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PSYCHOSOCIAL

PSYCHOSEXUAL

COGNITIVE

MORAL

Intimacy vs. Isolation STAGE

Genital

Formal Operation

Post Conventional or Principled

DEFINITION

The Intimacy vs. Isolation conflict is emphasized around the age of 30. At the start of this stage, identity vs. role confusion is coming to an end, though it still lingers at the foundation of the stage (Erikson, 1950). Young adults are still eager to blend their identities with friends. They want to fit in. Erikson believes we are sometimes isolated due to intimacy. We are afraid of rejections such as being turned down or our partners breaking up with us. We are familiar with pain, and to some of us, rejection is painful; our egos cannot bear the pain. Erikson also argues that "Intimacy has a counterpart: Distantiation: the readiness to isolate and if necessary, to destroy those forces and people whose essence seems dangerous to our own, and whose territory seems to encroach on the extent

The fifth stage of psychosexual development is the genital stage that spans puberty and adult life, and thus occupies most of the life of a man and of a woman; its purpose is the psychologic detachment and independence from the parents. The genital stage affords the person the ability to confront and resolve his or her remaining psychosexual childhood conflicts. As in the phallic stage, the genital stage is centered upon the genitalia, but the sexuality is consensual and adult, rather than solitary and infantile. The psychological difference between the phallic and genital stages is that the ego is established in the latter; the person's concern shifts from

It marks a movement from an ability to think and reason from concrete visible events to an ability to think hypothetically; to entertain what-if possibilities about the world

Individuals make their own choices, understanding the views of other people but make their own decisions.

Stage 5: Humans Rights and Social Welfare Morality Promote fundamental human rights and values Freely entered social contract to protect members rights and ensure the welfare of all Agreements determine the obligations of relationships of the individual Stage 6: Morality of Universalizable, Reversible, and Prescriptive General Ethical Principles Morality focuses on the equal consideration of others in all aspects in the situation Actions and decisions are based on generally accepted principles of all situations (i.e. equality for

of one's intimate relations Once people have established their identities, they are ready to make long-term commitments to others. They become capable of forming intimate, reciprocal relationships (e.g. through close friendships or marriage) and willingly make the sacrifices and compromises that such relationships require. If people cannot form these intimate relationships perhaps because of their own needs a sense of isolation may result.

primary-drive gratification (instinct) to applying secondary process-thinking to gratify desire symbolically and intellectually by means of friendships, a love relationship, family and adult responsibilities.

mankind/human rights) Typically not reached by students

ANALYSIS

A. PHYSICAL ASSESSMENT VITAL SIGNS: PR= bpm Date Obtained: PARTS TO BE ASSESSED

TEMPERATURE= degree

RR= cpm

TECHNIQUE

NORMAL FINDINGS General appearance

ACTUAL FINDINGS

REMARKS

1. Body built in relation to clients age, lifestyle & health 2. Clients posture & gait, standing, sitting & walking 3. Clients overall hygiene & grooming 4. Body & breath odor 5. Signs of distress in posture or facial expression 6. Obvious signs health or illness of

Inspection

Proportionate and varies with lifestyle

He has a proportionate (endomorph) body built which is appropriate with her lifestyle

Normal

Inspection

Relax, erect posture, coordinated body movements Neat No body odor or minor body odor relative

Cannot stand perfectly

Deviation from normal due to the operation performed Normal

Inspection

He is neat and clean.

Inspection

no body odor

Normal

Inspection

No distress noted

No distress noted

Normal

Inspection

Healthy appearance

Healthy appearance

Normal

PARTS TO BE ASSESSED 7. Clients attitude 8. Clients affect/mood; appropriateness of the clients response 9. Quantity of speech, quality & organization

TECHNIQUE Inspection

NORMAL FINDINGS Cooperative Appropriate to the situation Understandable, moderate pace; exhibits thought association Logical sequence; makes sense; has sense of reality. SKIN

ACTUAL FINDINGS Cooperative Appropriate to the situation

REMARKS Normal

Inspection

Normal

Inspection

Understandable

Normal

10. Relevance & organization of thoughts

Inspection

has sense of reality

Normal

1. Skin moisture

Inspection

moisture in skin fold and axillae

moisture in skin fold

Normal Deviation from normal due to the stretch skin during her pregnancy. Normal

