Chapter 22 Growth & Development Chapter 23 Self Concept

What are 3 common conditions affecting cognition in older adults?

Delirium, dementia, & depression.

Describe the growth & development changes that occur in the young adult.

(20yrs-40yrs) Have reached their highest level of cognitive ability, and are expected to exhibit a high degree of psychosocial maturity, they are also at their peak health and less commonly experience severe illnesses compared to older adults. Formal and informal educational experiences, general life experiences, and occupational opportunities dramatically increase conceptual, problem solving and motor skills. Rational thinking habits and flexibility of thought increase steadily through the adult years. The emotional health of a young adult is related to their ability to effectively address personal and social tasks. In the young and middle adult years job satisfaction is a major factor in achievement and responsibility. Most have the physical and emotional resources to meet challenges, tasks, and responsibilities. Young adults are generally active and have no major health problems; however their fast-paced lifestyles put them at risk for illnesses or disabilities. Many do not experience hospitalization, but when they do, it is often threatening because it interferes with employment and family time.

Describe the growth & development changes that occur in the middle aged adult.

(40-65) Most have experienced personal and career achievements, along with socioeconomic stability. Accepting and adjusting to the physiological changes of middle age is one of the major developmental tasks of this age period; adapt self-concept and body image to physiological realities and change on physical appearance. Climacteric (the decline of reproductive capacity & accompanying changes brought about by the decrease of sex hormones). They often perform slower than the young adult and are not as adept at solving new or unusual problems, the ability to solve practical problems based on experience peaks at midlife because of the ability for integrative thinking. The primary developmental task is to achieve generativity (the willingness to establish and guide the next generation and care for others). Expected changes involve events such as children moving away from the home, or unexpected events such as the death of a spouse or parent. An increasing situation is caring for both the children living at home and at the same time having to care for elderly parents. They are more prone to stress-related illnesses i.e. heart attacks, hypertension, migraine headaches back aches, arthritis, cancer, autoimmune diseases; they are at risk for a decline in their physical health, and usually interested in his health and wants to be informed.

Discuss factors that influence the following components of self concept: body image, self esteem, roles, & identity.

A change in physical appearance can disturb body image. Identity is formed in childhood as children learn culturally acceptable values, behaviors, and roles through identification and modeling. Feelings about body image include those also related to sexuality, femininity, masculinity, youthfulness, health and strength. Racial/ ethnic background can influence ones idea regarding body image. Values like ideal body weight and shape, as well as ideas about body piercings and tattoos, youth, beauty, and Western culture's ideas regarding aging, impact self-concept and self-esteem. Having difficulty living up to perceived societal or cultural standards can also affect self-concept and self-esteem.

Explain delirium.

An acute state of confusion; requires prompt assessment. Potentially reversible cognitive impairment that causes electrolyte imbalance, hypoglycemia, infection and medication. Slight body temperature change can cause delirium. Signs are: fluctuation in cognition, acute changes in mood, arousal, self-awareness, hallucination, transient incoherent speech, disturbed sleep patterns, and disorientation.

Identify specific nursing interventions for health promotion of middle-age adults.

Are more prone to stress-related illnesses such as heart attacks, hypertension, migraine headaches, backache, arthritis, cancer and autoimmune diseases. The leading cause of death are heart disease, cancer (lung, breast, and colorectal), stroke, accidental injury, and COPD. Patients need to continue the same recommended health practices as the young adult; when they seek health care, you need to develop goals for positive health behaviors. Middle-aged adults are at risk for a decline in their physical health; they need to also follow cancer screening guidelines. Chronic problems require ongoing medical care and often brief hospitalizations. The middle aged adult is usually interested in his health and wants to be informed.

Identify specific nursing interventions for health promotion of young adults.

Explain psychological principles of changing habits, offer information about health risks and provide positive reinforcement of health-directed behaviors and decisions. Eliminate barriers to change such as lack of knowledge or motivation to bring about change. Young adults are generally active and have no major health problems, however their fast paced life puts them at risk for illnesses or disabilities later in life. Motor accidents and violence are the greatest cause of mortality; poor adherence to routine screening schedules puts patients at risk for severe illness because of failed early detection. Encourage patients to follow cancer screening guidelines for breast self-examination, testicular self-examination, and genital self-examination. Identify stressors and work with the patient to modify the stress response. Support groups help patients with the challenges of managing a chronic health problem.

Explain depression.

Is increasing among older adults. It is often treatable and reversible; health care workers must look at the possible underlying or contributing factors in an attempt to find the proper treatment method.

Describe the growth & development changes that occur in the older adult.

Most are physically active, intelligent, and socially engaged; traditionally begins after retirement (the time when people retire varies). Care of the older adult poses special challenges because of diversity in physical, cognitive, and psychosocial health, they vary in level of function and productivity. Be aware of the normal expected findings for an older adult and consider the normal changes of aging. They often remain alert and highly perceptive until the time of their death. Certain aspects of short-term memory decrease with age; but visual memory (allows a person to remember how to read) remains strong. Long term memory for newly learned information decreases significantly with age.

Describe effective nursing interventions that promote a patient's positive self concept.

Nurses can use touch and eye contact to enhance a patient's self-esteem. Implementation needs to be targeted to the patient at the specific level of care. Work with patients to help them develop healthy lifestyle behaviors that contribute to a positive and healthy self-concept. Support adaptation to stress, like proper nutrition, regular exercise within the patients normal capabilities, adequate sleep and rest, and stress reducing practices, contribute to a healthy self-concept.

Identify specific nursing interventions for health promotion of older-age adults.

Some older adults need encouragement to maintain a pattern of physical exercise and activity. Assessment of activity tolerance helps to decide a program that meets physical needs while allowing for physical impairments. Changes in social roles, family responsibility, and health status influence the living conditions of the patient; experiencing this grieving process requires support from HCP, family. Monitor elderly patients while in the hospital for confusion and encourage family to visit. Use reality orientation techniques to help reorient the patient. Help patients maintain a pleasant appearance/positive body image and present a socially acceptable image when they are hospitalized or have an acute/chronic illness. Instruct patient about their prescriptions and side effects, get their medications at one pharmacy, and on environmental safety issues.

Identify factors that can facilitate or interfere with normal growth and development.

Teratogens (chemical or physiological agents that may produce effects in the embryo or fetus), barbiturates (drugs that act as a CNS depressant) , alcohol, anticonvulsants (drugs that prevent or reduce severity/frequency of seizures in varies types of epilepsy), antibiotics, anticoagulants (blood thinners), and over-the-counter medication are capable of having adverse effects on a fetus. Infants depend completely on caregivers to provide for basic needs of food, warmth, comfort, love, security and sensory stimulation; if they don't get these they may not develop normally. Not getting adequate nutrition/unsafe environment can interfere with toddler growth and development.

Explain dementia.

broad category of disorders referring to a generalized impairment of intellectual functioning that interferes with social and occupational functioning. Differs from delirium in that it is a gradual, progressive, irreversible dysfunction. Alzheimer's is the most common form of dementia; It is a progressive loss of memory (amnesia), loss of ability to recognize objects (agnosia), loss of the ability to perform familiar tasks (apraxia), and loss of language skills (aphasia). Some patients experience changes in personality and behavior as the disease progresses. The second most common form of dementia is IVD (ischemic vascular dementia); it can be characterized by either an abrupt loss of function (stroke), or general slowing of cognitive abilities.