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Human Development- Final exam study guide

by: Jazmine Morales

Human Development- Final exam study guide NURS 10303

Marketplace > Texas Christian University > Nursing and Health Sciences > NURS 10303 > Human Development Final exam study guide
Jazmine Morales
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This study guide covers chapters 15-19
Human Development
Susan Fife
Study Guide
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This 17 page Study Guide was uploaded by Jazmine Morales on Wednesday April 27, 2016. The Study Guide belongs to NURS 10303 at Texas Christian University taught by Susan Fife in Spring 2016. Since its upload, it has received 53 views. For similar materials see Human Development in Nursing and Health Sciences at Texas Christian University.

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Date Created: 04/27/16
Chapter 15: Physical & Cognitive Development in Middle Adulthood40-65 yrs Physical Development in Middle Adulthood  Continuation of gradual changes in early adulthood  Older body  Gray hairs; new thin lines  Experience life-threatening health episodes  Less emphasis on hoped-for gains & more on feared declines  Concerns for getting a fatal disease, being too ill to maintain independence & losing mental capacities Vision changes in Middle Adulthood  Presbyopia: “old eyes”:  inability to adjust focus to varying distances  Nearsightedness  Pupil shrinks, lens yellows, vitreous changes:  poor vision in dim light  decline in color discrimination  Glaucoma risk damage of optic nerve Hearing changes in Middle Adulthood  Presbycusis: “old hearing”:  initially, decline in sensitivity to high frequencies  gender, cultural differences: men show earlier, more rapid decline  hearing aids, modifications to listening environment, communication can help  Men’s hearing tends to decline earlier & more rapidly than women’s Skin changes in Middle Adulthood  Wrinkles  forehead: starting in thirties  crow’s feet: forties  Sagging:  face, arms, legs  Age spots:  after age 50  Faster with sun exposure, and for women Muscle-fat changes in Middle Adulthood  Middle-age spread common: fat gain in torso:  men: upper abdomen, back  women: waist, upper arms  Very gradual muscle declines in 40s & 50s  Can be avoided:  low-fat diet with fruits, vegetables, grains  exercise, especially resistance training Types of exercise that offset excess weight and muscle loss Resistance training & moderate to intense exercise Skeletal changes  Bones broaden but become more porous:  loss in bone density  women at greater risk  Loss in bone strength:  disks collapse, height shrinks  bones fracture more easily, heal more slowly  Healthy lifestyle can slow bone loss Osteoporosis  Severe bone loss, fragile bones  Causes:  normal aging:  with age, bones more porous, lose bone mass  menopause estrogen drop speeds loss  heredity, body build  lifestyle—diet, physical activity, smoking, alcohol use  Women develop osteoporosis earlier; men often overlooked Variations in timing of menopause  Gradual end of fertility:  menopause follows 10-year climacteric  age range: late thirties to late fifties  earlier in non-childbearing women, smokers  Drop in estrogen:  monthly cycles shorten, eventually stop  can cause difficulties:  complaints about sexual functioning  decreased skin elasticity, loss of bone mass Western view of menopause  “Medicalized”  More symptoms reported, the more negative their attitude  3 contexts: **Medical problem evoked more negative statements **Life transition **Symbol of aging Reproductive changes in men  Decrease in:  sperm volume, motility starting in twenties  semen after age 40  Gradual decline in testosterone:  sexual activity stimulates production  Erection difficulties:  frequent problems may be linked to anxiety, disease, injury, loss of sexual interest  Viagra and other drugs offer temporary relief Leading causes of death in middle age  Chronic & cardiovascular diseases  Cardiovascular diseases= 25% of deaths a.k.a “silent killers” (High blood pressure/ atherosclerosis Double standard of gender & aging  Aging men rated more positively  Women more negatively  Evolutionary roots; also media, social messages  Appears to be declining, with new, positive view of middle age What most cognitive aging research focused on Development= multidimensional & multidirectional; plastic (open to change)  Biological, psychological, & social forces  Cohort effects explain contradiction between cross-sectional studies & longitudinal; peak performance at age 35 & steep drop into old age vs. modest gains of mental abilities in 50s & 60s Crystallized intelligence= skills that depend on accumulated knowledge & experience, good judgement, & mastery of social conventions valued by the individual’s culture EX: vocabulary, verbal comprehension, logical reasoning Fluid intelligence=depends