321 adulthood & development

Question 1

young adult age category

Answer 1

young young adults: 18-24
older young adults: 25-35

Question 2

young adulthood is defined by which social contexts

Answer 2

voting, culture, turning 21,

Question 3

key milestones in young adulthood

Answer 3

economic independence, committed long term relationship, independent decision making, increase in critical thinking habits leaving parents/the person who took care of you

Question 4

young adulthood biology

Answer 4

usually healthy and do not experience severe illnesses regularly time of physical and emotional changes

Question 5

in young adulthood, what is the exception to physical growth being complete

Answer 5

pregnancy and lactation

Question 6

when is physical growth complete

Answer 6

females: 17 y/o
males: 21 y/o

Question 7

how do young adults treat illnesses?

Answer 7

do not take them seriously and usually postpone seeking health care

Question 8

when does physical strength peak?

Answer 8

young adulthood (starts to change as person approaches middle adulthood, usually bc of diet and lifestyle)

Question 9

self perception / self concept pattern (erikson) for young adults

Answer 9

development of increased sense of competency and self esteem -> intimacy vs isolation -> making attachments to others or not

Question 10

life change adjustments for a young adult

Answer 10

-career change or career move
-relocation
-balancing multiple roles
-developing long term goals for family security

Question 11

identity of young adulthood

Answer 11

-increasing separation from family authority
-beginning adult identity (career/work)
-work provides self esteem and socialization

Question 12

work and personal responsibilities for a young adult

Answer 12

-beginning balance of personal and work responsibilities
-developing relationships within the workforce

Question 13

characteristics of young adulthood

Answer 13

-healthiest time of life
-peak abilities (venturesome, daring, enterprising, aggressive)
- abstract, analytical thinking
-principled moral reasoning
-less experience of death
-risk takers
-lack of fear

Question 14

challenges of young adulthood

Answer 14

-lots of changes needing adaptation leading to stress (+ or -)
-marriage/children/starting a career
-miscarriage/serious illness/divorce

Question 15

achievement oriented stress

Answer 15

“internal pressure to succeed defined goals” (workaholic) -> affects you physically and emotionally leading too nutrition problems, lack of sleep & burn out very common in young adults

Question 16

how can young adults adapt to challenges

Answer 16

-requires coping skills and problem solving
-stress mgt
-reaching out for help when it is needed

Question 17

young adult health risks

Answer 17

• “it wont happen to me”
  unintentional injuries
• substance use
• violence
• suicide
• risky sexual behavior
• workplace hazards

Question 18

nurses main focus for young adults

Answer 18

prevention !!
check up every 1-2 yrs to educate on deceasing the incidence of accidents, injuries and acts of violence, reduce drugs and alcohol. improve mental health

Question 19

interventions for young adults

Answer 19

needs to be relatable to make them see it can happen to you

Question 20

health promotions in young adulthood - exercise

Answer 20

ask about history w/ exercise and then focus on safety measures (helmets, protective equipment & sunscreen)

Question 21

health promotions in young adulthood - sleep

Answer 21

insomnia effects 40 million per year which causes fatigue that affects work, stress and promotes inactivity. Recommendations include: change activity or stressors (ex: job switch), try new tasks/PA, sleep hygiene

Question 22

infertility in young adults

Answer 22

increased risk for diagnosis in those over >25 years & it affects 10-15% of reproductive couples

Question 23

nurses role in unintended pregnancy

Answer 23

educate on contraceptive and help clients choose method most appropriate to their needs

Question 24

STIs

Answer 24

50% of all new STIs occur in people 24 or younger & they can have short term or long term impacts nurses education on contraceptives and how to prevent sti’s

Question 25

Is depression in young adulthood increasing or decreasing

Answer 25

increasing

Question 26

nursing role in depression

Answer 26

screening and if there is concerns for suicide risk have to ask "are you having thoughts about harming yourself?**, take action

Question 27

general nursing application for young adults

Answer 27

- role of counselor (listen, offer support, remove barriers, provide resources) -goals: maintaining optimal physical conditions, encouraging healthy habits, screenings, treating illness

Question 27

general barriers to change for young adults

Answer 27

lack of knowledge & motivation, insufficient skills to change health status, undefined short & long term goals, lack of social support

Question 28

age range for middle adulthood

Answer 28

36-64

Question 29

what type of changes happen in middle adulthood

Answer 29

dynamic -> physiologic decline begins but still relatively healthy, early lifestyle choices begin to yield cost or benefit

Question 30

sandwich generation

Answer 30

stage within middle adulthood that contains major economic productivity and family responsibility (caring for children & aging parents)

Question 31

middle adulthood biology

Answer 31

-physiologic changes start ~ 45 y/o (grey hair, wrinkled skin, wt change, decline in hearing & near vision, menopause & climacteric) -onset of chronic conditions

Question 32

self perception / self concept pattern (erikson) - middle adulthood

Answer 32

generativity vs stagnation -> establishing or guiding the generation (productive & creative, desire to care) vs self absorbed, fails too care for others **+ critical review of life choices**

