Professional Documents
Culture Documents
Growth
Physical change and increase in size Measure quantitatively Examples: height, weight, head
circumference.
Development
Increase in the complexity of function and
skill progression Capacity and skill of a person to adapt to the environment Examples: learning to walk, run, talk
complex. Development becomes increasingly differentiated Certain stages of growth and development more critical than others Pace can be uneven
Toddlerhood (1 to 3 years)
Motor development permits increased physical autonomy Psychosocial skills increase
exploration) Security primary need Major conflict: weaning Feeding produces pleasure, sense of comfort, safety Feeding should be pleasurable and provided when required
Anal (1 to 3 Years)
Anus and bladder source of pleasure (sensual
satisfaction, self-control) Major conflict: toilet training Toilet training should be a pleasurable experience
Phallic (4 to 6 Years)
Genitals center of pleasure Masturbation offers pleasure Fantasy, experimentation with peers Questioning adults about sexual topics Major conflict: Oedipus/Electra complexes Resolves when the child identifies with parent
of same gender
activities Sexual impulses tend to be repressed Develop relationship between peers of the same gender Encourage child with physical and intellectual pursuits Encourage sports and other activities with same gender peers
and function Development of skills needed to cope with the environment Encourage separation from parents Achievement of independence and decision making
Infancy (birth to 18 months) Trust versus mistrust Early Childhood (18 months to 3 years) Autonomy versus shame and doubt Late Childhood ((3 to 5 years) Initiative versus guilt School-age (6 to 12 years) Industry versus inferiority Adolescence (12 to 20 years) Identity versus role confusion Young Adult (18 to 25 years) Intimacy versus isolation Adulthood (25 to 65 years) Generativity versus stagnation Maturity (65 years to death) Integrity versus despair
Learning to walk and talk Eat solid foods Control elimination Learning sex differences and modesty Achieving psychologic stability Learning to relate emotionally Learning to distinguish right from wrong Developing a conscience
Middle Childhood
Learning physical skills for ordinary games Building wholesome attitudes toward oneself Learning to get along with peers Learning appropriate gender social role Developing fundamental skills in reading, writing, math Developing concepts for everyday living Developing conscience, morality, scale of values Achieving personal independence Developing attitudes toward social groups and institutions
Adolescence
Achieving more mature relationships with peers Achieving gender role Accepting one s own body Using the body effectively Achieving emotional independence from parents Achieving economic independence Preparing for an occupation Preparing for marriage and family life Developing intellectual skills and concepts for civic competence Achieving socially responsible behaviors Acquiring set of values and an ethical system
Early Adulthood
Selecting a mate Learning to live with a partner Starting a family Rearing children Managing a home Getting started in an occupation Taking on civic responsibilities Finding a congenial social group
Middle Age
Achieving adult civic role and social
responsibilities Establishing and maintaining an economic standard of living Assisting teenage children to become happy adults Developing adult leisure-time activities Relating oneself to one s spouse as a person Accepting and adapting to physiologic changes Adjusting to aging parents
Later Maturity
Adjusting to decreasing physical strength and health Adjusting to retirement and reduced income Adjusting to death of spouse Establishing an explicit affiliation with peers Meeting social and civic obligations Establishing physical living arrangements
Sensorimotor
Accommodation
Process of change Cognitive processes mature to solve problems that were unsolvable
adults Focused on the reasons an individual makes a decision Moral development progresses through three levels and six stages Levels and stages are not always linked to a certain developmental stage Some people progress to a higher level of moral development than others
Toddlers (1 to 3 years)
Progress from no control to walking and speaking Control elimination Acquire information about environment
Length
Gains 13.75 cm (5.5 in.) by 6 mo Additional 7.5 cm (3 in.) by 12 mo.
