321 adulthood & development Flashcards
young adult age category
young young adults: 18-24
older young adults: 25-35
young adulthood is defined by which social contexts
voting, culture, turning 21,
key milestones in young adulthood
economic independence, committed long term relationship, independent decision making, increase in critical thinking habits leaving parents/the person who took care of you
young adulthood biology
usually healthy and do not experience severe illnesses regularly time of physical and emotional changes
in young adulthood, what is the exception to physical growth being complete
pregnancy and lactation
when is physical growth complete
females: 17 y/o
males: 21 y/o
how do young adults treat illnesses?
do not take them seriously and usually postpone seeking health care
when does physical strength peak?
young adulthood (starts to change as person approaches middle adulthood, usually bc of diet and lifestyle)
self perception / self concept pattern (erikson) for young adults
development of increased sense of competency and self esteem -> intimacy vs isolation -> making attachments to others or not
life change adjustments for a young adult
-career change or career move
-relocation
-balancing multiple roles
-developing long term goals for family security
identity of young adulthood
-increasing separation from family authority
-beginning adult identity (career/work)
-work provides self esteem and socialization
work and personal responsibilities for a young adult
-beginning balance of personal and work responsibilities
-developing relationships within the workforce
characteristics of young adulthood
-healthiest time of life
-peak abilities (venturesome, daring, enterprising, aggressive)
- abstract, analytical thinking
-principled moral reasoning
-less experience of death
-risk takers
-lack of fear
challenges of young adulthood
-lots of changes needing adaptation leading to stress (+ or -)
-marriage/children/starting a career
-miscarriage/serious illness/divorce
achievement oriented stress
“internal pressure to succeed defined goals” (workaholic) -> affects you physically and emotionally leading too nutrition problems, lack of sleep & burn out very common in young adults
how can young adults adapt to challenges
-requires coping skills and problem solving
-stress mgt
-reaching out for help when it is needed
young adult health risks
- “it wont happen to me”
unintentional injuries - substance use
- violence
- suicide
- risky sexual behavior
- workplace hazards
nurses main focus for young adults
prevention !!
check up every 1-2 yrs to educate on deceasing the incidence of accidents, injuries and acts of violence, reduce drugs and alcohol. improve mental health
interventions for young adults
needs to be relatable to make them see it can happen to you
health promotions in young adulthood - exercise
ask about history w/ exercise and then focus on safety measures (helmets, protective equipment & sunscreen)
health promotions in young adulthood - sleep
insomnia effects 40 million per year which causes fatigue that affects work, stress and promotes inactivity. Recommendations include: change activity or stressors (ex: job switch), try new tasks/PA, sleep hygiene
infertility in young adults
increased risk for diagnosis in those over >25 years & it affects 10-15% of reproductive couples
nurses role in unintended pregnancy
educate on contraceptive and help clients choose method most appropriate to their needs
STIs
50% of all new STIs occur in people 24 or younger & they can have short term or long term impacts nurses education on contraceptives and how to prevent sti’s
Is depression in young adulthood increasing or decreasing
increasing
nursing role in depression
screening and if there is concerns for suicide risk have to ask “are you having thoughts about harming yourself?**, take action
general nursing application for young adults
- role of counselor (listen, offer support, remove barriers, provide resources)
-goals: maintaining optimal physical conditions, encouraging healthy habits, screenings, treating illness
general barriers to change for young adults
lack of knowledge & motivation, insufficient skills to change health status, undefined short & long term goals, lack of social support
age range for middle adulthood
36-64
what type of changes happen in middle adulthood
dynamic -> physiologic decline begins but still relatively healthy, early lifestyle choices begin to yield cost or benefit
sandwich generation
stage within middle adulthood that contains major economic productivity and family responsibility (caring for children & aging parents)
middle adulthood biology
-physiologic changes start ~ 45 y/o (grey hair, wrinkled skin, wt change, decline in hearing & near vision, menopause & climacteric)
-onset of chronic conditions
self perception / self concept pattern (erikson) - middle adulthood
generativity vs stagnation -> establishing or guiding the generation (productive & creative, desire to care) vs self absorbed, fails too care for others + critical review of life choices
midlife crisis