Question 33

midlife crisis

Answer 33

realizing physical decline, mistakes made, death is nearing, less time to make change but the usual results is acceptance (if no acceptance then it is considered a true midlife crisis)

Question 34

middle adult challenges

Answer 34

divorce (self or offspring), young adults moving back home, raising grandchildren

Question 35

life events w/ potential disruptive effects on middle adulthood

Answer 35

two or more jobs families, divorce, caring for aging parents, death of spouse, unintended pregnancies

Question 36

leading causes of death in middle adulthood

Answer 36

heart disease (#1 for over 44y/o), malignant neoplaasms (#2), unintentional injuries **many of these diseases are still preventable through lifestyle & routine primary care**

Question 37

common chronic disease in middle adulthood

Answer 37

heart disease, arthritis, back & spine impairments, COPD, DM, mental health, dental disease

Question 38

sexuality - reproductive changes

Answer 38

**all points of education & conversation & health history that should be addresses in middle adults** consider pregnancies (un and in), hidden sti risks, changes in sex drive

Question 39

obesity in middle adulthood and health promotion

Answer 39

one of the biggest issues and leads to other chronic diseases -> nurses should educate on diets, encourage increase PA, manage wt to reduce risk for chronic disease

Question 40

exercise recommendations

Answer 40

30 mins five or more days/weeks (150 total mins) goal is for it to be a continuous, rhythmic exercise (walking, swimming, biking)

Question 41

oral health and health promotion in middle adults

Answer 41

increase in gingivitis and periodontitis -> teach dental hygiene and making sure that we are encouraging our clients to have routine dental exams

Question 42

barriers to change in middle adulthood

Answer 42

lack of materials, social support, motivation, & knowledge, insufficient skills to change habits, undefined goals (short & long term)

Question 43

middle adults and nursing practice

Answer 43

-through identification of risk factors, health promotion and other nursing inventions, nurses help improve quality of life -nursing practices focus on the personal habits and lifestyles of middle aged adults to improve their biological, spiritual & psychosocial development

Question 44

older adult age range

Answer 44

65+ years old

Question 45

key to older adult care

Answer 45

help them live longer but fulfilled lives with dignity and independence

Question 46

why are there so many older adults

Answer 46

-improved standard of living -improved nutrition -progress in medical care -increased health consciousness (increase in HP effects)

Question 47

statistics on aging in the US

Answer 47

-23% men & 15% women are 65 years+ -by 2050, 1 million people will be 100 yrs or older -older adults use most health care dollars in the last 7 years of life

Question 48

older adulthood biology

Answer 48

-identify normal age related changes from pathological process and illness -older adults concepts of health generally depend on personal person perceptions of functional ability

Question 49

common chronic conditions in older adults

Answer 49

HTN, arthritis, heart disease, cancer, diabetes, asthma, chronic respiratory, stroke

Question 50

Erikson's development stages for older adults

Answer 50

1) generativity & stagnation - active involvement + care vs self absorption + boredom 2) integrity vs despair - acceptance of life + reconciliation of hopes compared to what actually happened vs not accepting of death

Question 51

misconceptions about older adults

Answer 51

-disease is normal and unavoidable -HP is not important since their lives are almost over -damage to health resulting from inactivity or poor nutrition is irreversible -ageist beliefs about older adults

Question 52

the decline in health in old agge is primarily due to what

Answer 52

unhealthy lifestyle choices in earlier years

Question 53

what factors contribute to coping and stress in older adults

Answer 53

-decrease in strength & health -retirement / lower income -death -new relationships w/ adult children -slower responses -keeping active & involved -making satisfying living arrangements

Question 54

comprehensive assessment of older adults

Answer 54

-id individual strengths & weaknesses -develop plan of care that corrects problems -maintain health -improve quality of life

Question 55

older adult assessment

Answer 55

a functional, physical, social and mental assessment of pt, caregiver, and environment

Question 56

goals of older adult assessment

Answer 56

**improve quality of life by detecting any signs of impairment which may be amenable to early intervention** minimize hospitalization -establish complete diagnoses that are frequently overlooked -decrease over prescription of meds -maintain health and health maintenance practices

Question 57

key principles of older adult assessment

Answer 57

-pt centered -client/caregiver as an active partner -focus on functional ability ("how do you manage x task") -multidisciplinary -knowing what is abnormal vs normal (certain changes, lab values)

Question 58

health promotion in older adults

Answer 58

healthy wt & diet, staying active, fall prevention, maintaining relationships, regular medical check ups, shots, screenings

Question 59

SPICES assessment told

Answer 59

*frame work that guides providers in assessing older adults, when done regularly can signal the need for more specific assessment and treatment* sleep disorders, problems w/ eating or feeding, incontinence, confusion, evidence of falls, skin breakdown ** help guide plans of care**

Question 60

HP for older adults - respiratory

Answer 60

-immunizations -stop smoking -daily exercise -seeing HCP if SOB, infection more than 3 days, cannot tolerate fluids for 1+ day

