Middle Adult
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| Early Adult Age Range | 18-40
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| Physical Development | Minimal-depends on diet and exercise; Changes with pregnancy and lactation
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| Psychosocial Development | Stresses are great with new roles and role conflict; Erikson—intimacy vs. isolation
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| Cognitive, moral, spiritual development | Can move into postconventional level of moral
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| Middle Adults Experience stability in: | Finances, personal freedom, social relationships
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| 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
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| Havighurst's Theory | Tasks are learned behaviors arising from maturation, personal motives and values, and civic responsibility
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| 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
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| 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.
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| Gould's Theory | The middle adult years are for looking inward
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| 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
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| Midlife Transitions are NORMAL | Employment, spousal/partner relationships, Relationships with children & aging family members.
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| Major Health Problems of Middle Adulthood | Cardiovascular Disease, Pulmonary Disease, Cancer, Rheumatoid Arthritis, Diabetes Mellitus, Obesity, Alcoholism, Depression
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| Educative/Supportive Role of the Nurse | Risk Identification, Prevention, Health Screening
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| Risk Identification of Middle Adulthood | Lifestyle behaviors, Developmental or situational crisis, Family history, Environmental factors
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| Health Management Middle Adult-Prevention | Diet low in fat & cholesterol, Regular exercise, Alcohol in moderation (if at all),Do not smoke
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| Health Screenings | Physical Exam, Mammography & Breast Exam (self), Cervical Cancer, Pap Smear, Testicular Exam (self), Prostate Exam, Colonoscopy or Sigmoidoscope, Bone Density
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| 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
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| Perimenopause | Time before menopause—approximately 2-8 years; Ovarian function wanes; Hormonal deficiencies begin to produce symptom; Contraception still a concern during this period
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| 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;
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| Change of Life- Climacteric: Physical Changes....continued | Atrophy of fallopian tubes;Vag mucosa smooth, thin & loss of elasticity;Vag pH + - dryness & itching
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| 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
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| Change of Life Climacteric: S&S Long Term | Low estrogen levels = Risk for coronary artery disease & Osteoporosis
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| 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.
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| 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
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| 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):
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| 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
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| 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
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| Nursing Diagnosis | Risk for Injury;Risk for imbalanced nutrition: more than body requirements;Risk for care giver role strai;Readiness for self-health management
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| Adulthood: Developmental Changes | Age:26-64; Physiologic, Cognitive, Psychosocial
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