Professional Documents
Culture Documents
Development
1/7/2010
Objective
1/7/2010
Age Groups
Neonate: birth to 1 month
Infant: 1 month to 1 year
Toddler: 1 year to 3 years
Preschool: 3 to 5 years
School age: 6-12 years
Adolescence: 13-18 years
Early Adulthood: 19-40 years
Middle Adulthood: 41-60 years
Late Adulthood: 61 years and older
1/7/2010
Neonate & Infant: Physiologic
Vital Signs
• HR
100-160 120 after first 30 mins
CO is HR dependent
• Vent Rate
40-60 30-40 after 1st mins of life
20-30 by one year
• Tidal Volume
Doubles by first year
1/7/2010
Neonate & Infant: Physiologic
Weight
• 3 to 3.5 kg at birth
• slight after 1st week
• weight triple by 1 year (10 kg)
• head 25% TBW
1/7/2010
Neonate & Infant: Physiologic
Cardiovascular System
• ductus arteriosus, ductus venosus and
foramen ovale close soon after birth
• SVR
• PVR
• L ventricle strengthens during year
1/7/2010
Neonate & Infant: Physiologic
1/7/2010
Neonate & Infant: Physiologic
Pulmonary System
• Short, narrow, easily obstructed
• neonate: obligate nose breather
• immature accessory muscles
• flexible chest wall
• diaphragmatic breathing normal
• higher oxygen consumption rate
• vent rate leads to rapid heat & fluid loss
1/7/2010
Neonate & Infant: Anatomic
Airway
Considerations
1/7/2010
Neonate & Infant: Physiologic
Renal System
• unable to concentrate urine
Immune System
• passive immunity first 6 months
• immature immune system
• no acquired immunity after 6 months
1/7/2010
Neonate & Infant: Physiologic
Nervous System
• reflexes: sucking, rooting, palmar grasp
• fontanelles: posterior closes @ 3 mos; anterior
closes @ 9-18 mos
• sleep 16-18 hrs/day
• even wake throughout 24 hr day
• sleeps thru night at 2-4 mos
• infant easily arousable
1/7/2010
Neonate & Infant: Physiologic
Developmental Changes
• 2 mos: tracks objects with eyes; recognizes familiar faces
• 4 mos: reaches out to people
• 6 mos: sits upright; one syllable sounds
• 7 mos: fears strangers
• 9 mos: pulls to standing position
• 10 mos: crawls
• 11 mos: attempt to or walks; knows name
1/7/2010
Neonate & Infant: Social
How would
you
describe
this infant?
1/7/2010
Toddler & Pre-School: Physiologic
Vital Signs
• HR
80-120/130 bpm
• Vent Rate
20-30 breaths per min
• Systolic BP
Toddler: 70-100 mm Hg
Pre-School: 80-110 mm Hg
Min systolic: 70 + (2 X age yrs)
1/7/2010
Toddler & Pre-School: Physiologic
Weight
• Avg gain 2 kg/year (up to 8 yrs)
Cardiovascular system
• capillary beds developed to aid in
thermoregulation
• hemoglobin levels approach adult
Renal system
• toddler urine findings similar to adults
1/7/2010
Toddler & Pre-School: Physiologic
Immune system
• more susceptible to minor infections
• develops acquired immunity as exposures
occur
Nervous system
• myelination increases cognitive development
• fine motor skills developing
1/7/2010
Toddler & Pre-School: Physiologic
Musculoskeletal system
• muscle mass & bone density
Sensory development
• visual acuity: 20/30 during toddler yrs
• hearing: mature at 3-4 yrs
1/7/2010
Toddler & Pre-School:
Psychosocial
Cognitive
• basics of language by 3 yrs
• separation anxiety at 18-24 mos.
