Nursing Care Plan: Middle Years Development and Stress Factors

This paper presents a comprehensive nursing care plan for an eleven-year-old boy, Liam, navigating stressful circumstances during his middle years of development. It explores factors influencing his health decisions and behavior, including the Medicare health insurance scheme, social influences from family, peers, and teachers, and the impact of inequalities such as financial problems. The report examines the role of culture, psycho-physiological aspects like emotions and stress, and the body's physiological responses to stress. Detailed stress management interventions are discussed, including teaching the patient skills to cope with stress. The paper emphasizes the importance of considering the patient's emotional, social, and cognitive development during this critical stage, offering insights into effective care strategies and the prevention of illness. The report underscores the significance of addressing inequalities and cultural factors in providing holistic and culturally sensitive care.

Running head: NURSING CARE PLAN 1
Nursing Care Plan
Student’s name
Institution
Table of Contents

NURSING CARE PLAN 2
Abstract................................................................................................................................3
Description of the patient.....................................................................................................4
Factors affecting health decisions and behavior..............................................................5
Social influences..........................................................................................................5
Psycho-physiological aspects of health...........................................................................7
Emotions and health....................................................................................................7
Prevention of illness and promotion of health.................................................................9
Prevention method.....................................................................................................10
Conclusion.....................................................................................................................10
References......................................................................................................................12

NURSING CARE PLAN 3
Abstract
This paper discusses the considerations to be taken in demonstrating a care plan for an eleven-
year-old boy in his middle years development stage undergoing stressful circumstances. The
factors that have been considered in demonstrating the planning care includes the Medicare
health insurance scheme, the social influences of his behavior such as family, his fellow children
at school, and teachers, the manner in which inequality issues such as financial problems have
affected him, and the way culture has contributed to his behavior in relationship to the middle
years development stage. The paper also discusses how psycho-physiological factors such as
emotions and stress have influence to the health. Finally, stress management interventions have
been discussed in detail including teaching the patient the necessary skills needed to cope with
stress. It is essential to note that during middle years development, children are developing in
many areas including their emotions, individuality, and cognitive skills.
Keywords: middle years development stage, planning care, psycho-physiological

NURSING CARE PLAN 4
Nursing care plan
The purpose of this paper is to demonstrate a care plan appropriate for a patient
undergoing stressful situations. The paper discusses the issues and factors that informs the
approach and plan that has been demonstrated. Some of the issues that informs the kind of care
plan developed includes the use of lifespan approach and the use of development theories, and
the behavioral aspects of the patient (Sigelman & Rider, 2014).
In light of this, the paper will describe the patient by using a lifespan approach and
describe the health concern of the patient. Additionally, the paper will discuss a model of health
that requires consideration when planning for the nursing care. The factors affecting the health
decisions such as the influence of the society, inequalities, and culture shall also be discussed
(Capuzzi & Stauffer, 2016). Psycho-physiological aspects of health such as the relationship
between stress and stress management, health and emotions, and how the patient responds to
such scenarios will additionally be discussed. Finally, the paper will discuss interventions that
can be employed to promote health and prevent the illness.
Description of the patient
The case study is about an eleven-year-old boy called Liam. Liam is a school going boy
and he is new in school. Liam likes being on his own without the company of anybody and most
of the times he walks home alone. He prefers sitting under the tree most of the time when not in
class for instance, during lunch breaks. Liam does not seem to be interested in having close
friends but he is happy having an occasional conversation with anybody who comes by.
Furthermore, Liam is not interested in any school extra curriculum activities. When he is asked
about any issues at home, he is really not interested in talking about it. On one occasion, he
pushed a fellow student to the ground when a group of children used unkind words to describe

NURSING CARE PLAN 5
him. With all these factors put into consideration, Liam is in his middle years of lifespan
developmental stage. According to Payne (2017), this is the stage in the development of a child
where great emphasis is put on family, school, friends, and individuality. In Liam’s case, there
seems to be a problem since there are no signs of any emphasis put on family or friends or his
individuality. In consideration to all these factors, Liam is stressed up.
In planning for Liam’s nursing care, the Medicare health insurance scheme is the best for
him (Porche, 2017). The Medicare health insurance covers both public and private patients but
Liam will be treated as a public patient. Public hospitals are best placed to deal with his mental
problem. Additionally, Liam seems to come from a low-income family hence the family may not
be able to carter for him as a private patient. Liam struggles with school since he doesn’t have
enough pens, writing books, and other necessities. He also struggles with food as he can only
afford $2 twice a week, while on the other days he carries a packet of chips or biscuits from
home for lunch. (Kail & Cavanaugh, 2018)
Factors affecting health decisions and behavior1
When planning care for a patient, several factors affecting health decisions come into
consideration (Edelman, Mandle & Kudzma, 2013). Such factors include the impacts of
inequalities surrounding the patient, the impact of culture, and the impact of social influences. In
the case of Liam, these factors play a very important role in the way he behaves and in the
making of health decisions.
Social influences
The social environment for Liam includes his family, the school children and the
teachers. Liam’s family appears to be having major problems which are influencing the child in a
negative way. Liam is possibly having inferiority complex since he does not want to join the rest

