Chapter 24 lifespan development

Which statement by the older adult indicates that nutritional counseling was effective?

"I need to eat more fats and proteins."

Early Adulthood

20-40 years

early adulthood

20-40 years

School age

6-12 years

Wear and tear theory

According to the wear and tear theory, are is not based on chronologic age but is determined by the amount of wear and tear experienced. Many believe that the structural and functional changes associated with growing old are accelerated by abuse of the body.

What grade level did Erikson influence the most?

Pre-school

Adult vitals

RR 12-20 HR 60-100 BP LESS THAN 120/80

The parents of a 1-week-old infant are concerned that they are going to "spoil" their baby if they hold him too much. The nurse understands that according to Erikson, when infants are cuddled, fed, and loved, they develop which characteristic?

Trust

Democratic family pattern

adult members function as equals

which developmental skill is commonly accomplished by the 4th month of life?

holding head up at 90 degree angle

The nurse is observing a group of preschool children playing. What type of play is most common with age group?

imaginary play

the nurse is observing a group of preschool children playing. what type of play is most common with this age group

imaginary play

Erikson Stage 4 - 7 to 11

industry v. inferiority children eagerly learn to be competent and productive or feel inferior and unable to do any task we..

School age (6-12 years old)

physical characteristics : During the school-age period, the growth pattern is usually gradual and subtle. The most obvious growth is in the long bones of the extremities and in the development of the facial bones. As a result of this bone growth, some children report growing pains particularly at night. Persistent pains call for evaluation by a physician to rule out any underlying pathologic condition. From ages 6 - 12 years, height and weight increase by about 2 inches and 4.5 to 6.5 lbs per year for boys and girls. Motor skills in boys and girls develop with some differences; boys often become stronger, and girls more graceful and accurate. The child's posture becomes straighter. The causes of poor posture range from fatigue to emotional states or even minor skeletal defects. Ensure that school age children are screened routinely for scoliosis (abnormal lateral curvature of the spine). Muscle mass and strength, gradually increase, and the body loses the "baby fat" appearance of earlier childhood. Gross motor and fine motor development continue to be refined during the school age years. Vision improves, and most children have 20 / 20 vision at this stage. Regular vision testing is advisable throughout the school years. vital signs Heart and respiratory rate steadily decrease, whereas blood pressure increases. Normal pulse rate is between 55 and 90 per minute, respiratory rate is 22 to 24 per minute, and blood pressure is 110 / 65 mm Hg. Dentition: by age 6 years, the child begins to lose the deciduous teeth. Permanent teeth develop rapidly. Dental check ups should continue every 6 months throughout childhood. Psychosocial development: Entrance into school challenges the child and creates demands for new social and cognitive skills. The child demands for new social and cognitive skills. The child becomes more independent and participates in a broader world of peers and new experiences. School age children become increasing aware of rules and socialization skills and expectations. The beginning abilities to compromise and compete are challenges faced in this age group. Erikson identified the task of the school age years as industry versus inferiority. After the child realizes that "there is no workable future within the womb of his family" says Erikson, the school age child "becomes ready to apply himself to given skills and tasks". Children develop their own goals and direct their efforts toward mastery of these goals. As children discover their talents and accomplishments, they gain self confidence and a sense of purpose. During these years, the child learns to work and masters skills that produce satisfaction as the result of that work. Successful mastery of learning in school leads to strengthening and stabaliziing the child's sense of self. According to Erikson, as children busily try to master the skills valued in their culture, they develop views of themselves as either competent of incompetent as either industrious and productive or inferior and inadequate. Input from the outside is a key influenceon which direction the child's self-concept will take. If the environment inadequately supports a child's pursuits, the stage perhaps is set for the development of feelings of inferiority and the lack of self confidence. The good school setting is a pleasant, comfortable environment. Teachers and caregivers need to use praise, encouragement and rewards to reinforce the school age child's efforts positively. Teachers also must be positive role models. School helps the child learn new routines and establish important social relationships. However, the school climate can be affected negatively by bullying. Bullying can take on many forms, including physical (hitting, tripping), verbal (name calling, teasing), relational (spreading rumors, excluding), and cyber (email, text messaging)> CDC defines bullying as "any unwanted aggressive behavior(s) by another youth or group of youths who are not siblings or current dating partners that involves an observed or perceived power imbalance and is repeated multiple times or is highly likely to be repeated. In 2015 20% of high school students reported they had been bullied on school property. Bullying can lead to physical injury as well as depression, anxiety, sleep difficulties, and even death. One way to prevent bullying is for schools to have a consistently enforced antibullying policy. cognitive and intellectual development: according to Piaget, children in the school years move into the concrete operational phase. During this phase, thoughts become increasingly logical and coherent so that the child is able to classify, sort, and organize facts while still being incapable of generalizing or dealing with abstractions. Children have the capacity to think rationally about almost any specific and concrete perception. Between ages 7 and 11 years, children usually come to understand logical principles - again, as long as the principles can be applied to concrete, specific cases. They distinguish purpose from behavior and outcome and are able to focus on more than one aspect of a task. Children in this age group have begun to develop logical socialized thought. They view the world more realistically than they did at younger ages, and they are capable of understanding the views of others. Movement is away from fantasy as the child realizes that a physical cause is behind an event. The child's developing cognitive skills serve as a motivator for learning how to work. A supportive learning environment often enhances the child's approach to problem solving and helps lead to success. The school age child experiences gradual and subtle growth changes while learning new social and cognitive skills. communication and language Most 6 year olds have a good command of sentence structure. The child's vocabulary has become more extensive and includes slang and swear words, which many children enjoy using for the effect they create. Fine motor development continues and, combined with growth in cognitive and communication skills, produces refinements in written-language and musical abilities. By age 7 years, the hands of the child have become steadier. Printing becomes clearer and smaller. Between ages 8 and 10 years, the hand becomes more efficient, which enables the child to write rather than print. The 10 - 12 year old child has the capacity to accomplish complex, intricate, fine-quality handcrafts and sometimes begins piano, violin, or guitar lessons. Nutrition: total metabolic needs are determined by the energy expenditure of each individual child. The sedentary, quiet child who prefers fine motor activities needs fewer calories than the child who is more oriented to athletics or is more physically active. Building on toddler-age and preschool age foundations, strong dietary habits and food preferences are established during the school-age period. Cultural influences, family habits, and peer pressure are critical factors in how a child's food habits develop. Obesity during this period is correlated closely with obesity in adult years. Therefore the child's weight must be maintained within normal limits. In middle childhood, obese children are teased, picked on, and rejected. They know they are overweight, and they often hate themselves for it. Obese children usually have fewer friends than other children. The best way to get children to lose weight is to increase their physical activity. Indeed, inactivity is possibly as responsible for childhood obesity as overeating. Diets high in saturated fat increase a child's risk for high blood cholesterol and earlier occurrence of heart disease unless steps are taken to lower these levels. Sleep, play activity, and safety: Fatigue, irritability, inattention, and poor learning are often signs of inadequate sleep. The 6 year old needs about 12 hrs of sleep at night. By 12 years, the child usually needs about 10 hrs of sleep. Some children have frequent nightmares that disrupt their sleep. Stress, violence on TV and over-tiredness may contribute to a child's nightmares. Relaxation techniques such as quiet music, story time, and bathing often help the child relax before sleep. School age children need adequate exercise to enhance muscle development, coordination, balance, and strength. In addition, music, craft projects, board games, appropriate television, and video games are all enjoyed by the school age child. Privacy and a place for their belongings are important at this age. The school age child is often a willing worker and enjoys being paid for small jobs. Collection and hoarding of treasures among their belongings are a part of this stage of development. Many children during the school years become involved with competitive or team sports. Children of this age show interest and loyalty to peers of the same gender. Some may benefit from team competitiveness and use it to motivate themselves to excel. Others shy away from competition and become disinterested or develop feelings of inadequacy and disappointment. Accidents are still the leading cause of death in this age group. Impulsiveness, poor judgment, curiousity and incomplete control over motor coordination are some the factors that increase the school-age child's risk of accidents. TV often exerts a powerful influence on a child's development and children are watching an average of 4 hrs of TV daily. One concern about TV today is the increased amount of violence it portrays. Many believe that, although not the cause of aggressive behavior, a good deal of available TV content offers the child a potent model for aggressive behavior and is a significant factor in the development of aggressive behavior. Suggests ways for parents to help reduce the negative influence of TV by limit time and screen programs for content and age appropriateness. School violence : increased availability of weapons and breakdown of communication. Need resources to to help deal with daily stressors. Children need to feel comfortable discussing their feelings and concerns with parents and teachers and must be able to use these discussions to learn how to recognize whether they are in danger and whether others are exhibiting signs of troubled behavior. Parents need to be involved and active in their children's lives. kids need to be able to recognize and report the signs of troubled behavior if they notice them in a friend or a classmate without feeling that they have decided the other person or let the other person down. Guns must be kept locked and ammunition removed from guns when stored.