realizing physical decline, mistakes made, death is nearing, less time to make change but the usual results is acceptance (if no acceptance then it is considered a true midlife crisis)
middle adult challenges
divorce (self or offspring), young adults moving back home, raising grandchildren
life events w/ potential disruptive effects on middle adulthood
two or more jobs families, divorce, caring for aging parents, death of spouse, unintended pregnancies
leading causes of death in middle adulthood
heart disease (#1 for over 44y/o), malignant neoplaasms (#2), unintentional injuries many of these diseases are still preventable through lifestyle & routine primary care
common chronic disease in middle adulthood
heart disease, arthritis, back & spine impairments, COPD, DM, mental health, dental disease
sexuality - reproductive changes
all points of education & conversation & health history that should be addresses in middle adults consider pregnancies (un and in), hidden sti risks, changes in sex drive
obesity in middle adulthood and health promotion
one of the biggest issues and leads to other chronic diseases -> nurses should educate on diets, encourage increase PA, manage wt to reduce risk for chronic disease
exercise recommendations
30 mins five or more days/weeks (150 total mins)
goal is for it to be a continuous, rhythmic exercise (walking, swimming, biking)
oral health and health promotion in middle adults
increase in gingivitis and periodontitis -> teach dental hygiene and making sure that we are encouraging our clients to have routine dental exams
barriers to change in middle adulthood
lack of materials, social support, motivation, & knowledge, insufficient skills to change habits, undefined goals (short & long term)
middle adults and nursing practice
-through identification of risk factors, health promotion and other nursing inventions, nurses help improve quality of life
-nursing practices focus on the personal habits and lifestyles of middle aged adults to improve their biological, spiritual & psychosocial development
older adult age range
65+ years old
key to older adult care
help them live longer but fulfilled lives with dignity and independence
why are there so many older adults
-improved standard of living
-improved nutrition
-progress in medical care
-increased health consciousness (increase in HP effects)
statistics on aging in the US
-23% men & 15% women are 65 years+
-by 2050, 1 million people will be 100 yrs or older
-older adults use most health care dollars in the last 7 years of life
older adulthood biology
-identify normal age related changes from pathological process and illness
-older adults concepts of health generally depend on personal person perceptions of functional ability
common chronic conditions in older adults
HTN, arthritis, heart disease, cancer, diabetes, asthma, chronic respiratory, stroke
Erikson’s development stages for older adults
1) generativity & stagnation - active involvement + care vs self absorption + boredom
2) integrity vs despair - acceptance of life + reconciliation of hopes compared to what actually happened vs not accepting of death
misconceptions about older adults
-disease is normal and unavoidable
-HP is not important since their lives are almost over
-damage to health resulting from inactivity or poor nutrition is irreversible
-ageist beliefs about older adults
the decline in health in old agge is primarily due to what
unhealthy lifestyle choices in earlier years
what factors contribute to coping and stress in older adults
-decrease in strength & health
-retirement / lower income
-death
-new relationships w/ adult children
-slower responses
-keeping active & involved
-making satisfying living arrangements
comprehensive assessment of older adults
-id individual strengths & weaknesses
-develop plan of care that corrects problems
-maintain health
-improve quality of life
older adult assessment
a functional, physical, social and mental assessment of pt, caregiver, and environment
goals of older adult assessment
improve quality of life by detecting any signs of impairment which may be amenable to early intervention
minimize hospitalization
-establish complete diagnoses that are frequently overlooked
-decrease over prescription of meds
-maintain health and health maintenance practices
key principles of older adult assessment
-pt centered
-client/caregiver as an active partner
-focus on functional ability (“how do you manage x task”)
-multidisciplinary
-knowing what is abnormal vs normal (certain changes, lab values)
health promotion in older adults
healthy wt & diet, staying active, fall prevention, maintaining relationships, regular medical check ups, shots, screenings
SPICES assessment told
frame work that guides providers in assessing older adults, when done regularly can signal the need for more specific assessment and treatment
sleep disorders, problems w/ eating or feeding, incontinence, confusion, evidence of falls, skin breakdown
** help guide plans of care**
HP for older adults - respiratory
-immunizations
-stop smoking
-daily exercise
