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G.

DEVELOPMENTAL TASK

Psychosocial Central Task Crisis Infancy Birth-18 Months Trust vs. Mistrust Receiving care

Positive Outcome

Ego Quality

Definition

Developmental Task Social attachment; Maturation of sensory, perceptual, and motor functions; Primitive causality

Trust in Hope people and the environment

Enduring belief that one can attain ones deep and essential wishes

Imitation Autonomy vs. Shame & 18 Months-3 doubt Years Younger Years

Pride in self; Will Assertion of will in the face of danger

Determination Locomotion; to exercise free choice Fantasy play; and selfcontrol Language development; Self-control

Early Childhood 3-6 Years

Initiative vs. Guilt

Identification

Able to Purpose initiate activities and enjoy learning

Courage to Sex-role imagine and identification; pursue valued goals Early moral development; Self-esteem; Group play;

Egocentrism

Middle Childhood 6-12 Years

Industry vs. Inferiority

Education

Competence Free exercise Friendship; Acquire skills for and of skill and develop intelligence in Skill learning; competence completion of tasks in work; Selfevaluation; Enjoy achievement Team play A strong Loyalty group identity; Ready to plan for the future Ability to freely Physical pledge and maturation; sustain loyalty to others Emotional development; Membership in peer group; Sexual relationships

Early Group Adolescence Identity vs. 12-18 Years Alienation

Peer group

Later Individual Adolescence Identity vs. 18-22 Years Identity Confusion

Role Strong experimentation moral identity; Ready for intimate relationships

Fidelity

Ability to freely Autonomy pledge and from parents; sustain values and ideologies Sex-role identity; Internalized morality; Career choice

Early Adulthood 22-34 Years

Intimacy vs. Isolation

Caregiving

Form close Love relationships and share with others

Capacity for Stable mutuality that relationships; transcends childhood Child rearing; dependency Work etc

Middle Adulthood 34-60 Years

Generativity vs. Stagnation

Creativity

Care Nurturing children or helping the next generation in other ways

Commitment Nurture close to and concern relationships; for family and community Management of career and household; Parenting

Later Adulthood 60-75 Years

Integrity vs. Despair

Introspection

A sense of Wisdom fulfillment about life; A sense of unity with self and others

Detached yet Promote active concern intellectual with life in the vigor; face of death Redirect energy to new roles and activities;

Care: Generativity v.s Stagnation (middle adulthood)


y y y

Psychosocial Crisis: Generativity vs. Stagnation Main Question: "How can I contribute to the world?" Virtue: Care

Generativity versus stagnation is the seventh stage of Erik Eriksons theory of psychosocial development. This stage takes place during middle adulthood between the ages of approximately 40 and 65. During this time, adults strive to create or nurture things that will outlast them; often by having children or contributing to positive changes that benefits other people.

Contributing to society and doing things to benefit future generations are important needs at the generativity versus stagnation stage of development. 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. Those who are successful during this phase will feel that they are contributing to the world by being active in their home and community. Those who fail to attain this skill will feel unproductive and uninvolved in the world. Value of the theory One value of this theory is that it illuminated why individuals who had been thwarted in the healthy resolution of early phases (such as in learning healthy levels of trust and autonomy in toddlerhood) had such difficulty with the crises that came in adulthood. More importantly, it did so in a way that provided answers for practical application. It raised new potential for therapists and their patients to identify key issues and skills that required addressing. But at the same time, it yielded a guide or yardstick that could be used to assess teaching and child rearing practices in terms of their ability to nurture and facilitate healthy emotional and cognitive development. "Every adult, whether he is a follower or a leader, a member of a mass or of an elite, was once a child. He was once small. A sense of smallness forms a substratum in his mind, ineradicably. His triumphs will be measured against this smallness, his defeats will substantiate it. The questions as to who is bigger and who can do or not do this or that, and to whomthese questions fill the adult's inner life far beyond the necessities and the desirabilities which he understands and for which he plans." - Erik H. Erikson (19021994), U.S. psychoanalyst. Childhood and Society, ch. 11 (1950).

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D. PATIENT NEED ASSESSMENT

Date: May 09 2011 Name: Ulserio Barado Age: 41 y.o. Sex: male Status: Widow

Admission Date and Time: 04/30/10 - 1:15 am Admitting Medical Diagnosis: Partial intestinal obstruction prob. Secondary to post op adhesion s/p exlap for ppud. Arrived on unit by: stretcher Accompanied by: sister Admitting weight:_50_kg*VS: BP- 120/70mmHg; PR-88 bpm; RR- 26 cpm; T- 37 C Clients Perception of Reason for Admission: pag.sakit sa akong tiyan nya cge na ko ug suka, pamati nako busog ko perme dli ko mahilisan, maong nibalik ko pa.admitt How was the problem been managed at home: naa man koy gina.inum nga pain reliever sa balay Allergies:No known allergies Medication (at home): Celecoxib (celecoxx) Cefuroxime (xyfrox) Clarithromycin (claryl) From: Emergency Room

PHYSIOLOGIC NEED I. Oxygenation *BP: 120/70mmHg PR/CR: 88 bpm *RR: 26 CPM

*Lungs (per auscultation: character, lung sound; symmetry of chest expansion; breathing character and pattern): Use of accessory muscles noted upon breathing, with
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symmetrical__ chest expansion and use of intercostal retraction noted;no adventitious sound heard per auscultation on both lung fields *Cardiac status (per auscultation sounds, character, chest pain?: no adventitious

sound heard per auscultation, chest pain not noted, *Capillary Refill: Blanch test performed, pail nail beds returned within 3 seconds *Skin character and color: with fair complexion, dry and warm to touch *Life-supporting Apparatus: IVF of PLR 1L @160cc/ - right dorsal metacarpal *Other observations related: patient experienced deep and quick breaths when couging