pre-schooler 3 to 5 yrs

physical characteristics: physical development during early childhood occurs on many fronts. The most obvious are the striking changes in size and shape; and the most important maturation of the nervous system and mastery of motor skills. Growth during the preschool period tends to be slow and steady. The preschooler looks taller and thinner than at earlier stages as the toddler's lordosis and protuberant abdomen are left behind (the abdominal muscles strength, and the child loses the potbelly appearance). Average weight gain is less than 5 pounds (11 kg) per year. Linear growth is about 2 to 2.5 inches (5.08 to 6.35 cm) per year. Height of the 4 years old is usually double the birth length. The gait of the pre-schooler becomes steadier. The preschooler is more capable of focusing and refining activities, and the body grows slimmer, stronger, and less top heavy. Because of these developments, gross motor skills (large body movements such as running, climbing, jumping, and throwing improve dramatically. Tasks such as tying shoelaces, cutting food with a knife and for, and putting together a puzzle prove more difficult because of the preschooler's undeveloped fine motor skills (skills that involve small body movements) these are much harder for them to master than gross motor skills. Development of fine motor skills is important to encourage. The scribbling of the young child is comparable with the babbling of the infant. Both are ways to obtain practice with the means to later mastery of essential communication skills. Providing pencils, crayons, markers, and paper is an important as providing things to climb, objects to throw, and places to run. Vision in the younger preschooler is described as farsighted. Vision improves during this period, and most children achieve 20-30 visual accuracy by age 4 years. A yearly check of preschool children's vision is recommended. Sometimes Amblyopia, a condition commonly known as lazy eye, is detected during simple eye examination. Corrective measures, such as patching the good eye, usually strength the lazy eye and are necessary to prevent blindness. vital signs Heart rate for the preschooler ranges between 70 - 110 beats per minutes. Respiratory rate slows to about 23 breaths per minute at rest. BP averages 110/60 mm Hg. Temperature ranges from 97 to 99 F (36.1 to 37.2) depending on the method used for measurement. psychosocial development First children learn to function independently, they subsequently use imagination to explore new experiences creative.y. Erikson describes the task of the preschoolers in terms of initiative v. guilt. Preschoolers search for and create fantasies about the different kinds of people they would like to become. They pretend to be grown up and try out a variety of roles. During the preschool period, the child's superego (conscious) functions as a censor of behavior. The dilemma of the preschooler, according to Erikson, is to test initiative without creating an overwhelming sense of guilt. Typical development of the preschooler includes gender identification. At this time, the child commonly stereotypes roles and shows marked interest in sexual differences. Strong sibling bonding is established. cognitive and intellectual development According to Piaget, the preschool child is at the pre-operational stage of cognitive development. Pre-schoolers use symbols to represent objects. They use trial and error to to discover and adopt new traits and characteristics. Between ages 4 and 7 intiuitve thinking develops, and the child begins to think logically. Children in the preoperational stage see the world from their own viewpoint. They see things as absolutes, in terms of white and black and either good or bad. During the preschool stage, time is associated with weekly and seasonable events. Magical thoughts are typical of the child of this age, who believes that wishes have the power to make things happen. As a result, the preschool child sometimes feels powerful and responsible for events that occur. Because of the belief that a wish has caused serous harm or even death to a loved one, the preschooler at times feels guilty. The occasional "white lies" or untruths of this period usually reflect some of the child's fantasies. During this stage of development, the child needs trustworthy guidance to distinguish truth from fantasy. At this stage, the child is more vulnerable to certain fears, probably fallout from the typically vivd imagination. Excessive exposure to inappropriate television content and other media has the potential to manifest at this stage include fear of thunder, lightening, the dark, pain, abandonment and monster. communication and language By age 3 years children are able to carry on a conversation. Pronunciation problems continue into the school years. Language becomes more adult-like. If the child is not talking by age 3 years, evaluation by a physician for possible hearing loss or other pathologic speech disturbances is necessary. Advise parents to continue to read to their child to help expand language ability and comprehension and to continue to foster positive child-caregiver relationships. nutrition Because body systems and muscles still are growing steadily, the preschool child continues to need high levels of protein. Dietary calcium and phosphorus are important to toddlers and preschool children because of the increasing mineralization of their teeth and bones. Food habits, likes, dislikes and appetites vary greatly from child to child. Some physicians recommend supplementary vitamins. Vitamins like any other medication are not intended and do not have the capacity to take the place of food eating habits. A body mass index (BMI) at or above the 85th percentile and lower than the 95th percentile for children of the same gender and age is considered overweight. A BMI at or above the 95% percentile for children of the same gender and age is considered obese. Most cultures hold strong views regarding obesity, which results in emotional consequences for an obese child. Control of weight is an important parental concern because it helps prevent serous health issues later in life. Overweight infants are more likely to become overweight later in life. genetic factors may predispose individuals for obesity; additionally, children often adopt the eating habits of parents. Make suggestions to parents of way to help with their children's weight control, model good eating beheaviors, provide health food, and encourage physical activity. sleep, play, activity, and safety pre-schoolers often resist nap periods but still need 11 to 12 hours of sleep at night. Rest periods offered during the day enable children to reenergize and carry out the ret of their daily activities. Play style for the preschool child becomes cooperative. The child begins to share, take turns, and interact with playmates. Preschoolers enjoy pretending to carry out activities such as cooking, shopping, and driving. Through dramatic play, the child tries on different roles and identifies with adult models. Not only is fun for two or more children to cooperate in creating their own scenario but it also helps their social development to try out social roles, express their fears and fantasies, and learn to cooperate. Experiences with imaginary playmates are not uncommon in this age group. Children often feel a sense of control over what happens in their "imaginary world" and slowly learn to deal with reality through practice and experimentation. Children during the preschool period are becoming more coordinated and want to begin participating in more organized games. By age 4 to 5 year, s children learn to ride a bicycle with training wheels. They need guidance because they have difficulty maneuvering. Swimming, skating, and dancing are activities that children in this age group often begin to learn and enjoy. Activities of this nature should be fun for the child. It is not beneficial or appropriate for children to be pressured to participate in activities that they do not like or enjoy. Also advise parents and caregivers to space activities so that children are not overstessed by having too many lessons, practices, or games.All the safety precautions described previously apply to the preschool child and the infant and toddler. Instruct parents and caregivers to teach preschool children their full names, addresses and telephone numbers. Children need to know how to use the phone in case of an emergency. Discipline and limit setting are needed and are as important to the child as are love and security. Necessary guidance includes offering alternative ways of expressing feelings and meeting needs. The preschool period is a time of learning to function independently and exploring the imagination.

6-12 year vitals

pulse: 55-90 BP: 110-65 respiration: 22-24 temperature: 97-99*

12-19 years vitals

pulse: 70 BP: 120/770 respiration: 20 temperature: 97-99*

1-3 years vitals

pulse: 90-120 BP: 80-100/60 respiration: 20-30 temperature: 98-99*F

7-11 age expectations

they aim to please Erikson - industry v. inferiority they want to be top of their class - aim for perfection

infant mortality rate

this is the number of deaths before the first year of life

life expectancy

this the average number of years an individual will probably live for

todder 1 - 3

toilet training - if not trained at 3 - lack of normal parents find out at this stage development delayed physical characteristics: rate of growth in the toddler is slower than in infancy but follows the same general principles. It is orderly. It poceeds from head to foot, from the center outward, and from general to specific movements. One of most striking changes from infancy is the upright stance of the toddler. The chubby look of infancy is gone by 12 to 15 months. In the beginning of this stage, the toddler's body proportions result in a top heavy appearance. By the end of this period, however, rapid growth of the extremities and slowed growth in the trunk produce a more proportionate body appearance. An exaggerated lumbar lordosis (convex lumbar curve) and protruding abdomen produce a potbelly appearance, which disappears as the abdominal muscles strength. By age 2.5 years, all 20 deciduous teeth are present. Advise parents to begin routine dental examinations and tooth brushing during this period. vital signs: during the toddler period the pulse ranges from 90 to 120 beats per minute. BP averages 80 - 100 mm Hg systolic and 64 mm Hg diastolic. Body temperature ranges between 98 degrees to 99 F (36.6 degrees and 37.2 centigrade). Respirations slows to 20 - to 30 breaths per minute. Many gross motor skills emerge in this period including walking, climbing stairs (2 years) and hopping (3 years). The toddler develops running, pulling and holding on tight skills exploring the world in ways previously impossible. This time is also when the toddler begins acquiring fine motor skills, such as beginning to scribble (2 years) and copying a circle (3 years). Toilet training: children do not reach the physiologic or psychological maturity necessary to begin toilet training until 18 to 24 months of age. Children need to reach maturity to have neuromuscular control, the cognitive ability to understand what is expected of them, and the language skills to express their needs. Bowel control is achieved first. Bladder control begins at the same time but takes longer to achieve. Nighttime control usually is achieved after daytime control is established. Advise parents and caregivers to expect setbacks and accidents, particularly during times of stress or illness. Deemphasize accidents, never make the child feel inadequate. Praise success success and ignore accidents. If praise is given for toileting successes and accidents are cleaned up without negativism, the toddler gains a sense of self-control, inner goodness, and pride. However, if the toddler is punished and made to feel foolish, a sense of shame develops. If the toddler is kept in diapers and given no opportunities to control the urges, a sense of doubt is fostered. Feelings of shame and doubt are not healthy personality attributes. psychosocial development: the toddler is uninhibited, energetic little person who always seeks attention, approval, and achievement of personal goals. Sometimes the toddler is cuddly and loving: at other times the toddler may bite, hit or pinch. The toddler only slowly realizes that everything desired is not attainable and that some behaviors annoy others. The toddler tries to be independent yet becomes easily frightened and runs to the caregiver for protection, security, reassurance and approval. Erikson sees the toddler as struggling with autonomy (self-control) in opposition to shame and doubt. With newfound skills of independence, walking, talking, self-feeding, and beginning toilet training, the toddler is struggling to be independent. Characteristic of this search for autonomy is the toddler's use of the word "no" which gives a sense of control. The toddlers possesses endless energy yet often falls asleep almost while still in motion. As toddlers struggle for independence, they frequently display possessiveness and a desire to have things go their way. Ritualistic behavior and repetitive rituals are self consoling behaviors at this stage. Toddlers enjoy the same story, the same routine, and the same foods at each meal. Rituals decrease their anxiety by helping them know what to expect. When health care providers follow a hospitalized child's usual rituals, the toddler feels safer and more secure in the strange environment. Temper tantrums are common and are the result of frustration. A combination of wanting things "my way", the inability to communicate feelings, and the lack of impulse control are perhaps behind outbursts of temper. This type of negativism is best ignored unless the child or others are in danger of harm. Toddlers need many experiences of being able to choose among alternatives (to play outside or inside,, to wear green pants or red pants). However, advise caregivers to make use of questions and offer alternatives for children only in situations in which either choice is acceptable. When a particular behavior is necessary (such as going to bed, holding hands to cross a street, letting fo of another child's hair), it is better not to offer a choice. Erikson stressed that young children do not have the wisdom to know what behaviors are acceptable or unacceptable, healthy or unhealthy. Discipline is a necessary means of teaching limit setting and impulse control. Basic principles of disclipline are listed in Box 24.9 (page 710). Toddlers seek attention, approval, and love as they struggle for independence. Cognitive and intellectual development: The period from 12 to 24 months of age completes the last phase of sensorimotor development, in which the toddler's knowledge of the world comes about primarily through sensory impressions and motor activities. The period of early childhood is the preoperational thought stage - when the child focuses on the use of language as a tool to meet needs, the child has the emerging ability to think. The child uses trial and error to discover new traits and characteristics. According to Piaget, this stage extends from 2 to 7 years of age. Toddlers constantly are absorbing new ideas widening their cognitive world, and expanding memory. Activities can be connected to past events or memories. The toddler's concept of time is limited to the present. The child's thinking is egocentric at this stage. Toddlers are often demanding, wanting things to go their way. Communication and language the cognitive and language development of toddlers makes it possible for them to express their wishes. Commonly used words at this age are "no" and "me". Toddlers use these words in an attempt to exert their will and to take on new challenges. During the toddler period, the child identifies objects by use. At 2.5 years of age, the toddler's vocabulary consists of about 450 words and two word sentences that include a noun and verb (e.g. me run). By 3.5 years of age, the child is able to answer questions and use brief sentences, and even recite television commercials,. The 3 years olds vocabulary is approximately 900 words. Regular reading to the children by parents and caregivers can increase the size of the children's vocabularies greatly. This activity also promotes bonding. Nutrition daily diet should consist of one serving the meat groups, two or more serving of vegetables, and at least two servings of fruit, cereal or breads. Toddler needs 2 cups of food from the dairy group per day. Too few solid foods can lead to iron deficiency, may times this is the result of consuming too much milk (more than 24 oz) which causes the toddler's stomach to feel full and results in a decreased appetite. Most children are more likely to eat foods with which they are familiar; therefore, gradual introduction of new foods is advisable. Bite size pieces finger foods and smaller portions are generally more acceptable. foods with high risk of choking such as hot dogs, grapes, carrots, and small candies, should not be given to toddlers. In the past experts suggested to avoid the early introduction of foods known to be common allergens, such as eggs, wheat, nuts and cow's milk. Newer research is indicating that early introduction, around six months of age, actually helps prevent allergies to develop. Toddlers can be picky eaters and often are too busy playing to stop and eat. Parents should be encouraged to provide frequent, smaller and nutritious meals throughout the day. Toddlers need less food per unit of body weight than they did during infancy. A general guideline for serving size is 1 tablespoon of each solid food for each year of age. Parents must be informed that during illness, brief periods of anorexia are not usually serious. Examples of nutritious finger foods that are safe and easy to eat on the run include ripe fruits such as bananas, pears, melons and avocados, cooked vegetables including squash and sweet potatoes, shredded cheese is another good option. Sleep, play activity, and safety Toddlers expend a high level of energy in daily growth, play and exploration. Adequate rest and sleep are essential for maintaining optimal wellness. The toddler needs 12 hours of sleep each night plus a daytime nap. Suggestions helpful in promoting healthy sleeping patterns include limiting stimulation before sleep time, using quiet-time activities before sleep, allowing a favorite bedtime toy, telling a specified number of stories, and establishing and maintaining bedtime rituals. Play improves muscle co-ordination, balance and muscle strength. The toddler's play style described as parallel play refers to the need that toddlers have to play along with, but not directly with, their peers. Unable to share and interact with their peers at this stage, they play side by side with similar toys in similar ways but without interacting. Toddlers thrive on activities that allow them to move. Running, jumping, and climbing activities help toddlers to develop bones and muscles. This age group's natural curiosity about how things work encourages them to explore. Play groups help encourage the shy or reluctant child to particular and try new activities. The developmental tasks of toddlers are summarized in Box 24.11 (page 711).

the nurse is caring for a patient who has just undergone artificial insemination. the nurse recognizes that the fertilized egg is referred to as which term before implantation in the uterus?

zygote

The student nurse is preparing for a clinical day at a local long-term care facility. The student has a correct understanding of the theories of aging when she/he makes which statement? (Select all that apply.)

