Young and Middle Adult, Older Adult

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Young and Middle Adult, Older Adult
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YOUNG ADULT

• Physical growth stabilizes during young adulthood
  (the developmental stage from the ages of 21 to
  approximately 40 years). The young adult
  continues to experience physical and emotional
  changes at a slower rate than adolescents.
• Young adulthood is a time of transition from an
  adolescent to a person capable of assuming adult
  responsibilities and making adult decisions.

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Pregnancy, a time of transition and lifestyle
adjustment, is experienced by many young women
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Nursing Implications

• Usually, young adulthood is the healthiest time
  in a persons life. Consequently, concern for
  health is low among people in this age group and
  wellness is taken for granted by many young
  adults. Preventive measures for young adults
  focus on two primary areas
• 1. Avoidance of accident, injury, and violence
• 2. Development of health-promoting behaviors.
• The nurse plays an important role in each of
  these areas of health promotion by teaching and
  counseling. Other topics that are developmentally
  appropriate for the nurse to address are
  vocational counseling and establishing
  relationships.

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Wellness Promotion

• Decision making by young adults affects their
  health status. Since young adults tend to take
  excessive risks, they are at greater risk for
  death from accident, suicide, or homicide
  (Edelman Mandle, 1997). For example,driving
  recklessly, driving while intoxicated, engaging
  in unprotected sex, and participating in gang
  activities are examples of the lack of a sense of
  fear demonstrated by many young adults.

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Sexually transmitted disease

• Sexually transmitted disease is a leading cause
  of Infection with resultant reproductive
  dysfunction in young adults. The information
  presented about STDs in the discussion of safety
  considerations for adolescents is also applicable
  to young adults. Nurses should teach women how to
  perform a monthly breast self-examination (BSE).
  Men need to learn how to perform a testicular
  self-examination (TSE).

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STDs..

• Gonorrhea is a bacterial infection caused by the
  organism Neisseria gonorrheae (also known as
  gonococcus bacteriae) that is transmitted by
  sexual contact. Gonorrhea is one of the oldest
  known sexually transmitted diseases. It is
  estimated that over one million women are
  currently infected with gonorrhea. Among women
  who are infected, 25-40 also will be infected
  with chlamydia, another type of bacteria that
  causes another STD. (Chlamydia infection is
  discussed later in this article.)

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• Chlamydia (Chlamydia trachomatis) is a bacterium
  that causes an infection that is very similar to
  gonorrhea in the way that it is spread and the
  symptoms it produces. It is common and affects
  approximately 4 million women annually. Like
  gonorrhea, the chlamydia bacterium is found in
  the cervix and urethra and can live in the throat
  or rectum. Both infected men and infected women
  frequently lack symptoms of chlamydia infection.
  Thus, these individuals can unknowingly spread
  the infection to others. Another strain (type) of
  Chlamydia trachomatis, which can be distinguished
  in specialized laboratories, causes the STD known
  as lymphogranuloma venereum

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STDs..

• Syphilis is an STD that has been around for
  centuries. It is caused by a bacterial organism
  called a spirochete. The scientific name for the
  organism is Treponema pallidum. The spirochete is
  a wormlike, spiral-shaped organism that wiggles
  vigorously when viewed under a microscope. It
  infects the person by burrowing into the moist,
  mucous-covered lining of the mouth or genitals.
  The spirochete produces a classic, painless ulcer
  known as a chancre.

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STDs

• Genital herpes, also commonly called "herpes," is
  a viral infection by the herpes simplex virus
  (HSV) that is transmitted through intimate
  contact with the mucous-covered linings of the
  mouth or the vagina or the genital skin. The
  virus enters the linings or skin through
  microscopic tears. Once inside, the virus travels
  to the nerve roots near the spinal cord and
  settles there permanently.

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Safety Considerations

• Because vehicular accidents are a major cause of
  health problems for young adults, providing
  information about driving safety is a must.
  Another activity that poses a health risk for
  many young adults is sunbathing. Exposure to
  direct sunlight with the resultant radiation or
  use of tanning salons is directly linked to skin
  cancer. Nurses can be influential in decreasing
  the occurence of skin cancer through teaching and
  by role modeling safe behaviors.

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MIDDLE ADULT

• Middle adulthood (the developmental stage from
  the ages of 40 to 65 years) is characterized by
  productivity and responsibility. For most
  middle-aged adults, the majority of activity
  revolves around work and parenting, and success
  and achievement are measured in terms of career
  accomplishments and family life.
• Physiological changes that affect many of the
  body systems occur during middle adulthood.

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• When an individual successfully resolves this
  developmental conflict, acceptance of age-related
  changes occurs. Achievement of the developmental
  task is indicated by the following
• Demonstrating creativity
• Guiding the next generation
• Establishing lasting relationships
• Evaluating goals in terms of achievement
• The evaluation of goals often leads to a midlife
  crisis, especially if individuals feel they have
  accomplished little or not lived up to earlier
  self-expectations.

