1. Age-Related Care

2. General Communication
Allow caregiver to remain whenever possible
Observe child’s LOC, activity level, interaction, position of comfort, skin color, resp. rates/effort, degree of discomfort before touching the child
Ask caregiver about child’s normal behavior

3. General Communication
Address child by name
Use a kind, firm, direct approach- demonstration can be helpful
Be honest with child and caregiver
Remember all ages are capable of experiencing pain, but show differently

4. Infants PSYCHOSOCIAL:
Understand and experience the world through their bodies
Being held, cuddled, rocked or comforted with familiar touch and smells soothes
Common fears- separation, stranger anxiety

5. Infants A & P CHARACTERISTICS:
Obligate nose breathers for first several months, blocked or partially blocked nasal passages may cause resp. distress
Breathe predominately using abdominal muscles
Faster metabolic rate increases O2 need

6. Infants APPROACH: Slowly, gently, calmly
Assess while caregiver is holding, when possible
Up to about 7 months old can be comforted by strangers as long as basic needs are met
If calm, start with resp. rate and end with touching

7. Toddlers PSYCHOSOCIAL:
Common fears include separation from caregiver and loss of control
Tend to cling to caregiver when apprehensive
Strongly sensory based: “Seeing is believing”
Will demonstrate strong positive and negative behaviors

8. Toddlers A & P CHARACTERISTICS:
Babinski’s reflex normally present until walking, after 2 years should have plantar reflex
Still uses abdominal muscles for breathing
May still develop “cold stress” when critically ill/injured and exposed for extended periods of time

9. Toddlers
APPROACH:
Gradually, with quiet, soothing voice, keep physical contact minimal
Incorporate play, let touch equipment
Prepare immediately before procedure, tell when completed

10. Preschoolers PSYCHOSOCIAL:
Do not have a well-developed concept of time
Big imagination, take words literally
Common fears include body mutilation, loss of control, death, darkness and being left alone

11. Preschoolers A & P CHARACTERISTICS:
Continues to use abdominal muscles for breathing

12. Preschoolers APPROACH: Allow to handle equipment
Prepare immediately before procedure, in simple, concrete terms- delays can increase anxiety
Tell to still sit, but it’s ok to cry

13. School-aged Children PSYCHOSOCIAL:
Logical thought process is beginning, but misinterpretation is still common
Starting to understand simple anatomy and body functions
Starting to hide thoughts and feeling
Common fears include separation from friends, loss of control, physical disability

14. School-aged Children A & P CHARACTERISTICS:
By about 8 years old, resp. A & P is approximately that of an adult

15. School-aged Children APPROACH:
Let older child choose if caregiver is present during assessment- privacy needs are changing
Explain procedures simply and ask for feedback
Reassure that procedure/illness/injury is not a punishment

16. Early and Middle Adolescents
PSYCHOSOCIAL:
Acutely aware of body appearance
Psychosomatic complaints are common
May experience mood swings, depression, eating disorders, suicidal ideation, violent behavior- normal vs. poss. problem?
May regress to earlier stages of dev. For comfort
Need concrete explanations

17. Early and Middle Adolescents
A & P CHARACTERISTICS:
Rapid growth and heightened emotions, usually associated with hormonal changes

18. Early and Middle Adolescents
APPROACH:
Introduce self to child and family
Sit down and talk to them
Be honest, nonjudgmental, don’t talk down to
Respect privacy and confidentiality
Provide with concrete information

20. Erikson's Stages of Psychosocial Development
Infancy (birth to 18 months)
Trust vs. Mistrust
Children develop a sense of trust when caregivers provide reliability, care, and affection. A lack of this will lead to mistrust.

21. Erikson's Stages of Psychosocial Development
Early Childhood (2 to 3 years)
Autonomy vs. Shame and Doubt
Children need to develop a sense of personal control over physical skills and a sense of independence. Success leads to feelings of autonomy, failure results in feelings of shame and doubt.

22. Erikson's Stages of Psychosocial Development
Preschool (3 to 5 years)
Initiative vs. Guilt
Children need to begin asserting control and power over the environment. Success in this stage leads to a sense of purpose. Children who try to exert too much power experience disapproval, resulting in a sense of guilt.

23. Erikson's Stages of Psychosocial Development
School Age (6 to 11 years)
Industry vs. Inferiority
Children need to cope with new social and academic demands. Success leads to a sense of competence, while failure results in feelings of inferiority.

24. Erikson's Stages of Psychosocial Development
Adolescence (12 to 18 years)
Identity vs. Role Confusion
Teens need to develop a sense of self and personal identity. Success leads to an ability to stay true to yourself, while failure leads to role confusion and a weak sense of self.

25. Erikson's Stages of Psychosocial Development
Young Adulthood (19 to 40 years)
Intimacy vs. Isolation
Young adults need to form intimate, loving relationships with other people. Success leads to strong relationships, while failure results in loneliness and isolation.

26. Erikson's Stages of Psychosocial Development
Middle Adulthood (40 to 65 years)
Generativity vs. Stagnation
Adults need to create or nurture things that will outlast them, often by having children or creating a positive change that benefits other people. Success leads to feelings of usefulness and accomplishment, while failure results in shallow involvement in the world.

27. Erikson's Stages of Psychosocial Development
Maturity(65 to death)
Ego Integrity vs. Despair
Older adults need to look back on life and feel a sense of fulfillment. Success at this stage leads to feelings of wisdom, while failure results in regret, bitterness, and despair.

28. Resources Erikson's Stages of Psychosocial Development