Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Chapter 10 Adolescence Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Definition “To grow and mature” Bridge between childhood and adulthood Unique stage of development characterized by many physiological, cognitive, psychosocial, and sexual changes Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Developmental Tasks Establishing a stabilized sense of identity Separation from family Career planning Establishing close peer relationships Intimacy Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Growth and Development Early adolescence (10 to 13 years) Middle adolescence (14 to 16 years) Late adolescence (17 to 20 years) See Table 10-1 Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Physiological Changes Weight gain Asynchronous Active sweat glands Stomach and intestines increase in size and volume Increased appetite and food consumption Weight and volume of the lungs increase Improved eye-hand coordination and motor function Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Physical Activity 60 minutes or more every day At least three days per week should include vigorous exercise Warm-up and cool-down sessions Strength training can increase muscle and bone mass Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Puberty Boys Hormonal changes between the ages of 10 and 13 Secondary sex characteristics Spermatogenesis Ejaculation Nocturnal emissions Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Puberty (cont.) Girls Hormone secretions begin to establish a pattern within a monthly cycle Ovulation Menarche Menstrual cycle Secondary sex characteristics Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Birth Control Most effective: abstinence Hormonal Non-hormonal Permanent See Table 10-2. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Teen Pregnancy About 400,000 teenagers give birth each year according to the CDC Seek sexual activity because of coercion, peer pressure, or curiosity Sex education is important before adolescence See Patient Teaching (p. 157) Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Cognitive Development Concrete phase of thinking Formal operation stage May try to manipulate rules, engage in risky behaviors, or deny their own mortality Post-conventional stage of moral judgment Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Psychosocial Development Major task of adolescence is achieving a stable self-identity Role confusion Family should offer support and guidance Social skills and cognitive reasoning Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Teen Violence May use violence because they have not been taught nonviolent techniques of managing conflicts Episodes of fighting often precede homicides Adolescents who are homeless, abused, or disadvantaged may not be able to cope with the other developmental tasks of adolescence Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Cultural Considerations Culture plays a role in how adolescents think and interact Cultural competence Culture affects health-care practices and modes of communication Cultural and religious traditions can help stabilize identity and involve rituals that celebrate the transition from childhood to the adult phase of life See Figure 10-3. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Development Of Responsibility Adolescents look forward to challenges and often feel humiliated when placed in the dependent role Earn and learn to manage money Important for the adolescent to be responsible for making decisions Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Peer Relationships Peer group affiliation has a major impact on adolescent growth and development School provides the opportunity for social interaction, peer group association, and clique formation Failure to connect in a clique or a peer group can contribute to lower self-esteem or to feelings of inadequacy Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Sexuality Developing a sexual identity is an important part of the adolescent's sense of self Sexually active and exclusive relationships often develop during later adolescence Sexual exploration creates risk for unplanned or unprotected sexual activity Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Teaching Techniques The first step in effectively teaching adolescents involves establishing a trusting relationship Communication must be supportive and not threatening to adolescents' sense of independence or autonomy Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.