ADOLESCENTS:

COMMON HEALTH PROBLEMS

Common Health Problems in
Adolescence:
6.1 Scoliosis
6.2 Bone Tumor 6.6 Dysmenorrhea
6.3 Accidents 6.7 Obesity
(Trauma in Injury) 6.8 Anorexia Nervosa
6.4 STD & Bulimia Nervosa
6.5 Amenorrhea 6.9 Substance Abuse
6.10 Suicide
SCOLIOSIS
(Lateral Spinal Curve)
Lim, Michelle
DESCRIPTION
• Three-dimensional spinal deformity that usually
involves lateral curvature, spinal rotation resulting in rib
asymmetry, and hypokyphosis of the thorax
• Idiopathic scoliosis usually is diagnosed during the
preadolescent growth spurt
Assessment
• Adams test
• Hip height, rib positioning, and shoulder height are
asymmetrical, leg length discrepancy is also apparent
• Radiographs are obtained to confirm the diagnosis
Risk Factors
• Age
• Gender
• Genetics
Diagnosis
• Inclinometer (Scoliometer)
• Imaging scans- the pediatrician or orthopedic surgeon
will order an X-ray to evaluate for scoliosis, as well as
determining the shape, direction, location, and angle of
the curve.
Treatment
• Brace
• Surgery (Spinal fusion) - This spinal surgery permanently
fuses two or more adjacent vertebrae so that they grow together
at the spinal joint and form a solid bone that no longer moves.
Modern surgical approaches and instrumentation—rods,
screws, hooks, and/or wires placed in the spine—have enabled
spinal fusion surgeries to achieve better curvature correction
and faster recovery times than in the past.
Nursing Interventions
• Monitor progression of the curvature
• Prepare the child and parents for the use of a brace if prescribed
• Prepare the child and parents for surgery
• Promote comfort with proper fit of brace
• Provide opportunity for the child to express fears and ask
questions about deformity and brace wear.
Nursing Interventions
• Assess skin integrity under and around the brace frequently.
• Provide good skin care to prevent breakdown around any
pressure areas.
• Instruct the patient to examine brace daily for signs of
loosening or breakage.
• Instruct patient to wear cotton shirt under brace to avoid
rubbing.
BONE TUMORS
PAJAR, Mudzralyn T.
BONE TUMOR
• An abnormal growth of cells within a bone
• May be malignant (cancerous) or benign
(noncancerous)
• Malignant bone tumors can metastasize, while
benign tumors cannot
• Second most frequently occurring neoplasms
• Occur slightly earlier in girls than in boys
BONE TUMOR
• When a bone tumor is cancerous, it is either
a primary bone cancer or a secondary bone
cancer.
▫ Primary bone cancer begins in bone or cartilage
▫ Secondary bone cancer begins somewhere else in
the body and then metastasizes or spreads to bone.
• Types:
Osteochondroma (Benign)
Osteogenic Sarcoma (Malignant)
Ewing’s Tumor (Malignant)
 Osteogenic Sarcoma
• A malignant tumor of long
bone involving rapidly
growing bone tissue
• Most common site is the
epiphyses of a long bone
• More common in boys
than in girls
• Usually develops around
the hip, shoulder or knee
 Osteogenic Sarcoma
• Metastasis occurs early due to the extensive
vascular system in bones
• Metastasis to the lungs is the most common
sight
o Chronic cough
o Dyspnea
o Chest pain

• Other common sites are brain and other bone

tissue
 Ewing’s Sarcoma
• A malignant tumor in the bone
marrow of the diaphysis
(midshaft)of long bones.
• More common in boys than in girls
• Metastasis is usually present at the
time of diagnosis; the lungs and
bones are the most common sites
• Most common locations affected are
the upper and lower leg, pelvis,
upper arm, and ribs
Causes
• Cause of bone tumor is unknown
• Possible causes are:
▫ Genetics
▫ Radiation treatment
▫ Injuries to the bones
Signs & Symptoms
Bone pain
Bone fracture (Trauma)
Mass or swelling at the tumor site
Night sweats or fever
Possible Complications
• Pain
• Reduced function, depending on the
tumor
• Side effects of chemotherapy
• Spread of the cancer to other nearby
tissues (metastasis)
Diagnosis
• Medical History
• Physical Examination
• Blood and Urine Tests
▫ Alkaline phosphatase test
• X- Ray
• Biopsy
Treatment
• Non-surgical treatment
▫ Radiation therapy
▫ Chemotherapy
• Surgical treatment
▫ Limb salvage surgery
▫ Amputation
Nursing Management
• Pain Management
• Teach effective coping mechanism
• Provide adequate nutrition
• Provide comfort measures and therapeutic
activity
• Give local heating as indicated.
• Give strength in early bandage / replacement
in accordance with the indications, use aseptic
technique correctly.
Nursing Management
• Keep linen remains dry, free of wrinkles.
• Encourage the client to use loose cotton
clothing.
• Encourage the client to use stress
management, for example: guided
imagery, deep breathing.
• Assess the degree of immobilization produced.
• Identification signs or symptoms that require
medical evaluation, eg edema, erythema.
 ACCIDENTS
(TRAUMA IN INJURY)
DE LEON, ISIDORE
TRAUMATIC
BRAIN INJURY
TBI -- IN ADOLESCENTS
 TRAUMATIC BRAIN INJURY 
• Occurs when an external mechanical force causes
brain dysfunction.
•  Usually results from a violent blow or jolt to the
head or body. An object penetrating the skull, such
as a bullet or shattered piece of skull, also can
cause traumatic brain injury.
•  Mild traumatic brain injury may cause temporary
dysfunction of brain cells. More serious traumatic
brain injury can result in bruising, torn tissues,
bleeding and other physical damage to the brain
SYMPTOMS
 SYMPTOMS
MILD TRAUMATIC BRAIN INJURY
The signs and symptoms of mild traumatic brain injury may include: 
PHYSICAL SYMPTOMS
– Loss of consciousness for a few seconds to a few minutes
– No loss of consciousness, but a state of being dazed, confused or disoriented
– Headache
– Nausea or vomiting
– Fatigue or drowsiness
– Difficulty sleeping
– Sleeping more than usual
– Dizziness or loss of balance
SYMPTOMS
SENSORY SYMPTOMS
• Sensory problems, such as blurred vision, ringing in
the ears, a bad taste in the mouth or changes in the
ability to smell
• Sensitivity to light or sound

COGNITIVE OR MENTAL SYMPTOMS

• Memory or concentration problems
• Mood changes or mood swings
• Feeling depressed or anxious
 SYMPTOMS
MODERATE TO SEVERE TRAUMATIC BRAIN
INJURIES
PHYSICAL SYMPTOMS
– Loss of consciousness from several minutes to hours
– Persistent headache or headache that worsens
– Repeated vomiting or nausea
– Convulsions or seizures
– Dilation of one or both pupils of the eyes
– Clear fluids draining from the nose or ears
– Inability to awaken from sleep
– Weakness or numbness in fingers and toes
– Loss of coordination
 SYMPTOMS
 COGNITIVE OR MENTAL SYMPTOMS • Change in eating or nursing habits

– Profound confusion • Persistent crying and inability to be consoled

– Agitation, combativeness or other unusual behavior • Unusual or easy irritability

– Slurred speech • Change in ability to pay attention

– Coma and other disorders of consciousness • Change in sleep habits

• Sad or depressed mood
• Loss of interest in favorite toys or activities

 CHILDREN'S SYMPTOMS
CAUSES
 CAUSES
Injury may include one or more of the following
factors:
•  Damage to brain cells may be limited to the area directly below
the point of impact on the skull.
• A severe blow or jolt can cause multiple points of damage because
the brain may move back and forth in the skull.
• A severe rotational or spinning jolt can cause the tearing of cellular
structures.
• A blast, as from an explosive device, can cause widespread
damage.
• An object penetrating the skull can cause severe, irreparable
damage to brain cells, blood vessels and protective tissues around
CAUSES
COMMON EVENTS CAUSING TRAUMATIC BRAIN
INJURY INCLUDE THE FOLLOWING:
•  Falls / Falling - 35%
• Vehicle-related collisions -17%
• Violence – 10%
• Sports injuries- 21%
• Explosive blasts and other combat injuries -17%
RISK FACTORS
R I S K FA C T O R S

THE PEOPLE MOST AT

RISK OF TRAUMATIC
BRAIN INJURY
INCLUDE:
 Children, especially
newborns to 4-year-olds.

