Health and Illness Exam2 CH9,13,&32

Piaget's Four Stages of Cognitive Development

Piaget's Four Stages of Cognitive Development

Stage 1: Sensorimotor
Stage 2: Preoperational
Stage 3: Concrete operational
Stage 4: Formal operational

Sensorimotor

From birth to 2 years, develops cause and effect concept.

Preoperational

From 2 to 7 years, relates objects and events to self.

Concrete operational

From 7 to 11 years, develops concrete problem-solving and inductive reasoning.

Formal operational

11 years and older, develops analytical problem-solving and abstract reasoning abilities.

Jean Piaget’s Cognitive Development

Focused on how children's thinking develops, from simple problem-solving in childhood to abstract thinking in adolescence.

Erik Erikson’s Psychosocial Stages

Suggested that people face different emotional challenges at each stage of life.

EX: infants need to learn to trust, while teenagers focus on finding their identity.

Trust vs. Mistrust

Birth to 18 months

Task: Learn to trust others

Nursing Implication: Provide consistent, affectionate care

Autonomy vs. Shame/Doubt

18 months to 3 years

Task: Learn self-control and the ability to express oneself and cooperate

Nursing Implication: Increase independence by providing praise and encouragement

Initiative vs. Guilt

3 to 5 years

Task: Initiate activities and influence environment

Nursing Implication: Encourage creativity, answer questions; do not threaten or label behavior as "bad"

Industry vs. Inferiority

5 to 12 years

Task: Develop sense of social skills and self-esteem

Nursing Implication: Keep realistic expectations for behavior and recognize accomplishments

Identity vs. Role Confusion

12 to 18 years

Task: Seek sense of self and plan according to one's abilities

Nursing Implication: Assist with planning for future and help with decision making

Intimacy vs. Isolation

18 to 40 years

Task: Develop intimate relationships and choose a career

Nursing Implication: Avoid criticizing relationships; teach how to establish realistic goals

Generativity vs. Stagnation

40 to 65 years

Task: Become a productive member of society and establish a family

Nursing Implication: Recognize accomplishments and provide emotional support

Integrity vs. Despair

65+ years

Task: Accept worth, uniqueness, and death

Nursing Implication: Review accomplishments made by the person

Lawrence Kohlberg’s Moral Development

Theory that explains how people develop a sense of right and wrong, evolving from simple obedience to complex moral reasoning.

What are the 3 levels of Kohlberg's Stages of Moral Development?

Preconventional Level

Conventional Level

Postconventional Level

Preconventional Level

Ages 1 to 9 or 10: Focuses on avoiding punishment and gaining rewards.

Stage 1:  Punishment and Obedience Orientation: Children obey authority to avoid punishment.
Stage 2:   Individualism and Relativism: Children focus on fairness, not just for larger groups.

Conventional Level

Early adolescence: Conforms to avoid disapproval and respects law and order.

Stage 3:   Seeking Strong Interpersonal Relationships: Young adolescents focus on being good and helping others.
Stage 4:   Law-and-Order Orientation: Young adolescents follow laws for the greater good and respect for authority.

Postconventional Level

Postadolescence: Behaving according to internal codes and beliefs.

Stage 5:   Social Rules and Legal Orientation: Adult behavior is motivated by the desire to follow internal values and moral principles.
Stage 6:   Universal Ethical Principles: Adults have concern for human rights and dignity, wishing for an impartial interpretation of justice.

Growth 

Your body gets bigger and stronger over time.

This includes things like your arms and legs growing, bones getting harder, and baby teeth coming in and being replaced by permanent ones.

Growth happens at different speeds during different stages of life.

Development 

How you learn to do things like walk, talk, and make decisions as you grow up.

Factors That Affect Growth and Development

Biological and hereditary factors

Environmental factors

Social factors

Biological and hereditary factors

Some people may have physical or mental conditions that make it harder for them to grow or learn certain things.

Environmental factors

Things like eating healthy and avoiding pollution can affect how you grow.

Social factors

Your family, friends, and the environment you grow up in (like school or community) can influence your development.

Nature vs. Nurture

How much of a person’s growth and development is due to genetics (nature) versus how much is influenced by their environment (nurture). It's a balance of both.

What are some rules set by a big group called The Joint Commission to make sure hospitals are safe?

1. Identify patients correctly 

2. Improve staff communication 

3. Use medicines safely 

4. Use alarms safely 

5. Prevent infections 

6. Identify safety risks 

7. Prevent mistakes in surgery 

Things That Can Make a Hospital Unsafe

Age 

Trouble moving 

Communication problems 

Pain 

Help is late 

Broken equipment 

How to Keep Patients Safe?

Prevent falls – Use special tools like alarms or soft restraints so patients don't fall.

Restraints (LAST RESORT)– Sometimes patients might need something like a vest or mitts to keep them from pulling out important medical tubes.

Vest for Patient Protection

Used to protect patients from bed or wheelchair exits.

Crossover in front, straps tied to wheelchair's back.
For bed use, straps tied to bed frame's moveable portion, not bed rails.

Waist Protection in Healthcare

Protects patient from escaping.

Placed around patient's waist.
Straps tied to bed frame or wheelchair back.

Mitt Protection Overview

Used to protect patients from removing tubes or interfering with treatments.

Prevents scratching in severe skin disorders.
Patient's hand placed within mitt, secured around wrist.
Straps can be tied to bed frame, not bed rails.

