Young and Middle Adults YOUNG ADULT Physical changes

Young and Middle Adults

YOUNG ADULT • Physical changes • Growth completed by the age of 20 • Tend to ignore physical symptoms • postpone seeking health care.

YOUNG ADULT-COGNITIVE CHANGES • Critical thinking improves • • Formal education & informal life experience improves problem solving • Occupational Direction identified. • Continually learning and adapting to new lifestyles. “Millennial Generation” 3

PSYCHOSOCIAL CHANGES • Many changes • Key concepts: • Self. Perception, maturity and socialization

PSYCHOSOCIAL CHANGES Lifestyle Career Sexuality Childbearing cycle Types of families Parenthood Alternative family structures and parenting Singlehood Emotional health

PSYCHOSOCIAL STRESSORS

HEALTH RISKS Risk factors Family history Personal hygiene habits Violent death and injury Substance abuse Unplanned pregnancies Sexually transmitted infections Environmental or occupational forces

HEALTH CONCERNS Health promotion Psychosocial health Infertility Routine health screening Exercise Pregnant woman and childbearing family

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 and Health Promotion is important.

CHRONIC ILLNESS • Less prevalent • Hypertension, coronary artery disease, accidents, rheumatoid arthritis, AIDS, and cancer • Nursing interventions relate to • sense of identity, establishment of independence, reorganization of relationships, and launching a chosen career.

MIDDLE ADULT • Begins in the mid 30 s and lasts through the late 60 s • “Sandwich Generation” – potential stressor • Physical changes • • Graying hair, wrinkling skin, thickening of waist. Sensory losses May impact self-concept and body image Perimenopause & ED • Cognitive changes • Rare, unless illness or trauma occurs

PSYCHOSOCIAL CHANGES • Expected events • Career transition • May be voluntary or involuntary as demands change. • Sexuality • • Relationships may be re-cultivated when children leave. Stressors with sexuality secondary to physiologic changes. • Family psychosocial events: • • Marital changes- assess grief/loss Singlehood- assess pt. definition of family Family transitions- departure of last child Care of aging parents- potential area of stress. .

HEALTH CONCERNS AND PROMOTION Health promotion and stress reduction Forming positive health habits Obesity Positive health habits Psychosocial health: Anxiety and depression Community health programs

POSITIVE HEALTH HABITS

ACUTE AND RESTORATIVE CARE • Similar to Young Adulthood. • Recovery may take longer • Chronic illnesses affect roles and responsibilities. • Your role in assessment includes determining • • • the coping mechanisms of the patient and family adherence to treatment and rehabilitation regimens the need for community and social services, with appropriate referrals.

SCREENING: HEALTH PROMOTION • Screening is considered secondary prevention because it identifies individuals in early disease states. • Prompt treatment can be initiated • Usually safe, cost-effective and recommended by care providers • Can often prevent substantial morbidities. 16

SCREENING • Women: • • • Pap smear Q 1 -3 years until age 65 or hysterectomy BP Q 2 years Cholesterol if you. . . • Use tobacco, are obese, DM, HTN, heart dx, if someone in your family had an MI before age 50(M) 60(F). • • • Colorectal CA at age 50 Osteoporosis at 65 Mammograms every 2 years after age 50 17

SCREENING • Men: • • Colorectal CA at age 50 Depression if feeling down HTN Q 2 years Diabetes if BP >135/80 AAA if a smoker and between 65 -75 HIV is risk factors present Cholesterol at age 35 • Age 20 if: tobacco, obese, DBM, HTN, heart hx, familial heart disease. 18

REVIEW QUESTIONS With the exception of pregnant women, the young adult has usually completed physical growth by the age of: a) 18 b) 20 c) 25 d) 30 19

The RN is completing an assessment on a 24 y. o. male patient. Following the assessment, the RN notes that his physical and lab findings are WNL. The RN interventions are directed toward activities related to: a) Instructing him to return in 2 years b) instructing him in secondary prevention c) instructing him in health promotion activities d) Implementing primary prevention with vaccines. 20

When determining the amount of information that a patient needs to make decisions about the prescribed course of therapy, many factors affect the patient’s compliance with the regimen, including educational level and socioeconomic factors. Which additional factor affects compliance? a) Gender b) Lifestyle c) Motivation d) Family history 21

A patient is laboring with her first baby, which is coming 2 weeks early. Her husband is in the military and might not get back in time, and both families are unable to be with her during labor. The MD decides to call in which of the following people employed by the birthing area to be a support person to be present during labor? a) RN b) Midwife c) Assistant d) Lay doula 22

A single, young adult female interacts with a group of close friends from college and work. They celebrate birthdays and holidays together. In addition, they help one another through many stressors. She views these individuals as: a) Family b) Siblings c) Substitute parents d) Alternative family structure 23

Sharing eating utensils with a person who has contagious illness increases the risk of illness. This type of health risk arises from: a) Lifestyle b) Community c) Family history d) Personal hygiene habits 24

A 50 Y. O. woman has elevated cholesterol profile values that increase her cardiovascular risk factor. One method to control this risk factor is to identify current diet trends and describe dietary changes to reduce the risk. This nursing activity is a form of: a) Referral b) Counseling c) Health Education d) Stress management techniques 25

A 34 Y. O. female executive has a job with frequent deadlines. She notes that, when the deadlines appear, she has a tendency to eat high-fat, high-carbodyhrate foods. She also explains that she gets frequent headaches and stomach pain during these deadlines. The RN provides a number of options for the executive, and she chooses yoga. In this scenario yoga is used as a(n): a) b) c) d) Outpatient referral Counseling technique Health promotion activity Stress-management technique. 26

A 50 Y. O. male patient is seen in the clinic. He tells the RN that he has recently lost his job and his wife of 26 years has asked for a divorce. He has a flat affect. Family history reveals that his father committed suicide at the age of 53. The RN should assess for the following: a) Cardiovascular disease b) Depression c) Sexually transmitted infection d) Iron deficiency anemia 27

Middle-age adults frequently find themselves trying to balance responsibilities related to employment, family life, care of children and care of aging parents. People finding themselves in this situation are frequently referred to as being a part of: a) The sandwich generation b) millennial generation c) Generation X d) Generation Y 28

Intimate partner violence (IPV) is linked to which of the following factors? (select all that apply) a) Alcohol abuse b) Pregnancy c) Unemployment d) Drug use 29

Sexually transmitted infections (STIs) continue to be a major health problem in young adults. Men ages 20 -24 have the highest rate of which STI? a) Chlamydia b) Syphilis c) Gonorrhea d) Herpes zoster 30

Formation of positive health habits may prevent the development of chronic illness later in life. Which of the following are examples of positive health habits? (Select all that apply) a) Routine screening and diagnostic tests b) Unprotected sexual activity c) Regular exercise d) Excess alcohol consumption 31

Chronic illness (eg. , DM, HTN, RA) may affect a person’s roles and responsibilities during middle adulthood. When assessing the knowledge base of both the middle-age patient with a chronic illness and his family, the assessment should include which of the following? (select all that apply) a) The medical course of the illness b) The prognosis for the patient c) Coping mechanisms of the patient and family d) The need for community and social services 32

A 45 Y. O. obese woman tells the RN that she wants to lose weight. After conducting a thorough assessment, the RN concludes that which of the following may be contributing factors to the woman’s obesity (select all that apply)? a) the woman works in an executive position that is very demanding b) The woman works out at the corporate gym at 5 am two morning per week c) The woman says that she has little time to prepare meals that home and eats out at least four nights a week. d) The woman says that she tries to eat “low cholesterol” 33 foods to help lose weight.