13-Adolescence Dr. Nadia G1,2 - Copy.pptx

Objectives
• Define adolescence period .
• Mention classification of the Adolescent period.
• Identify physical, physiological growth in adolescent.
• Explain puberty and puberty changes.
• Point out primary and secondary sex characteristics during
adolescence.
• Determine psychological impact of puberty.

Objectives (cont.,)
• Discuss psychosocial, cognitive, and psychosexual
development.
• Determine adolescent play
• Summarize needs of the Adolescent child.
• Categorize common health problems during adolescent.
• Develop health promotion plan for adolescent period
• Prioritize parent’s guidance for adolescent period

Outlines
• Introduction
• Definition
• Classification
• Physical & Physiological growth
• Puberty and puberty changes
• Primary and secondary sex characteristics
4

Outlines cont,
• Psychological impact of puberty
• Psychosocial, cognitive, and Psychosexual development
• Adolescent play
• Needs
• Health problem
• Health promotion
• Parent guidance
5

Introduction
6
This is the transition from
childhood to adulthood.
The age of adolescence is
generally regarded as 12-18/20
years (this is very flexible)
Some persons continue to
function as adolescents until
the 20’s or more

Introducti
on
(cont.,)
7
One major dilemma encountered by
adolescents that leads to many growth
and development concerns is that they
are mature in some respects but still
young in others
The time for formulating a sense of
personal identity
The time for gaining emancipation (free)
from the family unit

Introduction
(cont.,)
8
During this period individuals reach physical
and sexual maturity.
Make educational and occupational decisions
that will shape their adult careers.
It is a time of profound biologic, intellectual,
psychosocial, and economic change.

Definition
•An adolescence begins when the secondary
sex characteristics appears and ends when
somatic growth is completed, and the
individual is psychologically mature, capable
of taking his place as a member of society.
9

Adolescent
classification
10
Classification
Early Adolescence (12-14 years)
Middle Adolescence (15-17 years)
Late Adolescence (18-20 years)

Physical growth
• The increase in skeletal system is
faster than muscular system
50% of ideal adult body weight
is gained during this time
Increase in growth of the
skeleton, muscles, and internal
organs at 12 years of age in girls
and 14 years in boys
11

Physical
growth
(cont.,)
Girls begin puberty and maturity
about 1.6 to 2 years earlier than
boys.
Height increase in girls during
early puberty, whereas in boys the
rate does not increase until mid
puberty.
Boys' growth in height ceases at
18 or 20 years of age.

Physical
growth
(cont.,)
Early Adolescence (12-14 years)
Characterized by:
Rapidly accelerating growth
Reaches peak velocity(rapid).
Secondary sexual characteristics appear

Physical
growth
(cont.,)
Middle Adolescence (15-17 years)
Characterized by:
Growth decelerating (slow) in girls
Stature reaches 95% of adult height
Secondary sexual characteristics well advanced

Physical growth
(cont.,)
Late Adolescence (18-20 years)
Characterized by:
Physically mature
Structure and reproductive
growth almost complete

Physical growth (cont.,)
Girls gain 5 to
20 cm in
height
7 to 25
kg in
weight
Boys gain 10
to 30 cm in
height
7 to 30
kg in
weight

Physiological growth
17
Heart and lung increase in size slowly: reduced
blood supply and O2 flow
Vital signs:
• Pulse: 70-105 b/min
• R.R: 12-20 breath/min
• BP: 110-120/64-83 mmHg (120/70 mmHg)

• Teeth
• Gain 2nd
molars around 12-13 yr
• Gain 3rd
molars 17-21 yrs
18

Adolescence periods
include:
Puberty
 Primary and
secondary sex
characteristics
19

PUBERTY
• Puberty is a stage of adolescence
• Puberty involves a predictable sequence of hormonal and
physical changes that occur universally over a defined period.
• The term puberty is restricted to physiologic phenomena
20

PUBERTY
(cont.,)
21
This the point at which
reproduction is possible
Puberty in girls can begin
between 8- 14 yrs and
completes within 3 years.
Puberty in boys begin 9-16
yrs

