ADOLECENTS

PROBLEMS
GROUP TWO
GENERAL OBJECTIVES
• We students should be able to understand and acquire knowledge on
the danger signs during pregnancy and also on adolescence problem
under social and physical
SPECIFIC OBJECTIVES
At the end of this assignment student should be able to:
• Define adolenscence
• Define terms associated with adolescence and pregnancy
• Explain all forms of adolescence problems during physical and social
growth
• Outline the danger signs in pregnancy
INTRODUCTION
• Adolescence is the transitory phase between childhood and
adulthood. An adolescent is someone between the ages of 10 and 19
(Steinberg,2008).. It is the transition from being a child (who is fully
dependent on the parent), to an independent and self-reliant adult.
Sometimes the start age can be earlier especially in girls. It is an
important stage of human development. The changes that occur
during this period range from biological, physical, psychological and
behavioral domains of functioning.
There are three Key Stages of
Adolescence
• Early Adolescence- This stage generally starts from 10 to 13 years of
age. It can be earlier for girls. It is the onset of puberty.
• Middle Adolescence - This stage starts from approximately age 14 to
16. Physical body changes continue- Boys begin to 'bulk up' and girls
begin to 'fill out'.
• Late Adolescence - This stage starts at about age 17 and spans to 21
(into adulthood, really) especially in males, this stage is between ages
17 and 19. By this stage, many kids are physically mature.
ADOLESCENT PROBLEMS
SOCIAL PROBLEMS
• Alcohol and drug use
Drinking alcohol among adolescents is a major concern in many countries.
Worldwide, more than a quarter of all people aged 15–19 years are current
drinkers, amounting to 155 million adolescents. Prevalence of heavy
episodic drinking among adolescents aged 15¬–19 years was 13.6% in
2016, with males most at risk. Cannabis is the most widely used
psychoactive drug among young people with about 4.7% of people aged
15–16 years using it at least once in 2018. Alcohol and drug use in children
and adolescents is associated with neurocognitive alterations which can
lead to behavioural, emotional, social and academic problems in later life
ADOLESCENT PROBLEMS CONT…
• Mental health
Depression and anxiety are among the leading causes of illness and
disability among adolescents, and suicide is among the leading causes
of death in people aged 15–19 years. Half of all mental health disorders
in adulthood start by age 14, but most cases are undetected and
untreated. Many factors have an impact on the well-being and mental
health of adolescents and lead to suicide as a complication. Violence,
poverty, stigma, exclusion, and living in humanitarian and fragile
settings can increase the risk of developing mental health problems.
ADOLESCENT PROBLEMS CONT…
Communicable diseases
• HIV
An estimated 1.7 million adolescents (age 10–19 years) were living with
HIV in 2021 with around 90% in the WHO African Region. While there
have been substantial declines in new infections amongst adolescents
from a peak in 1994, adolescents still account for about 10% of new HIV
infections, with three-quarters amongst adolescent girls. Additionally,
while new infections may have fallen in many of the most severely
affected countries, recent testing coverage remains low suggesting that
many adolescents and young people living with HIV may not know their
status.
• Tuberculosis
Tuberculosis (TB) is a preventable and curable disease, but it continues
to impact the lives and development of millions of children and
adolescents. Children and young adolescents aged under 15 years
represent about 11% of all people with TB globally. This means 1.1
million children and young adolescents aged under 15 years fall ill with
TB every year, and more than 225 000 of them lose their
lives.Adolescents and young adults usually present with
bacteriologically infectious TB characterized by cavities seen on chest x-
rays. The Global Tuberculosis Report shows that notification rates in
adolescents aged 15–19 years are relatively high compared with
younger adolescents.
• Other infectious diseases
• Diarrhoea and lower respiratory tract infections (pneumonia) are
estimated to be among the top five causes of death for adolescents
10–14 years, with mortality rates being particularly high in African
low- and middle-income countries. Thanks to improved childhood
vaccination, adolescent deaths and disability from measles have fallen
markedly.
• Early adolescence (9–14 years) is the optimal time for vaccination
against HPV infection and it is estimated that if 90% of girls globally
get the HPV vaccine more than 40 million lives could be saved over
the next century. However, it is estimated that in 2021 only 12% of
girls globally received the vaccine.
• Human papillomavirus (HPV) and cervical cancer fact sheet
• Overall there are proportionally fewer cases of and deaths from COVID-19 disease for
adolescents and young adults than for older adults. However, the pandemic has severe
indirect negative effects on young people’s well-being, including on their mental
health, loss of education time through school closures, social isolation, physical
inactivity, malnutrition and domestic violence.
• Early pregnancy and childbirth
• Approximately 12 million girls aged 15–19 years and at least 777 000 girls under 15
years give birth each year in developing regions. Complications from pregnancy and
childbirth are among the leading causes of death for girls aged 15–19 years globally
(Milgrom , et al 2008).