-seeing HCP if SOB, infection more than 3 days, cannot tolerate fluids for 1+ day
HP for older adults - cardio
- rest when feel tired or SOB
-daily exercise
-wearing socks to bed
-check for orthostatic changes (ed. to change positions slowly)
-elastic stockings
HP for older adults - nutrition & metabolic patterns
-proper nutrition for disease prevention and energy
-risk factors: low support or income
-problems: GI function, decreased smell/vision/taste, dental and swallowing issues, meds
-screen: health history, physical, labs, diet, functional status
nutrition interventions
-assess contributing factors + use tools
-educate about nutrition
-provide info about food assistance programs (barriers: embarrassed to apply, lack of knowledge)
HP for older adults - elimination patter
-bladder retains tone but capacity decreases
-incontinence leads to depression, UTI, skin breakdown, social isolation (tools to assess)
-incontinence is never a normal part of aging
-constipation (frequent finding) due to decreased motility, sedentary lifestyle & meds, decrease in fiber & fluids
mgt of elimination patterns - incontinence
kegel, pilates, scheduling, intake mgt, decrease caffeine, disposable undergarments
mgt of elimination patterns- constipation
education, increase exercise, increase fiber & fluid, caution against daily use of laxatives
health promotion for exercise of older adults
pre exercise assessment and education on the benefits & starting out slow
HP for older adults - sleeping pattern
-assessment tools
-do: schedule, exercise, ritual, quiet, dark, bed
-don’t: nap, activity right before bed, caffeine after mid morning, drink alc before bed, sleep meds, tobacco
HP for older adults - cognitive
** cognitive problems are not apart of the aging process**
-assess & treat confusion (associated w/ UTI & pneumonia)
-dementia: increase quality of life & decrease morbidity and cost (keep routine, calm, encourage self care, reduce sensory overload)
Benign forgetfulness
normal part of aging
-forgets but then remembers
-forgets unimportant events
-may repeat stories
-decline in abstraction, calculation, word fluency, spatial orientation, inductive reasoning but as little impact on day to day life
strategies for benign forgetfulness
use mental retracing, reminders, notes to compensate
nursing strategies for aging minds
confusion, disorientation, inappropriate behaviors, loss of ability to follow directions or concentrate are not a part of normal aging so evaluate and treat + look at meds & fluid/lytes imbalance
-attempt recall in calm, quiet place, use memory aid and techniques
HP for older adults - impaired hearing
periodic hearing evaluations, encourage use of hearing aids, teach methods to improve communication (quiet, do not shout, face speaker)
HP for older adults - visual changes
annual eye exam & glaucoma screening, bright non glare lights, limit night driving
visual assessments to identify possible vision changes
miss match clothes, bruises from bumping into things, increase in car accidents
HP for older adults - sexual & reproductive pattern
be matter of fact, approach that sex is normal and apart of everyday life
education on normal age related changes & their interventions, assess emotion, educate on STIs (s/s, treatments, preventions)
HP for older adults - depression
not a normal part of aging
-may occur w/ chronic illness, impaired functional ability, loss
-s/s: flat affect, anorexia, wt loss, sleep problems, decreased ability to think and concentrate, decreased participation in activities & socialization
HP for older adults - suicide
- high rates compared to other countries
-highest rates seen in men >75 years
-risk factors: isolation, alcohol & drug abuse, psychosis, bereavement, & serious medical illness
nurses need to assess & recognize, asking “have you thought about harming yourself” -> intervene
HP for older adults - falls
- 1 in 3 adults fall each year
-causes: neurological, osteoporosis, stroke, sensory impairment (vision)
-evaluate why fall causes and then evaluate injuries
** assess for falls (tool & motility w/ pt or ot) and teach safety interventions**
biological agents that can cause serious illness or death in older adults
-influenza (vaccinate annually)
-pneumonia (vaccinate @ 65)
-high rates of cancer
polypharmacy
-big problem in older adults
-often duplicate for same problem
-1/3 of all older adults take 5 or more prescriptions
-substance abuse is a growing problem
Alcohol & Tobacco Use in Older Adults
often underestimated/hidden in this age group
-more vulnerable to effects of alc
-tobacco promotes multiple chronic health conditions
-beneficial to stop smoking >65 y/o
within older adult abuse, what group is at the highest risk
older adult women dependent on a caregiver
nurses need to recognize and report
nursing care can determine whether an older adult patient
-maintains health
-recovers from an illness
-maintains or regains function & independence
-achieves a peaceful death
nursing interventions should support
-self care abilities
-practices that foster health while aging
