Unit 3 Study Guide:
Unit 3: Development Through the Life CycleChapter 9: The FamilyChapter 10: Infancy and ChildhoodChapter 11: AdolescenceChapter 12: Early and Middle AdulthoodChapter 13: Older Adulthood and AgingChapter 14: The End of Life: Death, Dying, Grief and Loss(References: Rosdahl, C. B, Kowalksi, M. T. ( 2017). Textbook of Basic Nursing ( 11th ed.). Wolters Kluwer / Summer Putt)(THIS IS NOT ALL INCLUSIVE!)Chapter 9: The FamilyA family consists of two or more people who are joined together by legal, genetic, and/or emotional bonds. A client’s family includes any person that he or she identifies as a family member.A family shares common characteristics:It is a small social system.It performs certain basic functions and tasks.It has structure.It has its own cultural values and rules.It moves through stages in its life cycle.Functions of Families:The family is organized as a unit for the achievement of the following basic functions:Providing for physical healthProviding for mental and spiritual healthSocializing membersReproducingProviding economic well-beingTypes of Family Structures:Single-adult householdNuclear familyNuclear dyad, commuter family, dual-career family or dual-worker family Extended familySingle-parent familyBinuclear familyBlended or reconstituted familyAlternative familiesGay or lesbian familyCommunal familyFoster familyAlternative Families:Cohabitation: unmarried individuals in a committed partnership living together, with or without children.Gay or lesbian family: partners of the same sex may live together in a familiar relationship. Communal family: several people live together and share financial resources, work, and childcare responsibilities.Foster family: Children live in temporary arrangements with paid caregivers. Influences of Culture, Ethnicity, and Religion on the Family:Choice of marriage partner, dating customs, number of spouses, and living arrangements How to deal with emotions Status of men and women Attitudes toward children and older adults in the familyAttitudes toward education and choice of vocation Family decision-makers and roles of family membersFamily disciplinarian and type of discipline Stages of the Family Life Cycle:TransitionalExpanding familyEstablishmentChildbearingChildrearingContracting familyChild launchingPostparentingAgingCommon Stressors:Socioeconomic stressors Divorce and remarriageFamily violence Addictions Acute or chronic illness Effective and Ineffective Family Coping Patterns:Adjustment PhaseThe family tries to maintain the status quo with minimal disruption to the family unit.The family may deny or ignore the stressor.The family may remove the demands of the stressor.The family may accept the demands created by the stressor.Adaptation PhaseThe family realizes that regaining stability will involve changes in the family structure.Friends and community provide assistance with the problem-solving process during the stressful period.Roles, rules, boundaries, and patterns of behavior within the family are altered as needed to regain stability.Chapter 10: Infancy and ChildhoodHuman Growth and Development:GrowthChange in body size and structureDevelopment Change in body function Genetic Factors Hereditary characteristics inherited from parentsRegressionA child’s behavior may go backward to that of an earlier stage of development.Characteristics of Human Growth and Development:Orderly sequenceSimple to complexCephalocaudalInclusiveProximodistalInterdependentDevelopmental Milestones/Delays:Developmental milestonesAccomplishing skills and abilities in predictable patterns within general age-specific timeframesDevelopmental delaysOccur when a child does not achieve predicted developmental milestones within acceptable patternsAnticipatory Guidance for Caregivers:ConcernBehavioral and developmental issuesThe nurse should:Communicate that normal growth and development occur within a wide range.Help caregivers understand the needs and problems of children.Help caregivers and children work toward increased abilities, skills, self-knowledge, and self-discipline. Chapter 11: AdolescenceErikson: Psychosocial Development:Focuses on the psychosocial and environmental aspects of personality as the person progresses from birth to death.Every stage of development contains:Psychosocial challengeInfluence of a significant person or groupNecessary accomplishmentAppropriate virtuesWays to help the child succeedPiaget: Cognitive Development:CognitiveKnowledge, understanding, or perception Four major levels of cognitive development:Sensorimotor Preoperational Concrete operations Exhibits reversibility, seriation, and conservation of matterFormal operations Role of Play in Childhood Development:Play with other children encourages peer cooperation, interaction, and sharing.Play enhances fine and large muscle coordination and strengthens muscles.Solitary play: infants play alone with their own toys in the same area as others but without interaction. Parallel play: two children play side-by-side with the same or similar toys