| Course | NU 345 Health Assessment and Promotion Across the Life Span |
|---|---|
| Unit | Unit 1 |
| Paper type | Lifespan assessment variations paper |
| Length | About 1,030 words, 6 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | RN to BSN |
| Updated | October 2026 |
Free sample paper for NU 345 Unit 1
One Assessment, Five Life Stages: How Pain Assessment Changes From Infancy to Advanced Dementia
Student Name
Department of Nursing, Herzing University
NU 345: Health Assessment and Promotion Across the Life Span
Instructor Name
January 20, 2026
One Assessment, Five Life Stages: How Pain Assessment Changes From Infancy to Advanced Dementia
Why Pain Assessment Shows Lifespan Variation Clearly
Pain assessment in adults rests on self-report: the patient rates pain on a scale and describes its location, quality, and timing. That foundation is only partly available at either end of life. Infants cannot report pain, young children report it in ways that depend on their language and understanding, adolescents may underreport it for social reasons, and older adults with dementia may lose the ability to report it at all. For that reason, pain assessment is a clear example of how approach, tools, and interpretation change across life stages, not only technique (Jarvis & Eckhardt, 2024). This paper compares five stages, using a composite patient at each, and states what differs and why.
Infant
Approach: assessment depends entirely on observation and on the caregiver's knowledge of the infant's usual behavior. The nurse observes before touching, because handling itself changes the infant's state. Tool: for an 8-month-old after a minor surgical procedure, a behavioral scale such as the FLACC scale, which scores face, legs, activity, cry, and consolability from 0 to 2 each, for a total of 0 to 10 (Merkel et al., 1997). Interpretation: a high score must be read against the infant's baseline, since hunger, fatigue, and separation from a parent also produce crying. The parent is asked, "Is this how she acts when something hurts?" because the caregiver's interpretation is often the most sensitive indicator.
School-Age Child
Approach: a 7-year-old can report pain but benefits from being told what will happen and from being offered a choice, such as which arm for a blood pressure cuff, which gives a sense of control. Tool: a faces scale, in which the child points to a drawing of a face that matches how much it hurts, is easier for this age than numbers; many 7-year-olds do not yet use a 0 to 10 scale reliably. Interpretation: children this age may deny pain to avoid an injection or to get home sooner, so the nurse watches behavior, such as guarding or reluctance to move, alongside the report.
Adolescent
Approach: a 15-year-old can use a numeric scale but may underreport pain in front of parents or peers or overreport it when anxious. Part of the assessment is done with the adolescent alone, and the nurse normalizes pain reporting: "Most people have pain after this surgery; it helps me to know exactly how much." Tool: the numeric rating scale, 0 to 10, with function-based questions such as whether pain stops the teenager from sleeping or walking. Interpretation: the adolescent's own report is the standard, and the nurse avoids assuming that a teenager who is texting and laughing cannot be in significant pain.
Adult
Approach: the adult interview is the baseline technique, covering onset, location, duration, character, aggravating and relieving factors, and severity. Tool: the numeric rating scale, combined with questions about function and the patient's goal, since a score of 4 may be acceptable to one patient and not another. Interpretation: self-report is accepted as the most reliable indicator. Cultural and personal factors shape how pain is expressed, so a quiet patient is not assumed to have less pain than a vocal one.
Older Adult, With and Without Dementia
Approach: an older adult without cognitive impairment can use the numeric scale, but may need more time, a quieter room, a larger printed scale, and words such as "ache" or "discomfort," because some older adults do not describe chronic discomfort as pain. Hearing aids and glasses should be in place before the assessment. For an 86-year-old woman with advanced dementia who cannot give a reliable self-report, the approach shifts back toward observation, as with an infant, but with a very different interpretation. Tool: the Pain Assessment in Advanced Dementia scale, which scores breathing, negative vocalization, facial expression, body language, and consolability, each from 0 to 2 (Warden et al., 2003). Interpretation: behaviors such as agitation, calling out, or resisting care may be misread as symptoms of dementia rather than signs of pain; the scale gives the nurse a structured way to consider pain first. Caregivers who know her well add information about changes from her usual behavior.
Documenting Pain So the Next Nurse Can Compare
Across all five stages, the record must say which tool was used, because a score of 4 on a behavioral scale and a score of 4 on a numeric self-report scale are not the same measurement. For the infant, the record notes the FLACC score, the circumstances, such as whether the infant had just been fed or was being held, and the parent's view. For the school-age child, it notes the faces scale choice and the behaviors observed. For the adolescent and adult, it records the numeric score together with the effect on function and the patient's own goal. For the older adult with dementia, it records the behavioral scale score and what the usual behavior is, so that a change can be recognized on the next shift. Reassessment after treatment uses the same tool, at a stated interval, so that the effect of a medication or a nonpharmacological measure can be judged.
Two errors recur across ages. One is switching tools between assessments, which makes a change in score meaningless. The other is recording only a number without the context that gives it meaning, which is especially misleading at the extremes of age, where behavior can change for many reasons besides pain.
What the Comparison Shows
Three patterns emerge. First, the source of information shifts across life: from caregivers and behavior in infancy, to self-report supported by age-appropriate tools in childhood and adolescence, to self-report as the standard in adulthood, and back toward observation and caregivers in advanced dementia. Second, the approach changes more than the technique: what matters is how the nurse positions herself, whom she asks, and when. Third, interpretation always requires a baseline, whether the infant's usual cry, the adolescent's usual demeanor, or the older adult's usual behavior before an illness. A nurse who carries the adult technique into every age will miss pain in the people least able to report it.
