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Slide 1 ight © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. CHAPTER 8 Life Span Development

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Slide 3 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Life Expectancy (continued)  Those in households with incomes of greater than $25,000 live 3 to 7 years longer depending on gender and race than do those in households with individual incomes of less than $10,000. Infant Mortality  This is the number of deaths before the first year of life.  The infant mortality rate for African-American infants is more than double that of white infants. Health Promotion Across the Life Span

Transcript of Slide 1 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. CHAPTER...

Page 1: Slide 1 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. CHAPTER 8 Life Span Development.

Slide 1Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

CHAPTER 8Life Span Development

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Slide 2Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

Health Promotion Across the Life Span

• Life Expectancy This is the average number of years an individual will

probably live. Life expectancy in the United States at the beginning

of the twentieth century was 47.3 years. Today, average life expectancy at birth in the United

States is 77 years. There are currently 18 countries that have a life

expectancy greater than that of the United States. Females outlive males by an average of 6 years.

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• Life Expectancy (continued) Those in households with incomes of greater than

$25,000 live 3 to 7 years longer depending on gender and race than do those in households with individual incomes of less than $10,000.

• Infant Mortality This is the number of deaths before the first year of

life. The infant mortality rate for African-American infants

is more than double that of white infants.

Health Promotion Across the Life Span

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• Development Begins at conception and ends with death The study of life span development is the study of how

and why persons change over time, as well as how they remain the same.

The eight stages of life span development• Infancy, toddler, preschool, school age, adolescence,

early adulthood, middle adulthood, and late adulthood

Health Promotion Across the Life Span

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Growth and Development

• Growth Refers to an increase in size of the whole or its parts

• Development Refers to function or the gradual process of change

and differentiation from simple to complex• Cephalocaudal

Growth and development that proceed from the head toward the feet

• Proximodistal Growth and development that proceed from the center

toward the outside

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• Patterns of Growth Growth patterns appear to be genetically controlled. Nutrition, heredity, and environment play an important

role in the patterns. The blueprint for all inherited traits is contained in the

chromosomes. At conception, the individual is endowed with a

complex set of biologic potentials involving characteristics such as height and skin, hair, and eye color.

Growth and Development

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• The Beginnings Development begins with conception. After fertilization, the zygote has 23 pairs of

chromosomes, for a total of 46 chromosomes. One of each pair has been contributed by the mother

and one by the father. Teratogen

• Any substance, an agent, or a process that interferes with normal prenatal development, causing the formation of one or more developmental abnormalities in the fetus

Growth and Development

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The Family

• The family is the basic unit of society.• Families are composed of two or more people who

are united by marriage, blood, adoption, emotional bonds, and/or social roles.

• The individuals of the family usually share ties that often last a lifetime.

• Family is the first socializing agent for teaching children society’s expectations and limitations

• Part of socialization Family is responsible for ensuring that the child

receives a formal education

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The Family

• Family is responsible for instilling morals, values, and ideals into children

• The birth of a baby and the death of a family member are happenings that create the need to rearrange family roles and structures

• Types of families Nuclear, extended, single-parent, blended, social

contract family and cohabitation, homosexual, adoptive, and foster

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The Family

• Types of Families Nuclear family

• Biological parents and their offspring• Thought of as traditional family• Sex-based roles assigned to its members• Consists of a husband and wife with or without children

living in independent household setting• Both parents work and share equally in financial

support, roles, and responsibilities Extended family

• Consist of biological parents, children, grandparent, grandchildren, aunts, uncles, other family members

• Sharing of support, roles, and responsibilities• Basic family group in many societies

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The Family

• Types of Families Single-parent family

• Family style of choice or a result of death, divorce, separation, or abandonment

• More than 40% are result of divorce• Head of household is either male or female• Result of unwed parent living alone or from decision of a

single person to adopt a child Blended (Reconstituted) family

• Also called step family• Adults remarry and bring together their children from previous

marriages• Losses from death or divorce may cause both adults and

children to be fearful of love and trust• A child’s loyalties to an absent parent may interfere with

forming ties to a stepparent, especially when the child goes back and forth between two households

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The Family

• Types of Families Social contract family and cohabitation

• Involves unmarried couple living together and sharing roles and responsibilities

