1. Young and middle-aged adults

2. Characteristics End of adolescence until death Young adulthood - 20 – 40 years middle adulthood – 40 – 65 years Late adulthood – 65 – death

3. Characteristics 20s is the prime physical years Most efficient functioning at about 25 years Musculoskeletal system is well developed and coordinated Peak efficient cardio, auditory and reproductive systems Peak of physical capabilities Brain reaches maximum in size and weight Senses are peak Most professional athletes at peak during early adulthood High risk takers

4. Psychosocial development Task : intimacy – loving relationship Sense of self Education, employment, marry, remail single

5. Cognitive development Formal operations – ability to think abstractly and employ logic Generate hypotheses Piaget _formal operational stage Others suggest postformal thought – includes creativity, intuition, ability to consider information in relationship to other ideas. An proceed from abstract reasoning to practical consideration Balance arguments created by both logic and emotion

6. Moral development Post conventional level Separate self from the expectations and rules of others – define morality in terms of personal principles Principled reason – ethic of justice

7. Spiritual development Fowler (1981) Individuating –reflective period sometime after 18 years of age. Focus on reality Religious teaching that the young had as a child may now be accepted or redefined Exploring faith, belief in God.

8. Health risks Injury, violence, suicide, hypertension, substance abuse, Sexually transmitted diseases, eating disorders, and certain malignancies. Injury and violence: Unintentional injuries –motor vehicle crashes are the 5 th leading cause of death in US

9. Health risks Violence: homicide is the 2 nd leading cause of death for young persons 15-24 years of age. Elderly, females, and children are targets of physical and sexual assaults.

10. Health risks Suicide: may result from problems with close relationships as marriage partners or parents, depression related to perceived occupational, academic, or financial failure Occurs due the inability to cope with pressures, responsibilities and expectations of adulthood. Nurses’ responsibility: prevention

11. Health risks Hypertension: Causes: biologic heredity, and contributing factors include smoking, obesity, a high sodium diet, and high stress levels A major risk factor in the development of chronic heart disease or stroke Measurement of blood measurement is recommended every 2 years for young adults

12. Health risks Substance abuse: Marijuana, alcohol Prolonged use lead to physical and psychological dependency and health problems During pregnancy = fetal damage Cirrhosis of liver and cancer of the esophagus

13. Health risks Sexually transmitted infections: Genital Herpes, AIDS, syphilis, and gonorrhea Knowledge about symptoms

14. Health risks Eating disorders Fear of obesity Nurses need to assess nutritional concerns

15. Health risks Malignancies such as lung, prostate, testicular and colon cancer among men Breast Early detection (BSE) Cervical cancer (pap smear)

17. Middle-Aged adults 40-65 years Years of stability and consolidation Children have grown and moved away from home Can pursue interests. Maturity: the state of maximal function and integration or fully developed Tolerant of the views of others Make sense of life Tolerate ambiguity, are flexible, and adapt to change, self acceptance, accept responsibility

18. Physical development Decreasing hormonal production Menopause Andropause

19. Psychosocial development Erikson : Generativity versus stagnation: the concern for establishing and guiding the next generation Volunteer work Stagnation: people have difficulty accepting their aging bodies and become withdrawn and isolated Midlife crisis: when one realizes that they have reached the halfway mark of life

20. Cognitive development Cognitive and intellectual abilities change very little Cognitive processes include reaction time, memory, perception, learning, problem solving, and creativity Genetic, environmental and personality factors in early and middle adulthood account for the large difference in the ways n which individuals maintain mental abilities

21. Moral development Postconventional level Extensive experience of personal moral choice and responsibility is required before people can reach the postconventional level. A stage where rights of others take precedence Few people attain stage 5 before age 40/

22. Spiritual development Not all people progress through Fowlers stages to the fifth called the paradoxical-consolidative stage = seeing truth from a number of viewpoints People rely on spiritual beliefs to help them cope with illness, death and tragedy.

23. Health risks Health risks: Motor vehicle and occupational injuries, chronic diseases Cancer, cardiovascular disease, obesity, alcoholism, mental health alterations