References
Jarvis, C., & Eckhardt, A. L. (2024). Physical examination and health assessment (9th ed.). Elsevier.
Merkel, S. I., Voepel-Lewis, T., Shayevitz, J. R., & Malviya, S. (1997). The FLACC: A behavioral scale for scoring postoperative pain in young children. Pediatric Nursing, 23(3), 293-297.
Warden, V., Hurley, A. C., & Volicer, L. (2003). Development and psychometric evaluation of the Pain Assessment in Advanced Dementia (PAINAD) scale. Journal of the American Medical Directors Association, 4(1), 9-15. https://doi.org/10.1097/01.JAM.0000043422.31640.F7
Reading the NU 345 Unit 1 instructions
Unit 1 asks you to explain how one assessment changes across the lifespan. Expect to choose an assessment, describe the approach, tools and findings at several life stages, explain why the variations exist and draw conclusions. Many versions ask how much technique actually changes by age and whether normal values are required. Check how many stages your section expects; four or five is common. Choose an assessment that changes visibly, such as pain, vital signs or development. Use validated tools for each stage and cite their sources. Address who else is in the room, since parents, adolescents and family caregivers affect what the patient reports. A documentation section that ensures findings can be compared between nurses adds practical value.
Inside the NU 345 Unit 1 example
The paper opens by explaining why pain is a good example: self-report is the standard, and not everyone can give it. Every stage uses one pattern, approach then tool then cautions, so stages line up side by side. The infant section relies on behavior and caregivers. The school-age section uses faces scales and choice. The adolescent section addresses privacy and peers. The adult section is the baseline. The older adult section separates those with and without dementia, introducing PAINAD for the latter. The documentation section explains the need to record the tool used. The final section draws three patterns across the lifespan, such as the shift from observation to self-report and back, which shows the stages were compared, not just listed.
NU 345 Unit 1 rubric: what full points look like
Herzing's rubric for a lifespan variations paper typically covers the choice of assessment, accuracy for each stage, use of validated tools, explanation of variation, practical application and writing. Accuracy at each stage is checked first, since a wrong tool or technique for an age group undermines the paper. Tool points reward validated instruments with sources, such as FLACC and PAINAD. Explanation criteria look for reasons the assessment changes, such as development or cognition. Application earns credit for documentation and communication advice. Patterns across stages often lift a paper into the top band because they show synthesis. Jarvis and Eckhardt's physical examination text and Warden's PAINAD study belong in the APA 7 list.
NU 345 Unit 1 help before you submit
A Unit 1 lifespan paper often falls short by describing each stage separately without drawing patterns across them. Another frequent problem is naming a tool without explaining how it is used. Students often forget that the same score means different things on different scales. Adolescent privacy is ignored. The dementia stage is merged with healthy older adults, though their assessment differs. Sources for tools are missing. Normal values are listed without connection to technique. Finally, end with what the comparison shows, because graders reward synthesis across the lifespan rather than five short sections that never speak to each other. Another gap is leaving out how caregivers' reports are weighed against the child's or patient's behavior.
Get a NU 345 Unit 1 example written to your instructions
Send the Unit 1 instructions and the rubric from your NU 345 classroom, plus the stages your comparison has to cover. We write a custom example that runs each stage against fixed dimensions with figures attached, returned in 24 to 48 hours. The first custom sample is free.
More NU 345 papers and RN-to-BSN samples
- NU 345 Unit 2: Functional health pattern assessment
- NU 345 Unit 3: Genogram and family health history
- NU 345 Unit 4: Health assessment and promotion plan
- NU 345 Unit 5: Developmental stage applied to assessment
- NU 345 Unit 6: Health risk appraisal
- NU 345 Unit 7: Teaching plan for one person
- NU 345 Unit 8: One health issue across the lifespan
- NU 476 Unit 1: Capstone topic proposal
- NSG 321 Unit 1: Delegation and supervision analysis
- NSG 323 Unit 1: Windshield survey
- NSG 324 Unit 1: Clinical question from practice
NU 345 Unit 1 questions, answered
How much does technique actually change by age?
Less than approach does. Auscultating a chest is the same maneuver at four and at eighty; what changes is how you get the patient to allow it, what order you work in, and what the finding means at that age. Papers that focus on technique miss most of what the assignment is asking about.
Do I need the normal values?
Yes, with figures. A comparison stating that respiratory rate is higher in infants tells a reader nothing they could use, whereas the actual ranges by age band tell them when to be concerned. Cite the source, because these figures vary slightly between references and an assessor will want to know which one you used.
How should I handle who else is in the room?
As part of the assessment. A parent's presence steadies a young child and can silence an adolescent; an adult daughter answering for her father changes what you learn about his function. Say for each stage who is normally present, what that adds, and when you would ask for time alone with the patient.
Where can I find a free NU 345 Unit 1 sample paper?
The full NU 345 Unit 1 pain assessment across five life stages is free on this page, with the tools, documentation advice and patterns. A paper following a different assessment across the lifespan can be written on request.
How is pain assessed in patients who cannot speak?
With validated behavioral scales: FLACC for infants and young children, PAINAD for advanced dementia, which score signs such as facial expression, breathing and body movement. This sample explains each and why the record must name the tool used.