Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. Chapter 13 Young and Middle Adults

2Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. Young Adult  Physical changes  Growth completed by the age of 20  Cognitive changes  Critical thinking habits increase.

3Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. Psychosocial Changes

4Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. Case Study  Crystal Taylor is a 25-year-old African American in her sixth month of pregnancy. She has a daughter, Monica, who is 6 years old, and a son, Zachary, who is 2½ years old.  Crystal lives with her mother and grandmother, both of whom are breast cancer survivors.  Crystal has brought Monica into the clinic for a check-up, and Louis is the nursing student who will be taking care of this family.

5Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. Psychosocial Changes

6Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. Case Study (cont’d)  Monica is in the 60th percentile for weight and the 75th percentile for height. Louis uses the Denver Developmental Screening Test and observes Monica balancing on each foot for 6 seconds, defining words like “banana,” copying a square, and completing other tasks successfully.  Crystal says that Monica is very protective of, and bossy to, her younger brother Zachary.  What does Louis know about the household from his observations of the family?

7Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. Health Risks

8Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. Case Study (cont’d)  Crystal is unsure about the status of her children’s immunizations. When asked about safety concerns, she states that all medicines and cleaning agents are locked in a cabinet.  During the conversation, Monica tries to play with her mother’s cigarette lighter.

9Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. Case Study (cont’d)  Louis asks Crystal about her preparation for the new baby. Crystal states that she isn’t sure what to do to get ready and asks for suggestions on how to prepare.  Monica asks how the baby will get out.

10Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. Health Concerns

11Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. Psychosocial Stressors

12Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. Case Study (cont’d)  Louis discusses immediate health and safety goals with Crystal. He recommends a list of books to help Monica and Zachary prepare for the birth of a new sibling, and he provides Crystal with several pamphlets on smoking cessation.  Crystal schedules her next prenatal appointment at the clinic in one month.  What knowledge and health outcomes might be appropriate for Crystal and her family?

13Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. Acute Care  Treatment for accidents, substance abuse, exposure to the environment, stress-related illness, respiratory infection, influenza, urinary tract infection, and conditions requiring minor surgery  Education is important.

14Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. Quick Quiz! 1. Which of the following might be a cause of stress for young adults? A. Being single B. Career C. Sexuality D. Activity

15Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. Restorative and Continuing Care  Hypertension, coronary artery disease, accidents, rheumatoid arthritis, AIDS, and cancer  Nursing interventions relate to sense of identify, establishment of independence, reorganization of relationships, and launching a chosen career.

16Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. Case Study (cont’d)  Crystal returns one month later for a prenatal visit. She tells Louis that she found two of the books recommended to her during her last visit, and the children love having her read the books to them.  Crystal has also read the pamphlets given to her on the last visit and expresses concern about her smoking.  Crystal asks Louis if he has any tips on how to manage a new baby and her two other children at the same time.

17Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. Middle Adult  Begins in the mid 30s and lasts through the late 60s  Physical changes  May impact self-concept and body image  Cognitive changes  Rare, unless illness or trauma occurs

18Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. Psychosocial Changes  Expected events  Sandwich generation  Career transition  Sexuality  Family psychosocial events:  Marital changes  Singlehood  Family transitions  Care of aging parents

19Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. Health Concerns and Promotion

20Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. Positive Health Habits

21Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. Quick Quiz! 2. Which of the following might be a cause of stress for the middle-aged adult? A. Financial security B. Planned retirement C. Arrival of grandchildren D. Caring for children and aging parents

22Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. Acute and Restorative Care  Recovering from an injury or illness may take longer.  Chronic illnesses affect roles and responsibilities.  Your role in assessment includes determining the coping mechanisms of the patient and family, as well as adherence to treatment and rehabilitation regimens and the need for community and social services, with appropriate referrals.