Wk5 -growth and development

Week 5 Lecture

  • Nursing through the lifespan

  • Lifted from: NURS 141 by Jessica Matthews MSN RN

Learning Objectives

At the end of Week 5, learners will be able to:

  • Demonstrate understanding of Erikson’s and Piaget’s stages of development and how it relates to nursing care across the lifespan.

  • Identify physical and cognitive milestones for each life stage from infancy to older adulthood.

  • Identify psychosocial patterns for each life stage from infancy to adulthood.

  • Describe age-appropriate activities for each life stage.

  • Identify different health screenings, nutritional considerations and immunizations for each life stage across the lifespan.

  • Discuss injury prevention and different safety hazards surrounding each life stage across the lifespan.

Lifespan Stages

  • Infancy (2 days-1 year)

  • Toddlers (1-3 years)

  • Preschoolers (3-6 years)

  • School-Age Children (6-12 years)

  • Adolescents (12-20 years)

  • Young Adults (20-35 years)

  • Middle Adults (35-65 years)

  • Older Adults (65+ years)

Erikson's Psychosocial Stages

Infancy (0-1 year)

  • Basic Conflict: Trust vs. Mistrust

  • Virtue: Hope

  • Description: Trust that basic needs, such as nourishment and affection, will be met.

Early Childhood (1-3 years)

  • Basic Conflict: Autonomy vs. Shame/Doubt

  • Virtue: Will

  • Key Development: Develop a sense of independence.

Play Age (3-6 years)

  • Basic Conflict: Initiative vs. Guilt

  • Virtue: Purpose

School Age (6-12 years)

  • Basic Conflict: Industry vs. Inferiority

  • Virtue: Competence

Adolescence (12-18 years)

  • Basic Conflict: Identity vs. Role Confusion

  • Virtue: Fidelity

Early Adulthood (19-29 years)

  • Basic Conflict: Intimacy vs. Isolation

  • Virtue: Love

Middle Age (30-64 years)

  • Basic Conflict: Generativity vs. Stagnation

  • Virtue: Care

Old Age (65 onward)

  • Basic Conflict: Integrity vs. Despair

  • Virtue: Wisdom

Piaget's Stages of Cognitive Development

Sensorimotor (0-2 years)

  • Key Characteristics: Coordination of senses with motor responses, sensory curiosity, language used for demands and cataloging, development of object permanence.

Preoperational (2-7 years)

  • Key Characteristics: Symbolic thinking develops, use of proper syntax and grammar, imagination and intuition are strong, but complex abstract thoughts are challenging.

Concrete Operational (7-11 years)

  • Key Characteristics: Understanding time, space, and quantity, but not as independent concepts.

Formal Operational (11 years and older)

  • Key Characteristics: Theoretical, hypothetical, and counterfactual thinking; abstract logic and reasoning develops.

Infants (2 days - 1 year)

Physical Development

  • Lose 5-10% of birth weight in two days, regain by week 2.

  • Double birth weight by 6 months, triple by 1 year.

  • Posterior fontanel closes at 2-3 months; anterior at 12-18 months.

  • Growth: Approximately 1 inch/month; average head circumference around 18 inches by age 1.

  • Reflexes: Startling, sucking, rooting, grasping, yawning, and cough reflexes present.

  • Average sleep time: 15 hours/day.

  • 6-8 teeth by end of first year.

Cognitive Development (Sensorimotor)

  • Separation recognized at 12 months (self separate from the environment).

  • Object permanence develops by 9 months (recognize objects exist even when out of view).

  • Communication primarily through crying.

Psychosocial Development (Trust vs. Mistrust)

  • Positive interactions foster trust and nurturing attachment; negative interactions foster mistrust.

  • Separation anxiety starts at 4-8 months; stranger anxiety at 6-8 months.

  • Newborns can mimic caregiver smiles by age 2 weeks.

Toddlers (1-3 years)

Physical Development

  • Anterior fontanel closes by 18 months.

