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Nursing Across the Lifespan - Conception to Young Adult

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by

Kathy Mixson

on 15 October 2012

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Transcript of Nursing Across the Lifespan - Conception to Young Adult

Nursing Across the
Lifespan
Conception to
Young Adult In which stage of prenatal development is
the fetus most vulnerable to factors
causing congenital anomalies?
a. preembryonic
b. embryonic
c. fetal
d. neonatal Physical Characteristics
of the Normal Neonate Physiologic Development of
the Neonate Brain grows to half adult size

Temperature stabilizes

Motor abililites develope

Eyes focus and follow

Heart doubles in size

Deciduous teeth

Triple weight by 1 year Health Care Issues for the Infant Accidental injuries Colic

SIDS Failure to thrive

Child maltreatment Physiologic Development
of the Toddler Physiologic Development
of the Preschooler Brain reaches 90=95% adult size, nersous system mature at 12
Motor abilities mature, writing in script
Full set adult teeth, x 2nd and 3rd molars
Sexual organs grow but dormant
Height increases 2-3 inches and weight 3-6 pounds per year Physiologic Development of
the School Age Child Full adult size

Primay and secondary sex characteristics
Prepubescence - reporductive organs not functional
Pubescence - ova and sperm produces
Post pubescence - mature functioning Physiologic Development
of Adolescents Injuries
Substance abuse
Suicide, homicide
Pregnancy
Nutritional problems
Developmental and situational stressors Health Issues for
Adolescents Head close to adult size by 6 years
Body is leaner and more coordinated
Motor abilities jumping, skipping. throwing ball, printing letters and numbers
Full set 20 diciduous teeth
Weight 45 pounds. Questions? Comments?
Concerns? Preembryonic stage—conception to 3rd week
Three distinct cell layers—endoderm, mesoderm,
and ectoderm
Embryonic stage—4th to 8th week
All basic organs established
Fetal stage—9th week to birth
Body organs and systems continue to grow Three Stages of the Fetus Objectives
Discuss physiological differences across the lifespan
Discuss psychological differences across the lifespan
Discuss the effects of culture across the lifespan
Discuss how nursing approach varies depending on developmental level
Discuss communication techniques used across the lifespan.
Discuss legal and ethical considerations
Discuss all chapter objectives b. The embryonic stage from the 4th to 8th week is one of rapid growth and change with differentiation of cell layers. Reflexes develop

Body temp responsive to environment

Urine and stool elimination

Active crying and quiet alert state Psychological Characteristics Oral gratification
Trust
Developmental tasks Special considerations
Attachment and bonding
Play
Temperment What is the most essential role of the nurse in promoting the health of the infant? Rapid brain growth, Increased bone and muscle growth
Increased fine motor skills. Turns pages in book, draws stick figures
Walks, runs, kicks, climbs, ride tricycle, drinks from cup
Bladder control during day, sometimes at night
Four times birth weight Cognitive
Last 2 senseriomotor stages
Self as separate from other
Beginnning perception of body image
Gender identity
Language development short
sentences Psychosocial
Freud - anal
Aturonomy vs shame and doubt
Dev tasks - elimination control, language, sex differences, form concepts, distinguish right from wrong Solitary or parallel play Cognitive
Egocentrism decreases as socialism increases
Play more related to real life events
Constant questions and increased reasoning
Language more elaborate According to Kohlberg, the preschooler in the preconventional stage of moral development, what is the focus that dominates the behavior of the preschooler?
a. obeying rules to avoid punishment or receive rewards
b. developeing peer relationships for status, skills and personhood
c. beginning to form concepts and distinguis right from wrong
d. stabilizing self concept with peer groups having the greatest influence Psychosocial
Freud - phallic
Initiative vs guilt, conscience development
Dev tasks - sex differences and modesty, social and physical reality, reading readiness
Imaginative play, fears Psychosocial Development
Freud - latency
Industry vs inferiority, peer relationships
Dev tasks- learning games, social roles, reading, writing calculations, independence, morality, values Health Issues
Obesity
Accidents
Communicable disorders
Chronic illness
ADHD
LD
Eneuresis Cognitive and Psychosocial Formal operations
Deductive and abstract
reasoning
Long term goals Freud - genital
Identity vs role confusion
Peer group most important
Morals and values internalized Drug Therapy During Pregnancy Pregnancy related conditions -nausea,, constipation, preeclampsia
Chronic disorders - HTN DM, epilepsy
Infectious diseases or cancer
Drugs of abuse, alcohol, cocaine, heroin Physiologic changes during pregnancy impact drug disposition and dosing
Renal blood flow
Bowel motility Placental drug transfer
Some more easily than others
Adverse effects mother and fetus
Heparin
Prostaglandins
Pain releivers Teratogenesis Structural
NeurobehavioralMetabolic Identifiction difficult
Minimize risk
Respond to exposure Related to stages of fetal development Drug Therapy and
Breest Feeding Drugs are excreted in breast milk
Drugs do affect baby Minimize risks
Take after breastfeeding
Avoid drugs w long half life
Choose drugs excluded from milk
Avoid known hazardous drugs Drug Therapy in Pediatric Patients All patients under
16 years Respond differently
than adults More sensitive
Greater differentiation Organ system immaturity

Increased risk adverse
reactions Different ages -different challenges
Ongoing G & D
Most never tested
with pediatrics Ineffective
Unanticipated side effects
Differnet dosages Pharmacokinetics Absorption Disrtribution
Blood-brain barrier Hepatic Metabolism Renal Excretion Concentration
Duration/intensity
of response Elevated drug levels
Delayed elimination
Immature organs Age Related Effects Growth supression
Teeth discoleration
Kernicterus Promoting Adherence Education
Size and timing
Route and Techniques
Demonstration
Storage
Written instructions Ethics Committee You see a child at school that has many large red bruised looking markings all over his body. The child states that mother was "coining" him as treatment for a fever he had. He says that the areas are very painful. Should you report this to Child Protective Services?
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