1. Health Promotion of young adult 20-40 years

2. Suhaila Halasa RN, PhD, CIMI,CPT
Learning objectives
By the end of this lesson you will be able to:
1- Describe physical development of young and middle- age adult
2- Discuss psychosocial, cognitive, moral, and spiritual development of young and middle age-adult
3- Explain health risks associated with young and middle adulthood
4- Discuss health promotion guidelines for young and middle age-adult
4/14/2019
Suhaila Halasa RN, PhD, CIMI,CPT

3. Adulthood divided into three phases: 1. Young adult (20-40)years 2
Adulthood divided into three phases: 1. Young adult (20-40)years 2. Middle-age adults ( 40-65) years 3. Older adult (over 65) years

4. Suhaila Halasa RN, PhD, CIMI,CPT
Young adult (20-40)years
Adult phase of development involves the years from the adolescence to death
4/14/2019
Suhaila Halasa RN, PhD, CIMI,CPT

5. Young adult (20-40)years
Young adult are busy people who face many challenges:
A. Expected to assume new roles at work, in home, and community
B. They develop interest, values, and attitudes towered their role.
C. Maturity is the maximal function and integration, or the state of being fully developed.

6. Suhaila Halasa RN, PhD, CIMI,CPT
Young adult (20-40)years
Physical development:
The musculoskeletal system is well developed and coordinate (athletic reach its peak).
All other system of the body are functional at peak efficiency
4/14/2019
Suhaila Halasa RN, PhD, CIMI,CPT

7. Suhaila Halasa RN, PhD, CIMI,CPT
Young adult (20-40)years
All body systems (e.g., cardiovascular, visual, auditory, reproductive ) are function at peak efficiency.
Physical change are minimal in this age, but, muscle mass may change as a result of diet and physical exercise
4/14/2019
Suhaila Halasa RN, PhD, CIMI,CPT

8. Suhaila Halasa RN, PhD, CIMI,CPT
Young adult (20-40)years
Health outcomes in middle- age and older adulthood may have their beginning in younger adult behavior
Extensive physical and psychosocial changes occur in pregnant and lactating women
4/14/2019
Suhaila Halasa RN, PhD, CIMI,CPT

9. Young adult (20-40)years
Psychosocial development of the young adult is great
See (Box : 22-1 R2 page 400)
The intimacy versus isolation phase of Erickson's stage of development.
The basic developmental task is establishing or very closed friendship

10. Suhaila Halasa RN, PhD, CIMI,CPT
Young adult (20-40)years
Choice of lifelong partner and
consideration of childbearing
depending on successful
negotiation of intimacy
4/14/2019
Suhaila Halasa RN, PhD, CIMI,CPT

11. Suhaila Halasa RN, PhD, CIMI,CPT
Young adult (20-40)years
Young adult face a number of new experiences and changes in lifestyle as they progress toward maturity
Young adult makes choices about:
Education and employment
Whether to marry or remains single
Starting home, and rearing children
4/14/2019
Suhaila Halasa RN, PhD, CIMI,CPT

12. Suhaila Halasa RN, PhD, CIMI,CPT
Young adult (20-40)years
Social responsibility include forming new friendship and assuming community activities
Education enhances employment opportunities and usually insure economic survival
4/14/2019
Suhaila Halasa RN, PhD, CIMI,CPT

13. Suhaila Halasa RN, PhD, CIMI,CPT
Young adult (20-40)years
The women role is changed, many women now choose to assume active careers and civic role in the society in addition to their role as mother and/or wife
4/14/2019
Suhaila Halasa RN, PhD, CIMI,CPT

14. Suhaila Halasa RN, PhD, CIMI,CPT
Young- age adult has the following developmental tasks:
Selecting a mate
Learning to live with a partner.
Starting family.
Rearing children.
4/14/2019
Suhaila Halasa RN, PhD, CIMI,CPT

15. Young adult (20-40)years 5. Managing home.
6. Getting started in occupation.
7. Taking on civic responsibility.
8. Finding a congenial social group.

