NUR 106 Developmental Stages/milestone/Stressors
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Stage One Trust Vs Mistrust
NUR206: age( 0-12 months)
Teaching: Geared towards teaching the parents.
- New Born-18months-
- Positive-results in confidence, optimism
- Negative-dissatifaction with self and other
- Maladaptive-over trusting
when does birth weight double?
when does the child sit unsupported?
When does the child receive 50% of adult height?
When does a child throw a ball overhand?
When does a child speak two-three word sentences?
when does a child use scissors?
when does a child tie his or her shoes?
When does a child pull him/herself up to stand?
when does a child develop a social smile?
When can a child support upper body while lying prone?
When does a child feed him/herself? and use a cup?
when does a child hop and skip?
which stage of development is most unstable and challenging regarding developmental personal identity?
adolescence -Stage 5 -13-19years.
detachment toddler 18-months -3 years.
When does a child respond to the word no?
Stage two Autonomy vs Shame/guilt
NUR206: Age (1-3 years)
Teaching: Geared towards parents, use simple words for child and use play/ pictures.
- Negative-lack of self confidence
Stage three initiative vs guilt
NUR206: Age (3-6 years)
Teaching: play therapy, simple pictures for learning and stories, allow manipulation of objects.
- 4-5 years preschool
- Positive-Self control
- Negative-inadequate-scared to try new things
Stage four industry vs inferiority
Teaching: psycho-motor skills, offer opportunities to answer questions, play therapy-group activities, adhere to group rules.
- 6-12 years-school age
- Positive-moves from fantasy to real world-mastery of work habits
- negative-difficulty with interpersonal relationships-cover up-inadequacy
- Maladaptive-Narrow virtuosity
- Malignant -inertia-resisitance
Stage five-Identity vs role confusion
NUR206: Age (12-18)
Teaching: allow them to make decisions on health and health promotion, ensure confidentiality, use problem solving to help make choices, use peers for support and influence.
- 13-19 years adolescence
- Positive-maturing Independence
- Negative-leads to rebellion and delinquency
- Malignant-repudiation-drink the apple juice
Stage six- intimacy vs isolation
NUR206: Age (19-40)
Teaching: encourage participation in teaching plan by setting mutual goals, encourage independent learning, offer information so adults understand effects of health problems.
- 18-25y early adult hood
- Positive-mutual respect and love in healthy relationships
- Negative-social isolation-unable to create health relationships
- Malignant-exclusion-inability to commit
Stage seven-Generativity vs stagnation
- 26-65years Middle Adult hood
- Positive-acheivement of ones goals and considering future generations
- Negative-Self indulgence-no ability to care for others
- Maladaptive-overextension-caring for others not able to care forself
- Malignant-Self centered unable to care for others, Midlife crisis.
Stage Eight-integrity vs despair
NUR206: age (65 and older)
Teaching: Use concrete examples when rested and alert, experiential, one concept at a time, use repetition.
- 65Y-death older adulthood
- positive-feel good about life and lifes goals
- Negative-feelings of worthlessness, wants a do over.
- Maladaptive-presumption-feels like they did everything right. Retrogression-children should take care of you.
- Malignant-disdain-contempt for others-unable to cope with life.
- Balance-Wisdom-acceptance of life.
◦physical work, shift work, overload, patient concerns◦interpersonal problems◦family caregiving
- Natural or human caused disaster
- External changes
- Affects one or more
- ◦Purpose of life◦
- Responsibilities ◦
Physical S/S of Stress
- CV: tightness of chest, ↑ Heart rate
- Resp: breathing difficulty & rate
- Neuroendocrine: Headache, fatigue, insomnia
- GI: change in appetite & weight, GI bleeding
- GU: Urinary frequency
- MS: backaches, slumped postures
- Reproductive: amenorrhea, impotency, loss of libido
- Immune: frequent colds
Emotional S/S of stress
- Disruption of logical thinking
- Blaming Others
- Lack of motivation
- Crying tendencies
- Lack of interest
Behavioral S/S of stress
- Decreased involvement with others
- ↑ or ↓ food intake
- ↑ smoking or alcohol intake
- Excessive humor or silence
- No exercise
- Overvigilance to environment
Cognitive S/S of Stress
- Poor concentration
- Inattention to detail
- Decreased creativity
- Memory problems
Dependent on the age at which you experience stress. School age, adolescence, early child hood. ex-getting married, buying a house, starting middle school. We all experience stress differently and have levels of tolerable stress.
Maslow's Hierarchy of needs-Loss examples
- Physiologic: amputation, mastectomy, diseases that impair function (COPD)
- Safety: domestic violence, natural disaster, breach in confidentiality
- Love & belonging: change in relationship (birth, marriage, divorce, illness, death), change in role (retirement, empty-nest), change in financial status (bankruptcy, job loss)
- Self-esteem: change in self-perception related to role loss (marriage to widow, worker to retiree)
- Self-actualization: give up on goals or direction
5 stages of grief
Types of grief
- disenfranchised-illegitimate relationship-unable to grieve in a normal way.
- normal-expected emotional & behavioral reactions
- Complicated-difficulty progressing through loss-encompasses- Chronic, delayed, exaggerated, and masked.
- chronic:mourning does not decrease
- delayed:does not experience loss right away-but later and is considered unexpected(denial)
- exaggerated: develop deep depression-suicide and alcoholism
- masked: can't see a connection between grief and unwanted behaviors-drinking more, but can't see it's because of what caused the grief.
ego defense mechanisms
- dissasociation-compartmentalized memories
- regression-to a lower state
- compensation-poor communication-focuses on what they're good at to hide-poor communication.
- displacement- projecting anger at nurse
- denial-refusal to discuss prognosis
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