Model 1B MF

Growth

Quantitative increase in body size or physical structure, such as height, weight, organ size, or body proportions.

Development

An orderly, sequential pattern of changes in physical structure, thought, feelings, skills, function, and behavior across the lifespan.

How are growth and development related?

They are interrelated lifelong processes shaped by both heredity and environment; growth mainly refers to measurable physical change, while development includes functional and behavioral change.

Maturation

The biologically programmed process through which body structures and functions become more advanced and capable.

Differentiation

The process by which initially similar cells, tissues, behaviors, or abilities become specialized and distinct.

Developmental age

The age level at which a person functions physically, cognitively, socially, or emotionally, which may differ from chronological age.

Developmental level

A person's current degree of physical, cognitive, communication, adaptive, and social-emotional functioning.

Developmental milestones

Predictable skills or behaviors that most children achieve within an expected age range, such as walking, speaking, or interacting socially.

Developmental tasks

Skills, behaviors, relationships, and responsibilities normally expected during a particular stage of life.

Developmental delay

Failure to achieve one or more expected milestones within the typical age range.

Developmental arrest

A stopping or halting of developmental progress at a particular level.

Developmental regression

Loss of previously acquired skills or return to earlier behavior, which may occur temporarily during illness, stress, hospitalization, or crisis.

Adaptive development

Development of practical self-care and everyday skills needed to function independently and meet environmental demands.

Cognitive development

Development of thinking, learning, memory, reasoning, problem-solving, and understanding.

Communication development

Development of receptive language, expressive language, speech, nonverbal communication, and the ability to exchange meaning.

Physical development

Changes in body size, proportions, organ function, sensory ability, motor ability, and physical maturation.

Social-emotional development

Development of relationships, emotional expression and regulation, self-concept, attachment, empathy, and social skills.

Gross motor skills

Large-muscle abilities involving posture, balance, and movement, such as sitting, walking, running, and jumping.

Fine motor skills

Small-muscle abilities requiring coordination, especially of the hands and fingers, such as grasping, writing, buttoning, and feeding oneself.

Nature and nurture in development

Development results from the interaction of heredity or genetic potential with environmental experiences and conditions.

Major factors affecting growth and development

Prenatal influences, individual characteristics, caregiver factors, environment, nutrition, and health-illness status.

Examples of prenatal factors affecting development

Maternal nutrition, substance exposure, medications, infection, stress, prenatal care, and complications during pregnancy.

Examples of individual factors affecting development

Genetics, temperament, sex, cognitive ability, physical characteristics, and personal experiences.

Examples of caregiver factors affecting development

Attachment, responsiveness, stimulation, mental health, parenting practices, abuse, neglect, and caregiver knowledge.

Examples of environmental factors affecting development

Housing, safety, pollution, socioeconomic resources, education, culture, opportunities for play, and community support.

How does nutrition affect growth and development?

Adequate nutrients support brain, bone, muscle, and organ growth; deficiency or excess can delay development and cause illness.

How does health-illness status affect development?

Chronic illness, disability, pain, or hospitalization may restrict activity and socialization, interrupt learning, delay milestones, or cause temporary regression.

Erikson's psychosocial theory

A lifespan theory describing eight sequential stages, each with a psychosocial crisis or developmental task that may be resolved successfully or unsuccessfully.

Erikson: Trust vs. Mistrust

Infancy; consistent, responsive care helps the infant develop trust and hope, while inconsistent or neglectful care promotes mistrust.

Age-appropriate nursing care for an infant

Meet needs promptly, use soothing touch and voice, maintain routines, encourage parent presence and bonding, and provide comfort during procedures.

Erikson: Autonomy vs. Shame and Doubt

Toddlerhood; the child develops independence and will by making simple choices and mastering self-care, while excessive criticism or control creates shame and doubt.

Age-appropriate nursing care for a toddler

Offer two acceptable choices, allow safe independence, maintain routines, use simple explanations, and avoid shaming accidents or failed attempts.

Erikson: Initiative vs. Guilt

Preschool years; the child develops purpose by initiating activities, using imagination, and trying new roles, while discouragement can produce guilt.

Age-appropriate nursing care for a preschooler

Encourage play and creativity, offer choices, use simple concrete explanations, allow the child to help, and use dolls or play to demonstrate procedures.

Erikson: Industry vs. Inferiority

School-age years; the child develops competence through learning, completing tasks, and receiving recognition, while repeated failure or criticism promotes inferiority.

Age-appropriate nursing care for a school-age child

Explain procedures, involve the child in achievable tasks, praise accomplishments, support schoolwork and peer contact, and respect growing independence.

