HA PRELIMS WEEK 4

DEVELOPMENTAL ASSESSMENT

-            It is a critical component of the holistic health assessment. It determines if a client is meeting the expected psychosocial, cognitive, and moral milestones for their age, which influences their health behavior and coping mechanisms.

PSYCHOSEXUAL DEVELOPMENT

-            Theorist: Sigmund Freud

STAGE	KEY DEVELOPMENTS
Oral (0-1.5 years)	The infant derives pleasure from the mouth (sucking, eating, biting). The id (instincts) controls this stage.
Anal (1.5-3 years)	Pleasure focuses on elimination (bowel movements). The ego (reality) begins to develop as the child learns to control bodily functions (expel or retain feces)
Phallic (3-6 years)	Pleasure centers on the genital region. Curiosity about reproduction arises. The superego (conscience) emerges through interaction with parents. Oedipal (males) and Electra (females) complexes appears.
Latency (6-11 years)	Sexual urges go dormant (abeyance). Energy is redirected into school, hobbies, sports, and same-sex friendships. Defense mechanism appears.
Genital (Adolescence)	Puberty reawakens sexual impulses. The individual moves toward heterosexual attachments outside the family, leading to romantic relationships and potential marriage/parenting.

ORAL

The infant derives pleasure from the mouth (sucking, eating, biting).

The id (instincts) controls this stage.

ANAL

Pleasure focuses on elimination (bowel movements).

The ego (reality) begins to develop as the child learns to control bodily functions (expel or retain feces)

PHALLIC

Pleasure centers on the genital region. Curiosity about reproduction arises.

The superego (conscience) emerges through interaction with parents.

Oedipal (males) and Electra (females) complexes appears.

LATENCY

Sexual urges go dormant (abeyance).

Energy is redirected into school, hobbies, sports, and same-sex friendships.

Defense mechanism appears.

GENITAL

Puberty reawakens sexual impulses.

The individual moves toward heterosexual attachments outside the family, leading to romantic relationships and potential marriage/parenting.

PSYCHOSOCIAL DEVELOPMENT

-            Theorist: Erik Erikson (1902-1994)

-            Eight Stages of ______. Development occurs throughout the lifespan.

-            Each stage presents a major psychosocial crisis.

-            Resolution of the crisis is necessary to develop a healthy personality and progress successfully to the next stage.

STAGE	CRISIS	KEY DEVELOPMENT
Infant (0–1.5 yrs)	Trust vs. Mistrust	Developing a sense of security and trust in the caregiver and environment
Toddler (1.5–3 yrs)	Autonomy vs. Shame	Learning self-control, walking, feeding self, and striving for independence
Preschooler (3–6 yrs)	Initiative vs. Guilt	Exploring the environment, starting tasks, and developing a sense of purpose
School-Age (6–12 yrs)	Industry vs. Inferiority	Developing social skills and pride in accomplishments (schoolwork, hobbies)
Adolescent (12–20 yrs)	Identity vs. Role Confusion	Finding a sense of self and developing personal values and life goals
Young Adult (20–35 yrs)	Intimacy vs. Isolation	Forming deep, committed, loving relationships (not necessarily romantic)
Middle Adult (35–65 yrs)	Generativity vs. Stagnation	Leaving a legacy, contributing to society through career, family, and mentorship
Older Adult (65+ yrs)	Ego Integrity vs. Despair	Reviewing life accomplishments; feeling satisfaction vs. regret

TRUST VS MISTRUST

Infant (0–1.5 yrs)

Developing a sense of security and trust in the caregiver and environment

AUTONOMY VS SHAME

Toddler (1.5–3 yrs)

Learning self-control, walking, feeding self, and striving for independence

INITIATIVE VS GUILT

Preschooler (3–6 yrs)

Exploring the environment, starting tasks, and developing a sense of purpose

INDUSTRY VS INFERIORITY

School-Age (6–12 yrs)

Developing social skills and pride in accomplishments (schoolwork, hobbies)

IDENTITY VS ROLE CONFUSION

Adolescent (12–20 yrs)

Finding a sense of self and developing personal values and life goals

INTIMACY VS ISOLATION

Young Adult (20–35 yrs)

Forming deep, committed, loving relationships (not necessarily romantic)

GENERATIVITY VS STAGNATION

Middle Adult (35–65 yrs)

Leaving a legacy, contributing to society through career, family, and mentorship

EGO INTEGRITY VS DESPAIR

Older Adult (65+ yrs)

Reviewing life accomplishments; feeling satisfaction vs. regret

COGNITIVE DEVELOPMENT

-            Theorist: Jean Piaget (1896-1980)

-            It’s focused on how a person thinks, reasons, and perceives the world.

-            Children actively construct knowledge through exploration.

-            Assessment Focus: Assessing the client's ability to understand their illness and follow treatment plans based on their cognitive level.

-            Cognitive growth occurs in 4 distinct stages.

