Functional Health Pattern Assessment (FHP) Toddler
Erickson’s Developmental Stage:
1 to 3 years
Autonomy vs. Shame/Doubt
(Edelman & Mandle, 2010) Preschool-Aged
Erickson’s Developmental Stage:
(3 to 5 years)
Initiative vs. Guilt
(Edelman & Mandle, 2010) School-Aged
Erickson’s Developmental Stage:
6 to 11 years
Industry vs. Inferiority
(Edelman & Mandle, 2010)
Pattern of Health Perception and Health Management:

List two normal assessment findings that would be characteristic for each age group.

List two potential problems that a nurse may discover in an assessment of each age group. 1-Toddlers may eventually learn that being sick means feeling bad or having to stay in bed, but they have little, if any, understanding of the meaning of health.

2-Toddlers whose parents eat a variety of foods are more likely to try new foods 1-Their concepts of what is inside the body and how its internal functions operate are vague and inaccurate

2- Most preschoolers can name one or two items inside the body (blood, bones) 1- Most school-age children perceive symptoms and show an ability to participate in health-promoting behaviors

2- School-age children’s understanding of illness is directly correlated with their cognitive development and follows a direct sequence of developmental stages 1-Risk for injury is very high. Toddlers like to explore parent’s guidance is a must.

2- Parents need to be educated on ways to keep their toddlers safe for injuries 1-Pain or illness may be viewed as a punishment

2- Preschoolers should be able to contribute to their health by brushing their teeth, taking medication, wearing appropriate clothing for inclement weather, and performing other actions 1-School-Aged children may believe that a misdeed or misbehavior caused their illnesses

2- children can become passive health care consumers, asking few questions, doing as they are told, and perpetuating poor choices
Nutritional-Metabolic Pattern:

List two normal assessment findings that would be characteristic for each age group.

List two potential problems that a nurse may discover in an assessment of each age group. 1-Adequate iron intake must be ensured as the toddler changes from breast milk or iron-fortified formula and cereal to whole cow’s milk, which is low in iron.

2-Whole cow’s milk also interferes with the absorption of iron from other food sources 1- Favorite foods for this age are meat, cereal grains, baked products, fruits, and sweets.

2- Preschoolers in group settings learn both positive and negative eating habits and food preferences from care providers and other children. 1- Some children may eat only raw vegetables and fruits and go through a phase of eating only one food at lunch, such as a peanut butter sandwich

2- School -Aged children frequently make their own after-school snacks and need supervision regarding the content

1-The use of a bottle with milk or juice, especially at bedtime, has also been associated with dental caries

2-If parents want to give a bottle at bedtime, it should contain only water 1- Preschoolers need approximately 90 kcal/kg of body weight per day for health maintenance, activity, and growth

2-Preschoolers are at risk for iron-deficiency anemia 1-The overweight and obese child faces ridicule by peers and discrimination later in life

2- Frequent and lengthy watching of television and exposure to food-related advertisements has been linked to childhood obesity
Pattern of Elimination:

List two normal assessment findings that would be characteristic for each age group.

List two potential problems that a nurse may discover in an assessment of each age group. 1-Emotional and physiological readiness for toilet training rarely develops before 18 months of age

2-Daytime dryness usually is achieved by 3 years of age and ahead of nighttime dryness, where the need to wear a diaper remains 1- Older preschool children are capable of and responsible for independent toileting

2- They may forget to flush the toilet or wash their hands when they are rushed, but they have the physical ability to perform the skills 1- school aged children are able to undress, dress, wipe, flush, and clean their hands independently

2- Most children have full bowel and bladder control by 5 years of age

1-Toilet training is often a major parental concern during toddlerhood.

2-Parents who begin before their child is ready usually experience frustration. 1- Preschoolers should not be teased or punished when they are unable to perform independently

2- If their clothing becomes soiled, preschoolers should be allowed to change their own clothes. 1-Enuresis should not be considered a disease but a variation of normal development

2- For some school-age children, however, elimination continues to be a problem.
Pattern of Activity and Exercise:

List two normal assessment findings that would be characteristic for each age group.

List two potential problems that a nurse may discover in an assessment of each age group. 1-Toddlers are always busy—emptying wastebaskets and drawers, building and destroying towers, throwing, kicking, chasing after balls, or dressing and undressing

2-During the toddler period, children will advance from taking their first step to running, climbing stairs, and even pedaling a tricycle 1- Through play preschoolers learn to exert control over their own behavior

2- The young child frequently invents an imaginary companion who plays, eats, and sleeps with the child. 1- Boys are typically more active than girls

2- School-age children frequently prefer interacting with peers rather than with family 1-A toddler who shows no interest in playing is not normal. Toddlers usually spend most of their waking hours at play

2-Sharing and cooperative play will not develop until well into the preschool age.

