Chapter 22
Young Adult
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Biology and Genetics
18-35 years
Health-promotion needs
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Developing behaviors to promote healthy lifestyle
➢ Decreasing incidence of accidents, injuries, violence
Young adulthood at a glance
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Healthiest period, optimal muscle strength (age 25-30), manual
dexterity peaks
Gender differences
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Full growth
• Women: Age 17; men age 21
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Longevity: Women > men
➢ Health care seeking: Women > men
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Biology and Genetics (Cont.)
Greater complexity of thinking; more organized
emotional/cognitive development
Self-help resources very popular with young
adults
Maternal mortality rate primarily pertains to
young adults—health indicator of a nation’s
health resources
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Gordon’s Functional Health
Patterns
Health perception–health management pattern
Nutritional-metabolic pattern
Elimination pattern
Activity-exercise pattern
Sleep-rest pattern
Cognitive-perceptual pattern
Self-perception–self-concept pattern
Roles-relationships pattern
Sexuality-reproductive pattern
Coping–stress tolerance pattern
Values-beliefs pattern
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Health Perception–Health
Management Pattern
Behavioral health history
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Risk factors for unintentional injuries
Preventive care
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Maximize health status, detect problems early
Age 18: full health appraisal
Repeat history/physical every 2 years
Screenings: testicular examination, PAP smear
Experts now recommend against SBE
Over age 25: focus on coronary risk factors
• Cholesterol, diabetes, smoking, hypertension, metabolic
syndrome
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Health Perception–
Health Management Pattern
(Cont.)
Decision-making and risk taking
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Risk-taking behavior
Leading causes of death: unintentional injuries,
homicide, suicide
Communicable disease
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Threats: changes travel, social, sexual behaviors
➢ Drug resistance; new strains emerging
➢ Disease examples
• Immunizations: rubella, HPV (women), hepatitis B
• TB, HIV, Lyme disease
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Health Management for Young
Adults
Prevention is key for young adults
Modifying CHD risk factors for those >25 years
Hypertension screening and management
Education to focus on healthy lifestyle choices
ID metabolic syndrome—precursor to DM
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Obesity, high lipids, hypertension
Risk taking remains problematic for young
adults—accidents leading cause of death
Of concern: meningitis, hepatitis B, TB, HPV
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Nutritional-Metabolic Pattern
Obesity: epidemic proportions
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Basal metabolic rate declines
More intake than energy requirement = weight gain
Obesity rates vary by ethnicity
Factors : increasing portion size, “eating out,” sedentary
lifestyles
Teaching: increased activity, low fat, more
fruits/vegetables, limit portions
Assessment: BMI, waist circumference, BP, cholesterol
Nutritional needs/common deficiencies
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Iron, folic acid, calcium
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Elimination Pattern
Eating disorders
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Common complaints
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May persist
Constipation
Hemorrhoids
Occasional diarrhea
Teaching
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Report changes in elimination patterns
Adequate fluids, eating fruit/vegetables
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Activity-Exercise Pattern
Exercise recommendations
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Sun/radiation exposure
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Aerobic exercise of moderate intensity for 30 minutes, 5 days per
week
Barriers: lack of time, access to facilities, safe environments
Avoid excessive UV: use of sun blocks, sun-protective clothing,
avoid tanning, sunbathing
Sports
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Recreational activity history guides education
Helmets for bicycles, motorcycles
Protective equipment for sports
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Sleep-Rest Pattern
Subject to fatigue
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Work
➢ Stress
➢ Inactivity
Recommendations
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Change activity or stressors
Try out new tasks or physical activities
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Cognitive-Perceptual Pattern
Piaget: formal operations
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Intellectual growth
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Recall performance and memory: peaks in 20s
Erikson: intimacy vs isolation
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Analysis of all combinations of possibilities and constructs
hypotheses; more perceptive/insightful
Increased sense of competency/self-esteem
Learns to develop reciprocal intimate relationships (requires
mutual trust)
Postconventional moral reasoning
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Define rights and morality in terms of self-chosen principles
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Self-Perception–Self-Concept
Pattern
Western culture: adulthood
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Achieve financial and residential independence
Life stage conflict: Explore and experiment vs firm commitments
Employment tied to self-esteem
Employment issues
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Pay differentials by gender
Variance in benefits, occupational hazards
Stress of employment
Childbearing choices; child care issues
Increased job burden with decreased job security
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Roles-Relationships Pattern
Young adult friendships more enduring than
earlier relationships
Formation of intimate relationships
Decisions about life/career directions
Formation of family units
Multiple decisions related to childbearing,
finances, roles/relationships
Self and family development
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Roles-Relationships Pattern (Cont.)
