Adolescent Development and Care
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Questions and Answers

What is the approximate age range for the onset of puberty in girls?

  • 10-12 years
  • 16-18 years
  • 14-16 years
  • 8-11 years (correct)
  • Which of the following is NOT a characteristic of early adolescence (11-14 years)?

  • Fluctuating self-image and esteem
  • Developing abstract thinking skills (correct)
  • Rapid physical growth and development of secondary sex characteristics
  • Concerns about pubertal development
  • What is the primary function of the hypothalamic-pituitary-gonadal axis?

  • Controlling body temperature
  • Activating the immune system
  • Regulating sleep patterns
  • Initiating and regulating puberty (correct)
  • What happens to lymph tissue during adolescence?

    <p>It gradually decreases in size. (A)</p> Signup and view all the answers

    What is the approximate difference in the age of onset of growth spurts between girls and boys?

    <p>2 years (D)</p> Signup and view all the answers

    Which statement accurately describes the relationship between physical and psychosocial development in adolescence?

    <p>Psychosocial development does not always mirror physical growth. (D)</p> Signup and view all the answers

    What is a hallmark characteristic of middle adolescence (15-17 years)?

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

    During adolescence, muscle mass:

    <p>Doubles in boys and decreases in girls. (D)</p> Signup and view all the answers

    What is the primary focus of care for adolescents?

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

    Which of the following is NOT a characteristic of late adolescence?

    <p>Concrete thinking is dominant (D)</p> Signup and view all the answers

    Which of the following is a key factor contributing to morbidity in adolescents?

    <p>Poverty and its associated social determinants of health (A)</p> Signup and view all the answers

    Which of the following is NOT a common service provided as part of preventive care for adolescents?

    <p>Mental health screenings (A)</p> Signup and view all the answers

    Which age group is most likely to engage in risk-taking behaviors, according to the text?

    <p>Middle adolescence (15-17 years) (A)</p> Signup and view all the answers

    What is the primary role of parents in the lives of late adolescents?

    <p>Low, with minimal involvement in daily life (A)</p> Signup and view all the answers

    Which statement accurately reflects the importance of social history for adolescents?

    <p>It is a routine part of care and provides valuable insights into their health and well-being (B)</p> Signup and view all the answers

    What is the meaning of "morbidity" as it relates to adolescents?

    <p>The prevalence of disease and illness in adolescents (D)</p> Signup and view all the answers

    What is the primary purpose of a pre-participation sports physical examination?

    <p>To identify medical conditions that could pose a risk to the athlete's health during sports participation. (C)</p> Signup and view all the answers

    Which of the following are recommended immunizations for an 11-year-old during an early adolescent visit?

    <p>Covid, Influenza, Tdap, HPV, Meningococcal (A)</p> Signup and view all the answers

    What is the significance of the HEADSS assessment in adolescent health visits?

    <p>It helps to uncover potential psychosocial issues and risk factors impacting the adolescent's well-being. (D)</p> Signup and view all the answers

    Which of the following factors is NOT a challenge associated with transitioning adolescents to adult healthcare?

    <p>Strong preference for a more traditional, paternalistic approach to healthcare (B)</p> Signup and view all the answers

    What is the primary focus of sports physicals during adolescence besides identifying medical conditions?

    <p>Identifying and addressing musculoskeletal issues and previous injuries. (D)</p> Signup and view all the answers

    What is the recommended frequency of health supervision visits for adolescents?

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

    During an adolescent visit, what are some essential components of the physical exam?

    <p>Height, weight, body mass index (BMI), blood pressure, and screening for conditions. (B)</p> Signup and view all the answers

    Which of the following is NOT a typical component of anticipatory guidance provided during adolescent visits?

    <p>Counseling on college and career planning and financial management. (D)</p> Signup and view all the answers

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

    <p>16 (C)</p> Signup and view all the answers

    What is the 'Mature Minor Doctrine'?

    <p>A doctrine that allows minors to consent to routine care without parental consent in some states. (D)</p> Signup and view all the answers

    What is the legal status that allows a minor to consent to all or certain medical care without parental consent?