2-3 mo - vocalize to sounds and voices 3-6 mo - looks for sounds, pause to listen, responds to angry/happy voices 6-9 mo - may look at named objects/people 9-12 mo - understands some words, uses gestures, say one or two words 12 mo - responds to simple commands
Touch
Well developed at birth Poor temperature regulation Diffuse response to pain
Reflexes
Reflexes present at birth Disappear to permit voluntary movement
SIDS Video
grow more quickly Weight gain generally slow Doubles birth length by age 5 20/30 normal vision at age 5 Hearing at optimal levels Shows taste preferences Motor abilities strengthen as child begins to master physical activities
(boys) Growth spurt at age 10 12 (girls) and 12 14 (boys) 20/20 vision established between ages 9 11 Well-developed senses of hearing and touch Increased perspiration and other prepubertal changes Motor abilities well developed during this period
head, hands, and feet Rapid growth in height and weight for boys, slower in girls Glandular changes cause increased sweat and acne Primary and secondary sexual characteristics develop
Toddlers
Autonomy versus shame
Preschoolers
Initiative versus guilt
School-age Children
Industry versus inferiority
Adolescents
Identity versus role confusion
Phase
Trial-and-error problem solving Solving problems mentally
Phase
Cooperative interactions Intuitive reasoning Cause-and-effect Concepts of money and time learned Reading skills well developed
Toddlers
Preconventional level
Stage 1: Punishment and reward
School-age children
Preconventional level
Stage 1: Punishment and reward Stage 2: Instrumental-relativist
Conventional level
Stage 3: Good boy-nice girl Stage 4: Law and order
School-age children
Mythic-literal
Preschoolers
Intuitive-projective
Adolescents
Synthetic-conventional
Motor development
Gross and fine skills in normal range Appropriate reflexes Symmetrical movements No hyper- or hypotonia
Psychosocial development
Interacts with parents through movement and vocalizations
Assessment: Toddlers
Physical development
Physical growth in normal range Vital signs in normal range Vision, hearing within normal range
Motor development
Achieves gross and fine motor milestones
Psychosocial development
Achieves milestones
Assessment: Toddlers
Development in ADL
Feeds self Eats variety of foods Begins to develop bowel and bladder control Rest and sleep patterns appropriate for age
Assessment: Preschoolers
Physical development
Physical growth within normal range Vital signs in normal range Vision, hearing within normal range
Motor development
Achieves gross and fine motor milestone
Psychosocial development
Achieves milestones
Assessment: Preschoolers
Development in ADL
Control of bowel and bladder functions Performs simple hygiene activities Dresses and undresses self Engages in bedtime rituals Demonstrates ability to put self to sleep
Motor development
Possesses coordinated motor skills for age
Development in ADL
Concern for personal cleanliness and appearance Expresses need for privacy
Assessment: Adolescents
Physical development
Physical growth within normal range Demonstrates male or female sexual development within standards Vital signs within normal range for gender Hearing, vision within normal range
Assessment: Adolescents
Psychosocial development
Interacts well with parents and others Likes self Has plans for future Choose lifestyle and interests that fit own identity Determines own beliefs and values Begins to establish a sense of identity in family Seeks help from appropriate people as needed
Assessment: Adolescents
Development in ADL
Knowledge of physical development, menstruation, reproduction, and birth control Exhibits healthy lifestyle practice Demonstrates concern for personal cleanliness and appearance
Protective measures
Immunizations Fluoride supplementation as needed Screening for TB and PKU Prompt attention to illness Appropriate hygiene
Infant safety
Importance of supervision Home environmental safety Feeding measures Appropriate toys
Rest/Sleep
Patterns
Sensory stimulation
Touch stimulation Visually stimulating toys Hearing loss screening and intervention
Elimination
Characteristics Frequency Diarrhea
infants
Failure to thrive Infant colic Crying Child abuse including shaken baby syndrome Sudden infant death
Protective measures
Immunizations Screening for TB, lead poisoning Fluoride supplementation as needed
Nutrition
Nutritious meals and snacks Mealtime manners Dental care
Rest/Sleep
Sleep disturbances
Play
Adequate space Toys for acting on behavior Motor and sensory stimulation
toddlers
Injuries Visual problems Respiratory and ear infections Dental caries
Preschooler safety
Education Play safety Prevention of poisoning
Protective measures
Immunizations Screening for TB, vision, hearing, dental Fluoride treatment
Rest/Sleep
Sleep disturbances
Elimination
Proper hygiene
Play
Group play activities Teach simple cooperative and interactive games Toys for dress-up
preschoolers
Injuries Visual problems Dental caries Respiratory tract and ear infections
Communicable disease Congenital abnormalities correction
Protective measures
Immunizations Screening for TB Periodic vision, speech, hearing, dental screening Fluoride treatment Sexual education
Interaction
Organized group activities Parental expectations Parental responsibilities
Nutrition
No skipped meals Balanced diet Obesity
school-age children
Communicable Diseases Dental Cavities Injuries Obesity
Protective measures
Immunizations Periodic screenings for TB, vision, hearing, dental screening Accurate sexual information
adolescents
Consequences of Risky Behavior
Injury Sexually transmitted disease Teen pregnancy
