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Chapter 16

Health Promotion of theAdolescent and Family

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Promoting Optimum Growthand Development

• ransition bet!een c"ild"ood andad#lt"ood

• $apid p"ysical, co%nitive, social, andemotional mat#ration• &enerally defined as be%innin% !it" t"e

onset of p#berty and endin% !it" t"ecessation of body %ro!t" at 1' to 20 years

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Definitions

• (rep#bescence) Abo#t 2 years beforep#berty, "eraldin% p"ysical c"an%es

• (#berty) *e+#al mat#rity is ac"ieved• (ostp#bescence) 1 to 2 years after p#berty

s-eletal %ro!t" is complete and reprod#ctivef#nctions become establis"ed

• Adolescence) ime of %ro!in% intopsyc"olo%ical, social, and p"ysical mat#ration

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iologic Development

• (rimary se+ c"aracteristics E+ternal and internal or%ans necessary for

reprod#ction

• *econdary se+ c"aracteristics $es#lt of "ormonal c"an%es) /oice c"an%e,

"air %ro!t", breast enlar%ement, fat deposits

(lay no direct role in reprod#ction

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Hormonal Changes of Pu!erty

• $ole of anterior pit#itary and"ypot"alam#s

•ormones stim#late %onads• &onads prod#ce and release %ametes

• &onads secrete se+ appropriate

"ormones

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"e# Hormones

• *ecreted by ovaries, testes, and adrenal%lands

•(rod#ced in varyin% amo#nts by bot"se+es t"ro#%"o#t t"e life span Adrenal corte+ ca#ses small amo#nt of

secretion before p#berty Mat#ration of %onads prod#ces biolo%ic

c"an%es of p#berty

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$strogen

• 56emini7in% "ormone8• o! prod#ction d#rin% c"ild"ood

• In males, t"ere is %rad#al prod#ctiont"ro#%"o#t mat#ration• In females, levels increase #ntil abo#t 3

years after menarc"e estro%en t"enremains at t"is ma+im#m level t"ro#%"o#treprod#ctive life

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Androgens

• 5Masc#lini7in% "ormones8• *ecreted in small and %rad#ally increasin%

amo#nts #p to : to 9 years t"en rapidincrease in bot" se+es #ntil 1 years• $esponsible for rapid %ro!t" of t"e early

teena%er • estes secrete testosterone levels

increase to a ma+im#m level at mat#rity

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"e#ual %aturation

• anner sta%es of se+#al mat#rity *ta%es of development of secondary se+

c"aracteristics and %enital development ;efined as a %#ide for estimatin% se+#al

mat#rity

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"e#ual %aturation for Females

• "elarc"e <' to 13 years=) >reast b#ds• Adrenarc"e <' to 13 years=) (#bic "air

%ro!t"• Menarc"e) Abo#t 2 years after t"elarc"e,menstr#ation be%ins

• (#berty 5delay8) ?o t"elarc"e by a%e 13years

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&anner "taging' Females

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&anner "taging' Females(cont)d*

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"e#ual %aturation for %ales

• *ta%e 1 <91@2 to 1 years=) estic#larenlar%ement and sparse p#bic "air

• *ta%e 3) (enile enlar%ement, voicec"an%es, early facial "air %ynecomastia<temporary breast enlar%ement= occ#rs in1@3 of males in midp#berty

• *ta%e ) (enile %ro!t", first e ac#lation,a+illary, %roin, and facial "air, final voicec"an%e

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&anner "tages' %ales

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Physical Growth

• ;ramatic increase in %ro!t" accompaniesse+#al mat#ration

• Adolescent %ro!t" sp#rt 20B to 2 B of total "ei%"t is ac"ieved d#rin%

p#berty Cs#ally occ#rs !it"in a 2 to 34 mont"

period• D"aracteristic se #ence of c"an%es

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"e# Differences in GeneralGrowth Patterns

