Young Adulthood

(Drawn from primarily Murray & Zentner text)


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


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



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)



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

n  Surrogate parent

n  Adoption, incl. by single person

Developmental tasks

per Murray & Zentner, 1997, p. 654


n    Health promotion & protection (incl. immunizations)

n    Common health problems: prevention & rx

n    Spiritual health problems

n    Physical problems

n    Emotional health problems

n    Social health problems


Spiritual Health Problems

n    Lack of meaning or any values higher than the self

n    Alienation from self, others, cosmos


Physical problems


n    Accidents

n    Malignancies

n    Lifestyle & physical illness

n    Biofeedback


Emotional Health Problems

n    Substance abuse

n    Eating disorders

n    Smoking

n    Battered or abused women


Social Health Problems

n    Divorce

n    Abortion

n    Continuing health promotion

n    Continuing adjustments