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Adulthood:Early-Mid

Middle Adult

QuestionAnswer
Early Adult Age Range 18-40
Physical Development Minimal-depends on diet and exercise; Changes with pregnancy and lactation
Psychosocial Development Stresses are great with new roles and role conflict; Erikson—intimacy vs. isolation
Cognitive, moral, spiritual development Can move into postconventional level of moral
Middle Adults Experience stability in: Finances, personal freedom, social relationships
Erickson's Theory: Generativity vs. Stagnation Tasks: Establish and guide the next generation; adjust to needs of aging parents; reevaluate one's goals and accomplishments; Non-completed Tasks-Result in the middle adult focusing on their physical
Havighurst's Theory Tasks are learned behaviors arising from maturation, personal motives and values, and civic responsibility
Havighursts Theory- Tasks Accept and adjust to physical changes; Maintain satisfactory occupation;Assist children in becoming responsible adults; Adjust to aging parents; Relate to one’s spouse /partner as a person
Levinson's Theory-Tasks Task: to choose to either continue an established lifestyle or to recognize one's life in a period of midlife transition.
Gould's Theory The middle adult years are for looking inward
Gould's Theory- Tasks Accept their life span as having boundaries; Have special interests in spouse, friends, and community; Increase their feeling of self satisfaction; Value spouse/partner as a companion; Increase awareness of health  
Midlife Transitions are NORMAL Employment, spousal/partner relationships, Relationships with children & aging family members.
Major Health Problems of Middle Adulthood Cardiovascular Disease, Pulmonary Disease, Cancer, Rheumatoid Arthritis, Diabetes Mellitus, Obesity, Alcoholism, Depression
Educative/Supportive Role of the Nurse Risk Identification, Prevention, Health Screening
Risk Identification of Middle Adulthood Lifestyle behaviors, Developmental or situational crisis, Family history, Environmental factors
Health Management Middle Adult-Prevention Diet low in fat & cholesterol, Regular exercise, Alcohol in moderation (if at all),Do not smoke
Health Screenings Physical Exam, Mammography & Breast Exam (self), Cervical Cancer, Pap Smear, Testicular Exam (self), Prostate Exam, Colonoscopy or Sigmoidoscope, Bone Density
Menopause When menses cease, marking the end of reproductive abilities; Age (median) 51.3 yrs old; Due to decrease of estrogen levels below the level needed to sustain menstruation
Perimenopause Time before menopause—approximately 2-8 years; Ovarian function wanes; Hormonal deficiencies begin to produce symptom; Contraception still a concern during this period
Change of Life- Climacteric: Physical Changes Ovulation stops 1-2 years before complete menopause;Atrophy of the ovaries;Atrophy changes in vag,vulva, urethra & trigonal area of the bladder;Uterine cavity constricts;
Change of Life- Climacteric: Physical Changes....continued Atrophy of fallopian tubes;Vag mucosa smooth, thin & loss of elasticity;Vag pH + - dryness & itching
Change of Life Climacteric: S&S Short Term Hot flashes lasting 3-5 minutes often 20-30 times a day (vasomotor disturbance), Dizzy spells. Palpitations, Weakness
Change of Life Climacteric: S&S Long Term Low estrogen levels = Risk for coronary artery disease & Osteoporosis
Clinical Therapy: Hormone Replacement Therapy (HRT) Supplement of estrogen with/without progestin to “help” w/ s/s of menopause;Used for 1-2 years (maximum) due to long term use being associated with high risk of breast cancer, thromboembolic disease, and stroke.
Clinical Therapy: Hormone Replacement Therapy (HRT)....continued Can be prescribed orally, transdermally (patch), intramuscularly, topically, or vaginal ring;Require thorough history and physical exam prior to initiating HRT
Complementary Alternative Therapy Diet/Nutrition;High fiber, low fat diet & supplement with Vit. D & E, calcium;Phytoestrogens;Natural plant sterols w/ “estrogen like effects” such as soy milk & tofu;Weight bearing exercises (to prevent osteoporosis):
Complementary Alternative Therapy...Continued Walking, jogging, tennis, & low impact aerobics to help increase bone mass; Homeopathic & Herbal Remedies;Medications:Fosamax, Actonel,Selective estrogen receptor modulators (SERMs)--Evista,Calcitonin,Parathyroid hormone
Nursing Management: Things to Consider The patient is an individual;Menopause is an adjustment to change;Patient’s need support and understanding;Patient education and information is important BEFORE menopause begins
Nursing Diagnosis Risk for Injury;Risk for imbalanced nutrition: more than body requirements;Risk for care giver role strai;Readiness for self-health management
Adulthood: Developmental Changes Age:26-64; Physiologic, Cognitive, Psychosocial
Created by: nglidden