HSci305

Young Adulthood

(Drawn from primarily Murray & Zentner text)

Stages

n Becoming adult (23-28)

n Catch 30 (29-34)

n Midlife re-examination (35-43)

Young Adulthood

n Transition: adolescence to adulthood

n Choosing vocation

n Getting appropriate education

n Establishing a residence

n Formulating ideas about selecting a mate or close relationship

Family Relationships

n Independence from family

n Delayed by education or lack of job or parents meeting own needs

n Responsibilities of young adult when move in with parents (pp 600-601, Murray & Zentner, 2001)

n Cultural considerations

Family developmental tasks

n Rearranging home

n Re-establishing husband-wife companionship

n Maintaining communication with young adult

n Redistributing responsibilities

n Meeting expenses of releasing children

n Widen family circle

n Reconcile conflicting loyalties & philosophies

(p. 601, Murray & Zentner, 2001)

Moral spiritual development

n Kohlberg:

n Preconventional,

n Conventional,

n Postconventional

versus

n Gilligan: Individual survival,Self-sacrifice, Nonviolence (Tables 5-11 & 5-12, pp. 252-3, Murray & Zentner, 2001)

n Spiritual maturity

n May return to childhood religion or build a new version of it

n Continual growth in pursuing a purpose and meaning in life, non-conditional relationships, hope, forgiveness; values that transcend the physical and temporal boundaries guide actions consistently

Physical characteristics:

n Weight & height

n Musculoskeletal

n Skin

n CV system

n Respiratory system

n GI system

n Neuro system

n Endocrine system - BMR max at 30 with slow fall of thyroid hormones & BMR

Intimacy

n “Intimacy is reaching out and using the self to form a commitment to and an intense, lasting relationship with another person or even a cause, an institution, or creative effort.” (Murray & Zentner, 2001, p.642)

Sexuality

n “Sexual intimacy without a sense of commitment and love, responsibility, and care for the other means using another to meet one’s needs, taking the other as an object rather than as a person.” (Murray & Zentner, 1997, p.565)

Sexuality & Sexual Development

n Sexual maturity
a. Optimum childbearing capacity 20-30
b. Sexual identity & sex role

n Sexuality education: (see summary of research p. 559)

n Sexuality, Sex role, Sex values (p. 559)

n Human sexual response: excitement, plateau, orgasm, resolution

n Premenstrual phenomena

n Ovulation

n Female circumcision

n Personal attitudes

n Sexual history

Nutritional needs -

n Setting the stage for middle and old adulthood

n Normal nutrition

n Nutrition assessment

n Nutrition-disease relationships

n Obesity

n Vegetarianism: balance of amino acids; B12 if no milk or eggs

n Nutrition education: Food pyramids

Biological rhythms

Self-sustaining, repetitive, rhythmic patterns found in plants, animals, & persons

•Circadian rhythm

n Circadian rhythm is endogenous rhythm over 20-28 hours

n Temperature drops about 2 degrees by 10p then rises during morning

n ACTH rise in early morning then drop by evening

n R/t circadian rhythm: accidents, depression, ulcers/allergies aggravated

n Nursing assessment & intervention: Day or night person, Chronopharmacology, Vital signs routines

n Work schedules : Peak performance in planning your work

n Chronopharmacology

Sleep Patterns

n Reticular activating system (RAS) for wakefulness

n Stages: 70-90 min. cycles

Rest & sleep

n Stages: 70-90 min. cycles

n NREM I - transition, drowsy, think awake, easily aroused

n NREMII 40-50% of sleep; more relaxed but still easily wakened

n NREM III more relaxed; VS and metabolism lowered to basal rates

n NREM IV deep about 40 min. after NREM I; seldom moves; difficult to arouse; responds slowly if wakened, physiologic measure below normal; sleep walking or enuresis may occur

n REM dreaming (described p. 626)

Variations in sleep pattern

n REM sleep 20-25% throughout adulthood

n Older adult: arteriosclerosis= 20% less sleep; older women patterns change 10 yrs later than older men's

n REM - peptic ulcers, convulsions, MI;

n ETOH deprives of REM

n Sedatives, antidepressants, amphetamines decrease REM; with sedatives may return to REM and then when withdrawn REM greatly decreased

•Sleep deprivation

n After 48 hours body produces LSD like substance; after 4 days no ATP

n Frequent awakening requires restart of sleep cycle

Sleep disturbances

n Types

n Sleep onset

n Sleep maintenance

n Terminal insomnia

n Caused by

n Disturbed circadian rhythm

n Physical discomfort/symptoms

n Environmental disturbances

n Emotional stress

n Stimulant drugs

n Prevention & Rx (p. 628-9)

Physical fitness--exercise

n 1. Max Heart Rate = 220 - age; during exercise HR should be 60-80% of that level

n Improved psychosocial & physical health

n Sex differences

n Men greater upper body strength and heart & lungs 10% larger

n Women: better heat and cold tolerance, stored fat reserves, lighter

n Physical care: foot care, incontinence issues, other?