Modeling
• begin to recognize differences of sex
• begin to model themselves based on sex
1/7/2010
Toddler & Pre-School: Psychosocial
Play
• able to play simple
games & follow simple
rules
• begins
competitiveness
1/7/2010
School Age: Physiologic
Vital Signs
• HR: 70-110 bpm
• Vent rate: 20-30 breaths per min
• Sys BP: 80-120 mm Hg
• Avg weight gain of 3 kg/year
1/7/2010
School Age: Physiologic
All Systems
• most at adult levels during this period
• brain function continues to increase
1/7/2010
School Age: Psychosocial
Develop self-concept
• compare to others
• self-esteem
• affected by peer popularity, rejection,
neglect & emotional support
1/7/2010
School Age: Psychosocial
1/7/2010
Adolescence: Physiologic
Vital signs
• HR: 55-105 bpm
• Vent rate: 12-20 breaths per min
• Systolic BP: 100-120 mm Hg
1/7/2010
Adolescence: Physiologic
Growth
• most have a rapid 2-3 year growth spurt
begins with enlarged feet & hands
followed by enlarged arms & legs
then chest & trunk
• mostly done growing by
girls: age 16
boys: age 18
1/7/2010
Adolescence: Physiologic
Sexual development
• noticeable development of external sexual
organs
• pubic and axillary hair develops
• vocal quality changes (mostly males)
• menstruation begins (menarche)
1/7/2010
Adolescence: Physiologic
Endocrine
• female
gonadotropin promotes estrogen &
progesterone production
• male
gonadotropin promotes testosterone production
• reproductive maturity
1/7/2010
Adolescence: Physiologic
Other changes
• body fat early and later
• female requires 18-20% body fat for
menarche to occur
• blood chemistry nearly equal adult
1/7/2010
Adolescence: Psychosocial
Family Issues
• strive for autonomy
• puberty changes
• idealistic
• seeks independence &
identity
1/7/2010
Adolescence: Psychosocial
Identity issues
• Increase in:
self-consciousness
peer pressure
interest in opposite sex
• anti-social behavior peaks 8th or 9th grade
• wants to be treated like an adult
1/7/2010
Adolescence: Psychosocial
Identify issues
• body image of great concern
comparison against peers
eating disorders common
• self-destructive behaviors
tobacco
alcohol
drugs
1/7/2010
Adolescence: Psychosocial
1/7/2010
Early Adulthood: Physiologic
Vital signs
• HR: 60-100 bpm (avg 70)
• Vent rate: 12-20 breaths per min
• BP: avg 120/80 mm Hg
Peak physical condition: 19-26 years
Develop lifelong habits & routines
Body systems at optimal performance
1/7/2010
Early Adulthood: Psychosocial
1/7/2010
Middle Adulthood: Physiologic
Vital signs
• similar to Early Adulthood
Varying degrees of body system
degradation
Vision & Hearing changes
Cancer common in this age group
Weight control difficult
1/7/2010
Middle Adulthood: Physiologic
Cardiovascular system
• cholesterol levels increase
• decreased cardiac output
• high risk of AMI
• menopause in late 40s or early 50s
1/7/2010
Middle Adulthood: Psychosocial
1/7/2010
Late Adulthood: Physiologic
Vital signs
• all depend on patient’s
physical & health
status
1/7/2010
Late Adulthood: Physiologic
Cardiovascular system
• vascular
peripheral vascular resistance
atherosclerosis
baroreceptor sensitivity
• blood cells
functional blood volume, RBCs & platelets
poor iron levels
1/7/2010
Late Adulthood: Physiologic
Cardiovascular system
• Heart
increased workload
• myocardial elasticity
• mitral & aortic valve changes
myocardium less responsive to stress
pacemaker cells diminish resulting in dysrhythmias
tachycardia not well tolerated
previous injury
1/7/2010
Late Adulthood: Physiologic
Respiratory system
• diaphragm elasticity diminished
• chest wall weakens
• diffusion through alveoli decreased
• lung capacity diminished
• coughing less effective
1/7/2010
Late Adulthood: Physiologic
Endocrine system
• decreased glucose metabolism
• decreased insulin production
• cortisol diminished
Renal system
• 50% nephrons lost
• decreased elimination
1/7/2010
Late Adulthood: Physiologic
GI system
• peristalsis decreased
• esophageal sphincter less effective
• GI secretions decreased
• Vitamin & mineral deficiencies common
Nervous system
• neurotransmitters diminished
• neurons lost
1/7/2010
Late Adulthood: Physiologic
Sensory changes
• loss of taste buds
• olfactory, visual acuity & reaction time
decreased
• diminished pain perception
• loss of hearing
1/7/2010
Late Adulthood: Psychosocial
1/7/2010