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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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