"Free radicals improve cellular efficiency and delay the aging process." "With aging the body becomes less able to recognize itself and produces antibodies that act against the self." "Free radicals cause an accumulation of cellular waste that may accelerate the aging process." "Abuse of the body can accelerate functional and structural changes associated with growing old."

a new parent asks how to introduce solid foods to the infant. Which statement indicates that the teaching was effective?

"I will introduce one new food a a time"

which statement by the older adult indicates that nutritional counseling was effective.

'i need to eat more fats and protein"

Stages of family development - life cycle

-Engagement or commitment stage: plans to marry -Establishment stage: from wedding - birth of 1st child -Expectant Stage: conception - pregnancy -Parenthood: begins at birth of 1st child -Disengagement stage: grown kids leave home -Senescence stage: last stage of life cycle

Piaget's stages of cognitive development

1. Sensorimotor: birth to 2 years 2. Preoperational thought 2 to 7 years 3. Concrete operational thought 7 to 11 years 4. Formal operational thought: 12 years

Erikson's stage of psychosocial development initiative v. guilt

4 to 6 - initiative v. guilt children want to undertake many adult like activities, sometimes going beyond the limits set by parents and feeling guilty because of it

Middle adulthood

40 - 65 years

late adulthood

65 year old and older

How many stages did Erikson develop?

8 Stages

Which patient needs to get both pneumococcal and influenza vaccines?

Answer 1: 68 year old resident in an assisted living facility All of these people should be encouraged to get the influenza vaccine, but adults over 65 years should get the pneumococcal and influenza vaccines

Democratic family pattern

Family style in which the adult members are considered equal and children are treated with respect and recognized as individuals joint decisions - as a unit

Erikson's stage of psychosocial development Ego integriy v. despair

Stage 8 late adulthood age 65+ older adults try to make sense out of their lives, either seeing life as meaningful and whole or despairing at goals never reached and questions never answered

Integrity v. despair occurs in which age group/stage?

Stage 8 late adulthood 65+ Older adults try to make sense out of their lives, either seeing life as meaningful and whole or despairing of goals never reached and questions never answered

The father of 17 year old boy is concerned because his son is questioning all of the family's morals and values. Which is true regarding the development tasks of an adolescent?

adolescents question their own values and beliefs as they search for their identity

what term accurately describes the principle that growth begins at the head and moves toward the lower extremities

cephalocaudal

Piaget's stages of cognitive development Formal operational thought: 12+ years

uses a systematic, scientific problem-solving approach recognizes past, present, and future is able to think about abstractions and hypothetical concepts and is able to move in thought "from the real to the possible" becomes more interested in ethics, politics and all social and moral issues to take a broader and more theoretic approach to experience increases

Piaget's stages of cognitive development Sensorimotor : birth to 2 years

uses senses and motor abilities to understand the world and coordinates sensorimotor skills, this period begins with reflexes develops schema begins to interact with environment learns that an object still exists when it is out of sight (object permanence) and begins to remember and imagine experiences (mental representation) Develops thinking and goal directed behavior

Infancy

1 to 12 months

adolescence

12 - 19 years

adolescence

12 to 19 years

Middle adulthood: 40 - 65 years Psychosocial Development

According to Erikson, the development task of middle age is generativity versus stagnation, which means age is generativity versus stagnation, which means accepting responsibility for and offering guidance to the next generation. Generativity encompasses productivity, continuity, and creativity. If this developmental task is not met, people become stagnant - inactive or lifeless. The middle adult years are a time for vocational, interpersonal, and personal fulfillment. The impulse to foster development of the young is not limited to guiding one's own children and does not cease with their maturation. Many middle aged adults enjoyably express this desire through activities such as teaching and mentorship, a mutually fulfilling relationship that satisfies a younger protege's need for guidance along with an older person's need for generativity. Resumption of education, career growth or changes, reentry into the workforce, and involvement with community activities create a multitute of possibilities for personal growth and satisfaction during the middle adult years. Family roles change during this stage. Children are sometimes present in the home. For most caregivers, a significant change in their lives occurs with the end of daily, active responsibility for children. Relationships between spouses change, and the couple often has to regain familiarity with each other. For many, this offers the opportunity for new or renewed companionship. Survival of the marriage after children leave home possibly depends on the growth, the maturity, and the commitment of each partner. Most women with an "empty nest" look forward to their emancipation from parenting duties, seeing it as an occasion to develop further their personal and social roles. The role of grandparenting often begins at this developmental stage. Because it often does not have the constraints and responsibilities of childrearing, grandparenting becomes a rich and rewarding experiences for many middle-aged adults. The past few decades have probably been the best time ever to be an American grandparent and to enjoy grandparenting as a joyful experience. Grandparents now have the longest, healthiest lifespans ever recorded, the best social services, and the most independence. Many still hover just above the poverty line, and some are below it; however, many grandparents are prosperous. Many of today's grandparents have lots of grandchildren to enjoy. Many American grandparents are not involved in the upbringing and discipling of their grandchildren, preferring a norm of noninterference. Grandparents often refrain from giving their grown children childrearing instructions, even when they do not like something they see going on with their grandchildren. Most contemporary grandparents value their independence. Many are unwilling to exchange their hard won and long awaited lifestyles for another round of the hard, often frustrating work of raising children. On the other hand, most adults, are not prepared for the increased responsibility of caring for aging parents.Economic stress and emotional pressure are associated with the role reversal sometimes known as parenting the parent. Studies have indicated that a midlife daughter is most likely to be involved in elder care with her parents and her husband's parents.

Based on the knowledge of normal changes of the cardiovascular system, which reccomendation would the nurse make to an older adult?

Answer 1: maintain a low fat and low sodium diet Low-fat, low-sodium diet help decrease the risk of atherosclerotic heart disease and hypertension. Streptococcal pneumonia vaccine and coughing and deep-breathing are interventions for expected changes in the respiratory system. Frequent position changes help protect the skin.

What is an advantage of the theory?

Emphasizes the importance of relationships

Adoescence 12 - 19 years

Physical characteristics: covers the transition period from children to adulthood. Adolescence begins at puberty; accompanying the pubertal changes are corresponding changes in the personality. Puberty the period of life at which the ability to reproduce begins, entails the maturation of the reproductive system, including all the primary and secondary sexual developmental changes. Regarded as the psychological, social and maturational process initiated by pubertal changes. Adolescence is characterized as the second major period of rapid growth. Females grow 2 to 8 inches where males grow 4 to 12 inches. During this period, females gain 15 to 55 pounds and males gain 15 to 65 pounds. Females develop more body fat, and males develop more muscle tissue. After puberty, men average 50% muscle and 27% fat. Muscle strength and muscle mass increase in the male, which causes the average male to have more muscle strength. Exercise facilitates the size, strength, and endurance of each adolescent. girls have lower center of gravity. Both experience voice changes. Girls voices becomes fuller and richer because of lengthening of their vocal chords. Boys voices become lower and louder and deeper resulting from enlargement of the larynx. Sexual interest increases vital signs average pulse rate is 70 beats per minute, respiratory rate averages 20 breaths per minute. Blood pressure increases to 120 / 70 mm Hg. psychosocial development distinct behavior changes - mother may notice that her 11 year old daughter has become tight lipped about school and activities, no longer wanting her mother's opinion or listening ear. Her daughter is now spending time at home in her room with the door closed. Father may delight in his son's musical talents and his band's energy and success, although the two may argue over the taste of their lyrics and decibel level. The period of adolescence frequently is described as difficult and involving a stormy search for oneself. Confronting every adolescent are a changing body, sexual demands, responsibilities, expectations, and questions about values and beliefs. The search for identity amid a world of social pressures creates a painful struggle. Erikson described the developmental task of adolescence as establishing a sense of identity. He proposed the conflict of identity v. role confusion as characteristic of adolescence. The search for a sense of identity he believed, reaches crisis proportions at this time. Not only does the adolescent need to adjust to a sexually mature body but also all previous conflicts (trust v. versus mistrust. autonomy v. doubt, initiative versus guilt, and industry v. inferiority) must be resolved yet again in light of the newly sensuous self. The period of adolescence requires major reorganization of the personality, resolution of childhood insecurities, and acceptance of adult responsibilities. The value of peers influence preferences of dress, speech, and leisure activities. The peer group is often the milieu to learn and test developing interpersonal skills. Many adolescents use conforming, behavior to win praise and acceptance by peers. If handled properly, adolescence is often a great period of accomplishment and creativity. cognitive development According to Piaget, an individual's cognitive function reaches maturity during adolescence. Piaget describes this stage as the formal operational thought stage. This is a higher process that permits abstract reasoning and systematic, scientific problem solving. Adolescents become capable of reasoning and formal logic. At this time, thoughts may be influenced more by logical principles than by personal perceptions and experiences. The adolescent thinks beyond the present. Without having to focus exclusively on the immediate situation the adolescent can imagine the possible: a sequence of events that may occur, such as college and occupational possibilities; how things may change in the future, such as relationships with parents and the possible consequences of actions he or she is considering such as dropping out of school. moral development moral development approaches or achieves adult levels during adolescence. In some ways, adolescence is an uncomfortable in between phase. Old principles are challenged, but new and independent values do not emerge immediately. As a consequence, young people search for a moral code that preserves their personal integrity and guides their behavior, especially in the face of strong pressure to violate the old values. They face many decisions involving moral dilemmas. They ned to internalize gradually a set of principles that provides them with the resources to evaluate the demands of a situation and to plan a course of action consistence with their ideals. nutrition The rate of body growth and the adolescent's increased basal metabolic rate require an increase in the individual's caloric needs. At peak growth, females may need as much as 2600 calories per day and males as much as 3600 calories per day. Anorexia nervosa and bulimia are on the rise in young women. Parents should be educated about the warning signs, because these disorders can be fatal. Protein needs are increased as consequences of the rapid growth of this period. 12% to 16% of daily intake should be protein. sleep, play activity and safety the adolescent needs to pace activities to allow for adequate rest. The adolescent often requires increased hours of sleep to restore energy levels. During puberty and adolescence, caution must be taken to prevent injuries related to exercise and sports. Injuries sometimes occurr in connection with the adolescent's growth spurt. Growth spurts cause the bones to grow more quickly than the muscles and tendons, which causes the muscles and tendons to become short and tight. Sports related injuries may results from these factors. Teaching youngsters to perform appropriate warm up and stretching exercises before starting any strenuous sport can lessen the risk of injury. Greatest number of deaths in this age group due to accidents. adolescents are know to paticipate in more risk taking behaviors. Emotional health moods. One minutes outgoing and gregarious and other times they are moody and loners who seem not to want any part of family activities. monitor for depression defined as a mood disturbance characterized by feelings of sadness, despair, and hopelessness. Early detection important. Can lead to suicide.

