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Copyright (c) The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 8-1 Chapter 8 Lifespan Development.

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Presentation on theme: "Copyright (c) The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 8-1 Chapter 8 Lifespan Development."— Presentation transcript:

1 Copyright (c) The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 8-1 Chapter 8 Lifespan Development

2 8-2 Objectives

3 Lifespan –The period during which something is functional In humans, lifespan is the period from birth to death. 8-3

4 8-4 Human Development Human development is the process of growing to maturity –Infancy – birth to 12 months –Toddler – 12 to 36 months –Preschooler – 4 to 5 years –School-age – 6 to 12 years –Adolescence – 13 to 18 years –Early adulthood – 20 to 40 years –Middle adulthood – 41 to 60 years –Late adulthood – 61 years and older

5 Milestones Physiologic Cognitive Psychosocial 8-5

6 Infants 8-6

7 Physiologic Changes Birth – usually weighs about 7 pounds –Doubles birth weight by 3 to 4 months –Triples birth weight by end of first year Length –Usually about 19 to 20 inches long at birth –Reaches about 29 to 30 inches at 12 months 8-7

8 Physiologic Changes Top-heavy appearance –Chest circumference less than head circumference –About 9 to 10 months, circumference of head and chest are about the same –After 1 year of age, chest larger 8-8

9 Physiologic Changes Head may be misshapen during vaginal delivery Fontanels (soft spots) present on top and back of the head –“Gaps” in the bones of the head –Allow flexibility during delivery and growth of the brain 8-9

10 Physiologic Changes Reflexes –Feeding reflexes Rooting Sucking –Moro reflex –Palmar grasp reflex 8-10

11 Physiologic Changes Senses –At birth, the most developed of the senses is hearing. –Sight is the least developed sense. 8-11

12 Physiologic Changes Heart rate –Between 100 and 160 beats per minute during first 30 minutes of life Slows to about 120 beats per minute –Heart rate is usually between 80 and 140 beats per minute during first year. 8-12

13 Physiologic Changes Respiratory rate –Usually between 40 and 60 breaths per minute –Drops to about 30 to 40 breaths per minute after first few minutes of life, and slowing to 20 to 30 breaths per minute by one year. 8-13

14 Physiologic Changes Respiratory anatomy –In general, all structures are smaller. –More easily blocked than in adults –Nasal passages Soft and narrow Have little supporting cartilage 8-14

15 Physiologic Changes Tongue takes up proportionally more space in the mouth of a child than in an adult Tracheal rings are softer and more flexible Chest wall is softer and more elastic Fewer and smaller alveoli Depend more heavily on the diaphragm for breathing 8-15

16 Physiologic Changes Nervous system –Significant growth during first year –Neurons (nerve cells) grow and form increasingly dense connections Enables faster and more efficient message transmission 8-16

17 Physiologic Changes Skin –Susceptible to changes in temperature –Large body surface area –Skin is thin with few fat deposits –Poorly developed temperature-regulating mechanisms 8-17

18 Cognitive Changes 2 to 6 months –Increasingly aware of surroundings –Begins to explore own body –Should make eye contact by 6 months Between 6 and 12 months –Begins looking for things not in sight By 12 months –Speaks first understandable words 8-18

19 Psychosocial Changes Crying –Pre-cry signals –Basic cry –Angry cry –Pain cry 8-19

20 Implications for Healthcare Professionals Young infants are unafraid of strangers and have no modesty. Older infants have separation anxiety. If possible, assess the baby on the caregiver’s lap. Handle the infant gently but firmly Support the head and neck if the baby is not on a solid surface Keep the infant warm 8-20

21 Toddlers (1-3 Years of Age) 8-21

22 Physiologic Changes Looks chubby –Relatively short legs –Large head Heart rate –Between 80 and 130 beats per minute Respiratory rate –About 20 to 30 breaths per minute 8-22

23 Physiologic Changes Body systems continue to grow –Respiratory system Terminal airways continue to branch Alveoli increase in number –Musculoskeletal system Muscle mass increases Bone thickness increases –Nervous system Effortless walking Fine motor skills are developing 8-23

