NURSING CARE of a

FAMILY with an
ADOLESCENT
 OBJECTIVES
• At the end of the class, the students will be able to:
• describe the physical characteristics of an
adolescent;
• describe the normal growth and development of
an adolescent;
• formulate nursing diagnoses related to adolescent
growth and development and associated parental
concerns; and,
• integrate knowledge of adolescent growth and
development in providing nursing care.
 Video

• https://www.youtube.com/watch?v=PzyXGUCngo
U

•
• https://www.youtube.com/watch?v=TlfsGKDoVIQ

• https://www.youtube.com/watch?v=J8PyEVacaVA
• ADOLESCENCE = period between 13 and up to
20 years
• Serves as a transition between childhood and
becoming a late adolescent.
• Early period = 13 to 14 years old
• Middle period = 15 to 16 years old
• Late period = 17 to 20 years old
• Drastic change in physical appearance
• and
• Change in expectations of others (especially
parents) that occur during the period can
lead to both emotional and physical health
concerns
 PHYSICAL GROWTH
• Onset of puberty = 8 to 12 years old
• Cessation of body growth = 16 to 20 years old
• At first, the gain is mostly in weight.
• Girls stop growing within 3 years from menarche
• Closure of the epiphyseal lines = 16 or 17 years old
for females; 18 to 20 years old for males
• The heart and lungs increase in size more slowly
than the rest of the body = insufficient energy and
become fatigued trying the various activities.
• BP in males slightly higher because more force is
necessary to distribute blood to the larger male body
mass.
• Androgen stimulates the sebaceous glands
• Activity of the apocrine glands.
 TEETH

• Second molars = 13 years old

• Third molars = 18 and 21 years old; may
erupt as early as 14 to 15 years of age
 PUBERTY
• Time at which an individual first becomes capable
of sexual reproduction.
• Between 11 and 14 years old

• SECONDARY SEX CHARACTERISTICS (Table

33.1 page 888)
 PLAY or RECREATION
• 13 years old = listening to music, texting or chatting
• Most adolescents spend time just talking with peers
as social interaction.
• 16 years old = wants part time jobs
 EMOTIONAL
DEVELOPMENT
• Early and mid adolescence = sense of identity vs. role
confusion
• Late adolescence = intimacy vs. isolation
• SENSE of IDENTITY
• To decide whom they are
• What kind of person they will be
• ROLE CONFUSION
• Lead to difficulty functioning effectively as adults
• Lead them to exhibit acting out (attention getting)
behaviors because they believe it is better to have a
negative image than to have none at all.
 4 Main Areas in which they Must
Make Gains to Achieve a Sense of
Identity
• Accepting their changed body image
• Establishing a value system or what kind of person
they want to be
• Making a career decision
• Becoming emancipated from parents
• Help parents understand how important it is for
adolescents to have immediate successes such as making
the high school basketball team or having a date for the
senior prom
• Compassionate understanding
• Individuals tend to dress and behave similarly to other
members of their peer group.
• Encourage an open dialogue with adolescents to assist
them to process their feelings and establish their own
identity.
• Counseling may be helpful to assist with family
communication if family is not accepting.
• Emancipation became a major issue.
• Parents may not yet be ready for their child to be
totally independent.
• Some adolescents may not yet be sure they want to be
on their own.
• Encourage parents to give adolescents more
freedom in areas such as choosing their own clothes
or after-school activities
• Help parents continue to place some restrictions on
adolescent behavior
• Sense of INTIMACY = able to form long term,
meaningful relationships with persons of the
opposite as well as their same sex.
• Those who do not develop a sense of intimacy are
left feeling isolated; in a crisis situation, they have
no one to whom they feel they can turn to for help
or support.
• If parents suspect their adolescent is sexually active,
counsel them to be certain their child is
knowledgeable about safe sex practices.
 SOCIALIZATION
• Early adolescents tend to be boisterous and loud.
• Impulsive
• 13 years old = crushes
• 14 years old = become quieter and more
introspective; they are becoming use to their
changing bodies, have more confidence in
themselves, they feel more self-esteem.
• Searching for good role models with whom they
can identify
• 15 years old = fall in love 5 or 6 times a year
• 16 years old = boys are becoming sexually mature
• 17 years old = boys tend to have adult values and
responses to events.
 COGNITIVE
DEVELOPMENT
• Formal operational thought = begins at 12 or 13
years old
• Involves the ability to think in abstract terms and
use scientific method to arrive at conclusions.
• With the ability to use scientific reasoning,
adolescents can plan their future.
• They can create hypothesis.
 MORAL and SPIRITUAL
DEVELOPMENT
• Almost all adolescents question the existence
of God and any religious practices they have
been taught
 INJURIES
• Unintentional injuries = motor vehicles
• Drowning
• Firearms
• Athletic injuries
 NUTRITIONAL HEALTH

• Tend to eat faddish or quick snack foods.

• One form of adolescent rebellion = they refuse to
eat foods that parents stress as important.
• Bulimia nervosa / anorexia nervosa
• Importance of iron, calcium, vitamin D
 DRESS and HYGIENE
• When caring for hospitalized adolescents:
• Provide time for self-care
• Allow to wear their own clothing rather than a
hospital gown.
 COMMON HEALTH
PROBLEMS
• Hypertension
• Poor posture
• Body piercing and tattoos
• Fatigue
• Menstrual irregularities
• Acne
• Obesity
 Types of Abused Substances
• Prescription and OTC drugs

• Alcohol
• Tobacco
• Performance-enhancing substance use disorder
• Marijuana
• Amphetamines
• Cocaine
• Hallucinogens
• Opiates