The nurse is accessing a 6 month old infant who was 21 inches lomg at birth. Based on the expected growth patterns, what height would the nurse expect measuring this healthy baby.

Answer 2: Height (length) increases by about 1 inch per month for the first 6 months - 27 inches

The nurse must give the school-age child an immunizaton. Based on the nurse's awareness, that the child is in the concrete operational stage, what would the nurse do prior to giving an injection?

Answer 3: tell the child that it hurts a bit, but prevents sickness The school-age child is able to think logically and apply principles to specific cases. Using a helper is recommended for younger children, especially toddlers who are strong-willed. Magical thinking is also more relevant to younger children. Modesty and privacy are more important for adolescents.

Causes of family stress

Chronic illness, abuse, divorce, working mothers, financial problems

Early adulthood 20 - 40 years

Early adulthood 20 to 40 years marked by financial responsibilities, making career choices, beginning social relationships entering marriage, and becoming a parent. All the challenges and accomplishments of the earlier development stages have helped prepare the individual for the responsibilities of adult maturity. Fantasies of what adulthood entails usually give way to more realistic expectations and hopes. Early adulthood, the period of optimal physical condition, is marked by momentous changes in lifestyle. Physical characteristics The body during early adult years is at its optimal level of functioning. The typical young adult is a fine physical specimen. During the middle 20s, most body functions are fully developed and muscular strength, energy and endurance are now at this peak. Physical appearance is influenced by heredity., environment, and general state of wellness. Females usually reach their maximal height at about 16 to 17 years of age. Between ages 30 and 45 years, height is stable, and then it begins to decline because of settling of spinal disks. Often an increase in fatty tissue causes weight gain, a decrease in muscle strength, and a stabilization of reaction time. The senses are also at their sharpest during young adulthood. Visual acuity is keenest at about age 20 years and does not begin to decline until about age 40 years. physical health Dual career families have emerged based on current economic realities and women's interest in pursuing careers. The feminist movement has resulted in many position social changes. The home and the workplace show the effects of these changes and dual career lifestyle. Another important option for this age group is the decision to start a family. If procreation is the choice, a subsequent issue is how many children to have. Also consider financial means, family support, safety, housing the relationship to members of the extended family and the roles of and responsibilities of the nuclear family unit. young adults who establish a family need to have open communication about self development which includes issues of dual careers, child rearing practices, and domestic duties within the home. Physical and mental health of one family member effects rest of family. Erikson identified early intimacy versus isolation as the developmental task of adulthood. Intimacy is the connection to another person. One aspect of intimacy is the capacity to accept the closeness of another person. Intimacy leads to commitment, sharing, and compromise. The "virtue" that develops in young adulthood is the virtue of love, or the mutuality of devotion between partners who have chosen to share their lives. As young adults resolve conflicting demands of intimacy, competitiveness and distance, they develop an ethical sense, which Erikson considers the mark of the adult. The opposite of intimacy, the distancing of oneself from intimate relationships is the negative resolution of the task of this life stage and leads to isolation and self absorption. Cognitive delopment Piaget saw adulthood as actively developing the formal operational approach to learning and problem solving. He believed that the same cognitive operations apply throughout adulthood to a larger, more expansive list of experiences. Adults tend to think in an integrative way. Nutrition fewer total numbers of calories are needed compared with the amount needed in adolescence. Biophysical growth completed - just need calories for function. Diet - heart disease and cancer major concerns. rest and sleep 7 - 9 hrs sleep needed physical activity reached sexual maturity. Exercise for heart and lung capacity, lowers BP and helps control weight enhances body function and improves emotional health Physical and dental examinations annual physical recommended routine testicular exam for male and annual Pap smear for females mammogram yearly starting at 45-54 55 men should talk about prostate screening - 1/3 50% higher in African American men Safety accidents largest cause of disability and death in this age group.

What concepts/ideas did Erik Erikson introduce with his developmental theory?

Identity crisis

A straight A student turned party goer shows what stage?

Identity v. role confusion

What stage dealt with dating and marriage?

Intimacy v. isolation (18-40)

Erik Erikson

his theory is the psychological theory of human beings

Erikson Stage 3 pre-school 4 - 6

initiative v. guilt children want to undertake many adult like activities, sometimes going beyond the limits set by parents and feeling guilty because of it

psychosocial development of toddler

psychosocial development: the toddler is uninhibited, energetic little person who always seeks attention, approval, and achievement of personal goals. Sometimes the toddler is cuddly and loving: at other times the toddler may bite, hit or pinch. The toddler only slowly realizes that everything desired is not attainable and that some behaviors annoy others. The toddler tries to be independent yet becomes easily frightened and runs to the caregiver for protection, security, reassurance and approval. Erikson sees the toddler as struggling with autonomy (self-control) in opposition to shame and doubt. With newfound skills of independence, walking, talking, self-feeding, and beginning toilet training, the toddler is struggling to be independent. Characteristic of this search for autonomy is the toddler's use of the word "no" which gives a sense of control. The toddlers possesses endless energy yet often falls asleep almost while still in motion. As toddlers struggle for independence, they frequently display possessiveness and a desire to have things go their way. Ritualistic behavior and repetitive rituals are self consoling behaviors at this stage. Toddlers enjoy the same story, the same routine, and the same foods at each meal. Rituals decrease their anxiety by helping them know what to expect. When health care providers follow a hospitalized child's usual rituals, the toddler feels safer and more secure in the strange environment. Temper tantrums are common and are the result of frustration. A combination of wanting things "my way", the inability to communicate feelings, and the lack of impulse control are perhaps behind outbursts of temper. This type of negativism is best ignored unless the child or others are in danger of harm. Toddlers need many experiences of being able to choose among alternatives (to play outside or inside,, to wear green pants or red pants). However, advise caregivers to make use of questions and offer alternatives for children only in situations in which either choice is acceptable. When a particular behavior is necessary (such as going to bed, holding hands to cross a street, letting fo of another child's hair), it is better not to offer a choice. Erikson stressed that young children do not have the wisdom to know what behaviors are acceptable or unacceptable, healthy or unhealthy. Discipline is a necessary means of teaching limit setting and impulse control. Basic principles of disclipline are listed in Box 24.9 (page 710). Toddlers seek attention, approval, and love as they struggle for independence. Cognitive and intellectual development: The period from 12 to 24 months of age completes the last phase of sensorimotor development, in which the toddler's knowledge of the world comes about primarily through sensory impressions and motor activities. The period of early childhood is the preoperational thought stage - when the child focuses on the use of language as a tool to meet needs, the child has the emerging ability to think. The child uses trial and error to discover new traits and characteristics. According to Piaget, this stage extends from 2 to 7 years of age. Toddlers constantly are absorbing new ideas widening their cognitive world, and expanding memory. Activities can be connected to past events or memories. The toddler's concept of time is limited to the present. The child's thinking is egocentric at this stage. Toddlers are often demanding, wanting things to go their way.

A 60-year-old female is being seen for her annual physical. She conveys to the nurse that she is concerned about losing her memory and intelligence as she enters her late adult years. Which statement by the nurse indicates a need for further teaching? (Select all that apply.)

"Benign forgetfulness is uncommon in older adults and indicates a need for further examination." The older adult often confuses recent memories and past memories.

The nurse is explaining Piaget's preoperational thought stage of development to a mother. Which statements teaching was effective? by the mother indicate that the (Select all that apply.)

"This stage of development will last from ages 2 through 7 years." "My child's thinking will be focused mainly on himself during this time." "My child will use trial and error to discover new things."

the nurse is providing education regarding the influenze immunization. which statements indicate that further teaching?

- "i will have immediate protection from the flu after I receive the vaccine."- "the immunization will protect me from the rest of my life"- "Because i am immunosuppresse, iI should avoid taking this vaccine.

the nurse is caring for a hospitalized 2 yr old child. what interventions are appropriate for inclusion in the plan of car?

- establish a routine- offer choices when possible- encourage parental involvment

the nurse is explaining piaget's preoperational thought stage of development to a mother. which statements by the mother indicate that the teaching

-"this stage of development will last from ages 2 throught 7.)-"my child's thinking will be mainly focused on himself during this frist time"-"my child will use trial and error to discover newthings."

Erikson's stage of psychosocial development autonomy v. shame and doubt

1 to 3 Toddler Children learn to undertake many adult-like activities, sometimes going beyond the limits set by parents and feeling guilty because of it

Middle adulthood

40-65 years

Introduction of solid foods

6 months of age. Vegatable, fruit, then nuts and other stuff after 1 y/o Becareful not to give these before 1 y/o: -HONEY -Cow's Milk -Hard stuff (nuts, raw carrots etc) --- Honey must be avoided due to the risk of Clostridium botulinum spores, which may be present even in pasteurized honey, and might colonize the infant's GI tract and lead to infant botulism. --- Cow's milk must be avoided because it does not contain the appropriate balance of water, fat, and protein for human infants and can cause iron deficiency. Breastmilk or formula should be continued through the infant's first birthday, at which point they may be replaced with cow's milk. Note: Other dairy products such as cow's milk yogurt and cheese are acceptable, as long as they do not replace breastmilk or formula in the infant's diet.

Erikson's stage 4 school age

7 to 11 industry v. inferiority Children eagerly learn to be competent and productive or feel inferior and unable to do any task well

school age industry v. inferiority

7-11 children eagerly learn to be competent and productive or feel inferior and unable to do any task well

Activity theory

According to this theory, the older person who is more active socially is more likely to adjust well to aging. Older adults with more social involvement have higher morale and better life satisfaction and personal adjustment. The number and the quality of the activities are important. People who give up activities or roles should be advised to find replacements. Meaningful activities that involve close personal contact with others are extremely important. Activities of this nature reinforce self concept, which in turn is associated with a higher life satisfaction.

Which behaviors indicate that young adult is achieving the developmental task of early adulthood? select all that apply

Answer 1, 2, 3, 4: lives at home with parents, but is saving for an apartment deposit accepts that sister's decision to have a big family is okay establishes a permanent relationship with a same sex partner identifies with and seeks out gay and lesbian peer groups Seeking identity and reaching out to peers is more typical of adolescents . The other behaviors are consistent with the tasks of development during early adulthood.

A parent expresses concern because her healthy active 11 year old son seems very short. She reports that all men on both sides of the family are tall. What is the best information that the nurse can give to the mother about growth and development? select all that apply

Answer 1, 2, 3: during the school age period, the growth is usually gradual and subtle a second period of rapid growth is expected during adolescence from ages 6-12, height increases by about 2 inches It is normal for the school-age child to have gradual gains in height and weight, although the full growth potential is yet to come during the adolescent and young adult periods. Nutrients and genetics could be contributing to the child's shorter stature, but it would be inappropriate for the nurse to say this to the mother without first doing a dietary assessment and referring her to a genetic counselor.

Which routine check-up or screening are recommended for school-age children?