Homosexual family• Group made up of same-sex couple• Homosexual adults form family units• Their members share bonds of emotional commitment

and roles of child rearing• Consists of either natural children or adopted or foster

children• Each family type has common parenting concerns and

responsibilities

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The Family

• Types of Families Adoptive family

• Family unit with adopted children• Childless or infertile couples often are lonely and lack

fulfillment of joys parenthood• Ordeal of adoption may be time consuming and anxiety

provoking• Role of parenting both exciting and fulfilling for natural

and adoptive families

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The Family

• Types of Families Foster family

• Allows for care supervision, and nurturing of children whose parents are unable to care for them

• Length of stay maybe temporary and depends on individual circumstances

• Basic functions are inherent to family unit Protection, nurturance, education, sustenance, and

socialization• Unconditional affection, acceptance, and

companionship are guaranteed to each family member

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The Family

• Types of Families Nuclear

• Consists of married man and woman and their children• Lives in independent household

Extended• Nuclear plus additional family members living in same

household• Provides a sharing of responsibilities

Single-parent• Occurs by divorce, death, separation, abandonment, or

choice• More common in recent years• Typically adult must perform roles of two people

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The Family

• Types of Families Blended (reconstituted)

• Occurs when adults from previous marriage remarry and combine children within new household

Social contract and cohabitation• Made up of man and woman living together without legal

commitment but sharing roles and responsibilities Homosexual

• Involves homosexual partners living together with shared responsibilities

Adoptive• Consists of traditional members, husband, wife and adoptive

child Foster

• Responsible for care, supervision, and nurturing of children in their charge

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• Family Patterns Refers to the way in which family members relate to

each other Types of family patterns

• Autocratic• Patriarchal• Matriarchal• Democratic

The Family

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The Family

• Family Patterns Autocratic

• Relationships are unequal• Parents attempt to control the children with strict, rigid

rules and expectations• Least open to outside influence

Patriarchal• Male assumes dominant role• Male member functions in work role• Male responsible for control of finances• Male makes most decision

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The Family

• Family Patterns Matriarchal

• Known as matrifocal• Female assumes primary dominance in areas of child

care and homemaking as well as finance decisions• Older female relative provides child care so that mother

of children is free to work outside of home Democratic

• Adult members function as equals• Children are treated with respect and recognized as

individuals• Encourages joint decision making, it recognizes and

supports uniqueness of each member• Favors negotiation, compromise and growth

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The Family

• 12 qualities of functional families 1. sense of commitment toward promoting members’

well-being 2. sense of appreciation and encouragement for tasks

accomplished 3. directed effort toward spending quality time with

individual members 4. sense of purpose that encourages progress during

good or difficult times 5. sense of harmony between members of family

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The Family

• 12 qualities of functional families 6. effective communications between individuals 7. established values, rules, and beliefs 8. Variety of different coping techniques to enhance

functioning 9. use of effective problem-solving measures and use

of a variety of options 10. positive outlook 11. ability to be flexible and adapt to changes 12. use of varied resources to facilitate coping skills

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• Stages of Family Development Engagement/commitment stage

• Begins when the couple acknowledges to themselves and others that they are considering marriage

Establishment stage• Extends from the wedding up until the birth of the first

child Expectant stage

• Begins with conception and continues through pregnancy

The Family

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• Stages of Family Development Parenthood stage

• Begins at birth or adoption of the first child Disengagement stage of parenthood

• Period of family life when the grown children depart from the home

Senescence stage• Last stage of the life cycle, which requires the individual

to cope with a large range of changes

The Family

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• Causes of Family Stress Common Signs of Stress in Children

• Mood swings• Acting out behavior• Change in eating or sleeping patterns• Frequent stomachaches, headaches, or other

unexplained somatic complaints• Excessive clinging to parents• Thumb-sucking• Bed wetting• Return to behavior typical of an earlier stage of

development

The Family

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• Causes of Family Stress Chronic illness Working mothers Abuse Divorce

The Family

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The Family

• Causes of Family Stress Chronic Illness

• Physical or emotional illness of parent or child affects all family members

• Financial resources, family stability, adequate support system determine individual’s ability to cope with family member’s chronic illness

