Adolescence and Emancipation in New Mexico
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Questions and Answers

In New Mexico, what is the minimum age for a minor to be considered emancipated?

  • 18 years old
  • 17 years old
  • 16 years old (correct)
  • 13 years old
  • Which of the following is NOT a recognized pathway to emancipation in New Mexico?

  • Court declaration
  • Marriage
  • Turning 18 years old (correct)
  • Military service
  • According to the content, what does 'Medical Emancipation' refer to?

  • A legal status allowing a minor to consent to specific medical care without parental consent (correct)
  • A legal status where a minor is recognized as an adult
  • A minor's ability to consent to all medical care without parental consent
  • A doctrine where a minor can consent to routine medical care without parental consent
  • What is the 'Mature Minor Doctrine'?

    <p>A legal principle allowing minors to consent to routine, non-emergency medical care without parental consent (A)</p> Signup and view all the answers

    Which of the following healthcare services can minors in New Mexico consent to without parental consent?

    <p>Mental Health Treatment (B)</p> Signup and view all the answers

    Which of the following is NOT a change that takes place during puberty?

    <p>Increased bone density (C)</p> Signup and view all the answers

    What is the primary role of the hypothalamic-pituitary-gonadal (HPG) axis in puberty?

    <p>To trigger the onset of puberty (C)</p> Signup and view all the answers

    Which of the following statements is TRUE regarding the timing of puberty?

    <p>Puberty is typically earlier in girls than boys. (D)</p> Signup and view all the answers

    What is the Tanner Stage System used for?

    <p>Evaluating the progression of puberty in adolescents (B)</p> Signup and view all the answers

    Which of the following statements is TRUE regarding physical growth during adolescence?

    <p>Girls experience a growth spurt before boys. (C)</p> Signup and view all the answers

    What is a common characteristic of psychosocial development during early adolescence?

    <p>Concrete thinking and difficulty imagining the future (D)</p> Signup and view all the answers

    What is MOST likely to happen during middle adolescence?

    <p>Increased comfort with one's self and a sense of identity (C)</p> Signup and view all the answers

    Which of the following is an example of a common misconception about adulthood held by adolescents?

    <p>Adulthood is a time of endless freedom and financial security (A)</p> Signup and view all the answers

    What is the primary responsibility of parent decision makers regarding their child’s medical future?

    <p>To protect the child’s future rights until full decision-making capacity is attained (A)</p> Signup and view all the answers

    What is a key step in educating Jamie to gain her informed consent?

    <p>Responding to her viewpoint truthfully and openly (A)</p> Signup and view all the answers

    Which outcome indicates that persuasion for Jamie’s treatment has failed?

    <p>Jamie wants to discontinue treatment (D)</p> Signup and view all the answers

    What must a clinician ensure when an adolescent's preferences differ from their parents' regarding treatment?

    <p>That the adolescent fully understands the condition and consequences of decisions (D)</p> Signup and view all the answers

    What role do parents typically play in their child's medical decisions according to the discussed practices?

    <p>They often act as decision makers but should involve the child in care decisions (D)</p> Signup and view all the answers

    What characterizes formal operational thought in late adolescence?

    <p>Abstract thinking and realistic future orientation (C)</p> Signup and view all the answers

    How does peer influence change from early to late adolescence?

    <p>The role of peers decreases significantly in late adolescence (B)</p> Signup and view all the answers

    Which of the following best describes the primary psychosocial focus for at-risk teens?

    <p>Emotional, cognitive, and psychosocial changes (B)</p> Signup and view all the answers

    What is a common outcome associated with morbidity in adolescents linked to poverty?

    <p>Higher rates of substance abuse (A)</p> Signup and view all the answers

    How does self-centered thinking typically shift as adolescents enter late adolescence?

    <p>It shifts to a more caring attitude toward others (B)</p> Signup and view all the answers

    What is a key strategy for effectively working with adolescents in a professional setting?

    <p>Adopting a diplomatic and gentle demeanor (C)</p> Signup and view all the answers

    What trend is observed in adolescent risk-taking behavior as they progress through the stages of adolescence?

    <p>Risk-taking behavior decreases with age (B)</p> Signup and view all the answers

    Which topic must be addressed in the social history of adolescents during medical visits?

    <p>Substance use including sex, drugs, tobacco, and alcohol (C)</p> Signup and view all the answers

    Which health issue is commonly experienced by adolescents?

    <p>Diabetes (C)</p> Signup and view all the answers

    What is a major leading cause of death among adolescents aged 15-19 years?

    <p>Homicide by firearms (B)</p> Signup and view all the answers

    What does conditional confidentiality in healthcare typically involve?

    <p>Notifying patients that certain information must be reported (C)</p> Signup and view all the answers

    Which of the following substances is associated with disorders in adolescents?

    <p>Alcohol (D)</p> Signup and view all the answers

    What aspect does confidentiality depend on in a medical context?

    <p>Degree of independence (D)</p> Signup and view all the answers

    Which condition typically does not require parental consent for a minor’s treatment?

    <p>Substance use treatment (D)</p> Signup and view all the answers

    What is NOT a listed health problem among adolescents?

    <p>Dementia (B)</p> Signup and view all the answers

    Which factor is NOT mentioned as affecting confidentiality?

    <p>Cognitive development (B)</p> Signup and view all the answers

    At what age can an unemancipated minor consent to medically necessary health care under NMSA?

