Chapters. 12 and 13: Early and Middle Adulthood/Older Adulthood and Aging
Areas of concern: young adult transitions/ physical health
-Loss of strength, flexibility, and endurance -Decrease in functioning of organs -Changes in visual acuity; Cataracs -Auditory changes; hearing loss in upper frequencies -Decreased reaction time -Unsteady gait, decreased sense of balance -Diminished sense of smell and taste -Decreased, tactile sensation -Loss of bone density -Less restful sleep; more frequent naps -stiff joints -Increased emotional and physical losses -Decreased capacity for recovery from illness or injury ** common physical changes that come with aging include changes in vision, hearing, muscle, strength, and reproductive functioning**
Areas of concern: Middle adulthood transitions
-adjusting to roll changes -Physical aspects of aging -Perceiving one's own mortality -Reestablishing equilibrium -Planning for retirement
Areas of concern: young adult transitions
-chronic conditions -An increase in chronic conditions -influences of medical technology -Cost of healthcare -Mental health -Depression and dementia are not normal part of aging
Areas of concern: early adulthood transitions
-leaving home -choosing a career -Establishing an adult identification: sinking oneself -Establishing adult relationships -Starting a family -Reappraising commitments -settling in -Making career decision -women's issues
Areas of concern: the oldest adult
-physical health * The oldest individuals are the generations most vulnerable to the physical and psychosocial aspects related to normal aging. Consequences of healthy and unhealthy lifestyle factors that were present during the individuals, growth and development and current access to dental, mental, and physical health care will also become more apparent in the oldest adult.. -psychosocial considerations -loss of independence and mobility -The social environment and loss -Finances and loss of income -Stress and loss -Mortality and loss
What are the challenges likely to be faced by divorced adult?
A divorced adult may face the challenges of dating and financial instability, as well as redefining the relationship with the ex-spouse.
What are the changes that take place in the lives of adults in their 30s?
Adults in their 30s may find themselves without a job as companies are taken over by bigger conglomerates, headquarters move to another city, and plants close. Some adults decide to embark on a new career path or to return to school. Changes in career status, either voluntary or because of economic needs, can place stress on couples and families. Individuals must engage the support and assistance of the entire family.
Stagnation
Adults who focus on personal pursuits and interests
A middle-aged client informs the nurse of a 15-16 weight gain without changing any eating habits or level of activity. Which response by the nurse is the best? a. "You are going to have to go on a diet." b. "That's what happens when you don't exercise and eat junk food." c. "This occurs from excessive calorie intake and decreased metabolism." d. "I wouldn't worry about 15 lb. That isn't so bad."
Answer: C Explanation: The middle-age person cannot eat the same amount of calories as the adolescent or young adult. The possibility of obesity and diabetes increases as the middle-age adult gains weight due to excessive calorie intake and a slower metabolism. Weight gain tends to be insidious (sneaky), and it is typically very difficult to lose weight during middle adulthood. The client wants to understand why they are gaining weight. Telling the client to go on a diet or that junk food shouldn't be eaten is a nontherapeutic response to the client's concern. Informing the client not to worry about it dismisses the client's concern without addressing it.
A client asks the nurse why so many wrinkles have developed on the client's face. Which response by the nurse is the best? a. "This is related to problems with your liver." b. "The wrinkles are caused by stress." c. "Wrinkles are the result of a loss of elasticity." d. "The wrinkles are caused by an increase in pigmentation
Answer: C Explanation: Wrinkles are due to a loss of skin elasticity and not problems with the liver or stress. An increase in pigmentation would cause a darkening of areas of the skin.
Which client should the nurse monitor more closely for signs of developing depression? A. a 58-year-old, Hispanic female, raising a grandchild B. a seven-year-old married African-American male C. a 68-year-old Caucasian male, who lives alone D. a 46 year old married mother of three
Answer: C Explanation: depression, and the oldest adult client is not readily recognized and is often an undertreated medical illness. The highest rate of suicide occur in the older adult. Of particular concern are older, Caucasian men who live alone. Although the other clients may develop depression, the 68-year-old Caucasian male who lives alone is at greater risk.
The nurse is providing care for a client with presbycusis. Which nursing action should the nurse perform to accommodate the client's condition? a. Speak in a clear voice while facing the client. b. Provide educational brochures in large print. c. Speak very loudly so that the client can hear. d. Have the walkways to the client's bed clear from obstruction.
