Erikson’s psychosocial development (focuses on person’s relationship to family and culture)
Individuals need to accomplish a particular task for successfully mastering the stage and
progressing to the next one.
1. Trust vs. Mistrust (Birth to 12 to 18 months) infancy stage
a. At this stage an infant needs a consistent caregiver who is available to meet
his needs
b. Ability to trust others
2. Autonomy vs. sense of shame and doubt (18 months to 3 years) toddler/early
childhood stage
a. Child is able to walk, feed, and go to the bathroom at this stage
b. Toddler is able to make choices
c. Limiting choices or enacting harsh punishments leads to feelings of shame
and doubt
d. The nurse models empathetic guidance that offers support for and
understanding of the challenges of this change
e. Self-control and independence
3. Imitative vs. Guilt (3 to 6 years old) preschool age
a. Fantasy, pretending and imagination occur (highly imaginative)
b. Develops superego
c. Conflicts concerning child’s desire to explore and limitations place on his/her
behavior
d. Preschoolers frequently engage in treating dolls or stuff animals like they have
thoughts and feelings
e. Play therapy is important at this stage and helpful for a child that is dealing
with inherent threats related to hospitalization or chronic illness.
4. Industry vs Inferiority (6 to 12 years old) middle childhood (engaged in tasks and
activities)
a. Eagerness to apply themselves to learn socially productive skills and tools
b. Thrive on their accomplishments and praise
c. Without proper support for learning skills or if too difficult, they develop
inadequacy and inferiority
d. Benefits from real achievements to develop a sense of compency.
e. During hospitalization it’s important for this age group to understand routine
and participate, when possible, in the treatment process. i.e., like keeping a
record of their intake/output
5. Identity vs. role confusion (puberty)
a. Sexual maturation begins at this age as well as dramatic physiological changes
with appearance and body
b. Identity development begins with the goal of achieving some perspective or
direction (Who am I?)
c. Nurses have the opportunity to provide education and anticipatory guidance
for parents about the changes and challenges and risks to adolescents.
d. If hospitalized at this age, help them deal with their illnesses by giving them
enough information to help make some decisions about their treatment plan
6. Intimacy vs. isolation (young adult) affiliation vs love
a. Develops a sense of identity deepens their love to care for others
b. Have meaningful friendships and intimate relationships with another person
c. If they are able to establish companionship and intimacy, isolation happens
because of fear of rejection and disappointment
d. Nurses must understand young adults’ need for intimacy
e. Young adults benefit from the support of their partner or significant other
7. Generativity vs self-absorption and stagnation (middle age)
a. Adults focus on supporting future generations
b. Important to expand one’s personal and social involvement
c. Achieves success by contributions to future generations through parenthood,
teaching, mentoring, and community involvement.
d. “care for others” is the basic strength
e. Nurses help physically ill adults choose creative ways to foster social
development
f. Fulfillment by volunteering in a school/church/hospital is important at this
stage
8. Integrity vs Despair (old age)
a. Older adults review their lives with a sense of satisfaction or with failures
marked by despair and regret.
b. Interpret meaningful whole or experience regret because of goals not achieved
c. Nurses can encourage this age group to reflect on their relationships with
family members or community.
Kohlberg’s Moral development
1. Level 1-Preconventional Reasoning is based on limited cognitive thinking and individuals
have egocentric views. Thinking at this stage is based on likes and pleasures.
Consequences come from reward or punishments. Children view illness as a punishment
for fighting or disobeying their parents. Nurses need to be aware of this egocentric
thinking and reinforce that the child does not become ill because of wrongdoing.
a. Stage 1: Punishment and Obedience
i. Child response to moral dilemma by absolute obedience to authority and
rules.
ii. A child must follow rules or otherwise thinks he/she will be punished
iii. Physical consequences guide right or wrong choices
b. Stage 2: Instrumental Relativist
i. Child recognizes there is more than one right view (ex: a teacher has one
view that is different than the child’s parent)
ii. The decision to do something morally right is based on satisfying one’s
own needs and sometimes the needs of others
iii. Child perceives punishment not as a proof of being wrong (stage 1) but as
something to avoid
iv. Children in this stage follow parent rules such as being on time for supper
because they don’t want to have to be confined to their room for the rest
of the evening if late
2. Conventional Reasoning -the person sees moral reasoning based on his/her personal
internalization of societal and others’ expectations. A person wants to fulfill the
expectations of the family, group, or nation and develop a loyalty to and actively
maintain support and justify the order. This thinking centers around the question of,
“How will it affect my relationships with others?” Nurses observe this when family
members make end-of-life decisions for loved ones.
a. Stage 3: Good Boy-Nice Girl
i. Individuals want to win approval and maintain the expectations of one’s
immediate group.
ii. Being good is important and it shows positive motives, concerns for
others, and keeping mutual relationships through trust, loyalty, respect
and gratitude
b. Stage 4: Society-Maintaining
i. Individuals expand their focus from a relationship with others to societal
concerns.
ii. Right behavior is doing one’s duty, showing respect for authority, and
maintain the social order
iii. Adolescents choose not to attend a party where they know beer will be
served because they know it’s not right.