Puberty Changes
• Puberty consists of two changes that mark the
change from childhood to young adulthood.
Dramatic increases in height, weight, and
body fat distribution.
Changes in the reproductive organs that
mark sexual maturity, as well as secondary
sexual characteristics.
 (primary and secondary sex
characteristics)
22

Primary and secondary sex
characteristics
• Sexual Maturation
• Primary sex characteristics are the organs of reproduction.
They include the ovaries, uterus, and vagina in girls and the
scrotum, testes, and penis in boys.
• Secondary sex characteristics represent physical signs of
maturity. They include the breasts and the width of the
pelvis in girls, and facial hair and broadening of shoulders in
boys.
23

Females (Hormone changes)
Development and release of ovum, from the
ovaries (FSH stimulates estrogen in early puberty).
Concentrations of estrogen do not reach levels
high enough to cause ovulation.
By the time girls reach mid puberty, the body
produces estrogen in larger amounts (production
of a mature ovum occur 1 year or more after
menarche).

Males (Hormone changes)
• During puberty, FSH acts on testicular cells,
stimulating the production of viable sperm.
• FSH and LH also act in increased production and
secretion of testosterone.
• Resulting first ejaculations and the appearance of
pubic hair.

Secondary sex characteristics (Physical signs of
maturity)
Boys:
• Increase size of genitalia
• Growing of pubic hair, axillaries, facial& chest
hair
• Voice change, acne
• Production of spermatozoa
• Increase shoulder breadth
 Nocturnal Emissions
26

Secondary sex characteristics (Physical signs of maturity)
Girls
 Increase in the transverse diameter of the pelvis
Development of the breast
 Change in the vaginal secretion
Growth of pubic & axillary's hair
Menstruation
27

Psychological
impact of
puberty
• Body Image
• Teenagers are very attentive to physical changes, which take place
very rapidly and are dramatic.
• Girls are more critical of their appearance and are likely to be
dissatisfied.
• Boys are more likely to be pleased.
28

Psychological
impact of
puberty
• Moodiness
• Increase in hormone levels are associated with greater
irritability and impulsivity but not moodiness.
• Moodiness has been found to be more associated with
activities.
e.g., recreational activities are more associated with good
mood and adult-regulated activities with negative mood.
29

Psychosocial Development
• According to Erikson's psychosocial theory,
adolescent develop a sense of Identity versus
Identity Diffusion or Confusion (12-20 years).
• A sense of identity means a sense of being at
one with oneself as one grows and develops. It
closely linked with the mastery of skills.
• Sense of identity begins to develop sense of
“I”, this is a lifelong process.
30

Psychosocial Development (cont.,)
Identity Development:
•The task of identity formation is to develop a
stable, coherent picture of oneself that includes
integrating one’s past and present experiences
with a sense of where one is headed in the
future.
•Identity development moves from the reality of
being to the reality of becoming.
31

Psychosocial
Development (cont.,)
• Identity diffusion is the lack
of attention or feedback as
being worthwhile
• Danger of role
confusion, doubts about
sexual and vocational
identity
32

Adolescent
Play
Adolescent Play: Day –dreaming:
• During the adolescence period, children
spend most of their times in
daydreaming.
• They like to play competitive games as well
as abstract problem-solving kind of games.
34

Cognitive
Development
(Piaget)
• Movement from concrete to formal
operational thinking which occurs
between the ages 11-16 yrs, adulthood.
• Developing abstract thinking skills.
• Abstract thinking means thinking about
things that cannot be seen, heard, or
touched.
e.g., include things like faith, trust,
beliefs and spirituality.
35

Cognitive
Development
(Piaget)
(cont.,)
• Developing advanced reasoning skills.
• The ability to think about multiple
options and possibilities. It involves
asking and answering the question, "what
if...?".
• Hypothetical thinking.
• In practical terms, being able to plan and
identify future consequences of possible
actions are skills dependent on being able
to think hypothetically.
• Decision making abilities increase.
36

Cognitive
Developmen
t (Piaget)
(cont.,)
37
Can use deductive
(general to specific) and
inductive (specific to
general) reasoning.
They think about their
future and parts they
will play in society as
adults.
They dream of changing
society to conform to
their own ideas.