1-Preschoolers should be monitored for safe activities that enhance gross and fine motor skills while creating fun in movement.

2- Many preschoolers spend long periods each day watching television, videos, and playing electronic games 1- Monitoring of daily television and computer use that detract from physical activity and more active mental activities

2- Parents and teachers should complement children when they perform well to enhance self-esteem
Cognitive/Perceptual Pattern:

List two normal assessment findings that would be characteristic for each age group.

List two potential problems that a nurse may discover in an assessment of each age group. 1-Toddlers thoughts are dominated by what they see, hear, or otherwise experience, and they want to experience everything

2- Toddlers also learn the use of inflection. “Mommy” may mean “Pick me up” on one occasion and “I’m scared” or “Where are you?” on another 1- At this stage, children concentrate solely on their own perspective

2- Preschoolers may have one or more imaginary companions who exist for varying periods 1- By age 8, most children understand the difference between past and present, and history becomes meaningful

2- A school-age child begins to take the other person’s point of view into account 1-Parents need to understand saying no is the toddlers favorite word

2- Toddlers can inadvertently put themselves in harm’s way as they pursue an object or person they sense is just out of view 1-By approximately age 5, children should be able to repeat four consecutively named numbers easily

2-Most preschoolers should know and be able to name colors. 1-the school-age environment can affect the learnings

2-School-age children should have a clear understanding of right and wrong
Pattern of Sleep and Rest:

List two normal assessment findings that would be characteristic for each age group.

List two potential problems that a nurse may discover in an assessment of each age group. 1-Toddlers’ need for sleep decreases to 12 hours a day, including 1 or 2 naps of shorter duration

2- The toddler may be involved in an activity and not be aware of fatigue, especially when visitors are in the home or some interesting new toys have been discovered. 1- Most preschoolers sleep from 8 to 12 hours during the night, with wide variation among children

2- By age 5, most preschoolers no longer regularly nap during the day 1- Most school-age children have no difficulties with sleep

2- most school-age children sleep between 10 and 12 hours a night without naps during the day 1- Many toddlers will try to delay sleep by calling for water, another story, or another kiss, or by making other requests

2-Parents need to schedule nap and quiet time even when there are house-guests or holidays that pre-empt the toddler’s routine. 1- Many children do not receive the recommended number of sleep hours and sleep problems in preschool children commonly occur

2- Sleep terrors are at a peak during this stage of development

1- Parents who are concerned about sleepwalking or sleep talking need to know that most children outgrow these episodes with CNS maturation

2- If a child has many episodes of sleepwalking or sleep talking or if parents express particular concern, he or she may need further evaluation and treatment by health care professionals.
Pattern of Self-Perception and Self-Concept:

List two normal assessment findings that would be characteristic for each age group.

List two potential problems that a nurse may discover in an assessment of each age group. 1- The toddler must explore the world, not only the physical aspects but also the interpersonal aspects of relationships, to develop a true sense of autonomy

2- Exploring the physical world involves poking into, climbing onto, crawling under, tasting, smelling, and taking apart the objects encountered 1-Social acceptance helps children feel successful in their role as child, sibling, and friend

2- Preschoolers investigate roles through rich imagination 1- The way in which others, especially peers, view the child influences the sense of self

2- Acceptance by a peer group contributes to feelings of self-worth and a sense of belonging to a desired group 1- A typical toddler response to frustration is the well-known temper tantrum.

2- Toddler may also need to express autonomy by refusing a drink when they really need it 1-Preschoolers can get embarrassed by their actions

2-Preschoolers are becoming very sensitive when others criticize them

1- Girls experience greater competition now than in earlier times, and they face pressures about personal appearance

2- Children with chronic illness worry that their peer relationships will be negatively influenced if others know about their illness
Role-Relationship Pattern:

List two normal assessment findings that would be characteristic for each age group.