• Appear to be t"e res#lt of "ormonal effectsd#rin% p#berty

• *-eletal %ro!t"• /oice c"an%es• ean body mass

• ?on lean body mass• *-in, %lands, and "air

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Physiologic Changes

• *i7e and stren%t" of "eart, blood vol#me,and systolic blood press#re increase

• (#lse rate and basal "eat prod#ctiondecrease

• Ad#lt val#es for all formed elements of blood• $espiratory vol#me and vital capacity

increase• Increased performance capabilities

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Psychosocial Development

• Eri-son) *ense of identity Early adolescent) &ro#p identity vers#s

alienation ;evelopment of personal identity vers#s role

diff#sion *e+ role identity

Emotionality

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Piaget+ Cognitive Development

• 6ormal operations period• Abstract t"in-in%

"in- beyond present Mental manip#lation of m#ltiple variables Doncerned abo#t ot"ersF t"o#%"ts and needs

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,ohl!erg+ %oral Development

• Internali7ed set of moral principles• G#estionin% of e+istin% moral val#es and

relevance to society• Cnderstand d#ty and obli%ation, reciprocal

ri%"ts of ot"ers•

Doncepts of #stice, reparation

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"piritual Development

• *ome may #estion t"e val#es and beliefsof t"e family

• Dapable of #nderstandin% abstract conceptsand interpretin% analo%ies and symbols

• May fear t"at ot"ers !ill not #nderstandt"eir feelin%s

• endency for introspection and emotionalintensity

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"ocial Development

• &oal is to define oneFs identityindependently from parental a#t"ority

• M#c" ambivalence Abo#t spirit#al system t"ey !ere raised in

• Intense sociability intense loneliness•

Acceptance by peers

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Peer Group

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-elationships with Parents

• $oles c"an%e from 5protectiondependency8 to 5m#t#al affection ande #ality8

• (rocess involves t#rmoil and ambi%#ity• *tr#%%le of privile%es and responsibility•

Emancipation from parents may be%in!it" t"e re ection of parents by t"eteena%er

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-elationships with Peers

• (eers ass#me an increasin%ly si%nificantrole in adolescence <5best friend8=

• (eers provide a sense of belon%in% and afeelin% of stren%t" and po!er

• (eers form a transitional !orld bet!eendependence and a#tonomy

• $ole of social media and advancedtec"nolo%y

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Adolescent "e#uality

• ;atin%• *e+#al orientation

• *e+#al e+perimentation <!ide ran%e=• $easons for se+#al e+perimentation D#riosity

(leas#re Don #est (eer press#re to conform

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Development of "elf.Conceptand ody /mage

• 6eelin%s of conf#sion in early adolescence• Ac#te a!areness of appearance,

comparison of appearance !it" ot"ers• >lemis"es and defects are ma%nified o#t

of proportion• Mat#res to self concept based on

#ni #eness and individ#ality

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-esponses to Pu!erty

• $esponses differ dependin% on t"e sta%eof development D#riosity in early adolescence Doncerns !it" 5Am I normalH8 Doncerns for late mat#rin% teens Doncept of 5perfect body8 ac"ievement

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Promoting Optimum Healthduring Adolescence

• Ass#mption of responsibility for "ealt"• Assess for ris- factors <&A(*=

• Imm#ni7ations• ?#trition• Eatin% "abits and be"aviors

• ealt"y lifestyle "abits

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Promoting Optimum Healthduring Adolescence (cont)d*

• *leep and rest• E+ercise and activity

• ;ental "ealt"• (ersonal care /ision, "earin%

(ost#re >ody art <piercin% and tattooin%= *#ntannin%, #ltraviolet dama%e

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Promoting Optimum Healthduring Adolescence (cont)d*

• *tress red#ction• *e+#ality ed#cation and %#idance

Media infl#ences no!led%e from peers, /, movies,

ma%a7ines ?eed fact#al information, presentation based

on developmental mat#rity and ability to as-#estions

$ole modelin%

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/n0ury Prevention

• Motor ve"icle cras"es are t"e sin%le%reatest ca#se of serio#s and fatal in #ries inteens

• Jt"er ve"icles• 6irearms and ot"er !eapons• *ports in #ries• Kater safety• (oisonin%, tobacco, alco"ol, and ot"er dr#%s

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Anticipatory Guidance+Care of Families

• (arents need s#pport and %#idance• Information needs re%ardin%

developmental c"an%es and process of%ainin% independence

• elp 5lettin% %o8 and promotin%independence

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