but do not interact with each other or the other’s toy Growth and Development of Infants:InfancyThe period from 1 to 12 months of age. Physical growth by the end of the yearWeigh about three times their birth weightIncrease birth height by about halfHave six to eight deciduous teethPsychosocial DevelopmentEstablishment of trust in primary caregiversChanging families and role of caregiversBondingAccomplishing tasksCognitive and Motor DevelopmentDepends on physical maturity and environmental factorsStranger anxietyTemperamentPast experiences with strangersNew environmentsPresence of primary caregiver, number of caregiversInteraction of strangers AgeAreas of Concern:Feedings Bottle mouth Weaning Sucking DaycareGrowth and Development of Toddlers:Toddler Phase Encompasses ages 1 to 3 yearsPhysical Growth Gain only about 5-10 lb annually Grow about 3 in per year Make great strides in physical and motor skills Psychosocial Development Challenge Autonomy (independence) versus shame and doubtVirtues Self-control and willpowerDisciplineCognitive and Motor DevelopmentIntellectual and social development Increased motor skillsVerbal skills improveAreas of Concern:Toilet training Accident prevention Setting limits Thumb sucking and the security blanket Temper tantrums Sleep habits and the family bed Separation anxietyGrowth and Development of Preschoolers:Preschool Phase Encompasses ages 3 to 6 yearsPhysical growthMay gain less than 6 lb per year( generally gain 3-5 lbs per year)May gain 3 in annually until school Have a steadier walkPsychosocial DevelopmentChallengeTo acquire initiative VirtueSense of direction and purpose Cognitive and Motor Development Develop more refined motor skills become by age 3 years Have great desire to be independent and to do things on their own Comfortable with themselves and their relationships with others by age 5 years Areas of Concern:Sibling rivalry Phobias and nightmares Masturbation Enuresis Growth and Development of School-Aged Children:School AgeEncompasses ages 6 to 10 yearsPhysical GrowthSlow and steady period of growth begins Lose deciduous teethPermanent teeth eruptsPsychosocial Development ChallengeDeveloping a sense of industry VirtuesSense of belonging Feelings of competence and self-worth Cognitive and Motor DevelopmentBecome increasingly independent Fitting in becomes very important Learn to abide by rules Reasoning and conceptual powers expand Areas of Concern:Sibling rivalry Responsibilities Sex educationPuberty and Adolescence:Puberty The period when a person becomes able to reproduce sexuallyAdolescenceDevelopmental period between puberty and maturitySpans the ages between 11 and 20 yearsCharacteristics of Adolescence:Rapid growth spurt occursAchievement of adult height occursEmotional needs predominateCritical choices are made that affect their livesSkills are developed as part of cognitive growthLeadership and diplomatic abilities developMoral judgment and thinking are no longer egocentricErikson’s Theory:VirtuesIndependence, self-esteem, self-reliance, self-control, devotion, fidelityWays to help the adolescent succeedProvide privacy, encourage activities, support decisions, allow independence, give recognition and acceptance, maintain a good family atmosphere, facilitate information gatheringPiaget’s Theory:Age 12 to 15 yearsStage IV of cognitive developmentThink in the abstract Develop skills to solve complex problemsEnhance diplomatic abilities Stages of Adolescence:Pubescence, Preadolescence, or Early Adolescence (Ages 11–14): Waver between playfulness and a need for regular approvalTake frequent flights of independence but has a strong need to return to the “nest” for guidance and encouragementBecome more accepting of other people and more conscious of what makes them uniqueMiddle Adolescence (Ages 15–17): Introspection and fluctuations in self-assuranceFormation of ideas and plan for the futureExhibition of true attitudes of maturity Physical Growth/Adolescent:Reaches 90% of adult heightHas all permanent teeth except second and third molars by age 12Increase in glandular activity causes sweat and body odorGrowth of body hair occursReproductive organs grow to adult sizeAlterations in body chemistry increase need for energySexual Development in Adolescent Boys:Enlargement of testicles and penis Changes in appearance of scrotum Appearance of pubic hairSpontaneous erections and nocturnal emission Appearance of chin whiskers Deepening of the voiceStrong, muscular appearance Sexual Development in Adolescent Girls:Rapid growth and signs of approaching sexual maturity Breast and hip developmentAppearance of pubic hair Onset of menstruation—menarche Secondary sex characteristics are those of an adultPsychosocial Development:Major task is to form a sense of identity.Family relationshipsPeer relationships FriendshipDatingPeer pressureFamily Relationships/Adolescents:May be delicate during adolescenceAttitudes toward younger siblingsAttitudes toward family caregiversInfluence lifetime interpersonal successCaregivers must recognize