Unit 8 Flashcards
Cephalocaudal principle
Human developmental principal that follows a head to toe progression
Ex: infants gain control of their neck and head before their extremities
Proximodorsal principle
Human development principle that progresses from the center of the body in a outwards direction
Ex: Spine develops first then limbs and then digits
Simple to complex principle
Human development principle that evolves from simple to complex
Ex: infants can control their heads and neck before they can crawl
Continuous process principle
Human development principle that is continuous and characterized by periods of growth spurts and periods of slow steady growth
General to specific principle
Human development principle that occurs from large muscle movement to more refined muscle movements
Individualized rates principle
Human development principle that varies from individual to individual
Psychosexual development theory
Sigmund Freud
Theory is highly criticized, but still used bringing forward the unconscious to the conscious
5 stages: Oral, Anal, Phallic, Latent, Genital
Psychosocial Development theory
Eric Erickson
Impact of social experiences throughout the lifespan
8 stages:
-Basic trust vs Mistrust
-Autonomy vs Shame
-Initiative vs Guilt
-Industry vs Inferiority
-Identity vs Confusion
-Intimacy vs Isolation
-Generatively vs Stagnation
-Integrity vs Despair
Cognitive Development theory
Jean Piaget
How we acquire knowledge, intellect, and cognition
4 Stages:
-Sensorimotor
-Preoperational
-Concrete operational
-Formal operational
Moral Development theory
Lawrence Kholberg
Believed children progressively develop moral reasoning as they gain the ability to think logically
3 stages:
-Preconventional Reasoning
-Conventional Reasoning
-Postconventional Reasoning
Young Adult
Age range: 20s-mid 40s
-Brain maturation continues until 25
-Physical growth by 20
-Go through role transitions: self sufficient, committed relationships, career path
Middle Adult
Age range: mid 40s- early 60s
-Empty nest and caring for elderly parents
-Decrease in muscle tone, strength bone mass, visual and auditory acuity
-Increase in BP (muscles of heart and lungs lose elasticity)
-Fat around trunk, decrease in height
-Climacteric: menopause and occurs in males
Health risks in adulthood
Heart disease- atherosclerosis, HTN, dysrhythmias
Cancer- 80% of cancers in US are 55+ age,
42% are avoidable; caused by smoking, obesity ETOH, poor nutrition, inactivity
Type 2 Diabetes- asymptomatic at first,
can develop signs: polyuria, polydipsia, blurred vision, fatigue, poor wound healing, dry skin
Late adulthood
Average lifespan: 78.6
Types of grief
Normal, Anticipatory, Prolonged, and Disenfranchised grief
Normal grief
Uncomplicated.
Lasts several months to a year (no set timetable, but most see decline after 6 months)
Sadness, guilt, yearning, anger, regret
Anticipatory grief
grief experienced before loss
Sadness, anger, loneliness, guilt, anxiety, fear, fatigue, poor concentration
Happens with terminal patients
prolonged grief disorder
Lasts longer than 6 months and effects person’s ability to function
may not accept death, persistent need to find parison, preoccupied with thoughts of deceased
Guilt, anger, difficulty participating in activities, detached
Disenfranchised grief
Grief related to a relationship that does not coincide with what’s considered by society to be a recognized or justified loss, leads to no support and left to grieve with no support
Ex: loss of a pet, miscarriage, an extramarital affair, a young child trying to grieve
Depression, unstable emotions, social isolation, physical symptoms, insomnia, low self esteem
5 stages of grief
Denial
Anger
Depression
Bargaining
Acceptance
Bereavement
The period of time someone experiences grief
Mourning
Grief in public
What factors will affect a person’s grief response?
Age
Shock
Culture
Spiritual Beliefs
Manifestations of grief
Crying spells, difficulty sleeping, changes in food intake, decreased productivity
Grief reactions
Shock, anger, anxiety, numbness, denial, guilt, sadness, relief, depression
Psychological: disbelief, fixation, trouble concentrating, hallucinations
Physical: tightness in chest, GI upset, headache, weakness, fatigue
Behaviors: difficulty sleeping, loss of appetite, anger
What does NURSE stand for?
Elderly nutrition health promotion
Increased need for calcium, vitamin D, Vitamin E, Vitamin A, folate, fiber, fluids
Health promotion Health screening
Annual: hearing, vision, fecal occult blood test, digital rectal and prostate specific antigen (male), DXA for osteporosis
Periodic: Mental health (high risk for depression), Cholesterol and diabetes (every 3 years)
Integumentary expected changes in late adulthood?
Decreased skin turgid, SQ fat, connective tissue, thinning, gray hair, thickened nails
Cardiopulmonary expected changes in late adulthood?
Decreased chest wall movement, vital capacity and cilia, less effective cough, reduce CO, decreased peripheral circulation, increased SBP (more rigid heart aloes and decreased elasticity in blood vessels)
Neurological expected changes in late adulthood?
Slower reaction time, decreased touch, smell, taste, vision, decreased adjusting light to dark, presbycusis (inability to hear high pitched sounds), reduced spatial awareness
GI expected changes in late adulthood?
Decreased production of saliva, decreased thirst mechanism, decreased digestive names and insteinal motility, increased dental problems, can have decreased gag reflex, external sphincter control may weaken, decrease glucose control
MS expected changes in late adulthood?
Decreased height d/t dehydration of intervertebral discs, decreased muscle strength and lean muscle mass, decalcification of bones, degeneration of joints, curation of spine- kyphosis, decreased ROM
GU expected changes in adulthood?
Decreased renal function, decreased bladder capacity, prostate hypertrophic, decline in estrogen and testosterone, atrophy of breast tissue
Endocrine Expected changes in late adulthood?
Decline in T3, decreased insulin sensitivity
Immune expected changes in late adulthood?
Decreased antibodies by B cells, increased autoantibodies, i=decreased core temp, T cell, stress response, response to immunizations
Cognitive expected changes in late adulthood?
Some decline in cognitive function-impaired memory of recent events, decreased reaction to stimuli
Sensory perception expected changes in late adulthood?
peripheral vision loss, conductive hearing loss, decreased taste buds
Safety issues in older adults
Falls are most common
Safe driving- reduced visual acuity and reaction times
Elder abuse and neglect- Neglect, physical, financial abuse, emotional abuse
Medication safety
Signs and symptoms of elder abuse
Bruises in clusters or patterns, burns, unusual hair loss, multiple injuries, pressure injuries, contractures, dehydrations, malnutrition, urine burns, excessive body odor, listlessness (feeling no energy to do anything needing effort), depression, dementia
Must report when abuse is suspected
Medication misuse in elderly
Financial strains and lack of health literacy puts patients at risk to misuse medication
Patients may share medications, or alter dose to save money not understanding the ramifications
Physiologic changes in elderly that increase risk for toxicity- Drug receptors interactions
Drug receptor interaction: brain receptors more sensitive increasing potency of psychoactive drugs
Physiologic changes in elderly that increase risk for toxicity- Absorption
Slowing of GI mobility and emptying rate
Physiologic changes in elderly that increase risk for toxicity- Distributiion
Decreased lean body mass and total body water- increases concentration of water soluble drugs.
Decreased plasma proteins- reducing sites for protein bound drugs, increasing free drug in blood.
Increased adipose stores.
Physiologic changes in elderly that increase risk for toxicity- Metabolism
Decreased liver function, prolonging drugs 1/2 life
Physiologic changes in elderly that increase risk for toxicity - Elimination
Decreased renal function, and drugs stay in body longer