Answer 1, 2, 4: vision testing dental examination every 6 months scoliosis screening Vision, dentition, and signs of scoliosis are recommended for routine screening. Hearing would be tested if the child showed some signs such as inattentiveness while being spoken to, speaking very loudly, or failing to attend to instructions. Cancer screening is recommended by the American Cancer Society for adults. Human immunodeficiency virus testing is not routinely done on children.

The working mother has an 8 month old child who has to go to day care while she works. How can the nurse best help the mother prepare for their first day of daycare?

Answer 1: explain the likelihood of separation anxiety as normal behavior An 8-month-old child is likely to demonstrate separation anxiety. This is a traumatic time for the parent and the child, but knowing that this is a normal behavior will help the mother feel less anxious and guilty. An 8-month-old should have an established sleep/rest pattern; ideally the daycare staff will interact with the child so that nap pattern is maintained. Parallel play is a form of play used by toddlers. Assess mother's feelings before validating guilt. It is likely that the mother will feel some guilt, but the mother may also want to return to work and it would be inappropriate to imply that she should feel guilty.

Most of the weight gain in the first month of life is in the form of fat. What is the best physiologic explanation for this gain of fat?

Answer 1: fat provides insulation and a source of nourishment if teething or other problems decrease food intake for a few days The infant's body is using nutrients according to a system of growth and development; thus fat reserves are accumulated in the first several months for insulation and a reserve of nutrition. Muscle and bone are expected to develop around 8 months. Cephalocaudal growth is defined as growth and development that proceeds from the head toward the feet. Breast milk and formula supply the appropriate nutrients for the growth of young infants.

Which nursing actions contribute to the accomplishing the healthy people 2020 health indicators. Select all that apply.

Answer 2, 3, 4, 6: b. reinforces the need for preventive dental care c. encourage patients to routinely exercised. assist patients to locate smoking cessation literature f. teaches patients how to limit fats and sugar in the diet Administering medication on time and showing respect to elderly patients are important to being a good nurse; however, Healthy People 2020 Health Indicators are more about improving the overall health of the general population.

The nurse is interviewing the parents of a toddler who must be admitted for 23-hours observation for a febrile illness. What would be the most important question to ask about the child's bedtime?

Answer 2: "what do you usually do when you put him to bed?" The toddler prefers ritualistic behaviors; therefore, the nurse would assess nighttime rituals and try to approximate them as much as possible (e.g., favorite bedtime story). Night bottles with milk or juice should not be encouraged because they contribute to dental caries. Amount of sleep is a relevant question, but it is more likely that he will have trouble falling asleep in a strange environment. Once he is asleep, he is likely to sleep for the accustomed period of hours. Keep explanations simple and honest.

A 52 year old women tells the nurse that she has been experiencing flushingm mood swings, night sweats, and breast tenderness for the past several months. Based on knowledge of life-span development, which question is the nurse most likely to ask?

Answer 2: "when was your last normal menstrual period?" The nurse recognizes that based on the patient's age and description of symptoms, perimenopause or menopause is most likely. Increased incidence of cancer, changes in libido and osteoporosis may also occur for women as they age.

The nurse preforms a dressing change on a 7 - year old. The nurse explains that the procedure will not be painful, but the child appears apprehensive. What is the best approach for the nurses to use?

Answer 2: Give the child a role as a helper. This increases the feeling of control and appeals to the developmental task of industry. Praise is an important reinforcer of desired behavior. Demonstrating on a doll is a method used for preschoolers. Coaching the parent would be a good choice if the child had to have ongoing dressing changes at home.

A mother reports that her child occasionally complains of pain in the legs particularly at night. Which question would the nurse ask to determine if this is an expected symptom.

Answer 2: How old is your child? The nurse should ask the age of the child because complaints of "growing pains" related to rapid growth are reported by school-aged children. Obvious growth in the long bones and increase in height of approximately 2 inches per year for both boys and girls are physical characteristics of the school-age child. The other questions could help to identify contributing factors.

The nurse is assessing the vision of an older adult patient. Which findings is not associated with the aging process.

Answer 2: Visualization of half the field is a pathologic condition that is usually associated with stroke or damage to the brain. The other options are part of the normal aging process.

Under what circumstances would the nurse advise the parents to contact the provider about their one year old infant?

Answer 2: baby cries persistently during usual sleep periods and is inconsolable Persistent crying during a usual sleep period indicates illness or some other type of discomfort. Whenever the infant is inconsolable with usual measures, the provider should be contacted. The other behaviors are normal and expected

The nurse is interviewing a woman who is from a different culture than the nurse's. The nurse directs the questions to the woman, but the woman consistently looks toward her husband and he gives all the answers. What should that nurse do first?

Answer 2: continue the interview and observe for additional nonverbal behaviors. The nurse would continue the interview and assess the interaction between the wife and husband and how they are responding to each other. After additional assessment, the nurse might ask the husband to leave if the wife seems fearful to speak in front of him. The nurse could seek advice about cultural norms, but discontinuing the interview may be impractical. Directing the questions towards the husband is likely to feel awkward, but it is possible that the wife prefers that he provide the answers.

The provider asks the nurse to please watch the 4 year old child because she needs to talk privately with her mother. What would be the best way for the nurse to interact with the child?

Answer 2: give him some paper and crayons and ask him to draw a picture Preschoolers use imagination and are developing fine motor skills, and drawing is a way to communicate. The nurse should not offer the child a snack without the mother's permission and advice because of potential allergies or food restrictions. Desire to "help" is more related to the school-age child. Talking to a child is always beneficial; however, a 4-year-old is less likely to be able to independently entertain himself with a book.

Which infant behavior is consistent with Piaget's theory that infants are the sensorimotor stage of cognitive development?

Answer 2: reaches for objects and puts them into mouth Infants use sensory impressions and motor activities to learn about the environment; thus reaching for, tasting, and feeling objects with the mouth gives the child information. Clinging to parents is an intellectual function that occurs as the child learns to distinguish parents from others. Shoulder control prior to hand control is an example of proximodistal growth and development that originates in the center and moves toward the outside. Saying "me" and "no" is a toddler behavior.

Which behavior most strongly indicates that the older adult is successfully aging?

Answer 2: studies Latin and combines subject matter with previous interest in literature All of these behaviors have some positive merit, but studying a new subject stimulates mental capacity and linking it to a previous interest suggests satisfaction and continuity with the past. The other behaviors reflect feelings of regret and loss and running out of time.

The mother of a 5 year old infant reports the child is irritable; gums are red and edematous, and he demonstrated excessive drooling. What would the nurse reccomend?

Answer 2: suggest the mother wipe and massage the guns and offer sips of clear water The signs and symptoms reported by the mother are the first expected evidence of teething. Massaging the gums and giving water are recommended for infant dental hygiene. Brushing the teeth is recommended after the first tooth has erupted. The nurse would advise the mother to contact the provider if the nurse believes that infant acetaminophen is needed to relieve discomfort. The nurse would not recommend medication to the mother.

The nurse is working with groups of parents of HS students. During the discussion, the following statements are made by the parents. Based on an understanding of the needs of adolescents, which statement requires follow-up by the nurse

Answer 3: "we are generally not in favor of allowing sex education to be taught at school" The nurse should follow up on the statement about sex education and reinforce that sex education should be provided by someone. If they prefer to give the information at home, the nurse can offer to help with resources and communication methods. The other statements indicate that parents are helping teenagers by setting boundaries.

The home health nurse is interviewing an older patient who lives alone. The patient is underweight and the kitchen is so cluttered that it appears impossible to do any cooking or cleaning. What should the nurse do first?

Answer 3: Assess for additional factors that are contributing to the malnutrition The nurse can see several of the problems, but additional assessment should be made for contributing factors, such as loneliness, poor dentition, poverty, food intolerances, and constipation. The nurse should also assess the patient's ability to maintain a household and live independently. Based on assessment findings, the nurse may decide to use the other options.

Which patient group is the nurse most likely to assess for possible exposure to teratogens?

Answer 3: a group of young women who are planning pregnancy Teratogens are substances, agents or processes that interfere with prenatal development and can cause developmental abnormalities.

The nurse is watching a group of mothers interact with their young children. Which behavior by a mother would most likely strongly suggest that additional assessment for potential child abuse might be required?

Answer 3: berates and shames her toddler for refusing to share toys with other children Toddlers are unable to share because of their egocentric nature, so this mother is demonstrating expectations beyond the ability of the child. Harsh discipline techniques can be evidence of how the mother was treated as a child. The nurse would carefully assess for other risks factors, behaviors, and signs and symptoms before making any conclusions. Continuously retrieving a toddler will cause frustration for the child, but this mother is demonstrating anxiety about his safety. Rather than allowing the child to climb onto eating surfaces, the nurse could suggest that the mother redirect the child to climb on equipment that is designed for the purpose of climbing. Ignoring a fussy toddler is probably a strategy that this mother has developed to use if the child is not hurt, but is not getting his own way.

The mother is ordering lunch for her toddler. The nurse would intervene if the mother selected which food for the toddler.

Answer 3: carrot sticks Small hard foods have a greater potential for aspiration and choking. Reassure the mother that her nutritional logic is sound, but carrot sticks can be served when the child gets older.

Which behavior demonstrates that a 60-year-old adult is meeting his developmental task of generativity?

Answer 3: gives advice to nephew about succeeding in life Generativity is accepting responsibility for and offering guidance to the next generation. Focusing on fears, concerns, and failures is evidence of stagnation, which is the opposite of generativity. Reviewing a personal will and belongings is more typical of late adulthood.

The parent reports that her 15 year old daughter seems more moody than usual and hse is concerned because there was a teenager in the neighborhood talking about suicide. What is the most important question that the nurse should ask to determine if the daughter has a high risk of suicide?

Answer 4: "has she talked about ways to commit suicide?" The more concrete the plan, the greater the risk for committing suicide. The other questions are relevant because these are indicators of depression.

The school nurse notices that an 8 year old boy comes to her office during recess for a tummy ache, which seems to disappear as soon as recess is over. What should the nurse do?

Answer 4: contact the parents and discuss the pattern of stomachache and recess time The nurse suspects that something is happening at recess that is causing the child to seek a temporary haven in the nurse's office. The nurse should contact the parents first to alert them about the tummy ache and the association with recess time. The nurse should tell parents, signs and symptoms that would prompt a doctor's appointment. Parents, nurse, teachers and school administrators should be involved if there are suspected incidents of bullying or violence in the school.

The parents report that their 3-year old child has not started talking, but he seems happy and active and very interactive with the world in nonverbal ways. What should the nurse advise the parents to do?

Answer 4: suggest consultation with the provider for possible hearing and speech problems Three year-olds are usually able to carry on a conversation. Children do grow at their own pace, but if expected milestones are not being met, then consulting a provider is recommended. Reading and playing do help to expand vocabulary once the child is talking.

The school nurse is talking to a child who sustained an abrasion and bruise during recess. When the nurse asks the child what happened, he begins to cry, shake his head and refuses to answer. What should the nurse do?

Answer 4: talk to him while treating the wounds and give him encouragement to establish rapport. The child's nonverbal behavior indicates to the nurse that something has happened that causes the child to feel fear, embarrassment, or possibly anger. The child has to trust the nurse before sharing the events associated with the strong feelings. The nurse should not promise confidentiality. Parents have to be informed about injuries and illnesses that occur at school and if there is some violence, bullying, or safety issue, the principal must be informed.

The nurse is accessing a 1 year old who weighed 9lbs at birth. Based on expected growth patterns, how much should this healthy child weigh?

