Puberty & Adolescence
Life Span - Lecture 6
Chapter 10
Puberty / Pre-adolescence
• Rapid growth
• @ 2 yrs to complete
• 2nd sex characteristics
Factors that influence Puberty
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Heredity
Climate
Nutrition
Gender
Socioeconomic status
4 Major Changes - Puberty
1.
2.
3.
4.
Rapid growth
Δ body proportions
1o sex characteristics
2o sex characteristics
Puberty Frustrations
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Independence / supervision
Appearance / body changes
Peer acceptance / peer frustration
Academic success / h workload
Adult behavior / child behavior
h schedule / need for h sleep
Adolescence
• Begins
– Sexual maturity
• Ends
– Cessation of growth 
emotional maturity
Characteristics of Adolescence
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Volatile emotions
Insecurities
Introspection
Experimentation
Testing values
Physical Characteristics
What is another name for the
adenohypophysis?
A.
B.
C.
D.
E.
Thyroid gland
Posterior Pituitary gland
Anterior Pituitary gland
Thymus
Adrenal Cortex
What hormones are secreted by the
Anterior pituitary that affect the
gonads?
A. Estrogen & Progesterone
B. Estrogen and Testosterone
C. Follicle stimulating Hormone and Luteinizing
hormone
D. Follicle stimulating Hormone & Estrogen
E. Testosterone & Luteinizing hormone
Puberty: Height & Weight
• Rapid Growth
• Girls before Guys
– Feet 1st
• Height
– h 20 – 25%
• Weight
– h 15 – 60 lbs
• Disproportionate
Puberty: Development of Sex
• 1o sex characteristics
– Gonads
Puberty: Male
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Testes
Scrotum
Sperm
Testosterone
Ejaculation
Penis
Puberty: Female
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Ovaries
Ova
Estrogen
Progesterone
Menarche
Menopause
Puberty: Development of Sex
• 2o sex characteristics
– Pubic hair
– Axillary hair
– Sebaceous glands
•  oil
– Apocrine glands
•  sweat
Body Changes: Puberty
Male ♂
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Penis
Erections
Wet dreams
Voice changes
Female ♀
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Breasts
Menstruation
Cramps
Pregnancy
Hygiene
Body Changes: Puberty
Male ♂
• 10 – 11
– Gonad growth
– Pubic hair
• 12-13
– Growth spurt
• 13-15
– 2o hair
– Ejaculation
– Voice deepens
Female ♀
• 10-11
– Growth spurt
– Breast
– Pubic hair
• 11-14
– Menarche
• 12 – 13
– 2o hair
When do girls stop growing?
A.
B.
C.
D.
E.
14-15
16-17
18-20
21–22
23-24
When do boys stop growing?
A.
B.
C.
D.
E.
14-15
16-17
18-20
21–22
23-24
Adolescence: Height & Weight
• Slows after puberty
• ♀
– 16 - 17
• ♂
– 18 – 20
What is the term for lateral curvature of
the spinal cord?
A.
B.
C.
D.
E.
Scoliosis
Lordosis
Kyphosis
Barrel chest
Curvilateralospinosis
Muscle & Bone development
• h strength
• h endurance
• h size
• Sore
• Awkward
• Scoliosis
– “lateral curvature of the
spine”
Respiratory System G&D
• h Lung size, weight
• i rate
• h performance
• Nurse intervention
– EXERCISE!!!
GI System G&D
• h size & capacity
Teeth: G&D
• 12yrs
– 2nd molars
• 14 – 25 yrs
– 3rd molars
– “Wisdom teeth”
Vital Signs
• Pulse
– 60-90
• Resp
– 16 – 24
• Nursing intervention
– EXERCISE!!!
Developmental Milestones
Motor Development
• Rapid growth  Clumsy
• *Eye-hand coordination
Sexual Development
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Comparisons
Masturbation
Sexual activity
Education
STD’s
• h
• Prevention education
Teen pregnancy
“The pregnant adolescent
has twice the mortality rate
of a non-adolescent
pregnant woman.”
Teen Pregnancy
• What are the “downsides” of teenage
pregnancy?
Rape
• h
• Stranger
• Date-rape
Psychosocial Development: Behavior
Behavior
• Rebellious
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Parental Response
Overlook
Avoid confrontation
Be tolerant
“Pick your battles”
Avoid seeing behavior as a
rejection of parental love
Psychosocial Development: Behavior
Behavior
• Need for privacy
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Parental Response
Own space
Understanding
Offer help – step back
Open communication
Psychosocial Development: Behavior
Behavior
• Dishonesty
Parental Response
• Don’t overreact
• Reinforce reality
• Be consistent
Psychosocial Development: Behavior
Behavior
• Responsibility
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Parental Response
Listen
Expect uneven maturity
Enc. decision making &
responsibility
Set reasonable rules
Psychosocial Development: Behavior
Behavior
• Curfews
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Parental Response
Allow unexpected delays
Enc phone contact
Set example
Socialize at home
Psychosocial Development: Behavior
Behavior
• Friends
Parental Response
• Accept \ criticism
• Get to know them
• Avoid showing disapproval
Psychosocial development: Puberty
• Attitude
– Happy  negative
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h self-consciousness
Self-doubt
h time alone (room) 
Find new peers
• Antagonism
What task do adolescence need to complete according to the
psycho-social development model?