Erikson: Identity vs. Role Confusion

Adolescence; the person explores values, roles, relationships, and body changes to develop a stable identity and fidelity.

Age-appropriate nursing care for an adolescent

Provide privacy, respect confidentiality within safety limits, encourage questions and decision-making, allow peer contact, address body image, and give honest risk education.

Erikson: Intimacy vs. Isolation

Young adulthood; the person seeks the ability to form close, committed relationships while maintaining identity; success develops love.

Age-appropriate nursing care for a young adult

Respect privacy and independence, include chosen support persons, address relationships and sexuality, support role responsibilities, and involve the patient in decisions.

Erikson: Generativity vs. Stagnation

Middle adulthood; the person seeks to guide the next generation, contribute to society, and care for others; success develops care.

Age-appropriate nursing care for a middle-aged adult

Support meaningful family, work, caregiving, mentoring, and community roles; promote preventive care and adaptation to physical or role changes.

Erikson: Ego Integrity vs. Despair

Later adulthood; the person reviews life and seeks acceptance, meaning, and wholeness; satisfaction produces wisdom, while regret may produce despair.

Age-appropriate nursing care for an older adult

Encourage life review and reminiscence, recognize accomplishments, promote independence, respect choices, and support adaptation to loss and change.

Why does developmental level matter in nursing?

It affects how patients understand information, communicate, cope, learn, participate in care, and respond to illness and hospitalization.

How should care be planned using developmental age?

Care should be tailored to the individual's developmental age to ensure effective communication and understanding.

Delayed development response

Assess further, compare with expected milestones, discuss findings with the healthcare team, support caregivers, and arrange appropriate referrals such as speech, occupational, physical, or developmental services.

Developmental regression during illness

Recognize it as a possible stress response, accept and support the person without shaming, meet current needs, and encourage gradual return to forward development.

Health

A dynamic state of physical, mental, social, and functional well-being that each person interprets through personal values, beliefs, culture, and experience.

Illness

A person's response to disease, injury, or a change in health that alters well-being or level of functioning; it is a personal experience.

Disease versus illness

Disease is an objective pathologic condition; illness is the person's subjective experience and response to a change in health.

Perceptions of health

Influenced by values, beliefs, culture, family, society, experiences, expectations, and functional ability.

Health-illness continuum

A model viewing health as a constantly changing state along a graduated scale from high-level wellness to death.

Movement on the health-illness continuum

Health behaviors, illness, treatment, recovery, environment, coping, and support can move the person toward greater wellness or greater illness at any time.

Nurse's role on the health-illness continuum

Assess the person's present position, teach and support behavior change, promote self-care and independence, prevent illness, manage chronic conditions, and collaborate to enhance wellness.

Six human dimensions affecting health

Physical, emotional, intellectual, environmental, spiritual, and sociocultural dimensions.

Physical dimension of health

Genetics, age, sex, developmental level, physical condition, organ function, mobility, nutrition, and existing illness.

Emotional dimension of health

Feelings, stress, self-esteem, coping, relationships, and the ability to express and regulate emotions.

Intellectual dimension of health

Knowledge, reasoning, judgment, health literacy, learning ability, and capacity to understand and manage care.

Environmental dimension of health

Housing, climate, air and water quality, sanitation, pollution, safety, transportation, and neighborhood conditions.

Spiritual dimension of health

Beliefs, values, faith, meaning, purpose, hope, and connection that may guide coping and healthcare decisions.

Sociocultural dimension of health

Culture, family roles, language, traditions, education, income, community expectations, and patterns of healthcare use.

Six major areas of risk factors for illness or injury

Age, genetics or heredity, lifestyle, health history, environment, and psychosocial or sociocultural factors.

Risk factor

A characteristic, condition, exposure, or behavior that raises the likelihood of illness, injury, disability, or functional decline.

Modifiable risk factor

A risk that can potentially be changed, such as activity level, nutrition, tobacco use, sleep, environment, or management of health conditions.

Nonmodifiable risk factor

A risk that cannot be changed, such as age, genetics, developmental conditions, permanent disability, or some cognitive decline.

Health promotion

The process of helping people increase control over and improve their health; it is motivated by a desire to increase well-being and health potential.

Illness prevention/health protection

Behavior motivated by a desire to avoid or detect disease, reduce risk, or maintain function despite illness or disability.

Primary prevention

Actions taken before disease or injury develops to promote health and prevent occurrence.

Examples of primary prevention

Immunizations, exercise, healthy nutrition, sleep, hand hygiene, sunscreen, seat belts, smoking prevention, and health education.

