Published on March 6, 2014
WELCOME TO ADOLESCENT HEALTH. DR. MAHESWARI JAIKUMAR.
SEX EDUCATION. •THE AIM OF SEX EDUCATION IS AS FOLLOWS. •To have first hand knowledge on sex & sexuality. •To understand about one’s own sex & be comfortable about it. •To help to handle changes during adolescence. •To cope with both physical & emotional changes. •To establish a stable social relationship with individuals of the same & opposite sex based on mutual respect & concern for each other.
ADOLESCENT HEALTH. •Adolescence is a period of transition from childhood to adulthood. •This period is crucial as these days are formative days. •Major physical, psychological & behavioral changes take place. •This is the period of preparation for undertaking grater responsibilities including healthy responsible parenthood. •The future of the society depends on the quality of adolescents in the community.
•Health problems of the adolescents are different from those of children & adults. •Adolescents are prone to various behavioral & reproductive health problems. •Therefore there is a need for proper guidance & .
PHYSICAL & PHYSIOLOGICAL CHANGES IN ADOLESCENTS. •PUBERTY IN GIRLS. •MENARCHE & MENSTURATION. •PUBERTY IN BOYS. •PSYCHOLOGICAL & BEHAVIOURAL CHANGES. •NUTRITION & HEALTH NEEDS IN ADOLESCENTS. •PERSONAL HYGEINE. •HEALTH PROBLEMS IN ADOLESCENTS.
PUBERTY IN GIRLS. •In girls physical changes may begin at around 10 yrs, & may reach their maximum growth by around 14 yrs. •There after the growth continues at a slower rate till the age of 18 yrs. •Secondary sexual characteristics appear – appearance of hair in the pubic area, growth of breast. •Other changes include accelerated growth & development of genital organs – uterus & overies. •Overies begin to ovulate at around 11-14 yrs once every 28 – 30 days.
MENARCHE & MENSTURAL CYCLE. •Menarche is the onset of first menstruations that occurs in a young girl at around 12 yrs. •There are variations in the age at which the menstruations occurs. •Good nutritional status will lower the age of menarche. If menstruation has not started by 16 yrs counsel the girl’s parents to consult the medical officer. The ovum produced by the overies when unites with the male sperm, fertilization occurs,--- failing which menstruations occurs.
•Menstruation occurs once in a month as a regular rhythmic period. •Menstrual cycle is a continuous process. •It remains as a normal physiological phenomenon throughout the child bearing age, except during pregnancy. •Menstruation stops permanently at menopause approximately between 45-55 yrs.
PUBERTY IN BOYS. •Puberty in boys appears little later in case of boys. •It may begin with the change in voice, growth of hair on chin, under arms, face, chest & pubic region. •Enlargement of external genitalia starts & sperm production also starts. •Occasionally penile erection & involuntary ejaculations also occur. •The changes are normal.
PSYCHOLOGICAL & BEHAVIOURAL CHANGES. •During the transition phase, there is rapid changes in the body. •The adolescent develops anxiety & apprehension. •Adolescence is a time for exploration, adventure & discovery of one’s own body & one’s own capability & potential. •Some times this can lead to confusion & experimentation with harmful substances like drugs, alcohols, & be involved in risky behaviour like risky driving.
•Some times expression of sexual urge by adolescents may lead to anger among adults. •This may lead to feeling of anger, guilt& shame. •Adolescents often hesitate to make communicate about sexual development & other matters related to health. •Therefore it is imperative that they are given adequate information about sex education – normal physical, sexual & psychological changes etc. •They should be advised & warned about sex experiments, drug abuse, teenage pregnancy, contracting RTI/HIV/aids,injuries,accidents,violence,rape,homicides, & suicides etc.
NUTRITION & HEALTH NEEDS IN ADOLESCENCE. •The nutritional requirement of adolescents is more due to rapid growth spurt & increase in physical activity. •Encourage healthy eating habits & life style. •Good nutrition is important for optimal growth. •Adolescents need plenty of all nutrients – calcium, iodine, & iron. •The increased iron is due to growth spurt & the onset of menstruation.
Inadequate iron stored in the body is a major cause of iron deficiency anemia during pregnancy – aggravates the risk during pregnancy. In endemic areas increased incidence of iodine deficiency disorder results in growth retardation, mental retardation & poor psychomotor development. Stunted & under nourished girls are more likely to have complications during pregnancy & give birth to low birth weight babies. Therefore the community should be educated on the importance of god nutrition, health eating habits & good life style.
PERSONAL HYGIENE. •Personal hygiene IS THE BASIC COMPONENT FOR protection of good health. •Adolescents should take care of personal hygiene as follows: •Clean hands thoroughly before & after taking food & after going to toilet. •Clean teeth & tongue twice daily. •Must take bath daily. •Boys should give attention to clean smegma (thick secretion collected under the fore skin of the penis.) during bath & after urination.