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The Family

• Causes of Family Stress Working mother

• Create wider role models for young children• Compensate for time rhey are not with their child by

establishing quality time during their limited at-home time• Care giving arrangement

In-home care by a relative or paid caregiver or out of home in a group-organized setting

• Choosing a day care, consider: Balance of age-appropriate educational structure and an

open environment Ample space with a variety of materials and activities Small calss size with appropriate staff/child ratio Environment that fosters active staff invlovement, positive

encouragement and high quality care in a safe environment

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The Family

• Causes of Family Stress Abuse

• Refers to physical, emotional, financial, or sexual assault or neglect

• About 6 million women, children and men are victims of physical abuse inflicted by parents, spouses, siblings, children and other relatives

• Visible factors related to family violence Financial strain, social isolation, low self-esteem, history

of abuseo Presence of these indicate individual is more prone

to abuse and possess ineffective coping skills that prevent maintaining family wellness and safety

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The Family

• Causes of Family Stress Abuse – cont’d

• Characteristics of parents who abuse their children: Abused themselves as children Loners, harsh, strict and punitive Have unreasonable expectations Immature, lack self-control, and have low self-esteem

• Early recognition, prompt reporting, preventive measures are employed to help detect and end all forms of abuse and neglect

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The Family

• Causes of Family Stress Divorce

• Effects of divorce on children are varied and complex One factor is age of child

o Younger children feel abandoned and feel they are no longer loved by both parents

Other factors that affect child are bitterness surrounding the conflicts, the child’s prior relationship with the absent parent, and effects of divorce on custodial parent, and post-divorce relationship of parents

Children have reconciliation fantasies for extended periods after divorce is finalized

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The Family

• Tips for divorcing parents Encourage children to talk about their feelings Don not use children as pawns or “go-betweens” Never speak negatively about ex-spouse in front of

children Seek professional help if children need additional

support

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Stages of Growth and Development

• Infancy: 1 to 12 Months Physical Characteristics

• Gains about 1.5 lbs. per month until 5 months• Doubles birth weight by 4 to 6 months• By 1 year of age, birth weight triples

Vital Signs• At 2 months, the average apical rate is about 120 beats

per minute. At 12 months, average resting respirations is about 30 breaths per minute and blood pressure will gradually increase to 90/60.

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• Infancy: 1 to 12 Months Motor Development

• 2 months: holds up head• 4 months: holds head up steadily to a 90-

degree angle.

• 6 months: balances head• 7 months: sits up easily without support and

crawls• 9 months: creeping• 8 to 15 months: standing with support and

walking

Stages of Growth and Development

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Figure 8-2

Development of locomotion.

(From Wong, D.L. [1995]. Whaley & Wong's nursing care of infants and children. [5th ed.]. St. Louis: Mosby.)

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• Infancy: 1 to 12 Months Dentition

• Teething begins at about 5 to 6 months• Signs of teethingirritability, edematous red gums,

excessive drooling, change in stools usually begin 3 to 4 weeks before appearance of tooth.

• Oral hygiene consists of offering sips of clear water and wiping and massaging the infant’s gums.

• Tooth brushing should begin after the first teeth appear.

Stages of Growth and Development

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• Infancy: 1 to 12 Months Psychosocial Development

• Basic trust versus mistrust Cognitive and Intellectual Development

• Infant uses senses to learn about self and the environment.

• Infant learns through exploration of objects and events and through interaction.

• Infants are in the sensorimotor stage of cognitive development; knowledge occurs primarily through sensory impressions and motor activities.

Stages of Growth and Development

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Figure 8-3

Nine-month-old infant enjoying own image in a mirror.

(From Hockenberry-Eaton, M.J., Wilson, D., Winkelstein, M.L., Kline, M.D. [2003]. Wong’s nursing care of infants and children. [7th ed.]. St. Louis: Mosby.)

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• Infancy: 1 to 12 Months Communication and Language

• During infancy, the unique ability of the brain to sort out basic sounds and to extract from sentences becomes apparent.

• Infants will not speak spontaneously; the environment must provide a means for them to acquire these skills.

