Chapter 7: Life Span Development

review q's Original which of the following is the LEAST likely cause of a fall in a patient of this age? a. hypertension b. hypotension c. balance issues d. muscle weakness

hypertension (why)

which of the following should be expected when you assess the patients pupils? a. slower pupillary reaction b. vision deficit c. fixed, dilated pupils d. unequal pupils

slower pupillary action

vital sign ranges

*

special populations

-infants often land head first when they fall because their heads account for 25% of their total body weight. -when counting an infants resps, count the number of times the abdomen rises instead of concentrating on the chest rise -when you interview adolescents in the presence of their family, they may not tell you the complete truth . Ask certain questions in total privacy -be patient when interviewing older pts.

6. Describe the major physical and psychosocial characteristics of an early adult's life. (pp 249-250)

19-40 y/o. Pulse rate will average around 70 beats/min. Respiratory rate will stay in the range of 12 to 20 breaths/min. Systolic blood pressure will be between 90 and 140 mm Hg. lifelong habits are solidified work, family, stress body is at peak efficiency But as this period continues: The disks in the spine begin to settle. Fatty tissue increases, which leads to weight gain. Muscle strength decreases. Reflexes slow. Unintentional injuries is still leading cause of death since last mentioned.

7. Describe the major physical and psychosocial characteristics of a middle adult's life. (pp 250-251)

41-60 y/o vital signs same as early adult group is vulnerable to hearing and vision loss, cardiovascular issues, and cancer menopause begins in late 40's early 50's health is stable 41-44 leading cause of death is unintentional injuries 45-60 is cancer

4. Describe the major physical and psychosocial characteristics of a school-age child's life. (p 247)

6-12 y/o, vital signs approach adult levels most children grow 2.5 inches each year and about 4 pounds Pulse rate is approximately 70 to 120 beats/min. Respiratory rate 15 to 20 breaths/min. Blood pressure is 80 to 110 mm Hg Preconventional reasoning: Children act almost purely to avoid punishment and to get what they want. Conventional reasoning: Children look for approval from their peers and society. Postconventional reasoning: Children make decisions guided by their conscience. Self concept and self esteem develop

8. Describe the major physical and psychosocial characteristics of an older adult's life. (pp 251-255)

61 years and up 61-64 = cancer is leading cause of death 65 and older, leading cause of death is heart disease Experience many changes in the body: Cardiovascular: Cardiac function declines with age as a result of anatomic and physiologic changes largely related to atherosclerosis. Cholesterol and calcium build up inside the walls of coronary blood vessels, forming plaque, which leads to a partial or complete blockage of blood flow. More than 60% of people older than 65 years have atherosclerotic disease, leading to decreased blood supply to the organs of the body. -decrease in heart rate and CO -Diastolic P increases -bone marrow is replaced with fatty tissue Respiratory: The size of the airway increases and the surface area of the alveoli decreases. -chest is more fragile -immune cells less functional, so lung infections increase By age 75, vital capacity decreases and residual volume (the amount of air left in the lungs after expiration of the maximum possible amount of air) increases with age. Endocrine insulin levels drop, making some prone to diabetes mellitus metabolism decreases Hormone production decreases for both genders. Sexual desire may diminish with age but does not stop. Digestive taste bud sensitivity decreases saliva secretion decreases loss of teeth intestines contract less blood flow can drop by 50%, decreasing absorption in intestines gall stones common fecal incontinence Renal filtration function declines by 50% from age 20 to 90 years. less blood supply to nephrons nephron number decreases Nervous system Brain weight shrinks 10% to 20% by age 80. The metabolic rate in the older brain does not change and oxygen consumption remains constant throughout life. Motor and sensory neural networks become slower and less responsive. neurons decreases. but no loss of knowledge or skill biphasic sleep cycle brain shrinkage causing void in outermost meninge layer diminished sensation Sensory changes Pupillary reaction and ocular movements become more restricted. pupils are smaller Hearing loss is four times more common than loss of vision in late adulthood. Psychosocial changes Until about 5 years before death, most late-stage adults retain high brain function.In the 5 years preceding death, mental function often declines. Today, more than 50% of all single women in the United States who are 60 years of age or older are living at or below the poverty level. challenged with isolation and depression

