Fluid intelligence (how one learns and processes) declines slightly
Creativity decflines slightly
Psychosocial Development in middle adulthood
The middle adult may strive for generativity
Uses life as an opportunity for creativity and productivity
Has concern for others
Parenting considered an important task
Strives to do well in one's own environment
Moral development in middle adulthood
Religious maturity
Spiritual beliefs and religion may take on added importance
The middle adult may become more secure in his/her convictions
The middle adult often ahs advanced moral development
Self-concept development
Women may experience issues r/t menopause, empty nest, and sexuality. Men experience issues related to job performance and ability to provide. Middle adults may also experience:
Depression
Irritability
Difficulty with sexual identity
Issues r/t job performance and ability to provide
Marital changes with the death of a spouse or divorce
Body-image changes in middle adulthood
women: symptoms of menoause, may represent a loss of the reproductive role or femininity, new interest in intimacy
Men: decreasing strength may be rustrating or frightening
Decreased sex drive may occur as a result of declingig hormones, chronic diseases, or medications
Changes in physical appearance may raise concerns about desirability
In regards to nutrition, most middle adults need to:
Reduce calories
Reduce fats and protein
Increase calcium
Increase fiber
The middle adult is esp at risk for alterations in health from:
Obesity and type 2 diabetes
Cardiovascular disease
Cancer
Substance abuse (alcoholism)
Psychosocial stressors
Health screenings recommended for middle adults include:
Cardiovascular - bp, cholesterol, lipid levels, and bg levels
Nutrition: height and weight
Cancers: pap smears, mammograms, BSE
Health screenings for middle adults after age 50 include:
Stool for occult blood and/or sigmoidoscopy
Prostate-spcific antigen (PSA) and rectal exam
Osteoporosis - bone density
Immunization recommendations for healthy middle adults 40-60 yrs include
Td (just tetanus and diptheria) every ten years, substituting with one dose of Tdap
One dose of MMR or 2 doses if college student, health care worker, r planning international travel
2 doses or varicella if no evidenc of immunity (up to age 50)
Starting at age 50, one dose annually of influenza vaccine
Mental health screenings for middle adult can include:
Depression
Stress
Nutrition counseling for the middle adult includes:
Increasing the consumption of whole grains
Increasing the consumption of fresh fruits and veggies
Limiting fat and cholesterol
Increasing Vit. D and calcium supplementation
Injury prevention for the middle adult includes:
Avoiding drugs that can lead to subsance abuse
Avoiding taking drugs while drivin a vehicle
Wearing a seat belt when operating a vehicle
Wearing helmets while bike riding
Installing smoking and carbon monoxide detectors in the home
Securing firearms in a safe location
When performing a psychosocial assessment, a nurse would expect a healthy middle adult to
B. Accept one's life as creativ and productive
Which of the following physical changes increases during the middle adult years?
C. Blood pressure
Erikson Devlopment/Stage older adulthood
development: psychosocial
Stage: Integrity vs. Despair
Freud Development/stage older adulthood
development: psychosocial
stage: genital
Piaget development/stage older adulthood
development: cognitive
stage: formal operations
physical changes r/t the older adult
A decrease in skin turgot and subQ fat which leads to wrinkles and dry skin
Thinning hair
A decrease in chest wall movement, vital capacity, and an incrase in cilia which increases the risk for respiratory infections
Slowe reaction time
A decrease in smell and taste sensations
A decline in near vision (presbyopia)
The decreased ability for th eyes to adjust from lght to dark can lead to night blindness while driving
An inability to hear high-pitched sounds (presbycusis)
A decrease in muscle strength and tone
Decrease in digestive enzymes
Decrease in intestinal motility, which can lad to an increased risk of constipation
An increase in dental problems
Decalcification of bones
Degeneration of joints
Decrease in bladder capacity
Prostate hypertrophy in men
A decline in estrogen/testosterone production
A decline in thyroid hormone an dinsulin production
Atrophy of breast tissue in women
True or false: many older adults maintian their cognitive function
true
What causes common cognitive disorders in older adults?
