3.

Level of Growth and Development

3.3.1 Normal development of a young adult (Potter and Perry)

Young adulthood is the period between the late teens and the mid to late 30s
(Edelman and Mandle, 2010). In recent years young adults between the ages of 18 and
29 have been referred to as part of the millennial generation. In 2009 young adults
made up approximately 33% of the population (U.S. Census Bureau, 2009). According
to the Pew Research Center (2010), todays young adults are historys first always
connected generation, with digital technology and social media major aspects of their
lives. They adapt well to new experiences, are more ethnically and racially diverse than
previous generations, and are the least overtly religious American generation in modern
times. Young adults increasingly move away from their families of origin, establish
career goals, and decide whether to marry or remain single and whether to begin
families; however, often these goals may be delayed (e.g., because of the economic
recession of recent years).
Physical Development
The young adult usually completes physical growth by the age of 20. An exception to
this is the pregnant or lactating woman. The physical, cognitive, and psychosocial
changes and the health concerns of the pregnant woman and the childbearing family
are extensive. Young adults are usually quite active, experience severe illnessesless
commonly than older age-groups, tend to ignore physical symptoms, and often
postpone seeking health care. Physical characteristics of young adults begin to change
as middle age approaches.
Unless patients have illnesses, assessment findings are generally within normal limits.
Psychosocial Development

The emotional health of the young adult is related to the individuals ability to address
and resolve personal and social tasks. The young adult is often caught between wanting
to prolong the irresponsibilityof adolescence and assume adult commitments. However,
certain patterns or trends are relatively predictable. Between the ages of 23 and 28, the
person refines self-perception and ability for intimacy. From 29 to 34 the person directs
enormous energy toward achievement and mastery of the surrounding world. The years
from 35 to 43 are a time of vigorous examination of life goals and relationships. People
make changes in personal, social, and occupational areas. Often the stresses of this reexamination results in a midlife crisis in which marital partner, lifestyle, and occupation
change.
Cognitive Development
Critical thinking habits increase steadily through the young- and middle-adult years.
Formal and informal educational experiences, general life experiences, and
occupational opportunities dramaticallyincrease the individuals conceptual, problemsolving, andmotor skills. Identifying an occupational direction is a major task of young
adults. When people know their skills, talents, and personality characteristics,
educational preparation and occupational choices are easier and more satisfying. A
bachelors or associates degree is the most significant source of postsecondary
education for 12 of the 20 fastest-growing occupations. An understanding of how adults
learn helps you to develop patient education plans. Adults enter the teaching learning
situation with a background of unique life experiences, including illness. Therefore
always view adults as individuals. Their adherence to regimens such as medications,
treatments, or lifestyle changes such as smoking cessation involves decision-making
processes. When determining the amount of information that an individual needs to
make decisions about the prescribed course of therapy, consider factors that possibly
affect the individuals adherence to the regimen, including educational level,
socioeconomic factors, and motivation and desire to learn. Because young adults are
continually evolving and adjusting to changes in the home, workplace, and personal
lives, their decision making processes need to be flexible. The more secure young

adults are in their roles, the more flexible and open they are to change. Insecure
persons tend to be more rigid in making decisions.
Moral Development
Individual judgment is based on self-chosen principles, and moral reasoning is based on
individual rights and justice. According to Kohlberg this level of moral reasoning is as far
as most people get.
Only 10-15% are capable of the kind of abstract thinking necessary for stage 5 or 6
(post-conventional morality). That is to say most people take their moral views from
those around them and only a minority think through ethical principles for themselves.
Stage 5. Social Contract and Individual Rights. The child/individual
becomes aware that while rules/laws might exist for the good of the greatest
number, there are times when they will work against the interest of particular
individuals.
The issues are not always clear cut. For example, in Heinzs dilemma the
protection of life is more important than breaking the law against stealing.
Stage 6. Universal Principles. People at this stage have developed their
own set of moral guidelines which may or may not fit the law. The principles
apply to everyone.
E.g. human rights, justice and equality. The person will be prepared to act to
defend these principles even if it means going against the rest of society in the
process and having to pay the consequences of disapproval and or
imprisonment. Kohlberg doubted few people reached this stage.

Spiritual Development

According to Fowler, it is ideal that a person reach stage IV in their early to midtwenties, it is evident that many adults never reach it. If it happens in the thirties or
forties, Fowler says, it is much harder for the person to adapt. It is called the
Individuative-Reflective Stage.
This is the tough stage, often begun in young adulthood, when people start
seeing outside the box and realizing that there are other "boxes". They begin to critically
examine their beliefs on their own and often become disillusioned with their former faith.
Ironically, the Stage 3 people usually think that Stage 4 people have become
"backsliders" when in reality they have actually moved forward.
.

3.3.2 The ill person at a particular stage of Patient

Many young adults remain healthy; however risk of developing a health problem
is lower than that of the middle adult. Health risk factors for a young adult originate in
the community,lifestyle patterns, and family history. The lifestyle habits that activatethe
stress response increase the risk of illness.Smoking is a well-documented risk factor for
pulmonary, cardiac, and vascular diseases in smokers and the individuals who receive
second-hand smoke. Inhaled cigarette pollutants increase the risk of lung cancer,
emphysema, and chronic bronchitis.
A family history of a disease puts a young adult at risk for developing it in the
middle or older adult years. For example, a young man whose father and paternal
grandfather had myocardial infarctions (heart attacks) in their 50s has a risk for a future
myocardial infarction. The presence of certain chronic illnesses such as diabetes
mellitus in the family increases the family members risk of developing a disease.

Regular physical examinations and screening are necessary at this stage of

development.
As in all age-groups, personal hygiene habits in the young adult are risk factors.
Sharing eating utensils with a person who has a contagious illness increases the risk of
illness. Poor dental hygiene increases the risk of periodontal disease. Individuals avoid
gingivitis (inflammation of the gums) and periodontitis (loss of tooth support) through
oral hygiene.
Violence is a common cause of mortality and morbidity in the young-adult
population. Factors that predispose individuals to violence, injury, or death include
poverty, family breakdown, child abuse and neglect, drug involvement (dealing or illegal
use), repeated exposure to violence, and ready access to guns. It is important for the
nurse to perform a thorough psychosocial assessment, including such factors as
behaviour patterns, history of physical and substance abuse, education,work history,
and social support systems to detect personal and environmental risk factors for
violence. Death and injury occur from physical assaults, motor vehicle or other
accidents, and suicide attempts. In 2007, homicides occurred at a higher rate among
men and people ages 20 to 24 years than other violent deaths (USDHHS, CDC,2010a)