2. Skin Texture

Inspection

smooth

Rough at the abdomen

3. Skin turgor

Inspection and palpation

Springs back

Springs back

PARTS TO BE ASSESSED

TECHNIQUE

NORMAL FINDINGS Hair and Nails

ACTUAL FINDINGS

REMARKS

1. Fingernails plate shape to determine its curvature & angle

Inspection

Convex curvature, angle of nail plate about 160 degrees. Highly vascular and pink in light skinned clients; dark- skinned clients may have brown or black pigmentation in longitudinal streaks.

angle of nail plate about 160 degrees.

Normal

2. Fingernail & toenail bed color

Inspection

Pinkish in color

Normal

3. Tissues surroundings nails 4. Fingernail & toenail texture 5. Blanch test capillary refill of

Inspection

Intact epidermis.

She has an intact epidermis with no hangnails Smooth nail texture The color return to the original color in 2 seconds

Normal

Palpation

Smooth texture. Prompt return of pink or usual color (generally less than 4 seconds.)

Normal

Palpation

Normal

1. Evenness of growth over the scalp

Inspection

Evenly distributed hair.

Her hair is well distributed

Normal

PARTS TO BE ASSESSED 2. Hair thinness thickness &

TECHNIQUE

NORMAL FINDINGS

ACTUAL FINDINGS

REMARKS

Palpation

Thick/thin hair.

has a thick hair

Normal

3. Presence of infections or infestations 4. Texture & oiliness over the scalp

Inspection

Not present.

Not present.

Normal

Palpation

Silky, resilient hair. SKULL Rounded (normocephalic and symmetrical, with frontal, parietal, and occipital prominences); smooth skull contour. Smooth, uniform consistency; absence of nodules or masses. FACE Symmetric or slightly asymmetric facial features; palpebral fissures equal in size; symmetric nasolabial

Silky, resilient hair.

Normal

1. Size, symmetry

shape

&

Palpation

Head is symmetrically round.

Normal

2. Nodules or masses & depressions

Palpation

No mass or nodules noted;

Normal

1. Facial features

Inspection

Symmetric or slightly asymmetric facial features; palpebral fissures equal in size; symmetric nasolabial

Normal

folds. 2. Symmetry of facial movements the Inspection Symmetrical facial movements. EYEBROWS & EYELASHES Hair evenly distributed; skin intact. Eyebrows asymmetrically aligned equal movement. Eyelashes curl slightly outward. CORNEA Transparent, shiny and smooth; details of the iris are visible. In older people, a thin grayish white ring around the margin, called arcussenilis, may be evident. IRIS 1. Shape & color Inspection Flat and round PUPILS

folds. Facial movements are symmetrical Normal

1. Evenness of distribution & direction of curl

Inspection

Eyebrows and eyelashes are both evenly distributed, symmetrical aligned. Eyelashes curl slightly outward.

Normal

1.Clarity & color

Inspection

Details of iris are visible. Transparent, shiny and smooth.

NORMAL

Flat and round and uniform in color.

NORMAL

1. Color, shape symmetry of size

&

Inspection

Black in color; equal in size; normally 3-7 mm in diameter; round, smooth border.

Firm and equal pupils

NORMAL

EYELIDS Skin intact, no discharge, no discoloration. Lids close symmetrically approximately 15-20 involuntary blinks per minute; bilateral blinking. When lids open, no open, no visible sclera above corneas, and upper and lower borders of cornea are slightly covered.

1. Surface characteristics & ability to blink

Inspection and Palpation

Eyelids skin are intact, no noted discharge, and no noted discoloration. Lids close symmetrically. Client exhibited 18 involuntary blinks per minute.

NORMAL

CONJUNCTIVA 1. Bulbar conjunctivas color, texture & presence of lesions 2. Palpebral conjunctivas color, texture & presence of Transparent; capillaries sometimes evident. Transparent, capillaries evident, no discharge was noted. Shiny, smooth ,pink in color.

Inspection

NORMAL

Inspection

Shiny, smooth, pink or red in

NORMAL

lesions SCLERA

color.

