Chapter 18 The Adult Client

18-2 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Passage Through Adulthood  The changes facing adults are very different from those of the infant, the child, and the adolescent.

18-3 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Passage Through Adulthood  Role development and role stress influence the health and well-being of all adults.

18-4 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Passage Through Adulthood  Adult relationships are strongly influenced by the experiences of childhood and adolescence.

18-5 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Passage Through Adulthood  Healthy independence is reflected in a lifestyle that selects health-promotion activities and illness-prevention strategies.

18-6 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. The Adult in Society  The nurse must apply what is known about the physiology, psychology, spirituality, morality, and cognitive development of adults in order to assess each person as an individual.

18-7 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Ending Adolescence and Beginning Adulthood  May last from two to eight or ten years.  Struggles with autonomy versus attachment with parents reach resolution and maturity.

18-8 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Ending Adolescence and Beginning Adulthood  Peer pressure diminishes.  Individual identity becomes clearer and is achieved.

18-9 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Ending Adolescence and Beginning Adulthood  Full-time employment and residence outside of the parental home  Assumption of responsibility for one’s own actions and behaviors

18-10 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Young Adulthood  Approximately 21 to 40 years.  Plans, behaviors, and decisions made during this period profoundly affect one’s current and future well-being.

18-11 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Decision-Making Issues during Young Adulthood  Developing eating behaviors  Selecting an appropriate exercise routine  Using illicit drugs  Moderating alcohol consumption  Expressing one’s sexuality  Developing adult relationships

18-12 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Health Issues and Implications for Nursing during Young Adulthood  Pregnancy  Acute Problems  Health Promotion and Wellness

18-13 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Health Issues and Implications for Nursing  Pregnancy Changes in self-concept Physical changes

18-14 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Health Issues and Implications for Nursing  Acute Problems Highest death rates are due to accidents or suicide. AIDS is a leading cause of death in persons 25 to 44 years of age.

18-15 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Health Issues and Implications for Nursing  Health Promotion and Wellness Critical time for nurses to teach: -Dangers of drinking and driving -Risk factors for skin cancer -Breast self-examinations (BSE), testicular self- examination (TSE)

18-16 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Middle Adulthood  Period between 30 and 55 years  Some sources state 40 to 65 years

18-17 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Health Issues and Implications for Nursing in Middle Adulthood  Cardiovascular disease, cancer, and obesity become a major cause of morbidity and mortality.

18-18 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Health Issues and Implications for Nursing in Middle Adulthood  Occupational health hazards  Effects of unhealthy lifestyle practices smoking Sedentary habits Inadequate nutrition Overuse of alcohol

18-19 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Developmental Considerations for Middle Adulthood  Generativity versus Stagnation Generativity is a sense that one is making a contribution to society. Stagnation is a sense of nonmeaning in one’s life.

18-20 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Developmental Considerations  Achievement of the generativity versus stagnation task: Demonstrating creativity Guiding the next generation Establishing lasting relationships Evaluating goals in terms of achievement

18-21 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Developmental Considerations of Middle Adulthood  Physiological Changes Sensory changes may begin. Muscle tone decreases. Physical performance and stamina decline. Cardiovascular and respiratory changes occur.

18-22 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Developmental Considerations of Middle Adulthood  Physiological Changes Body fat increases. Hair loss and graying begins. Skin begins to wrinkle. Hormonal changes begin. Incidence of osteoporosis increases.

18-23 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Developmental Considerations of Middle Adulthood  Stressors Relationships with adult children Increasingly dependent, aging parents Changes in professional or personal status

18-24 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Developmental Considerations of Middle Adulthood  Stress can contribute to: Cardiovascular disability and disease Gastrointestinal disorders Alcohol-related problems Violence Vehicular deaths and injury Depression, suicide

18-25 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Middle Adulthood  Stress Management Stress reduction and relaxation techniques should be fundamental to a nurse’s practice. Nurses provide counseling, guidance, and referrals to outside services.

18-26 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Health Promotion and Wellness  Nurses play a key role in helping individuals manage their lives and practice personal wellness.  Nurses can encourage middle-aged adults to assume more responsibility for their own health.

18-27 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Health Promotion and Wellness  Regular Checkups  Well-Balanced Diet  Regular Exercise Program  Maintenance of Body Weight

18-28 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Health Promotion and Wellness  Resources for Wellness American Cancer Society Agency for Health Care Research and Quality United States Preventive Services Task Force Healthy People 2010 (2003) Initiative