the need for self-assertion, privacy, information, acceptance, experimentation, and growth and developmentAreas of Concern for Adolescents:Development of healthy habitsSafety measures with motor vehiclesImportance of scholastic and skill achievementImportance and development of self-respectSelection of peers as friendsWise counseling about sex and sexualityProblems that arise from substance use and abuse Food and Eating Habits:Special nutritional needsPoor dietary habits lead toFatigue, unhealthy appearance, and susceptibility to illness Teenage boys normally have huge appetites.Teenage girls are concerned about appearance. Anorectic or bulimic patterns of eating may emerge.Sexual Identity and Orientation/Adolescent:Questions sexual preferencesRealizes sexual orientationHomosexual orientation may cause confusion:Fear of rejectionRisk for alienation, doubt, and depressionSex Education:Family caregivers and trusted adults give accurate information.Incorrect beliefs may develop from information received from peer groups.Sexually active adolescents need counseling about prevention of STIs and forms of birth control. Chapter 12: Early and Middle AdulthoodErikson: Psychosocial Development:Early Adulthood ChallengeIntimacy versus isolationNecessary accomplishmentsChoose relationship style, select occupation, build independenceVirtuesAffiliation, loveMiddle AdulthoodChallengeGenerativity versus stagnation Necessary accomplishments Develop self, plan retirement, raise family, enhance relationshipsVirtuesProduction, caring, cooperationEarly Adulthood Transitions:Leaving homeChoosing a careerEstablishing an adult identification: seeking oneselfEstablishing adult relationshipsStarting a familyReappraising commitmentsSettling inMaking career decisionsLife Choices Made During Early Adulthood:Establishing adult relationshipsStarting a family Establishing careersBecoming financially secure before marriage Having childrenReappraising commitmentsWomen’s Issues:Making decisions related to childbearingFeeling pressure to give birth as third decade advancesDealing with conflicting career goals and motherhoodConsidering adoption and reproductive technologiesFacing decisions about employment, childcare arrangements, and financial responsibilitiesDevelopment in Middle Adulthood:Addressing midlife transitions or midlife crisisVisualizing their own agingFeeling they have failed to achieve goalsFailing to resolve this stage may result in: Brooding, physical illness, suicide, chemical dependency, and depression Role changesChildren turn into adultsFormer children become responsible caregiversCaring for aging parents and growing childrenPerceiving one’s own mortalityDeath becomes more of a realityReestablishing equilibriumLife becomes more peacefulSpend more time with grandchildrenPlanning for retirementDevelop interests and hobbies Plan financesMove to simple living arrangementsMiddle Adulthood Transitions:Adjusting to role changesPhysical aspects of agingPerceiving one’s own mortalityReestablishing equilibriumPlanning for retirementChapter 13: Older Adulthood and AgingTerms Related to Aging:Gerontology: study of all dimensions of the aging processGeriatrics: study of medical and social problems and care related to older adultsElderly: word applied to individual past 50 years old/may be respectful or derogatory termSenescence: the process of becoming oldSenior/senior citizen: individual 50 years or olderAgeism: labeling and discriminating against older adultsErikson: Psychosocial Development:Ego integrityRealization that their lives have been worthwhile DespairInability to accept death Life reviewHelps to gain a more positive perspective on the conflicts of earlier stagesEncourage reminiscenceErikson’s Theory:ChallengeEgo integrity versus despairNecessary accomplishmentsBalance choices, achieve stability, retire, evaluate life, accept life choicesVirtuesRenunciation, wisdom, dignityMajor Physical Changes:Decrease in functioning of organsChange in visual and auditory acuityDecreased reaction timeUnsteady gait, decreased sense of balance, stiff jointsDecrease in tactile sensationsIncreased emotional and physical lossesDecreased capacity for recovery from injury or illnessPsychosocial Considerations:Key elements of maintaining independenceHealth, financial stability, and social resources Community resources help lessen dependence on family and friends.Participation in social activities is important for older adults.Skilled and sympathetic listeners can help acceptance of the aging process and one’s life history and decisions.Areas of Concern:Preventable disorders may arise due to Lack of effective exerciseUse of tobacco productsObesity and poor eating habits Preventive health screening and early detection practices are less expensive than treatment. Work, retirement, and activitiesplan activities that bring joy and happinessFinances and povertyStress and lossPhysical and psychological stressors accumulate SpiritualityImportant sources of personal solace MortalityReligious or spiritual beliefs