HHNP1_Module 11_student PDF

Module 11 Growth and Development Part Two  Learning Objectives Identify principles of growth and development Describe the physical growth, cognitive and psycho-social development from young adulthood to older adult Synthesize health risks and health concerns rele...

Module 11 Growth and Development Part Two  Learning Objectives Identify principles of growth and development Describe the physical growth, cognitive and psycho-social development from young adulthood to older adult Synthesize health risks and health concerns relevant to developmental stages from young adulthood to older adult Analyze appropriate nursing interventions and considerations when caring for each age group.  A period of challenges, rewards, and crises Challenges may include the demands of working and raising families. Young to Rewards may include career, family, and personal successes. Middle Crises may include job loss and Adulthood caring for children or adolescents in crisis or for aging Overview parents. Adult developmental changes are unique to each person and are influenced by social and ecological contexts. Young Adulthood  Young Adulthood During this period, individuals move away from Period from late teens to the their families of origin, middle to late 30s establish career goals, and decide whether to marry and begin families.  Young Adulthood Physical Growth is completed by the age of 20. changes Few physical illnesses occur. Cognitive Critical thinking habits improve. Choosing an occupation is a major task. changes Health literacy becomes important.  Young Adulthood Psychosocial changes Emotional health related to ability to address and resolve personal and social tasks Gender roles Career Sexuality Gender Identity and Expression. Singlehood Marriage or common law Child-bearing cycle Parenthood Alternative family structures and parenting  Young Adulthood 10 Hallmarks of Emotional Health: (cont’d) When married, feelings of love for partner; when single, satisfaction with social interactions Satisfaction with friendships Generally cheerful attitude Acceptance of constructive criticism No unrealistic fears  Young Adulthood 10 Hallmarks of Emotional Health: A sense of meaning and direction in life Successful negotiation through transitions Absence of feelings of being cheated or disappointed by life Attainment of several long-term goals Satisfaction with personal growth and development  Young Adulthood Social support in health and illness: A current trend in health care is the use of a peer support worker to facilitate well-being e.g., Child-bearing families Chronic disease  Young Adulthood Health risks Lifestyle Computer-mediated communication Family history Accidental death and injury Substance abuse Unplanned pregnancies Sexually transmitted infections Environmental or occupational factors  Young Adulthood Health concerns Infertility Exercise Routine health screening Job stress Family stress  Young Adulthood Acute care Treatment for accidents, substance abuse, exposure to environmental hazards, stress- related illnesses, respiratory infections, influenza, urinary tract infections, and conditions necessitating minor surgery Major mental illness Importance of education Developmental Risks Risks related to lifestyle habits  Young Adulthood Restorative and continuing care Nursing interventions related to sense of identity, establishment of independence, reorganization of relationships Hypertension, coronary artery disease, accidents, rheumatoid arthritis, HIV infection, and cancer all involve restorative and continuing care. Middle Adulthood  Middle Adulthood For many, enjoyment is Period from mid- found in assisting to late 30s to the others to become mid-60s productive and responsible adults Socioeconomic Sometimes also instability may beginning to help leave some aging parents jobless or in lower-paying jobs  Middle Adulthood Need to adapt self-concept and body image to physiological realities and changes in physical appearance Physical changes May affect self-concept and body image Perimenopause and menopause Cognitive changes Rare, unless illness or trauma occurs Psychosocial changes Expected events “Sandwich generation” “Midlife crisis” Career transition Sexuality Middle Family types Adulthood Singlehood Marital changes Family transitions Care of aging parents  Middle Adulthood Health concerns Stress and stress reduction Levels of wellness Obesity Forming positive health habits Anxiety Depression  Middle Adulthood Primary health care programs Illness prevention Health promotion Disease detection Health education  Middle Adulthood Acute care Possibly longer recovery from an injury or illness Risk factors for HIV Developmental Risks Risks related to lifestyle habits Restorative and continuing care Roles and responsibilities affected by chronic illness Older Adult  Older Persons - Overview Age of 65 years is used as the lower boundary to define older adulthood in demographics and social policy. This population is sometimes divided into groups of youngest old, old, and oldest old (oldest old is those over 85 years of age). Number of older persons is growing, both absolutely and as a proportion of the total population.  Variability Among Older Persons Great variation in physiological, Levels of functional Dependence versus Strengths and cognitive, and ability independence abilities psychosocial health  Myths and Stereotypes That older persons are: Ill and disabled Not interested in sex or sexual activities Unable to use computers Forgetful, confused, rigid, boring, unfriendly Unable to learn and understand new information Unattractive and worthless to society  Nurses’ Attitudes Toward Older Persons Nurses need to recognize and address ageism: By questioning prevailing negative attitudes and stereotypes By advocating for older persons Nurses must treat older persons as independent, dignified persons.  