3. Level 3: Postconventional Reasoning-person finds a balance between basic human rights
and obligation and societal rules and regulations. They find their own moral values and
principles. They also look at what an ideal society would be like.
a. Stage 5: Social Contract
i. Societal laws are followed but recognizes the possibility of changing the
law to improve society. Individual recognizes that different social groups
have different values but believes all rational people would agree on
basic rights such as liberty and life. Agree on making more of an
independent effort to determine what society SHOULD value rather than
what the society as a group would value.
ii. Stage 5 emphasizes the basic rights, democratic process and following
the laws without question
b. Stage 6: Universal Ethical Principle
i. Defines “right” by the decision of conscience in accord with self-chosen
ethical principles.
ii. Stage 6 defines the principles by which agreements will be most just.
(Civil disobedience)
iii. A person in stage 6 may not follow a law if it does not seem just to the
racial group
4. Herbal Therapy
a. Patient using herbal therapy- caution patients about the dosage and use of
herbal compounds because the FDA does not regulate them. Herbal compounds
(melatonin, valerian, lavender, passionflower, and chamomile) may interact with
prescribe medications and patients need to avoid using these together.
b. Ginseng is used in the traditional healing practices of many ethnic groups to
combat age related diseases by increasing physical endurance and improving
immune function. It is not safe for people taking prescription meds that thin the
blood (anticoagulants, aspirin, non-steroidal anti-inflammatory drugs).
5. High Risk Practices in Young Adults (Smoking)
a. Late teens to mid to late 30s
b. Family history of disease
c. Personal hygiene habits, poor dental hygiene
d. Violence-MOST COMMON CAUSE OF MORTALITY
e. Nurses can perform psychosocial assessment
f. Domestic violence
i. Pregnant women delay prenatal care; delivery of preterm babies
g. Substance use
i. Overdose and death
ii. Caffeine-MOST USED STIMULANT
h. Human trafficking-growing problem
i. Unplanned pregnancies
j. STI’s
k. Environmental/occupational factors
i. Lung disease from inhalation of dust/smoke
ii. cancer
6. Health promotion in young adults
a. Susceptible to chronic diseases-Diabetes
b. Encourage to perform self exams
c. Nurses provide education regarding breast exams and UV exposure
d. Encourage partners to know of sexual history
e. Nurses provide information on safe sex practices
7. Complimentary therapy for Pain Management
a. Relaxation, repositioning, distraction, focused breathing, art therapy, and humor
8. Healthy People initiative 5 questions
a. Clinical Preventative Services.
b. Maternal infant child health
i. A type of intervention to help with First time pregnant women would be
providing teaching on proper nutrition.
ii. What is the leading cause of death in pregnant women
c. Access to health care services
d. Environmental quality
e. Injury and violence
f. Mental health
g. Reproductive and sexual health
h. Nutrition, physical activity and obesity
i. Oral health
j. Social determinants
k. Substance abuse
l. tobacco
9. What is the leading health indicator?
a. Access to health services, injury and violence prevention, maternal/infant/child
health
b. Obesity, nutrition, and physical activity
i. Unhealthy nutrition in children and adolescents can lead to stunting,
anemia, eating disorders
c. Cover populations across the lifespans like drug overdose deaths in all ages and
current use of any tobacco products among adolescents
d. Goal is to help reduce the misuse of drugs and alcohol helping people with
substance use disorders get the treatment they need and prevent drug and
alcohol misuse
10. Leading cause of death for pregnant women is infection, hemorrhage, HTN disorders
11. Unhealthy nutrition in older children/adolescents leads to obesity
12. Access to Healthcare issues
a. People of color, ethnic minorities, low-income residents
b. Most contributing factor to poorer quality of care
c. Uninsured people less likely to get care for disease prevention and management
13. Leading health indicator Reproductive and Sexuala. behavior meets the healthy indicator
st
14. 1 time pregnant women interventions
a. Good health practices before conception
i. Diet, folic acid, exercise, dental checkups, avoid alcohol, stop smoking
b. Education on STI’s, vaginal infections and UTI’s
i. Counseling on diet, exercise, child care
c. Education on symptoms
15. Complementary vs Alternative therapy
a. Complementary is used in addition to conventional treatment (integrative
therapies)
i. The most effective complementary nursing therapies is relaxation
therapy.
b. Alternative therapies-replace allopathic medical care
16. Symptoms of stress- anger/ fear /anxiety/ depression; increased heart
rate/bp/vasoconstriction, release of glucose; illness/disease, trouble sleeping/changes
in appetite, food cravings/headaches; burnout
a. Developmental crises occur as a person moves through the stages of life
b. Situational-external sources such as a job change, motor vehicle crash, death, or
severe illness provoke situational crises
c. Adventitious-a major natural or man-made disaster or crime of violence can
create an adventitious crisis.