Answer: a Explanation: Presbycusis is the gradual loss of hearing in both ears that begins in middle age and becomes very noticeable by the mid-60s. The best action by the nurse would be to speak clearly while facing the client so that the client may also read the nurse's lips. It is not necessary to speak very loudly to the client and may make the understanding of the words difficult. Large print and clearing obstruction would be interventions for the client who is sight impaired.
A middle-aged client informs the nurse of an increasing weight gain. Which screening should the nurse prepare the client for to assess for potential complications of the weight gain? a. Glucose level to screen for diabetes b. White blood count to screen for infection c. Hemoglobin and hematocrit to screen for anemia d. Urine specimen to screen for ketones
Answer: a Explanation: The possibility of obesity and diabetes increases as the middle-age adult gains weight due to excessive calorie intake and a slower metabolism. The client should be screened for diabetes, especially with the weight gain. Weight gain is not associated with a white blood count, hemoglobin and hematocrit, or urine specimen.
The nurse is talking with an oldest adult client and the client states, " I have done so many things in life and was able to achieve my goals." Which developmental stage has this client achieved? A. Ego Integrity B. Despair C. Stagnation D. Generativity
Answer: a Explanation: this client has achieved the developmental stage of ego integrity by accomplishing life, goals, and leading a productive life. The client is not feeling despair or hopelessness since life goals have been achieved. The tasks of generativity occur when older adult individuals decide to pass on learning and share skills with younger generations. Stagnation applies to adults who focus on personal pursuits and interests, without concern for the welfare of future generations or contributions to others
A young-old adult client informs the nurse, "I want to remain independent and not have to depend on my children." What key elements does the nurse recognize will allow this to occur? Select all that apply. a. Healthcare b. Financial stability c. Number of adult children d. Social resources e. Psychological integrity
Answer: a, b, d Explanation: older adult. Client usually want to remain independent for as long as possible. Independence does not necessarily mean living alone. However, it does mean retaining control over the major aspects of life. The three key elements of maintaining independence, our healthcare, financial stability, and social resources. Transportation opportunities are part of these concerns. A loss of functional ability may make self-care difficult. Financial losses may prevent the maintenance of living quarters. Participation in social activities is important for the oldest adult clients. Family and friends may be unavailable for social support. Such factors place the oldest adult clients in danger of losing their independence. Oldest a dog individuals and their families can strive to promote independence in every area possible. The number of adult children and the clients psychological integrity are not factors that allow independence. The client may still be independent with stable mental illness. The number of adult children is not a factor.
A young-old adult nurse wishes to mentor new nurse, and ask the supervisor or a mission to be humid. According to Erikson, which developmental stage is the young-old adult nurse experience? A. Stagnation B. Generativity. C. Integrity. D. Despair.
Answer: be explanation:. The tasks of generativity occur when young-old adult individuals decide to pass on learning and share skills with younger generations. Stagnation applies to adults who focus on personal pursuits and interest without concern for the welfare of future generations or contributions to others. Erikson believed if we see our lives as unproductive, feel guilty about our past, and did not accomplish our life goals, then depression and hopelessness sets in.
The nurse over here is an old is the dog Kline saying to another client, "I feel depressed because I have so many regrets about my life." Which activity can the nurse provide to help this client in a positive perspective? A. Provide a craft project B. Encourage ambulation C. Provide a game such as bingo D. Encourage reminiscence
Answer: d Explanation: Individuals who experience overwhelming regrets may enveloped by feelings of failure. When working with oldest adult clients healthcare practice, the nurse can encourage reminiscence, the act of discussing, thirking, or writing about things that happened in the past. E reviewing life's events, older adults can gain a positive perspective on u conflicts of earlier stages. Games such as Bingo and craft projects can or distraction but do not address the underlying problem. Ambulation assist movement and is not a therapy to use to help individuals who are experie regrets about their life.
A middle-aged client is experiencing some age-related skin changes. Which action is a priority by the nurse related to these changes? a. Tell the client to be checked every 3 months for skin changes. b. Inform the client that there are no problems related to these changes. c. Discuss with the client normal versus abnormal changes. d. Inform the client that the age spots on the hands can be cancerous.
Cognitive Level: Analyze Explanation: Nursing implications for age-related changes include educating the client regarding normal changes versus abnormal conditions. It is not necessary for the client to have a skin check every 3 months. If there are any changes in any lesions, the client should inform the care provider. Although there are not usually complications related to these skin changes, it is not impossible.