Young adults,
especially those
between ages 15
and 24
Adults age 75 and older
COMPLICATIONS
COMPLICATIONS
Several complications can occur immediately or soon
after a traumatic brain injury. Severe injuries increase
the risk of a greater number of complications and
more-severe complications.

ALTERED CONSCIOUSNESS
– Coma
– Vegetative state
– Minimally Conscious state
– Locked in syndrome
– Brain death
 COMPLICATIONS
SEIZURES
FLUID BUILDUP
INFECTIONS
BLOOD VESSEL DAMAGE
NERVE DAMAGE
– Paralysis of facial muscles
– Damage to the nerves responsible for eye movements, which can cause double
vision
– Damage to the nerves that provide sense of smell
– Loss of vision
– Loss of facial sensation
– Swallowing problems
 COMPLICATIONS
INTELLECTUAL
PROBLEMS
Cognitive problems Executive functioning
• Memory problems

• Learning • Problem-solving

• Reasoning • Multitasking

• Speed of mental processing • Organization

• Judgment • Decision-making

• Attention or concentration • Beginning or completing

tasks
COMPLICATIONS
 COMMUNICATION PROBLEMS may include:
Cognitive problems
• Difficulty understanding speech or writing
• Difficulty speaking or writing
• Inability to organize thoughts and ideas
• Trouble following conversations
Social problems
•  Trouble with turn taking or topic selection
• Problems with changes in tone, pitch or emphasis to express
emotions, attitudes or subtle differences in meaning
• Difficulty deciphering nonverbal signals
• Trouble reading cues from listeners
• Trouble starting or stopping conversations
• Inability to use the muscles needed to form words (dysarthria)
COMPLICATIONS
 BEHAVIORAL CHANGES  EMOTIONAL CHANGES
•  Difficulty with self-control •  Depression

• Lack of awareness of abilities • Anxiety

• Risky behavior • Mood swings
• Inaccurate self-image • Irritability
• Difficulty in social situations • Lack of empathy for others
• Verbal or physical outbursts • Anger
• Insomnia
• Changes in self-esteem
COMPLICATIONS
SENSORY PROBLEMS
•  Persistent ringing in the ears
• Difficulty recognizing objects
• Impaired hand-eye coordination
• Blind spots or double vision
• A bitter taste, a bad smell or difficulty smelling
• Skin tingling, pain or itching
• Trouble with balance or dizziness
COMPLICATIONS

DEGENERATIVE BRAIN DISEASES

•  Alzheimer's disease, which primarily causes the
progressive loss of memory and other thinking skills
• Parkinson's disease, a progressive condition that causes
movement problems, such as tremors, rigidity and slow
movements
• Dementia pugilistica — most often associated with
repetitive blows to the head in career boxing — which
causes symptoms of dementia and movement problems
TEST AND
DIAGNOSIS
TESTS AND DIAGNOSIS
Because traumatic brain injuries are usually
emergencies and because consequences can worsen
swiftly without treatment, doctors usually need to
assess the situation rapidly.
GLASGOW COMA SCALE
• This 15-point test helps a doctor or other emergency
medical personnel assess the initial severity of a brain
injury by checking a person's ability to follow
directions and move their eyes and limbs. The
coherence of speech also provides important clues.
• Abilities are scored numerically in the Glasgow Coma
 TESTS AND DIAGNOSIS
INFORMATION ABOUT THE INJURY AND
SYMPTOMS
Answers to the following questions may be beneficial in judging the
severity of injury:
• How did the injury occur?
• Did the person lose consciousness?
• How long was the person unconscious?
• Did you observe any other changes in alertness, speaking,
coordination or other signs of injury?
• Where was the head or other parts of the body struck?
• Can you provide any information about the force of the injury? For
example, what hit the person's head, how far did he or she fall, or
was the person thrown from a vehicle?
TESTS AND DIAGNOSIS

IMAGING TESTS
• Computerized tomography (CT) scan.
• Magnetic resonance imaging (MRI).

INTRACRANIAL PRESSURE MONITOR

•  Tissue swelling from a traumatic brain injury can
increase pressure inside the skull and cause additional
damage to the brain. Doctors may insert a probe
through the skull to monitor this pressure.
TREATMENTS
AND DRUGS
 TREATMENTS AND DRUGS
 MILD INJURY
• Mild traumatic brain injuries usually require no
treatment other than rest and over-the-counter
pain relievers to treat a headache. However, a
person with a mild traumatic brain injury usually
needs to be monitored closely at home for any
persistent, worsening or new symptoms. He or she
also may have follow-up doctor appointments.
 TREATMENTS AND DRUGS
IMMEDIATE EMERGENCY CARE
• Emergency care for moderate to severe traumatic brain
injuries focuses on making sure the person has an
adequate oxygen and blood supply, maintaining blood
pressure, and preventing any further injury to the head or
neck.
• People with severe injuries may also have other injuries
that need to be addressed. Additional treatments in the
emergency room or intensive care unit of a hospital will
focus on minimizing secondary damage due to
inflammation, bleeding or reduced oxygen supply to the
TREATMENTS AND DRUGS

MEDICATIONS
Medications to limit secondary damage to the
brain immediately after an injury may include:
• Diuretics.
• Anti-seizure drugs.
• Coma-inducing drugs.
TREATMENTS AND DRUGS
SURGERY
Emergency surgery may be needed to minimize
additional damage to brain tissues. Surgery may
be used to address the following problems:
• Removing clotted blood (hematomas).
• Repairing skull fractures.
• Opening a window in the skull.
 TREATMENTS AND DRUGS
 REHABILITATION
• Most people who have had a significant brain injury will
require rehabilitation. They may need to relearn basic
skills, such as walking or talking. The goal is to improve
their abilities to perform daily activities.

• Therapy usually begins in the hospital and continues at an

inpatient rehabilitation unit, a residential treatment facility
or through outpatient services. The type and duration of
rehabilitation varies by individual, depending on the
severity of the brain injury and what part of the brain was
 TREATMENTS AND DRUGS
REHABILITATION
• Neuropsychologist
SPECIALISTS MAY
• Social worker or case
INCLUDE: manager
• Physiatrist
• Rehabilitation nurse
• Occupational therapist
• Traumatic brain injury
• Physical therapist nurse specialist
• Speech and language • Recreational therapist
pathologist
• Vocational counselor
NURSING
MANAGEMENT /
INTERVENTION
NURSING MANAGEMENT FOR MILD TBI
• Provide analgesia as required according to pain scale.
• Patient receives hourly observations as per additional observations
above for 4 hours as a minimum
• If any deterioration in patient condition is detected then medical
officer must be immediately notified
• If the patient requires increasing amounts of analgesia to manage
their pain, notify the medical officer
• Patient must be discharged into the care of a responsible adult or
carer
• Provide patient / carer with head injury discharge information in
addition to discharge letter
• Document assessment findings, interventions and outcomes
NURSING MANAGEMENT FOR SEVERE TBI
• Preventing any further injury to the head or neck
• Provide analgesia as required according to pain scale.
• If the patient requires increasing amounts of analgesia to manage
their pain, notify the medical officer
• Routinely monitored hemodynamic parameters such as oxygen
saturation, blood pressure, and temperature..
• Monitoring intracranial pressure and cerebral perfusion pressure
approximately 50% of the time.
• Neurophysiologic interventions.
• Psychosocial interventions.
• Injury prevention interventions.
• And interventions to maintain a therapeutic milieu.
LIFESTYLE AND
HOME REMEDIES
LIFESTYLE AND HOME REMEDIES

