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Questions and Answers
In New Mexico, what is the minimum age for a minor to be considered emancipated?
In New Mexico, what is the minimum age for a minor to be considered emancipated?
Which of the following is NOT a recognized pathway to emancipation in New Mexico?
Which of the following is NOT a recognized pathway to emancipation in New Mexico?
According to the content, what does 'Medical Emancipation' refer to?
According to the content, what does 'Medical Emancipation' refer to?
What is the 'Mature Minor Doctrine'?
What is the 'Mature Minor Doctrine'?
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Which of the following healthcare services can minors in New Mexico consent to without parental consent?
Which of the following healthcare services can minors in New Mexico consent to without parental consent?
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Which of the following is NOT a change that takes place during puberty?
Which of the following is NOT a change that takes place during puberty?
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What is the primary role of the hypothalamic-pituitary-gonadal (HPG) axis in puberty?
What is the primary role of the hypothalamic-pituitary-gonadal (HPG) axis in puberty?
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Which of the following statements is TRUE regarding the timing of puberty?
Which of the following statements is TRUE regarding the timing of puberty?
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What is the Tanner Stage System used for?
What is the Tanner Stage System used for?
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Which of the following statements is TRUE regarding physical growth during adolescence?
Which of the following statements is TRUE regarding physical growth during adolescence?
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What is a common characteristic of psychosocial development during early adolescence?
What is a common characteristic of psychosocial development during early adolescence?
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What is MOST likely to happen during middle adolescence?
What is MOST likely to happen during middle adolescence?
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Which of the following is an example of a common misconception about adulthood held by adolescents?
Which of the following is an example of a common misconception about adulthood held by adolescents?
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What is the primary responsibility of parent decision makers regarding their child’s medical future?
What is the primary responsibility of parent decision makers regarding their child’s medical future?
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What is a key step in educating Jamie to gain her informed consent?
What is a key step in educating Jamie to gain her informed consent?
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Which outcome indicates that persuasion for Jamie’s treatment has failed?
Which outcome indicates that persuasion for Jamie’s treatment has failed?
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What must a clinician ensure when an adolescent's preferences differ from their parents' regarding treatment?
What must a clinician ensure when an adolescent's preferences differ from their parents' regarding treatment?
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What role do parents typically play in their child's medical decisions according to the discussed practices?
What role do parents typically play in their child's medical decisions according to the discussed practices?
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What characterizes formal operational thought in late adolescence?
What characterizes formal operational thought in late adolescence?
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How does peer influence change from early to late adolescence?
How does peer influence change from early to late adolescence?
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Which of the following best describes the primary psychosocial focus for at-risk teens?
Which of the following best describes the primary psychosocial focus for at-risk teens?
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What is a common outcome associated with morbidity in adolescents linked to poverty?
What is a common outcome associated with morbidity in adolescents linked to poverty?
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How does self-centered thinking typically shift as adolescents enter late adolescence?
How does self-centered thinking typically shift as adolescents enter late adolescence?
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What is a key strategy for effectively working with adolescents in a professional setting?
What is a key strategy for effectively working with adolescents in a professional setting?
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What trend is observed in adolescent risk-taking behavior as they progress through the stages of adolescence?
What trend is observed in adolescent risk-taking behavior as they progress through the stages of adolescence?
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Which topic must be addressed in the social history of adolescents during medical visits?
Which topic must be addressed in the social history of adolescents during medical visits?
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Which health issue is commonly experienced by adolescents?
Which health issue is commonly experienced by adolescents?
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What is a major leading cause of death among adolescents aged 15-19 years?
What is a major leading cause of death among adolescents aged 15-19 years?
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What does conditional confidentiality in healthcare typically involve?
What does conditional confidentiality in healthcare typically involve?
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Which of the following substances is associated with disorders in adolescents?
Which of the following substances is associated with disorders in adolescents?
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What aspect does confidentiality depend on in a medical context?