Answer: 27 pounds. By the time the baby is 1 year of age, the birth weight has tripled

What stage am I? Toddlers - they wish to do things on their own, or they're ashamed

Autonomy v. shame Toddler - 1 - 3 Children learn to be either self sufficient in many activities (including toileting, feeding, walking, and talking) or doubt their own abilities

Erikson Stage 2 Toddler (1 to 3)

Autonomy v. shame and doubt Children learn to be either self sufficient in many activities (including toileting, feeding, walking, and talking) or doubt their own abilities

engagement or commitment stage

Begins when the couple acknowledges to themselves and others that they are considering marriage. At that time, opposition or support is evident from friends and parents. Wedding plans are arranged. Housing, work, and furnishing are some of the items on the agenda that require discussion and exploration

cognitive development for a 10-year-old child include The nurse understands that characteristics of the which concepts? (Select all that apply.)

Better understands other viewpoints Uses a systematic, scientific problem-solving approach

early adulthood 20 - 40 years psychosocial development

Dual career families have emerged based on current economic realities and women's interest in pursuing careers. The feminist movement has resulted in many positive social changes. The home and the workplace show the effects of these changes and the dual-career lifestyle. Another important option for this age group is the decision to start a family. If procreation is the choice, a subsequent issue is how many children to have. Further consideration to financial means, safety, family support, housing, the relationship to members of the extended family and the roles and responsibilities of the nuclear family unit. Young adults who establish a family need to have open communication about self development, which includes issues of dual careers, child rearing practices and domestic duties within the home. Family development and harmony are important goals for many young adults. Although family size and structure have undergone dramatic changes in the past decades, concerns about individual members' health and safety continue to form a primary focus within the family as a unit. Family life is influenced by the characteristics of individual family members. Typically, healthy family adjustment is associated with the age of the individuals, job security, the family's and the individuals' places in the community, and healthy patterns of living (good nutrition, personal cleanliness, physical fitness). Therefore, the physical and mental health of one family member affects al family members. Erikson identified early intimacy versus isolation as the development task of adulthood. Intimacy is the ability to develop one's deepest hopes and concerns in connection to another person. One aspect of intimacy leads to commitment sharing, and compromise. The "virtue" that develops in young adulthood is the virtue of love, or the mutuality of devotion between partners who have chosen to share their lives. As young adults resolve conflicting demands of intimacy, competitiveness, and distance, they develop an ethical sense, which Erikson considers the mark of the adult. The opposite of intimacy, the distancing of oneself from intimate relationships, is the negative resolution of the task of this life stage ad leads to isolation and self-absorption.

The school nurse is preparing a presentation for the high school football team. The nurse should include that peak physical strength and endurance occurs during what period of life?

Early adulthood

the nurse is reviewing a supplement for all my nutritional needs. one assigned patient is an older adult. When considering the needs of the pt, the nurse should recognize that the patient is in which developmental stage?

Ego integrity vs despair

School age: 6 to 12 years psychosocial development

Entrance into school challenges the child and creates demands for new social and cognitive skills. The child becomes more independent and participates in broader world of peers and new experiences. School age children become increasingly aware of rules and socialization skills and expectations. The beginning abilities to compromise and compete are challenges faced in this age group. Erikson identified the task of the school age years as industry v. inferiority. After the child realizes there is no workable future in the womb of his family, Erikson says the school age child becomes ready to apply himself to give skills and tasks. Children develop their own goals and direct their efforts toward mastery of these goals. As children discover their talents and accomplishments, they gain self confidence and a sense of purpose. During these years, the child learns to work and masters skills that produce satisfaction as the result of that work. Successful mastery of learning in school leads to strengthening and stabilizing the child's sense of self. According to Erikson, as children busily try to master the skills valued in their culture, they develop views of themselves as either competent or incompetent - as either industrious and productive or inferior and inadequate. Input from the outside is a key influence on which direction the child's self concept will take. If the environment inadequately supports a child's pursuits, the stage perhaps perhaps is set for the development of feelings of inferiority and the lack of self confidence. The good school setting is a pleasant, comfortable environment. Teachers and caregivers need to use praise, encouragements, and rewards to reinforce the school-age child's efforts positively. Teachers also must be positive role models. School helps the child learn new routines and establish important social relationships. However the school climate can be affected negatively by bullying. Bullying cake take on many forms, including physical, teasing etc, cyber bullying. CDC defines "any unwanted aggressive behavior by another young or group of youths who are not siblings or current dating partners thats that involves an observed or perceived power imbalance and is repeated multiple times or is highly likely to be repeated. In 2015 20% of high school students reported they had been bullied on school property. Bullying can lead to physical injury as well as depression, anxiety, sleep difficulties, and even death. One way to prevent bullying is for schools to have a consistently enforced antibullying policy.

The nurse is caring for a hospitalized 2-year-old child. What interventions are appropriate for inclusion in the plan of care? (Select all that apply.)

Establish a routine. Offer choices when possible. Encourage parental involvement.

Adolescence: 12 to 19 years psychosocial development

Exactly when adolescence begins is different in each person. Some enter adolescence at an early age; others develop later. Regardless of the exact age of onset, the nearing of this stage is evident by recognizing the onset of distinct behavioral changes. A mother may notice that her 11 year old daughter has become right lipped about school and activities, no longer wanting her mother's opinion or listening ear. Her daughter is now spending most of her time at home in her room with the door closed. A father may delight in his son's musical talents and his band's energy and success, although the two may argue over the taste of their lyrics and decibel level. The period of adolescence frequently is described as difficult and involving a stormy search for oneself. Confronting every adolescent are a changing body, sexual demands, responsibilities, expectations, and questions about values and beliefs. The search for identity amid a world of social pressures creates a painful struggle. Erikson described the developmental task of adolescence as establishing a sense of identity. He proposed the conflict of identity versus role confusion as characteristic of adolescence. The search for a sense of identity , he believed, reaches crisis proportions at this time. Not only does the adolescent need to adjust to a sexually mature body but also all previous conflicts (trust v. mistrust, autonomy v. doubt, initiative v. guilt, and industry v. inferiority) must be resolved yet again in light of the newly senuous self. The period of adolescence requires major reorganization of the personality, resolution of childhood insecurities, and acceptance of adult responsibilities. The value of peers is usually significant to the adolescent. Peers influence preferences of dress, speech, and leisure activities. The peer group is often the milieu to learn and test developing interpersonal skills. Many adolescents use conforming behavior to win praise and acceptance by peers. If handled properly adolescence is often a great period of accomplishment and creativity.

pre-school 3 to 5 years psychosocial development

First, children learn to function independently. They subsequently use imagination to explore new experiences creatively. Erikson describes the task of the preschooler in terms of initiative v. guilt. Preschoolers search for and create fantasies about the different kinds of people they would like to become. They pretend to be grown up and try out a variety of roles. During the preschool period, the child's superego (conscience) functions as a censor of behavior. The dilemma of the preschooler, according to Erikson is to test initiative without creating an overwhelming sense of guilt. Typical development of the preschooler includes gender identification. At this time, the child commonly sterotypes roles and shows marked interest in sexual differences. Strong sibling bonding is established.

Which developmental skill commonly is accomplished by the fourth month of life?

Holding head up at 90-degree angle

What stage am I? Teens test different roles, or they're confused about who they are

Identity v. role confusion Adolescence 12 - 19 Adolescents try to figure out their personal identity. They establish sexual, ethnic, and career identities or are confused about what future roles to play.

formal operational thought

In Piaget's theory, the fourth and final stage of cognitive development, characterized by more systematic logical thinking and by the ability to understand and systematically manipulate abstract concepts.

According to Erikson's Psychosocial Stages of Development, which stage describes a child who needs to learn important academic skills and compare favorably with peers in school to achieve competence?

Industry v. inferiority

What stage am I? Kids feel good about being productive, or they feel inferior for failing to do so.

Industry v. inferiority school age 7 - 11 Children eagerly learn to be competent and productive or feel inferior and unable to do any task well.

What stage am I? The child begins school and must tame imagination and impulses, and please others. If adults support the child's efforts, a sense of competence develops

Industry v. inferiority school age 7 - 11 Children eagerly learn to be competent and productive or feel inferior and unable to do any task well.

Erikson - Stage 6 Young Adulthood - 20-44

Intimacy v. isolation Young adults seek companionship and love with another person or become isolated from others

senescence stage (last stage of family development) Engagement or commitment stage establishment stage expectant stage parenthood stage Disengagement of phase of parenthood Senescence stage

Last stage of life cycle and requires the individual to cope with a large range of changes. For the older adult, the family unit continues to be a major source of satisfaction and pleasure. Most older adults prefer to live independently. The greater life expectancy for women means that older women commonly outlive their spouses and continue life alone.

Senescence stage of family development

Last stage of the life cycle, which requires the individual to cope with a large range of changes. For the older adult, the family unit continues to be a major source of satisfaction and pleasure. The greater life epectancy for women means that older women commonly outlive their spouses and continue to life alone. Most older adults have regular contact with other family members. The grandparenting role requires new adaptions, such as a change in one's roles and sense of identity. In the past, grandparents often lived with their extended families because they had to, not necessarily because they wanted to. Grandparents today are independent. They want close, stable, emotionally satisfying family ties. Simultaneously, they tend to want an independent life, away from kin. They want to see their grandhildren but not be responsible for them. complex stage Women live longer than men because men die high with prostate cancer (1/3)

the cognitive approach to understanding development is explained by ________________ theory.

Piaget's

concrete operational thought

Piaget's term for the ability to reason logically about direct experiences and perceptions

Genetic theory

Similar life expectancies within families lend support to the idea of a hereditary basis for aging. After all, our hair color and height are determined by our genes, so it could be that our lifespan also is determined by our genes. Scientists have been studying short lived animals to identify longevity genes and manipulate them to study how those changes affect the animal's lifespan. Studying the genetics of aging is complex and requires much more research to fully understand. however, it is not expected that one gene solely determines the lifespan for a human, but rather several genes affect the process of aging.

Erikson's stage of psychosocial development intimacy v. isolation

Stage 6 Young adulthood 20 - 44 Young adults seek companionship and love with another person or become isolated from others

Erikson's stage of psychosocial development generativity v. stagnation

Stage 7 middle adulthood 45 - 65 Generativity v. stagnation middle aged adults are productive, performing meaningful work and raising a family, or become stagnant and inactive.

autoimmunity theory

The autoimmunity theory states that with aging, the body becomes less able to recognize or tolerate the "self". As a result, the immune system produces antibodies that act against the self. This theory is supported by the increased accumulation of lymphocytes., plasma cells found in the tissues of healthy older people. The primary organs of the immune system (thymus and bone marrow) are believed to be affected by the aging process. With aging, the thymus decreases in size and wight and becomes less able to produce T cells. The bone marrow stem cells also show reduced efficiency in performing certain functions. As immune system function decreases, the risk of development of infection and cancer increases.

life expectancy

The average number of years an individual can be expected to live, given current social, economic, and medical conditions. Life expectancy at birth is the average number of years a newborn infant can expect to live. 85 African Americans have higher infant mortality rate than causasians (by 50%) because malnutrition, lack of medical care, congenital defects such a sickle cell disease

A 5-year-old child is brought to the doctor's office for an annual well child visit by his grandmother. The student nurse knows which of the following is true regarding grandfamilies?

The number of children in foster care being raised by relatives because of substance abuse is increasing.

