Wrinkles? Already?

Neonates (0-1mo) & Infants (1mo-1yr) Characteristics Fear of strangers (begins 6-8 mos of age) Communicate discomfort by crying, facial expressions, body movement Prefer to be held in familiar positions Like established routines, verbal repetition Understand simple commands, respond well to consistency Are fearless, choke easily, accident prone, require constant supervision Need to consistently have needs met to develop sense of trust (feeding, changing) Nursing Implications Talk to baby before touching Involve parents in procedure if possible Imitate how parent holds baby Explain procedure to parents beforehand Remove unnecessary equipment Keep infant clothed as much as possible Do not leave infant unattended Allow parent to hold infant while waiting Ask parents about immunization record R: 20-30 HR: 80-140 Systolic: 70-100

Toddlers (1yr -3yr) Characteristics Views hospitalization as punishment Needs security objects Curious, unaware of danger Comprehension greater than ability to verbalize Short attention span Frequently says “NO” trying to demonstrating independence Can be cooperative if trust is won R: 20-30 HR: 80-130 Systolic:70-100 Nursing Implications Reassure that treatment is not a punishment Simple explanations Give one direction at time Demonstrate equipment Speak at eye level, maintain eye contact Remove unnecessary equipment Use distraction techniques Involve parents, allow to be present during procedures

Preschoolers (4yr -6yr) Characteristics Seek explanations “Why?” By age 5 speaks in 8 word sentences Increased speech skills, attention span and memory Truth important Fear bodily injury, separation, death, punishment Difficulty expressing needs Privacy important Accident prone R: 20-30 HR: 80-120 Systolic: 80-110 Nursing Implications Use simple explanation Adapts to changes in environment more easily than toddler Be truthful about pain, discomfort Encourage questions regarding fears Show caregiver location of restrooms Include parents in teaching Plan procedure to minimize waiting time

School Age (7yr -12yr) Developing greater sense of self Characteristics Developing greater sense of self Start to negotiate for independence Need to fit in with peers Rules very important Need respect for privacy Fear mutilation, loss of control Nursing Implications Allow child to exercise some control Allow to handle equipment as learning tool (as appropriate) Respect privacy Include parent in teaching Reassure child it is okay to cry Guide in making choices that are healthy and safe R: 20-30 HR: 70-110 Systolic: 80-120

Adolescents (13yr -20yr) Characteristics Transition stage (developing identity) & stress filled Continually striving for independence and control Appreciate being treated as adults Self-conscious about appearance (body image) Need respect of privacy Risk takers, strong sense of immortality Rapid growth, awkwardness on gross motor skills, development of occupational identity Nursing Implications Encourage questions Treat more as adult, avoid authoritarian approach Allow maintenance of control Talk directly to them, not through parents, and offer explanations Maintain privacy Establish trust to gain cooperation R: 12-20 HR: 55-105 Systolic: 110-120

Young Adult (21yr -39yr) Characteristics Sets career goals, chooses lifestyle May start own family, building connections Developing responsible attitude Need to establish healthy lifestyle Nutrition needed for maintenance not growth Mental abilities peak during 20s Nursing Implications Respect personal values, be honest & supportive Consider significant others, impact on job Encourage to pursue healthy lifestyle Teach & encourage testicular & breast self-exam Maintain privacy Encourage creating Advance Directive R: 12-20 HR: 55-105 Systolic: <120

Middle Adult (40yr -64yr) Characteristics May develop chronic health problems Decrease in bone and muscle mass, short term memory, loss of skeletal height and calcium, skin elasticity, dry skin, wrinkles Women experience menopause “Sandwich generation” Use life experiences to learn, solve problems Future oriented, has specific goals Nursing Implications Encourage regular check-ups & preventative exams Assist person to recognize risk factors related to health Focus on their strengths Address worries about children & aging parents Treat with respect Provide explanations and educate

Older Adult (65yr -79yr) Characteristics Continue to be active learner/thinker Takes on new roles, balances independence v. dependence Most elderly are not depressed May become isolated Some decline in physical abilities, senses, memory skills (short term memory, attention span shortens) Nursing Implications Promote mobility & ADL Consider needs related to diminished sight, hearing (may need to read information to patient, face person when talking to them) Allow reminiscing about the past Promote physical, mental, social activities to prevent isolation Allow more time for processing new information Educate about safety measures