A.
B.
C.
D.
E.
Identity
Pre-conventional
Genital
Intimacy
Formal operation
Psychosocial Development:
Adolescence
• Explore own values
– Test them
• Ambivalence
– Two opposing feelings at
the same time
• Mood swings
• Love / hate family
• Freedom/supervision
• Wanting to be part of a
group / wanting to be
alone
• Emotions
– Expressed feelings 
behavior
• Mood swings
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Anger
Fears
Worries
Jealousy
Envy
Happiness
• Boredom
– Daydreaming
• Humor
– “Biting”
• Work / employment
Age 13 - 14
• Hide feelings
• Negative & hostile
• Narrow perspective
–  compromise
Ages 15 - 16
• i self absorption
• h compromise
• h independent thinking
– Discuss
– Debate
• Experimenting
– h risk taking
– h adventure
• Dating
Age 17 -19
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Serious
Idealistic
h Stress
Relationships
– Family
– “boy-friend” /“girl-friend”
– Peers
• Career
Discipline
• Clear rules
• Set rules
– Dating
– Curfew
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Open communication
Be realistic
Be available
Listen!
Cognitive Development
• Concrete thinking 
(with training)  formal
operational
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Logical
Scientific reasoning
Problem solving
Look at all possibilities
Moral Development
• “Cognitive development is a prerequisite for
moral reasoning”
• Conventional Level
– Follow rules
– Show concern for others
– Want to be trusted
• BEGIN TO QUESTION EVERYTHING
• Post conventional
Communication
• Verbal communication
Nutrition
• Caloric intake
–♀
• 2,600 / day
–♂
• 3,000 / day
Key nutrients
• Protein
– 15%
• Calcium
• Iron
Sleep & Rest
• h need for sleep
– 8 hours
• Affects of poor sleep
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Irritable
I school performance
i concentration
h stress
h susceptibility to illness
Auto accidents
University of Chicago Medical Center
October 23, 1999 The Lancet.
• “Chronic sleep loss can reduce the capacity of
even young adults to perform basic metabolic
functions, such as processing and storing
carbohydrates or regulating hormone secretion…
Cutting back from the standard eight down to
four hours of sleep each night produced striking
changes in glucose tolerance and endocrine
function--changes that resembled the effects of
advanced age or the early stages of diabetes-after less than one week.”
Anorexia Nervosa
• Eating + emotional
disorder
• Willful starvation
• < minimum body weight
• Fear of weight gain
• Extreme dieting
– Diet pills
– Laxatives
– Ipecac
• Excessive exercise
Bulimia
• Binge & purge
• loss of control
Safety
• MVA
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Driving
Independence
Poor judgment
Don’t drink and drive
Safety
• Sporting activities
– Pre-sport physicals
– Protective equipment
• ♂
– Football
– Hockey
• ♀
– gymnastics
Safety
• Firearms
– Storage
– Training
MVA are the leading cause of death in the adolescent population,
what is the 2nd leading cause of death?
A.
B.
C.
D.
E.
Poisoning
Drug over dose
Homicide
Falls
Suicide
How often should a adolescent have a
dental exam?
A.
B.
C.
D.
E.
4 times a year
3 times a year
2 times a year
1 time a year
1 time every two years
Health Promotion
• nutrition patterns =
health level
• Annual physical
• Vision & hearing
• √ Height & weight
Which of the following disorders are
adolescent girls prone to having?
A.
B.
C.
D.
E.
Anemia
COPD
Arthritis
High blood pressure
Stomach ulcers
Depression
• “Prolonged feeling of
sadness and
unworthiness”
• h d/t long period of…
– Self reflection
S&S of Depression in Adolescence
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Crying
Insomnia
Eating disorders
Social isolation
Acting out
Hopelessness
Physical symptoms
Loss of interest in
appearance
• Giving away things
Contributing Factors to Adolescent
suicide
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Depression
Low self-esteem
Poor impulse control
Substance abuse
Emotional isolation
Depression/suicide: Nursing
interventions
• Assess for clues
• Listen carefully
• Do not undervalue
emotions!
• Ask if they are thinking
about suicide
• Do they have a plan?
• Constant supervision
Substance Abuse
• How to know
•
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