SIDS Sudden infant death syndrome

This disorder produces sudden, abrupt death with no identifiable warning signs. Formerly known as crib death, its incidence seems to peak 2 to 3 months after birth. Steps to reduce the incidence of SIDS are outlined: 1. back to sleep: place infants on their backs to sleep 2. avoid exposure to cigarette smoke 3. avoid use of soft bedding or pillows 4. keep room well ventilated 5. breast feed if possible 6. Maintain regular medical checkups for infants.

Late adulthood 65+ psychosocial development

Years of living along with successes, failures, strengths, weaknesses, and all the early experiences influence the emotional stability of older adults. Despite the physiologic changes associated with the aging process, the older years should be viewed as a time of satisfaction and pleasure. Many older adults choose to work after age 65 years. These activities provide interest, intellectual stimulation, and added income. Older people need to recognize their changing capabilities and begin a process of adjustment. Erikson described the challenge of late adulthood as ego integrity v. a sense of despair. The task here is to evaluate one's life and accomplishments and find satisfaction and meaning in life. The process of reminiscence with others often further validates the meaning and importance of the individual's life. Those who can believe that their lives have been well spent and are satisfied with their decisions and achievements have mastered this task of integrity. This allows the person to continue life with a sense of dignity and peacefulness. Adults who are dissatisfied with their accomplishments often experience conflict and espair. Dissatisfaction contributes to a feeling of restlessness and a sense of panic that time is running out. Often the individual feels the need for more time and a chance to do things over again differently. Many other factors also affect the older adult's adjustment to his stage of life. Retirement is a major adjustment for the older adult. Health and financial resources are critical elements in determination of life satisfaction after retirement. Generally speaking, society is relatively unprepared for the phenomenon known as retirement. Retirement creates many changes - soe welcome, some not. Examples are changes in roles, self esteem, support systems, life patterns, and leisure time. Retirement brings more time to spend as one wishes, therefore individuals need to plan and discuss their hopes and expectations for the retirement period. Planning for retirement helps identify activities that will be meaningful and promote self esteem and a sense of usefulness to oneself and society.

psychological theories of aging Disengagement theory

according to supports of the disengagement theory of aging, a natural withdrawal or disengagement, between the individual and society is best. This withdrawal is initiated either by the individual or by others in society. Adherents to this belief suggest that such withdrawal prevents older adults from experiencing frustration when they can no longer function adequately and allows a younger member of society to fulfill the now empty role. They charactertize this process as a normal, inevitable, universal process. Two major criticisms of the disengagement theory are as follows: it does not allow for the many active, functional older adults. the process i not seen in all cultural groups, it is therefore not universal

Age 20-30 expectations

age 20-15, even 30 - do not have decline in their physical abilities, hair, hearing should be intact - that's the expectation

late adulthood 65 years and older

ageism - a form of discrimination and prejudice against older adults - definitely exists

formal operational thought stage

an individual's cognitive function reaches maturity during adolescence; Piaget describes this stage as a higher process that permits abstract reasoning and systematic, scientific problem solving. Adolescents become capable of reasoning and formal logic.

how much does baby gain in first year of life

average 21.5 lbs or 47.3 kg 1.5 lbs per month to 5 months and then double their birth weight by 4-6 months tripled by one year 21.1 lbs

Erickson's stages of psychosocial development

babies - [formation of identity] trust v mistrust toddlers - 1 to 3 autonomy v shame need a lot of encourage in this stage pre-schooler - 4 to 6 initiative v guilt, mimicking school age - 7 to 11 - industry v inferiority, challenge because they are not fully separated to their peers - start separating from parents. Need to praise kids in this area otherwise their self esteemed goes low. Need to know they are equal to others adolescence 12 to 19 identity v role confusion - lot of peer pressure - got to fit in young adult - 20 - 44 intimacy v isolation, middle adulthood 45 to 65 - generativety v stagnation, late adulthood - 65+ integrity v despair

Parenthood stage of family development

begins at the birth or adoption of the first child

Expectant stage of family development

begins with conception and continues through pregnancy

Expectant stage

begins with conception and continues through pregnancy one of the most challenging and rewarding times in life. Pregnancy requires physiologic and psychological adjustments. Many important ecisions must be considered during pregnancy, including childbirth methods, continuation or modifications of employment, child care, and feeding methods. The desired outcome of pregnancy is that a bond or attachment is established between the parents and the new baby.

Erikson's stage of psychosocial development basic trust v. mistrust

birth to 1 Infancy infants learn to either trust or not trust their significant others will properly care for their basic needs, including nourishment, sucking, warmth, cleanliness, and physical contact

a mother asks why it is important for her preschooler to be tested for amblyopia. the nurse explains that amblyopia can lead to which condition?

blindness

The nurse is completing the assessment of an 8-month-old infant at a well child visit. The nurse notes that the child has good head control and can now sit up unsupported. What term accurately describes this sequence of growth and development?

cephalocaudal

The central theme of Erikson's theory psychosocial stages was the development of

conflict

when teaching a parenting class, the nurse explains that nighttime bottles should be avoided to help prevent which occurence?

dental cavities

Piaget's stages of cognitive development Pre-operational though: 2 to 7 years

develops egocentric thinking (understands the world from only one perspective - that of self) uses trial and error to discover new traits and characteristics conceptualizes time in present terms only uses symbols to represent objects develops more logical, intuitive thinking centers of focuses on a single aspect of an object, producing some distortion of reality gains in imaginative ability gradually begins to "decenter" (becomes less egocentric and understands other points of view)

peak physical strength and endurance occurs during what period of life

early adulthood

Erikson - Stage 8 Late adulthood age 65+

ego v. integrity v. despair old adults try to make sense out of their lives, either seeing life as meaningful and whole or despairing at goals never reached and questions never answered

establishment stage

extends from the wedding up until the birth of their first child. Big adjustment phase Success at marriage satisfies Erikson's taslk of intimacy - early adulthood)

Free radical theory

free radicals are highly re-active cellular components derived from unstable atoms or molecules. Free radicals have a reduced cellular efficiency and cause cellular waste to accumulate. Some free radicals are produced by radiation, heat and oxidation. The presence of free radicals possibly accelerates aging and results in the death of an organism. Lipofuscin is a pigmented material that accumulates in many organs as a part of aging. This accumulation interferes with the diffusion and transportation of essential metabolites and perhaps also contributes to the aging process.

which statement most accurately describes growth during the school age period?

growth is slow and consistent

Growth

growth refers to an increase in size and may involve the entire being or parts within.

A mother asks the nurse why her "no" and has a negative attitude. says the mother that such behavior is toddler always The nurse assures common in toddlers developmental task? and helps the child meet which

independence

a mother asks the nurse why her toddle says no and has a negative attitude. the nurse assures the mother that such behavior is common in toddlers and help the child meet who which developmental task?

independent

An 8-year-old loves to draw and do craft projects. The nurse understands that the child's need for praise and encouragement for the work efforts demonstrates the development of which of Erikson's tasks?

industry

Types of families

nuclear, extended, single parent, blended, social contract family and cohabitation, homosexual, transgender, adoptive, grandfamilies, and foster

engagement/committed relationship

one intends to act over time in a way that perpetuates the well-being of the other person, oneself, and the relationship. help make decisions, buy cars and groceries together

Biologic theories of aging

one of earliest theories of aging, generated by hippocrates, speculated that aging was an irreversible natural event caused by a decrease in body heat. Later, Galen supported this concept and claimed that aging was a lifelong process rather than an event that occurred at the end of the lifespan. Leonardo da Vinci, among the first to attempt to identify the physical changes associated with aging performed autopsies to compare old men and young children. In the period after 1900 only a few scientists focused on aging as their main interest. Finally, in the past 30 years, we have begun to see a renewed interest in researching the causes of the aging process. Recent theories focus on the roles of autoimmunity, free radicals (compounds with an extra electron or protein), wear and tear, and biologic programming, among others. The only definitive conclusion however is that aging is a slow continuous complex process that probably involves intrinsic and extrinsic factors.

Disengagement stage of parenthood

period of family life when the grown children depart from the home During this phase couples or the single parent need to redefine personal roles and structure time so that there is a sense of usefulness, accomplishment, and self-fulfillment

Late adulthood 65 years and older

physical characteristics Aging is a complex process that affects cells, tissues and organs. Like growth and development, aging occurs at a highly individualized rate. A gradual reduction in the number of aging cells and a change in the composition of aging cells occur. A slow increase in body weight is seen until 45 to 50 years of age, and then a gradual decline begins. Body fat content and distribution differ in men and women. The accumulation of adipose tissue in females typically is found over the chest, the waist, the hips and the thighs. Adipose tissue in the male is deposited mostly in the waist, the chest and the lower abdomen. Loss of height begins after age 50 years. Most of the noticeable decrease in trunk length is a rsult of the increase in spinal curvature cause by a slight thinning of the intervertebral disks. In addition, to the shortening of the spine, certain abnormal postures and contours are noted. Kyphosis, an exaggeration of the thoracic curvature, may increase with aging. This sometimes leads fo barrel chest appearance, which possibly affects the position of the diaphragm and reduces the effectiveness of inspiration. These and other postural changes have the potential to affect body posture, mobility gait, and respiratory efficiency. psychosocial development years of living along with successes, failures, strengths, weaknesses and all the early adults. Despite the physiologic changes associated with the aging process, the older years should be viewed as a time of satisfaction and pleasure. Many old adults choose to work after age 65 years. These activities provide interest, intellectual stimulation and added income. Older people need to recognize their changing capabilities and begin the process of adjustment. family roles change with time grandparenting / death of spouse, fewer financial resources

infancy 1 to 12 months

physical characteristics: an infant's physical development happens so rapidly that size, shape, and skills seem to change daily. Grwoth which proceeds in cephalocaudal and proximodistal sequence, is rapid during the first 6 months of life. Infants are expected to gain about 1.5 lbs (.3.3 kg) per month until 5 months, and infants usually double per month until 5 months, and infants usually double their birth weight by 4 to 6 months. By the time the baby is 1 year of age, the birth weight has tripled (average weight is 21.5 lbs, or 47.3 kg). Most of the weight gain in the first months of life is in the form of fat, which provides insulation and a source of nourishment to draw on if teething or other problems decrease food intake for a few days. After 8 months, weight gain includes more bone and muscle. Height (length) increases by about 1 inch (2.54 cm) per month for the first 6 months. By 12 months of age, the infant's birth length has increased about 50%; the typical length is 30 inches (75 cm) vital signs - their normal is not our normal. Infants are subject to wide variations in body temperature related to activity levels and state of health. Apical rate is slow in infancy. At 2 months, the average apical rate is about 120 beats per minute. Count the apical pulse for a full minute, noting variations in rate, volume, and rhythm. Respiratory rates also decrease during infancy; these rates are related to activity level. Average resting respiratory rate for the 12 month old is about 30 breaths per minute. BP readings gradually increased to 90/60 mm Hg at 12 months. Motor development: at 2 months the infant can hold the head up while in the prone position. By 4 months, the infant can hold the head up steadily to a 90 degree angle while in the prone position. At 6 months, most infants can balance the head well. By the end of the 7 months, infants have acquired the ability to sit up steadily without support. sleep, play activity and safety: newborns and infants sleep 18 to 24 hours. These sleep periods usually consist of short, naplike periods. Infants are normally restless and make noises during these periods. Toward the end of the first 3 months, definite sleep patterns emerge, and nap and wake periods clearly are established. By the end of the fist year, infants usually sleep 12 hours at night and take one nap during the day. Persistent crying during usual sleep or nap periods often signals discomfort or illness and calls for investigation. play is important part of learning. Play captures the pleasures of using the sense and motor abilities is called sensorimoto play. when they get sick even though may not have cough of fever, they lie around