Separation/divorce
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Affects children, families of couple
➢ Reevaluation of basic values, strengths, personality
➢ Depression common—supportive counseling/services
Violence
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80% of violence is individual acts (homicide, suicide)
➢ Homicide: second leading cause of death age 15-24
➢ Associated: guns, alcohol, drug abuse, crimes
➢ Intimate partner violence
• Crosses all demographic boundaries
• Underreported; women report higher lifetime violence
• Appropriate assessment, detection, treatment needed
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Sexuality-Reproductive Pattern
Infertility
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Affects10%-15% of US couples; increased incidence >25 years
Assistive reproductive technologies (stressful, costly)
Sterilization: choice increases with age
Male issues: orchitis, epididymitis, varicoceles, hydroceles
Unintended pregnancy (half of all pregnancies)
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Teen birth rate down 30% in the past decade
Half of unplanned pregnancies are caused by contraceptive
failure
Nurse’s role: help choose most appropriate method
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Sexuality-Reproductive Pattern
(Cont.)
Prenatal care
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STDs
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Insufficient for high-risk and minority women
Leading cause of infection (high-risk age group)
Screening for chlamydia recommended
Multiple STDs increases risk of HIV
HIV challenges
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Treatment/prevention needs of chronically ill
Effective strategies to prevent new infections/improve case
finding
Counsel on risk-reduction behaviors
Education of individuals and general public
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Coping–Stress Tolerance Pattern
Stress
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Assess for stress-related complaints
➢ Assess for signs of achievement stress
➢ Listen, offer support; referrals as needed
Suicide and depression
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Suicide: leading cause of death
Cause: unable to cope with stressful circumstances or
events
More women attempt suicide; more men succeed
Assess for depression and suicidal ideation
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Values-Belief Pattern
Health promotion
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Altering value/belief patterns that encourage poor
health practices
Parenting
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Ensuring healthy offspring
Genetic testing and prenatal diagnosis decisions
• Decision-making of potential risk of transmission
• Values and decision-making related to genetic impairment
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Environmental Processes
Ethnicity, race, culture
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Accidents
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Nonmajority ethnicity/culture
Health effects from prejudice, discrimination, educational/work
decisions, residential setting
Highest cause of death in young adults
Motor vehicle accident prevention important: seat belts, use of
alcohol, aggressive driving
Pollution
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Noise: increases risk of hearing loss (e.g., recreational
exposure)
Air: automobile exhaust; industrial exposures
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Environmental Processes (Cont.)
Occupational hazards/stressors
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Young adults work in hazardous jobs
➢ Vocational training needed to avoid hazards
➢ Periodic assessment, counseling for risks
Chemical agents
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Drug use—injury, disability, violence, social problems
Alcohol use—accidents, future chronic conditions;
binge drinking
Tobacco use—leading cause preventable death
• Synergistic effect with asbestos, dust, radiation exposures
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Environmental Processes (Cont.)
Cancer—environmental carcinogens
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Work exposure
• Hazardous chemicals
• Latex: long-term immune system disease
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Unhealthy practices
• Multiple sexual partners, exposure to HPV: risk of cervical
cancer
• Smoking: lung cancer, cervical cancer
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Determinants of Health: Social
Factors and Environment
Social factors and environment
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Culture and ethnicity
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Neighborhood resources—sets standards for individual health
Challenges: transportation, medical home, health coverage
Health care based on Western belief system
Identification needed of culturally influenced health behaviors
and culturally acceptable interventions
Legislation
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Major political constituency
Have time/energy to affect issues related to common good
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Determinants of Health: Social
Factors and Environment (Cont.)
Economics
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Homelessness
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Satisfying careers; adequate economic returns
Changes in employment choices, types of jobs, work styles,
potential for job security
More families homeless
Poverty, poor education, lack skills, domestic violence,
substandard health care
Dual careers
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May amplify relationship strain, domestic violence
Increased life complexity: child day care, caring for parents,
varied living arrangements
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Nursing Application
The physical abilities of the young adult are in
peak condition so the goals of the nurse are
aimed at maintaining optimal physical
conditions, encouraging healthy habits,
screening for disease, and treating illnesses
As the nurse obtains an assessment of the
individual and family history, the necessity of
further screening, education, or monitoring is
determined
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