NRS101 Week5 Developmental Theories by xl771209

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									Developmental Theories Growth and Development
NRS 101

Why study theory?
Provides a framework Offers logic for observations and explanations How and why people act Important for nurses to combine theory, practice, and research Nurses assess responses to illness and treatments

Organized and logical set of statements about a subject, frameworks to clarify, to make sense of. Human Development Theory: Models intended to account for how and why people become who they are, tries to explain and predict human behavior.

Growth and Development
Growth: Quantitative changed, measured and compared to norms Height, weight compared to normal growth charts Development: Qualitative, progressive, continuous process of change leading to a functional capacity Child crawls, rolls over, walks

Four Areas of Developmental Theories
Biophysical-How do we grow, change, age Psychosocial-Personality & behavior Cognitive-Thinking, intellect

Moral-Knowing right from wrong, ethics

Biophysical Developmental Theories
Gesell’s Theory: Grow according to our own genetic blueprint and pace, growth is directed by gene activity, environmental factors can modify pattern of development Genetic Theory of Aging: DNA function of cell lifespan, programmed cell death, accounts for longevity in families

Biophysical Developmental Theories
Nongenetic Cellular Theories: Looks at cell rather than DNA, “wear and tear” theory, our bodies just wear out. Free Radical Theory Physiological Theories of Aging: 1) Breakdown of performance of a single organ 2.) Impairment of physiological control mechanisms

Erik Erikson
Student of Anna Freud Evolutionary process: Biological, psychological, and social events contribute to readiness for each task/stage Added 3 adult stages to Sigmund’s model

Erikson’s Stages of Psychosocial Development
Trust vs. Mistrust Autonomy vs. Shame Initiative vs. Guilt Industry vs. Inferiority Identity vs. Role Confusion Intimacy vs. Isolation Generativity vs. Stagnation Integrity vs. Despair

Jean Piaget Cognitive Development Theory
How we think, learn to reason, exercise judgment, have intellectual organization Observed children Defined 4 periods that children move through: Sensorimotor (Birth-2 yrs) Preoperational (2-7 yrs.) Concrete (7-11 yrs) Formal (11 yrs-adult)

Jean Piaget Moral Development
Stages of moral development influenced by environment Observed boys, ages 5-13 yrs.

Moral Development Theories
How we acquire moral values, are guided by morals, how we treat others based on morals Jean Piaget-Environmental influences Lawrence Kohlberg-Cognitive and moral linked, expanded Piaget’s work, defined 3 levels with 6 stages of moral development

Lawrence Kohlberg Moral Development Theory
Level 1- Preconventional Stage 1- Punish and Obey Stage 2- Instrumental Relativist Level 2- Conventional Stage 3- Good boy/Nice girl Stage 4- Society Maintenance Level 3- Post-Conventional Stage 5-Social Contract Stage 6- Universal Ethics

Theories give nurses some answers on why and how people react, respond as they do Human behavior is complex No one theory answers all questions All theories are multi-dimensional, not linear, they are guidelines

Growth and Development
Refer to P&P pg. 173 Table 11-1 for Developmental Age periods Conception through adolescence Physical growth and cognitive development Stages of development per age

Intrauterine Life
40 weeks, 9 calender months Nagele’s Rule 3 Trimesters (every 3 months) Prematurity- 20-37 weeks gestation pg. 175 Table 10-1 Tocolysis: Therapeutic interventions to stop labor before 37 weeks (IV’s, meds. Bedrest)

Neonatal period to first month of life P&P pg. 183 Box 11-4 for injury prevention during infancy

1 Month to 1 year Health Risks: Injury prevention, child abuse/maltreatment Health Concerns: Nutrition, feeding, supplementation, overfeeding, dentition, sleep, immunizations

12-36 months Health Concerns and Risks: need for close supervision curiosity poisonings auto safety

3-5 years Concerns fear of dark fear of animals fear of thunderstorms fear of medical procedures

School Age
6-12 years Cognitive changed Concrete operations Mature language development Health risks: Accidents, falls, cancer, abduction, infections

Teen years Ages 13-20 years Increased growth rate, sexual changes, changes in muscle and fat distribution Risks for accidents, homicide, suicide, substance abuse, tobacco use, eating disorders, sexual experimentation, pregnancy, STD’s

Young to Middle Adult
20’s to 40’s Physical, cognitive, psychosocial changes Lifestyle, career, marriage, sexuality, childbearing. Infertility Risk factors for family history of disease, personal hygiene, environmental and occupational factors, family and career stress, health screenings, exercise and nutrition

Middle Adult
40’s to 60’s Menopause- Women- disruption of menstruation and ovulation, ovaries no longer produce sex hormones Climacteric- Men- decrease levels of testosterone, decrease erection/ejaculation; sperm still is produced Psychosocial Changes: career transition, sexuality, family changes Health Concerns: Stress, family diseases, forming positive health habits, anxiety, depression

Older Adult
Above 65 years Health Concerns: Chronic disease/disability, injury, decreased senses and physical strength, retirement, family changes, assisted living, grandchildren, support of other seniors, remaining independent, sexual concerns, death/dying/loss, medications, insurance coverage, memory, aging process, nutrition, hydration, skin care

Older Adult
Gerontology-Geriatrics Myths and Stereotypes Theories of Aging:Stochastic (random damage over time), NonStochastic (predetermined by body mechanisms) Psychosocial Theories: Disengagement, Activity, Continuity

Older Adult
Health services: Active adult communities, retirement communities, home care, adult day care, assisted living long term care, respite care, living with children or grandchildren

Older Adult Physiological Changes
Skin Head and Neck Thorax and Lungs Heart and vascular system GI Reproductive GU Musculoskeletal Neuro

Older Adult Cognitive Changes
Delirium Dementia Alzheimer’s Disease


Older Adult Psychosocial Changes
Retirement Social Isolation Sexuality Housing and environment Death

Older Adult Heath Risks
90% Of adults over 65 have atleasr one health risk Heart disease Cancer CVA COPD, Smoking cessation Nutrition, dental problems Arthritis Falls Polypharmacy

Older Adult Psychosocial Concerns
Therapeutic communication Touch Reality orientation Validation Therapy Reminiscence Body Image interventions

Older Adult Psychosocial Concerns
Therapeutic communication Touch Reality orientation Validation Therapy Reminiscence Body Image interventions

Older Adult Acute Care Considerations
Risk for dehydration, malnutrition Risk for delirium Risk for nosocomial infection Risk for incontinence Risk for falls Risk for skin breakdown

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