24 Physiologic Changes Always on the move Prone to injury 8-24

25 Physiologic Changes Immune system –More susceptible to minor respiratory and gastrointestinal infections 8-25

26 Physiologic Changes Digestive and urinary systems –Stomach capacity increases –Voluntary control of elimination Toilet training Average age for completion is about 28 months 8-26

27 Cognitive Changes 12 to 18 months –Imitates older children and parents –Knows major body parts –Knows 4 to 6 words 18 to 24 months –Begins to understand cause and effect –Can identify objects –Talks in short sentences 24 months –Knows about 100 words 8-27

28 Psychosocial Changes Strong separation anxiety Temper tantrums Can answer simple questions and follow simple directions –However, you cannot reason with a toddler. 8-28

29 Psychosocial Changes Comfort object –Blanket –Stuffed animal –Toy Afraid of: –Being left alone –Monsters –Interruptions in their usual routine –Getting hurt (such as a fall or cut) 8-29

30 Implications for Healthcare Professionals Favorite words: no and mine Distrustful of strangers May scream, cry, or kick when touched Do not like having clothing removed Do not like anything on their faces 8-30

31 Implications for Healthcare Professionals Approach the child slowly Address him by name Talk to him at eye level Use simple words and short phrases Use a calm, reassuring tone of voice Assess the child’s head last Respect the child’s modesty Praise for the child for cooperative behavior 8-31

32 8-32 (4-5 Years of Age)

33 Physiologic Changes Taller and thinner than a toddler Heart rate –Between 80 and 120 beats per minute Respiratory rate –About 20 to 30 breaths per minute Hops, swings, climbs… Dresses self Brushes own teeth 8-33

34 Cognitive Changes Has a better understanding of time Can count ten or more objects Increased attention span Vocabulary of about 1500 words Sentences now consist of 6 to 8 words Can correctly name at least four colors Can say his name and address Understands a 3-part request 8-34

35 Psychosocial Changes Likes to sing, dance, and act Wants to be like his friends Certain that he knows everything May be rude when you ask him to do something he does not want to do Able to play more independently May be able to spend more time apart from caregiver Explores his body Finds playing “doctor” an interesting activity 8-35

36 Implications for Healthcare Professionals Afraid of adults who look or act mean Approach slowly Talk to the child at eye level 8-36

37 Implications for Healthcare Professionals Preschoolers are curious and like to "help.” Encourage the child to participate Preschoolers are highly imaginative –Choose your words carefully –Avoid baby talk –Avoid frightening or misleading terms –Dress and bandage wounds promptly 8-37

38 Distractions Ask about the child’s favorite: –Foods –Games –Cartoon characters –Movies –Computer game Ask the child to: –Visually locate an item in the area –Sing a song –Tell you about school 8-38

39 School-Age Children (6-12 Years of Age) 8-39

40 Physiologic Changes Heart rate usually 70 to 110 beats per minute Respiratory rate 20 to 30 breaths per minute Systolic blood pressure 80 to 120 mmHg Growth in height and weight continues Growth spurts begins before onset of puberty Fine motor skills continue to develop Baby teeth are lost and permanent teeth come in 8-40

41 Cognitive Changes Thinks logically Able to see things from another’s point of view Ability to read is acquired 8-41

42 Psychosocial Changes Important to a school-age child: –School –School-related activities –Popularity –Peer groups More interaction with adults and children Begins comparing himself with others Develops self-esteem Takes pride in learning new skills 8-42

43 Psychosocial Changes Body image is important Children with a chronic illness or disability are very self-conscious. Physical differences often result in taunts from other children –Can have lasting effects 8-43

44 Psychosocial Changes Begins to understand that death is permanent May feel responsible and guilty for a loved one’s death Grief reaction varies 8-44

45 Implications for Healthcare Professionals Usually cooperative Very modest May view illness or injury as punishment Talk directly to the child about what happened Explain procedures Be honest 8-45