Follow these tips to reduce the risk of brain

injury:
• Seat belts and airbags.
• Alcohol and drug use.
• Helmets.
Sexually Transmitted
Disease/Infection
(STD/STI)
GUMBAHALI,
JIMENO, Aileen
STD(STI)
• Sexually transmitted diseases (STDs) are infectious
diseases transmitted through sexual contact. 50% of
new STDs happen in people in the age range of 15 to 24
years.
Transmission
 In
order for transmission to occur, it is necessary to
have:
–A body fluid with the germ in it
–A way of spreading the germ from one person to another
Methods of Transmission
• Sexual Intercourse
• vaginal
• anal
• oral
• Blood-to-blood contact
• Sharing needles or other drug-use equipment
• Tattoo or body piercing
• Infected mother to her baby
Bacterial vs. Viral STI’s
• Bacterial STI’s include
Chlamydia, LGV, gonorrhea &
syphilis
• Can be treated and cured with
antibiotics
• Untreated infection can cause
PID, infertility, & epididymitis
• Viral STI’s include HPV, HIV,
Herpes, & Hepatitis B
• There is NO cure
• Medication available to treat
symptoms only
• Can pass onto others for the rest
of your life
CHLAMYDIA
• The most common bacterial STI
• Greatest number of infections found in people 15 to 24 years
old
• Untreated, it can affect the cervix and urethra, and occasionally
the rectum, throat and eye
• 50% have NO symptoms - men and women
• Can be treated with antibiotics
CHLAMYDIA
GONORRHEA
• The 2nd most common bacterial STI
• Most common in people aged 15 to 29
• Can affect the cervix, urethra, rectum, throat, and occasionally
the eyes
• Can be treated with antibiotics
• Often NO symptoms, especially in females
GONORRHEA: Signs & Symptoms
• Female • Male
• Increased vaginal • Thick, yellowish-
discharge green discharge from
• Painful urination penis
• Lower abdominal • Painful urination
pain • Testicular pain or
• Bleeding after sex swelling
and between periods • Rectal pain,
• Pain during sex discharge or itching
GONORRHEA
SYPHILIS
• A bacterial infection that progresses in stages
• Primary: (3 days – 3 months) starts as a small, painless sore called a
chancre; goes away on it’s own
• Secondary: (2 – 24 weeks) rash on the body, palms of hands & soles of
feet, hair loss, feeling sick
• Latent: lesions or rashes can recur
SYPHILIS - Complications
• Untreated syphilis may lead to tertiary syphilis, which can
damage:
• The cardiovascular system (heart & blood vessels)
• The neurological system
• Other major organs of the body
• Complications may lead to death
 Genital Herpes
(Herpes Simplex Virus - HSV)
• Two types: HSV-1, causing cold sores, and HSV-2,
causing genital herpes
• It is a viral infection causing outbreaks of painful
sores and blisters
• Spread through direct vaginal, oral or anal sexual
contact with an infected partner
• Also transmitted by receiving oral sex from a partner
with a history of cold sores
• Symptoms can be treated with antiviral medications,
but NO CURE
 Genital Herpes – Signs & Symptoms
• Prior to an outbreak, the person may feel a tingling or
burning sensation where the virus first entered the skin
• Painful sores (external or internal)
• Inflammation and redness
• Fever
• Muscular pain
• Tender lymph nodes
Genital Herpes
Hepatitis B (HBV)
• Virus that attacks the liver
• Most infected people (90%) naturally produce
antibodies to fight the disease, but some
develop chronic HBV and will carry the virus
for the rest of their life
• Chronic infection can lead to liver damage,
cirrhosis, and cancer
• There is NO CURE, but vaccination can
prevent infection
 Hepatitis B
Woman suffering from liver cancer
caused by HBV
Human Papilloma Virus or HPV
(Genital Warts)
• One of the most common STIs
• About 75% of people will have at least one
HPV infection during their lifetime
• There are over 100 types of HPV
• Low-risk HPV types cause genital warts
• High-risk HPV types may cause cancer of the
cervix
• There is NO CURE, but vaccination is
available to prevent certain types of HPV
HPV – Signs & Symptoms
• Many people with low-risk types have no
symptoms
• Other HPV types may cause:
• Warts on vulva, cervix, penis, scrotum, anus or
in the urethra
• Itchiness
• Discomfort and bleeding during sex
HIV/AIDS
• HIV is a virus that destroys the immune system over time,
robbing the body of its ability to fight other infections and
illnesses
• Once the immune system is weakened, other infections occur
and AIDS develops (the fatal stage of HIV infection)
• The virus is present in blood, semen, vaginal secretions &
breast milk
HIV / AIDS – Signs & Symptoms
• 2 to 4 weeks after exposure, some people experience mild flu-
like symptoms that last a few weeks, then disappear
• Many people have NO symptoms until years after exposure
• The only way to know is to get TESTED!
Pubic Lice & Scabies
• Infections caused by parasitic infestations
• Pubic lice: tiny crab-like insects that nest in
pubic hair & bite their host to feed on blood
• Scabies: mites that burrow below the surface
of the skin to lay their eggs
• Can live for 1 – 3 days on bedding, towels and
clothing
• Treated with medicated creams & lotions
Pubic Lice
Scabies mite
Other diseases that may be sexually transmitted include:
• Bacterial vaginosis
• Chancroid
• Cytomegalovirus infections
• Lymphogranuloma venereum
• Granuloma inguinale (donovanosis)
• Molluscum contagiosum
• Pubic lice
• Scabies
• Trichomoniasis
• Oral ulcers (oral sex can result in ulcers from
gonorrhea or herpes)
STI Prevention
• Abstain from sexual intercourse (only method
that is 100% effective)
• Don’t share needles or other drug-use
equipment
• Have only 1 mutually faithful, uninfected
sexual partner
• Get tested for STI’s before having sex
• Use a latex condom & spermicide
• Avoid alcohol & other drugs
When should I get tested?
• Once you become sexually active, you need a
check-up & STI testing once a year
• You also need an STI test if:
• You didn’t use a condom or the condom broke
• Your partner has an STI
• Your partner is having sex with someone else
• You have ever injected drugs
• You or your partner have any STI symptoms
• You have been raped
Where to go for help:
• Parents
• Health Teacher
• Health Unit Clinic
• Family Doctor or Nurse Practitioner
• Walk-in-clinic
• Hospital Emergency Department
Amenorrhea
Asmad, Adawiya
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Amenorrhea (Absence of Menstruation)

• Amenorrhea is the absence of menstruation. There are
two categories: primary amenorrhea and secondary
amenorrhea.