2. Describe the major physical and psychosocial characteristics of an infant's life. (pp 241-244)

At birth, a pulse rate of 90 to 180 beats/min and a respiratory rate of 30 to 60 breaths/min are considered normal. Within the first half hour after birth, a neonate's pulse rate often drops to 120 beats/min and the respiratory rate falls to between 30 and 40 breaths/min. By age 1 year, the respiratory rate slows to 20 to 30 breaths/min. Blood pressure directly corresponds to the patient's weight, so it typically increases with age. At birth, the average systolic blood pressure of a neonate is 50 to 70 mm Hg. By 1 year of age, it ranges between 70 and 95 mm Hg. Neonate typically weighs 6-8lbs head = 25% total weight first week, weight loss occurs due to fluid loss week 2, weight gain begins at 1oz/day prior to the first breath, a neonate's lungs have never been inflated primarily nose breathers -therefore prone to nasal congestion -belly breathers - as infants move more, more O2 is needed, and alveoli grow in mumber Nervous system: The neonate lacks the ability to isolate a particular response to sensation. The Moro reflex (startle reflex) happens when a neonate is caught off guard by something or someone; the neonate opens his or her arms wide, spreads the fingers, and seems to grab at things. A palmar grasp occurs when an object is placed into the neonate's palm. The rooting reflex takes place when something touches a neonate's cheek; the neonate will instinctively turn his or her head toward the touch. The sucking reflex occurs when a neonate's lips are stroked. Fontanelles eventually fuse to form the skull At birth, the neonate cannot turn over or focus his or her eyes beyond a very short distance. By 2 months, the infant is able to track objects with his or her eyes and should recognize familiar faces. At 6 months, the infant is able to sit upright and begins to make cooing and babbling sounds. By 12 months, the infant can walk with assistance and even knows his or her name. Immune system: fetuses collect antibodies from mom via naturally acquired passive immunity. also through breastfeeding Leading cause of death = congenital abnormalities Psychosocial changes: crying= method of communicating stress bonding, secure attachments, anxious-avoidant attachment, separation anxiety, trust and mistrust occur.

3. Describe the major physical and psychosocial characteristics of a toddler and preschooler's life. (pp 245-247)

In toddlers (ages 1 to 3 years): Pulse rate is normally 90 to 150 beats/min. Respiratory rate is 20 to 30 breaths/min, slower than the corresponding vital signs in infants. Systolic blood pressure is higher (80 to 100 mm Hg). Average body temperature is 96.8°F (36°C) to 99.6°F (38°C), usually leveling off at 98.6°F (37°C) by school age. Preschoolers (3-6 y/o): -pulse rate = 80-140 beats/min -resp. rate = 20-25 breaths/min gross motor activities develop to fine motor activities Physiologically, toddlers have the neuromuscular control capable of bladder control by 12 to 15 months of age. The child may not be psychologically ready until 18 to 30 months of age.The average age for toddlers to complete toilet training is 28 months. The leading cause of death for this age group is unintentional injuries (accidents). Psychosocial changes: 10-18 months separation anxiety peaks 36 months- basic language is mastered By 18 to 24 months, toddlers begin to understand cause and effect. children also learn to recognize gender differences by observing their role model.

list at least three psychosocial issues people experience during late adulthood

Rising costs of health care, mortality, death of friends and loved ones, isolation, depression

what influence will the medications the patient takes have on the potential reason for the fall?

Side effects of certain medications may cause weakness, dizziness, and/or hypotension. Knowing what medications the patient takes and the side effects of those medications makes you better able to understand what caused a fall.

why is there an increased need for additional extended care facilities?

The increasing number of older adults in the United States as a result of the baby boom of the 1940s through the 1960s has produced a need for additional extended care facilities.

describe some of the contributors that affect life expectancy

The year you were born and the country you live in can affect your life expectancy. These two factors are based on public health advances, changes within diets, attitudes regarding exercise, advances in medical care, access to that medical care, and personal behaviors. Overall health, medical conditions, and medications taken also contribute.

5. Describe the major physical and psychosocial characteristics of an adolescent's life. (pp 247-249)

adolescents (ages 12 to 18 years): Systolic blood pressure is generally between 90 and 110 mm Hg. Pulse rate is between 60 and 100 beats/min. Respirations are in the range of 12 to 20 breaths/min. Growth begins with hands and feet, then moves to the long bones of the extremities, and finishes with growth of the torso. girls finish growth spurt at 16. Boys finish at 18 Secondary sexual development and enlargement of external reproductive organs psychosocial changes: -need for privacy and space -self consciousness -create adult image -Antisocial and high-risk behavior and peer pressure tend to peak at around age 14 to 16 years. -greater interest in sex -may have to question away from parents to get truthful answers

who provides the most care for older adults in the US? a. home health nurses b. nursing homes c. family members d. an assisted-living facility

family

1. Know the terms used to designate the following stages of life: infants, toddlers and preschoolers, school-age children, adolescents (teenagers), early adults, middle adults, and older adults. (pp 241-251)

infants 0-12 Months toddlers 1-3 yrs preschoolers 3-6yrs school-age children 6-12 yrs adolescents 13-18 yrs early adults 19-40 yr middle adults 40-60 yrs older adults 60+years

which of the following statements is true regarding communication with older adults? a. you must speak loudly so the patient will hear you b. communication may be difficult since the weight of the brain shrinks up to 40% by the age of 80 c. it may take older adult patients more time to respond to your questions d. place yourself directly in front of the patient since peripheral vision narrows as the patient becomes older

it may take older adult patients more time to respond to your questions

changes in which of the following body systems can result in the most debilitating of age-related illnesses? a. nervous b. renal c. sensory d. endocrine

nervous

which of the following affects the vital signs the most in older adults? a. patient's immune system b. overall health of the patient c. patient's cardiovascular system d. patient's diet

overall health of the parient