Growth and Development Visual report: Elizabeth Dellamary By: Eugenia Dellamary
About Elizabeth and family
Introduction. Elizabeth is a 16 year old Mexican female and a sophomore in high school. She was born in Escondido, CA, and has lived in San Marcos all of her life. Elizabeth loves to study hard in school and is a perfectionist. She is the co-captain of the varsity dance team and has loved to dance since she was three years old. Elizabeth is well groomed, has long hair, clear skin, a lean figure, and is very pleasant to interact with. She smiles a lot and is a very happy girl. She has already gone through puberty.
Family life. Elizabeth’s parents are Luis and Gaby Dellamary. Elizabeth is the youngest child and has an older sister Eugenia and older brother Eddie. Both of Elizabeth’s parents and her older sister were born in Mexico. Her parents both work full-time jobs. Her parents speak both Spanish and English equally in the home, however, Elizabeth speaks English although she can understand and speak Spanish.
Nuclear family structure. Her parents have an authoritative parenting styles. They are strict in setting rules and limits but are still flexible and not overbearing (Perry, Hockenberry, Lowdermilk, & Wilson, 2014).
Extended family. She has some extended family that lives nearby but most of her extended family including both her maternal and paternal grandparents reside in Mexico.
Elizabeth has lived in her family’s home since they moved there when she was 6 years old. She has a cat named Lucy.
Social. Elizabeth has childhood friends that she has made from school and from dance classes. Her family is very busy but they spend time together and take vacations and spend weekends together when they can. The family makes trips to Mexico every so often to visit family. Elizabeth goes to public school, takes dance classes at a dance studio, and also has dance practice for her school’s dance team. Apart from that, she also likes to volunteer at the library once a week. Elizabeth is Catholic and goes to church every Sunday with her parents. She has a boyfriend Paul that she enjoys spending time with at school and outside of school.
Growth and Development: Adolescence
Physical development Elizabeth is now 5’4” and weighs 115 lbs. which puts her at a BMI of 19.7 (normal BMI). According to the Centers for Disease Control growth chart, 2000, Elizabeth’s weight of 115 lbs. (52.3 kg.) is within normal limits for a girl her age. Her height is also normal for a girl her age. In the past year she grew approximately 2 inches. Since being an adolescent, she has grown approximately 2-3 inches per year.
Sexual development. Elizabeth has gone through puberty as evidenced by her physical changes she has undergone (breast development and axillary/pubic hair). Adolescence is the period where puberty takes place. She began menstruating at the age of twelve and has had regular menstrual cycles of about 30 days (Perry, Hockenberry, Lowdermilk, & Wilson, 2014).
Gross and fine motor skills. Elizabeth has achieved all the gross and fine motor skills that were developed from previous stages (Perry, Hockenberry, Lowdermilk, & Wilson, 2014). She has no physical impairments, has no major illnesses, has not been hospitalized or had surgeries. Because dancing is very physically demanding, she has had minor injuries that cause her feet, knees, back, and/or neck to hurt from time to time. She will see a chiropractor occasionally.
Piaget, Erikson, and Kohlberg
Cognitive (Piaget): Formal operation. Elizabeth is in this stage which is characterized by abstract thought and being able to think beyond the real and actual and consider what is possible (Perry, Hockenberry, Lowdermilk, & Wilson, 2014). Elizabeth shows that she is in the stage by the type of school work that she does. She takes classes such as chemistry and pre-calculus which require abstract thinking. When conversing with her, she is able to formulate thoughts about the future such as when asking her what career she wants to pursue when she is an adult.
Psychosocial (Erikson): Identity versus role confusion. Adolescence is the stage where it is important for the person to embrace their unique identity and to think of what kind of person they are and want to be (Perry, Hockenberry, Lowdermilk, & Wilson, 2014). Elizabeth demonstrates that she is in this stage of creating her own identity because she makes her own choices in how she dresses and what kind of activities she participates in. For example, she has always liked to dance and continues to participate in dance now that she is an adolescent. Being a dancer is part of Elizabeth’s identity as a child and as an adolescent who is capable of making her own decisions she continues to do dance because she enjoys it.
Moral (Kohlberg): Postconventional or principal level. At this level, Elizabeth’s cognitive stage is at the formal operations stage. At the postconventional moral level, ethical principals guide conscious action (Perry, Hockenberry, Lowdermilk, & Wilson, 2014). In other words, what Elizabeth says and does reflect her ethical principals she has learned and developed. For example, Elizabeth believes that drinking alcohol at her age is not appropriate. Elizabeth has learned that underage drinking is not permissible in accordance to the law. Although some adolescents her age may participate in drinking alcohol, Elizabeth does not think it is appropriate by her own ethical beliefs.
