Young and Middle Adulthood Development Quiz

Module 11: Growth and Development - Part Two

• Learning Objectives: Identify principles of growth and development; describe physical, cognitive, and psychosocial development from young adulthood to older adulthood; synthesize health risks and concerns relevant to developmental stages; analyze appropriate nursing interventions for each age group.

Young to Middle Adulthood Overview

• Challenges and Crises: Demands of working and raising families; job loss; caring for aging parents or adolescents in crisis.
• Rewards: Career success; family and personal successes.
• Developmental Changes: Unique to each person and influenced by social and ecological contexts.

Young Adulthood

• Timeframe: Late teens to middle/late 30s.
• Life Transitions: Moving away from family of origin; establishing career goals; deciding on marriage and starting a family.
• Physical Changes: Growth complete by age 20; few physical illnesses.
• Cognitive Changes: Improved critical thinking; choosing an occupation; health literacy.
• Psychosocial Changes: Emotional health related to ability to address personal and social tasks; gender roles; career; sexuality (gender identity and expression, singlehood, marriage/common law, childbearing, parenthood, alternate family structures, and parenting); satisfaction with friendships and social interactions; a generally cheerful attitude; acceptance of constructive criticism; absence of unrealistic fears.
• Hallmarks of Emotional Health: A sense of meaning and direction; successful negotiation through transitions; absence of feelings of being cheated; attainment of long-term goals; satisfaction with personal growth.
• Social Support: Peer support workers to facilitate well-being (e.g., child-bearing families, chronic disease).
• Health Risks: Lifestyle; computer-mediated communication; family history; accidental death and injury; substance abuse; unplanned pregnancies; sexually transmitted infections; environmental/occupational factors; fertility.
• Health Concerns: Infertility; exercise; routine health screening; job stress; family stress.
• Acute Care: Treatment for accidents, substance abuse, environmental exposures, stress-related illnesses, infections, minor surgeries, major mental illness.
• Developmental Risks: Lifestyle habits; importance of education; risk factors linked to HIV.
• Restorative and Continuing Care: Hypertension, coronary artery disease, accidents, rheumatoid arthritis, HIV infection, and cancer all involve restorative and continuing care; Nursing interventions related to sense of identity, establishment of independence, reorganization of relationships.

Middle Adulthood

• Timeframe: Mid-30s to mid-60s.
• Life Transitions: Assisting others become productive adults; beginning to help aging parents.
• Socioeconomic Stability: Some may experience instability, leading to job loss or lower-paying jobs.
• Physical Changes: Need to adapt self-concept and body image to physiological changes; perimenopause and menopause; minimal/rare cognitive changes unless illness or trauma occurs.
• Psychosocial Changes: Expected life events; "sandwich generation"; midlife crisis; career transition; sexuality; family types (singlehood, marital changes, family transitions); care of aging parents.
• Health Concerns: Stress and stress reduction; levels of wellness; obesity; forming positive health habits; anxiety; depression.
• Primary Health Care Programs: Illness prevention; health promotion; disease detection; health education.
• Acute Care: Possibly longer recovery times from injury or illness; risk factors for HIV; risks related to lifestyle habits; chronic illness affecting roles and responsibilities.

Older Adult

• Timeframe: Age 65 and older.
• Demographic Trends: Growing number of older persons, both absolutely and as a proportion of the total population.
• Population Divisions: Youngest old; old; oldest old (over 85).
• Variability: Great variation in physiological, cognitive, and psychosocial health; levels of functional ability; dependence versus independence; strengths and abilities; myths/stereotypes around aging.
• Myths and Stereotypes: Older persons are ill, disabled, uninterested in sex, unable to use computers, forgetful/confused/unfriendly, unable to learn new information, and unattractive/worthless to society.
• Nurses' Attitudes: Recognizing and addressing ageism; questioning negative attitudes/stereotypes; advocating for older persons; treating as independent, dignified persons.
• Developmental Tasks: Adjusting to decreasing health; retirement/reduced income; death of a spouse; accepting aging; maintaining satisfactory living arrangements; redefining relationships with adult children; finding ways to maintain quality of life.
• Quality of Life: "Aging well" or active aging; nurse's work with elder to set objectives together.
• Community-Based Care: Care settings (private homes, apartments, adult day care, home care, personal care homes, assisted-living facilities, long-term care facilities, hospices); assistive support regarding healthcare decisions.
• Nursing Assessment: Understanding interrelationship between physical and psychosocial aspects of aging; effects of disease/disability on functional ability; decreased efficiency of homeostatic mechanisms; lack of standards for defining health/illness; altered manifestations/responses to specific disease.
• Two Key Principles of Age-Appropriate Care: Timely detection of cardinal signs of illness; focus on underlying causes of illness for appropriate treatment.
• Physiological Changes: Older patients' concept of health revolves around their perceived ability to function; not all physiological changes are pathological. Common changes with aging in organ systems (integumentary, respiratory, cardiovascular, gastrointestinal, musculoskeletal, neurological, sensory, genitourinary, reproductive, endocrine, immune).
• General Survey: Initial observation to check for appropriate eye contact/facial expressions, common signs of aging (wrinkles/grey hair/body mass).
• Functional Changes: Physical, psychological, cognitive decline linked to illness; sensitive indicator of health/illness in older persons.
• Cognitive Changes: Common misconception that cognitive impairment is pervasive; Brain changes are normal with aging; symptoms like disorientation, poor judgment etc. are not always indicative of cognitive decline.
• Conditions Affecting Cognition: Delirium (sudden confusion); dementia (gradual intellectual impairment); depression (unresolved sadness/despair).
• Psychosocial Changes: Retirement, social isolation, abuse, sexuality, housing/environment (age-friendly communities), death.
• Health Concerns and Causes of Death: Cancer, heart disease, respiratory disease, stroke, accidents, falls, diabetes, kidney disease, and liver condition.
• Promoting Health and Maintaining Physiological Health: Emphasize activities, nutrition, oral care, exercise; address arthritis, falls, sensory impairments, pain, polypharmacy.
• Promoting Health and Maintaining Psychosocial Well-being: Therapeutic communication; touch; cognitive stimulation; reminiscence, body image intervention.
• Older Person in Acute Care: Risks of adverse events (delirium, dehydration, malnutrition, nosocomial infections, urinary incontinence, skin breakdown, falls); importance of identifying pre-hospitalization functioning.
• Nursing Interventions: Reduce risk of falls; prevent accidental medication overdose; ensure environmental safety; promote accident reduction in older people; ensure proper motor-vehicle safety.
• Restorative Care: Ongoing care to support recovery from acute illness or surgery; managing chronic conditions; aim to regain/improve prior independence.
• Palliative Care: Fulfilling goals and expectations for illness management in end-of-life situations; symptom management; focus on improving quality of life for those with life-limiting illnesses.