The document provides information on age-specific competencies in caring for patients from neonates to older adults. It outlines characteristics and nursing implications for each age group. Key points include: - For infants, talk to them before touching and allow the parent to hold them. Maintain safety and meet their needs for trust. - Toddlers may view hospitalization as punishment; use simple explanations and involve parents. - Preschoolers understand more than they can say; be truthful and allow questions about fears. - Adolescents strive for independence; treat them as adults by explaining directly and maintaining privacy. - Elderly patients may have declining abilities; promote mobility and consider needs related to senses.

1. Age Specific
Competencies
Caring for patients at
every stage of Life
San Diego

2. Wrinkles?
Already?

3. 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
record
R: 20-30 HR: 80-140
Systolic: 70-100

4. 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

5. 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

6. San Diego
School Age (7yr -12yr)
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

7. 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: 55-105
Systolic: 110-120

8. 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

9. 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
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

10. 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)
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

11. San Diego
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

13. San Diego
Age Specific Competency
Post Test

14. San Diego
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

15. San Diego
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"

16. San Diego
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

17. San Diego
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

18. San Diego
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

19. San Diego
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.
A. True
B. False

20. San Diego
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.
A. True
B. False

21. San Diego
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

22. San Diego
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