on basic information-processing skills; ability to detect relationships among visual stimuli, speed of analyzing information, & working memory Intelligence tests= reflect spatial visualization, digit span, letter-number sequencing & symbol search Memory in Middle Adulthood  Working memory declines from 20s to 60s:  reduced use of memory strategies  slower processing, attention difficulties  Adults can compensate:  self-paced tasks  training in strategies  Few changes in  factual knowledge  procedural knowledge  metacognitive knowledge Expertise  Practical problem solving:  evaluate real-world situations  analyze how best to achieve goals that have high uncertainty  aided by expertise  Expertise:  extensive, highly organized knowledge base  provides efficient, effective approaches to solving problems  result of years of experience The presence of middle-aged college students  39% of U.S. college students are over age 25; 60% of them are women  Reasons are diverse:  job changes, seeking better income  life transitions  personal achievement, self-enrichment  Concerns:  academic abilities: aging and gender stereotypes  role overload Chapter 16: Emotional & Social Development in Middle Adulthood Erikson’s Theory in Middle Adulthood Generativity  Reaching out to others in ways that give to and guide the next generation  Extending commitment beyond self and partner  May be realized through parenting or other family, work, and mentoring relationships Stagnation  Self-centered, self-indulgent, self-absorbed  Lack of interest in young people  Focus on what one can get from others, not what one can give  Little interest in being productive at work or developing talents Levinson’s interviews with adults  Begins with a transition, during which people evaluate their success in meeting early adulthood goals; remaining years as precious Vaillant’s Adaptation to life  “Keepers of meaning”: older people as guardians of their culture  “Passing the torch” to next generation  Focus on longer-term, less-personal goals Midlife crisis/regrets  Wide individual differences in response  Gender differences in work-related turning points:  women: early adulthood  men: midlife  Sharp disruption uncommon  Differences in handling life regrets:  making life changes or not  role of interpretation, acceptance in well-being  Most experts regard midlife adaptation as combined result of growing older and social experiences Possible selves/current selves  What one hopes to become or fears becoming  Become fewer in number, more modest and concrete with age  Rely more on temporal than on social comparisons  Can be redefined by the individual, permitting affirmation of the self  Play protective role in self-esteem Self-acceptance, Autonomy, Environment Mastery  Gains in expertise, practical problem solving  More complex, integrated self-descriptions  Increase in  self-acceptance Middle age people acknowledged & accepted both their good & bad qualities & felt positively about themselves & life  autonomyless concerned about others’ expectations & evaluations, more concerned w/ following self-chosen standards  environmental masterycapable of managing a complex array of tasks easily & effectively  Factors contributing to well-being differ among cohorts “Big Five” Personality Traits (high & low for each trait)  Neuroticism= worrying, temperamental, self-pitying, self-conscious, emotional & vulnerable  Extroversion= affectionate, talkative, active, fun-loving, & passionate; low= reserved, quiet, passive  Openness to experience= imaginative, creative, original, curious & liberal; low= down-to-earth, uncreative, conventional, uncurious  Agreeableness= soft-hearted, trusting, generous, acquiescent, lenient, & good natured; low= ruthless, suspicious, stingy, antagonistic, critical & irritable  Conscientiousness= conscientious, hard-working, well-organized, punctual, ambitious & persevering; low= negligent, lazy, disorganized, late, aimless & nonpersistent  Basic, enduring individual dispositions persist  Changes occur in overall organization and integration of personality:  Agreeableness and conscientiousness increase  Neuroticism declines  extroversion and openness to experience remain the same or decrease slightly Divorce in Middle Adulthood  Rate for U.S. 50- to 65-year-olds has doubled over past 20 years  More likely among those who are  remarried  highly educated  Midlifers adjust more easily than young adults:  practical problem solving  effective coping strategies  Contributes to feminization of poverty Chapter 17: Physical & Cognitive Development in Late Adulthood Gains in Maximum lifespan of humans  Species-specific biological limit:  little increase for those 65 and older  oldest verified age: 122 years  Some scientists believe upper limit not yet reached:  question: Should maximum lifespan be increased?  