• The rate of speech development varies from child to child and is directly related to neurologic competence and intellectual development.

Stages of Growth and Development

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• Infancy: 1 to 12 Months Nutrition

• Both human breast milk and commercially prepared formula are available to meet the nutritional needs of the infant.

• Foods that should be avoided in the first 6 months of life are citrus fruits, egg whites, wheat flour all frequently identified as allergy-producing substances.

• Rules for solid foods: introduce only one new food at a time; introduce cereals first, then fruits and vegetables, and meat last.

Stages of Growth and Development

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• Infancy: 1 to 12 Months Sleep, Play Activity, and Safety

• Newborns and infants sleep 18 of 24 hours.• Toward the end of the first 3 months, definite sleep

patterns emerge.• By the end of the first year, the infant will sleep 12

hours at night and take one nap during the day.• Play is important for learning.• Accidents are the leading cause of injury and death in

infants and young children.

Stages of Growth and Development

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• Toddler: 1 to 3 Years Physical Characteristics

• Rate of growth is slower in the toddler than in infancy.• In the beginning of this stage, the toddler’s body

proportions result in a top-heavy appearance, but by the end they have a more proportionate body appearance.

• Toddlers have an exaggerated lumbar lordosis and protruding abdomen.

• By 2.5 years, all 20 deciduous teeth are present.

Stages of Growth and Development

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• Toddler: 1 to 3 Years Vital Signs

• Pulse: 90-100 beats per minute• Blood pressure: 100-80/64• Temperature: 98-100º F• Respirations: 20-30 breaths per minute

Neuromuscular Development• Walking, climbing, hopping, running, pulling, holding on

tight skills• Scribble and copy a circle

Stages of Growth and Development

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• Toddler: 1 to 3 Years Toilet Training

• Children do not reach the physiologic or psychological maturity necessary to be toilet trained until 18 to 24 months of age.

• Nighttime control may be achieved after daytime control is established.

• Success should be praised and accidents should be ignored.

Stages of Growth and Development

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• Toddler: 1 to 3 Years Psychosocial Development

• The toddler is an uninhibited, energetic little person always seeking attention, approval, and personal goals.

• Autonomy versus shame and doubt• Use of the word “no” gives a sense of control.• Possessiveness and a desire to have things go their

way are characteristic.• Ritualistic behavior and repetitive rituals• Temper tantrums are common.

Stages of Growth and Development

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• Toddler: 1 to 3 Years Cognitive and Intellectual Behavior

• The period from 12 to 24 months is the last phase of the sensorimotor development.

• Preoperational thought stage The child focuses on the use of language as a tool to

meet needs. The child has the emerging ability to think mentally.

• Toddlers are constantly absorbing new ideas, widening their cognitive world, and expanding their memory.

Stages of Growth and Development

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• Toddler: 1 to 3 Years Communication and Language

• Toddlers think about their actions and make their will known to their caregivers.

• They identify objects by use.• At age 2.5, their vocabulary is about 450 words.• By age 3.5, the child can answer questions, use brief

sentences, and recite television commercials.

Stages of Growth and Development

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• Toddler: 1 to 3 Years Nutrition

• One serving of meat, two or more servings of vegetables, at least two servings of fruit, cereal or bread

• Twenty-four ounces of milk per day• Bite-size pieces, finger foods, and smaller portions

Stages of Growth and Development

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Figure 8-8

Milk and other dairy products supply the toddler with the calcium and vitamin D for growing bones.

(From Mahan, L.K., Escott-Stump, S. [2004]. Krause’s food, nutrition, and diet therapy. [11th ed.]. Philadelphia: Saunders.)

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• Toddler: 1 to 3 Years Sleep, Play Activity, and Safety

• Toddlers expend a high level of energy in daily growing, playing, and exploring.

• They require 12 hours of sleep each night plus a daytime nap.

• Parallel play: play alongside of, but not with, peers• Running, jumping, and climbing help develop their

growing bones and muscles.• More than half of all childhood deaths are caused by

accidents, many of which are motor vehicle accidents.

Stages of Growth and Development

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Figure 8-5

Children are most likely to ingest substances that are on their level.