46 Adolescents (13-18 Years of Age) 8-46

47 Physiologic Changes Size and strength of the heart increases Blood volume increases Systolic blood pressure increases Heart rate decreases –Heart rate is usually 55 to 105 beats per minute –Respiratory rate is 12 to 20 breaths per minute –Systolic blood pressure is100 to 120 mmHg 8-47

48 Physiologic Changes Muscle size and strength increase Bone growth is nearly complete Rapid 2 to 3 year growth spurt Physical maturity –Girls Begins at age 10 and ends about age 16 –Boys Begins at age 12 and ends about age

49 Physiologic Changes Primary sexual development –Ovaries, uterus, breasts, and penis Secondary sexual development –Voice changes –Development of facial and genital hair 8-49

50 Physiologic Changes Menarche –Onset of menstruation during puberty –Average age of menarche is 12.5 years Menstruation –Periodic discharge of blood and tissue from the uterus –Occurs about every 28 days Increased risk of teen pregnancy and sexually transmitted infection 8-50

51 Cognitive Changes Ability to reason Think beyond the present Concerned about the opinions of others Develop morals –Question adults who say one thing but do another 8-51

52 Psychosocial Changes Wants to be treated like an adult Conflicts between an adolescent and parents are common 8-52

53 Psychosocial Changes Self-consciousness increases Peer pressure increases Interest in the opposite sex increases Anti-social behavior peaks around eighth or ninth grade. Hormone surges cause wide mood swings. 8-53

54 Psychosocial Changes Peer groups are important School is typically the focus of social life Body image is of great concern –Compare themselves with their peers and determine if they are “normal” based on what they observe 8-54

55 Psychosocial Changes Eating disorders common Experimentation with tobacco, alcohol, and illicit drugs Depression and suicide are more common in adolescents than any other age group. 8-55

56 Psychosocial Changes Between 15 and 17 years of age: –Cautiously establishes relationships –Usually knows if he or she is homosexual or heterosexual Around the age of 18: –Begin to understand who they are –Develop an attachment to another person –Stable relationships form 8-56

57 Implications for Healthcare Professionals Inconsistent, unpredictable Expect to be treated as adults Obtain the history from the patient instead of a caregiver Expect many questions Do not bargain in order to do what you need to do 8-57

58 Implications for Healthcare Professionals Try to have an adult of the same gender as the child present during the exam Do not tease or embarrass an adolescent patient, particularly in front of peers 8-58

59 Early Adulthood (20 to 40 Years of Age) 8-59

60 Physiologic Changes Peak physical condition –Heart rate averages 70 beats per minute –Respiratory rate averages 16 to 20 breaths per minute –Systolic blood pressure averages 120/80 mmHg Accidents are a leading cause of death in this age group 8-60

61 Cognitive Changes Young adults recognize that, in some situations, there is no single correct solution. –In fact, the solution may vary from situation to situation. 8-61

62 Psychosocial Changes Becomes independent of parents Completes education Establishes a career –High levels of job stress Establishes an intimate relationship Decides whether to have children Friendships are important 8-62

63 Psychosocial Changes Demonstrate reckless behavior less often than adolescent More likely to use abuse alcohol and illicit drugs and have serious emotional difficulties than older adults Eating disorders are more common in this age group than at other ages. 8-63

64 Implications for Healthcare Professionals Approach in a respectful, friendly manner. Obtain a history from the patient. Explain what you are planning to do and why it needs to be done. Allow time for questions. Provide clear and honest explanations. 8-64

65 Middle Adulthood (41 to 60 Years of Age) 8-65

66 Physiologic Changes Heart rate averages 70 beats per minute Respiratory rate averages 16 to 20 breaths per minute Systolic blood pressure averages 120/80 mmHg In the early 40s, the body is still functioning as effectively as it did in 20s 8-66

67 Physiologic Changes Near vision declines by the late forties Taste sensations diminish Ability to hear high frequency sounds decreases, particularly in men Metabolism slows, making weight control more difficult 8-67

68 Physiologic Changes Cardiovascular health becomes a concern –Blood vessels lose elasticity and become thicker. –Cholesterol levels increase –Cardiac output decreases 8-68