• The global adolescent birth rate in 2021 was 42 births per 1000 girls this age, and
country rates range from 1 to over 200 births per 1000 girls annually. This indicates a
marked decrease since 1990. This decrease is reflected in a similar decline in maternal
mortality rates among girls aged 15–19 years.
• One of the specific targets of the health Sustainable Development Goal (SDG 3) is that
by 2030, the world should ensure universal access to sexual and reproductive health-
care services, including for family planning, information and education, and the
integration of reproductive health into national strategies and programmes.
OVERWEIGHT
• Globally, in 2016, over 1 in 6 adolescents aged 10–19 years was
overweight. Prevalence varied across WHO regions, from lower than
10% in the WHO South-East Asia Region to over 30% in the WHO
Region of the Americas
NUTRITION
• Many boys and girls in developing countries enter adolescence
undernourished, making them more vulnerable to disease and early
death.
• Iron deficiency anaemia was the second leading cause of healthy years of
life lost due to disability by adolescents aged 10–19 in 2019. Iron and
folic acid supplements are a solution that also helps to promote health of
adolescents. Regular deworming in areas where intestinal helminths such
as hookworm are common is recommended to prevent micronutrient
(including iron) deficiencies.
• Globally, in 2016, only 1 in 5 adolescents are estimated to meet WHO
guidelines on physical activity. Prevalence of inactivity is high across all
WHO regions, and higher in female as compared to male adolescents.
ROAD TRAFFIC ACCIDENTS
• In 2019, 115 000 adolescents (10–19 years) died as a result of road traffic
accidents. Many of those who died were vulnerable road users, including
pedestrians, cyclists or users of motorized two-wheelers.
Violence
• Interpersonal violence is among the leading causes of death in adolescents and
young people globally. Its prominence varies substantially by world region. It
causes nearly a third of all adolescent male deaths in low- and middle-income
countries in the WHO Region of the Americas. Violence during adolescence also
increases the risks of injury, HIV and other sexually transmitted infections,
mental health problems, poor school performance and dropout, early
pregnancy, reproductive health problems, and communicable and
noncommunicable diseases.
PHYSICAL DEVELOPMENT
Male adolecents
• There are separate Tanner stages for penis/testicles and pubic hair. There are
five stages of puberty for boys.
• Stage 1 is prepubertal. In this stage, boys have not experienced any visible
changes.
• In Stage 2, physical changes begin. Between the ages of 9 and 14, boys
typically begin to experience:
•• Genital development (growth of their testicles and scrotum).
•• Growth of sparse hair around their penis and under their arms.
•• An increase in height (typically about 2 to 2½ inches per year), which
could bring growing pains.
• In Stage 3, physical changes speed up. Between the ages of 10 and 16, boys
experience:
• Continued growth of their penis and testicles, as well as possible “wet
dreams.” Wet dreams are ejaculation at night while they sleep.
• Darkening, coarsening pubic hair in the shape of a triangle in their genital
area.
• Continued increase in height (about 2¾ to just over 3 inches per year).
• More sweating, which can lead to body odor.
• Vocal changes (and cracking in the process).
• Increased muscle mass.
• In Stage 4, puberty hits full stride. Between the ages of 11 and 16 years, boys
experience:
• Growth in penis size and darkening of the skin on their scrotum and testicles.
Red ridges on their testicles called rugae will begin to develop.
• Body hair growth that reaches adult levels. Pubic hair remains in a coarse
triangle.
• A peak growth spurt that averages nearly 4 inches per year.
• Development of acne.
• Continued cracking of the voice
Stage 5 is the final phase. Puberty ends in this stage. Boys finish their growth and
physical development. Many may not develop facial hair until this step in the
process. Pubic hair may extend out to their thighs, and some boys may have a
line of hair up to their belly button. Most boys finish growing by age 17, but some
may continue growing through their early 20s
FEMALE ADOLESCENTS
Stage 1 is prepubertal. In this stage, girls have not experienced any
visible changes.
In Stage 2, physical changes begin. Between the ages of 8 and 13, girls
typically experience:
• Their breasts begin to bud, and their areolas (pigmented area around
the nipple) enlarge.
• Scant pubic hair appears.
• Height increases by about 2¾ inches per year.
In Stage 3, physical changes speed up. Between the ages of 9 and 14:
• Their breasts continue budding.
• Underarm hair begins to grow, and pubic hair continues to grow. Pubic
hair is coarse, curly and in the shape of a triangle.
• A growth spurt of more than 3 inches per year occurs.
• Their skin becomes oilier, and acne develops
In Stage 4, puberty hits full stride. Between the ages of 10 and 15:
• Their breasts continue growing, and their nipples start to protrude.