What aspect does confidentiality depend on in a medical context?
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Which condition typically does not require parental consent for a minor’s treatment?
Which condition typically does not require parental consent for a minor’s treatment?
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What is NOT a listed health problem among adolescents?
What is NOT a listed health problem among adolescents?
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Which factor is NOT mentioned as affecting confidentiality?
Which factor is NOT mentioned as affecting confidentiality?
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At what age can an unemancipated minor consent to medically necessary health care under NMSA?
At what age can an unemancipated minor consent to medically necessary health care under NMSA?
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What aspect of mental health care can a 14-year-old consent to without parental permission?
What aspect of mental health care can a 14-year-old consent to without parental permission?
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If Jamie disagrees with her parents' decision about her treatment at age 16, what is her legal status regarding her ability to make a treatment decision?
If Jamie disagrees with her parents' decision about her treatment at age 16, what is her legal status regarding her ability to make a treatment decision?
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What is a significant consequence of allowing Jamie to refuse hemodialysis based on her autonomy?
What is a significant consequence of allowing Jamie to refuse hemodialysis based on her autonomy?
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Which of the following is a reason that limits parental authority in clinical decision making?
Which of the following is a reason that limits parental authority in clinical decision making?
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What might the exercise of paternalism mean for Jamie's treatment decisions?
What might the exercise of paternalism mean for Jamie's treatment decisions?
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What form of medical care is explicitly mentioned as being available to anyone under emergency circumstances?
What form of medical care is explicitly mentioned as being available to anyone under emergency circumstances?
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What could be a potential emotional impact of Jamie returning to hemodialysis after her transplant?
What could be a potential emotional impact of Jamie returning to hemodialysis after her transplant?
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Flashcards
Parental decision-making
Parental decision-making
Parents must protect a child's future rights until adulthood.
Informed consent
Informed consent
Educating a child to understand treatment decisions for autonomy.
Persuasion outcomes
Persuasion outcomes
Possible results when attempting to persuade a child for treatment.
Child involvement in care
Child involvement in care
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Respecting autonomy
Respecting autonomy
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STI treatment
STI treatment
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Pregnancy care for minors
Pregnancy care for minors
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Contraception consent
Contraception consent
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Emergency consent
Emergency consent
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Mental health consent (14+)
Mental health consent (14+)
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Unemancipated minor healthcare consent
Unemancipated minor healthcare consent
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Jamie’s treatment decision
Jamie’s treatment decision
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Emancipated Minor
Emancipated Minor
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Mature Minor Doctrine
Mature Minor Doctrine
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Medical Emancipation
Medical Emancipation
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Consent for Minors
Consent for Minors
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NM Statutes on Minor Consent
NM Statutes on Minor Consent
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Adolescence
Adolescence
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Puberty
Puberty
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Tanner Stages
Tanner Stages
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Physical Growth in Adolescents
Physical Growth in Adolescents
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Early Adolescence (11-14 years)
Early Adolescence (11-14 years)
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Middle Adolescence (15-17 years)
Middle Adolescence (15-17 years)
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Growth Spurts
Growth Spurts
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Psychosocial Development
Psychosocial Development
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Formal Operational Thinking
Formal Operational Thinking
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Omnipotence in Adolescence
Omnipotence in Adolescence
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Psychosocial Development in Late Adolescence
Psychosocial Development in Late Adolescence
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At-Risk Teens
At-Risk Teens
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Social Determinants of Health (SDoH)
Social Determinants of Health (SDoH)
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Morbidity Among Adolescents
Morbidity Among Adolescents
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Peer Pressure
Peer Pressure
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Role of Parents in Adolescence
Role of Parents in Adolescence
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Common health problems of adolescents
Common health problems of adolescents
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Leading causes of death in adolescents
Leading causes of death in adolescents
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Confidentiality in healthcare
Confidentiality in healthcare
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Conditional confidentiality
Conditional confidentiality
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Unconditional confidentiality
Unconditional confidentiality
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HIPAA regulations
HIPAA regulations
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Accidents as a cause of death
Accidents as a cause of death
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Mental health issues in adolescents
Mental health issues in adolescents
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Study Notes
Pediatrics I: Adolescents
- Adolescence is a gateway to adulthood, marked by completing puberty, developing socially, emotionally, and cognitively, establishing an independent identity, and preparing for a career.