(From Hockenberry-Eaton, M.J., Wilson, D., Winkelstein, M.L., Kline, M.D. [2003]. Wong’s nursing care of infants and children. [7th ed.]. St. Louis: Mosby.)

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Figure 8-9

Parallel play.

(From Hockenberry-Eaton, M.J., Wilson, D., Winkelstein, M.L., Kline, M.D. [2003]. Wong’s nursing care of infants and children. [7th ed.]. St. Louis: Mosby.)

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• Preschooler: 3 to 5 Years Physical Characteristics

• Maturation of nervous system and mastery of skills• Growth slow and steady; taller and thinner.• Average weight gain less than 5 lbs. per year.• Linear growth about 2 to 2.5 inches per year.

Vital Signs• Heart rate: 70-110 beats per minutes• Respiratory rate: 23 beats per minute• Blood pressure: 110/60• Temperature: 97-99° F

Stages of Growth and Development

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• Preschooler: 3 to 5 Years Psychosocial Development

• First, learns to function independently• Then, begins to use imagination to explore• Initiative versus guilt• Pretends to be grown up by trying a variety of roles• Superego functions as a censor of behavior• Typical development includes gender identity• Strong sibling bonding established

Stages of Growth and Development

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Figure 8-12

Siblings establishing a bond.

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• Preschooler: 3 to 5 Years Cognitive and Intellectual Development

• Uses symbols to represent objects• Trial and error to discover new traits and characteristics• Begins to think logically• Sees things as absolute; either good or bad• Time associated with weekly and seasonal events• Needs trust and guidance to distinguish truth from

fantasy

Stages of Growth and Development

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• Preschooler: 3 to 5 Years Communication and Language

• By age 3 years, children can carry on a conversation; language becomes more adult-like.

• Pronunciation problems continue. Nutrition

• They need high levels of proteins.• Calcium and phosphorus are important for bones and

teeth.• Food habits, likes, dislikes, and appetites vary greatly

from child to child.

Stages of Growth and Development

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• Preschooler: 3 to 5 Years Sleep, Play Activity, and Safety

• They need 11 to 12 hours of sleep at night.• The child begins to share, take turns, and interact with

playmates.• Through dramatic play, the child tries different roles and

identifies with adult models.• Child can learn to ride a bicycle with training wheels.• Discipline and limit setting are needed.• They learn to function independently and explore the

imagination.

Stages of Growth and Development

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Figure 8-10

Trying out new roles.

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• School Age: 6 to 12 Years Physical Characteristics

• Growth is usually gradual and subtle.• Most obvious change involves long bones of the

extremities and development of the facial bones.• Height and weight increases by about 2 inches and 4.5

to 6.5 lbs. per year. Vital Signs

• Pulse rate: 55-90 beats per minute• Respiratory rate: 22-24 per minute• Blood pressure: 110/65

Stages of Growth and Development

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• School Age: 6 to 12 Years Psychosocial Development

• Become more aware of rules, socialization skills, and expectations

• Beginning skills of compromise and competition• Industry versus inferiority • Learns to master skills that produce satisfaction as the

result of work• Develop their own goals and direct their efforts toward

mastery of these goals

Stages of Growth and Development

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• School Age: 6 to 12 Years Cognitive and Intellectual Development

• Thoughts become increasingly logical and coherent, so the child is able to classify, sort, and organize facts while still being incapable of generalizing or dealing with abstractions.

• They view the world more realistically, and they are capable of understanding the views of others.

• They begin to develop logical socialized thought.

Stages of Growth and Development

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• School Age: 6 to 12 Years Communication and Language

• Good command of sentence structure• Vocabulary becomes more extensive and includes

slang and swear words• Printing becomes clearer and smaller

Nutrition• Dietary habits and food preferences are strongly

established.• Childhood obesity is correlated with obesity in adult

years; maintain weight within normal limits.

Stages of Growth and Development

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• School Age: 6 to 12 Years Sleep, Play Activity, and Safety

• Fatigue, irritability, inattention, and poor learning are often signs of inadequate sleep.

• They need about 10-12 hours of sleep at night.• They need adequate exercise to enhance muscle

development, coordination, balance, and strength.• Privacy and a place for their things are important.• They may become involved with competitive or team

sports.• Accidents are the leading cause of death.