Adult 80 & Older Characteristics Decline in physical ability, increased risk for chronic illness Decline in memory & learning skills May need assistance in ADL May have diminished appetite, fluid intake Nursing Implications Encourage as much mobility & ADL as possible Encourage healthy eating & adequate fluid intake, monitor bowel function Avoid treating older adult like a child Respect & support end of lie decisions

Age Specific Competency Post Test

Age Specific Competency Post Test 1. When performing any procedure on an infant, it is important to: A. Move as quickly as possible B. Talk to the baby while performing the procedure C. Avoid eye contact D. Allow mother to hold infant while waiting 2. It is important to always speak to the infant before a touch: A. True B. False 3. To help the newborn feel secure, caregivers can: A. Hold the infant only when he cries B. Imitate how the parent holds the newborn C. Encourage friends and neighbors to be involved in care

Age Specific Competency Post Test 4. As a healthcare provider, one of the most important parts of the infant's history is: A. Favorite meals B. Likes and dislikes C. Favorite toys D. Immunization record 5. The toddler who is having blood drawn: A. Will usually want a parent present B. Will be concerned with privacy C. Will require a detailed explanation of the procedure 6. Use of the word "No" by a toddler indicates: A. He has limited vocabulary B. He is showing his independence C. He is not friendly towards strangers D. He hasn't learned how to say "Yes"

Age Specific Competency Post Test 7. Preschoolers have increased speech skills, attention span and memory. This helps them to: A. Manipulate their environment B. Sleep better without their parents C. Change their routines more easily D. Understand what is happening to them 8. School-aged children have a need to: A. Gain independence from their friends B. Fit in with peers C. Be separated from siblings in a stressful situation 9. When doing procedures with children, it is important to let them: A. Know they can cry B. Become separated from their parents C. Know your first name D. Leave them alone to gain control of their emotions

Age Specific Competency Post Test 10. During the adolescent period, it is normal to be concerned with: A. Current events B. Childhood memories C. The same things as adults D. Body image 11. It is important for staff working with adolescents to: A. Assume the patients will ask if they have any questions B. Talk to the parents since an adolescent is unable to really understand fully C. Talk directly to the adolescent and offer explanations D. Tell them as little as possible so they will not be frightened 12. The hospitalized adolescent patient : A. Is not affected by the hospital stay B. Continually strives for independence and control C. Is not concerned with assisting with plan of care, and encourages parents advice D. Is too immature to understand or care about the changes occurring in their bodies

Age Specific Competency Post Test 13. The adolescent population is usually characterized by: A. Rapid growth B. Awkwardness on gross motor skills C. Beginning of development of occupational identity D. All of the above E. None of the above 14. For the young adult, it is important to involve the individual and significant other in the plan of care. A. True B. False 15. Which statement about young adults is NOT true: A. Nutritional needs are for growth, not maintenance B. Seeks closeness with others & may start own family C. Makes lifelong decisions D. Needs to be encouraged to have regular checkups

Age Specific Competency Post Test 16.Young adults like others to make decisions for them and to control their lives. A. True B. False 17. Which of the following physical change(s) occur in middle adulthood? A. Loss of skin elasticity, dry skin and an increase in wrinkles B. Decrease in muscle strength and mass C. Decrease in bone mass D. Loss of skeletal height and calcium E. All of the above 18. During middle adulthood, short-term memory or recall increases.

Age Specific Competency Post Test 19. We should be patient with the middle-aged adult who is part of the “sandwich generation” (caring for aging parents and their own children). A. True B. False 20. Which of the following intervention(s) should we do with middle-aged adults? A. Treat them with respect and explain everything to them B. Encourage as much dependency as possible C. Make decisions for them instead of allowing them choices D. All of the above 21. The middle-aged adult is future-oriented and has specific goals.

Age Specific Competency Post Test 22. Which of the following statement(s) is true, related to the elderly? Select all that apply. A. They do not like to talk about the past B. They may have difficulty hearing and/or seeing C. They tend to be depressed D. They need more time to process new information 23. When giving an elderly person instructions, it is important to: A. Shout in the ear B. Treat the person as you would a person of any age C. Face the person so he/she can see your lips D. Wait until a family member is present

Age Specific Competency Post Test 24. Identify the appropriate change for visual impairment in the elderly. A. No change in lighting is needed B. With glasses, no changes in lighting needed C. Staff may need to read information to the patient D. The family is responsible for the accommodations 25. When educating a person over 65, the following changes in cognitive functioning need to be considered: A. Short-term memory may be impaired B. More time is needed to process information C. Attention span shortens D. All of the above