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

    In what instance would a 17-year-old in New Mexico be considered an emancipated minor?

    <p>If the 17-year-old is serving in the armed forces. (C)</p> Signup and view all the answers

    At what age can a minor in New Mexico consent to mental health treatment and psychotropic medications without parental consent?

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

    Which condition allows certain minors over the age of 14 to consent to medically necessary healthcare in New Mexico?

    <p>Being homeless or a parent (C)</p> Signup and view all the answers

    What role do parental decision makers have in relation to their child's future rights to autonomy?

    <p>They must protect the child's future rights until the child has full decision-making capacity. (B)</p> Signup and view all the answers

    Which of the following is NOT a condition that limits parental authority in clinical decision making?

    <p>The child's terminal illness (A)</p> Signup and view all the answers

    What potential consequence does accepting Jamie's current decision imply?

    <p>She may die without further treatment. (B)</p> Signup and view all the answers

    Which of the following health problems can be considered a leading cause of death among adolescents?

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

    Which of the following health problems is NOT commonly reported in adolescents?

    <p>Alzheimer's Disease (D)</p> Signup and view all the answers

    What is the key difference between unconditional and conditional confidentiality in the medical context?

    <p>Unconditional confidentiality means that a doctor cannot share information with anyone, while conditional confidentiality allows sharing in specific circumstances. (D)</p> Signup and view all the answers

    Which of the following factors is NOT considered in determining the level of confidentiality for an adolescent patient?

    <p>The adolescent’s social media presence (B)</p> Signup and view all the answers

    Based on the statistics provided, what is the most common cause of death for people aged 15-24 years in New Mexico according to data from 2016-2020?

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

    In New Mexico, which of the following situations would REQUIRE a health care professional to break confidentiality?

    <p>The adolescent expresses suicidal thoughts. (C)</p> Signup and view all the answers

    Which of these conditions would require reporting EXCEPT for?

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

    What is the primary purpose of confidentiality within the medical context?

    <p>To create a safe and trusting environment for the patient to freely disclose information related to their health. (C)</p> Signup and view all the answers

    Flashcards

    Adolescence

    The transitional stage of development from childhood to adulthood.

    Puberty

    The physical and sexual maturation process that leads to fertility.

    Tanner Stages

    A classification system for the physical development during puberty.

    Physical Growth

    Significant changes in weight and height that occur during adolescence.

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    Early Adolescence

    The developmental phase from ages 11 to 14, marked by rapid growth and self-image changes.

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    Middle Adolescence

    The developmental stage from ages 15 to 17 characterized by more stable emotions.

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    Self Image

    The perception and feelings one has about oneself, often fluctuating in adolescence.

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    Psychosocial Development

    The growth in thought and emotional processes during adolescence, including identity and peer relationships.

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    Formal Operational Stage

    Stage in adolescence where abstract thinking develops.

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    Omnipotence

    Belief that misfortunes won't happen to oneself.

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    Identity Experimentation

    Process where adolescents explore different identities.

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    Risk-Taking Behavior

    Engaging in activities that pose a risk during adolescence.

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    Social Determinants of Health (SDoH)

    Conditions in which individuals are born, live, and work impacting health.

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    Morbidity in Adolescents

    Health issues predominantly affecting adolescents due to various factors.

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    Preventative Care for Teens

    Healthcare aimed at preventing issues in teenagers.

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    Informed Consent

    A process ensuring patients understand the risks and benefits of treatments.

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    Emancipated Minor

    A minor who has legal independence, can make personal decisions.

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    Medical Emancipation

    Not a legal status, allows certain medical decisions by minors without parent involvement.

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    Mature Minor Doctrine

    A principle allowing some adolescents to consent to their own non-emergency medical care.

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    Parental Consent Exceptions

    Certain medical treatments can be accessed by minors without parental approval in most states.

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    Common health problems in adolescents

    Health issues frequently seen in teenagers, including acne, obesity, and asthma.

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    Leading causes of death in adolescents

    Main reasons for deaths in 15-19 year olds, such as accidents, suicide, and homicide.

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    Confidentiality

    The right to keep certain information private, especially in healthcare settings.