  • Weight gain: 4-6 pounds/year; height growth: 3 inches/year.

  • Learns self-care activities (dressing, feeding, toilet training).

  • Walking without help by 15 months; jumping with both feet by 2.5 years.

Cognitive Development (Preoperational)

  • Object permanence fully developed.

  • By 24 months, average vocabulary of 300 words; can form 2-3 word phrases.

  • Comprehension of speech exceeds spoken vocabulary.

Psychosocial Development (Autonomy vs. Shame and Doubt)

  • Development of self-concept; assert independence (uses “NO,” temper tantrums).

  • Continues developing body image (toilet training, later control of bowel and bladder).

  • Separation anxiety persists, with potential for regression under stress.

  • Egocentric view of the world; experiences parallel play.

Preschoolers (3-6 years)

Physical Development

  • Growth: 4.5-6.5 pounds/year; height: 2.4-3.5 inches/year.

  • Development of fine motor skills.

Cognitive Development (Preoperational)

  • Judgments based on visual perception; artificialism and animism evident.

  • Awareness of cause and effect develops.

  • Vocabulary growth continues; struggles with phonetic similarities.

  • Engaging in pretend play is essential.

Psychosocial Development (Initiative vs. Guilt)

  • Sense of guilt if tasks aren't accomplished (within capabilities).

  • Develops understanding of socially acceptable behavior; fear and fantasies around body image.

  • Effective use of routine and favorite toys to combat fears.

School-Age Children (6-12 years)

Physical Development

  • Weight gain: 4-7 pounds/year; height: 2 inches/year.

  • Puberty begins towards end of this age range.

Cognitive Development (Concrete Operations)

  • Understands time, seasons, emotions.

  • Self-motivated with developing problem-solving abilities.

  • Understanding of words leads to recognizing multiple meanings.

Psychosocial Development (Industry vs. Inferiority)

  • Promotion of self-worth through tasks; increases stress from school and peer relationships.

  • Body image education important; same-gender friendships become significant.

Adolescents (12-20 years)

Physical Development

  • Growth spurts: 20-25% of height gained; variations by sex.

  • Common issues: Acne, change in sleep habits due to metabolism.

Cognitive Development (Formal Operations)

  • Adolescent-level thinking; evaluation of one's own thought quality.

  • Hypothetical and abstract thought develops.

Psychosocial Development (Identity vs. Role Confusion)

  • Formation of personal and group identity; introspection and emotional control are key.

  • Begin to establish autonomy, sexual identity, and long-lasting relationships.

Young Adults (20-35 years)

Physical Development

  • Growth stabilizes; peak of physical senses and cardiac efficiency typically occurs here.

Cognitive Development (Formal Operations)

  • Critical thinking skills and creative thought peak.

  • Openness to change in decision-making processes develops.

Psychosocial Development (Intimacy vs. Isolation)

  • Focus on relationships, responsibilities; issues of self-concept emerge.

Middle Adults (35-65 years)

Physical Development

  • Various physical declines (skin, hair, height, muscle strength).

Cognitive Development (Formal Operations)

  • Memory and crystallized intelligence remain intact, but fluid intelligence slightly declines.

Psychosocial Development (Generativity vs. Stagnation)

  • Focus on helping others and parenting; dealing with physical and emotional changes.

Role Changes

  • Responsibilities may involve raising children, grandchildren, aiding parents, or experiencing empty nest.

Older Adults (65 and older)

Physical Development

  • Common characteristics: wrinkles, decreased skin turgor, increased blood pressure, loss of senses, various health issues.

Cognitive Development (Formal Operations)

  • Cognitive function may decline; health factors play a significant role.

  • Disorders: delirium, dementia, and depression may arise.

Psychosocial Development (Integrity vs. Despair)

  • Lifestyle changes due to retirement; coping with loss and adjusting to aging.

Conclusion

  • Each age range presents unique strengths and struggles.

  • The nursing approach adapts based on physical, cognitive, and psychosocial needs across the lifespan.