• Pubic hair is still in a triangle, and there are now too many hairs to count.
• Growth may continue at the rate of about 2¾ inches per year.
• Acne may continue.
• Periods (menstruation) typically start around age 12 (usually around
the same age their mother’s and sisters’ periods began). Some girls,
especially those with disordered eating, start later.
• Stage 5 is the final phase. Development typically ends in this stage.
Girls reach physical adulthood. Pubic hair may extend out to their
thighs, and some girls may have a line of hair up to their belly button.
Most girls attain their peak height by age 16, but some may continue
growing through age 20.
DANGER SIGNS IN PREGNANCY
1.During pregnancy, it’s important to be aware of potential danger
signs that may indicate a complication or a risk to the health of the
mother or the baby. While the following are my findings of some
common danger signs, it’s essential to regularly visit and consult a
healthcare professional for a thorough evaluation and appropriate
medical advice. Here are a few examples:
• i. Vaginal bleeding: : Bleeding from the vagina during any stage of
pregnancy can indicate a potential problem. It may range from light
spotting to heavy bleeding. Any amount of vaginal bleeding during
pregnancy should be promptly reported to a healthcare provider as it
can be a sign of various complications, such as placenta previa,
placental abruption, or miscarriage.
• ii. Severe or persistent abdominal pain: Intense or prolonged
abdominal pain can indicate conditions like ectopic pregnancy,
preterm labor, or appendicitis, and should be evaluated by a
Healthcare professional. Intense or persistent abdominal pain could
also be a sign of a serious issue, such as placental abruption.
• iii. Severe headache or visual disturbances: Sudden severe
headaches, changes in vision, or the appearance of spots or flashing
lights in the field of vision can be signs of preeclampsia, a potentially
serious condition that affects blood pressure and organ function.
• iv. Severe swelling: While mild swelling is common during
pregnancy, sudden or severe swelling of the hands, face, legs, or feet
can be a symptom of preeclampsia or other conditions and should be
evaluated by a healthcare provider.
• v.Decreased fetal movement: If a pregnant woman notices a significant decrease in
fetal movement or no movement at all, it may indicate a potential problem, and she
should seek medical attention promptly.
• vi.Prolonged vomiting or severe nausea: While morning sickness is common in
pregnancy, severe and persistent vomiting or inability to keep any food or fluids
down may lead to dehydration and require medical attention.
• Signs of preterm labor: These include regular contractions before 37 weeks of
gestation, pelvic pressure, or a sudden gush or leakage of fluid from the vagina.
• Fever and chills: A high fever during pregnancy could be a sign of infection, which
may pose risks to both the mother and the baby.
• It is important to note that these danger signs may vary depending on individual
circumstances and each pregnancy is unique. It is recommended to seek immediate
medical attention if any of these signs or symptoms are experienced during
pregnancy, as they may indicate potentially serious complications. Consulting with a
healthcare provider is crucial for appropriate evaluation and management.
DANGER SIGNS DURING LABOR AND POSTNATAL
• Adolescent mothers are prone to preeclampsia, a progressive hypertensive
disorder of pregnancy that can present with multiorgan involvement,
leading to adverse maternal and perinatal consequences, particularly for
prim gravid adolescent females .
• Pregnancies in adolescence result in no biological, mental, or social
maturation process and adversely affect maternal and fetal outcomes due
to biological immaturity, insufficient antenatal care, malnutrition,
stress,depression and anxiety.
• The primary objective is to have a greater understanding for future
researchers of not only adverse maternal outcomes (preeclampsia,
preterm premature rupture of the fetal membrane, anemia, sexually
transmitted diseases, and maternal mortality) but also adverse fetal
outcomes (preterm births, low birth weight, Apgar scores, stillbirths, and
neonatal mortality) concerning adolescent pregnancy.
DURING LABOR
•• Excessive Vaginal Bleeding
•• Preterm Labor
•• Prolonged Labor
•• Convulsion
•• Severe Headache
•• Retained Placenta
 POSTNATAL PERIOD
• Vaginal Bleeding
• Convulsion after child birth
• High fever
CONCLUSION
• Apart from smooth tenor of childhood development, the adolescent years
are characterised by rapid growth and change. In addition to growing taller
and heavier, the child develops secondary sexual characteristics and has to
contend with the emotional and social problems that often accompany these
changes. Although the adolescent years are not invariably a period of storm
and stress, adolescence is nevertheless a difficult phase in the course of the
child's becoming. It is almost unfair that so many socialisation demands -
associated with gaining independence, changing relationships with peers and
adults, sexual adjustment, educational and vocational preparation - are
made at the same time that the young person is experiencing an
unprecedented rate of biological maturation. Above all, the adolescent
struggles with her emotional development, the forming of her own identity,
and the stabilisation of a realistically positive self-concept.