influence attitudesAreas of Concern: Eldest AdultPhysical considerationsDependence upon caregivers for ADLsVulnerability to physical and psychosocial aspects related to normal agingMultiple chronic conditionsPsychosocial considerationsMaintaining independenceParticipation in social activitiesLosses Occurring as a Result of Aging:Loss of independence and mobilitySocial environment and lossFinances and loss of incomeStress and lossMortality and lossChapter 14: The End of Life: Death, Dying, Grieving and Loss (Megan Wray)Understanding death is a fundamental concept.Nurses are likely to care for patients who are dying in emergency rooms, acute care, hospice care and nursing homes or a client’s home.The Dying Process:Dying is a unique and intimate process for each individual.KEY CONCEPT:Death is one of the most profound emotional experiences humans encounter. Fear and anxiety are natural.A continuing challenge for many individuals is to resolve personal feelings about the process of dying and the finality of death.As a nurse you can become more comfortable with the concept of death by confronting your own personal feelings.End of Life Care:Specific acute situations, illnesses, or trauma affect events related to the dying process.Terminal illness: State in which an individual faces a medical condition that will end in death within a relatively limited period.Palliative care: Collaboration of client, caregiver, and family that focuses on the treatment of symptoms for clients with a serious illnesses, usually, but not always, associated with a terminal illness.Often incorporated into the treatment plan during the months, days, or hours that occur during a terminal condition.The goal is to improve the quality of life by providing for relief of symptoms such as pain, nausea, anxiety, and depression.It is appropriate for many illnesses and can be provided simultaneously with curative care.As natural death approaches, called active dying, the LT caregiver role changes. As the client enters the last phases of life, a steady decline toward death becomes notable, and the care given to the client must adjust to changing needs.The needs of the dying client vary according to the individual’s condition.The needs of each client typically vary from day to day. As death approaches, emotional support, reassurance, and pain relief become the caregiver’s priorities.KEY CONCEPT:Physical care and emotional care are two very different types of care.Physical care, usually some form of treatment, can be observed and quantified.Emotional care relates to the physiological support. It effects cannot be measured and may seem less immediately obvious than those of physical care, but is equally important to the well-being of the client.Impact of the Dying Process:Often, caregivers and families are coping with deep feelings of anticipated loss.Stress of the caregivers or family should not be overlooked.Efforts to appear hopeful and cheerful may appear non-supportive or insincere.Not all family members can cope with death and the dying process.Each family member or caregiver will progress through the grieving and loss process.End-of-life Discussions and Advanced Directives:End-of-life Discussions:These discussions should take place as a routine, practical adult responsibility.They should occur ASAP after a terminal diagnosis has been given.They need to include the goal of care and treatment options which range from an overview of the needs for basic nutritional supplementation to the use of advanced life support.Advanced Directives:Utilization of AD can be of great assistance to the dying client and their family.Wishes of the client are more likely to be followed if that individual has considered his or her own desires and ensured that these wishes are given in writing to physicians, family and significant others.Without an AD, the healthcare provider or a family member may be given the responsibility to dictate life or death decisions.These decisions can result in feelings of guilt, self-doubt about making the “right” decisions, and hostility among family members.Relief of Pain:Relief of pain is an important palliative treatment.Use of opioid analgesics, narcotic pain meds such as morphine, are known interventions of palliative care. Caregivers may be afraid to give meds that could be beneficial in a rumored fear of addicting the client or causing the client’s premature death due to med overdose.Providing adequate pain meds can result in a client who has improved alertness because their physical body is not fighting pain. When a client is able to swallow, oral pain meds can be used.KEY CONCEPT: The family should realize that crying or sadness in front of a dying loved one is acceptable. Such behavior can be therapeutic, because otherwise the dying individual may feel that nobody cares.Finances and Economic Concerns:Financial concerns, such as cost of meds or specialized equipment, may become an increasing source of worry and stress.Daily events and routine concerns contain economic considerations.Funeral