1. Color & clarity

Inspection

Sclera appears white (yellowish in dark- skinned clients).

Sclera appears white

NORMAL

PARTS TO BE ASSESSED

TECHNIQUE

NORMAL FINDINGS EARS AURICLE

ACTUAL FINDINGS

REMARKS

1. Color & symmetry of size &position

Inspection

Color same as facial skin, symmetrical, auricle aligned with outer canthus of eye, about 10cm from vertical.

Color is same with facial skin, symmetrical with each other, auricle aligned with outer canthus of eye, about 10 cm vertical

NORMAL

2. Texture & elasticity & areas of tenderness

Palpation

Mobile, firm and not tender, pinna recoils after it is folded.

Both pinna recoils after being folded. Mobile, firm and not

NORMAL

tender. EXTERNAL EAR CANAL Distal third contains hair follicles and glands. Dry cerumen in various shades of brown HEARING ACUITY TEST 1. Clients response to normal voice tones Inspection Normal voice tones audible NOSE Symmetric and straight Inspection No discharge or flaring Uniform color Mucosa pink Inspection Clear, watery discharge No lesions. Inspection Nasal septum intact and in midline, intact No discharge and/or flaring noted. Symmetrical on both sides. Also uniform in color. Mucosa are intact and pinkish; minimal moist noted inside; no swelling or nodules found. Nasal septum is intact and in midline Client responds to normal voice tones NORMAL No noted pus, blood and odor. Minimal cerumen noted. Distal third contains hair follicles.

1. Cerumen, skin lesions, pus & blood

Inspection

NORMAL

1. Shape, size or color & flaring or discharge from the nares

NORMAL

2. Presence of redness, swelling, growths & discharge or nares using the flashlight

NORMAL

3. Position of nasal septum

NORMAL

4. Test patency of both nasal septum

Inspection

Air moves freely as the client breathes through the nares

Air moves freely as the client breathes through each nares No tenderness, no lesions noted. No displacement of bone & cartilage.

NORMAL

5. Tenderness, masses displacement of bone cartilage

& &

Palpation

Not tender; no lesions

NORMAL

LIPS Uniform pink color Uniform pink color 1. Symmetry of contour color & texture Inspection and Palpation Soft, moist, smooth texture Symmetry of contour Ability to purse lips Soft, moist, smooth texture NORMAL

TEETH 1. Inspect for color, number & condition & presence of dentures 32 adult teeth Inspection Smooth, white, shiny tooth enamel GUMS Pink gums (bluish or dark patches in dark-skinned clients) Moist, firm texture to gums 29 teeth Deviation from normal

1. Color & condition

Inspection

Pink gums, , firm texture

NORMAL

TONGUE/FLOOR OF THE MOUTH 1. Color & texture of the mouth floor & frenulum Smooth tongue base with prominent veins Smooth tongue base with prominent veins

Inspection and Palpation

NORMAL

Central in position Pink in color (some brown pigmentation on tongue borders in darj-skinned clients); moist; slightly rough; thin white coating Inspection and Palpation Smooth, lateral margins, no lesions Raised papillae (taste buds) Moves freely, no tenderness

2. Position, color & texture, movement & base of the tongue

, Centered; pink in color, slightly rough, has thin white coating, smooth, no lesions; moves freely.

NORMAL

ABDOMEN Unblemished skin, uniform in color, silver white striae (stretch marks) or surgical scars. Deviation from normal due to the operation performed and stretch skin during her pregnancy NORMAL Convex in shape.

Uniform in color. With stretch marks.

1. Skin integrity

Inspection

2. Abdominal contour

Inspection

Flat, rounded (convex) or scaphoid(concave)

NORMAL 3. Bowel Sounds Auscultation Audible bowel sounds Audible bowel sounds

Summary of Physical Assessment: General appearance: Clients posture & gait, standing, sitting & walking: Cannot stand perfectly- Deviation from normal due to the operation performed Skin Texture: Rough at the abdomen-Deviation from normal due to the stretch skin during her pregnancy. Teeth: 29 teeth- Deviation from normal. Abdomen: Skin integrity: with stretch marks.- Deviation from normal due to the operation performed and stretch skin during her pregnancy.

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