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    Conditional confidentiality

    Confidentiality that has limits; certain situations require reporting to authorities.

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    Unconditional confidentiality

    Full privacy in discussions without conditions or exceptions.

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    HIPAA

    Health Insurance Portability and Accountability Act; protects patient privacy but allows parental access.

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    Impact of mental illnesses

    Mental health conditions are significant issues affecting adolescents, influencing their daily lives.

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    Health risks of substance use

    Involves misuse of drugs or alcohol, leading to various health complications, especially in youth.

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    Adolescent Visit Types

    Health visits categorized by age: Early (11-14), Middle (15-17), Late (18-21).

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    Annual Health Supervision

    Routine check-ups assessing development, interaction, and health metrics like vitals and immunizations.

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    HEADSS Screening

    A psychosocial assessment tool covering Home, Education, Activities, Drugs, Sexuality, and Suicide.

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    Fasting Lipid Panel

    Blood test recommended for adolescents to assess cholesterol levels.

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    Transitioning to Adult Care

    The process adolescents go through when moving from pediatric to adult health care systems.

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    Sports Physical Exam Goals

    Evaluate cardiovascular and musculoskeletal health; identify and manage risks in sports participation.

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    Immunizations for Adolescents

    Vaccines recommended for 11-21 year-olds including Tdap, HPV, and Meningococcal.

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    Anticipatory Guidance

    Advice given to parents and youth to prepare for upcoming developmental changes and health issues.

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    STI Consent

    Examination and treatment consent for anyone with STIs.

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    Minor's Pregnancy Care

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

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    Contraceptive Consent

    Family planning services available to anyone seeking contraception.

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    Emergency Consent

    In emergencies, consent can be given by someone other than parents if efforts are made to contact them.

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    Confidential Mental Health Rights

    Minors aged 14 can consent to verbal therapy, retaining confidentiality while parents are notified.

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    Consent for Unemancipated Minors

    Certain minors over 14, like homeless youth, can consent to necessary medical care if living apart from parents.

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    Jamie's Treatment Decision

    Jamie, 16, disagrees with her parents on returning to hemodialysis after a kidney transplant.

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    Autonomy vs. Paternalism

    Balancing Jamie's autonomy with the need for parental guidance in critical health choices.

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    Study Notes

    Pediatrics I: Adolescents

    • Adolescence is a gateway to adulthood, encompassing puberty, growth, social, emotional, and cognitive development, independent identity formation, and career/vocation preparation.

    What is Puberty?

    • Puberty is sexual maturation, leading to fertility.
    • In boys, it typically starts around 10-12 years old and ends around 16-18 years old. Key stages include testicular enlargement (first sign), pubic hair, axillary hair, muscle growth, and voice deepening, and body/facial hair growth.
    • In girls, it usually begins around 8-11 years old and ends around 14-16 years old. Key stages include breast budding (often first sign), pubic hair, axillary hair, and menarche (average age 12 years).

    Hormones

    • Prior to puberty, pituitary and gonadal hormones are low.
    • The hypothalamic-pituitary-gonadal axis is activated during childhood.
    • Timing of puberty is affected by genetics, ethnicity, and environmental factors.

    Tanner Stages

    • Tanner stages describe the physical development of puberty, specifically in the genitals and breasts.
    • Stages of development are illustrated for both boys and girls.

    Physical Growth

    • Weight almost doubles during adolescence.
    • Height increases by 15-20%.
    • Major organs double in size.
    • Lymph tissue decreases.
    • Muscle mass doubles in boys and decreases in girls.
    • The growth spurt starts approximately 2 years earlier in girls than boys.
    • Growth begins approximately 1 year before puberty-related physical characteristics appear.
    • Psychosocial development often does not mirror physical growth.

    Psychosocial Development: Early Adolescence (11-14 years)

    • Rapid physical growth and secondary sex characteristics.
    • Self-image and esteem fluctuate dramatically.
    • Concerns about pubertal development.
    • Curiosity about sex, often with same-sex group preference.
    • Development of sexual orientation and abstract thinking begins.
    • Difficulty imagining the future with unrealistic expectations.

