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Texas State - NURS 3440 - Study Guide - Midterm

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Texas State - NURS 3440 - Study Guide - Midterm

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background image Nursing Over the Lifespan Exam 1: Ms. Finney, Mrs. Jillapalli, Ms. Neller Major Concepts/Blueprint headings in Purple  Sub point in Red  My answer from book, slides and lecture in black Important terms highlighted Growth and Development Theories of growth and development 6 th -15 th  Century (Medieval)-after 7yrs old children were considered adults.  16 th   Century (Reformation)-Children were born evil and had to be raised to adult status. 
17
th  Century (Enlightenment)-Children were a blank slate that needed nurturing. 18 th Century (Age of Reason)-Children were born good and should be left to develop on 
their own. 19
th  Century (Industrial Revolution)-Darwinism encouraged survival of the fittest. 20 th  Century-Childhood was important and needed to be protected. 21 st   Century-Parents not raising children. Piaget- Cognitive development: How do children learn about the world Sensori-motor (birth-2), Preoperation (2-7), Concrete operation (7-11), Formal  operation (>12) Freud-  Psychoanalysis: what drives children’s behavior Oral (birth-1yr), Anal (1-3yrs), Phallic (3-6yrs), Latency (6-12yrs), Genital  (>12yrs) Erikson- Psychosocial: Interactions drive children’s development Trust vs. Mistrust (birth-1yr)  Autonomy vs. shame and doubt (1-3yrs)  Initiative vs. guilt (3-6yrs)  Industry vs. inferiority (6-11yrs)  Identity vs. identity confusion (adolescence) Intimacy vs. isolation (young adulthood)  Generativity vs. stagnation (middle adulthood)  Integrity vs. despair (elderly) Kohlberg (not on test)-  Moral development Role of Play Play helps with physical, mental, social, moral and emotional development. There 
are five types of play.
Solitary (0-2yrs), Spectator (2-2 ½ yrs), Parallel (2 ½-3yrs), Associate ex: temporary 
cooperation with others, before returning to parallel play (3-4yrs), Cooperative (4-
6+yrs)
background image Play can be games, pretend, social, sense-pleasure, unoccupied behavior or skill 
based.  In play children can express feelings and concerns that they can’t talk about
because they don’t have the vocabulary. 
Infancy Physical:  Body weight DOUBLE at 6mo and TRIPLE at 1yr. This will be on the  test. First year is a sensitive period for brain growth and bonding.  Fine motor : pincer grasp and controlling objects.  Gross Motor : Walking by 1 yr. Object permanence  acquired (even if object is hidden, they know it is there.)  Social development Attachment and stranger fear, language development, separation anxiety are 
normal.  Reactive attachment disorder (RAD) is not normal, and is characterized by 
inappropriate social interactions.  The person is either too clingy with strangers, or 
is abnormally distant from even “safe” people
.  Nutrition : human milk for first 6  months, gradual weaning until 1 year. Fed is Best, Breast is Better.  Sleep : by 3- 4mos, sleep for 9-11 hours at night. Toddlers Physical:  Slower growth, physiological anorexia, legs grow longer than trunk,  upper respiratory system promotes infection (ear and tonsil)  Fine motor:  improved  hand dexterity  Gross motor:  Improved movement, throwing a ball  Social:  Differentiation between self and others.  Aware of accomplishments and also gender
differences. By 2 yrs using sentences with multiple words. 
Health promotion:  Make  every bite count, because toddlers eat less food. Car seats, drowning, burns, 
accidental poisoning. 
Preschoolers Physical:  Growth still slow, body systems can handle stress better.  Gross  motor:  running, climbing  Fine motor:  hand-eye coordination (scissors, drawing,  dressing)  Spiritual:  learning of faith and religion from family, development of  conscience  Cognitive:  “magical thinking” children make up crazy explanations for  things they don’t understand (my body will come out if cut myself).  Sexual 
exploration, modesty is a concern. A lot of fears: of the dark, being alone, ghosts, 
pain 
Social:  Less need of parental security, instead feel safe with familiar objects.  Play helps with stress. Language main method of communication, becomes more 
complete and connected.  
Health promotion:  give healthy food options to avoid  obesity, 12 hours of sleep and a lot of activity is good. Protective equipment and 
education for dangers.
School aged Physical:  gradual growth, losing teeth, increased muscle and decreased fat,  change in facial proportions. Prepubescence: 11-12 yrs old when early physical 
changes occur. 
Spiritual:  want to learn about their God, expect punishment for  misbehavior.  Social:  Peers very important, bullying an issue, parent influence  personality but child becoming more independent. Rules and rituals important in 
play. Body image becomes important (may have feelings of inferiority with 
eyeglasses or physical defects). 
Health promotion:  Sleep 9-11 hours, safety during  sports important, open communication about sex and sexuality, routine health 
services.
background image Adolescents Physical:  Growth spurt of 20% of height in 3 years. Primary sex  characteristics (internal and external organs of reproduction), secondary sex 
characteristics (physical changes that do not directly involve reproduction). Sexual 
development, Girls: breasts, pubic hair, menarche (first menstrual cycle). Boys: 
testes enlargement, penis enlargement, pubic hair, voice drop and facial hair. 
Temporary gynecomastia in 1/3 of boys. Can have inaccurate sexual information. 
