Adolescents

• Adolescence


  The period of physical and psychological mature and acquires a personal identity
• Puberty


  The first stage of adolescence in which sexual organs begin to grow and mature
• Stages of adolescent period

  • Early adolescence (12-13 years)
  • Middle adolescence (14-16 years)
  • Late adolescence (17-18/20 years)
• Late adolescence


  • A more stable stage, adolescents are involved mostly with planning their future and economic independence
• Physical Development in Adolescence

  1. Growth is markedly accelerated

  2. Sudden and dramatic physical changes, referred to as the adolescent growth spurt

  3. Growth spurt begins earlier in girls, many girls surpass boys in height at this time

  4. Height and weight changes
• For males, the growth spurt is fastest at about 14 years, and maximum height is often reached at about 18 or 19 years. Some men add another 1 or 2 cm to their height during their 20s as the vertebral column gradually continues to grow
• For males, 10-18 years old, the average American male doubles his weight, gaining about 32 kg (72 lb)
• For females, 10-18 years old, the average American female gains about 25 kg (55 lb)
• Glandular Changes in Adolescence

  • Eccrine and apocrine glands increase their secretions and become fully functional
  • Eccrine glands produce sweat
  • Apocrine glands release sweat in response to emotional stimuli
  • Sebaceous glands become active, secrete sebum, and often contribute to an increased incidence of acne
• Primary sexual characteristics


  • Testes, penis, ovaries, vagina, uterus
• Secondary sexual characteristics


  • Pubic hair growth, breast development, voice changes
• Thelarche


  First noticeable sign of puberty in females, breast buds
• Menarche


  Milestone of female puberty, onset of menstruation
• Ovulation is usually established 1 to 2 years after menarche
• Female internal reproductive organs reach adult size by about age 18 to 20
• Ego identity vs. role confusion


  Establishing a sense of sexual identity and clarifying one's sexual orientation occurs during late adolescence
• Psychosocial Development in Adolescence

  1. Exploration of sexual images, fantasies, ideas, and roles

  2. Experimenting with dress, language, and social interactions to define who they are

  3. Begin to establish intimacy with a partner or partners

  4. Sexual experimentation is not part of true intimacy, but once intimacy is achieved, sexual activity is often included
• Genital stage


  The final stage of psychosexual development begins at the start of puberty when sexual urges are once again awakened
• Cognitive Development in Adolescence

  • Cognitive abilities mature, can think beyond the present and beyond the world of reality, highly imaginative and idealistic, consider things that do not exist, use logic, organization, and consistency
• Adolescents' ability to think abstractly may be misunderstood by parents as arguing or being contrary
• Conventional level of moral development

  Adolescents accept the Golden Rule and want to abide by social order and existing laws
• Postconventional or principled level of moral development


  Adolescents start to question the rules and laws of society, right thinking and right action become a matter of personal values and opinions, which may conflict with societal laws
• Synthetic-conventional stage of spiritual development


  Adolescents encounter different groups in society, are exposed to a wide variety of opinions, beliefs, and behaviors regarding religious matters, and often believe that various religious beliefs and practices have more similarities than differences
• Nursing activities relative to the synthetic-conventional stage of spiritual development include presenting an open, accepting attitude, arranging for adolescents to see a member of their religious faith, and providing a comfortable environment for them to practice the rituals of their faith
• High-risk behaviors in adolescence

  • Behaviors contributing to unintentional injury or violence
  • Tobacco use
  • Alcohol or other drug use
  • Sexual activity that contributes to pregnancy and sexually transmitted infections, including HIV
  • Unhealthy diet
  • Physical inactivity
• Suicides in adolescents has declined in recent years, but continues to be a significant problem, and may be reported as an accidental death
• School bullying among adolescents affects school achievement and psychological well-being for both victims and perpetrators, and can take different forms: physical, verbal, relational/social, and cyber or electronic
• Eating disorders and self-injury are often related, and can lead to negative effects on memory, attention, and concentration, as well as personal, family, and social difficulties for the adolescent
• Obesity among adolescents has increased significantly over the years, making type 2 diabetes more common among teens than previously, and there is also an inherited form of diabetes, maturity-onset diabetes of the young (MODY), that can cause diabetic complications as early as the teens
• Health promotion guidelines for adolescents

  • Health examinations as recommended by primary care provider
  • Immunizations as recommended
  • Screening for tuberculosis
  • Periodic vision and hearing screenings
  • Regular dental assessments
  • Obtaining and providing accurate information about sexual issues
  • Assessing for mental health status
  • Adolescents taking responsibility for using motor vehicles safely
  • Proper precautions during athletic activities
  • Parents keeping lines of communication open and being alert to signs of substance abuse and emotional disturbances
  • Importance of healthy snacks and appropriate patterns of food intake and exercise
  • Engaging in regular vigorous exercise, at least three times a week for 1 hour each time
  • Encouraging and facilitating adolescent success in school
  • Encouraging adolescents to establish relationships that promote discussion of feelings, concerns, and fears
  • Parents encouraging adolescent peer group activities that promote appropriate moral and spiritual values
  • Parents acting as role models for appropriate social interactions
  • Parents providing a comfortable home environment for appropriate adolescent peer group activities
  • Expecting adolescents to participate in and contribute to family life