• These terms refer to the time when menstruation stops

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Primary Amenorrhea
• Occurs when a girl does not begin to menstruate.
• Girls who show no signs of sexual development (breast
development and pubic hair) by age 14 should be evaluated.
• Girls who do not have their periods by two years after sexual
development should also be checked.
• Any girl who does not have her period by age 16 should be
evaluated for primary amenorrhea.
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Secondary Amenorrhea
• Occurs when you’ve had at least one menstrual period and you
stop menstruating for six months or longer. Secondary
amenorrhea is different from primary amenorrhea, which
occurs if you haven’t had your first menstrual period by age 16.
• You must miss at least three to six menstrual periods to be
diagnosed with secondary amenorrhea.
• A variety of factors can contribute to this condition, including:
• Birth control use
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Secondary Amenorrhea
• Certain medications that treat cancer, psychosis, or schizophrenia
• hormone shots
• Missed menstrual periods are usually associated with pregnancy, breast-
feeding, or menopause. However, these conditions don’t cause
amenorrhea.
• Secondary amenorrhea usually isn’t harmful to your health. It can be
treated effectively in most cases. However, you must address the
underlying conditions that cause amenorrhea to prevent any
complications.
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Hormonal Imbalances
• A hormonal imbalance is the most common cause of secondary
amenorrhea. A hormonal imbalance can occur as a result of:
• Tumors on the pituitary gland
• Overactive thyroid gland
• Low estrogen levels
• High testosterone levels
• Testosterone is the primary sex hormone in men. However, it also plays a
role in the growth and development of reproductive tissues in women.
High testosterone levels in a woman can result in irregular or absent
menstrual periods.
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Hormonal Imbalances
• Hormonal birth control can also contribute to secondary
amenorrhea. Depo-Provera, a hormonal birth control shot, and
hormonal birth control pills may cause you to miss menstrual
periods. Certain medical treatments and medications, such as
chemotherapy and antipsychotic drugs, can also trigger
amenorrhea.
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Structural Issues
• Conditions such as polycystic ovary syndrome (PCOS) can cause
hormonal imbalances that lead to the growth of ovarian cysts. Ovarian
cysts are benign, or noncancerous, masses that develop in the ovaries.
The hormonal imbalances that result from PCOS can also cause
amenorrhea.
• Scar tissue that forms due to pelvic infections or multiple dilation and
curettage (D&C) procedures can also prevent menstruation. D&C
involves dilating the cervix and scraping the uterine lining with a spoon-
shaped instrument called a curette. This surgical procedure is often used
to remove excess tissue from the uterus or to diagnose and treat
abnormal uterine bleeding.
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Lifestyle Factors
• Body weight can potentially affect regular menstruation as
well. Women who are very overweight or who have less than
15 percent body fat may stop getting menstrual periods. This is
especially true for athletes who train extensively or excessively.
• Emotional stress is another possible cause of secondary
amenorrhea. Your body may respond to extreme stress by
temporarily disrupting your normal menstrual cycle. Your
menstrual periods will most likely resume once you work
through your tension and anxiety.
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Symptoms of Secondary Amenorrhea

The primary symptom of secondary amenorrhea is missing several
menstrual periods in a row. Women may also experience:
• acne
• vaginal dryness
• deepening of the voice
• excessive or unwanted hair growth on the body
• headaches
• changes in vision
• nipple discharge
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Treatment
• Treatment varies depending upon the causes of the
amenorrhea. Treatment options include:
• Dietary changes, including an increase in fat and calories in
order to stimulate estrogen production.
• Counseling for eating disorders.
• Using stress reduction techniques to help regulate the period.
• Hormonal supplements, like the birth control pill or patch, or
hormone replacement therapy.
• Surgery to remove cysts, fibroids or tumors
DYSMENORRHEA

ADAWIYA, Asmad
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DEFINITION
• Primary dysmenorrhea, which is defined as painful
menses in women with normal pelvic anatomy,
usually begins during adolescence. It is
characterized by crampy pelvic pain beginning
shortly before or at the onset of menses and lasting
one to three days.
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Pathogenesis
• Dysmenorrhea is thought to be caused by the release of
prostaglandins in the menstrual fluid, which causes
uterine contractions and pain.
• Vasopressin also may play a role by increasing uterine
contractility and causing ischemic pain as a result of
vasoconstriction.
▫ Elevated vasopressin levels have been reported in women
with primary dysmenorrhea.
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Risk Factors
• Age < 20 years
• Attempts to lose weight
• Depression/anxiety
• Disruption of social networks
• Heavy menses
• Nulliparity
• Smoking
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Diagnosis
• History and physical examination
▫ perform only an abdominal examination in young adolescents
with a typical history who have never been sexually active
• Always R/O secondary dysmenorrhea
▫ Pelvic mass, abnormal vaginal discharge…
• Ultrasonography
• laparoscopy or laparotomy with biopsy
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Nursing Interventions
1. Acute Pain related to increased uterine contractility,
hypersensitivity.
• Goal: pain reduced client

• Nursing Interventions:

1. Warm the abdomen.

• Rationale: may cause vasodilation and reduce the spasmodic
contractions of the uterus.
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Nursing Interventions
2. Massage the abdominal area that feels pain.
• Rationale: reduce pain due to the stimulus of therapeutic touch.

3. Perform light exercise

• Rational: it can improve blood flow to the uterus and muscle
tone.
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Nursing Interventions
4. Perform relaxation techniques.
• Rationale: reduce the pressure to get relaxed.

5. Give the natural diuresis (vitamin) sleep and rest.

• Rationale: reduce congestion.
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Conclusion
• NSAIDs are the initial therapy of choice in patients with
presumptive primary dysmenorrhea.Because all NSAIDs are
equal in efficacy, agent selection should be guided by cost,
convenience, and patient preference,with ibuprofen or
naproxen being a good choice for most patients.
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Prevention Methods
• Beneficial steps include:
• Making appropriate changes in diet and exercise activity to achieve a healthy weight.
Polycystic ovarian syndrome, for example, can often be managed by maintaining a
healthy weight. Women may wish to consult a registered dietician for assistance with
dietary changes. Women with eating disorders, such as anorexia nervosa, may need
to gain weight in order to restore normal menstruation.
• Avoiding recreational drug use, excessive alcohol consumption and cigarette
smoking.
• Striving for a healthy balance in work, recreation and rest.
• Assessing areas of stress or conflict in life. If necessary, contacting a mental health
professional (e.g., psychologist, psychiatrist) for help dealing with stress.
OBESITY
What is obesity?
• Obesity is that, you
have a high amount
of fat in your body
or refers to an
excess amount of
body fat.
 DIAGNOSIS
BMI (Body Mass Index) is the tool most commonly
used to estimate overweight and obesity in children's
and adults.
DIAGNOSIS
Waist Circumference

• Male- your waist

measurement is 94 cm (37
inches) or more
• Female- your waist
measurement is 80 cm
(31.1 inches) or more
Signs and Symptoms
• Clothes feeling tight and needing a larger size
• The scale showing you’ve gain weight
• Having extra fat around the waist
• A higher than normal body mass index and waist
circumference.
 Causes
1. Inactivity - without activity
2. Diets – bad eating habits
3. Pregnancy- increasing in their weight
4. Lack of sleep – disturbances in the body
hormones
5. Drugs – it can lead body to gain more weight
Complications
1. Type 2 diabetes
2. Heart disease
3. High blood pressure
4. Non alcoholic fatty liver
5. Osteoarthritis
6. Some types of cancer: breast, colon,
endometrial
7. Stroke
Medical Condition
1. Genetics – genes affects the amount of body fat we store and
where to store.
2. Family lifestyle- because of their life style and the food they
eat.
3. Age - could occur at any age
 Treatment
1. Eat colorful vegetables and fruits
2. Eat dark chocolates
3. Drink at least 4 liters of water everyday
4. Drink green tea
5. Regular exercise
6. Maintain a healthy BMI ratio
7. Avoid saturated and transfat
8. Weight loss surgery
9. Prescription drugs
Prevention
1. Eat healthy
2. Monitor your weight
3. More exercise
Nursing Management
1.Assist patient to identify a workable method of weight control
incorporating healthful foods.
2.Promote improved self-concept, including body image, self
esteem.
3.Encourage health practices to provide for weight control
throughout life.
ANOREXIA
NERVOSA
\ A N - O - R E K- S E E - U H /
P R E S E N TAT I O N N O. 6 . 8
WHAT IS
ANOREXIA
NERVOSA
E AT I N G D I S O R D E R
 WHAT IS ANOREXIA NERVOSA
• Often simply called anorexia – is an
eating disorder characterized by an
abnormally low body weight,
intense fear of gaining weight and
distorted perception of body
weight.
• People with anorexia placed a high
value on controlling their shape, using
SHORT
INTRODUCTION
TO ANOREXIA
INTRODUCTION
• To prevent weight gain or to continue
losing weight, people with anorexia usually
severely restrict the amount of food
they eat. They may control calorie intake by
vomiting after eating or by misusing
laxatives, diet aids, diuretics or enemas.
They may also try to lose weight by
exercising excessively.
INTRODUCTION
• More common in western societies and
people of higher socioeconomic
classes.