Puberty
- Puberty is a period of sexual maturation and achieving fertility.
- Boys typically start puberty between ages 10 and 12, with testicular enlargement being one of the first signs. Puberty ends around ages 16-18.
- Girls typically start puberty between 8 and 11, with breast buds usually appearing first. Puberty concludes around ages 14 to 16.
Hormones
- Pituitary and gonadal hormones are low before puberty begins.
- Late in childhood, the hypothalamic-pituitary-gonadal axis becomes active.
- The timing of puberty is influenced by genetics, ethnicity, and the environment.
Tanner Stages
- Tanner stages are used to track the progression of puberty through physical changes.
- These changes show stages of development in both boys and girls, specifically in areas like breast development, pubic hair growth, and other related physical characteristics.
- Images illustrating the different stages are included in the provided notes.
Physical Growth
- During adolescence, weight almost doubles.
- Height increases by 15-20%.
- Major organs double in size.
- Lymph tissue decreases.
- Muscle mass doubles in boys.
- Muscle mass decreases in girls.
- Growth spurts begins in girls about 2 years earlier than in boys.
- A general increase in breast/hair growth in girls about 1 year earlier than the growth spurt in girls.
- Psychological-social development can be separate from physical growth.
Psychosocial Development (Early Adolescence 11-14 Years)
- Rapid physical growth and secondary sex characteristics.
- Self-image and esteem fluctuate significantly.
- Concerns regarding pubertal development.
- Curiosity about sex, with a preference for same-sex groups initially.
- Gradual development toward concrete thinking.
Psychosocial Development (Middle Adolescence 15-17 years)
- Decreased rate of rapid development/growth compared to earlier stages.
- Feeling more comfortable with self.
- Experience intense emotions.
- Move toward abstract thinking.
- Omnipotence, or the belief that something won't happen to them, is a common attitude during this stage.
- Self-centered thinking; identity experimentation.
- Dating, sex, peer pressure, and conformity.
- Stress is a common element during this period.
Psychosocial Development (Late Adolescence 18-21 years)
- Less self-centered, more caring towards others.
- Transition from peer group relationships to individual interactions.
- More intimate dating.
- Abstract thinking regarding the future; more realistic outlook.
- Idealism and rigid thinking regarding right/wrong are common.
Adolescents: Handling and Diplomacy
- Put personal biases aside
- Identify at-risk adolescents early
- Focus on emotional, cognitive, and psychosocial changes
- Ensure preventative care for enrolled teens
Stages of Adolescence
- Shows age-related patterns of parental involvement, risk-taking behaviors, and peer influence.
Morbidity in Adolescents
- Social determinants of health (SDoH) negatively impact adolescent health.
- Poverty affects notable ethnic and racial disparities, especially within single-mother households.
- Poor academic performance and risky behaviors are linked with poor mental and behavioral health.
- Psychosocial issues and poverty are associated with morbidity in adolescents.
- These issues include teen pregnancy, STIs, substance abuse, school dropout, depression, running away from home, violence, and delinquency.
Common Health Problems in Adolescents
- A range of health concerns that frequently affect adolescents, including acne, asthma, diabetes, gynecological/menstrual issues, high blood pressure, infectious mononucleosis, mental illnesses, obesity, oral/dental health, and Osgood-Schlatter disease.
- Other conditions also impacting adolescent health, like scoliosis, slipped capital femoral epiphysis, sexually transmitted infections, sports injuries, substance use disorders, heat-related problems, road traffic accidents, early pregnancy, and violence.
