Puberty & Adolescence

Life Span - Lecture 6Chapter 10

Puberty / Pre-adolescence

• Rapid growth• @ 2 yrs to complete• 2nd sex characteristics

Factors that influence Puberty

• Heredity• Climate• Nutrition• Gender• Socioeconomic status

4 Major Changes - Puberty

1. Rapid growth2. Δ body proportions3. 1o sex characteristics4. 2o sex characteristics

Puberty Frustrations

• Independence / supervision• Appearance / body changes• Peer acceptance / peer frustration• Academic success / h workload• Adult behavior / child behavior• h schedule / need for h sleep

Adolescence• Begins– Sexual maturity

• Ends– Cessation of growth

emotional maturity

Characteristics of Adolescence

• Volatile emotions• Insecurities• Introspection• Experimentation• Testing values

Puberty: Height & Weight

• Rapid Growth• Girls before Guys– Feet 1st

• Height– h 20 – 25%

• Weight– h 15 – 60 lbs

• Disproportionate

Puberty: Development of Sex

• 1o sex characteristics– Gonads

Puberty: Male

• Testes• Scrotum• Sperm• Testosterone• Ejaculation• Penis

Puberty: Female

• Ovaries• Ova• Estrogen• Progesterone• Menarche• Menopause

Puberty: Development of Sex

• 2o sex characteristics– Pubic hair– Axillary hair – Sebaceous glands

• oil

– Apocrine glands• sweat

Body Changes: Puberty

Male ♂• Penis• Erections• Wet dreams• Voice changes

Female ♀ • Breasts• Menstruation• Cramps• Pregnancy• Hygiene

Body Changes: Puberty

Male ♂• 10 – 11

– Gonad growth– Pubic hair

• 12-13– Growth spurt

• 13-15– 2o hair– Ejaculation– Voice deepens

Female ♀ • 10-11

– Growth spurt– Breast– Pubic hair

• 11-14– Menarche

• 12 – 13– 2o hair

Adolescence: Height & Weight

• Slows after puberty• ♀– 16 - 17

• ♂– 18 – 20

Muscle & Bone development

• h strength• h endurance• h size

• Sore• Awkward• Scoliosis– “lateral curvature of the

spine”

Respiratory System G&D

• h Lung size, weight• i rate• h performance

• Nurse intervention– EXERCISE!!!

GI System G&D

• h size & capacity

Teeth: G&D

• 12yrs– 2nd molars

• 14 – 25 yrs– 3rd molars– “Wisdom teeth”

Vital Signs

• Pulse– 60-90

• Resp– 16 – 24

• Nursing intervention– EXERCISE!!!

Motor Development• Rapid growth Clumsy • *Eye-hand coordination

Sexual Development

• Comparisons• Masturbation• Sexual activity• Education

STD’s

• h• Prevention education

Teen pregnancy

“The pregnant adolescent has twice the mortality rate

of a non-adolescent pregnant woman.”

Teen Pregnancy

• What are the “down-sides” of teenage pregnancy?

Rape

• h• Stranger• Date-rape

Psychosocial Development: Behavior

Behavior• Rebellious

Parental Response• Overlook• Avoid confrontation• Be tolerant• “Pick your battles”• Avoid seeing behavior as a

rejection of parental love

Psychosocial Development: Behavior

Behavior• Need for privacy

Parental Response• Own space• Understanding• Offer help – step back• Open communication

Psychosocial Development: Behavior

Behavior• Dishonesty

Parental Response• Don’t overreact• Reinforce reality• Be consistent

Psychosocial Development: Behavior

Behavior• Responsibility

Parental Response• Listen• Expect uneven maturity• Enc. decision making &

responsibility• Set reasonable rules

Psychosocial Development: Behavior

Behavior• Curfews

Parental Response• Allow unexpected delays• Enc phone contact• Set example• Socialize at home

Psychosocial Development: Behavior

Behavior• Friends

Parental Response• Accept \ criticism• Get to know them• Avoid showing disapproval

Psychosocial development: Puberty

• Attitude– Happy negative

• h self-consciousness• Self-doubt• h time alone (room) • Find new peers

• Antagonism

Psychosocial Development: Adolescence

• Explore own values– Test them

• Ambivalence– Two opposing feelings at

the same time

• Mood swings

• Love / hate family• Freedom/supervision• Wanting to be part of a

group / wanting to be alone

• Emotions– Expressed feelings

behavior

• Mood swings– Anger– Fears– Worries– Jealousy– Envy– Happiness

• Boredom– Daydreaming

• Humor– “Biting”

• Work / employment

Age 13 - 14

• Hide feelings• Negative & hostile• Narrow perspective– compromise

Ages 15 - 16• i self absorption• h compromise• h independent thinking– Discuss– Debate

• Experimenting– h risk taking– h adventure

• Dating

Age 17 -19• Serious• Idealistic• h Stress• Relationships– Family– “boy-friend” /“girl-friend”– Peers

• Career

Discipline

• Clear rules• Set rules – Dating– Curfew

• Open communication• Be realistic• Be available• Listen!

Cognitive Development

• Concrete thinking (with training) formal operational– Logical– Scientific reasoning– Problem solving– Look at all possibilities

Moral Development

• “Cognitive development is a prerequisite for moral reasoning”

• Conventional Level– Follow rules– Show concern for others– Want to be trusted

• BEGIN TO QUESTION EVERYTHING• Post conventional

Communication

• Verbal communication

Nutrition

• Caloric intake– ♀

• 2,600 / day

– ♂• 3,000 / day

Key nutrients

• Protein– 15%

• Calcium• Iron

Sleep & Rest

• h need for sleep– 8 hours

• Affects of poor sleep– Irritable– I school performance– i concentration– h stress– h susceptibility to illness– Auto accidents

University of Chicago Medical Center October 23, 1999 The Lancet.

• “Chronic sleep loss can reduce the capacity of even young adults to perform basic metabolic functions, such as processing and storing carbohydrates or regulating hormone secretion… Cutting back from the standard eight down to four hours of sleep each night produced striking changes in glucose tolerance and endocrine function--changes that resembled the effects of advanced age or the early stages of diabetes--after less than one week.”

Anorexia Nervosa

• Eating + emotional disorder

• Willful starvation• < minimum body weight• Fear of weight gain• Extreme dieting

– Diet pills– Laxatives– Ipecac

• Excessive exercise

Bulimia

• Binge & purge• loss of control

Safety

• MVA– Driving– Independence– Poor judgment– Don’t drink and drive

Safety

• Sporting activities– Pre-sport physicals– Protective equipment

• ♂– Football– Hockey

• ♀– gymnastics

Safety

• Firearms– Storage– Training

Health Promotion

• nutrition patterns = health level

• Annual physical• Vision & hearing• √ Height & weight

Depression• “Prolonged feeling of

sadness and unworthiness”

• h d/t long period of…– Self reflection

S&S of Depression in Adolescence

• Crying• Insomnia• Eating disorders• Social isolation• Acting out• Hopelessness• Physical symptoms• Loss of interest in

appearance• Giving away things

Contributing Factors to Adolescent suicide

• Depression• Low self-esteem• Poor impulse control• Substance abuse• Emotional isolation

Depression/suicide: Nursing interventions

• Assess for clues• Listen carefully• Do not undervalue

emotions!• Ask if they are thinking

about suicide• Do they have a plan?• Constant supervision

Substance Abuse

• How to know• http://www.youtube.com/watch?feat

ure=player_detailpage&v=RkgZujOQSFU