Stages of Growth and Development

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• School Age: 6 to 12 Years Sleep, Play Activity, and Safety

• There appears to be an increase in school violence in many locations.

• Children must feel comfortable discussing their feelings and concerns with parents and teachers.

• They need to be taught constructive ways to handle their impulses; may resort to unacceptable behavior.

Dentition• Permanent teeth develop rapidly.

Stages of Growth and Development

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• Adolescence: 12 to 19 Years Physical Characteristics

• Adolescence Transition from childhood to adulthood Begins at puberty

• Second major growth period Females grow 2-8 inches and gain 15-55 lbs. Males grow 4-12 inches and gain 15-65 lbs.

• Females begin menarche; males begin sperm production.

• Sexual interests increase markedly in vigor and intensity; usually focus on members of the opposite sex.

Stages of Growth and Development

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• Adolescence: 12 to 19 Years Vital Signs

• Pulse rate: 70 beats per minute• Respiratory rate: 20 breaths per minute• Blood pressure: 120/70

Psychosocial Development• Identity versus role confusion• Requires major reorganization of the personality,

resolution of childhood insecurities, and acceptance of adult responsibilities

• Value of peers significant

Stages of Growth and Development

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Figure 8-16

Many adolescents become very introspective.

(From Hockenberry-Eaton, M.J., Wilson, D., Winkelstein, M.L., Kline, M.D. [2003]. Wong’s nursing care of infants and children. [7th ed.]. St. Louis: Mosby.)

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Figure 8-17

The peer group provides the adolescent with a sense of belonging.

(From Jarvis, C. [2004]. Physical examination and health assessment. [4th ed.]. Philadelphia: Saunders.)

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• Adolescence: 12 to 19 Years Cognitive Development

• Higher process that permits abstract reasoning and systematic scientific problem solving

• Thinks beyond the present Moral Development

• Young people search for a moral code that preserves their personal integrity and guides their behavior, especially in the face of strong pressure to violate the old values.

Stages of Growth and Development

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• Adolescence: 12 to 19 Years Nutrition

• Increase in caloric needs• Protein needs increased• Likely to be deficient in calcium, iron, and zinc

Sleep, Play Activity, and Safety• There is an increased need for hours of sleep to restore

energy levels.• Caution must be taken to prevent injuries related to

exercise and sports.• Accident prevention is vital.• Different moods are common.

Stages of Growth and Development

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• Early Adulthood: 20 to 40 Years Physical Characteristics

• Body is at its optimal level of functioning.• Strength, energy, and endurance are not at their peak.• Females usually reach maximum height by 16 to 17

years of age; males may continue to grow until 18 to 20 years of age.

• Diet plays an important role throughout.• Sexual maturity is reached.

Stages of Growth and Development

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• Early Adulthood: 20 to 40 Years Psychosocial Development

• About 95% of Americans marry at some point.• Dual-career lifestyle has affected both the home and

workplace.• Decision to start a family.• Family development and harmony are major goals.• Early intimacy versus isolation• Resolve conflicting demands of intimacy,

competitiveness, and distance; develop an ethical sense.

Stages of Growth and Development

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• Early Adulthood: 20 to 40 Years Cognitive Development

• Actively developing the formal operational approach to learning and problem solving

Nutrition• Few total number of calories needed

Rest and Sleep• Most adults function with 7 to 9 hours of restorative

sleep.

Stages of Growth and Development

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• Early Adulthood: 20 to 40 Years Physical Health

• Annual physical and dental examinations are recommended.

• Testicular examinations, prostate-specific antigen (PSA), Pap smears, monthly breast self-exams, mammograms

Safety• Accidents are the leading cause of disability and death;

injuries commonly result from work, vehicles, sports, and violence.

Stages of Growth and Development

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• Middle Adulthood: 40 to 65 Years Physical Characteristics

• Bone mass decreases skeletal growth cells.• Slight changes in height occur.• Changes in muscle strength may be related more to

level of activity than to age.• Body shape and contour changes occur related to a

redistribution of body weight.• Changes in vision and loss of hearing occur.• Changes occur in the appearance of the skin.• There is a higher incidence of periodontal disease.