Secondary prevention

Screening and early detection followed by prompt diagnosis and treatment to stop, slow, reduce, or cure disease.

Examples of secondary prevention

Blood-pressure screening, mammography, Pap testing, cholesterol testing, depression screening, and communicable-disease testing.

Tertiary prevention

Actions begun after disease or injury is diagnosed and treated to reduce disability, prevent complications, rehabilitate, and maximize function.

Examples of tertiary prevention

Cardiac rehabilitation, physical therapy after stroke, diabetes management, support groups, pressure-injury prevention, and occupational therapy.

Health-risk assessment

A comprehensive assessment of the whole person used to identify risks, strengths, behaviors, and opportunities for health promotion.

Nursing health-promotion assessment

Should include physical status, emotional well-being, coping skills, social supports, culture, environment, current behaviors, risks, strengths, readiness, and functional ability.

Nursing interventions for health promotion

Assess risks and readiness, educate, counsel, motivate, set achievable goals, support self-care, reinforce healthy behaviors, provide resources and referrals, and evaluate progress.

Functional ability

A person's physical and cognitive capacity to carry out normal activities of life safely and as independently as possible.

Activities of Daily Living (ADLs)

Basic self-care activities: bathing, dressing, toileting, transferring or mobility, continence, and eating or feeding.

Instrumental Activities of Daily Living (IADLs)

More complex skills required for independent community living, such as shopping, cooking, housekeeping, transportation, medication management, appointments, communication, and finances.

ADLs versus IADLs

ADLs are basic personal self-care tasks; IADLs are higher-level tasks needed to live independently in the community.

Why assess ADLs and IADLs?

They reveal a person's independence, care needs, safety risks, functional decline, and need for services or caregiver support.

Major influences on functional ability

Developmental stage, physical health, cognitive status, psychosocial health, environment, and social or cultural factors.

Modifiable risks for impaired functional ability

Low activity or mobility, untreated sensory loss, poor physical health management, depression or other psychosocial problems, unsafe environments, and inadequate nutrition.

Nonmodifiable risks for impaired functional ability

Age, genetics, developmental conditions, permanent disability, and progressive cognitive decline.

Functional assessment

Evaluation of a person's ability to perform ADLs, IADLs, mobility, cognition, communication, and necessary roles safely and independently.

Physical assessment of functional ability

Assess strength, range of motion, gait, balance, transfers, endurance, pain, sensory status, continence, nutrition, and ability to complete ADLs.

Psychosocial assessment of functional ability

Assess mood, cognition, coping, motivation, social support, living situation, roles, finances, and environmental barriers affecting daily function.

Diagnostic evaluation of functional decline

May include laboratory studies and tests such as CT or MRI when indicated to identify medical or neurologic causes.

Goal of early functional-deficit identification

Optimize current function, prevent or slow decline, reduce complications, and improve health outcomes and quality of life.

How can nurses promote physiologic function in older adults?

Perform ongoing assessment, manage pain and chronic illness, promote safety, prevent falls and skin breakdown, support continence, and encourage appropriate activity.

How can nurses promote cognitive function in older adults?

Assess baseline and changes, provide orientation cues and routines, support sensory aids, encourage mental activity, reduce delirium risks, and communicate clearly.

How can nurses meet psychosocial needs in older adults?

Assess mood and isolation, promote social contact, respect preferences and beliefs, support meaningful roles, encourage independence, and connect the person with resources.

How can nurses promote nutrition in older adults?

Assess appetite, weight, dentition, swallowing, access to food, and preferences; provide appropriate textures, assistance, supplements, and referrals when needed.

How can nurses promote sleep and rest in older adults?

Assess usual patterns and causes of disruption, control pain, reduce nighttime noise and light, schedule care thoughtfully, encourage daytime activity, and promote a consistent routine.

How can nurses promote activity in older adults?

Assess mobility and fall risk, encourage safe regular movement, use assistive devices correctly, involve therapy, pace activity, and support independence.

General age-related functional change

Older adults commonly have less physiologic reserve and slower responses, but aging varies widely and should not automatically be equated with disability.

Age-related integumentary changes

Skin becomes thinner, drier, and less elastic; subcutaneous tissue and pigment change; vessels become fragile; bruising, skin breakdown, and slow healing are more likely.

Nursing implications of age-related skin changes

Inspect skin, moisturize, reposition as needed, reduce friction and pressure, protect from temperature extremes and sun, and support nutrition and hydration.

Age-related musculoskeletal changes

Muscle mass and strength decrease, bones become less dense and more brittle, joints stiffen, posture may stoop, gait slows, and range of motion declines.