    Psychosocial Development: Middle Adolescence (15-17 years)

    • Rapid development slows.
    • Increased comfort with oneself.
    • Experience of intense emotions.
    • Progress towards more abstract thinking ("formal operational").
    • Development of an "omnipotence" attitude, feeling unaffected by negative consequences.
    • Self-centered thinking, and identity experimentation.
    • Increased engagement with dating, sex, peer pressure, and conformity.

    Psychosocial Development: Late Adolescence (18-21 years)

    • Decline in self-centeredness, with increased concern for others.
    • Shift from peer group interactions to more individual relationships.
    • Deeper, more intimate dating relationships.
    • Maturation of abstract thinking, leading to more realistic views of the future.
    • Idealism and rigid "right/wrong" thinking may still be present.

    Adolescents: Handling Care

    • Put biases aside when dealing with adolescents.
    • Avoid authoritarian, intimidating or overly professional interactions.
    • Early detection of adolescents at risk is important.
    • Adolescent care focuses on emotional, cognitive, and psychosocial changes affecting behavior.
    • Essential preventative care includes immunizations, contraception, and STI screening.
    • Health providers must assess social history, including sex, drugs, tobacco, and alcohol use.
    • Risk of low insurance coverage and service utilization must be considered.

    Stages of Adolescence

    • Presents data in a tabular format summarizing parental involvement, risk-taking, and peer group dynamics across early, middle, and late stages of adolescence.

    Morbidity in Adolescents

    • Social determinants of health (SDoH), such as poverty, ethnic disparities, and single-parent households negatively influence health.
    • Poor academic performance, behavioral and mental health issues, and risk behaviors are notable concerns.
    • Common morbidities in adolescents are psychosocial, often correlated with poverty.
      • Pregnancy, STIs, substance abuse, school dropout, depression, running away from home, violence, and delinquency are examples.

    Common Health Problems in Adolescents

    • Presents a list of common health problems that adolescents experience. Includes acne, asthma, diabetes, gynecological issues, high blood pressure, infectious mononucleosis, mental health issues, obesity, oral/dental health, Osgood-Schlatter disease, scoliosis, slipped capital femoral epiphysis, sexually transmitted infections, sports injuries, substance use disorders, heat-related illnesses, and road traffic injuries.

    Leading Causes of Adolescent Deaths(Ages 15-19)

    • Accidents (MVA), poisonings, suicide (firearms), homicide (firearms), cancer and heart disease are leading causes of death.

    Confidentiality

    • Confidentiality considerations depend on factors such as maturity, intelligence, independence, and the presence of chronic illness.
    • A patient's confidentiality has exceptions, which include suicide, homicide, sexual, or physical abuse.

    Confidentiality: Medical Records

    • New Mexico does not have state statutes that protect confidential medical information in a child's medical record from a parent who wishes to review it.
    • HIPAA laws vary among states.
    • Parents' access to a minor's medical records is generally allowed under HIPAA, except in cases where the minor consents to care without parental consent.
    • University Hospital has specific guidelines regarding portal access for patients aged 13-17, and their parents.
    • Adolescents can provide consent for specific healthcare services and medical care, but parental/guardian consent is required for minors.
    • Emancipated minors and minors in specific circumstances may have the rights to grant informed consent.
    • Medical emancipation status is variable among states, and can vary concerning the scope of treatment a minor can consent to.
    • Mature minor doctrine permits routine, non-emergent medical care consent without parental involvement in specific states, not all.

    New Mexico Statutes Concerning Minors

    • Describes conditions under which minors can obtain an emancipated minor status including marriage, active duty in the US armed forces, and legal declaration by a court.
    • Most US states allow minors some level of self-determination regarding their medical care, particularly for certain health issues, without parental involvement or consent.
    • New Mexico state laws allow minors to make decisions and consent for sexually transmitted infection (STI) treatment, contraception, mental health, and substance abuse without parental consent.

    New Mexico Statutes (NMSA) Concerning Minors' Health

    • Lists specific medical circumstances or necessities where minors 14+ years of age can consent to care, including medical care, contraception, and STIs.
    • If a pregnant minor does not want to seek medical care from the parent or guardian, any person can act in their place when appropriate.

