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2 Oakton Community College Associate Degree Nursing Unit III Part 2 Basic Human Needs & The Developmental Stages of Man

©SLK 3 Young to Older Adult Adult phase covers the years from the end of adolescence to death: Young Adults – 20 to 40 years Middle Age – 40 to 65 years Older Adults – over 65 years

©SLK 4 The Young Adult ERIKSON: Psychosocial development Intimacy vs. Isolation PIAGET: Cognitive development - Postformal operations thinkers (researching this possible fifth stage of cognitive development) Able to comprehend the contradictions that exist between both personal and physical reality, i.e. both love/hate exist together in a relationship

©SLK 5 Common health concerns of the young adult include: MVA’s Suicide Hypertension (African American men) Substance abuse Sexually transmitted diseases Abuse of women Malignancies Breast Testicular

©SLK 6 Health Promotion Health tests and screenings 1-3 yrs for female Every five years for male Immunizations Dental exams annually Vision and hearing screening Breast exam Testicular exam

©SLK 7 Pap smear annual Screening for CV disease Cholesterol Blood pressure Baseline 35 yrs for males TB skin test Q2yrs Safety Motor vehicle safety reinforcement Sun protection Workplace safety Water safety

©SLK 8 Nutrition and exercise Adequate iron intake in diet Nutrition and exercise to decrease risk of CV disease Social interactions Encourage personal relationships Set short and long-term Goals for work and career choices

©SLK 9 Middle-Aged Adults ERIKSON: Generativity vs stagnation Generativity – concern for establishing and guiding the next generation (providing for mankind is equal to concern of self) Stagnation: inability to expand interests leads to boredom

©SLK 10 Transition into middle life critical: Midlife crisis Cognitive development: middle-aged adults can “reflect on the past and current experience and can imagine, anticipate, plan and hope” Common health concerns of the middle-aged adult include: Accidents Cancer

©SLK 11 Common health concerns (cont): Cardiovascular disease Obesity (decrease in metabolism) Alcoholism Mental health alterations

©SLK 12 Health Promotion Health tests and screening Routine physical examination Annual for females 2-3 years for male Immunizations Dental care Tonometry for signs of glaucoma Breast self-exam Screening for CV disease

©SLK 13 Screening for colorectal, breast, cervical, uterine and prostate cancer Screening for TB Q 2 yrs Safety Motor vehicle safety Workplace safety measures Home safety measure Adequate lighting Smoke detectors

©SLK 14 Nutrition and exercise Adequate protein, calcium and vitamin D Cholesterol screening Exercise program Social interactions Encourage discussion of feeling, concerns and fears (Midlife crisis) Expand and review previous interests Retirement planning

©SLK 15 Older Adults ERIKSON: Integrity vs despair Ego integrity Satisfaction from past accomplishments Death acceptable completion of life Serenity and wisdom Despair Believe they made poor choices Wish they could live life over Frustration, discouragement

©SLK 16 Lifestyle Changes Retirement Economic change Relocation Move closer to children Less expensive housing More moderate climate Assisted living Long term care

©SLK 17 Independence & Self-Esteem Need sense of accomplishment Encourage them to do as much as possible for themselves Acknowledge ability to think, reason and make decisions Demonstrate thoughtfulness, consideration and acceptance of their waning abilities

©SLK 18 Death and Grieving Loss of spouse Coping easier Meaningful friendships Economic security Ongoing interest in community Private hobbies

©SLK 19 Physical Changes Integumentary Skin drier, fragile,  SQ fat,  elasticity Hair loses color Nails thicken Lentigo senilus Musculoskeletal Decrease in muscle fibers,  strength, muscle atrophy, Kyphosis (humpback), osteoporosis, pathologic fractures

©SLK 20 Sensory/Perceptual Vision: Presbyopia  visual acuity  adaptability to darkness and dim light  accommodation to near and far  peripheral vision  Color discrimination (blues, greens, and purples) Cataracts Arcus sinilus  Hearing: easier to hear low pitched sound  Taste and Smell  Sensation of pain, touch and temperature

©SLK 21 Respiratory: Reduced efficiency Weaker expiratory muscles Greater expiratory residual  capacity to cough effectively Respiratory infections Cardiovascular Arteries less elastic, diminished blood supply Orthostatic hypotension

©SLK 22 Gastrointestinal  indigestive enzymes  in absorption rate  peristalsis and elimination Indigestion and constipation Urinary  excretory function of kidneys  filtering abilities Urinary urgency/frequency Nocturnal frequency Retention

©SLK 23 Cognitive Function Physical changes Progressive loss of neurons Blood flow to brain decreases Meningis thicken Brain metabolism slows Cognitive abilities Difference in speed Maintains intelligence, problem solving, judgment and creativity Intellectual loss generally caused by disease process - atherosclerosis

©SLK 24 Memory Long-term memory: Retrieval of information can be slower Short-term memory: Differences occur related to aging. Older adults tend to forget the recent past.

©SLK 25 Health Problem Older Adult Accidents Hypothermia Chronic disabling illness Drug use and misuse (adverse drug reactions) Alcoholism Dementia Elder abuse

©SLK 26 Health Promotion Tests and screenings Home safety screening Nutrition and exercise Foods high in Vitamin D and calcium Cholesterol screening Moderate exercise to maintain Mobility Muscle tone Bone calcification

©SLK 27 Elimination Adequate roughage Adequate exercise Adequate fluid intake Social Intellectual and recreational pursuits Personal relationships Community center and programs for seniors

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