•Psychosocial concepts

n Cognitive development

n Work & leisure activities

n Emotional development

n Adaptive mechanisms: denial & regression or adaptability (think in terms of Aguilera)

n Self-concept & body image development

n Lifestyle options

n Family planning

n Developmental tasks as per 654, M&Z

Cognitive development

n Myelinization & intellectual growth

n Influences on learning (M&Z, p. 633)

n Formal operations stage (Piaget)

n Problem-solving

n Problem-finding - "characterized by creative thought in the form of discovered problems, the formation of generic problems, the raising of general questions from ill-defined problems, use of intuition and hunches, and the development of significant scientific though" (M&Z, p. 584)

n Teaching the adult; principles of learning (p. 636)

Work & Leisure

n Work options & attitudes:

n Balancing work & families

n Leisure: "freedom from obligations and formal duties of paid work and opportunity to pursue, at one's own pace, mental nourishment, enlivenment, pleasure, and relief from fatigue of work" (M&Z, 639)

“The unhappy worker will not automatically becomethe happy player. Challenging work makes leisure a time of refreshment. Successful leisure prepares the worker for more challenge.” (Murray & Zentner, 1997, p. 639)

Emotional Development

n Developmental crisis (Erikson): Intimacy vs. Isolation

n Love & marriage

Developmental crisis

n Erikson intimacy vs. isolation

n Intimacy "Reaching out and using the self to form a commitment to and an intense, lasting relationship with another person or even a cause, an institution, or a creative effort" (M&Z, 592)

n Beyond sexuality; more of a spiritual growth experience

n Isolation or self-absorption "inability to be intimate, spontaneous or close with another, thus becoming withdraw, lonely, and conceited and behaving in a stereotyped manner" (M&Z, 595)

Love & Marriage

n Joining of families interpreted by culture

n Tasks:
-Establish as pair in own & others eyes
-Working through intimate communications allowing for exchange of feelings & confidences
-Planning together on a stable relationship and how life should be lived
-Giving positive reinforcement and affection to each other
-Dealing with crisis positively

Adaptive mechanisms: denial & regression or adaptability

Self-concept & body image development

n Contributing influences

n Self-knowledge

n Body image change in illness

n Adult undergoing body changes
a. Assessment p. 649, M&Z
b. Intervention, p. 649

Lifestyle options

n Base lifestyle around

n Work

n Youth culture

n Leisure

n Substances

n Marriage & family

n Singlehood

Family Planning

n Reasons for childbearing

n Developmental tasks during expectancy

n Father's response:

n Announcement

n Moratorium

n Focusing

n Mother's response

n Pregnancy validation

n Fetal embodiment

n Fetal distinction

n Role transition

n Nursing roles

n Special parenthood issues

n Infertility = inability to achieve pregnancy after 1 year of regular, unprotected intercourse or the inability to carry a pregnancy to term

HSci305

Young Adulthood

Stages

n Becoming adult (23-28)

n Catch 30 (29-34)

n Midlife re-examination (35-43)

Young Adulthood

n Transition: adolescence to adulthood

n Choosing vocation

n Getting appropriate education

n Establishing a residence

n Formulating ideas about selecting a mate or close relationship

Family Relationships

n Independence from family

n Delayed by education or lack of job or parents meeting own needs

n Responsibilities of young adult when move in with parents (pp 600-601, Murray & Zentner, 2001)

n Cultural considerations

Family developmental tasks

n Rearranging home

n Re-establishing husband-wife companionship

n Maintaining communication with young adult

n Redistributing responsibilities

n Meeting expenses of releasing children

n Widen family circle

n Reconcile conflicting loyalties & philosophies

(p. 601, Murray & Zentner, 2001)

Moral spiritual development

n Kohlberg:

n Preconventional,

n Conventional,

n Postconventional

versus

n Gilligan: Individual survival,Self-sacrifice, Nonviolence (Tables 5-11 & 5-12, pp. 252-3, Murray & Zentner, 2001)

n Spiritual maturity

n May return to childhood religion or build a new version of it

n Continual growth in pursuing a purpose and meaning in life, non-conditional relationships, hope, forgiveness; values that transcend the physical and temporal boundaries guide actions consistently

Physical characteristics:

n Weight & height

n Musculoskeletal

n Skin

n CV system

n Respiratory system

n GI system

n Neuro system

n Endocrine system - BMR max at 30 with slow fall of thyroid hormones & BMR

Intimacy

n “Intimacy is reaching out and using the self to form a commitment to and an intense, lasting relationship with another person or even a cause, an institution, or creative effort.” (Murray & Zentner, 2001, p.642)

Sexuality

n “Sexual intimacy without a sense of commitment and love, responsibility, and care for the other means using another to meet one’s needs, taking the other as an object rather than as a person.” (Murray & Zentner, 1997, p.565)

Sexuality & Sexual Development

n Sexual maturity a. Optimum childbearing capacity 20-30 b. Sexual identity & sex role

n Sexuality education: (see summary of research p. 559)

n Sexuality, Sex role, Sex values (p. 559)

n Human sexual response: excitement, plateau, orgasm, resolution

n Premenstrual phenomena

n Ovulation

n Female circumcision

n Personal attitudes

n Sexual history

Nutritional needs -

n Setting the stage for middle and old adulthood

n Normal nutrition

n Nutrition assessment

n Nutrition-disease relationships

n Obesity

n Vegetarianism: balance of amino acids; B12 if no milk or eggs

n Nutrition education: Food pyramids

Biological rhythms

Self-sustaining, repetitive, rhythmic patterns found in plants, animals, & persons

•Circadian rhythm

n Circadian rhythm is endogenous rhythm over 20-28 hours

n Temperature drops about 2 degrees by 10p then rises during morning

n ACTH rise in early morning then drop by evening

n R/t circadian rhythm: accidents, depression, ulcers/allergies aggravated

n Nursing assessment & intervention: Day or night person, Chronopharmacology, Vital signs routines

n Work schedules : Peak performance in planning your work

n Chronopharmacology

Sleep Patterns

n Reticular activating system (RAS) for wakefulness

n Stages: 70-90 min. cycles

n Sexual maturity
a. Optimum childbearing capacity 20-30
b. Sexual identity & sex role