PEDI | Teens

Based on the provided sources, the following is a summary focusing on the adolescent age group (11 to 20 years), covering their developmental milestones, vital signs, and immunization schedule.Adolescent Growth and DevelopmentAdolescence is defined as the transition from childhood to adulthood, spanning ages 11 to 20. This period is characterized by rapid physical, cognitive, and psychosocial changes.• Physiologic Changes: Puberty is driven by the hypothalamus releasing GnRH, stimulating the pituitary to release FSH and LH, which triggers gonadal response (estrogen in females, testosterone in males). Females generally enter puberty (ages 9–10) and reach physical maturity before males. A distinct growth spurt occurs, with females gaining 15–55 lbs and males gaining 15–65 lbs during this period. Organ systems mature, resulting in increased respiratory volume and blood volume, while the basal metabolic rate reaches adult levels.• Cognitive Development (Piaget): Adolescents enter the Formal Operations stage. Early adolescence involves limited abstract thought, while middle and late adolescence (14–20 years) see the development of abstract thinking, deductive reasoning, future planning, and the ability to think outside the present.• Psychosocial Development (Erikson): The primary task is Identity vs. Role Confusion. Adolescents strive to develop a sense of self and autonomy separate from parents. Peer groups become the essential source of support and identity validation, often leading to conflict with parents and a focus on conformity to peer norms.Vital Signs (Adolescents 13–18 Years)The expected physiological ranges for this age group approach adult values:• Temperature: Approximately 36.6° C (97.9° F) via oral, axillary, or tympanic routes.• Pulse Rate: 50 to 100 beats/minute.• Respirations: 16 to 20 breaths/minute.• Blood Pressure: Systolic less than 120 mmHg; Diastolic less than 80 mmHg.• Pain Assessment: The Numeric Scale (0–10) is the standard tool for self-reporting pain in children 5 years and older. The FACES scale (0–5 or 0–10) may also be used.Immunization Schedule (7–18 Years)The CDC recommends the following vaccines specifically for adolescents, assuming the childhood primary series was completed.Routine Vaccinations at 11–12 Years:• Tdap (Tetanus, diphtheria, and acellular pertussis): 1 dose is routinely administered at 11–12 years.• HPV (Human papillomavirus): Routinely recommended at 11–12 years (can start at age 9). If started before age 15, it is a 2-dose series (0, 6–12 months). If started at age 15 or older, it is a 3-dose series (0, 1–2, 6 months).• Meningococcal ACWY (MenACWY): 1st dose at 11–12 years, with a booster dose recommended at 16 years.Routine Annual Vaccination:• Influenza: 1 dose annually for all adolescents.Catch-up and Risk-Based Vaccinations:• Meningococcal Serogroup B (MenB): Recommended based on shared clinical decision-making for adolescents ages 16–23 (preferred 16–18 years), or for those at increased risk (e.g., asplenia).• Dengue: Recommended for ages 9–16 years living in endemic areas with laboratory confirmation of previous dengue infection.• Catch-up: Adolescents with incomplete histories should receive catch-up doses for Hepatitis B, Hepatitis A, Poliovirus (IPV), MMR, and Varicella.• COVID-19: Recommended per current schedule details