Chapter 34 A Physical growth: physical changes associated with puberty a. Weight: gains 7 to 25 kg (15 to 55 lb) b. Height: approximately 95% of mature height achieved by onset of menarche or by skeletal age of 13 years; grows 5 to 25 cm (2 to 10 inches) c. Secondary sex characteristics appear in order a. Weight: gains 7 to 30 kg (15 to 65 lb) b. Height: approximately 95% of mature height achieved by skeletal age of 15 years; grows 10 to 30 cm (4 to 12 inches) c. Secondary sex characteristics appear in order d. Gynecomastia: 33% during mid-puberty; usually disappears within 2 years 1. Abstract thinking; increased understanding a. Comprehends satire and double meanings b. May say one thing and mean another c. Conceptualizes thought; more interested in exploring ideas than facts d. Appreciates scientific thinking; problem solves; explores theoretical alternatives 1. Increased social communication 2. Develops peer-group identity a. Strong motivating force of behavior b. Important to be part of group and be similar to peers c. Clique formation: based on common culture (e.g., race, social class, ethnic group), common interests (e.g., hobbies, music, sports) 3. Interpersonal relationships a. Major goal: learning to form close intimate relationship with opposite sex or same sex, if homosexual b. May develop crushes, worship idols (e.g., rock or movie star) c. Engages in sexual exploration; questions sex role a. Age 15 or 16 years: wants to be treated as adult b. Ambivalence: wants freedom but has difficulty accepting responsibility; may yearn for carefree days of childhood c. Parental ambivalence and discipline problems: try to allow for increasing independence but continue to offer guidance and enforce discipline 1. Provide optimum nutritional support for demands of rapid growth and high energy expenditure 2. Support development of appropriate eating habits through variety of foods, regular food pattern, quality snacks (e.g., high in protein; low in refined carbohydrate, primarily sugar) B Range of nutrient requirements increases; adequate intake of all nutrients should form basis of diet D Possible causes of nutritional deficiencies; need for effective counseling 1. Psychologic factors: food aversions; emotional problems 2. Fear of overweight: cultural pressure 3. Choice of junk foods for snacks (e.g., high in sugar, fat, salt) 5. Pregnancy: requires higher intake of protein, calcium, and calories E Nutrition education: associated with concerns about physical appearance, figure control, complexion, physical fitness, athletic ability 1. Sexual maturation, reproduction, sexual behavior 2. Driving in school or privately 3. Accidents: leading cause of death 4. Use and abuse of drugs and alcohol 5. Health hazards associated with smoking 6. Nutritional problems: anorexia nervosa, bulimia nervosa, obesity
Nursing Care of Adolescents
Growth and Development
Developmental Timetable
Health Promotion during Adolescence
Nutrition during Adolescence
Injury Prevention during Adolescence
Nursing Care of Adolescents
