Individualized Care For Adolescent Client
Adolescent client warrants individualized care specific for this developmental stages. These age oriented developmental considerations include physical changes, cognitive level and abilities and emotional factors.
Physically, adolescence is a highly diverse period of growth and development. Growth rates during the teen years maybe impacted by nutrition, factors within the environment, genetics and heredity, and gender. A group of adolescents of similar ages may manifest very different sizes, height to weight proportions, secondary sex characteristics, and other indicators of physical maturity. These differences may warrant individualization of dosages base on weight or body surface area, even when the adolescent meets or exceeds the size of standard adults. For examples, an adjustment may be required in the dosage of a lipid soluble medication because changes in lean to fat body mass, especially in young adolescent males, coincide with physical maturation. Hormonal changes and growth spurts may necessitate changes in medication dosages; many children with chronic illness require dosage adjustments in the early teen years as a result of these transitions. Teens sleep requirements and metabolic rates may greatly increase during the teen years, along with appetites and food consumption, which may affect their scheduling of and response to medications. Although adolescents resemble the physical appearance and organ structure and function of adults, their body continues to grow and change, requiring increase vigilance in monitoring therapeutic and toxic drug levels.
The cognitive level and abilities of the adolescent may pose even greater challenge. Adolescents progress from concrete to abstract reasoning. Individuals who are still in the concrete operational stage may have difficulty comprehending how a medication exerts its effects on the body and the importance of meticulous dosing and administration. Teen may also have difficulty understanding such concepts as drug interactions, side effects, adverse reactions and therapeutic levels. Client teaching must also consider the cognitive level of the individual; as adolescents learn to reason in an abstract manner, teaching may be based on more complex information.
Teens difficulty in relating future consequences to current actions and their commonly perceived invulnerability may dictate that the nurse adapt teaching to address specific adolescent thought processes. The adolescent who is told that an insulin injection schedule must be adhered to in order to avoid long term complications may not understand the rationales for treatment if only substantiated by future risk. The same teen may find the relationship between insulin to maintain normoglycemia and the ability to participate in sports more immediate and relevant. Although teens may physically resemble soon to be adults, the nurse must continue to assess client’s cognitive level as they relate to medication.
The emotional development of a teen also occurs on an individual basis. The teen years are characterized by sensation seeking, risk taking, questioning, formation of identity and increasing influences exerted by peer groups. One should assess the high risk behaviors including use of alcohol, tobacco and drugs to avoid potential drug interaction. Other issues including sexual practices, stressful family and social situations and lifestyle behavior may impact the clients response to medications. It is important to be respectful to the emotional needs of the adolescence while attending to the mental health issues that may surface during the teen years. A comprehensive history must be solicited from the teen client to ensure appropriate medication.