Research the range of contemporary issues teenagers face today. In a 500-750-word paper, choose one issue (besides teen pregnancy) and discuss its effect on adolescent behavior and overall well-being. Include the following in your submission:

1. Describe the contemporary issue and explain what external stressors are associated with this issue.
2. Outline assessment strategies to screen for this issue and external stressors during an assessment for an adolescent patient. Describe what additional assessment questions you would need to ask and define the ethical parameters regarding what you can and cannot share with the parent or guardian.
3. Discuss support options for adolescents encountering external stressors. Include specific support options for the contemporary issue you presented. 

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Week 4: Question for Discussion

Chapter 7 – Posttraumatic Stress

Question(s): Name the DSM-IV-TR indicators necessary for a diagnosis of PTSD? (full criteria for diagnosis) five of condition/symptoms, with at least two in each category. Please, include specific symptoms in children (PTSD symptoms in children that are different than in adults). Note: (DSM-5 will be accepted).

Guidelines:The answer should be based on the knowledge obtained from reading the book, no just your opinion. If there are 2 questions in the discussion, you must answer both of them. Your grade will be an average of both questions.

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  Urinary Obstruction Case Studies The 57-year-old patient noted urinary hesitancy and a decrease in the force of his urinary stream for several months. Both had progressively become worse. His physical examination was essentially negative except for an enlarged prostate, which was bulky and soft. Studies Results Routine laboratory studies Within normal limits (WNL) Intravenous pyelogram (IVP) Mild indentation of the interior aspect of the bladder, indicating an enlarged prostate Uroflowmetry with total voided flow of 225 mL 8 mL/sec (normal: >12 mL/sec) Cystometry Resting bladder pressure: 35 cm H2O (normal: <40 cm H2O) Peak bladder pressure: 50 cm H2O (normal: 40-90 cm H2O) Electromyography of the pelvic sphincter muscle Normal resting bladder with a positive tonus limb Cystoscopy Benign prostatic hypertrophy (BPH) Prostatic acid phosphatase (PAP) 0.5 units/L (normal: 0.11-0.60 units/L) Prostate specific antigen (PSA) 1.0 ng/mL (normal: <4 ng/mL) Prostate ultrasound Diffusely enlarged prostate; no localized tumor Diagnostic Analysis Because of the patient’s symptoms, bladder outlet obstruction was highly suspected. Physical examination indicated an enlarged prostate. IVP studies corroborated that finding. The reduced urine flow rate indicated an obstruction distal to the urinary bladder. Because the patient was found to have a normal total voided volume, one could not say that the reduced flow rate was the result of an inadequately distended bladder. Rather, the bladder was appropriately distended, yet the flow rate was decreased. This indicated outlet obstruction. The cystogram indicated that the bladder was capable of mounting an effective pressure and was not an atonic bladder compatible with neurologic disease. The tonus limb again indicated the bladder was able to contract. The peak bladder pressure of 50 cm H2O was normal, again indicating appropriate muscular function of the bladder. Based on these studies, the patient was diagnosed with a urinary outlet obstruction. The PAP and PSA indicated benign prostatic hypertrophy (BPH). The ultrasound supported that diagnosis. Cystoscopy documented that finding, and the patient was appropriately treated by transurethral resection of the prostate (TURP). This patient did well postoperatively and had no major problems. Critical Thinking Questions 1. Does BPH predispose this patient to cancer? 2. Why are patients with BPH at increased risk for urinary tract infections? 3. What would you expect the patient’s PSA level to be after surgery? 4. What is the recommended screening guidelines and treatment for BPH? 5. What are some alternative treatments / natural homeopathic options for treatment?   Case Studies The 57-year-old patient noted urinary hesitancy and a decrease in the force of his urinary stream for several months. Both had progressively become worse. His physical examination was essentially negative except for an enlarged prostate, which was bulky and soft. Studies Results Routine laboratory studies Within normal limits (WNL) Intravenous pyelogram (IVP) Mild indentation of the interior aspect of the bladder, indicating an enlarged prostate Uroflowmetry with total voided flow of 225 mL 8 mL/sec (normal: >12 mL/sec) Cystometry Resting bladder pressure: 35 cm H2O (normal: <40 cm H2O) Peak bladder pressure: 50 cm H2O (normal: 40-90 cm H2O) Electromyography of the pelvic sphincter muscle Normal resting bladder with a positive tonus limb Cystoscopy Benign prostatic hypertrophy (BPH) Prostatic acid phosphatase (PAP) 0.5 units/L (normal: 0.11-0.60 units/L) Prostate specific antigen (PSA) 1.0 ng/mL (normal: <4 ng/mL) Prostate ultrasound Diffusely enlarged prostate; no localized tumor Diagnostic Analysis Because of the patient’s symptoms, bladder outlet obstruction was highly suspected. Physical examination indicated an enlarged prostate. IVP studies corroborated that finding. The reduced urine flow rate indicated an obstruction distal to the urinary bladder. Because the patient was found to have a normal total voided volume, one could not say that the reduced flow rate was the result of an inadequately distended bladder. Rather, the bladder was appropriately distended, yet the flow rate was decreased. This indicated outlet obstruction. The cystogram indicated that the bladder was capable of mounting an effective pressure and was not an atonic bladder compatible with neurologic disease. The tonus limb again indicated the bladder was able to contract. The peak bladder pressure of 50 cm H2O was normal, again indicating appropriate muscular function of the bladder. Based on these studies, the patient was diagnosed with a urinary outlet obstruction. The PAP and PSA indicated benign prostatic hypertrophy (BPH). The ultrasound supported that diagnosis. Cystoscopy documented that finding, and the patient was appropriately treated by transurethral resection of the prostate (TURP). This patient did well postoperatively and had no major problems. Critical Thinking Questions 1. Does BPH predispose this patient to cancer? 2. Why are patients with BPH at increased risk for urinary tract infections? 3. What would you expect the patient’s PSA level to be after surgery? 4. What is the recommended screening guidelines and treatment for BPH? 5. What are some alternative treatments / natural homeopathic options for treatment?  

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4-5 page paper concept map

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  Testicular Cancer Case Studies 

A 21-year-old male noted pain in his right testicle while studying hard for his midterm college examinations. On self-examination, he noted a “grape sized” mass in the right testicle. This finding was corroborated by his healthcare provider. This young man had a history of delayed descent of his right testicle until the age of 1 year old. Studies Results Routine laboratory studies Within normal limits (WNL) Ultrasound the testicle Solid mass, right testicle associated with calcifications HCG (human chorionic gonadotropin) 550mIU/mL (normal: <5) CT scan of the abdomen Enlarged retroperitoneal lymph nodes CT scan of the chest Multiple pulmonary nodules Diagnostic Analysis At semester break, this young man underwent right orchiectomy. Pathology was compatible with embryonal cell carcinoma. CT directed biopsy of the most prominent pulmonary nodule indicated embryonal cell carcinoma, compatible with metastatic testicular carcinoma. During a leave of absence from college, and after banking his sperm, this young man underwent aggressive chemotherapy. Repeat testing 12 weeks after chemotherapy showed complete resolution of the pulmonary nodules and enlarged retroperitoneal lymph nodes. 

Critical Thinking Questions 

 1. What impact did an undescended testicle have on this young man’s risk for   developing testicular cancer?

 2. What might be the side effects of cytotoxic chemotherapy? 

 3. What was the purpose of preserving his sperm before chemotherapy?

 4. Is this young man’s age typical for the development of testicular carcinoma? 

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