Nutrition
Nutrition. Elizabeth is at a stage of rapid growth and therefore requires good nutrition. She is also a very active girl and would then require additional calories due to her increased activity. According to the HHS/USDA Dietary Guidelines for American, 2010, a very active girl from age 14-18 should consume 2,400 calories. When doing a nutritional assessment, Elizabeth stated that on a typical day she eats breakfast and dinner at home, and brings a packed homemade lunch to school. She states that she likes to eat a variety of foods including meats, poultry, eggs, vegetables, fruits, nuts, and grains. She eats homemade nutritious foods that are cooked by her mom. Occasionally she admits she does consume “junk food” such as sweets, sodas, chips, and fast foods. She says that she eats at a fast food restaurant about once a week or sometimes more. She says she drinks a lot of fresh water but she also likes to drink lemonade which is sweetened. She brings a lot of nutritious snacks to dance practice such as apples and peanut butter and sandwiches.
Food allergies. Elizabeth is allergic to dairy products and reacts strongly to it (with symptoms such as upset stomach and diarrhea) and therefore stays away from dairy products. She is upset that she cannot eat ice cream. Milk has a lot of calcium which is an important mineral needed for bone development (Perry, Hockenberry, Lowdermilk, & Wilson, 2014).
Teaching and anticipatory guidance
Nutrition- Calcium
Intervention
1,100 milligrams is the estimated amount of calcium needed for an adolescent 14 to 18 years old. Calcium is essential for this age because it is needed for bones since they are still growing and to prevent osteoporosis later in life (Perry, Hockenberry, Lowdermilk, & Wilson, 2014).
First, assess what kinds of foods Elizabeth likes to eat. Then, teach Elizabeth and her parents about the foods that are high in calcium that are from a non-dairy source. See which foods that are high in calcium would be enjoyed by Elizabeth. • Calcium fortified foods such as cereals, breads, or alternative milk (soy or almond milk) • Canned fish, beans, and leafy greens also are high in calcium (Non-dairy sources of calcium, 2016).
Physical developmentSelf-concept and body image
Intervention
At this stage of rapid development and physical changes that take place with puberty, adolescents become preoccupied with how they perceive themselves (Perry, Hockenberry, Lowdermilk, & Wilson, 2014).
Explain to Elizabeth that at her age it is normal to become self-conscious and maybe even uncomfortable with the changes occurring in adolescence. Ask Elizabeth if she has any questions regarding the changes in her body. Assess if there is anything that require further investigation such as if she has painful menstruation or PMS (Perry, Hockenberry, Lowdermilk, & Wilson, 2014). Assess for frequent comments about low self-esteem which can indicate depression (Perry, Hockenberry, Lowdermilk, & Wilson, 2014).
Teaching and anticipatory guidance
Social development Interventi on
Give anticipatory guidance teaching to the parents regarding Elizabeth as an adolescent to include: • To allow Elizabeth to be a unique individual • To respect her likes, dislikes, and wishes. • To avoid making comparisons with older siblings. • To allow increasing independence to Elizabeth but to consider safety. • Welcome Elizabeth’s friends into the home including her boyfriend. • Respect her privacy • To have open and clear communication • Allowing Elizabeth to have choices and options and to accept the natural consequences of those actions (Perry, Hockenberry, Lowdermilk, & Wilson, 2014).
Safety teaching- Car safety Intervention
Elizabeth has just begun to drive a car. It is important to assess and teach in different areas of motor vehicle safety: • Assess seatbelt use and teach the importance of using a seat belt every time she drives. • Assess and educate on use of cell phone use during driving such as texting and driving. • Assess and teach to not ever consume alcohol and drive. Rationale: Adolescents engage in risk taking behavior. Motor vehicle accidents are one of the primary causes of death in adolescents. Seat belts reduce injury in motor vehicle accidents. 61% of teenagers who drive have admitted to texting while driving. Texting while driving can cause accidents. Alcohol impairs mental function and can cause accidents as well (Kann et. al, 2016).
References
Centers for Disease Control. (2000). 2000 CDC Growth Charts for the United States: Methods and Development. Retrieved from: https://www.cdc.gov/nchs/data/series/sr_11/sr11_246.pdf HHS/USDA Dietary Guidelines for American. (2010). Parent tip: calories needed each day. Retrieved from: https://www.nhlbi.nih.gov/health/educational/wecan/download s/calreqtips.pdf Kann, L., McManus, T., Harris W. A., Shanklin S. L., Flint, K., Hawkins, J., Queen, B., Lowry, R., O’Malley Olsen, E., Chyen D., Whittle, L., Thornton J., Lim, C., Yamakawg, Y., Brener, N., & Zaza, S. (2016). Youth risk behavior surveillance- United States 2015. Morbidity and Mortality Weekly Report, 65(6). United States Department of Agriculture. (2016). Non-dairy sources of calcium. Retrieved from: https://www.choosemyplate.gov/dairy-calcium-sources Perry, S. E., Hockenberry, M. J., Lowdermilk, D. L., & Wilson, D. (2014). Maternal Child Nursing Care (5th ed.). St. Louis, MO: Mosby: Elsevier.