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DEVELOPMENTAL TASKS

Irish Nicole Dela Cruz

ERIK ERIKSONS STAGES OF PSYCHOSOCIAL


DEVELOPMENT THEORY
Erikson describes eight developmental stages through which a healthy developing human should
pass from infancy to late adulthood. In each stage, the person confronts and hopefully masters
new challenges. Each stage builds on the successful completion of earlier stages. The challenges
of stages not successfully completed may be expected to reappear as problems in the future.
Each of Eriksons stages of psychosocial development is marked by a conflict, for which
successful resolution will result in a favorable outcome and by an important event that this conflict
resolves itself around.
Patient T is on the 7th stage of psychosocial development theory which is Generativity vs.
Stagnation. Generativity refers to making your mark on the world, through caring for others,
creating things and accomplishing things that make the world a better place. Stagnation refers to
the failure to find a way to contribute. These individuals may feel disconnected or uninvolved with
their community and with society as a whole.
Adults need to create or nurture the things that will outlast them, often by having children or
creating a positive change that benefits other people. Success leads to feelings of usefulness and
accomplishment, while failure results in shallow involvement in the world.

SIGMUND FREUDS PSYCHOSEXUAL


DEVELOPMENT THEORY
According to Freud, people enter the world as unbridled pleasure seekers.
Specifically, people seek pleasure through from a series of erogenous zones.
These erogenous zones are only part of the story, as the social relations learned
when focused on each of the zones are also important. Freuds theory of
development has two primary ideas: One, everything you become is determined
by your first few years. Indeed, the adult is exclusively determined by the childs
experiences, because whatever actions occur in adulthood are based on a
blueprint laid down in the earliest of life (childhood solutions to problems are
perpetuated). Two, the story of development is the story of how to handle social
impulses in socially acceptable ways. Patient T belongs to the Genital stage
which begins at puberty. It involves the development of the genitals, and libido
begins to be used in its sexual role.

JEAN PIAGETS THEORY OF DEVELOPMENT


According to Piaget, development is driven by the process of Equilibration. Equilibration
encompasses assimilation (i.e, people transform incoming information so that it fits within
their existing schemes or thought patterns) and accommodation (i.e, people adapts their
schemes to include incoming information). Patient T belongs to the formal operational
stage which starts in adolescence. In this stage, individuals move beyond concrete
experiences and begin to think abstractly, reason logically, and draw conclusions from
the information available, as well as apply all these processes to hypothetical situations.
The abstract quality of thought at the formal operational level is evident in the persons
verbal problem solving ability. The logical quality of the persons thought is when they are
more likely to solve problems in a trial-and-error fashion because adolescents begin to
think more as a scientist thinks, devising plans to solve problems and systematically
testing solutions. They use hypothetical-deductive reasoning, which means that they
develop hypotheses or best guesses, and systematically deduce, or conclude, which is
the best path to follow in solving the problem.

MEDICAL MANAGEMENT

OXYGEN THERAPY
July 13, 2013

Regulation: 3-4 LPM


Via nasal cannula
Purpose:
To supply proper amount of
oxygen required to the body.

NURSING RESPONSIBILITIES
1. Place an Oxygen in use at the
clients bedside
2. Assessment:
Skin and mucus membrane
Breathing Patterns
Chest movement
Lung sounds
Presence of clinical signs of
hypoxemia
Presence of clinical signs of O2
toxicity

DIET
Iron rich foods with increased Oral Fluid Intake as
tolerated

Rationale:
Iron is an important mineral for all body cells--especially
red blood cells. Iron helps red blood cells make
hemoglobin, which helps to oxygenate your body
tissues.

Type of
Solution

D5LR
(5%
Dextrose in
Lactated
Ringers
Solution)

Classification

-Hypertonic
-Non
pyrogenic
-Parenteral
fluid
-Electrolyte
and nutrient
replenisher

Components

Electrolytes in
1000ml
Sodium 130
mmol
Potassium
4mmol
Calcium 1.4
mmol
Chloride
109mmol
Lactate
28mmol

Indications

Dosage
Contraindica
&
tions
Frequen
cy

-Tx for persons Amphotericin


needing extra B Mannitol
Diazepam
calories who
cannot tolerate
fluid overload
-Treatment of
shock

Nursing
Responsibilities

-Do not administer


1L
unless solution is
infusing
clean and container
at
is undamaged
30gtts/mi
-Caution must be
n

Mechanism of
Action

Hypertonic
Solutions are those
that have an
effective osmolarity
greater than the
body fluids. This
pulls the fluid into
exercised in the
the vascular by
administration of
osmosis resulting in
parenteral fluids
an increased
-Solution containing vascular volume. It
dextrose should be raises the
intravascular
used with caution
osmotic pressure
and provides fluid
-Discard unused
electrolytes and
portion
calories for energy

LABORATORY EXAMS

COMPLETE BLOOD COUNT


The test used to quantify the number of the RBC, WBC and Platelets, provide
information about size, shape, measure the hemoglobin content of RBCs,
determine the percentage absolute number of White Blood Cell types, and
identify early abnormal blood cells.
Purpose:
The method was done to Pt. as part of physical examination. It is an effective
tool that provides valuable diagnostic information about the patients condition
and used as a basic screening as part of wellness check.

