Term
| Morbidity and Mortality in Adolescents |
|
Definition
Generally a healthy group
• Low incidence of serious medical
problems, especially those not already
present in childhood
• Mortality: leading cause is injury
• Morbidities: behaviorally determined |
|
|
Term
Leading Causes of Mortality,
Ages 15–19 years |
|
Definition
| 39% unintentional injury. 21% other. 19% suicide. 15% homicide. 6% cancer |
|
|
Term
| Morbidity and Adolescents |
|
Definition
• Mental health problems
- Depression, suicide, anxiety, stress-related problems,
family dysfunction, ADHD, substance use/abuse;
behavior problems
• Obesity
- Poor nutrition, sedentary lifestyles
- Medical consequences occurring earlier
• Sexuality-related
- STDs, pregnancy
• Injuries—intentional and unintentional
• Dental problems
• Most health problems directly or indirectly
caused by behavioral, environmental, or social
issues
- Driven by developmental changes occurring during
this time and social/environmental contexts
surrounding adolescents
- Many patterns established that also determine adult
health
- Thus, adolescence is a key time for health promotion
and disease prevention
• Access to appropriate care often key obstacle |
|
|
Term
|
Definition
• Puberty
• Psychosocial development
- Autonomy
- Identity
• Cognitive development
- Concrete to abstract thinking |
|
|
Term
|
Definition
• Growth spurt (peak height velocity)
• Body composition change
• Organ changes (CNS organization)
• Sex organ changes (reproductive
capacity)
• Secondary sex characteristics
• Hormone changes |
|
|
Term
| Sequence of Puberty—Girls |
|
Definition
• Breast buds (thelarche; SMR II)
• Pubic hair (pubarche or adrenarche; SMR II)
• Growth spurt (peak height velocity)
• Axillary hair
• Pubic hair matures (SMR III ® V)
• Breasts mature (SMR III ® V)
• First menstrual period (menarche; SMR III-IV)
• Adult height (SMR V) |
|
|
Term
|
Definition
1- no elevatin
2- sub-areolar bud
3- tissue beyond areola
4- double-mound effecxt
5- areola in same plane as breast tissue; raised papilla |
|
|
Term
| female pubic hair tanner stages |
|
Definition
1- no pubic hair
2- sparse, dark, straight hair
3- denser, mostly straight hair
4- adult type hair, not on medial thigh
5- adult type hair, on medial thigh |
|
|
Term
|
Definition
• Enlargement of testes (> 4 cm; SMR II)
• Pubic hair (SMR II)
• Growth of penis (length then width; SMR III)
• Axillary hair (SMR III-IV)
• Nocturnal emissions (SMR III-IV)
• Growth spurt (peak height velocity; SMR III-IV)
• Facial hair (SMR IV)
• Adult height (SMR V +) |
|
|
Term
| Adolescent Developmental Stages |
|
Definition
early- am i normal
middle- who am i? where do i belong?
late- where am I going? |
|
|
Term
|
Definition
• Limit-testing (challenging rules)
• Experimental behavior (smoking, alcohol,
marijuana)
• Risk-taking (D.U.I., contraception)
• Need for control (resisting authority) |
|
|
Term
| Well Child Care time frames |
|
Definition
• 2 days
• 2 weeks
• 2 months
• 4 months
• 6 months
• 9 months
• 12 months
• 15 months
• 18 months
• 2 years
• 2½ years
• 3 years
• And yearly thereafter… |
|
|
Term
|
Definition
• Forum to address concerns
• Assessment of current state
• Physical examination
• Anticipatory guidance
• Immunizations
• Testing
• Health care home
• Education regarding chronic illnesses |
|
|
Term
| Forum to Address Concerns |
|
Definition
Informant
• Parent->à Parent + Patient -> Patient
• Other (i.e., schools, nannies, family members)
• Confidentiality
- Open-ended versus close-ended
questions
• How do you best help the child?
• Parent/patient goals |
|
|
Term
| Current State—Development |
|
Definition
- Sequential process
- Surveillance and
screening
• What is the
difference?
• Early identification
• Not a diagnosis
• Parental concerns
important
(70–80% sensitivity)
- Common domains
• Gross motor
• Fine motor
• Receptive language
• Expressive language
• Social/emotional
- School success—
ABCs
• Academics
• Behavior
• other Children |
|
|
Term
|
Definition
• Age/sex-specific
• Track over time
• Early identification
of potentially
severe disorders
• Prediction of adult
height |
|
|
Term
|
Definition
• Breast versus bottle
• “Solid” food à
pieces à eat like
parents
- Increasing
independence
- Parents choose what;
Kids choose how
much
- Monkey see, monkey
do (eat)
• My plate
• Common deficits—U.S.
- Iron
- Calcium
- Fiber
- Zinc, vitamin B6, folic
acid, vitamin A |
|
|
Term
|
Definition
Exercise
Television/computer/phone
• Obesity
• ADHD
• Sleep disturbance
• Decreased school
performance
• Violence
• Consumerism |
|
|
Term
|
Definition
- Location
- Common sleep problems
• Nighttime feeding
• Sleep apnea
• Sleep association problems
• Poor sleep hygiene |
|
|
Term
|
Definition
• Who is there?
• What changed?
• How are they managing? |
|
|
Term
|
Definition
• Home and environment
• Education and employment
• Activities
• Drugs
• Sexuality
• Suicide and depression |
|
|
Term
| Physical Examination for adolescents |
|
Definition
Not just little adults
• Full exam
• Calm demeanor
• Quiet things first
• Scary things last
• Assistance from
parent
Special exams
• Red reflex
• Hip exam
• Scoliosis
• Tanner staging |
|
|
Term
|
Definition
Information We Give Parents So They
Know What to Expect in the Future!
• Based on development (and current state)
• Teach them positive outcomes: what we
think their child will be doing
• Teach them negative outcomes: how to
avoid problems |
|
|
Term
Anticipatory Guidance:
Injury Prevention |
|
Definition
• SIDS
• Burns
• Poisons
• Cars
• Bikes
• Water
• Falls
• Sunscreen
• Sports
• Drowning
• Guns
• Strangers
• Airway obstruction |
|
|
