Fundamentals Unit Exam 4

Growth

Increase in body size

Changes in body cell structure, function, and complexity

Development

Pattern in order

Changes in structure, feelings/thoughts and behaviors

Results from maturation and learning

Spheres of growth

Physical

Cognitive

Psychosocial

Moral

Spiritual

Genomics

Study of an organism’s entire set of DNA

Epigenomics

Study of the changes that occur in organisms due to modification of gene expression and heritability

Freud

Psychosexual

Piaget

Cogntive

Erikson

Psychosocial

Havighurst

Developmental

Freud’s theory

Unconscious mind contains memories, fears

• Id: Part of self-gratification

• Ego: Conscious mediator between id and reality

• Superego: Conscience

Erikson’s theory

Expanded on Freud to include cultural/social influences

Four concepts:

• Stages of development

• Developmental goals/tasks

• Psychosocial crises

• Process of coping

Gould

Central theme if adult years as transformation

Levinson

Evolution of individual life structures

Kohlberg

Closely follows Piaget

Gilligan

Looks at morality from female viewpoint

Fowler

Spiritual identity

Regression

Anticipate possible regression during difficult periods/times of crises

• Crying

• Selective mutism

• Thumb-sucking

• Bed wetting

Embryonic stage

4-8 weeks

Rapid growth and change

All basic organ established

Neonate (0-28 days)

Reflexes present (Moro, grasp, sucking)

Recognizes voices/faces

Jerky movements

Erikson: Trust vs. mistrust

Neonate considerations

Traumatic birth will affect bonding and feeding

Premature/c-section more prone to respiratory distress syndrome

Infant (1mo-1y)

Triple birth weigh (~22lb)

Pincer grasps, roll, sit, expressive + receptive language

Erikson: Trust vs. mistrust still

Piaget: Object permanence

Freud: Oral

Infant considerations

PLAY

Attachment and bonding (reciprocal relationships crucial)

Concerns:

• Colic

• Failure to thrive

• SIDS

• Maltreatment

Toddler (1-3y)

Walking, running, climbing

Toilet training! + use of utensils

Independence! → “I’ll do it myself”

PLAY and READING exposure

Erikson: Autonomy vs. shame and doubt

Freud: Anol

Preschool (3-6y)

Imagination + pretend play

“Why?” stage

School readiness (ABC, counting, rhyming)

Egocentrism decreases

Freud: Phallic

School age (6-12yo)

Logical thinking

Teamwork, friendship, problem-solving

Classifications, awareness of others

Strong identification with own gender

School age considerations

Obesity

Accidents/communicable conditions

Learning/behavioral disorders (ex. dyslexia, ADHD)

Enuresis

Adolescent (12-18y)

Identity formation

Transition child→adult

Risk taking (brain not fully developed!)

Secondary development (puberty)

Can set long-term goals

Egocentrism returns

Erikson: Identity vs. confusion

Piaget: Formal operational (abstract ideas)

Puberty in girls/boys

Girls: 9-13yo

Boys: 10-14yo

3 stages of pubery

Prepubescence

Pubescence

Postpubescence

Prepubescence

Sec. sex characteristics begin

Rep. organs don’t function yet

Pubescence

Ova/sperm begin to be produced

Postpubescence

Full functioning reproductive development

Body adult maturity

Young adult

Creative, objective, realistic

Independence

Erikson: Identity vs. role confusion

Freud: Genital

Levinson: Early adult transition

Gould: Transformation

Young adult considerations

Suicide

Substance abuse

STI/pregnancy

Situational stressors

Mental health concerns

Stochastic theory of aging

Wear-and-tear

Free radical theory (released oxygen causes aging)

Cross-linkage (glucose molecules attach to proteins cause malfunction)

Middle adult development

Increased motivation to learn

Increased personal freedom

Economic stability

Social relationships

Middle adult

Erikson: Generativity vs. stagnation

Middle adulthood health issues

cardiovascular/cerebrovascular disease

Kidney/liver disease

Obesity/alcoholism

Screenings, examinations, immunizations

Older adults considerations

Falls

Dementia

Polypharmacy

Older adult

Erikson: Ego integrity vs. despair and disgust

Gerotranscendence

Transformation from materialistic/rational view to more cosmic, spiritual and transcendent vision

Older adult assessment tool

S: sleep disorders

P: problems with eating/feeding

I: incontinence

C: Confusion

E: Evidence of falls

S: Skin breakdown

Estrogen

Reproductive system regulation

Oocyte maturation

Bone health!