16. Young adult (20-40)years Cognitive development:
Piaget believes that cognitive structures are complete during the formal operations period.
It characterized to think abstractly and employ logic

17. Suhaila Halasa RN, PhD, CIMI,CPT
Young adult (20-40)years
They are able to:
Generate hypotheses about what will happen, and do not have to engage in trial – and-error behavior
Post formal thought include creativity, intuition, and ability to consider information in relationship to other ideas
4/14/2019
Suhaila Halasa RN, PhD, CIMI,CPT

18. Suhaila Halasa RN, PhD, CIMI,CPT
Young adult (20-40)years
They aware that most problems have more than one cause and more than one answer and some solutions will work better than others
4/14/2019
Suhaila Halasa RN, PhD, CIMI,CPT

19. Young adult (20-40)years Moral development:
young adult who have mastered the previous stages of Kohlberg's theory of moral development now enter the post conventional level
The person is able to define morality in terms of personal principles

20. Young adult (20-40)years
Spiritual development: according to fowler, the individual enters the individualizing-reflective period sometime after 18 years of age

21. Suhaila Halasa RN, PhD, CIMI,CPT
During this period the individual focuses on reality
The religious teaching that the young adult has a child may now be accepted or redefined
4/14/2019
Suhaila Halasa RN, PhD, CIMI,CPT

22. Health Risks Young adulthood is generally a healthy time of life
Health risks include:
Injury and violence
Suicide, hypertension, substance abuse, sexually transmitted infection, eating disorders, and certain malignancies.

23. Suhaila Halasa RN, PhD, CIMI,CPT
Some problems such as Injuries, substance use and STDs are related to behaviors that could possibly be prevented through appropriate education and other primary preventive strategies
4/14/2019
Suhaila Halasa RN, PhD, CIMI,CPT

24. Health Risks Injuries Unintentional injuries :
Motor vehicle crashes are the fifth leading cause of death for total population but the leading of death for people 1-44 years of age
Education about safety precautions is major role of the nurse in promoting health of young adult

25. The new rules and regulation related to drive in Jordan !!!!!!!!!!
4/14/2019
Suhaila Halasa RN, PhD, CIMI,CPT

26. Suhaila Halasa RN, PhD, CIMI,CPT
Health Risks
Violence:
Violence threatens lives and well being of people of all ages
The youth are perpetrators مرتكبيand victims of violence
Homicides القتل is the second cause of death for young persons years of age
Other violence includes work- setting violence, and random shooting
4/14/2019
Suhaila Halasa RN, PhD, CIMI,CPT

27. Health Risks
Suicide:
Suicide is a leading cause of death in the young adult age group
Many suicides may actually be mistaken for accidental death.
It may result from the young adult's inability to cope with pressures, expectations, and responsibilities

28. Suhaila Halasa RN, PhD, CIMI,CPT
Health Risks
Suicide may result from problems with
a. Marriage partner
b. Depression related to perceived educational, academic or financial failure
4/14/2019
Suhaila Halasa RN, PhD, CIMI,CPT

29. Health Risks The role of the nurse in prevention suicide include:
Identifying behaviors that may indicate potential problems like depression physical complaints including weight loss, sleep disturbance and digestive disorder, decrease interest in social and work role
Participating in educational programs that provide information about early signs of suicides

30. Suhaila Halasa RN, PhD, CIMI,CPT
A suicide threat should never be ignored
Young adult identified at risk of suicide should be referred to a mental health specialist
4/14/2019
Suhaila Halasa RN, PhD, CIMI,CPT

31. Health Risks Hypertension: Causes:
Biologic inheritance, contributing factor like smoking, obesity and high sodium diet and high stress level
Hypertension is the major risk of development of chronic heart disease or stroke (cerebrovascular accidents)
Blood pressure measurement every 2 years for young adult to screen for hypertension

32. Health Risks Substance abuse: Alcohol, marijuana, cocaine
Prolonged use cause addiction or physical and psychological dependence, and health problems
addiction or physical and psychological dependence on a substance is related to:
-- properties of the substance
-- the individual user
-- the social net work of the individual

33. Suhaila Halasa RN, PhD, CIMI,CPT
Health Risks
Examples of health problems:
Drug use during pregnancy lead to fetal damage
Prolonged use of alcohol can lead to
liver cirrhosis
cancer of the esophagus
4/14/2019
Suhaila Halasa RN, PhD, CIMI,CPT

34. Health Risks Nursing strategies related to drug abuse including:
Teaching about the complication of their use
Changing individual attitude towered drug abuse
3. Counseling regarding the problems that lead to drug abuse
4. Assessment of young adult for drug abuse
5. Assist young adult to access intervention services