Question 61

HP for older adults - cardio

Answer 61

- rest when feel tired or SOB -daily exercise -wearing socks to bed -check for orthostatic changes (ed. to change positions slowly) -elastic stockings

Question 62

HP for older adults - nutrition & metabolic patterns

Answer 62

-proper nutrition for disease prevention and energy -risk factors: low support or income -problems: GI function, decreased smell/vision/taste, dental and swallowing issues, meds -screen: health history, physical, labs, diet, functional status

Question 63

nutrition interventions

Answer 63

-assess contributing factors + use tools -educate about nutrition -provide info about food assistance programs (barriers: embarrassed to apply, lack of knowledge)

Question 64

HP for older adults - elimination patter

Answer 64

-bladder retains tone but capacity decreases -incontinence leads to depression, UTI, skin breakdown, social isolation (tools to assess) -**incontinence is never a normal part of aging** -constipation (frequent finding) due to decreased motility, sedentary lifestyle & meds, decrease in fiber & fluids

Question 65

mgt of elimination patterns - incontinence

Answer 65

kegel, pilates, scheduling, intake mgt, decrease caffeine, disposable undergarments

Question 66

mgt of elimination patterns- constipation

Answer 66

education, increase exercise, increase fiber & fluid, caution against daily use of laxatives

Question 67

health promotion for exercise of older adults

Answer 67

pre exercise assessment and education on the benefits & starting out slow

Question 68

HP for older adults - sleeping pattern

Answer 68

-assessment tools -do: schedule, exercise, ritual, quiet, dark, bed -don't: nap, activity right before bed, caffeine after mid morning, drink alc before bed, sleep meds, tobacco

Question 69

HP for older adults - cognitive

Answer 69

** cognitive problems are not apart of the aging process** -assess & treat confusion (associated w/ UTI & pneumonia) -dementia: increase quality of life & decrease morbidity and cost (keep routine, calm, encourage self care, reduce sensory overload)

Question 70

Benign forgetfulness

Answer 70

**normal part of aging** -forgets but then remembers -forgets unimportant events -may repeat stories -decline in abstraction, calculation, word fluency, spatial orientation, inductive reasoning but as little impact on day to day life

Question 71

strategies for benign forgetfulness

Answer 71

use mental retracing, reminders, notes to compensate

Question 72

nursing strategies for aging minds

Answer 72

**confusion, disorientation, inappropriate behaviors, loss of ability to follow directions or concentrate are not a part of normal aging** so evaluate and treat + look at meds & fluid/lytes imbalance -attempt recall in calm, quiet place, use memory aid and techniques

Question 73

HP for older adults - impaired hearing

Answer 73

periodic hearing evaluations, encourage use of hearing aids, teach methods to improve communication (quiet, do not shout, face speaker)

Question 74

HP for older adults - visual changes

Answer 74

annual eye exam & glaucoma screening, bright non glare lights, limit night driving

Question 75

visual assessments to identify possible vision changes

Answer 75

miss match clothes, bruises from bumping into things, increase in car accidents

Question 76

HP for older adults - sexual & reproductive pattern

Answer 76

**be matter of fact, approach that sex is normal and apart of everyday life** education on normal age related changes & their interventions, assess emotion, educate on STIs (s/s, treatments, preventions)

Question 77

HP for older adults - depression

Answer 77

**not a normal part of aging** -may occur w/ chronic illness, impaired functional ability, loss -s/s: flat affect, anorexia, wt loss, sleep problems, decreased ability to think and concentrate, decreased participation in activities & socialization

Question 78

HP for older adults - suicide

Answer 78

- high rates compared to other countries -highest rates seen in men >75 years -risk factors: isolation, alcohol & drug abuse, psychosis, bereavement, & serious medical illness **nurses need to assess & recognize, asking "have you thought about harming yourself" -> intervene**

Question 79

HP for older adults - falls

Answer 79

- 1 in 3 adults fall each year -causes: neurological, osteoporosis, stroke, sensory impairment (vision) -evaluate why fall causes and then evaluate injuries ** assess for falls (tool & motility w/ pt or ot) and teach safety interventions**

Question 80

biological agents that can cause serious illness or death in older adults

Answer 80

-influenza (vaccinate annually) -pneumonia (vaccinate @ 65) -high rates of cancer

Question 81

polypharmacy

Answer 81

-big problem in older adults -often duplicate for same problem -1/3 of all older adults take 5 or more prescriptions -substance abuse is a growing problem

Question 82

Alcohol & Tobacco Use in Older Adults

Answer 82

**often underestimated/hidden in this age group** -more vulnerable to effects of alc -tobacco promotes multiple chronic health conditions -beneficial to stop smoking >65 y/o

Question 83

within older adult abuse, what group is at the highest risk

Answer 83

older adult women dependent on a caregiver **nurses need to recognize and report**

Question 84

nursing care can determine whether an older adult patient

Answer 84

-maintains health -recovers from an illness -maintains or regains function & independence -achieves a peaceful death

Question 85

nursing interventions should support

Answer 85

-self care abilities -practices that foster health while aging