or commemorative services can be costly.Some individuals prepay for finances so that these costs do not affect the finances of caregivers or family members.Occasionally, accumulated stress becomes difficult for families to handle, resulting in increased conflicts and outbursts of emotion or domestic violence.Support from friends, neighbors, and coworkers can be helpful.Children and Their Concern:Families question how to handle death when children are involved in the family.They do grieve and need to be part of the family’s mourning.Adults should talk honestly and clearly with children about illness and death when it occurs.Children should be allowed to see the body or attend the funeral (or both) if they wish to do so.Children who are dying should be told the truth and be allowed to ask questions.SPECIAL CONSIDERATIONS CULTURE:Cultural, ethnic, and religious beliefs help to shape people’s attitudes towards death. The cultural context often determines the procedures related to death, dying, and after death care.Some cultures view death as an intensely personal experience, with families keeping most of their emotions and feelings within a private circle. Other cultures grieve openly.BOX 14-1 Traditional Religious Beliefs and Practices Related to Death:RELIGION:PRACTICES:Amish and MennoniteFamily cares for the body. Funeral often at home.BaptistPrayer. Communion. Call pastor.BuddhistPriest performs last rites and chanting rituals. Cremation is common.Christian ScienceReader is called. No last rites. Autopsy is forbidden.EpiscopalPrayer. Communion. Confession. Sacrament of the sick.Friends (Quakers)Individual communicates with God. No belief in afterlife.Greek OrthodoxPrayer. Communion. Sacrament of the sick. Mandatory baptism.HinduPriest performs ritual of thread around neck or wrist, water is put in mouth. Family cares for the body. Cremation is common.JudaismAfter death, a rabbi or designate cleanses the body.LDS/MormonBaptism required (adults). Body is dressed in temple garments. Call Bishop or Elder.LutheranPrayer. Communion. Call Pastor.MuslimImam performs specific procedures for washing and shrouding the body, with assistance of the family. Body is buried facing Mecca.PentecostalPrayer. Communion. Call Pastor.PresbyterianPrayer. Communion. Call Pastor.Roman CatholicPrayer. Sacrament of the sick. Communion. Mandatory baptism.Russian OrthodoxPrayer. Communion. Sacrament of the sick. Mandatory baptism.ScientologistConfession. Visit with pastoral counselor.Seventh-Day AdventistBaptism. Communion.UnitarianPrayer. Cremation is common.KUBLER-ROSS’S STAGES OF GRIEF AND LOSS:Dr. Elisabeth Kubler-Ross, a psychiatrist that described certain phases through which a person may pass in an attempt to cope with impending death.Formerly referred to as stages of death and dying.Well known for her initiation of the terms; death, anger, bargaining, depression, and acceptance. (DABDA)NURSING ALERT: A key nursing intervention for the dying client is to be aware that physical care is enhanced by understanding the grieving process and augmenting by providing emotional support during these phases.Greif: Common to all individuals; however, not all individuals experience grief in the same way.There is no right or wrong way to grieve.Loss: Can include grief, but does not necessarily have to include death. Loss can be related to any emotional suffering, such as the loss of health, the breakup of a relationship, or the loss of employment.Loss also includes the realization that one’s personal ambitions will not or cannot be achieved.All terminally ill people pass through some of these stages, unless death is instantaneously or the person is unable to resolve conflicts.KEY CONCEPT: The Kubler-Ross stages of grief and loss typically also occur in individuals who are close to the person who has died or is expected to die. These stages have also been identified and used for many or life’s situations.Denial:The preliminary stage, occurs when the person does not believe that the diagnosis is correct.During the stage of denial, the individual may seek advice from several doctors, hoping the one of them will offer a more acceptable prognosis.Concept Mastery Alert - Stages of grief:In caring for an elderly client who is dying, it is important to use the client’s statements as clues to the client’s stages of grief. A statement of “Why did this happen to me?” indicates that the client is in the anger stage of grief. In anger, the client asks, “Why?” Conversely, a statement of “Not, not me!” reflects the denial stage of grief.Anger:In the anger stage, the individual is angry and may have periods of acting-out or rage.Often, the individual envies the person who is young and healthy; he or she may lash out at family members or healthcare personnel.The anger that the person is expressing generally Chapter 14: The End of Life: Death, Dying, Grieving and Loss (Summer Putt)Death:Final stage of growth and development Part of life, an extension of birthCompared with the process of labor Fear and anxiety of