goal is quality, not quantity, of life ADL ’s & IADL ’s  Activities of Daily Living (ADLs):  basic self-care tasks  bathing, dressing, eating  Instrumental Activities of Daily Living (IADLs):  conducting business of daily life  require some cognitive competence  shopping, food preparation, housekeeping, paying bills Heart changes in Late Adulthood  Cardiovascular/respiratory systems:  heartbeat less forceful; slower heart rate, blood flow  less oxygen delivered to tissues  vital lung capacity reduced by half Immune System in late adulthood  effectiveness declines  more infectious, autoimmune diseases  stress-related susceptibility  Healthy diet, exercise help protect immune response Assisted Technology  Devices that permit people w/ disabilities to improve their functioning  Computers are greatest source  Software to enlarge texts or have it read aloud  Phones can be dialed & answered using voice commands  “Smart cap” placed on medicine bottles & beeps on programmed schedule as reminder Sexuality in late adulthood  Sex remains important:  decline in frequency; fewer male partners for women  healthy couples: continued regular, enjoyable sex  Continue patterns of earlier years  Factors reducing sexual activity:  tobacco, alcohol, prescription drugs may interfere  men with erection problems may stop all sexual interaction Primary vs. Secondary Aging Primary (Biological)  Genetically influenced declines  Affects all members of species  Occurs even when health is good Secondary  Declines due to heredity and environment  Effects individualized: major contributor to frailty  Illnesses and disabilities:  arthritis  diabetes  unintentional injuries  mental disabilities Falls in Late adulthood  Vision, balance, strength problems  Risk of hip fracture  Limits mobility, social contact Symptoms of Alzheimer ’s disease  Forgetting, disorientation, personality change, depression, motor problems, delusions, speech problems, infections Long-Term care in late adulthood  More common with advanced age:  severe disorders  loss of support network  Varies by SES, ethnic group  Alternatives:  home care by family  assisted living  home-helper systems Language Processing/ Age related losses  Little change in comprehension  Losses in  retrieval of words from long-term memory (tip-of-the-tongue state) knowing a word accompanied by inability to say it  ability to plan what to say and how to say it  Compensatory techniques:  speak more slowly, using more sentences, but shorter ones  Represent gist of information, not details Chapter 18: Emotional & Social Development in Late Adulthood Erikson’s Theory in Late Adulthood Coming to terms w/ one’s life Ego integrity  Feel whole, complete, satisfied with achievements  View life in context of all humanity  Associated with psychosocial maturity Despair  Feel many decisions were wrong, yet time is now too short  Bitter, unaccepting of death  Expressed as anger, contempt for others Pecks Tasks of Ego Integrity  Ego differentiation:  affirm self-worth through family, friendship, community life  alternative to work-role preoccupation  Body transcendence:  emphasize cognitive, emotional, social powers psychological strengths  alternative to body preoccupation  Ego transcendence:  face reality of death constructively  Orienting toward a larger, more distant future Joan Erikson’s gerotranscendence  Beyond ego integrity  Cosmic, transcendent perspective  Directed forward and outward, beyond self  Heightened inner calm, contentment  Quiet reflection Self-focused, other-focused, Knowledge-based reminiscence Telling stories about the past:  Self-focused: can deepen despair used to reduce boredom & revive bitter events  Other-focused: solidifies relationshipsdirected at social goals; solidifying family & friendship ties & reliving relationships w/lost loved ones  Knowledge-based: effective problem-solving strategies; teaching younger people Agreeableness, Acceptance of Change, and Openness to Experience  Secure, multifaceted self-concept:  allows for self-acceptance  continued pursuit of possible selves  Shifts in some personality characteristics:  gain in agreeableness coming to term’s w/ life despite its imperfections  modest declines in extroversion narrowing of social contacts; more selective about relationships  greater acceptance of changeimportant for psychological well-being; effective coping  Resilience promotes adaptive functioning Religious involvement  Religion very important to majority of Americans age 65 and older Disengage   Mutual withdrawal between older adults Late- ment and society theory life Activity  Social barriers cause declining rates of theory interaction Continuity  Effort to maintain consistency between theory past and anticipated future  Social networks become more selective Socioemoti with age, extending lifelong selection onal process selectivity theory  Emphasis on emotion-regulating functions of social contact changes:  development of new faith