    <p>14 years (A)</p> Signup and view all the answers

    What aspect of mental health care can a 14-year-old consent to without parental permission?

    <p>Verbal therapy with confidentiality (B)</p> Signup and view all the answers

    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?

    <p>She cannot make her own decisions as she is not emancipated. (B)</p> Signup and view all the answers

    What is a significant consequence of allowing Jamie to refuse hemodialysis based on her autonomy?

    <p>It may lead to her death. (D)</p> Signup and view all the answers

    Which of the following is a reason that limits parental authority in clinical decision making?

    <p>Neglect or abuse (A)</p> Signup and view all the answers

    What might the exercise of paternalism mean for Jamie's treatment decisions?

    <p>Potentially overriding her refusal to protect her health. (C)</p> Signup and view all the answers

    What form of medical care is explicitly mentioned as being available to anyone under emergency circumstances?

    <p>Contraception (C)</p> Signup and view all the answers

    What could be a potential emotional impact of Jamie returning to hemodialysis after her transplant?

    <p>Fear and anxiety about her medical condition. (A)</p> Signup and view all the answers

    Flashcards

    Parental decision-making

    Parents must protect a child's future rights until adulthood.

    Informed consent

    Educating a child to understand treatment decisions for autonomy.

    Persuasion outcomes

    Possible results when attempting to persuade a child for treatment.

    Child involvement in care

    Involving children in medical decisions as they mature is crucial.

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    Respecting autonomy

    Clinicians must respect a minor's understanding and choices.

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    STI treatment

    Exam and treatment for anyone regardless of age.

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    Pregnancy care for minors

    Prenatal, delivery, and postnatal care provided to female minors.

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    Contraception consent

    Consent to family planning services is available to anyone.

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    Emergency consent

    Anyone can consent for someone else if parents/guardians are inaccessible.

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    Mental health consent (14+)

    At 14 yrs, minors can consent to therapy and medications with parent notification.

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    Unemancipated minor healthcare consent

    Certain minors over 14 (e.g. homeless youth) can consent to necessary medical care.

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    Jamie’s treatment decision

    At 16, Jamie disagrees with parents on treatment after transplant complications.

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    Emancipated Minor

    A minor who has attained legal adulthood, allowing them to make decisions independently.

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    Mature Minor Doctrine

    A principle allowing certain minors to consent for non-emergent medical care without parental involvement, varying by state.

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    Medical Emancipation

    Not a legal status; allows minors to consent to specific medical care independently in different states.

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    Consent for Minors

    Typically requires a parent/guardian's permission unless under specific conditions like emancipation or mature minor status.

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    NM Statutes on Minor Consent

    New Mexico laws allow minors to consent to treatment for STIs, pregnancy, contraception, mental health, and substance abuse without parental consent.

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    Adolescence

    The transitional stage from childhood to adulthood marked by physical, emotional, and social growth.

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    Puberty

    The stage of sexual maturation and ability to reproduce, starting earlier for girls than boys.

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    Tanner Stages

    A system used to measure the stages of physical development during puberty.

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    Physical Growth in Adolescents

    Significant increases in weight, height, and size of major organs, with muscle mass changes differing by gender.

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    Early Adolescence (11-14 years)

    A phase where self-image fluctuates, with concerns about development and shifting social dynamics.

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    Middle Adolescence (15-17 years)

    A developmental stage characterized by a decrease in rapid change and emergence of self-comfort.

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    Growth Spurts

    Rapid increases in height and weight during adolescence, beginning earlier for girls than boys.

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    Psychosocial Development

    The emotional and social progress made during adolescence that may vary from physical growth.

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    Formal Operational Thinking

    A cognitive development stage where abstract and logical thinking emerge, typically found in late adolescence.

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    Omnipotence in Adolescence

    The belief that one is invulnerable or that negative experiences won't happen to them.

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    Psychosocial Development in Late Adolescence

    A stage where individuals become less self-centered and start caring for others, while forming intimate relationships.

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    At-Risk Teens

    Adolescents who may engage in risky behaviors and need early identification and support.

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    Social Determinants of Health (SDoH)

    Conditions in which people are born, grow, live, work, and age that impact health outcomes.

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    Morbidity Among Adolescents

    Health issues common in teens, often linked to psychosocial factors and poverty.

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    Peer Pressure

    Influence from peers to engage in behaviors, significant during adolescence.

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    Role of Parents in Adolescence

    Parental influence decreases as teens gain independence, shifting from high to low involvement.

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    Common health problems of adolescents

    Various health issues commonly experienced by teens, including acne, asthma, and obesity.

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    Leading causes of death in adolescents

    Main reasons for deaths among adolescents aged 15–19, such as accidents and suicide.

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    Confidentiality in healthcare

    The principle that information shared between a patient and healthcare provider is private.

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    Conditional confidentiality

    Confidentiality that can be broken if there are risks of harm to self or others.

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    Unconditional confidentiality

    An agreement that patient information remains private without exceptions.

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    HIPAA regulations

    Laws ensuring patient privacy, including limits on parental access to minor's medical records.

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    Accidents as a cause of death

    Injuries from unexpected events, such as motor vehicle accidents, are a leading cause of adolescent death.

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    Mental health issues in adolescents

    Varied mental disorders that commonly affect teens, including anxiety and depression.

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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.
    • 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.

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