Stages of Growth and Development

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• Middle Adulthood: 40 to 65 Years Physical Characteristics

• Hormonal changes include the woman’s inability to produce estrogen and progesterone.

• Signs of menopause: irregular menstrual periods, flow changes, excess fluid retention, breast tenderness, hot flashes, flushes, palpitations, night sweats, and irritability and mood swings

• Male climacteric: decreased libido, loss of body hair, and delayed erection

Stages of Growth and Development

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• Middle Adulthood: 40 to 65 Years Psychosocial Development

• Generalivity versus stagnation• Accepting responsibility for and offering guidance to the

next generation• Encourages productivity, continuity, and creativity• May become stagnantinactive and lifeless• Role of grandparenting often begins• No longer responsible for children in the home;

relationships with spouses change• Most adults not prepared for the increased

responsibility of caring for aging parents

Stages of Growth and Development

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Figure 8-19

According to Erikson, generativity is the developmental task of middle adulthood.

(From Leahy, J.M., Kizilay, P.E. [1998]. Foundations of nursing practice: a nursing process approach. Philadelphia: Saunders.)

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• Middle Adulthood: 40 to 65 Years Nutrition

• They need fewer calories.• Of the population, 25% are overweight.• Regular exercise is important.• A reduced intake of fat is recommended.

Physical and Dental Examinations• They should have regular physical and dental

examinations. Sleep and Rest

• They sleep less and have more awakenings.

Stages of Growth and Development

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• Late Adulthood: 65 Years and Older Ageisma form of discrimination and prejudice

against the older adultdefinitely exists Theories of aging

• Autoimmunity theory • Free radical theory • Wear and tear theory • Biological programming theory • Disengagement theory • Activity theory • Continuity theory

Stages of Growth and Development

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• Late Adulthood: 65 Years and Older Physical Characteristics

• Gradual decline in weight• Decrease in trunk length as a result of the increase in

spinal curvature• Abnormal postures and contours

Kyphosis Barrel chest

Stages of Growth and Development

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• Late Adulthood: 65 Years and Older Psychosocial Development

• Older years should be viewed as a time of satisfaction and pleasure.

• Ego integrity versus despair• Evaluate one’s life and accomplishments and find

satisfaction and meaning in life.• Retirement is a major adjustment.

Stages of Growth and Development

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Figure 8-23

Many older people continue to work and learn after the traditional retirement age.

(From Leahy, J.M., Kizilay, P.E. [1998]. Foundations of nursing practice: a nursing process approach. Philadelphia: Saunders.)

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• Late Adulthood: 65 Years and Older Family Roles Change with Time

• Today’s grandparent may be working and highly active.• Caring for grandchildren may be a full-time

responsibility.• Couples may need to adjust to increased time together,

companionship, and closeness.• The impact of the death of a spouse is traumatic; being

widowed is more common for women than for men.

Stages of Growth and Development

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Figure 8-20

A loving relationship with a spouse is an example of a positive influence during older adulthood.

(From Leahy, J.M., Kizilay, P.E. [1998]. Foundations of nursing practice: a nursing process approach. Philadelphia: Saunders.)

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Figure 8-21

Beauty throughout the life span .

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• Late Adulthood: 65 Years and Older Cognitive and Intellectual Development

• Older adults in good health and nurturing environments will have the capacity to maintain or increase their level of functioning.

Memory• Some older adults notice some changes; benign

forgetfulness.• There appears to be a greater loss of recent memory

over remote memory.

Stages of Growth and Development

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• Late Adulthood: 65 years and Older Nutrition

• Older adults should have a diet of foods higher in quality and lower in quantity while maintaining the basic nutrient content.

• Most frequently recommended are diets that are low in saturated fats and carbohydrates and high in fiber.

• Psychosocial factors: economic factors, loneliness; inability to shop for and prepare meals

• Adequate fluid intake is important.

Stages of Growth and Development

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• Late Adulthood: 65 Years and Older Activity

• Exercise is crucial to general well-being. Sleep

• More rest but less actual sleep is required. Safety

• Most accidents are preventable. • The key to prevention is knowledge and recognition

of the contributory factors that place the person at greater risk.

Stages of Growth and Development