NURSING CARE PLAN 6
in any activity that may need competition especially with his male peers. According to the
psychosocial theory, children at this stage usually begin developing a sense of pride in their
abilities and accomplishments (Buckingham & Best, 2016). Liam on the other hand, is very
reserved and not ready to showcase any of his abilities of skills. The theory further states that
children who are not encouraged at this stage either by parents, teachers, or peers end up
doubting their abilities to excel.
Liam is not ready to discuss any maters dealing with his family and so this is an
indication that the family may not be socially supportive enough in encouraging him about his
abilities. On the other hand, the teachers seem to be very supportive to Liam since Liam is
getting along well with them. Some of the children are also ready to play with Liam which is an
indication that they recognize the abilities of Liam hence encouraging him socially. These social
aspects of Liam are very key considerations when planning care for Liam’s health.
Impact of inequalities
Cases of inequalities in several aspects of Liam’s school life has contributed significantly
to his withdrawal and very over reactive behavior. Liam’s family is financially unstable and so
they are not able to take care of his school needs properly. Liam, in comparison to other children
in school, does not have enough essentials for learning, he does not have a decent lunch, his
clothes are not well kept by the end of the week, he has a strong body odor, and he is overweight.
The other students make fun of his big body size. Due to these inequalities with the rest of the
children, Liam is not confident enough to engage with other students. The impact of inequality to
Liam is very significant until at one time when he was made fun of, he pushed one child to the
ground. Therefore, inequality is another factor affecting the health decision to be made when
planning care for Liam (McLeod, Lawler & Schwalbe, 2015).

NURSING CARE PLAN 7
Impact of culture
Culture plays a critical role in planning care for a patient. Understanding the patients
culture enables the nurse plan the care with the cultural aspects of the patient in mind
(Matsumoto & Juang, 2017). Additionally, practical knowledge of culture will assist in effective,
safe, and suitable clinical communication between the nurse and the patient. The manner in
which Liam does his activities in the school enables us identify with his cultural background.
First and foremost, there must be an awareness of the differences in culture that exists
between Liam and the nurse. The nurse should appreciate that the differences exist and
appreciate them. Cultural awareness of Liam will assist in effective and proper communication
with him. Another aspect of culture that needs to considered is cultural safety which means the
nurse working from the cultural perspective of Liam. The actions of the nurse should recognize
and nurture Liam’s culture in order to safely meet his expectations, rights, and needs.
Additionally, cultural respect must be considered. This is whereby the nurse protects, recognizes,
and promotes the advancement of the inherited rights and traditions of Liam’s culture.
(Matsumoto & Juang, 2017).
Psycho-physiological aspects of health
The psycho-physiological aspects of an individual’s health are also key considerations
when planning care for the patient. Liam is in his middle years of development and various
developments are taking place in him in terms of his psychology and physiology. At this stage of
his life development, Liam’s emotions, individuality, social relations, and expectations are
developing. Additionally, the way he perceives the world, and his skills in solving problems, and
his cognitive skills are developing (Feuerstein, 2013). The development of Liam’s emotions has
influenced his behavior and consequently he has developed stress as a mental health issue.

NURSING CARE PLAN 8
Emotions and health
Emotions, both positive and negative, have an influence to the overall health of a child in
the middle years of development. Emotions have the capability to heal and harm both
psychologically and physically. According to Carrera (2013) the body responds to the way an
individual act, feels, and think. Positive emotions have positive influence towards the body and
leads to improved immunity and overall health. On the other hand, negative emotions influence
health negatively and may lead to conditions such as stress, anxiety, and high blood pressure.
(Carrera, 2013)
Dealing with negative emotions is crucial for survival during the middle years
development of a child since emotions that are kept within may lead to disastrous circumstances
in the long run as in the case of Liam when he pushed a fellow student to the ground. Certain
situations such as financial issues, going through an embarrassing incident, and low self-esteem
may be detrimental to the emotional wellbeing and mental health.
Stress and stress management
There are various situations that can lead to stressful situations in middle years
development stage. To some degree, stress is an inevitable component of life (Tummers, 2013).
Too much stress in the life of children in the middle years of development can cause a major
health concern. Stressful events occur affecting children in different ways and with different
intensities. Most of the stressors are similar to one another and are repeated throughout the
development of an individual.
The manner in which an individual manages the stressor depends on previous
experiences. Tummers (2013) explains that children, however, need to be given effective
education on stress management to ensure they cope positively with the stressful situations. Life

