Nursing 109

N109: Foundations in Nursing Practice Study Guide

Piaget’s Cognitive Development Piaget assumed that cognitive development was complete with mastery of the formal operations phase. However, other theorists posit that there may be a post-formal phase during which the individual develops the ability to problem solve, taking into consideration the relativity of knowledge. Kohlberg’s Moral Development Post-conventional level: As adults, individuals begin to understand that people have different opinions about morality and that rules and laws vary from group to group and culture to culture. Morality is seen as upholding the values of one’s group or culture. Understanding personal beliefs allows the adult to judge themselves and others based upon higher levels of morality. In this stage, what is right and wrong is based upon the circumstances surrounding an action. Basics of morality are the foundation with independent thought playing an important role. Gilligan’s Moral Development Conventional level: In this level, the focus is on women caring for others and not hurting others. They understand the value and need for caring relationships. Fowler’s Spiritual Development Individuating-reflexive faith: This stage requires that the person be willing to interrupt his reliance on external authority and relocate the source of authority within. The person is more able to govern him/herself without the need for rules from the outside. The person gains the ability to make comparisons and whatever meanings they retain are explicitly held and are more authentic. 1.8 Middle Adulthood: 40 to 65 Years Physical Development As hormones begin to decrease, men and women experience many changes during this period. When menstruation stops in women (usually by the age of 55), menopause ensues. During this time, women may experience hot flashes, insomnia, weight gain, and headaches. Although men go through a similar “change of life” called the climacteric, androgen levels decrease slowly and the changes are subtle. During this period, hair begins to thin and gray and the skin begins to lose turgor and fat, resulting in wrinkles. By age 60, both sexes will notice a decrease in muscle mass and an increase in abdominal fat. Vision and hearing (particularly high-pitched sounds) will begin to diminish. A slowing metabolic rate may lead to weight gain and bouts of constipation. Common Health Problems Identified in thisStage During the middle adulthood stage the individual continues to be relatively healthy, however the incidence of chronic illness begins to increase during this stage. Some of the common problems include: • Accidents • Cancer • Hypertension and cardiovascular disease • Pulmonary diseases • Alcoholism • Obesity

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