Review Questions

Review Questions

1. What do the terms “physical,” “cognitive,” and “psychosocial” mean as they relate to growth and development?

“Physical growth and development” refers to changes in the human body. These changes include differences in height, weight, sensory adaptation, and sex organs. “Cognitive growth and development” refers to a human’s intellectual ability, including thought, awareness, and the ability to comprehend the world rationally and to try to determine its meaning. Psychosocial skills include both psychological and social development, expression of emotions (love, hate, joy, fear, anxiety), and the ability to cope with complex situations and apply appropriate social and interpersonal relations skills.

2. What are the nine life stages? What age group does each stage represent?

The nine life stages and approximate ages:

* Prenatal: conception to birth
* Infancy: birth to 1 year
* Toddler: 1 to 3 years
* Preschooler: 3 to 6 years
* School-aged child: 6 to 12 years
* Adolescence: 12 to 20 years
* Young adulthood: 20s and 30s
* Middle adulthood: 40s to 65 years
* Later adulthood: 65 to death

3. What are the primary physical changes that occur at each of the life stages?

There are nine stages:

* Prenatal: from conception to birth, a human grows from two cells to recognizable human appearance and function in 9 months

* Infancy: tremendous physical growth: birth weight triples or quadruples, length increases to 29 to 30 inches, and teeth begin to show between 8 and 12 months

* Toddler: the body grows and proportions change: the head no longer looks uncharacteristically large, walking and climbing skills develop, 20 teeth are present, and bowel/bladder control begins

* Preschooler: become taller/thinner than toddlers; the self-care skills progress, including dressing themselves; sensory skills improve

* School-age: body growth continues, puberty begins, permanent teeth start erupting, sensory skills become well-coordinated

* Adolescence: reproductive system maturation occurs; fine motor skills improve, even as gross motor skill awkwardness is present; and more rest and sleep are needed to overcome fatigue

* Young adulthood: physical functioning, including muscular and sensory skills, peaks at 30; and then the skin begins to lose moisture, gastrointestinal secretions diminish, problems with weight can develop, muscular and sensory skills peak, and visual and auditory senses begin to decline

* Middle adulthood: physical abilities continue to decline, bone and muscle mass and physical strength and endurance decline, skin elasticity fails, wrinkles develop, major body systems decline, and chronic illness can begin

* Later adulthood: general decline; loss of muscle and bone; atrophy of reproductive organs; cardiac, renal, and immune systems decline; peripheral circulation decreases; visual, auditory, gustatory, and olfactory senses diminish; pain tolerance and some motor skills decline; and physical responses slow

4. What are the challenges of each stage according to Erik Erikson’s Psychosocial Development theory?

Challenges encountered in each life stage:

* Infancy: trust vs. mistrust
* Toddler: autonomy vs. shame/doubt
* Preschooler: initiative vs. guilt
* School-age child: industry vs. inferiority
* Adolescence: identity vs. role confusion
* Young adulthood: intimacy vs. isolation
* Middle adulthood: generativity vs. stagnation
* Later adulthood: ego integrity vs. despair

Generally, Erikson believed that psychosocial development occurs as the result of a person’s resolving specific types of conflicts encountered at each stage. Resolving these conflicts, at least in part, allows the individual to advance successfully to the next stage.

5. What specific care considerations would relate to each of the life stages that would address age-appropriate communications and care?

Each life stage is characterized by its own physical, cognitive, and psychosocial challenges. Still, all patients at all times need/deserve respectful, compassionate, and empathetic care. Examples of specific age/stage care considerations are provided in Table 8-2.

6. List the five stages of grief and give an example of behaviors that may be observed during each stage.

The five stages of grief:

* Denial: feeling an inability to focus, unreality, hysteria, etc.
* Anger: rage, wondering “Why me?”
* Bargaining: more time is wanted, for example, to complete unachieved goals, have grandchildren, etc.; patient attempts to “make deals” with a higher power
* Depression: profound sadness is felt; patient turns inward
* Acceptance: a sense of peace is realized and specific “loose ends” are tied up and resolved