•Boys & girls should keep the groin clean & dry ----fungal infection leading to itching will develop. •Girls should use clean clothes or sanitary napkins during periods. It should be changed frequently & the part should be kept clean & dry. Adolescent girl may have itching around the groin following the menstruation – this is normal •Some times girls may have vaginal discharge that stains in such case she should consult the physician •The vaginal opening & anus are close to the urethral opening, therefore wash after passing urine. •Washing after passing stool & urine must be from front to back & not reverse as there is a chance of urinary infection..
HEALTH PROBLEMS IN ADOLESCENTS. THE FOLLOWING ARE THE HEALTH PROBLEMS AMONG ADOLESCENTS: •Irregular menstrual cycle. •Under nutrition. •Unprotected sex& unwanted pregnancy/unplanned pregnancy. •Risk of pregnancy in adolescents. •Unprotected sex & sexually transmitted disease. •Prevention of adolescent pregnancy & STD’s.
IRREGULAR MENSTURAL CYCLE. •Irregular menstrual cycle is reported among adolescents. •Reassure the girl & parent & advice nutritious diet. •Generally periods get regularized with in 2 yrs of menarche. •If menstruation is not regularized then refer to PHC.
UNDER NUTRITION. •Under nutrition is a major & common problem among adolescents in India. •Undernutrition during childhood & adolescence results in impaired growth,anemia, iodine deficiency etc. •Under nutrition among adolescents is found to be the major cause of LBW in India.
UNPROTECTED SEX / UNWANTED PREGNANCY. •There is a wide spread ignorance among adolescents about sexuality & risks associated with unprotected sex. •Un protected sex may lead to unwanted pregnancy / unplanned pregnancy ----- need for induced abortion. •This may lead the girls to seek abortion services from untrained practitioners & become victims of complications. •Termination of pregnancy poses greater risk to life. •Even if pregnancy progresses it may lead to complications.
RISK OF PREGNANCY IN ADOLESCENCE. •The health of the adolescent is at risk when they are married at young age. •This predisposes the girl to complications like early child bearing. •The probability of the mother having anemia, retarded fetal growth, premature birth & complications are high with situation. •Some times these complications may even lead to death.
UNPROTECTED SEX / STD. •STD is the major consequence of unprotected sex. •The commonest ones being syphilis, gonorrhea & HIV/AIDS. •Young adolescents who engage in unprotected sex are more vulnerable to these sexually transmitted diseases. •Acquiring STD’s during adolescence results in serious consequences like infertility, pelvic inflammatory diseases, ectopic pregnancy etc.
PREVENTION OF ADOLESCERNT PREGNANCY. •Adolescent pregnancies are high risk pregnancies. •Therefore counseling should be done both the parents & children on the avoidance of early marriage •This can be achieved through advocacy, counselling, & by social & legal action. •Counseling should focus on enabling –decisions on prevention of pregnancies by adopting abstinence or use of contraceptives..
NURSING INTERVENTION – MENSTURATION. Pre menstrual symptoms. Lower abdominal pain / discomfort. Fullness of breast. Tenderness. Weight gain / fluid retention/ . Irritability Depression.
AMENHORRHOEA. : Acknowledge client’s feelings. Provide emotional support. Refer to counselling as necessary. Explain diagnostic procedures. Provide information, privacy.
DYSMENORRHOEA Assess the nature of pain. Observe non verbal cues. Encourage pain reduction technic.– medication, comfort measure, back rub, use of heat / cold application. Monitor vital signs. Provide quiet environment, calm activities.
MENRORRHAGIA. Assess for bleeding, pain,vaginal secretions & psychosocial concerns. Encourage the women to express her feeling. Explain the recording dates, type of flow, number of sanitary pads used. Teach pain relieving technics.
OTHER SYMPTOMS & MANAGEMENT Irritability, lethargy, fatigue, sleep disturbance, depression, headache, vertigo, backache, acne, paresthena. Encourage verbalization of feelings. Encourage to plan activities during symptom free period. Administer Vit & mineral supplements. Encourage daily relaxation & exercises. Provide emotional support. Assist in coping mechanism.
GENERAL MANAGEMENT. PROVIDE HEALTH EDUCATION ON THE FOLLOWING, PHYSIOLOGICAL PROCESS. FACTORS ALTERING MENSTRUAL CYCLE.: stress, fatigue, exercise, acute or chronic illness, changes in climate, working hours , pregnancy. PERSONAL HYGIENE.: Usage of pads, frequent change of pads, general & perenial hygiene. BALANCED DIET & PLENTY OF FLUIDS.
ROLE OF A NURSE. •ENSURE SAFE & SECURE ENVIRONMENT. •EDUCATE THE FAMILY MEMBERS & THE ADOLESCENS •GIVE CLARIFICATION & CORRECT INFORMATION TO THE CLIENTS. •EDUCATE ON HEALTHY LIFE STYLE..
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