As a matter of fact, the adolescent period is sometimes very challenging for young individuals since it is during this period that they do experience remarkable physical and intellectual development. During this period, nurturing a strong relationship with healthcare providers and family members, more so parents is extremely critical because it helps them to take responsibilities for their health-care decisions. In this case, a gerontology nurse working in a community health center see a 14-year old adolescent patient for annual visit. The mother of the patient is also present during the visit and claims that the 14 year old boy has been experiencing a gradual decline in school grade. The mother is really concerned with what might be going on with her son.
Components of an annual exam for an adolescent patient
Despite the fact that adolescent is regarded as the healthiest life stage, it is unfortunate that the stage is characterized by not only infectious diseases, but also developmental issues of childhood that threatens the quality of their lives (People, 2014). Some of the challenges experienced during adolescence include changing hormones, rapid physical growth, and sexual maturity, and behavioral and sexual factors leading to mortality and morbidity. According to the American College of Preventive Medicine (2017), more than 70% of the adolescent deaths are caused by homicide, motor vehicle crashes, and suicide.

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Additional common issues that are associated with adolescents include sexually transmitted disease, substance abuse, depression, pregnancy, and suicide, eating disorders, which negatively affect the quality of their lives. In the above case, the mother complains that her son’s grade is declining. This could be as a result of getting involved in some of the activities that does ruin adolescent behavior, including substance or alcohol abuse.

While conducting the annual examination of an adolescent, the first component entails addressing concerns and needs of parents and adolescent using open ended questions for purposes of clarifying issues. It is imperative to assess concerns that might be affecting the person in question like in this case why the son’s grade is declining. Other factors worth taking into consideration include reviewing charts and forms with the adolescent, assessing the level of interaction with the parents, unearthing needs, and working together with the family and adolescent to prioritize goals for visiting. In addition to the above, another vital step or component is performing comprehensive physical exam; the nurse takes the opportunity to ask the parent to leave the room for further assessment and employ this opportunity to ask for things that they are always afraid discussing with the mother, including substance and alcohol experimentation, or sex.

Based on the above, examination components that are deemed relevant during this stage include weight, height, and BMI status (percentile for gender and age), skin the status of blood (percentile for gender/age), Genitalia; structural abnormalities, sexual maturity, and the sexually transmitted disease. Additional components include Breast: gynecomastia (males) and sexual maturity (females). Therefore, annual exam for an adolescent should be based on the above documented components.

Is the Mother Required To Be Present During Your Exam
While performing a comprehensive physical exam, the mother may be requested to live the room. This is important because adolescent prefers privacy, particularly while discussing issues, such as substance experimentation and sexual life.

One health promotion idea that you would discuss with your middle adolescence patient and Why is this idea important?
One health promotion idea that the author would discuss with the middle adolescence patient is how to promote healthy and safe behaviors. This is because at this age, the youth is at a greater risk of attracting sexually transmitted diseases, including HIV/AIDS, and gonorrhea, placing their lives in danger.

What are some screening tools that might be of importance in this situation?
Undoubtedly, screening plays an incredible role in preventing the adolescents against contracting risks, such as substance abuse that they are vulnerable to. Some of the screening tools that could be used in this case include Alcohol Use Disorders Identification Test (AUDIT), Severity of Alcohol Dependence Questionnaire, and Drug Abuse Screening Test (DAST) (Goyal, Shea, Hayes, Badolato, Chamberlain, Zaoutis, & Fein, 2016). These tools are vital for testing for alcohol and drug abuse. These are some of the screening tools that could be used in this case.

    References
  • American College of Preventive Medicine. (2017). Adolescent wellness exam time tool. Retrieved from http://www.acpm.org/?adwellness_timetool.
  • Goyal, M. K., Shea, J. A., Hayes, K. L., Badolato, G., Chamberlain, J. M., Zaoutis, T., & Fein, J. (2016). Development of a Sexual Health Screening Tool for Adolescent Emergency Department Patients. Academic Emergency Medicine, 23(7), 809-815.
  • People, H. (2014). 2020: Adolescent Health Objectives.