17. Stress management-modifiable stressor
a. The key health promotion interventions for stress are decreasing situations that
cause stress, increasing stress resistance and learning ways to lessen the
physiological responses to stress
b. Burnout-chronic stress
i. Nurses perceive demands of work exceed perceived resources
ii. Emotional exhaustion, poor decision making, loss of sense of personal
identity, feelings of failure
18. Identify the step of nursing process
a. Someone is providing diet education to patient-implementation
b. Identifying problems with families-assessment
19. Leading Health indicator environmental quality
a. Lung disease from inhalation of dust/smoke
b. Cancer
c. Water quality
d. Noise
20. Interventions for adolescent pregnancy
a. Early prenatal supervision
b. Special attention to nutrition, health supervision, psychological support
c. Help in planning the future and obtaining day care for infants
21. Health risk for toddlers
a. Poisoning, drowning, motor vehicle accidents
22. Primary preventative service childhood death that is underused -immunizations cost
effective
23. Most effective intervention of newborn health
a. Breast feeding-most effective, low cost
24. Proper intervention for cardiovascular-avoid excess alcohol, unhealthy eating, physical
inactivity, tobacco use
a. Major risk factors are high blood pressure, cigarette smoking, unhealthy diet,
lack of physical activity and diabetes
25. Oral rehydration therapy-dissolved dried salts in clean water to reduce contimants
found water. Given to
26. How do you promote health in school age and adolescent health
a. Perceptions
b. Health education
c. Health maintenance
d. Safety
e. Nutrition
27. Proper nurse intervention with a woman victim of sex trafficking-use compassionate
care, empathy , listen, therapeutic answers
28. Pick social determinant of health view healthy people website
a. Economic stability, education access and quality, health care access and quality,
neighborhood and built environment, and social and community context
29. Primary reason for the lack of access of carea. Lack of access to insurance, lack of healthcare workers, cost of healthcare too
high
30. Child mortality impacted on a global scale-immunizations, improving maternal health,
family planning, and improving nutrition
31. What can a nurse do to better maternal newborn health for Pregnant mother/newborn
a. Provide women with the education they need about nutrition before conception
and throughout pregnancy
b. Listen to patient
c. Provide self-care education
d. Complementary and alternative therapies
e. Immunizations, family planning, prevention and HIV treatment
32. Know the mindfulness/
33. How is mindfulness useful to a nurse
a. Can reduce stress and burnout
b. Improve empathy, job satisfaction and sense of well being
c. Greater awareness, less distraction
d. Improve assessments and enhance communication
34. Resiliency question
35. Key practices to develop for a mindful nurse
a. Yoga, breath awareness and body scans
36. How does a mindful nurse help develop care
a. Can reduce stress and burnout
b. Improve empathy, job satisfaction and sense of well-being
c. Greater awareness, less distraction
d. Improve assessments and enhance communication
37. How has resiliency improved
a. Healthy practice environments
b. Healthcare organizations implement strategies toward improvement
38. Healthy practice environment factor to improve resiliency:
a. Supportive coworkers and management
b. Caring environments
c. Optimal healing environments
39. How is resiliency important to the nurse
a. Ineffectively dealing with stress
b. Can lead to job and employer dissatisfaction
40. Which nursing process is involved
a. The nurse provides all parts of videos lectures, handouts-implementation
41. Team sports in 8 year old’s fosters what?
a. Learning to contribute, collaborate, and work together toward a common goal is
a measure of success
b. Gain a sense of achievement working and playing with peers
42. Target percentage of health insurance coverage access to care-92.4%
43. Determine the pain level is what step of the nursing process
44. Complementary therapy
45. Primary goal of healthy people 2030
a. A society in which all people can achieve their full potential for health and wellbeing across the lifespan
b. Promote strengthen and evaluate the nation’s efforts to improve the health and
well-being of all people
46. Newborn safety
a. Screenings to identify life threating conditions, educating parents about car seat
safety upon discharge, crib standards