Lifespan Development & Health Across the Lifespan
Understand human growth and development from birth through older adulthood. Apply Erikson's psychosocial stages, Piaget's cognitive development, developmental milestones, and age-related physiological changes to nursing assessment and patient care across all clinical settings.
Visual learning
Developmental milestones timeline
Track how communication, teaching, safety, and family support change across age groups.
- 1
Infant
Trust, attachment, feeding, safety, and caregiver presence are central.
- 2
Toddler
Autonomy, simple choices, routines, and safety limits guide care.
- 3
Preschool
Magical thinking requires reassurance that illness is not punishment.
- 4
School-age
Concrete explanations, participation, and skill mastery matter.
- 5
Adolescent
Privacy, identity, peer influence, and future consequences shape teaching.
- 6
Older adult
Baseline function, delirium screening, polypharmacy, and dignity are priorities.
Clinical connection
Developmental fit matters: the same teaching message must be delivered differently to a toddler, school-age child, adolescent, adult, and older adult.
Infancy and Neonatal Development
Birth through 12 months — the most rapid growth period of life
Neonatal Assessment — APGAR Score
Assessed at 1 and 5 minutes post-birth. Score 0–2 for each:
Score 7–10 = normal; 4–6 = moderate concern; 0–3 = immediate resuscitation
Infant Developmental Milestones
Erikson Stage 1 — Trust vs Mistrust (Birth–18 months)
The central task: Can I trust the world? Consistent, responsive caregiving develops basic trust — the foundation for all future relationships. Inconsistent or neglectful care leads to mistrust and insecurity. Nursing application: involve parents/caregivers in care; minimize separation; use consistent caregivers for hospitalized infants.
Infancy — Self-Check
1/1A 10-month-old infant begins crying when a nurse (stranger) approaches. This is MOST consistent with:
Childhood Development
Toddlers through school age — Piaget and Erikson in clinical practice
Piaget's Cognitive Development Stages
Erikson Stages — Childhood
Stage 2 — Autonomy vs Shame/Doubt (18mo–3yr)
Central task: developing independence. Allow choices within safe limits. Avoid shaming toddlers for toilet training accidents.
Stage 3 — Initiative vs Guilt (3–6yr)
Central task: initiating and trying new things. Encourage play and creativity. Avoid harsh criticism that creates excessive guilt.
Stage 4 — Industry vs Inferiority (6–12yr)
Central task: achieving competence. School success builds industry. Repeated failure creates inferiority. Teach health skills as competencies: 'You can learn to check your own glucose.'
Adolescent Development
The transition stage — identity, risk-taking, and health behavior formation
Erikson Stage 5 — Identity vs Role Confusion (12–18 yr)
Central task: developing a coherent sense of self. Adolescents explore values, careers, relationships, and beliefs. Role confusion = inability to establish a stable identity. Nursing: support identity exploration; maintain confidentiality (critical for trust); address body image concerns directly.
Adolescent Health Priorities
- Puberty and sexual health education
- Risk-taking behavior (substance use, driving, sexual activity)
- Mental health — peak onset of anxiety, depression, eating disorders
- LGBTQ+ identity and minority stress
- Injury prevention (leading cause of death: unintentional injury)
- Confidentiality — many jurisdictions allow adolescent consent for STI/mental health care
Adolescence — Self-Check
1/1A 14-year-old patient asks the nurse not to share their mental health concerns with their parents. The nurse's BEST initial response is:
Adult Development and Health Across Adulthood
Young adult through middle age — developmental tasks and preventive health
Stage 6 — Intimacy vs Isolation (Young Adult, 18–40)
Central task: forming deep, committed relationships. Failure leads to isolation and loneliness. Young adults establish careers, partnerships, and family. Health priorities: reproductive health, STI prevention, prenatal care, mental health, cardiovascular risk prevention (diet, exercise, smoking cessation).
Stage 7 — Generativity vs Stagnation (Middle Adult, 40–65)
Central task: contributing to society — raising children, mentoring, creating, building. Stagnation = self-absorption and feeling unproductive. Health priorities: chronic disease management begins (hypertension, diabetes, dyslipidemia), cancer screening, menopause, perimenopause, mental health, work-life balance.
Recommended Cancer Screenings by Age (US/Canada)
Older Adulthood and Geriatric Considerations
Age-related changes, the 3Ds, and lifespan patient education
Normal Physiological Changes of Aging
Normal aging produces predictable physiological changes that affect how nurses assess and care for older adults. Key changes: cardiac output decreases 1% per year after age 30; renal function declines (creatinine may appear normal even with reduced GFR because muscle mass decreases with age); hepatic metabolism slows (drugs metabolized by liver have longer half-lives); lung compliance decreases; skin becomes thinner and less elastic; immune response weakens (immunosenescence); bone density decreases (osteoporosis risk). These changes require medication dose adjustments and altered assessment interpretation.
The 3Ds — Distinguishing Delirium, Dementia, and Depression
| Feature | Delirium | Dementia | Depression |
|---|---|---|---|
| Onset | ACUTE (hours–days) | Insidious (months–years) | Weeks to months |
| Course | Fluctuating | Progressive/stable | Persistent |
| Reversible? | YES — treat cause | Usually NO | YES — with treatment |
| Consciousness | Impaired (fluctuates) | Usually intact early | Intact |
| Attention | Severely impaired | May be intact early | Mildly impaired |
| Cause | Infection, meds, metabolic | Neurodegeneration | Mood disorder |
Erikson Stage 8 — Integrity vs Despair (65+)
Central task: reflecting on life with acceptance (integrity) or regret (despair). Nursing: acknowledge and validate life experience; involve patients in decisions; support legacy activities (life review, connecting with family); provide dignified, patient-centered end-of-life care.
Lifespan Development — Comprehensive Quiz
1/4According to Piaget, a 5-year-old who believes their illness is punishment for being naughty is demonstrating:
Pre-nursing comprehensive review
1/20Which organelle contains its own DNA and is inherited exclusively from the mother?