Chapter 16: School-Age & Adolescent Health Problems

School-Age & Adolescent Health Problems begins by addressing elimination disorders, specifically enuresis and encopresis, detailing the diagnostic criteria, the distinction between primary and secondary forms, and therapeutic interventions such as bedwetting alarms, desmopressin acetate, and bowel retraining regimens. A significant portion of the text is dedicated to behavioral and cognitive challenges, most notably Attention-Deficit/Hyperactivity Disorder (ADHD), where it outlines clinical manifestations and the efficacy of multimodal treatment combining environmental manipulation, behavioral therapy, and pharmacologic agents like methylphenidate. The chapter further explores mental health issues including childhood depression, anxiety, school phobia, and Posttraumatic Stress Disorder (PTSD), emphasizing the critical role of nurses in recognizing warning signs and conducting suicide risk assessments using methods like the SLAP mnemonic. Dermatologic concerns are addressed through a detailed analysis of acne vulgaris, covering its pathophysiology involving sebaceous glands and Cutibacterium acnes, along with a stepwise management approach utilizing topical retinoids, benzoyl peroxide, and systemic isotretinoin. The text separates reproductive health issues by biological sex, discussing male conditions such as testicular torsion, varicocele, and gynecomastia, alongside female concerns including primary and secondary amenorrhea, dysmenorrhea, and premenstrual syndrome (PMS). Furthermore, the chapter delves into adolescent sexuality, providing guidelines for preventing and treating Sexually Transmitted Infections (STIs) like chlamydia, gonorrhea, syphilis, and HPV, as well as managing adolescent pregnancy and providing contraceptive counseling. It also highlights the nurse's role in identifying and supporting victims of sexual violence and human trafficking. Nutritional disorders are examined through the polarizing lenses of obesity and eating disorders; the text contrasts the lifestyle and metabolic interventions required for obesity management with the psychotherapeutic and nutritional rehabilitation needed for anorexia nervosa and bulimia nervosa. Finally, the chapter reviews high-risk behaviors, analyzing the trends and prevention strategies for substance abuse, including alcohol, vaping, and illicit drugs, within the context of adolescent development.