Developmental Tasks for Older Persons Adjusting Adjusting to decreasing health and physical strength Adjusting Adjusting to retirement and reduced or fixed income Adjusting Adjusting to the death of a spouse Accepting Accepting oneself as an aging person Maintaining Maintaining satisfactory living arrangements Redefining Redefining relationships with adult children Finding Finding ways to maintain quality of life  Aging Well and Quality of Life “Aging well” or active aging Quality of life Nurse’s work with older person to set objectives together  Community-Based and Institutional Health Care Services Older persons are cared for in various settings: Private homes, apartments, adult day care centres, home care, personal care home, assisted-living facilities, long-term care facilities, hospice Older persons may request assistance with making decisions regarding which type of health care service is appropriate for them. This Photo by Unknown author is licensed under CC BY-SA.  Assessing the Needs of Older Persons Nursing assessment: The interrelationship between physical and psychosocial aspects of aging Effects of disease and disability on functional status Decreased efficiency of homeostatic mechanisms Lack of standards for defining health and illness norms Altered manifestations and responses to specific disease  Assessing the Needs of Older Persons Two key principles of providing age- appropriate nursing care: Timely detection of the cardinal signs of illness A focus on finding underlying causes of illness so that treatment can begin  Physiological Changes Older patients’ concept of health revolves Not all physiological Nurses need to be around how they changes are cognizant of normal perceive their ability to pathological. age-related changes. function.  Systems Common Integumentary Sensory Physiological Respiratory Genitourinary Changes with Cardiovascular Reproductive Aging Gastrointestinal Endocrine Musculoskeletal Immune Neurological system  General Survey Occurs during the initial encounter with An initial inspection of an older person an older person (head to toe scan) might reveal: Whether eye contact and facial expression are appropriate to the situation Common aging changes such as facial wrinkles, grey hair, loss of body mass in the extremities, and an increase of body mass in the trunk  Functional Changes Declines in physical, psychological, cognitive, and social function are usually linked to illness or disease and degree of chronicity. Influences an older person’s functional abilities and overall well-being The capacity and safe performance of activities of daily living (ADLs) is a sensitive indicator of health or illness in older persons.  Cognitive Changes A common misconception about aging is that cognitive impairments are widespread among older persons. Structural and physiological changes within the brain are normal with aging. Symptoms such as disorientation, loss of language skills, loss of the ability to calculate, and poor judgement are not normal changes with aging. Conditions Affecting Cognition Delirium Acute state of confusion; sudden onset Dementia Generalized impairment of intellectual functioning; gradual deterioration Depression A mood disturbance characterized by feelings of sadness and despair 37  Psychosocial Changes Retirement Social isolation Abuse Sexuality Housing and environment Age-friendly community Death Two most common causes of death: 1. Cancer Addressing 2. Heart disease the Health Other common causes of death: Respiratory disease, stroke, Concerns accidents, falls, diabetes, kidney disease, and liver disease of Older Preventive measures to reduce/delay all Persons of these conditions  Health Cancer Arthritis Promotion Heart disease Falls and Smoking Sensory Maintenance: Substance abuse impairments Physiological Nutrition Pain Health Oral health Medication use Concerns Exercise Polypharmacy  Health Promotion and Maintenance: Psychosocial Health Concerns Therapeutic communication Touch Cognitive stimulation Reminiscence This Photo by Unknown author is licensed under CC BY. Body-image interventions  Older Persons and the Acute Care Setting This setting poses risks for adverse events: Delirium Dehydration Malnutrition Nosocomial infections Urinary incontinence Skin breakdown Falls It is important to identify pre-hospitalization level of functioning This Photo by Unknown author is licensed under CC BY-SA-NC.  Nursing Interventions for the Older Adult Reduce risk of falls Reduce risk of accidental medication overdose Environmental safety Example: Carbon monoxide detectors Reduce risk of accidents Burns Motor Vehicle This Photo by Unknown author is licensed under CC BY-NC.  Older Persons and Restorative Care Restorative care includes two types of Aim of care ongoing care: Continues the Addresses chronic To regain or improve recovery from acute conditions that affect prior level of illness or surgery daily functioning independence, ADLs Older Persons and Palliative Care Improving overall quality of life for persons with life- Good management of limiting illness and their symptoms families Interprofessional Palliative care collaboration A focus on fostering patient and family hopes and achieving their goals and expectations for illness management over time