capacities  openness to other religious perspectives  enlarged vision of common good  Religious involvement associated with  better physical, psychological well-being, exercising, leisure activites  closeness to family and friends  greater generativity Control vs Dependency (scripts)  Dependency–support script: attend immediately to dependent behaviors  Independence–ignore script: ignore independent behaviors  Person–environment fit: match between person’s abilities and demands of living environments; when people cannot maximize use of their capacities, they react w/ boredom & positivity Social Theories of Aging Elder Maltreatment  Physical abuse= intentional infliction of pain, discomfort or injury through hitting, cutting, burning, physical force, restraint, sexual assault  Physical neglect= intentional or unintentional failure to fulfill caregiving obligations, resulting in lack of food, medication, or health services  Emotional abuse= verbal assaults (name calling),humiliation (treated as child) & intimidation (threats of isolation)  Sexual abuse= unwanted sexual contact  Financial abuse= illegal or improper exploitation of the aging person’s property or financial resources; theft or use w/o consent (fraud) Chapter 19: Death, Dying, & Bereavement 3 phases of death Agonal phase= Gasps and muscle spasms during first moments in which regular heartbeat disintegrates Clinical death= Interval in which heartbeat, circulation, breathing, brain functioning stop, but resuscitation still possible Mortality= death Death with Dignity  Integrity of person’s life is fostered by the quality of communication with and care for dying person:  assurance of support  compassionate care  esteem and respect  candidness about death’s certainty  information to make reasoned end-of-life choices Enhancing children’s understanding of death  Depends on basic notions of biology  Permanence is understood first, then inevitability  Most attain adultlike death concept by middle childhood  Factors that affect understanding:  experience with death  religious teachings  candid, sensitive discussion with adults Kubler-Ross’s stages  Denial= denies its seriousness, refusing to accept the diagnosis, avoiding discussions to escape from prospect of death  Anger= recognition that time is short promotes anger at having to die w/o having had a chance to do all one wants to do; rage, resentment & envy towards family members  Bargaining= realizing the inevitability of death; terminally ill patient begins to bargain for extra time; listen sympathetically; if I could live just one more year  Depression= denial, anger & bargaining fail to postpone the illness; person becomes depressed about loss of their life  Acceptance= state of peace & quiet about upcoming death Personality & Coping styles  Dying as imprisonment  “I felt like the clock started ticking… like the future has suddenly been taken… I feel like I’m already dead”  Mandate to live ever more fully “You’re not ready to live until you’re ready to die…never meant much to me until I looked death in the eye”  Part of life’s journey “I learned all about my disease… I wanted to know as much as I can about it… I realized for the first time in my life that I can really handle anything”  Experience to be transformed making it more bearable...” I am an avid, rabid fan of Star Trek… I watch it to the point I’ve memorized it… In my mind I play the various characters” Family member’s & Health Professional’s Behavior  Be truthful about  diagnosis  course of disease  Doctor can 1 offer information to the patient, if patient refuses, ask who should receive information & make health-care decisions  Listen perceptively  Acknowledge feelings  Social support from family members affects adaptation to dying  Maintain realistic hope  Effective communication w/ dying person; fostering trusting relationship  Assist in final transition  Nurses who respond effectively to needs of dying patient & families benefit from in-service training, mutual support, & development of personal philosophy Hospice Approach Comprehensive program of support for dying and their families:  patient and family as unit of care  interdisciplinary team  palliative (comfort) care  home or homelike setting  bereavement services Advance Medical Directives  Written statement of desired medical treatment in case of incurable illness  Living will: specifies desired treatments  Durable power of attorney:  authorizes another person to make health-care decisions on one’s behalf  more flexible than living will  can ensure partner’s role in decision making even in relationships not sanctioned by law Grief Avoidance, Confrontation, & Restoration Avoidance  “emotional anesthesia” Confrontation  most intense grief Restoration  dual-process model of coping with loss  alternate between dealing with emotions and with life changes


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