the unknownPriority for the dying person Basic human needsPalliative Care Versus Curative Care:Palliative care: Improve the quality of life by providing for relief of symptoms such as pain, nausea, anxiety, and depression Curative care:Focus on recovery from one or more physical or emotional issues with the expectation of lengthening the lifespan. Influence of Culture, Ethnicity, and Religion:Beliefs shape people’s attitudes toward death. Culture determines how one responds to death. Religion and spirituality help individual and family meet the challenging concepts related to death.Spiritual support may be expressed as Compassionate careSpecific religious practice or ritualNormal Processes of Dying:Withdrawal from the external environmentVisions and hallucinationsLoss of appetiteChanges in bowel and bladder functionChanges in vital signsChanges in mental acuityFatigue and sleepChanges in sleep–wake patternsPainCongestion in lungs or throatSkin changesPhysical Care Versus Emotional Care:Physical care:Usually some form of treatment that can be observed and quantifiedEmotional care:Relates to psychological supportEffects cannot be measured and may seem less immediately obvious than physical careEqually important to well-being of the clientKübler-Ross: Stages of Grief and Loss:GriefCoping with this physical and psychological pain has the potential to heal and to strengthen those going through this process.LossCan include grief; related to any emotional suffering; realization that one’s personal ambitions will not or cannot be achievedStages of Dealing With Death:DenialShock and disbelief, often followed by a feeling of isolationAngerRage, acting-out physically or verbally at family or health professionalsBargainingGuilt and developing awareness of the situation Depression Grief and realization that death is certainAcceptanceSelf-reliance and a feeling of peaceSummer Putt Study Guide (Need to Knows):UNIT 3: (Chapter 9, 10, 11, 12, 13, & 14)What makes up a family? What are family characteristics? How is a family organized and what is the basic function? ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________What is an example of an alternative family? What does cohabitation mean?___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________What are the stages of the family life cycle and how is each stage defined? ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________How does a family cope? What is ineffective coping verses effective coping? Examples for each…….___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________What are the characteristics of human growth and development? Do we just grow randomly or is there a specific way? ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Who is Erikson? What did he develop? What are the psychosocial stages/ categories? ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Who is Piaget? What did he develop? What are the cognitive development stages/categories? ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________How do Erikson and Piaget plug into growth and development?___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________What is role play and how is it important in childhood development? Are there different types of play?___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________What is going on in infancy, toddler, preschool, school age, puberty and adolescence? What age is the child through each of these stages? What are some characteristics of growth during this period for each stage? ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________What is menarche?______________________________________________________________________________________________________________________________________________________________________________________________________________What is your role as a nurse in sexual education? ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________What are some issues specific to women (sorry guys) regarding aging?___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________What do the terms: gerontology, geriatrics, elderly, senescence, senior/senior citizen, and ageism mean? ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________What are some major physiological changes that occur with aging? I.e. decreased reaction time (there are several) ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________What is palliative care? What is curative care? How are they different?___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________What is the normal process of dying? How does culture, ethnicity and religion influence dying?___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________What is physical care versus emotional care? Why are these important?___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________What are the stages of grief and loss according to Kubler-Ross? What are the definitions of each stage? ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ................
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