Leading Causes of Death in Adolescents
- Accidents, including motor vehicle accidents and poisonings—suicide by firearms, homicide via firearms—also affect the mortality rates in adolescents.
- Additional factors like cancer and heart disease contribute to mortality.
- Specific data has been provided for New Mexico concerning adolescent deaths and suicide attempts; based on the years 2016-2020 and 2021.
Confidentiality Exceptions
- Confidentiality is dependent on factors such as maturity, intelligence, independence, and presence of illness.
- Exceptions to confidentiality include suicide, homicide, sexual abuse, and physical abuse.
Confidentiality: Medical Records
- New Mexico has no state statutes to protect a child's medical records from parental review.
- HIPAA laws generally allow parental access to a minor's medical records, except if the minor has consented to healthcare that is not dependent on parental consent.
Adolescents Consent
- Informed consent is a core principle in healthcare.
- Minors (under 18) typically require parental consent for medical care.
- Emancipated minors have legal adult status.
- States have varying rules about medical emancipation.
- Mature minors can consent to some routine, non-emergency care without parental consent.
- Examples are shown in cases like New Mexico cases.
NM Statutes Annotated
- Emancipation minors – a minor at least 16 years old who is married, serving in the armed forces, or received a declaration of emancipation.
- Limited consent for STI/pregnancy/contraception, and mental health/substance abuse, without parental consent in New Mexico.
Adolescent Well Visit
- The Bright Futures pocket guide provides resources related to early-childhood, middle-childhood and late-childhood adolescent visit information.
- Health supervision is critical for these visits that assess development, parent-youth interaction, and anticipatory guidance to support the adolescent.
HEADSS
- HEADSS (Home and Environment, Education and Employment, Activities, Drugs, Sexuality, and Suicide/Depression) is a mnemonic to review pertinent history information in adolescence.
- A HEADSS+ expands the mnemonic by having additional information as part of history. A HEADS can be applied if there are no additional resources beyond the mnemonic and if there are no specific clinical concerns noted with the patient.
11-year old visit
- A 11-year-old visit includes a comprehensive review of history, vitals (weight, height, BMI, blood pressure), hearing screening, developmental surveillance, psychosocial/behavioral assessment, physical exam, immunization assessment (Covid, flu, Tdap, HPV), meningococcal vaccination, fasting lipid panel and anticipatory guidance.
Transitioning to Adult Care
- Transition process is essential for adolescents entering adult healthcare systems.
- Various stages are involved in the transition, including tracking progress, assessing skills, developing a Health Care Transition plan and more.
- Challenges can include fear of a new system, different therapies, family concerns, inadequate planning, and adolescent disinterest compared with broader life circumstances.
Pre-participation Sports Physical Exam
- Identifies medical problems, life-threatening complications, conditions requiring treatment plans, rehabilitates injuries, and addresses conditions interfering with performance.
Sports Physical Exam
- Obtains medical and family history, especially menstrual history in females.
- Assesses cardiovascular factors and previous injuries or surgeries.
- Includes a comprehensive general physical exam of the heart, lungs, vision, and hearing, along with a focused musculoskeletal exam including weakness, range of motion, and other relevant issues.
Adolescent Decision Making: Jamie
- Jamie, a 14-year-old diagnosed with renal failure, is now 16 years old and is considering her own decisions about potential treatment.
- The case highlights the complexities of adolescent decision-making, autonomy, conflicts between parents and adolescents, and healthcare decisions when adolescents disagree with their parents.
- Potential outcomes include successful persuasion or treatment failure.
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Description
This quiz covers key concepts related to adolescent development and emancipation laws in New Mexico. Test your knowledge on medical emancipation, the Mature Minor Doctrine, and the Tanner Stage System. Understand the physical and psychosocial changes that occur during adolescence.