69 Physiologic Changes Hormonal changes occur in both women and men. –In women, menopause occurs in the late 40s or early 50s. –In men, testosterone levels gradually decline and sperm production decreases. Hair begins to thin and turn gray Skin’s elasticity and moisture decrease –Wrinkling occurs Cancer often strikes in this age group. 8-69

70 Cognitive Changes Memory, perception, learning, problem solving, and creativity change very little. Reaction time may diminish toward the later part of middle adulthood. Experience and expertise allows them to surpass younger workers in problem solving ability. 8-70

71 Psychosocial Changes Approach problems more as challenges than threats Typically the center of the family, between aging parents, adult children, and grandchildren Some may be burdened by financial commitments for them. 8-71

72 Psychosocial Changes Empty nest syndrome –A feeling of sadness and loneliness when one or more of the children leaves home 8-72

73 Implications for Healthcare Professionals Talk to the patient in a respectful, friendly manner. Obtain a history from the patient. Listen carefully to the patient’s answers. Explain what you are planning to do and why it needs to be done. Allow time for the patient to ask questions. Provide clear and honest explanations. 8-73

74 Late Adulthood (61 Years of Age and Older) 8-74

75 Physiologic Changes Maximum life expectancy –Oldest age to which any person lives Average life expectancy –The age at which half of the people born in a particular year will have died 8-75

76 Physiologic Changes Cardiovascular system changes –Thickening of the blood vessels –Decreased vessel elasticity –Increased peripheral vascular resistance –Marked increase in systolic blood pressure –Heart’s valves become hard and thick –Heart is less responsive to exercise –Rapid heart rates are not well tolerated 8-76

77 Physiologic Changes Respiratory system changes –Diminished elasticity of the diaphragm –Weakening of the chest wall muscles –Coughing is often ineffective –Decreased number of alveoli that participate in gas exchange –Activity of cilia in the lungs is decreased 8-77

78 Physiologic Changes Sensory changes –Loss of taste buds –Hearing loss –Diminished sense of smell –Diminished vision –Diminished perception of pain –Diminished reaction time. 8-78

79 Physiologic Changes Older adults have –Less subcutaneous tissue –Inefficient blood vessel constriction –Diminished shivering and sweating –Diminished perception of temperature –Diminished thirst perception –Increase the likelihood of a heat- or cold- related emergency 8-79

80 Physiologic Changes Musculoskeletal system changes –Loss of muscle strength –Decrease in the number of muscle cells –Loss of bone mass –Falls are common in older adults 8-80

81 Physiologic Changes Urinary system changes –Reduced blood flow to the kidneys Thickening of the blood vessels Narrowing of the renal arteries –Bladder holds less urine Increased urinary frequency 8-81

82 Physiologic Changes Gastrointestinal (GI) system changes –Some older adults have no teeth and depend on dentures. –Saliva declines with age. –Delayed gastric emptying. –GI secretions are decreased. –Less efficient break down of protein. –Less efficient break down of fats. –Vitamin and mineral deficiencies. 8-82

83 Physiologic Changes Nervous system changes –Loss of nerve cells –Can learn new material, but may have difficulty retrieving information –Balance and coordination are decreased –Sleep disorders common 8-83

84 Cognitive Changes Short-term memory is relatively unaffected Age-related changes in memory most often occur in recent memory Long-term memory is essentially unaffected by the aging process 8-84

85 Psychosocial Changes Making personal choices to find the meaning of life Evaluating one’s self-worth Adjusting to retirement Adjusting to reduced income Establishing satisfactory living arrangements Adjusting to the death of a spouse or companion Maintaining contact with friends and family Meeting social and civic obligations 8-85

86 Implications for Healthcare Professionals Elderspeak should be avoided: –Speaking louder and more slowly –Using a patronizing tone –High pitch –Increased volume –Increased repetition –Simpler vocabulary and grammar than normal adult speech –Making statements that sound like questions –Exaggerating words 8-86

87 Implications for Healthcare Professionals Elderspeak does not communicate appropriate respect. –Implies that the patient is dependent and incompetent An older adult will better understand you if you repeat and reword what you are saying. 8-87

88 8-88 Questions?


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