• More than 90 percent of cases are

diagnosed in females, but some
experts believe that many cases of
anorexia nervosa in males go unreported.
The disorder typically begins in the mid-
INTRODUCTION
• Anorexia isn’t really about food. Its an
unhealthy way to try to cope with
emotional problems. When you have
anorexia you often equate thinness with
self worth.
• Anorexia can be very difficult to
overcome. But with treatment, you can
gain a better sense of who you are,
SYMPTOMS
OF ANOREXIA
 SYMPTOMS
The physical signs and
symptoms of anorexia
nervosa are related to
starvation, but the
disorder also includes
emotional and
behavior issues related
to an unrealistic
perceptions of body
weight and an
extremely strong fear
PHYSICAL SYMPTOMS
Extreme weight loss
Thin appearance
Abnormal blood counts
Fatigue insomnia
Dizziness or fainting
Bluish discoloration of the
fingers
Hair that thins, break or
falls out
Soft or downy hair covering
Absence of menstruation
Constipation
Dry or yellowish skin
Intolerance of cold
Irregular heart rhythms
Low blood pressure
Dehydration
osteoporosis
PHYSICAL SYMPTOMS
 EMOTIONAL AND BEHAVIORAL
SYMPTOMS
• Severely restricting food intake through
dieting or fasting and may include
excessive exercise
• Bingeing and self induced vomiting to
get rid of the food and may include use
of laxatives, enemas, diet aids or herbal
products
 OTHER EMOTIONAL AND BEHAVIORAL
SYMPTOMS
Preoccupation with food Flat mood (lack of
Refusal to eat emotion)
Denial of hunger Social withdrawal
Fear of gaining weight Irritability
Lying about how much Reduced interest in sex
food has been eaten Depressed mood
Thoughts of suicide
WHAT CAUSES
ANOREXIA?
CAUSES

The exact cause of anorexia nervosa is

unknown. As with many diseases, it’s
probably a combination of:
Biological Factors
Psychological Factors
Environmental Factors
RISK FACTORS
INCREASING RISK OF DEVELOPING
ANOREXIA NERVOSA
RISK FACTORS

∞Being female ∞Weight changes

∞Young age ∞Transitions
∞Genetics ∞Sports, work and
∞Family history athletic activities
∞Media and
society
COMPLICATIONS
COMPLICATIONS

Anorexia nervosa can have numerous

complications. At its most severe, it can
be fatal. Death may occur suddenly —
even when someone is not severely
underweight. This may result from
abnormal heart rhythms (arrhythmias) or
an imbalance of electrolytes — minerals
such as sodium, potassium and calcium
OTHER COMPLICATIONS OF ANOREXIA INCLUDE:

• Anemia • Gastrointestinal problems,

• Heart problems, such as such as constipation,
mitral valve prolapse, bloating or nausea
abnormal heart rhythms or • Electrolyte abnormalities,
heart failure such as low blood
• Bone loss, increasing risk of potassium, sodium and
fractures later in life chloride
• In females, absence of a • Kidney problems
period • Suicide
• In males, decreased
OTHER COMPLICATIONS OF ANOREXIA
• In addition to the host of physical
complications, people with anorexia also
commonly have other mental disorders
as well. They may include:
–Depression, anxiety and other mood
disorders
–Personality disorders
–Obsessive-compulsive disorders
TESTS AND
DIAGNOSIS
TESTS AND DIAGNOSIS

Physical exam
Lab tests
Psychological evaluation
Other studies
DIAGNOSTIC CRITERIA FOR ANOREXIA

To be diagnosed with anorexia nervosa, the

Diagnostic and Statistical Manual of Mental
Disorders (DSM-5) must be met, published
by the American Psychiatric Association.
This manual is used by mental health
providers to diagnose mental conditions
and by insurance companies to reimburse
for treatment.
 DIAGNOSTIC CRITERIA FOR ANOREXIA
DSM-5 diagnostic criteria for anorexia include:
• Restricting food intake — eating less than needed
to maintain a body weight that's at or above the
minimum normal weight for your age and height
• Fear of gaining weight — intense fear of gaining
weight or becoming fat, or persistent behavior that
interferes with weight gain, such as vomiting or using
laxatives, even though you're underweight
• Problems with body image — denying the
seriousness of having a low body weight, connecting
your weight to your self-worth, or having a distorted
DIAGNOSTIC CRITERIA FOR ANOREXIA
• BMI (body mass index) is used by the
DSM-5 as an indicator of anorexia
nervosa.
• Mild: BMI of 17-17.99
• Moderate: BMI of 16-16.99
• Extreme: BMI of <15
TREATMENTS
AND DRUGS
TREATMENTS AND DRUGS

• When you have anorexia nervosa, you

may need several types of treatment.
Treatment is generally done using a team
approach that includes medical providers,
mental health providers and dietitians, all
with experience in eating disorders.
Ongoing therapy and nutrition education
are highly important to continued
TREATMENTS AND DRUGS
• Hospitalization and other programs
•  Medical care
• Restoring a healthy weight 
• Psychotherapy
Family based therapy
•  

• Individual therapy
• Medications
NURSING
MANAGEMENT /
INTERVENTION
 NURSING INTERVENTIONS:
• Cognitive and Behavioral therapy to positive and negative reinforcement
• Increase self-esteem by acceptance and non-judgmental approach
• Teach about the disorder
• Monitor weight three times a week but weigh with the patient facing
away from the weighing scale to help them reduce their focus on weight.
Make sure the patient is not hiding heavy objects under her clothing.
• As soon as the ideal weight is gained, allow patient to regulate his or her
own progression and program.
• High protein and high carbohydrate diet, serve foods the patient prefer
in small frequent feedings. NGT if the patient refuses to eat.
 NURSING INTERVENTIONS:
• Setting limits to avoid manipulative behavior:
– Restrict use of bathroom for 2 hour after eating.
– Accompany to the bathroom to ensure that they will not self induce vomiting.
– Stay with client during meals.
– Do not accept excuses to leave eating area.
• Help the patient identify and express feelings. Avoid being judgmental
• Help the patient to identify and express other bodily concerns such as hairstyle,
clothing. Typically anorectic patients have little bodily awareness other than a
distorted perception of their size.
• Identify the patients non-weight related interests.
• Avoid being confrontational and engaging in long discussions or explanations
about food or body.
• Ignore manipulative behaviors.
• Refer to self-help groups.
LIFESTYLE AND
HOME REMEDIES
 LIFESTYLE AND HOME REMEDIES
•  There's no guaranteed way to prevent
anorexia nervosa. Primary care physicians may
be in a good position to identify early indicators of
anorexia and prevent the development of full-blown
illness.
• If you notice that a family member or friend has low
self-esteem, severe dieting habits and
dissatisfaction with appearance, consider talking to
him or her about these issues. Although you may
not be able to prevent an eating disorder from
ALTERNATIVE
MEDICINE
 ALTERNATIVE MEDICINE
• Alternative medicine is the use of a
nonconventional approach instead of
conventional medicine. Complementary
medicine is a nonconventional approach used
along with conventional medicine.
•  Alternative medicine hasn't been well-studied
as a treatment for people with eating
disorders, but complementary treatments may
help reduce anxiety. Such treatments may
ALTERNATIVE MEDICINE