35. Health Risks
Smoking is another type of drug abuse that lead to lung cancer and cardiovascular diseases The nursing role regarding smoking is: 1- serves as role model by not smoking 2- provide educational information regarding the dangers of smoking 3- help make smoking socially unaccepted 4- suggest resources hypnosis, life style training and behavioral modification to client who desire to stop smoking

36. Health Risks
Sexually transmitted infection (STIs) as AIDS, Syphilis and gonorrhea
Nurses have a significant role in health education about
Eating disorder: obesity
Nurse should assess nutritional concern, discuss diet and exercises pattern
Meet calcium requirement and proper nutrition for young women

37. Health Risks Malignancy
Testicular cancer is the most common neoplasm in men
Monthly testicular-self examination for all men helpful for early identification
Lung cancer is the first cause of death among women

38. Suhaila Halasa RN, PhD, CIMI,CPT
Health Risks
Breast cancer is the second cause of death among women
American cancer society recommendations the following:
Breast-self exam (BSE) is an option for women starting in their 20s
Women in 20s and 30s should have a clinical breast exam (CBE) by care provider, perfectly every 3 years.
Women at high risk should get MRI and mammogram every year
Women age 40 and older should have screening mammogram annually as long as they are in good health
4/14/2019
Suhaila Halasa RN, PhD, CIMI,CPT

39. Young adult women should also be screened for cervical cancer by having a routine Papanicolaou (Pap) test
Health promotion Guidelines for young adult Box (page 404 ref 2 (Kozier) )
Group discussion
( very important)

40. Middle-aged Adult(40-65 years)

41. Middle-aged Adult
The middle-aged adult ( years) called the years of stability or consolidation.

42. Suhaila Halasa RN, PhD, CIMI,CPT
Middle-aged Adult
Physical development:
Both men and women experience decreasing hormonal production during the middle years ( menopause) menstruation cease
climacteric (andropause-) →↓ sexaul activity.
4/14/2019
Suhaila Halasa RN, PhD, CIMI,CPT

43. Suhaila Halasa RN, PhD, CIMI,CPT
Middle-aged Adult
It is said to have occurred when a women has not had a menstruation period for 12 months
The menopause usually occurs sometimes between ages 40-55, the average is about 47 years
4/14/2019
Suhaila Halasa RN, PhD, CIMI,CPT

44. Suhaila Halasa RN, PhD, CIMI,CPT
Middle-aged Adult
Symptoms of menopause:
Common symptoms occur related to a decline in estrogen:
Hot flashes
Chilliness
A tendency of the breast to become smaller and less dense
Decrease in metabolic rate that may lead to weight gain
Insomnia and headache
4/14/2019
Suhaila Halasa RN, PhD, CIMI,CPT

45. Middle-aged Adult
Physical development
( see Developmental Assessment Guideline, table page:405
Appearance:
Hair ;thin, gray
Skin; ↓ turgor, moisture, SC fat& wrinkle appears.
Fatty tissue is redistribution mainly in abdominal areas.

46. Suhaila Halasa RN, PhD, CIMI,CPT
Middle-aged Adult
Musculoskeletal system
Skeletal muscle bulk decrease at about age 60s,
Calcium loss from bone tissue common among postmenopausal women
Thinning of the intervertebral discs lead to decrease in height about 1 inch
Metabolism; Slow lead to weight gain
4/14/2019
Suhaila Halasa RN, PhD, CIMI,CPT

47. Middle-aged Adult
Cardiovascular; blood vessels lose elasticity& become thicker
Sensory perception; ↓ taste sensation,
Vision: visual acuity decline by late 40s, especially for near vision (presbyopia)
Hearing: hearing acuity for high frequency sound decreased especially in men

48. Suhaila Halasa RN, PhD, CIMI,CPT
Middle-aged Adult
Gastrointestinal; gradual decrease in tone of large may predispose the individual to constipation.
Urinary system; nephron units are lost & glomerular filtration rate decreased .
Sexuality; hormonal changes in both sexes.
4/14/2019
Suhaila Halasa RN, PhD, CIMI,CPT

49. Middle-aged Adult Psychosocial development:
Most people become increasingly aware of gradual changes in their bodies that mark the ageing process
People usually accept the fact that they are aging
Some try to challenge the years by changing their dress and actions