    Adolescent Decision Making: Jamie

    • Provides a case study of a 14-year-old girl (Jamie) diagnosed with renal failure and later receiving a kidney transplant.
    • Highlights how treatment decisions can create conflict between adolescents and their parents.

    Respect for Jamie's Autonomy

    • Discusses the concept of respecting adolescents' autonomy in healthcare decision-making.
    • Explains how respecting a child's autonomy may involve some limitations regarding decision-making for the child's well-being in the present.
    • Emphasizes that parental decision-makers should protect a child's future rights until adulthood.

    Preserving Jamie's Future Autonomy

    • Outlines strategies for healthcare providers to engage and educate adolescents on informed consent, including understanding their perspectives.
    • Explains the importance of truthfully responding when discussing treatment options with adolescents.
    • Proposes engaging adolescents with the advantages of continuing treatment.

    Possible Outcomes for Jamie

    • Presents possible results if the persuasion, regarding Jamie's care, isn't successful or if the strategy succeeds initially, but treatment or decisions end up not improving the adolescent's health outcome.
    • If the adolescent intends to discontinue treatment, healthcare providers must ensure they fully understand the ramifications.

    Conclusions: Jamie's Case

    • Summarizes parental involvement in decision-making for adolescent children.
    • Emphasizes the importance of involving children/adolescents in medical decisions as they mature.
    • Presents steps for clinicians to take when adolescent preferences differ from parental ones, including patient education and negotiation regarding treatment options.
    • Emphasizes respecting adolescents' autonomy when persuasion in regards to treatment fails.

    Adolescent Well Visit

    • Provides guidelines/details for an Adolescent Well Visit.
    • Discusses different age categories (early, middle, late) for adolescents.
    • Highlights components of an annual visit, including health supervision, developmental surveillance, parent-youth interactions, physical exam review, screenings, immunizations, and anticipatory guidance.

    Adolescent Screening

    • Overview of adolescent screenings and the importance of preventative health care.

    HEADSS: Adolescent Psychosocial History:

    • Presents components of a psychosocial history taking from healthcare providers, including pertinent information about home, education, activities, drugs, sexuality, and suicide/depression.

    11-year-old Visit

    • Provides a list of essentials for a wellness exam in an 11-year-old. Includes reviewing history, vital signs, hearing screenings, developmental surveillance, psychosocial/behavioral assessment, physical exams (including systems review and immunizations), immunizations, and anticipatory guidance.

    Transitioning to Adult Care

    • Discusses the various phases and components of transitioning adolescents to adult healthcare.
    • Includes discussion on policy, tracking progress, developing health plans (including medical summaries), integration into adult practice, and communication with patients.

    Transitioning to Adult Care: Challenges

    • Highlights the possible challenges associated with transitioning adolescent patients to adult healthcare settings.
    • Discusses adolescents' fears regarding their health and their health system.
    • Outlines various anxiety factors, family fears about care, inadequate planning, and differences in clinician care for adolescents with parents.

    Pre-participation Sports Physical Exam

    • Discusses the importance of pre-participation sports physical exams.
    • Details essential components of the pre-participation exam, including identifying medical problems with life-threatening complications or conditions requiring treatment before or during participation, musculoskeletal injury rehabilitation, and performance-related issues, such as exercise-induced asthma.
    • Provides details about removing limitations on participation.

    Sports Physical Exam Focus

    • Sports physicals should focus on cardiovascular health.
    • Exam includes thorough medical and family history, menstrual history (females), cardiovascular risk factors, past injuries, and surgeries.
    • General physical exam covers heart, lungs, vision, and hearing (including specific details for hearing and vision examinations).
    • Focused musculoskeletal exam includes weakness, limited range of motion, and prior injuries.

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    Description

    Test your knowledge on adolescent development, including physical changes, psychosocial factors, and care considerations. This quiz covers key concepts related to puberty, growth spurts, and risk-taking behaviors in adolescents. Perfect for students and professionals in health and education fields.

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