II. Temperature Maintenance *Temperature: 37.2 C *Skin character: with dry, clammy skin *Other observations related: not noted

III. Nutritional Fluids *Height/Weight:51/50 kls Amount of food consumed: on General liquid diet * Prescribed diet:General Liquid dieat Problem (nausea, vomiting, no. of times, frequency, amount, character): vomiting Eating Pattern: patients eating pattern isnt normal *Skin character: with dry skin but with fair skin turgor *Intake (IVF; Fluid/Water): IVF 350cc; H20 200 cc;

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IV. Elimination *Last Bowel Movement (Frequency, Amount, Character): Defecated on moderate amount, soft, yellowish stool as described by the patient *Normal Pattern: once a day *Urination ( Frequency, Amount, Character, Sensation):Urinated a yellowish color in a normal amount *Other observations related: not noted

V. Rest- Sleep *Bedtime: 10- 11PM (with some alterations) *Sleep (Pattern, Amount of Sleep): 6 7 hours *Problems (as verbalized): Maglisod jud og usahay kay mutukar ang sakit sa akong tiyan. *Other Observations related: Dark circles under eyes and frequent yawning noted. Waking up: 4:00-6:00AM

VI. Pain Avoidance *Rate Pain: Rated 7 from 1-10 Time started: not noted Location: Centered around the umbilicus

*Bedtime: 10- 11PM(with some alterations) *Frequency: 2-20 mins *Character: colicky

Behavior : Restless Facial expression noted

Irritable, Diaphoretic: Irritable

*Other observations related: not noted

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VII. Sexuality-Reproductive *LMP: N/A *Gravida/Parity: N/A *Menstrual Cycle: N/A *EDC: N/A *Family Planning Method Used: N/A *Children: 3 AOG: N/A Prenatal: N/A Gynecologic Problems: N/A

VIII. Stimulation-Activity *Work: Ukay-Ukay Vendor *Recreation / Pastime: Watching TV *Hobbies / Vices: Alcohol, Smoking

SAFETY SECURITY NEED *Neuro V/S: *Mental Status (Coherent, Responsive, Conscious, Unconscious): Patient is conscious, coherent and responsive *Emotional Problem (Diaphoretic, Trembling, Restless): Patient got easily nervous and depress in handling big problems especially in terms of financial matters;

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LOVE-BELONGING NEED *Children (Living with) : Client is presently living with her children. She has 3 siblings. *Wife (Living with): He is being loved by his children, due respect was given to him

and all efforts for her hospitalization was given

SELF-ESTEEM NEED * I observed that patient has developed low self esteem since according to him he is just a hindrance to his family Pabigat ko sa akong paminaw sa akong pamilya as client verbalized SELF-ACTUALIZATION * I can assess that patient is not that a self-actualized person because although he was well provided with basic needs such as food, clothing, shelter .poor coping mechanism is still evident in handling problems and fears on hospitalization. Date of Assessment: A. General Survey On bed, awake, coherent, and responsive to verbal communication. Sunkern eyeballs noted. Slightly Dry mucous membrane. With ongoing IVF of # 14 PLR 1L @ 160 cc/hr at 1000 cc level infusing well at right dorsal metacarpal vein. Capillary refill of less than 2 seconds noted. May 09, 2011

B. Vital Signs Date 5-2-11 Shift 11-7 Time 1:30am Temp 36.7 BP 120/100 RR 22 CR 81 Intake Output U-1 S-1

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7-3 3-11 5-3-11 11-7 7-3 3-11 5-4-11 7-3 3-11 5-5-11 11-7 7-3 3-11 5-6-11 7-3 3-11 5-7-11 11-7 7-3 3-11 5-8-11 11-7 7-3 3-11 5-9-11 11-7 7-3

10:05 6:10 1:40 10:30 8:00 10:30 6:55 1:00 10:25 6:10 10:05 6:10 1:00 9:30 8:00 1:40 10:00 3:00 1:00 8:00

37 36.3 37 35.9 37.1 36.8 35.9 37.1 36.1 37 36.8 36.3 36.7 37 36.9 35.9 37.3 37 36.7 37.3

100/70 120/90 140/90 120/90 120/80 110/70 130/90 120/80 130/90 130/90 120/80 110/70 110/70 110/70 120/70 110/70 100/70 110/70 140/100 130/100

21 20 21 21 20 20 21 20 23 21 23 20 23 22 23 19 25 23 20 21

68 81 86 75 80 69 80 85 67 80 85 75 80 75 85 70 85 88 70 81 IVF= 650cc

U-1 S-0 U-1 S-0 U-1 S-0 U-2 S-0 U-0 S-0 U-2 S-1 U-2 S-1 U-1 S-1 U-2 S-1 U-0 S-0 U-1 S-1 U-2 S-0 U-0 S-0 U-1 S-1 U-2 S-0 U-0 S-0 U-1 S-1 U-1 S-1 U-0 S-0 U-0 S-0

12:00 3-11 5-1011 7-3 8:00 11-7 5:30 1:20

36.9 37.1 37.1

130/100

20 26 24

85 86 87

H20= 210cc

130/80 130/90

U-1 S-1 U-1 S-1

37

110/70

20

80

IVF= 700cc

U-2 S-2

12:00

36.8

110/ 70

19

85

H20= 250cc
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