List 2 potential problems that a nurse may discover in an assessment of each age group. 1- By toddlerhood, children typically know their mother, father, and older siblings and have established some form of reciprocal relationship with them

2- Toddlers’ capability for relationships is limited and usually reflects their egocentric approach to everything else 1- Preschoolers receive ideas and information from peers

2- Younger children may admire and imitate an older sibling 1- School-age children learn responsibility for allowance, household chores, self-care, and pets and acquire a sense of empowerment as an integral part of the family

2- As children mature, they assume more responsibilities within the family and the community. 1- Parents cannot stop sibling fighting by forbidding it, but reasonable limits can be established

2- One way to deescalate fighting is to remove the reward of the fight 1- Parents and caregivers should be aware of the powerful influence that environment has on role perceptions

2- Preschoolers may question rules or expectations at home, comparing them to their friends’ situations
1- Older children may become involved in gangs, behavior that causes much stress for both children and their parents

2- Violent behavior must be discouraged, and nonviolent methods to reach resolutions for personal problems should be encouraged

Sexuality – Reproductive Pattern:

List two normal assessment findings that would be characteristic for each age group.

List two potential problems that a nurse may discover in an assessment of each age group. 1-Parents need to understand that masturbating is normal process of development.

2- The toileting process, during which attention is focused on the genital area, may precipitate the toddler’s curiosity about genital organs 1- Preschoolers recognize there are two genders and identify with their own gender

2- Preschoolers develop curiosity at this age, including inquisitiveness about bodies and sexual functions of others 1- A child may become extremely attached to another of the same gender, and they may explore one another’s sexual organs

2- Most school-age children have the cognitive skills to respond to programs on responsible sexuality, including discussions on abstinence and condom use, pregnancy, sexually transmitted diseases, and the human immunodeficiency virus 1- The use of cute alternative words often is a reflection of parental discomfort or embarrassment

2- Using correct terms will help toddlers develop accurate knowledge about sexuality and communicate more effectively if inappropriate touching by others occurs

1- Preschoolers should not be teases by parents regarding their curiosities of sexual information

2- Parents needs to know that positive feelings about all aspects of the self (including gender role) create positive self-esteem. 1- Exploring one another’s sexual organs is common exploratory behavior and does not reflect true homosexuality, even though parents and children may express concerns about it

2- Parents are often uncomfortable or unsure of what sexual information to give to their children and when to give it
Pattern of Coping and Stress Tolerance:
List two normal assessment findings that would be characteristic for each age group.

List wo potential problems that a nurse may discover in an assessment of each age group. 1- Toddlers are developing new ways to cope with the myriad of new stresses that come with being a toddler

2- Toddlers often imitate their parents’ behavior and this includes their methods of dealing with stress

1- Protest behavior in the form of temper tantrums normally disappears as a stress response in the older preschooler

2- Through fantasy play, they investigate solutions or responses to stressful events and find inner control for challenging situations 1- Threats to the child’s security (e.g., bullying) cause feelings of helplessness and anxiety that may affect the ability to function successfully

2- Some children respond to a stressful situation by transferring their feelings to a physical problem (somatization) 1- Toddlers also regress, at times, to earlier infantile behavior when overwhelmed, until they regain some sense of mastery

2- Typical stressors include new siblings, babysitters, day care, toilet training, parental limit setting, and an endless string of tasks involving skills they have yet to develop 1- Temper tantrums that persist through the fifth year indicate a lack of matured coping responses

2- Parents should not accuse the preschooler of lying, but rather the adult should help the child decide whether the story is pretend or real 1- The school-age child must learn to cope with stress as part of the developmental process.

2- Grief over the death of a loved one, parental divorce, loss of a favorite activity because of misbehavior, or expulsion from a favorite peer group may cause negative behavior
Pattern of Value and Beliefs:

List two normal assessment findings that would be characteristic for each age group.

List two potential problems that a nurse may discover in an assessment of each age group.

1-Healthy behaviors are expressions of positive values and beliefs

2- values and beliefs are learned, and their recognition and acceptance are fundamental to the integrity of every child 1- a preschooler may feel overwhelming guilt when behavior and internal controls conflict

2- Preschoolers frequently express their values by stating who or what they like or what they want to be when they become adults 1- Older children often lie because they fear punishment or ridicule

2- Some moral behavior problems, such as lying, stealing, or cheating, are common during the school-age years 1- Toddlers believe rules are absolute and behave, out of a fear of punishment

2- toddlers’ environments should not only help them become aware of right and wrong but also contribute to their sense of security, belonging, and autonomy 1- Guilt results from perceived reduction of self-esteem, a critical step in the development of conscience

2- Many children worry about who will care for them if their caregivers die, whether pain comes with death, what causes death, and what happens after someone dies 1- Environmental factors and culture strongly influence a child’s moral development

2- Parents frequently need reassurance that the child is normal and probably will outgrow the behavior with parental assistance