NURSING CARE PLAN 9
skill lessons can be given to the child in order to assist the children deal with the stressors
successfully even before their occurrence. When the children are taught to manage stress
successfully, any acquisition of unhealthy ways of managing stress in the future can be
minimized (Tummers, 2013).
Types of responses
The body responds automatically to any situation that may be perceived as dangerous or
upsetting. When the body responds to a stressful event, it produces a physiological response. The
flight or fight response is the body’s psychological response to stress (Wingo, 2016). The
response leads to a release of bodily hormonal reactions so that the body can be ready to either
fight or flee to keep an individual out of harm.
With regards to Liam’s response to a stressful event at school, the fight response was
evident. Liam perceived or sensed harm when the older boys teased him about his weight and
when they went further to film him using their phone while laughing at him. Without hesitating,
Liam went to the leader of the group and pushed him down to the ground. Liam responded to the
stressor by fighting back.
Prevention of illness and promotion of health
Prevention of stress is an important issue in the life of children at the stage of middle
years development. Children are not well able to cope with stressful situations since they do not
have any history of a stressful event to learn from. Rather, they are in the stage of developing
their skills in stress management (Edelman, Mandle & Kudzma, 2013). Additionally, promotion
of health with reference to negative emotions is very key in influencing good health of the child
and in the development of the child since at the middle years stage, emotions are being
developed.

NURSING CARE PLAN 10
Prevention method
The intervention plan for Liam would be considering ways of managing his stress and
ways in which he can deal with his emotions as he progresses with the stages of development.
Liam will be taught ways of managing any stressful situation that may arise in the course of his
life. Learning to adapt to stressful situations during the early stages of development has a direct
positive impact in the life of Liam at later stages of life development. The objective of stress
management intervention is to equip Liam to use workable and productive coping alternatives in
the event of a stressful occurrence.
Several planned events that integrate behavioral, cognitive, and affective components will
to be tailored to Liam so that he can acquire coping skills and deal effectively with stressors
before their occurrence or when they occur (Hetherington & Blechman, 2014). Skills needed for
handling real situations of life such as peer pressure, school, and economic pressures are to be
included in the stress management plan for Liam so that his coping skills can be enhanced. Stress
management skills such as clarification of value, decision making, and communication are also a
vital part in the learning process of Liam. Coping skills such as exercise, proper diet, talking
about his problems, and techniques in modifying his behavior are also key to Liam’s intervention
plan (Hetherington & Blechman, 2014).
Conclusion
In conclusion, several factors affect planning care for a patient. Factors such as
identification of life development stages of a patient is very important in determining the kind of
planning care to be developed (Krasner, 2013). Liam, who is in the middle years development
stage is undergoing stressful situations in his life both at school and at home. The health care
plan for Liam involves considering the factors that affect his behavior such as his social

NURSING CARE PLAN 11
interactions, the inequalities he is experiencing at school, and his cultural background. The other
aspects that have been considered in the planning care are the psycho-physiological aspects of
health such as the effect of his emotions to his health and the stress and stressful events.
Finally, an intervention plan for the stress has been developed whereby Liam will be
taught development skills on how to cope with stressful circumstances in a constructive way.
Some of the coping skills that would be taught include, behavioral skills, communication skills,
decision making skills, and value clarification skills (Newman & Newman, 2015). These coping
skills would be taught through events that are tailored towards integrating behavioral, cognitive
and affective components. The aim of the stress management intervention plan is to train Liam to
handle stressors using productive and workable alternatives.

NURSING CARE PLAN 12
References
Buckingham, S., & Best, D. (2016). Addiction, behavioural change and social identity.
Capuzzi, D., & Stauffer, M. (2016). Human growth and development across the lifespan.
Carrera, E. (2013). Emotions and health, 1200-1700. Leiden: Brill.
Edelman, C., Mandle, C., & Kudzma, E. (2013). Health promotion throughout the life span.
Feuerstein, M. (2013). Health psychology. [Place of publication not identified]: Springer-Verlag
New York.
Hetherington, E., & Blechman, E. (2014). Stress, Coping, and Resiliency in Children and
Families. Hoboken: Taylor and Francis.
Kail, R., & Cavanaugh, J. (2018). Human development.
Krasner, L. (2013). Environmental Design and Human Behavior. Burlington: Elsevier Science.
Matsumoto, D., & Juang, L. (2017). Culture and psychology. Boston. MA: Cengage Learning.
McLeod, J., Lawler, E., & Schwalbe, M. (2015). Handbook of the social psychology of
inequality. Dordrecht: Springer.
Newman, B., & Newman, P. (2015). Theories of human development.
Payne, V. (2017). Human Motor Development. Florence, UNKNOWN: Routledge.
Porche, D. (2017). Health policy.
Sigelman, C., & Rider, E. (2014). Life-span human development.

NURSING CARE PLAN 13
Tummers, N. (2013). Stress management. Champaign, IL: Human Kinetics.
Wingo, M. (2016). The impact of the human stress response.