Examples of anxiety-reducing
complementary treatments include: 
Acupuncture
Massage
Yoga
Meditation
COPING AND
SUPPORT
COPING AND SUPPORT
•  Whether you have anorexia
or your loved one has
anorexia, ask your doctor or
therapist for advice on
coping strategies and
emotional support. Learning
effective coping strategies
and getting the support you
BULIMIA
NERVOSA
( BY U - L E E - M E - U H )
DEFINITION
 DEFINITION
• Bulimia nervosa, commonly called bulimia,
is a serious, potentially life-threatening
eating disorder. People with bulimia may
secretly binge — eating large amounts of
food — and then purge, trying to get rid of
the extra calories in an unhealthy way. For
example, someone with bulimia may force
vomiting or engage in excessive exercise.
Sometimes people purge after eating only a
TWO
CATEGORIES OF
BULIMIA
 TWO CATEGORIES

Bulimia can be categorized in two

ways:
• Purging bulimia. You regularly self-induce
vomiting or misuse laxatives, diuretics or
enemas after bingeing.
• Non-purging bulimia. You use other
methods to rid yourself of calories and
PURGING
BULIMIA.

You regularly self-

induce vomiting or
misuse laxatives,
diuretics or
enemas after
bingeing.
SYMPTOMS
 SYMPTOMS
Bulimia signs and symptoms may include:
• Being preoccupied with your body shape and weight
• Living in fear of gaining weight
• Feeling that you can't control your eating behavior
• Eating until the point of discomfort or pain
• Eating much more food in a binge episode than in a normal meal or
snack
• Forcing self to vomit or exercise too much to keep from gaining
weight after bingeing
• Misusing laxatives, diuretics or enemas after eating
• Restricting calories or avoiding certain foods between binges
• Using dietary supplements or herbal products excessively for
weight loss
CAUSES
 CAUSES
The exact cause of bulimia is unknown.
There are many factors that could play a
role in the development of eating
disorders, including;
biology
emotional health
societal expectations
RISK FACTORS
RISK FACTORS
Factors that increase your risk of
bulimia may include:
 Being female.
 Age.
 Biology.
 Psychological and emotional issues
 Media and societal pressure.
 Sports, work or artistic pressures.
COMPLICATIONS
 COMPLICATIONS
Bulimia may cause numerous serious and even life-
threatening complications. Possible complications
include:
• Dehydration, which can lead to major medical problems, such as
kidney failure
• Heart problems, such as an irregular heartbeat or heart failure
• Severe tooth decay and gum disease
• Absent or irregular periods in females
• Digestive problems, and possibly a dependence on laxatives to
have bowel movements
• Anxiety and depression
TESTS AND
DIAGNOSIS
 TESTS AND DIAGNOSIS
If your doctor suspects you have bulimia, he or she will
typically perform:
• A complete physical exam
• Blood and urine tests
• A psychological evaluation, including a discussion of
your eating habits and attitude toward food
Your doctor may also request additional tests to help
pinpoint a diagnosis, rule out medical causes for weight
changes and check for any related complications.
 CRITERIA FOR DIAGNOSIS
For a diagnosis of bulimia, the Diagnostic and Statistical Manual of
Mental Disorders (DSM-5), published by the American Psychiatric
Association, lists these points:
You recurrently have episodes of eating an abnormally large amount of food ?
more than most people would eat in a similar amount of time and under
similar circumstances, for example, in a two-hour time period
You feel a lack of control during bingeing, such as how much you're eating
and whether you can stop eating
You get rid of the extra calories from bingeing to avoid weight gain by
vomiting, excessive exercise, fasting, or misuse of laxatives, diuretics or
other medications
You binge and purge at least once a week for at least three months
Your body shape and weight influence your feelings of self-worth too much
DIAGNOSTIC CRITERIA FOR BULIMIA
• BMI (body mass index) is used by the
DSM-5 as an indicator of bulimia nervosa.
• Mild: BMI of 17-17.99
• Moderate: BMI of 16-16.99
• Extreme: BMI of <15
NURSING
MANAGEMENT /
INTERVENTION
 NURSING INTERVENTIONS:
• Cognitive and Behavioral therapy to positive and negative reinforcement
• Increase self-esteem by acceptance and non-judgmental approach
• Teach about the disorder
• Monitor weight three times a week but weigh with the patient facing
away from the weighing scale to help them reduce their focus on weight.
Make sure the patient is not hiding heavy objects under her clothing.
• As soon as the ideal weight is gained, allow patient to regulate his or her
own progression and program.
• High protein and high carbohydrate diet, serve foods the patient prefer
in small frequent feedings. NGT if the patient refuses to eat.
 NURSING INTERVENTIONS:
• Setting limits to avoid manipulative behavior:
– Restrict use of bathroom for 2 hour after eating.
– Accompany to the bathroom to ensure that they will not self induce vomiting.
– Stay with client during meals.
– Do not accept excuses to leave eating area.
• Help the patient identify and express feelings. Avoid being judgmental
• Help the patient to identify and express other bodily concerns such as hairstyle,
clothing. Typically bulimic patients have little bodily awareness other than a
distorted perception of their size.
• Identify the patients non-weight related interests.
• Avoid being confrontational and engaging in long discussions or explanations
about food or body.
• Ignore manipulative behaviors.
• Refer to self-help groups.
TREATMENTS
AND DRUGS
 TREATMENTS AND DRUGS
Here's a look at bulimia treatment options and
considerations.
Psychotherapy
– Cognitive behavioral therapy
– Family-based
– Interpersonal psychotherapy
Medications
Nutrition education and healthy weight
Hospitalization
LIFESTYLE AND
HOME REMEDIES
 LIFESTYLE AND HOME REMEDIES
Although there's no sure way to prevent bulimia, you can
steer someone toward healthier behavior or professional
treatment before the situation worsens. Here's how you can
help:
Foster and reinforce a healthy body image to anyone, no
matter what their size or shape.
Talk with your pediatrician. Pediatricians may be in a good
position to identify early indicators of an eating disorder and
help prevent its development.
If you notice a relative or friend who seems to have food
issues that could lead to or indicate an eating disorder,
consider supportively talking to the person about these
ALTERNATIVE
MEDICINE
ALTERNATIVE MEDICINE