STAGE	CHARACTERISTICS	ASSESSMENT
Sensorimotor (0–2 yrs)	Learns through sensory stimuli and motor activity; develops object permanence	Reflexes; exploration by mouth
Preoperational (2–7 yrs)	Symbolic thinking; egocentric (cannot see other views); magical thinking	Symbolic play; language skills
Concrete Operational (7–11 yrs)	Logical thinking about concrete events; conservation (mass/volume)	Ability to solve logical problems
Formal Operational (11+ yrs)	Abstract thought; scientific reasoning; complex problem solving	Abstract reasoning (e.g., interpreting proverbs)

SENSORIMOTOR

(0–2 yrs)

Learns through sensory stimuli and motor activity; develops object permanence

Reflexes; exploration by mouth

PREOPERATIONAL

(2–7 yrs)

Symbolic thinking; egocentric (cannot see other views); magical thinking

Symbolic play; language skills

CONCRETE OPERATIONAL

(7–11 yrs)

Logical thinking about concrete events; conservation (mass/volume)

Ability to solve logical problems

FORMAL OPERATIONAL

(11+ yrs)

Abstract thought; scientific reasoning; complex problem solving

Abstract reasoning (e.g., interpreting proverbs)

MORAL DEVELOPMENT

-            Theorist: Lawrence Kohlberg (1827-1919)

-            Its focus is on conscience and determination of right and wrong.

-            He built upon Piaget’s work, detailing 3 main levels of moral reasoning.

STAGE	CHARACTERISTICS
Preconventional	External Rules: Focused on punishment and reward.
Conventional	Social Rules: Focused on social approval and maintaining social order.
Postconventional	Internal Principles: Focused on abstract reasoning, universal principles of justice, and individual conscience.

PRECONVENTIONAL

External Rules: Focused on punishment and reward.

CONVENTIONAL

Social Rules: Focused on social approval and maintaining social order.

POSTCONVENTIONAL

Internal Principles: Focused on abstract reasoning, universal principles of justice, and individual conscience.

NUTRITION

-            The intake of food, considered in relation to the body’s dietary needs.

-            Adequate nutrition is vital for growth, maintenance, and repair of the body.

NUTRITIONAL STATUS

-            The degree of balance between nutritional intake (food/fluids) and nutritional requirements (metabolism/activity).

MALNUTRITION

-            Can be undernutrition (insufficient calorie or nutrient intake) or overnutrition (excessive intake, leading to obesity or toxicity).

SUBJECTIVE DATA: DEITARY ASSESSMENT

-            Purpose: To gather data on the client’s actual intake, habits, and preferences.

METHOD	DESCRIPTION	PROS (+) & CONS (-)
24-Hour Recall	Lists everything eaten and drunk in the past 24 hours	(+) Easiest and fastest (-) Relies on memory; may not reflect typical intake
Food Diary	Records everything eaten for 3–7 days (including weekends)	(+) Most accurate for typical intake (-) Time-consuming; requires client commitment
Food Frequency Questionnaire	Determines how often specific foods are eaten (e.g., monthly)	(+) Identifies dietary patterns (e.g., sodium intake) (-) Poor for exact caloric intake

24 HOUR RECALL

Lists everything eaten and drunk in the past 24 hours

(+) Easiest and fastest (-) Relies on memory; may not reflect typical intake

FOOD DIARY

Records everything eaten for 3–7 days (including weekends)

(+) Most accurate for typical intake (-) Time-consuming; requires client commitment

FOOD FREQUENCY QUESTIONNAIRE

Determines how often specific foods are eaten (e.g., monthly)

(+) Identifies dietary patterns (e.g., sodium intake) (-) Poor for exact caloric intake

OBJECTIVE DATA: ANTHROPOMETRIC MEASUREMENTS

-            These are body measurements used to determine growth, body percentage, and muscle mass.

1. Body Mass Index

2. Regional Measurements

   1. Waist Circumference

      1. Wait-To-Hip Ratio

BODY MASS INDEX

-            BMI is the calculation of weight-for height and is used to estimate body fat.

-            Computation:

o   BMI = Weight in kg/Height in meters²

-            Classification Table:

BMI RANGE	STATUS
< 18.5	Underweight
18.5 – 24.9	Normal Weight
25.0 – 29.9	Overweight
30.0 – 39.9	Obesity (Class I & II)
> 40.0	Extreme Obesity

WAIST CIRCUMFERENCE

Used to assess visceral fat, which is strongly linked to cardiovascular risk and diabetes.

-             Females: > 35 inches -             Males: > 40 inches

WAIST TO HIP RATIO

WHR = Waist Circumference/Hip Circumference

-             Females: > 0.80 -             Males: > 0.90

BIOCHEMICAL ASSESSMENT

-            provide objective data on visceral protein status, immune function, and micronutrient status.

LAB TEST	NORMAL RANGE	NUTRITIONAL SIGNIFICANCE
Serum Albumin	3.5 – 5.5 g/dL	Indicates long-term protein status. Low levels suggest chronic malnutrition or liver disease.
Prealbumin	15 – 36 mg/dL	Reflects short-term protein status. Useful for monitoring recent nutritional changes.
Hemoglobin (Hgb)	Male: 13 – 18 g/dL Female: 12 – 16 g/dL	Low levels indicate anemia (iron or vitamin B12 deficiency).
Fasting Glucose	70 – 105 mg/dL	Assesses risk for diabetes and hyperglycemia related to dietary intake.

SERUM ALBUMIN

3.5 – 5.5 g/dL

Indicates long-term protein status. Low levels suggest chronic malnutrition or liver disease.

PREALBUMIN

15 – 36 mg/dL

Reflects short-term protein status. Useful for monitoring recent nutritional changes.

HEMOGLOBIN

Male: 13 – 18 g/dL Female: 12 – 16 g/dL

Low levels indicate anemia (iron or vitamin B12 deficiency).

FASTING GLUCOSE

70 – 105 mg/dL

Assesses risk for diabetes and hyperglycemia related to dietary intake.

OBTAIN HISTORY
ANTROPOMETRICS
PHYSICAL EXAM
BIOCHEMICAL DATA
HEALTH PROMOTION

Steps on How to Assess Nutrition