50. Middle-aged Adult Psychosocial development:
Is in the generativity versus stagnation phase of Eriksson's stages of development.
According to Havighurst, has the following developmental task:see box 22-3
page 406 Ref 2

51. Suhaila Halasa RN, PhD, CIMI,CPT
Middle-aged Adult
Achieving adult civic and social responsibility.
Establishing and maintaining an economic slandered of living .
Assisting teenage children to become responsible and happy adults
Developing adult leisure- time activities.
Adjusting to aging parents
Balancing the needs of multiple areas (children, parents, work
Has work as a central theme
4/14/2019
Suhaila Halasa RN, PhD, CIMI,CPT

52. Middle-aged Adult Cognitive development:
Middle age adult's cognitive and intellectual abilities change very little
Cognitive processes include reaction time, memory, perception, learning, problem solving, and creativity.
Memory and problem solving are maintain through middle adulthood.

53. Middle-aged Adult Cognitive development:
Learning continues and can be enhanced by increased motivation at this time in life.
The experiences of the professional, social, and personal life of middle-aged person will be reflect in their cognitive performance.
The middle-aged adult can reflect on the past and culture experience and can imagine, anticipate, plan and hope.

54. Middle-aged Adult Moral development:
According to Kohlberg, the adult can move beyond the conventional to the post conventional level
They archived the highest level of moral reasoning.
Some times the individual moves to stage in which rights to others take precedence.
The person establishes ethical and moral standards that are independent of the standards of others

55. Middle-aged Adult Spiritual development:
- Not all adults progress through Fowler's stages to the fifth, called the paredoxical-consolidative stage
The individual can view” truth” from a number of viewpoints.
People in this age group often rely on spiritual beliefs to help them deal with illness, death, and tragedy.

56. Health Risks
Middle -aged adults have a risk of developing a health problem than that of young adults The leading cause of death in this age group include: Motor vehicle and occupational injuries Cancer Cardiovascular diseases

57. Health Risks Injuries:
Decreasing reactions time and visual acuity may made the middle aged adult prone to injury
Motor vehicle crashes most common cause of unintentional death in this age group

58. Health Risks
Smoking and alcohol consumption place individual at risk of developing:
Chronic respiratory problems
lunge cancer
liver diseases
Overeating can result in:
Obesity
Diabetes mellitus
Atherosclerosis
Hypertension
Coronaty heart diseas

59. Health Risks
Cancer:
Cancer is the leading cause of death in middle adulthood
Men have higher incidence of lung, prostate, and colon
In women, lung cancer is highest in incidence followed by breast and colon cancer

60. Health Problems Cardiovascular disease:
heart disease and cancer are the the leading cause of death in middle –aged adult
Several factors of heart disease include
smoking, obesity, hypertension, hyperlipidemia, diabetes mellitus, sedentary lifestyles
Family history of myocardial infarction or sudden death in a father less than 55 years old or in a mother less than 65 old

61. Health Problems
Newly recognized cluster risk termed metabolic syndrome, increases the risk for heart disease are following:
1- abdominal fat
2- hypertension
3- high lipid
4- insulin resistance
Lifestyle activities and behaviors such as increasing activities and diet modification play an important role preventing the development of metabolic syndrome risk factors

62. Health Risks
Obesity:
Due to decrease metabolic rate and decreased physical activity
Nurse role :
Council client to prevent obesity by reducing caloric intake and participating in regular exercises
Educated client that being overweight is a risk factor for many chronic diseases such as diabetes and hypertension, and for problems of mobility such as arthritis

63. Health Risks
Alcoholism: the excessive use of alcohol can result in unemployment, disrupted home, injuries and diseases
Alcohol use may exacerbate other health problems
Nurse role include:
providing information to client about the dangers of excessive use of alcohol
helping client clarify values about health
referring client who abuses alcohol to special groups

64. Health Risks Mental health alteration:
Developmental stressors menopause, climacteric, aging, impeding retirement, and situational stressors as divorce, unemployment, death of a spouse can precipitate anxiety and depression in middle- aged adult

65. Health assessment and Promotion
Middle- aged adults usually take care of their health needs and interested in maintaining health and preventing the acceleration of aging
See health promoting guidelines for middle aged adult
( Box page 409)
Group Discussion
4/14/2019
Suhaila Halasa RN, PhD, CIMI,CPT