• Dietary supplements and herbal products

designed to suppress the appetite or aid in
weight loss may be abused by people with
eating disorders. Weight-loss supplements or
herbs can have serious side effects and
dangerously interact with other medications.
COPING AND
SUPPORT
 COPING AND SUPPORT
Remind yourself what a healthy weight is for your body.
Resist the urge to diet or skip meals, which can trigger binge
eating.
Don't visit websites that advocate or glorify eating disorders.
Identify troublesome situations that are likely to trigger thoughts
or behaviors that may contribute to your bulimia and develop a
plan to deal with them.
Have a plan in place to cope with the emotional distress of
setbacks.
Look for positive role models who can help boost your self-
esteem.
Find pleasurable activities and hobbies that can help distract you
 COPING AND SUPPORT
Remind yourself what a healthy weight is for your body.
Resist the urge to diet or skip meals, which can trigger binge
eating.
Don't visit websites that advocate or glorify eating disorders.
Identify troublesome situations that are likely to trigger thoughts
or behaviors that may contribute to your bulimia and develop a
plan to deal with them.
Have a plan in place to cope with the emotional distress of
setbacks.
Look for positive role models who can help boost your self-
esteem.
Find pleasurable activities and hobbies that can help distract you
SIMILARITIES &
DIFFERENCES
BETWEEN ANOREXIA
AND BULIMIA
 SIMILARITIES & DIFFERENCES
BETWEEN ANOREXIA AND BULIMIA
AN O R E X I A
• Eating disorder characterized by
immoderate food restriction, inappropriate
eating habits, obsession with thin figure
and fear of gaining weight.
• Typically involve massive weight loss.
• Anorexic tend to have a distorted body
image perception.
• They feel the hunger but deny it. Extreme
cases of self-starvation are known.
• Sufferers may commonly engage
themselves is self-harm behaviors in order
to override their feelings for hunger.
B UL I M I A
• Disease of hunger affecting the nervous
system. “ravenous hunger”
• Eating disorder characterized by binge
eating and purging.
• Bulimics tend to eat lots of food followed
by an attempt to rid the consumed food
(purging). Typically by vomiting, taking
laxative, diuretic or excessive exercise.
• Less life threatening than anorexia but
has higher occurrence.
• Bulimics usually have dental erosion.
SUBSTANCE ABUSE
PAJAR, Mudzralyn T.
BENSALI, Maegan
Substance Abuse
• Use of chemicals to improve a mental state or
induce euphoria
• Drug use occurs:
▫ From desire to expand consciousness
▫ To feel more confident and mature
▫ Response to peer pressure
▫ Form of adolescent rebellion
Risk Factors
• Family history of addiction
• Abuse, neglect, or other traumatic experiences
• Mental disorders such as depression and anxiety
• Early use of drugs
• Method of administration—smoking or injecting a drug may increase its
addictive potential 
Types of Abused Substances
Specific Drugs:
 Prescription and OTC Drugs
 Performance-Enhancing Drugs
 Marijuana
 Amphetamines
 Cocaine
 Opiates
 Tobacco
 Alcohol
 Specific Drugs
1. Amphetamines / Metamphetamines
2. Marijuana
3. Cocaine
4. Prescription and OTC Drugs
5. Performance Enhancing Drugs
6. Opiates
1. Amphetamines / Metamphetamines
• Shabu
• Used in the treatment of
hyperactivity and narcolepsy,
among other central nervous system
disorders.
• Readily available to adolescents.
• “Uppers” or “Speed” because they
give the user a false sense of well-
being, alertness, or self-esteem.
1. Amphetamines / Metamphetamines
• Physical and psychological effectImpaired verbal learning
▫ Experience of pleasure and motor function.
▫ Extreme weight loss
▫ Severe dental problems (“meth mouth”)
▫ Anxiety
▫ Confusion
▫ Insomnia
▫ Mood disturbances
▫ Violent behavior
2. Marijuana
• Widely known as pot or grass
• Derived from the leaves and stems
of the Indian hemp plant Cannabis
sativa
• Most common illicit substance,
next to alcohol, used by
adolescents.
• Impairs a person's ability to form
new memories and to shift focus.
2. Marijuana
• Physical and psychological effects:
▫ Euphoria
▫ A sense of well-being
▫ Temporary impairment of coordination or motor activities
▫ Altered sensory perceptions
▫ Rapid mood swings
▫ Altered self-image
▫ Decreased attention span
▫ Loss of memory for recent events
3. Cocaine
• “Snow” and “White lady”
• The drug may be sniffed into the
nose (snorted), smoked, or injected
intravenously
• Physical: Increased vital signs and
decreased appetite.
• Psychological: euphoria, excitement
and restlessness, increased
sociability, and possible
hallucinations.
4. Prescription and OTC Drugs
• Excessive Intake of sedatives,
pain medication, or cough
syrup containing
dextromethorphan (DXM)
• A small amount of DXM
causes lightheadedness.
• In larger doses, it can resort to
“Pharming”:
▫ distortions of color and sound
▫ visual hallucinations
5. Performance-Enhancing Drugs
• Anabolic steroids are derivatives
of the natural hormone
testosterone
• Common names are stanozolol,
an oral compound, and
testosterone propionate, an
injectable form.
• Adolescents take steroid to
enhance lean body mass and
muscular development
6. Opiates
• A drug containing opium or its
derivatives, used in medicine
for inducing sleep and relieving
pain.
• Drugs such as heroin,
meperidine and morphine
• Opiates can be extremely
dangerous because of their
tendency to decrease respiratory
rate.
 Specific Drugs
How drug abuse and addiction develop…
1. Drug abuse may start as a way to socially connect.
2. Problems can sometimes sneak up, as drug use gradually
increases over time.
3. If the drug fulfills a valuable need, increase reliance occurs.
4. As drug abuse takes hold, performance may progressively
deteriorate, and start to neglect social or family
responsibilities.
5. Eventually, drug abuse can consume life, stopping social and
intellectual development.
 Specific Drugs
• Physical warning signs of drug abuse
▫ Bloodshot eyes, pupils larger or smaller
than usual
▫ Changes in appetite or sleep patterns
▫ Sudden weight loss or weight gain
▫ Deterioration of physical appearance,
personal grooming habits
▫ Unusual smells on breath, body, or
clothing
▫ Tremors, slurred speech, or impaired
coordination
 Specific Drugs
• Behavioral signs of drug abuse
▫ Drop in attendance and performance at work or school
▫ Unexplained need for money or financial problems;
may borrow or steal to get it
▫ Engaging in secretive or suspicious behaviors
▫ Sudden change in friends, favorite hangouts, and hobbies
▫ Frequently getting into trouble (fights, accidents, illegal
activities)
 Specific Drugs
• Psychological signs of drug abuse
▫ Unexplained change in personality or attitude
▫ Sudden mood swings, irritability, or angry outbursts
▫ Periods of unusual hyperactivity, agitation, or giddiness
▫ Lack of motivation; appears lethargic or "spaced out"
▫ Appears fearful, anxious, or paranoid, with no reason
 FIVE MYTHS OF DRUG ADDICTION
1. Overcoming addiction is simply a matter of willpower. You
can stop using drugs if you really want.
2. Addiction is a disease; there’s nothing that can be done about
it.
3. Addicts have to hit rock bottom before they can get better.
4. You can’t force someone into treatment; they have to want
help.
5. Treatment didn’t work before, so there’s no point trying
again.
 Specific Drugs
• Diagnosis
▫ Diagnosing drug addiction requires a thorough
evaluation and often includes an assessment by a
psychiatrist, a psychologist, or a licensed alcohol and
drug counselor.
▫ Blood, urine or other lab tests are used to assess drug
use, but they're not a diagnostic test for addiction.
Treatment
• Rehabilitation
• Successful treatment has several steps:
▫ Detoxification
▫ Behavioral counseling
▫ Medication
▫ Evaluation and treatment for co-occurring mental health issues
such as depression and anxiety
▫ Long-term follow-up to prevent relapse
Nursing Management
• Meet basic needs like safety, hygiene, comfort, calm and quiet
environment of the patients
• Administer substitution therapy as ordered
• Help the patient understand & identify the causes of drug
dependence abuse and the need of life changes
• Develop trust and correct misconceptions,
• Do not allow blaming others, identify the maladaptive
behaviors for ineffective denial.
Nursing Management
• Maintenance of strict self discipline by ongoing supervision
• Set limits on manipulative behavior, explore options of
dealing with stress and to give positive reinforcement for
ineffective coping
• Restrict access to addicting substances
• Teach about skills like relapse prevention, supportive skills
and developmental sessions
• Advice on health hazards of injecting
• Encourage the patient to focus on the present and future, not
the past.
Nursing Management
• Encourage the patient to focus on the present and future, not
the past.
• Behaving to patients in a consistent manner confronting them
in a non-judgmental and non-punitive manner
• Random check of patients and his belongings
• Monitoring the signs and symptoms of intoxication
• Violation of rules must be handled by all the treating members
• Instruct the need for regular follow up and continue
medications
 Tobacco
• Adolescents usually begin smoking
because the habit conveys a stamp
of maturity
• More males than females smoked
• Adolescent girls are most likely to
begin smoking
• Tobacco contains a chemical called
nicotine.
• Tobacco also contains more than
19 known chemicals that can cause
cancer.
 Tobacco
• Compared to a nonsmoker, a smoker faces these risks:
▫ Fourteen times greater risk of dying from cancer of the
lung, throat, or mouth
▫ Four times greater risk of dying from cancer of the
esophagus
▫ Two times greater risk of dying from a heart attack
▫ Two times greater risk of dying from cancer of the bladder
 Tobacco
• Signs and symptoms:
▫ Nicotine-stained fingers and teeth
▫ Characteristic smell of smoke impregnated clothing and
household items
▫ Chronic “smokers cough”
▫  Gravelly voice
▫ Visible pack of cigarettes and lighter in a person’s pocket.
 Tobacco
• Nicotine use can have many different effects on the body:
▫ Decreases the appetite
▫ Boosts mood and may even relieve minor depression
▫ Increases activity of intestines
▫ Creates more saliva and phlegm.
▫ Increases heart rate
▫ Increases blood pressure
▫ May cause sweating, nausea, and diarrhea
▫ Stimulates memory and alertness
 Tobacco
• Treatment:
▫ Support from family members, friends, and coworkers
▫ Help adolescents find other methods to demonstrate their
maturity
▫ Smoking cessation program
▫ Nicotine replacement therapy
▫ Health care provider can prescribe medicines
 Alcohol
• Usage of alcohol is on the rise
• Underage drinking is a widespread public health concern that
poses far greater risks than any potential benefits
• Addiction to alcohol is a complex interplay of genetic,
environmental and physical risk factors working together to
create addiction
 Alcohol
• Genetic: Addictions to alcohol is known to have a familial component.
Teens born into families are four times more likely to develop an
addiction themselves than peers without similar history
• Physical: With chronic, repeated use, alcohol use change the structure
and function of the still-developing brains of adolescents which may
result in addiction to alcohol
• Environmental: Peer pressure and teens under intense amounts of
personal stress
 Alcohol
• Risk factors:
▫ Racial groups
▫ Presence of mental health disorders
▫ Being male
▫ Family influence
▫ Peer influence
 Alcohol
• Behavioral symptoms:
▫ Drastic changes in academic performance
▫ Changing groups of friends
▫ Loss of interest in previously-enjoyed activities
▫ Decreased personal hygiene
▫ Marked behavioral changes
▫ Sudden, inexplicable need for money
 Alcohol
• Behavioral symptoms:
▫ Increased interpersonal struggles
▫ Unusually passive or argumentative behaviors
▫ Increased legal problems
▫ Alcohol use in spite of consequences
▫ Neglecting responsibilities at school, work, or home
 Alcohol
• Physical Symptoms
▫ Smell of alcohol on breath or clothes
▫ Glazed, bloodshot eyes
▫ Flushed, reddened skin
▫ Slurred, garbled speech
▫ Appearing intoxicated
▫ Changes in sleep pattern
▫ Notable deterioration in physical appearance
▫ Coordination problems
▫ Double vision
 Alcohol
• Cognitive Symptoms
▫ Difficulty concentrating
▫ Short-term memory deficits
▫ Difficulty paying attention during class
• Psychosocial Symptoms
▫ Depression
▫ Mood swings
▫ Anxiety
▫ Using alcohol to numb extreme emotion
 Alcohol
• Long-term consequences and effects:
▫ Decreased ability to pay attention, leading to poorer academic
performances
▫ Teens who have been through alcohol withdrawal may have
long-lasting difficulties with memory
▫ Teens often combine alcohol with other drugs, often
marijuana, which can be especially dangerous
▫ Drinking in extreme amounts can lead to the usage of hard
drugs like cocaine or heroin
 Alcohol
• Long-term consequences and effects:
▫ Males who drink during the teen years tend to complete less
years of education
▫ The younger the age a person begins drinking, the more
prone they are to developing an addiction to alcohol or other
drugs later in life
▫ Extreme alcohol use can mask mental disorders such as
anxiety and depression
 Alcohol
• Long-term consequences and effects:
▫ Teens who drink are more likely to engage in risky sexual
activity, such as unprotected sex, sex with a stranger, or be
the victim or perpetrator of sexual assault
▫ Alcohol is involved in nearly half of all violent deaths
involving teens
▫ Alcohol intoxication is associated with suicide attempts and
completions using more lethal means
 Alcohol
• Alcohol use disorders rarely occur without a mental disorder.
The most common co-occurring disorders with alcoholism
include:
▫ Depressive disorders
▫ Anxiety disorders
▫ Other substance use
▫ Bipolar disorder
▫ Schizophrenia
SUICIDE
 Suicide
 Suicide, the taking of one’s own life by making a judgment
about whether life is or is not worth living.