Why do some couples in their 20s choose to postpone marriage?
Couples in their 20s who live together often prefer to postpone marriage until after completing college, establishing a career, and building up adequate financial resources. Others do not want to commit to a long-term relationship until later in life, if at all. Some adults live together for the same reasons others marry—for protection, to share expenses, or to escape the parental home.
Ageism
Discrimination based on age
Erickson's stages of psychosocial development: middle adulthood
Generativity vs stagnation (40-65) -individuals in the stage will either decide to pass on learning and share skills with younger generations or focus on personal pursuits and interest -The welfare of future generations and contributions to others are not a major concern to an individual in the phase of stagnation.
What are the various methods that can how older adults plan for retirement?
In preparation for a productive, an interesting retirement, that may last for 25 years or longer, adults should develop interests and hobbies in my life. Financial planning is an important component of retirement. The money available for pensions has declined, and many corporations offer no pension at all. Middle aged adults need to plan their own retirement, funds and investments. Large houses, maybe sold for simpler living arrangements. Individuals may look for part-time work and may consider relocating to warmer or more scenic environments. Many adults consider a return to school at this age, enrolling in colleges and universities.
Erickson's stages of psychosocial development: late adulthood (the oldest adult)
Integrity vs despair -Individuals achieve integrity, or acceptance of self, when the sense that their lives have meaning, and have been worthwhile -despair is if an individual's state of mind includes overwhelming regrets, feelings of failure, depression, and despair
Ericksons theory - late adulthood necessary, accomplishments, and virtues
Necessary accomplishments: balance choices, achieve stability, retire, evaluate life, accept life choices Virtues: renunciation, wisdom, dignity
Generativity
Passing on and sharing skills with younger generations
What is indicated by the term "sandwich generation"?
People in their middle years are caught between caring for aging parents and caring for their own growing children. Personal needs and goals are often shoved aside. Such adults have been referred to as the "sandwich generation. "
Mental health - key concept
Severe depression is not a normal consequence of aging. As a nurse, you need to notify the healthcare provider of signs or symptoms of depression. Depression can often be effectively treated by medications and/or counseling.
Midlife transition
Since that arises in the middle adulthood, that others of the same age have achieved more, and that one must contribute to society before it's too late
Words related to aging - key concept
Tasks of older adulthood are important challenges for development. Remember that each older person, because of their life, history, will experience aging uniquely.
reminiscence
The act of discussing, thinking, or writing about things that happened in the past
presbycusis
The gradual loss of hearing in both ears that occurs gradually starting in the middle age, and becoming very noticeable by the mid 60s
presbyopia
The loss of flexibility of the lenses of both eyes, making it difficult to see close objects
An adolescent client is discussing with the nurse their relationships with others. Which relationships should the nurse encourage?
The nurse should encourage relationships. That include coworkers, housemates, intimate, relationships, cohabitation, marriage, and religious orders. Some adults live with parents or other relatives for social support as well.
A nurse is participating in a meeting in which parents are being informed about the patterns of young adults leaving home. Which information should the nurse include?
The nurse should inform the parents about the important decisions that young adults make while leaving their home of origin. Some young people face financial problems that force them to return to their family homes temporarily. Leaving home can follow any of several patterns: • A person leaves home and does not move back. • A person stays at home until they are forced to leave by family members. • A person leaves, returns, leaves, returns, and continues a cycle of moving in and out. • A person leaves but remains within close proximity to the family of origin by moving next door.
emerging adulthood
The period between the age of about 20 years old to middle age, when an individual transitions from adolescent behaviors and choices to those of a mature adult. Choices during this period include adult lifestyle, occupation/career, and values.
Young - old adult
The person who is age range is approximately between 50 and 79 years, based on the biological effects of aging in the individuals functional capacity./
Demographics
The study of characteristics and changes in a population
geriatrics
The study of medical and social problems and care associated with older individuals
Polypharmacy
The use of multiple medications and/or the administration of medications that may not be clinically effective.
Erickson's stages of psychosocial development: early adulthood
intimacy vs isolation (20-40) -individuals choose to establish relationships with others (intimacy) or to remain detached from others (isolation). -in this stage people confront choices about their occupation, education, relationships, living environment, and independence.
Isolation
separation from others
Gerontology
study of the aging process
intimacy
the ability to form close, loving relationships
Senescence
the natural physical decline brought about by aging