What to Do in a Fire? 

RACE

RACE stands for?

Rescue – Help people get out of danger.

Alarm – Call for help or hit the fire alarm.

Confine – Close doors to stop the fire from spreading.

Extinguish – Use a fire extinguisher to put out small fires.

PASS is how you use a fire extinguisher

Pull the pin

Aim at the base of the fire

Squeeze the handle

Sweep side to side

Different Types of Fire Extinguishers

Type A 

Type B 

Type C 

Type D

Type K 

Type A Fire Extinguishers Extinguish?

Paper, wood, or trash fires

Type B Fire Extinguishers Extinguish?

Fires caused by oil, gasoline, or other liquids

Type C Fire Extinguishers Extinguish?

Electrical fires

Type D Fire Extinguishers Extinguish?

Powders, flakes, or shavings of combustible metals.

Type K Fire Extinguishers Extinguish?

Kitchen fires, like burning cooking oil

Most Fire extinguishers are a combination of which extinguishers?

A, B, and C

How to Stay Safe as a Nurse

Nurses also have to keep themselves safe:

Body mechanics – This means lifting things the right way so you don’t hurt your back.

Radiation hazards – Be careful around machines that use radiation, like X-rays.

Chemical hazards – Some cleaning supplies can be dangerous, so follow the safety rules when using them.

Helping in an Emergency

In emergencies, nurses and doctors use skills like CPR (to help someone who isn’t breathing) and the Heimlich maneuver (to help someone who is choking).

What are the three classifications of age groups (list them by classification name and age in years)

• Young-old: Ages 65 to 74.

  Elevated BP, high cholesterol, onset of type 2 diabetes

• Middle-old: Ages 75 to 84.

  Increased stressed and depression due to losses of spouses, family members, and friends to death

• Old-old: 85 and up.

  Decline in health status

What is Ageism?

The practice of discrimination and prejudice against older adults.

Name five signs that indicate your client may be experiencing abuse?

• Unexplained injuries (bruises, burns, fractures)

• Poor personal hygiene

• Sedation

• Lacerations

• Dehydration or malnutrition

What is 'Elder Abuse'?

The deliberate or careless actions that seriously endanger or injure an elderly person, frequently in their own homes or in nursing homes. It may cause financial loss, psychological distress, or physical harm. 

Name three physiological changes that are common for older adults.

Neurological

Musculoskeletal

Cardiovascular

Psychosocial problems of aging

Loss, grief, and dying

Safety from crimes and scams

Elder abuse

Financial concerns

Polypharmacy

This is when older adults take lots of different medications. Taking too many can cause bad side effects or drug interactions, putting them at risk for overdosing.

Long-Term Care for Older Adults

• Intermediate Care

• Skilled Care

• Memory Care

• Assisted Living

Intermediate Care

They need some daily nursing attention but not 24/7.

Skilled Care

This is for people who need constant supervision and help, like IV therapy or wound care.

Memory Care

Special care for people with memory problems like dementia.

Assisted Living

This is for older adults who can live mostly independently but still need some help.

Cataracts

The lens of the eye becomes cloudy, or opaque, causing visual blurring.

Glaucoma

An eye disease characterized by increased intraocular pressure, which affects the optic nerve and can lead to blindness.

Age-related macular degeneration

The destruction of the area in the retina where the optic nerve attaches, leading to the loss of central vision.

What is the most common type of dementia?

Alzheimer’s disease

Confusion

Cannot think clearly; considered a cognitive impairment

Reversible: Sometimes

Delirium

State of heightened awareness; hallucinations and vivid dreams present; often has emotional outbursts

Reversible: Yes

Dementia

Deterioration of cognitive functioning without a disturbance in consciousness.

Reversible: No

Depression

Alteration in emotional state marked by intense sadness or despondency; hopelessness, powerlessness.

Reversible: Yes

What factors play a role in the development of Alzheimer’s?

age, genetics, and lifestyle

The diagnosis of Alzheimer's disease is based on symptoms because the only way this disease can be confirmed is by:

finding the characteristic neurofibrillary tangles in the brain on autopsy.

Key features of Alzheimer's disease include:

Memory Loss

Cognitive Decline

Behavioral Changes

Plaques and Tangles

Four factors that impact the aging process

Genetics
Lifestyle Choices
Chronic Illnesses
Environmental Factors

The practice of ageism contributes to:

stereotyping, unequal treatment in the workforce, and denial of health care.

Rooting reflex

When a baby's cheek is gently touched, the infant will turn toward the stimulus and open his or her mouth to find milk.

Sucking reflex

When a nipple or finger is placed in a newborn's mouth, the baby begins to suck to obtain nourishment.

Startle (Moro) reflex

When a baby is moved suddenly or jarred in some way, they extend their limbs outward and then pull them toward the trunk of their body to protect themselves from injury.

Babinski reflex

When the sole of the foot on a newborn is stroked, the normal response is fanning of the toes while the great toe pulls upward.

Fontanels

The spaces between the bones of the skull that are not yet fused together, sometimes called the soft spots.

The posterior fontanel

Triangular-shaped soft area

Found on the top of the head toward the back

Closes first, between the ages of 4 and 8 months.

The anterior fontanel

Diamond-shaped soft area

Found on the top of the head toward the forehead

Closes last, at about 1 to 1 ½ years of age

A bulging fontanel

Is a sign of fluid excess

A sunken fontanel

Is a sign of fiuid loss