warriors whom he recognized as the best basketball player
today. Jayson made his journey to begin basketball by trying out every afternoon running with the
ball bouncing thirty minutes at basketball gym since the coach would like him to removed extra
fats and calories in his body. Besides liking the sport, Jayson is experiencing a bizarre feeling every
time he is around boys his age, especially Allen, one of his teammates in basketball.

Jayson's parents are pleased to see him maturing so much that he recently gave away his
chessboard to a young neighbor. As his Nurse, you mention to Jayson during the visit that a
decongestant would probably make him feel better. He asks you how many pills it would take to
kill someone and then jokes he was kidding. His healthcare provider prescribes a decongestant and
suggests Jayson return in 6 months.

Jayson tells you during a history assessment that he does not smoke, but you smell cigarette smoke
on his clothing. Although he says he doesn’t use drugs, several blue-and-white capsules fall out of
his shirt pocket when he unbuttons his shirt. He asks if he’s going to grow some more; being the
shortest boy in his gym class makes him feel “left out.” Also, he asks if his teeth are white enough.
As a nurse, you are aware that these are common concerns of an adolescent.

Jayson seems unusually happy at a clinic visit when usually he is sad because of the break-up. The
nurse knows he recently gave away his chessboard to a neighborhood boy because “I won’t need
them where I’m going.”

Patient Assessment: Seventeen-year-old male with a history of acne for the last 6 months. He
reports washing his face approximately five or six times a day with abrasive soap and covering
lesions with cocoa buttercream twice a day. He states, “Look at me. I look terrible.” Physical
examination reveals scattered pustules and comedones on the forehead and face, two lesions on
the right cheek with a large erythematous base, and tender to touch.

Physical examination reveals:

Weight: 75 pounds
Height: 157 centimeters
Vital signs: Temperature: 36.8*Celsius
Respiratory Rate: 20 cycles/minute
Pulse Rare: 70 beats/minute
Blood Pressure: 120/70 mmHg
Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program

Medication:
Sudafed 30mg 2caplets every 6 hours in 24 hours
Tetracycline 500mg 1capsule 2 times a day for 1 week

To immerse yourself in the care management of your patient, let us do some detailed description
of your patient care tasks. Using the Case Scenario assigned to you, you are expected to perform
the following:

1. Fill-up the needed data based on the given scenario/case. Note: Assessment findings of all
other areas must be filled up using fictional data BUT should be within the scope of the case
scenario given.
2. Conduct a history taking and physical assessment of your patient. Use BLUE pen for
normal findings and RED for abnormal findings under Review of Systems (ROS).
3. Develop a Concept Map of your patient’s condition using the Concept Map Format.
4. Present your drug study and IVF data.
5. Prior to administering a patient’s medications, you are required to make a drug study of
all medications required by your patient in oral or parenteral form and document it. Select
one drug. No duplications of selected drugs for study should be made.
6. Formulate a patient-centered care plan for your patient.

7. Clinical Reasoning Questions - Collaboration:

Jayson seems unusually happy at a clinic visit when usually he is sad because of the break-up.
The nurse knows he recently gave away his chessboard to a neighborhood boy because “I won’t
need them where I’m going.”

Knowing that this statement a safety concern, how would you communicate it to the physician?
Follow the CUS method.
Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program

8. Clinical Reasoning Questions - Ethico-Moral-Legal:

It has long been theorized there may be a “gateway” drug or one that, when used first,
leads to further and more dangerous substance use disorders. To determine whether alcohol,
tobacco, or marijuana was the gateway drug, researchers obtained information on the drug use of
a nationally representative sample of high school seniors. Results of the study showed alcohol was
the gateway drug, leading to tobacco, marijuana, and then other illicit substances (Barry, King,
Sears, et al., 2016). Based on the previous study, Jayson stated “My parents said I could celebrate
my next birthday by drinking my first beer.”

What would be your nursing action in this situation? What ethical principle is applicable in this
scenario? Justify?

DESTINATION CHECK
You are nearly done with your module!
Before we end, let us check what you have learned so far and touch on the topics which have been
discussed earlier but may not have been covered in the questions asked so far [Answer in a
separate sheet].

Knowledge of growth and development is important to the nurse to observe the sequence of
developmental behavior of each adolescent. Kindly answer the following questions:
1. Adolescents reach a point of cognitive development termed formal operational thought.
What does formal operational thought mean?
2. Promoting nutritional health to an adolescent is also important for them not to become
overweight. They need to consume adequate calories and especially protein, iron, calcium,
and zinc to meet their increased growth needs. Cite the nutritional requirements of an
adolescent.
3. Being an adolescent is difficult in today’s world. Be aware that to reduce stress, some
adolescents may begin to abuse substances. As a Nurse, you ask about an adolescent’s
drug experiences during a health assessment. The teenager reacted by saying “you are
invading my privacy”. What will be your response?
4. Promoting adolescent safety is an important nursing role. What are the most common safety
concerns in this age group?
5. What are the leading causes of death in this age group?

Have you answered all of the questions above? Great! You are now ready to proceed to
the next part of the module
Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program

REFLECTION TIME

Reflection Time:
Make a reading on personal experiences of a teenager, or a couple, or a family, or a health
professional taking care of an adolescent who experienced bullying in school or other settings.
Please do not forget the link to the article. Provide a 4 paragraph handwritten reflection. 1sT
paragraph will be the introduction of your article. 2nd paragraph will be your reflection as a Student
nurse. 3rd paragraph will be your reflection as a Future Health professional and lastly, the 4th
paragraph will be your conclusion about your reflections.
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program

Congratulations! You have completed this module. You may now proceed to the weekly quiz.
Please wait for further instructions from you instructor

References:
Silbert-Flagg,J. & Pillitteri, A. (2018). Maternal & Child Health Nursing, Care of the childbearing &
Childrearing Family, 8th Edition. Wolter Kluwer Health

Berman, A., Snyder, S., & Frandsen, G. (2016). Kozier & Erb’s fundamentals of nursing: Concepts,
process, and practice (10th ed.). Pearson Education, Inc.

Marieb, E., & Keller, S. (2017). Essentials of human anatomy & physiology (12th ed.). Retrieved
from https://bok.asia/book/5010929/ac07d2
Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program

Concept Mapping

▪ Use the DDC form for drug studies. Drugs will be assigned by the clinical
instructor according to the concept of the rotation
▪ Must contain the following:
o Generic Name
o Brand Name
o Classification
o Mode of Action
o Indications
o Contraindications
o Side Effects (organized per system; cephalocaudal)
o Adverse Effects (per system; cephalocaudal)
o Dosage
o Nursing considerations
o Reference(s) – Follow APA 7e format

For the NCP, please follow the DDC NCP template.

Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program