PROCEDURES
The skin surface is cleansed with Antiseptic; A tourniquet is placed around the upper arm
to apply pressure
A needle is inserted through the area of cleansed skin into the vein below where the
tourniquet is applied. The blood is then pulled from the vein via the needle by gently
pulling the plunger on the syringe or by a connection of the needle to a special vacuum
vial that collects the blood.
After the procedure, the tourniquet is removed.
The venipuncture site is covered with cotton or a bandage to compress the site to stop the
bleeding.
The sample is then taken to the laboratory for analysis, and the complete blood count
results may be available within hours after collection. *Prompt delivery of the blood
sample to the laboratory for analysis is important. A sample that is not delivered in a
timely manner may yield inaccurate results.

NURSING INTERVENTIONS
Explain test procedure. Explain that slight discomfort may be felt when the
skin is punctured.
Encourage to avoid stress if possible because altered physiologic status
influences and changes normal hematologic values.
Explain that fasting is not necessary. However, fatty meals may alter some
test results as a result of lipidemia.
Apply manual pressure and dressings over puncture site.
Monitor the puncture site for oozing or hematoma formation.
Instruct to resume normal activities and diet.

HEMATOLOGY RESULTS
Date Performed

Component

Normal Range

Result

Analysis

July 12, 2013

Hgb

14-18 g/dl

8.5 g/dl

Decreased; due to
impaired gas exchange

Hct

40.0-54.0 %

25.0

Decreased; due to blood


loss

WBC

4.0 10.0

5.2

Normal

Granulocyte

44.2 80.2 %

62.0

Normal

Lymphocyte

28.0 48.0 %

37.0

Normal

Monocyte

1-2%

Eosinophils

1-3%

1.0

Normal

Platelet

150-400 x 109/L

220.0

Normal

Blood Type

Clotting Time

2.00 6.00 minutes

Bleeding Time

1.00 4.00 minutes

Date Performed

Component

Normal Range

Result

Analysis

July 13, 2013

Hgb

14-18 g/dl

6.1 g/dl

Decreased; due to
impaired gas
exchange

Hct

40.0-54.0 %

18.0

Decreased; due to
blood loss

WBC

4.0 10.0

Granulocyte

44.2 80.2 %

Lymphocyte

28.0 48.0 %

Monocyte

1-2%

Eosinophils

1.4%

Platelet

150-400 x 109/L

Blood Type

Clotting Time

2.00 6.00 minutes

Bleeding Time

1.00 4.00 minutes

Date Performed

Component

Normal Range

Result

Analysis

July 14, 2013

Hgb

14-18 g/dl

7.8 g/dl

Decreased; due to
impaired gas
exchange

Hct

40.0-54.0 %

23.0

Decreased; due to
blood loss

WBC

4.0 10.0

Granulocyte

44.2 80.2 %

Lymphocyte

28.0 48.0 %

Monocyte

1-2%

Eosinophils

1.4%

Platelet

150-400 x 109/L

Blood Type

Clotting Time

2.00 6.00 minutes

Bleeding Time

1.00 4.00 minutes

CHEST X-RAY
A painless, non-invasive test that
creates picture of the structures
inside your chest such as your heart,
lungs and blood vessels.
Purpose:
This test is done to find the cause of
symptoms such as shortness of
breath, chest pain and chronic
cough.

PROCEDURES
The patient is typically instructed to wear a gown and remove all metal containing
objects around the upper body as these will interfere with the visualization of the
tissues. No other specific preparation, such as fasting, is necessary for a routine
chest x-ray.
The patient is then asked by the technician to stand in front of a surface adjacent to
the film that records the images. The front of the chest is closest to the surface.
Another part of the machine that releases radiation is then placed about 6 feet away,
behind the patient when the positioning is appropriate (normal standing position with
arms on the sides)
The technician may advise the patient to take a deep breath, and hold it and then
takes the image by activating the device (similar to taking a regular photograph)

The image is then captured on the film within a few seconds


The film can be developed within a few minutes to be reviewed by the doctor

NURSING RESPONSIBILITIES
Inform the client about the
procedure
Attend to the clients comfort
Assess vital signs and client
stability
Record and report data

Report of X-ray
Examination

Chest PA:
Examination shows fibrotic infiltrates at the left upper
lung

The rest of the lung field is clear


Age: 32 years old

Heart is not enlarged

Examination: Chest PA

Bony Thorax is intact

Date performed: July 13, 2013

Mediastinum, diaphragm and sulci are normal

Date interpreted: July 14, 2013

Other chest structures are not remarkable


Impression:
Pulmonary Kochs infiltrates the upper lung field

BLOOD SCREENING
A blood screening is a medical
process in which blood is
scanned to test for a particular
disease or condition.

BLOOD SCREENING RESULT


(BLOOD BANK)
The following blood has been screened the ff. serological tests to ensure
the safety of blood transfusion
Blood bag number: 13-1594
Preparation: Whole Blood
Volume: 500cc
ABO and RH Type: O+

Malaria: Negative
HBSAg : Non Reactive
RPR: Non Reactive
A HCV: Non Reactive

A HIV 1&2 : Non Reactive

A blood unit released should be subjected to compatibility testing


with the patients blood prior to transfusion

BLOOD TRANSFUSION
A blood transfusion is a safe, common
procedure in which you receive blood
through an intravenous (IV) line inserted into
one of your blood vessels.
Date: 07-13-2013 ; 8:50pm
Blood Bag Serial No. : 13-1594
Preparation: Fresh Whole Blood
Patients Blood Type: O+
Donors Blood Type: O+

Date of Collection: 07-06-2013


Expiry Date: 08-10-2013