Psychosexual
development
• Genital stage (12- adulthood). With the
onset of puberty
• Affect body image
• Self-exploration and evaluation,
compare with peers.
• Romantic relationships
• Engage in sexual relationships

Needs
1. Integration of personality
2. Emancipation from his parents
&family
3. Satisfactory relations with opposite
sex
4. Acceptance of new body image
after the rapid physical changes
of this period
5. A decision about the vocation he
will follow as an adult.
39

Health problems of adolescence
40
1. Eating Disorders, Obesity or Malnutrition
 Related to wrong dietary habits.
2. Hypertension, Hyperlipidemia
3. Sclerosis
4. Acne
5. Sleep Deprivation and Insomnia
 (9 hours of sleep each nighttime with peers or on the Internet
can make it difficult for them to get sufficient sleep )

Health problems of
adolescence (cont.,)
6. School and Learning Problems
7. Smoking and addiction
8. Physical, sexual, and
emotional Abuse
9. Depression and suicide
10. Accidents
Intentional and unintentional Injury

Health
promotion
42
1. Healthy Nutrition
Constantly hungry (more than
during young years)
Usually poorly nourished
despite the large intake (snacks)
(junk foods) high in fat, sugar,
sodium
Breakfast is the most common
meal missed by adolescents
Dietary deficiencies: iron,
calcium, zinc

1-Healthy Nutrition (cont.,)
• Teenagers need high caloric intake because of growth and
metabolism rates being high.
• Males 11-14 yrs 55 kcal/kg
• Females 11-14 yrs 47 kcal/kg
• Males 15-18 yrs 47 kcal/kg
• Females 15-18 yrs 40 kcal/kg
• Increase amount of milk, 5 food groups.
• More iron supplementation for girls
43

Health promotion (cont.,)
2. Sleep
• Need more sleep to support
growth spurt (12 hours/day)
• Sleepy at “getting up” times
• Wants to sit up at night as sign of
increasing maturity
3. Exercises
release stress , manage obesity
Physical Fitness, physical activity

4. Safety (Violence and injury prevention)
• Leading cause of death is the motor vehicle accidents: teach safety
measures
• Drowning
5. Risk reduction (tobacco, alcohol, other drugs, pregnancy)
• Smoking, drugs, alcohol should be discouraged
(safety instructions are needed)

6. Acne
• Acne self limiting inflammatory disease
• Genetic factors may play a part (45%)
• Hormonal factors: premenstrual flares (70%)
• Not known link with diet
Management:
• Adequate rest, exercise, well-balanced diet, decreases emotional stress
• Cleansing: gentle cleanser, no antibacterial soap is required
• Medication (topical) + sunblock
46

Health
promotion
(cont.,)
47
7. Immunization
8. Dental health
9. Adolescent Health
Screening
10. Emotional well-being
(mental health, sexuality)

Health
promotion
(cont.,)
48
11. Communication
Assist parents in understanding
adolescent development and issues of
individuality.
Reinforce the need for adequate and
open family communication skills.
12. Social and academic competence
(relationships with peers and family,
school performance, interpersonal
relationships)

Parent
Guidance
• Encourage parents to:
• Accept adolescent as a
unique individual
• Respect adolescent’s ideas,
likes and dislikes, and
wishes.
• Be involved with school
performances, or a school
play.
• Listen and try to be open to
adolescent’s views
• Avoid criticism.

Parent
Guidance
(cont.,)
• Provide opportunity for
choosing
• Increasing independence
within respect adolescent’s
privacy.
• Try to make communication
clear.
• Avoid comparisons with
siblings.
• Provide unconditional love.

References
• Beckett , c & Taylor, H (2010). Human Growth and Development. 2nd
ed .London SAGE Publications ltd.
• Hocknberry, M. & Wilson, D. (2013). Wong’s Nursing Care of Infants and
Children. 9th ed. London: Mosby.
• Developmental Psychology Forum
• British Journal of Developmental Psychology

13-Adolescence Dr. Nadia G1,2 - Copy.pptx

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