• WHO- globally over 800,000 people die by suicide every

year a rate of 1 death every 40 seconds and there are more
deaths from suicide than from war and homicide combined.

• The suicide rate is close to four times higher

among men than among women
Types of Suicide:
 Complete suicide- self administered action resulting in
death.

 Suicide attempt- self administered act with intent of death

but did not result in death

 Parasuicide/ Suicide Gesture- act of self harm but lacked

the lethality to cause death
Types of Suicide:
 Unintentional Suicide- self administered action without the
intent of death but result in death

 Suicide Ideation- thoughts of ending own life

 Euthanasia-the Greek, meaning a “good death”; the

intentional causing of a death to relieve pain or suffering, a
mercy killing
Causes
The exact cause of suicide is unknown

• Depression
• Anxiety disorder
• Bipolar disorder
• Schizophrenia
• Personality disorder
• Substance abuse disorder
• Posttraumatic stress disorder (PTSD)
Causes
• Bullying and peer pressure
• Death of love one
• Victim of sexual abuse
• Drug and alcohol use
• Parental divorce
• Parental emotional neglect
• Pressures at school to excel and choose a career path
Signs and Symptoms
• Withdrawal from family and peers
• Loss of interest in previously pleasurable activities
• Difficulty concentrating on schoolwork
• A feeling of hopelessness
• Low self-esteem
• Changes in appetite
Signs and Symptoms
• Obvious changes in personality
• Changes in eating patterns
• Changes in sleep patterns
• General lethargy or lack of energy
• Violent actions, rebellion, or running away
• Symptoms that are often related to emotional state
(e.g., headaches, fatigue, stomach aches)
Test and Diagnosis

• Physical Exam
• Assessments:
(mental health condition)
Treatment
• Psychotherapy- also called psychological counseling or talk
therapy.
• Medications-Antidepressants, antipsychotic medications, anti-
anxiety medications and other medications for mental illness can
help reduce symptoms, which can help you feel less suicidal.
• Family support and education- Your loved ones can be both a
source of support and conflict. Involving them in treatment can
help them understand what you're going through, give them
better coping skills, and improve family communication and
relationships.
Nursing Interventions
• The individual must not be left alone
• Anything that the patient may use to hurt or kill himself or
herself must be removed
• The suicidal patient should be treated initially in a secure,
safe, and highly supervised
 THANK YOU
&
GOD BLESS US ALL!
 BSN IID - Group 6
Members: Topic Assigned:
• LIM, Michelle Scoliosis
• PAJAR, Mudzralyn T. Bone Tumor & Substance Abuse
• DE LEON, Isidore Traumatic Brain Injury
• GUMBAHALI,STD/STI
• JIMENO, Aileen STD/STI
• ASMAD, AdawiyaAmenorrhea & Dysmenorrhea
• QUE, Clarizza Obesity
• JAMIL, Khadija Anorexia Nervosa & Bulimia
• BENSALI, Maeghan Suicide & Substance Abuse