12 months vitals

pulse: 120 BP: 90/60 respirations: 30

psychological theories of aging

see disengagement theory activity theory continuity theory

Piaget's stages of cognitive development

sensorimotor, pre-operational, concrete operational, formal operational

a father is concerned that his 8 yr old son does not seem to be growing very quickly. that nurse reassures the father that growth during the school age period can be descirbed in what manner?

slow and steady

Erikson's stage of psychosocial development identity v. role confusion

stage 5 adolescence 12 - 19 adolescents try to figure out their personal identity. They establish sexual, ethnic, and career identities or are confused about what future roles to play

the child between 7 and 11 yrs of age is most probably functioning in which of Piaget's stages of cognitive development

stage of concrete operation

A father is concerned that his 8-year-old son does not seem to be growing very quickly. The nurse reassures the father that growth during the school-age period can best be described in what manner?

steady and slow

Continuity theory

supporters of this theory suggest that the critical factors in adjustment to old age are the coping abilities developed previously in life and an ability to maintain previous roles and activities. Knowledge and understanding of a person's personality type are often useful in predicting response to the aging process. People who were never highly involved in society are likely to maintain the same mild level of involvement in old age. On the other hand, individuals who were highly involved and actively engaged with society need to remain active and involved with similar intensity. Supporters of the continuity theory contend that adjustment to the aging process is eased by maintaining roles and interests similar to those developed earlier in life.

matriarchal family pattern

the adult female (or females) of the family assumes primary dominance in areas of child care & homemaking, as well as financial decision making.

preoperational thought

the beginning of the ability to reconstruct in thought what has been established in behavior

Zygote

the developing ovum from the time it is fertilized until, as a blastocyst, it is implant in the uterus

patriarchal family system

the oldest men control cultural, political, and economic resources and, consequently, have power over females

concrete operational stage

thoughts become increasingly logical and coherent so that the child is able to classify, sort and organize facts while still being incapable of generalizing or dealing with abstractions

The nurse is educating a group of preschool teachers dbout psychosocial development for their population. The nurse is correct when stating a 4-year-old child is working on achieving which of Erikson's developmental tasks?

trust v. mistrust

What stage am I: Infants basic needs are met, they develop

trust v. mistrust

a 4 yr old child is working on which of Erikson's developmental tasks?

trust v. mistrust

The stage that occurs between birth and one ear of age is concerned with

trust v. mistrust infancy birth to 1 infants learn to either trust or not to trust that significant others will properly care for their basic needs, including nourishment, sucking, warmth, cleanliness, and physical contact

Erikson Stage 1: Infancy (0-1)

trust vs mistrust infants learn to either trust or not trust that significant others will properly care for their basic needs, including nourishment, sucking, warmth, cleanliness and physical contact

Piaget's stages of cognitive development Concrete operational thought : 7 to 11 years

understands and applies logical operations or principles to help interpret specific experiences or perceptions has more realistic views: better understands other view ponts improves use of memory focuses on more than one task: develops logical socialized thoughts recognizes cause-and-effect relationships learns to identify behaviour outcome understands basic ideas of conversation, number classification, and other concrete ideas

preoperational stage

when the child focuses on the use of language as a tool to meet a need, the child has the emerging ability to think

The central conflict in the eight stage of Erikson's theory focuses on integrity v. despair and involves reflecting back on your life. Those who are unsuccessful at resolving this conflict will look back with regret, anger, and bitterness. Those who are successful will feel a sense of satsifaction with the life they have lived . According to Erikson, those who are successful in this stage emerge with

wisdom

The nurse is discussing children when their Which statement by the nurse indicates a need for parents remarry after a divorce. stressors that are common for further teaching? (Select all that apply.)

There are no stressors to consider because thne new marriage only concerns the parents, not the children.

Development

development refers to function and the gradual process of change and differentiation, from simple to complex. Development proceeds as an orderly, sequential series of changes. Two directional terms important to understanding growth and development are Cephalcaudal and proximodstal

The nurse is reviewing the assigned patients for the shift. One assigned patient is a 45-year-old man. When considering the needs of the patient, the nurse should recognize that the patient is in which developmental stage?

ego integrity versus despair

to counteract the effect of aging, ____________________ helps to increase the flow of _________________________

exercise / oxygen

the nurse is aware that the first socializing agent for the child is:

family

Growth and Development

growth development cephalocaudal proximodistal patterns of growth

Proximodistal

growth and development that originates in the center of the body and moves toward the outside e.g. infant gains control of shoulders before developing control of hands and fingers

Cephalcaudal

growth head to feet head larger but gradually body catches up

Middle Adulthood 40 - 65 years

gradual shift away from peak performance. Physical characteristics bone mass decreases as skeletal growth cells are depleted. This bone loss leads to an increased risk of osteoporosis. Women lose calcium from bone tissue after menopause. Men also lose calcium from bones but at a more gradual rate than women, and their risk of osteoporosis is lower. Slight changes in height continue to occur as a result of hardening of collagen fibers. A decrease in muscle fibers and exercise patterns account for much of the individual variation commonly seen. Changes in muscle strength are perhaps related more to level of activity. A redistribution of body weight leads to changes in body shape and contour. A decrease in basal metabolism and less activity often necessitate calorie reductions to prevent weight gain. Basic neurologic functioning remains at a high level during this age period. noticeable changes in vision occur as a result of presbyopia loss of elasticity of lens. Presbycusis age related hearing loss (being age 40). Skin loses electicity, hair greys, hair loss. Higher gum disease, menopause for women. psychosocial development According to Erikson, the developmental task of middle age is generativity v. stagnation, which means accepting responsibility for and offering guidance to the next generation. Generativity encompasses productivity continuity and creativity. If this developmental task is not met, people become stagnant, inactive or lifeless. The middle adult years are a time for vocational interpersonal and personal fulfillment. The impulse to foster development of the young is not limited to guiding one's own children and does not cease with their maturation. Many middle aged adults enjoyably express this desire through activities such as teaching and mentorship, a mutually fulfilling relationship that satisfies a younger protege's need for guidance along with an older person's need for generativity. Resumption of education, career growth or changes, reentry into the workforce, and involvement with community activities create a multitude of possibilities for personal growth and satisfaction during the middle adult years. family roles change during this stage. Children are sometimes present in the home. For most caregivers, a significant change in their lives occurs with the end of daily active responsibility for children. Relationships between spouses change, and the couple often has to regain familiarity with each other. For many, this offers the opportunity for new or renewed companionship. Survival of the marriage after children leave home possibly depends on the growth, the maturity and the commitment of each partner. Most women with an empty nest look forward to their emancipation from parenting duties, seeing it as an occasion to develop further their personal and social roles. The role of grandparenting often begins at this developmental stage. Because it often does not have the constrains and responsibilities of childrearing, grandparenting becomes a rich and rewarding experience for many middle aged adults. The past few decades have probably been the best time ever to be an American grandparent and to enjoy grandparenting as a joyful experience. nutrition fewer calories needed. weight bearing exercise important. foods rich in phosphorus and magnesium, green leafy vegetables, fresh fruits, whole grain cereals or breaks and dairy products help support healthy bones. physical and dental examinations annual physical. biannual dental examinations. preventive. sleep and rest sleeps and experiences more nighttime awakening, subsequent day time rest needed.

Erikson - Stage 5 - Adolescence - 12-19

identity v. role confusion adolescents try to figure out their personal identity. They establish sexual, ethnic, and career identities or are confused about what future roles to play.

sensorimotor stage

in Piaget's theory, the stage (from birth to about 2 years of age) during which infants know the world mostly in terms of their sensory impressions and motor activities

The crisis that arises in young adulthood is concerned with

intimacy v. isolation

the young adult struggles with which of Erikson's developmental tasks

intimacy v. isolation

The young adult struggles with which of Erikson's developmental tasks?

intimacy versus isolation

Established stage

period of adjustment due to children - can change dynamics the adjustment period

A new parent asks how to introduce solid foods to the infant. Which statement indicates that teaching was effective?

"I will introduce one new food at a time."

pre-school

3 to 5 years

Which health care worker is demonstrating ageism?

Answer 4: nurse continuously smiles and nods as an older patient makes a complaint about the nursing care By continuously smiling and nodding, the nurse is nonverbally dismissing the patient's complaint, because the nurse's nonverbal behavior does not match the intended meaning of the communication. Ageism is manifest among health care workers when concerns, physical, emotional, social, etc. concerns are minimized or dismissed because of the belief that the elderly have many age-related behaviors and changes.

What stage dealt with "creating a legacy"

Generality v. stagnation (40 yr - 65)

A 38 year old woman quits her high paying marketing job to focus on her children and become a school counselor. What stage would Erikson consider this to be:

Generativity v. Stagnation

Schema

an innate knowledge structure that allows a child to mentally organize ways to behave in the immediate environment and assimilates and interprets the information

family

basic unit of society

Parenthood stage

begins at the birth or adoption of the first child

families

composed of two or more people who are united by marriage, blood, adoption, emotional bonds, and/or social roles

an 8 yr old loves to draw and do craft projects. Her need for praise and encouragement for her work efforts demonstrates her development of which Erikson's tasks?

industry

Erik Erikson was a

psychologist and neo-Freudian

adolescence stage 12-19 years old

struggle with body image - acne, voice breaks, conscious of how they look, hormones change bodies

according to Erikson, when infants are cuddled, fed, and loved, they develop which characteristic

trust

Infancy

1 to 2 months

The nurse is working in LTC facility. Which activity will help the residents to meet the developmental task of ego integrity as described by Erikson?

Answer 2: Reminiscing or reviewing one's life and past accomplishments validates the meaning and importance of life. The other activities are important for the socialization and health of the elderly residents.

which parent is doing the best job of using good parenting tips in dealing with adolescent child

Answer 2: parent gives up smoking cigarettes and encourages 18 year old to do so too By setting a good example, the parent has a better chance of talking to adolescent about quitting a bad habit. The other parental actions place the responsibility of mature decision-making on the adolescents. Adolescents can project some of the consequences of actions, but peer influence is also very important at this stage of development.

The nuyrse is teaching the parents of an infant the principles of introducing new foods. Which information should be provided? Select all that apply

Answer 3, 4, 5: Cereals should be started before vegetables and meats new foods should be introduced one at a time several days should pass between introducing new foods Introducing cereals first and then slowly introducing other foods allow the child and the parent to have new experiences and evaluate the outcomes. There is a possibility that the child could have a bad physical reaction or a dislike for a certain food, so the foods should not be mixed or introduced simultaneously. Early introduction of citrus fruits may contribute to the development of allergies; waiting until after 6 months is recommended.

infancy 1 to 12 months psychosocial development

Erikson defined the task of the infant as basic trust versus mistrust. The responsiveness of others to the needs of the infant helps established the basis of trust. Infants obtain gratification when their basic needs are fulfilled. Infants whose needs are not met develop a sense of dissatisfaction or mistrust.

Autocratic family pattern

Family unit with unequal relationships; parents attempt to control with strict, rigid rules and expectations - unequal

Erikson - Stage 7 Middle adulthood - 45-65

Generativity v. stagnation middle aged adults are productive, performing meaningful work and raising a family or become stagnant and inactive

What stage am I? They look back on their lives and either see a sense of worth of failure?

Late adulthood - 65+ ego integrity v. despair