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Nursing Implications

• A large proportion of the United States
  population consists of middle-aged adults
  (Edelman Mandle, 1997). Individuals of the
  baby-boom generation have entered their midlife
  stage and will require more nursing care to
  maintain wellness and cope with illness.
• Nurses have the opportunity to help middle-aged
  clients improve their health status (and thus
  quality of life) by identification of risk
  factors and early intervention. The major risk
  factors for adults in the middle years can be
  changed because they are primarily environmental
  and behavioral. Assisting the middle-aged client
  to change unhealthy behaviors can be done through
  one-to-one intervention or in group settings.

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Wellness Promotion

• As health educators, nurses can encourage
  middle-aged adults to assume more responsibility
  for their own health Self-care education topics
  appropriate for the middle-aged adult include
• Acceptance of aging
• Nutrition
• Exercise and weight control
• Substance abuse prevention
• Stress management
• Recommendations for health screening
  (cholesterol screening, prostate examination,
  mammogram, Papanicolaou

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Safety Considerations

• Automobile accidents, especially those involving
  the use of alcohol, are a serious health problem
  for middle-aged adults. Another significant
  problem is occupational health hazards such as
  exposure to environmental toxins. Middle
  adulthood is also the time when a lifelong
  accumulation of unhealthy lifestyle practices,
  such as smoking, sedentary habits, inadequate
  nutrition, and overuse of alcohol, begins to
  exert adverse effects.
• Most middle-aged individuals have increased
  leisure time. Consequently, there is an increased
  risk for recreational accidents, such as, boating
  accidents, sports related injuries, and jogging
  mishaps

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OLDER ADULT

• Older adulthood is the developmental stage
  occurring from age 65 and beyond. Therefore, this
  section only highlights the concepts of growth
  and development as they relate to the older adult.

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Nursing Implications

• Professional nursing care is important in
  assisting aging people to develop a sense of
  well-being (Eliopoulos, 1996). Nurses who work
  with the elderly must be especially sensitive to
  their own feelings, attitudes, and beliefs about
  aging and be aware of the effect of these
  responses on their care of older clients.
• When assessing the older adult for health-related
  needs, the nurse needs to learn about the
  clients background, family history, work
  history, hobbies, and achievements

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• Clients should be encouraged to talk about their
  life experiences. When planning care, it is
  important to build on the clients lifelong
  interests. By recognizing each clients unique
  experiences and assets, the nurse is more likely
  to individualize care.
• When clients express dissatisfaction and regrets
  about the past, the nurse should listen in a
  nonjudgmental manner and avoid trying to convince
  them that things are really better than they
  remember or perceive. It is important, however,
  to help clients put disappoint ments into
  perspective by balancing them with
  accomplishments and achievements. Nurses should
  encourage families to engage in a positive life
  review with elderly clients. Most nursing
  interventions for the elderly center around
  introspection and reflection on their lives.
• Life review (or reminiscence therapy) promotes a
  positive self-concept in older people

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Wellness Promotion

• Health promotion activities should be implemented
  with the elderly to maintain functional
  independence.
• Health promotion activities are aimed at
  maximizing the elders abilities and strengths.
  Specific topics that are developmentally
  appropriate for older clients are
• use of leisure time, increased socialization,
  engaging inregular physical activity, maintaining
  a positive mental attitude, and developing and
  maintaining healthy lifestyles.

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KEY CONCEPTS

• Growth is the quantitative changes in physical
  size of the body and its parts.
• Development refers to behavioral changes in
  functional abilities and skills.
• Maturation is the process of becoming fully grown
  and developed and involves both physiological and
  behavioral aspects of an individual.
• During each developmental stage, certain
  developmental tasks must be achieved for normal
  development to occur.
• Growth and development of an individual are
  influenced by a combination of factors, including
  heredity, life experiences, health status, and
  cultural expectations.

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• Piagets theory states there are four stages of
  cognitive development sensorimotor,
  preoperational, concrete operations, and formal
  operations. Each stage is characterized by the
  ways in which the child interprets and uses the
  environment.
• Kohlbergs theory describes six stages of moral
  development through which individuals determine
  amoral code to guide their behavior.
• Gilligan states that womens moral judgment
  revolves around three issues a concern with
  survival, a focus on goodness, and an
  understanding of others need for care.
• Fowlers theory states that there are six
  distinct stages of faith development and, even
  though individuals will vary in the age at which
  they experience each stage, the sequence of
  stages remains the same.
• Providing care to the whole person is a basic
  concept of professional nurses, and knowledge of
  growth and development concepts guides holistic
  care of clients.

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• According to Freud, certain developmental tasks
  must be achieved at each developmental stage
  failure to achieve or a delay in achieving the
  developmental task results in a fixation at a
  previous stage.
• Erikson stated that psychosocial development is
  a series of conflicts that occur during eight
  stages of life.
• Sullivan stated that personality development is
  strongly influenced by interpersonal
  relationships.
• The stages of the life cycle are the prenatal,
  neonate, infant, toddler, preschooler, school-age
  child, preadolescent, adolescent, young adult,
  middle adult, and older adult.
• Nurses have important roles in promoting the
  health and safety of individuals at each stage of
  the life cycle.

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