Secondary sex characteristics

Progesterone

Ovarian menstrual cycle regulation w/ estrogen

Pregnancy

Usually the first sign of puberty

Breast development

Menarche

First menstrual period

Follicular phase (day 4-14)

Mature ovum is produced

Ovulation (day 14)

Ovum enters the fallopian tube

Luteal (day 15-18)

Uterus prepared for fertilized ovum

Testosterone

Muscle growth

Nervous/skeletal tissue

Deep voice

Male characteristics

LGBTQ Population concerns

2-3x likely to commit suicide

More likely to be homeless

Less likely to have health insurance

Highest rate of tobacco, alcohol, drug use

Age-related sexual function changes

Medications can impact function

Illness affects desire

Loss of partner

Concern about heart strain

Sexual assessment

Sexual history

Reproductive history

BETTER model

BETTER model

B: Bring up topic

E: Explain importance

T: Tell dysfunction is normal

T: Timing

E: Educate

R: Record assessment

Dyspareunia

Painful sexual intercourse

Vaginismus

Vaginal opening is constricted to not allow penetration

Vulvodynia

Chronic vulvar dysfunction/burning/stinging

Makes sexual intercourse difficult

Sexual harassment

Unwanted behavior based on a person’s sex/gender

SH response with clients

Be assertive, not aggressive

Set liits

Enforce the limits

Report to supervisor

SH response coworkers

Confront

Document

Report to supervisor

File grievance if continues

Legal counsel if needed

Rest

Decreased state of activity, feeling of being refreshed

Sleep

Rest for both body and mind

Consciousness is altered and bodily functions partially suspended

Why is sleep important?

Rest, restore, repair

Metabolism regulation

Improves learning/adaptation

Reduce stress and anxiety

Brain areas used in sleep

Medulla

Pons

Midbrain

Hypothalamus

Circadian adjustement

Shift 1-2 hours MAX

Tales longer than 1 week to adjust to a circadian change

Light is main regulator (every 24hrs)

Melatonin

Hormone secreted by pineal gland

Signals time to sleep

Light suppresses melatonin

Sleep cycle

Every 90-110 minutes

NREM stage 1

Light sleep → Easily awakened

Temp. drops

Rolling eyes

Myoclonus jerk

• Twitching when falling asleep

NREM stage 2

Deeper sleep

Brain waves slow

MOST of sleep (50-55%)

NREM stage 3

Hard to wake

Deep sleep begins

10% of sleep

NREM stage 4

DEEPEST sleep (delta sleep)

Decreased HR, BP, RR

Metabolic rate decreases

Body healing!!

REM sleep

Brain ON, body OFF

Dreaming

Everything increases

Memory, learning, adaptation

Newborn sleep requirements

14-17hrs

Toddler sleep requirements

11-14hrs

Pre-schoolers sleep requirements

10-13hrs

School-age sleep requirements

9-11hrs

Adolescents sleep requirements

8-10hrs

Older adults sleep

Will typically sleep more but lower quality due to comorbidities

Lifestyle sleep changes

Routine changes

Night shift

Illness

Exercise 2hrs before bed

Environmental sleep factors

Noise

Light

Temperature

Bedding

Partner

Foods that inhibit sleep

High saturated fats

DO NOT eat 3 hrs before bed

Food that promote sleep

Tryptophan + adenoside = serotonin

Carbohydrates

Alcohol effect on sleep

Helps fall asleep BUT decreases sleep quality

Sleep deprivation

Cumulative effect of not getting enough sleep

Sleep deprivation effects

Sleepy

Dopey

Grumpy

Sneezy

Sleep deprivation health risks

Obesity

Depression

Diabetes

Heart disease

Insomnia

Difficulty falling/staying asleep

Most common

Acute: <3mo

Chronic: >3 nights/week, >3mo

Chronic fatigue syndrome

>6mo

Not caused by disorder

Interferes with daily activities

Must have 4/8 of qualifiers

Narcolepsy

Excessive daytime sleepiness

Cataplexy

Sleep paralysis

Cataplexy

Sudden, involuntary loss of muscle tone

Sleep apnea

Breathing stops during sleep

Collapse of upper airway

Increased, irregular BP

Requires sleep study, CPAP machine

Restless Leg Syndrome

Involuntary leg movement at rest

Bilateral

Unknown cause

Renal disease, OA, RA, pregnancy more at risk

Massage and stretch before bed can help

Parasomnias

Episodes/behaviors

Ex. Sleepwalking, night terrors, nocturnal enuresis, sleep-related eating disorders

Epwoth sleepiness scale

Measures daytime sleepiness

Higher the score, higher chance of dozing off

Newborn sleep considerations

Must sleep on back

No pillows, stuffs, blankets

No cosleeping

Toddler sleeping implications

Routine bedtime

Safety with transitioning to bed

Kids sleep implications

Nightmares are normal

School may interrupt sleep pattern

Teenagers sleep implications

use of tech decreases sleep

Encourage regular bedtime

Adult sleep implications

Avoid sleep meds long term

Encourage lifestyle changes

Older adults sleep implications

Safe environment!

Encourage discussions with provider if sleep concerns