Spiritual:  May question family beliefs, understand abstract concepts  Social:  Peers  very important, fear that others don’t understand their feelings, becoming adult 
separate from parents.  “Best friend” of same sex helps mature relationships.  Social
media used significantly, and cyber bullying a big problem.   Body image a big deal, 
teens may hide or advertise their bodies. Media impacts behavior.
Young adults Physical:  physical maturity reached by 20yrs. Focus on health maintenance  (exercise, eating, substance abuse).  Psychosocial:  Reaching maturity, can cope with stress, choosing career, starting family.   Maturity criteria:  independence, application of knowledge, communications, sensitivity to others, handle frustration, have self-
control, assume responsibility.
Middle adults Physical:  decrease in bone density, muscle tone and visual acuity,  menopause.  Psychosocial:  Adjusting to role as grandparent, finding adult leisure  activities, preparing for retirement Geriatric Physical:  Everything slows down and doesn’t work as well.  IQ doesn’t change much.  Psychosocial:  Lose companions, decreased activity, change in living  conditions Nurse caring strategies:  Adjust nursing interventions around the developmental  stage the patient/family is in.  Education, health promotion and preparation for 
common dangers can be applied to all levels of growth.
Apply concepts of growth and development to patients, communities and world 
health: 
Knowing normal growth and development helps nurses know when an  individual is not normal, and what can be done about it.  Awareness of trends in the 
community and the world prepares nurses to address those trends when individual 
patients present with s/sx of those trends
Key concepts with regards to alterations in growth and development:  Physical, skill  level, social, health promotion, prevention of harm Applying the concepts of growth and development to children with developmental 
disabilities and chronic conditions: 
Disabilities and diseases can have an impact on  every area of growth and development.  Physically some handicaps and diseases 
stunt or alter growth.  When neurological development is affected, the ability to 
perform skills, or interact with people can be affected. Health promotion will need to
be more specific in dealing with the disease.  Disabilities may hurt the patient 
background image socially, if bullying is not controlled. It can be hard for children to understand why 
they have a disease or disability, and may hurt them emotionally if they don’t have 
the resources to cope with the stress. 
Gerontology  The goal of services for the elderly is to maintain functional independence Nursing caring strategies for common health issues in the elderly: Nutrition:  have well flavored foods to encourage eating. Have quality food choices,  because elderly eat less food.   Mobility:  If patient is homebound, maintaining ADLs is important.  Exercise can  come in many forms, but starting slow and gradually increasing intensity is safest 
for elderly. 
Stress and coping:  Elderly need a good support group to deal with loss.  Loss can be the physical loss of health and abilities or the social loss of a friend or significant 
other.  Relocation trauma is the stress experienced when the elderly person moves 
to a new and different place.  S/sx include difficulty sleeping, GI distress, anxiety 
and depression. Interventions include avoiding relocation if possible, reorient 
patient to their location, keep familiar items close by and have familiar people 
attend the patient during the transfer.
Accidents:  Regular fall assessment and prevention plans need to happen in the  home or the hospital.  Driving safety also has to be assessed, and sometimes the 
safest thing to do is stop the person from driving.  Reliable regulation of medications
helps prevent polypharmacy
Drug use and misuse:  Be aware that older bodies process drugs slower than  younger bodies.  Patient education about drugs is vital to prevent drug interaction.  
Find out if anything keeps the patient from taking the drugs (unwanted side effects, 
forgetfulness).  Question medications that seem out of place (BEERS list).
Mental health and behavioral health:  Depression S/sx are sadness, lack of sleep,  indecisiveness. Geriatric depression scale: >5 needs to be investigated further, 
suggests depression. Rx is SSRIs or SNRIs.  Untreated depression leads to worse 
complications.  Delirium acute confusion  S/sx disorganized thinking, delusions, 
paranoia.  Delirium has several possible underlying causes. Drugs, 
Emotional/electrolyte imbalance, Low O2, Infection, Retention/reduced sensory 
perception, Ictal (post seizure), Undernutrition, Metabolic, Subdural hematoma. 
Dementia Cognitive, functional and behavioral changes over time.  Much harder to 
treat.
Elder neglect and abuse:  Can be physical, financial, emotional, sexual or neglect.   Also self-neglect.  Nurses need to watch for risk factors such as poor social support, 
dementia, poor health, poverty or being female.  Need to report evidence of 
mistreatment without sufficient explanation, complaint by the patient or even belief 
of nurse that there is risk for abuse.
Standards for restraints:  a restraint is any device or drug that keeps a patient from  freely moving. 

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School: Texas State University
Department: Nursing and Health Science
Course: Nur Care Lifespan
Professor: Regina Jillapalli
Term: Spring 2018
Tags: Nursing and d
Name: Test 1 Study Guide
Description: This covers growth and development, gerontology, diabetes, understanding labs, genetics and a little bit over lab information
Uploaded: 02/10/2018
16 Pages 57 Views 45 Unlocks
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