Wrinkles? Already?

Age Specific

Competencies

Caring for patients at every stage of Life

San Diego

Wrinkles?

Already?

San Diego

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

recordR: 20-30 HR: 80-140 Systolic: 70-100

San Diego

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

San Diego

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

San Diego

School Age (7yr -12yr)

CharacteristicsDeveloping greater sense

of selfStart to negotiate for

independenceNeed to fit in with peersRules very importantNeed respect for privacyFear mutilation, loss of

control


Allow child to exercise some control

Allow to handle equipment as learning tool (as appropriate)

Respect privacy Include parent in teachingReassure child it is okay to

cryGuide in making choices that

are healthy and safe R: 20-30 HR: 70-110 Systolic: 80-120

San Diego

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: 55-105Systolic: 110-120

San Diego

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

San Diego

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


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

San Diego

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)


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

San Diego

Adult 80 & Older

CharacteristicsDecline 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 ImplicationsEncourage as much mobility

& ADL as possibleEncourage healthy eating &

adequate fluid intake, monitor bowel function

Avoid treating older adult like a child

Respect & support end of lie decisions

San Diego

Age Specific Competency Post Test

San Diego


1. When performing any procedure on an infant, it is important to:A. Move as quickly as possibleB. Talk to the baby while performing the procedureC. Avoid eye contactD. 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 criesB. Imitate how the parent holds the newbornC. Encourage friends and neighbors to be involved in care

San Diego


4. As a healthcare provider, one of the most important parts of the infant's history is:A. Favorite mealsB. Likes and dislikesC. Favorite toysD. Immunization record

5. The toddler who is having blood drawn:A. Will usually want a parent presentB. Will be concerned with privacyC. Will require a detailed explanation of the procedure

6. Use of the word "No" by a toddler indicates:A. He has limited vocabularyB. He is showing his independenceC. He is not friendly towards strangersD. He hasn't learned how to say "Yes"

San Diego


7. Preschoolers have increased speech skills, attention span and memory. This helps them to:A. Manipulate their environmentB. Sleep better without their parentsC. Change their routines more easilyD. Understand what is happening to them

8. School-aged children have a need to:A. Gain independence from their friendsB. Fit in with peersC. Be separated from siblings in a stressful situation

9. When doing procedures with children, it is important to let them:A. Know they can cryB. Become separated from their parentsC. Know your first nameD. Leave them alone to gain control of their emotions

San Diego


10. During the adolescent period, it is normal to be concerned with:A. Current eventsB. Childhood memoriesC. The same things as adultsD. Body image

11. It is important for staff working with adolescents to:A. Assume the patients will ask if they have any questionsB. Talk to the parents since an adolescent is unable to really understand fullyC. Talk directly to the adolescent and offer explanationsD. Tell them as little as possible so they will not be frightened

12. The hospitalized adolescent patient :A. Is not affected by the hospital stayB. Continually strives for independence and controlC. Is not concerned with assisting with plan of care, and encourages parents adviceD. Is too immature to understand or care about the changes occurring in their bodies

San Diego


13. The adolescent population is usually characterized by:A. Rapid growthB. Awkwardness on gross motor skillsC. Beginning of development of occupational identityD. All of the aboveE. 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. TrueB. False

15. Which statement about young adults is NOT true: A. Nutritional needs are for growth, not maintenanceB. Seeks closeness with others & may start own familyC. Makes lifelong decisionsD. Needs to be encouraged to have regular checkups

San Diego


16.Young adults like others to make decisions for them and to control their lives.A. TrueB. False

17. Which of the following physical change(s) occur in middle adulthood?A. Loss of skin elasticity, dry skin and an increase in wrinklesB. Decrease in muscle strength and massC. Decrease in bone massD. Loss of skeletal height and calciumE. All of the above

18. During middle adulthood, short-term memory or recall increases.A. TrueB. False

San Diego


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. TrueB. False

20. Which of the following intervention(s) should we do with middle-aged adults?A. Treat them with respect and explain everything to themB. Encourage as much dependency as possibleC. Make decisions for them instead of allowing them choicesD. All of the above

21. The middle-aged adult is future-oriented and has specific goals.A. TrueB. False

San Diego


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 pastB. They may have difficulty hearing and/or seeingC. They tend to be depressedD. They need more time to process new information

23. When giving an elderly person instructions, it is important to:A. Shout in the earB. Treat the person as you would a person of any ageC. Face the person so he/she can see your lipsD. Wait until a family member is present

San Diego


24. Identify the appropriate change for visual impairment in the elderly.

A. No change in lighting is neededB. With glasses, no changes in lighting neededC. Staff may need to read information to the patientD. 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 impairedB. More time is needed to process informationC. Attention span shortensD. All of the above

Wrinkles? Already?

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