Slowed neurotransmission
Impaired vascular circulation
disease states
poor nutrition
structural brain changes
Delirium
Acute and temporary
Usually the symptom of other physiologic problems
Often the first symptom of infection in the older adult
Dementia
Chronic, progressive, and possibly with an unknown cause (alzheimer's)
Depression
Chronic, acute, or gradual onset (present for at least 6 weeks)
Developmental tasks of an older adult include
Adjustment to lifestyle changes r/t retirement
Adaptation to changes in family struture (may be role reversal in later yrs)
Dealing w/ multiple losses (ex: death of spouse, friends, siblings)
Finding ways not to become socially isolated and overcoming loneliness
Facing death
Older adults face difficulties in the are of self-concept which include:
Seeing oneslef as an ging person
Finding ways to maintain a quality of life
Becoming more dependent on others for activities of daily living
Body image changes in older adulthood
Adjustments to decreases in physical strength and endurance may be difficult, esp for older adults who are cognitively active and engaged
Many older adults may feel frustrated that their bodies are limiting what they desire to do
Factors that influence nutrition in the older adult include:
Difficulty getting to and from the supermarket to shop for food
Depression or dementia
Not wanting to eat alone
Meds that impact taste/appetite
Prescribed diets taht ususally do not taste good
Incontinence that mya cause the person to limit fluid intake
True or false: caloric intake should decrease for older adults
True, b/c metabolism and muscle mass decreases with age
nutritional recommendations for the older adult include:
Increasing the intake of vits D, K, and calcium
Increasing fluid intake to minimize the risk of dehydration
Taking a low-dosemultivitamin along with mineral supplementation
Lmiting salt intake
Cardiovascular risks that can affect the older adult include:
CAD
HTN
stroke
Factors affecting mobility of the older adult include
arthritis
osteoporosis
falls
Mental health disorders that can affec the older adult include:
Depression
Dementia
Suicide
Other disorders that can affect the older adult include:
Diabetes
Cancers
INcontinence
Abuse and neglect
Cataracts
Alcoholism
Pain
Heatlh scrennings recommended for the older adult include:
CDV (bp, cholesterol, lipid levels, and bg levels)
Nutrition (height and weight)
Vision exams
Hearing exams
Cancers (pap smears, mammograms, SBE)
Health screenings recommended for the older adult after age 60 include
Stool for occult blood or sigmoidoscopy
Prostate-specific antigen and rectal eam
Osteoporosis (bone density)
Immunizations for older adults
Tetanus and diptheria (Td) every 10years substituing with 1 dose of Tdap, one dose annually of influenza vaccinea, and starting at age 65, one dose of PVC
Exercise for the older adult
In addition to preserving respiratory and vardiovascular functioning, weight-bearing exercises are needed to increase bone density in the older adult
Nutritional supports for the older adult include:
Vitamin D and calcium supplementation
Congregate meals
Meals on wheels
Psychosocial interventions to improve self-concept and alleviate social isolation for the older adult include:
Therapeutic communication
Touch
REality orientation
Validation therapy
Reminiscence therapy
attending to physical appearance
Assisitve devices (hearing aids, walkers, etc)
List several factors tht put the older adult at an increased risk for falls
Impaired vision
Impaired mobility due to arthritis, muscle weakness, and pain
Slowed reaction time
Bowel or bladder incontinence
Side effects of meds
What measures can be implemented in the home to decrease th risk of falls for the older adult?
Remove throw rugs
Make sure extension and phone cords are out of the walkays/hallays
Install bath railings or grab bars
Install hand rails atstairways
Eliminate clutter
Identify lifestyle recommendations for the older adult client in order to promote health and independence
Aerobic and wieght-bearing exercises
Maintenance of appropriate body weight
Balanced diet with use of supplements as needed
Participation in socially satisfying activities
Regular physical exam
An older adult client who was treated with bronchitis 2 days ago is receiving home health care. Teh client's daughter tells teh nurse providing the care that her father was find yesterday, bu was up several times during the nightr looking for his son who lives in another state, emptying desk drawers, and then accusing her of stealing. What is the most likely cuase of this cognitive change?
B/c of the acute onset, probably delirium.
The client also had bronchitis which could have progressed to pneumonia, the infection causing the delirium
Delirium, as oposed to dementia, is typically
D. Acute
Presbyopia is a common visual age-related change that results in a declien in