Infectious Diseases
Baby Boomers
Years 1945-1964 An individualistic outlook Workaholic orientation Respect at work, but feel role overload
Generation X
Gen Xers Born 1965-1978 Frequently raised in two-worker households Less impressed with corporate values More skeptical Resist authority Enjoy challenges and opportunities to creatively
problem solve
Generation Y
Millennials Born 1979-2000 Part of an increasingly multi-cultural America Technologically sophisticated (and
40):
coordinated Other body systems functioning at peak efficiency Choices affect weight and muscle mass Physical changes in pregnant and lactating women
intellectual abilities Maintain memory and problem solving Continues learning Influence of genetic, environmental, and personality factors
spirituality May be self-conscious about spiritual matters Religious teaching from childhood accepted or redefined
illness, death, and tragedy After 30 years some reach the paradoxicalconsolidative stage
View truth from a number of viewpoints
(obesity) Violence Abuse of women Certain malignancies (testicular cancer and cervical cancer)
alterations
Anxiety Depression
Psychosocial development
Independence from parents Self-concept Direction in life Family interactions Coping skills Relationship with significant other Emotional, social, and economic responsibilities Values
Development in ADL
Lifestyle
Psychosocial development
Response to physical changes Comfort with self Independence Changes in family roles Relationship with life partner Interests Civic involvement Philosophy of life
Development in ADL
Preventive health practices
Safety
Motor vehicle safety Sun protection Workplace and water safety
Social interactions
Positive personal relationships Occupational long and short term goals
Social interactions
Midlife crisis Interest Retirement planning
Categories of Elders
Characteristics of Elders
Demographic
Longer life spans Fastest growing age group is 85 years and over
Socioeconomic
Women have longer life expectancy Men more likely to remarry Educational level gradually increasing Lower incomes Most live in community settings Poverty level more likely when living alone
Ethnicity
Number of minority elders increasing Elder Hispanic fastest growing subpopulation
Characteristics of Elders
Health
Chronic health problems and disabilities increase 73% rate health as good, very good, or excellent 20% report disability and most have chronic disease
Ageism
Discrimination based solely
on age Exists among some professionals Negative stereotypes based on myths and incorrect information
Ageism
Geriatrics
Associated with the medical care of the elderly
Gerontological Nursing
Historical development Certification through the American Nurses
Community
Hospice Home health care Nurse-run clinics Adult day care
Physical Changes
Integumentary Neuromuscular Sensory-perceptual Pulmonary Cardiovascular Gastrointestinal Urinary Genital Immunological Endocrine system
Integumentary Changes
Skin dryness, pallor, fragility Wrinkling and sagging Age spots Decreased perspiration Thinning, graying of body hair Slower growth and thickening of nails
Neuromuscular Changes
Decreased speed and power of muscles Slowed reaction time Loss of height Loss of bone mass Joint stiffness Impaired balance Greater difficulty with complex learning/abstraction
Sensory-Perceptual Changes
Loss of visual acuity Increased sensitivity to glare Decreased ability to adjust to darkness Arcus senilis Presbycusis Decreased sense of taste and smell Increased threshold for pain, touch, and temperature
Pulmonary Changes
Decreased ability to expel accumulated
matter Decreased lung expansion Less effective exhalation Reduced vital capacity Increased residual volume Dyspnea with exertion
Cardiovascular Changes
Reduced SV and CO Reduced elasticity Increased rigidity of arteries Increased SBP and DBP Orthostatic hypotension
Gastrointestinal Changes
Delayed swallowing time Increased indigestion Constipation
Urinary Changes
Reduced filtering Impaired renal function Less effective concentration of urine Urgency and frequency Nocturia Retention
Genital Changes
Prostate enlargement Atrophy of vulva, cervix, uterus, fallopian
tubes, ovaries Reduction in vaginal secretions Changes in vaginal flora Changes in sexual functioning
Immunological Changes
Decreased immune system function Lowered resistance to infection Poor response to immunizations Decreased stress response
Endocrine Changes
Increased insulin resistance
Developmental Tasks
Erikson
Ego integrity versus despair
Peck
Ego differentiation versus work-role preoccupation Body transcendence versus body preoccupation Ego transcendence versus ego preoccupation
Safeguarding physical and mental health Remaining in touch with other family
Psychosocial Changes
Retirement Economic change Grandparenting Relocation Maintaining
Cognitive Abilities
Formal operations (Piaget) Intellectual capacity
Perception Cognitive agility Memory Learning
preservation of right Believed moral development complete in early adult years Does not decline with age
Moral Reasoning
Values and belief patterns
Influence of time period Foreign-born or first-generation citizens Cultural background Life experience Gender Religion Socioeconomic status
views Understanding ideas missed previously or interpreted differently May derive sense of worth by sharing experiences or views Many take faith and religious practice very seriously Display a high level of spirituality Importance of religion in youth
Benefits to Spirituality
Helps resolve issues related to
Meaning of life Adversity Good fortune
matured spiritually
Health Promotion