Children’s Functional Health Pattern Assessment Functional Health Pattern Assessment (FHP) | Toddler Erickson’s Developmental Stage: Autonomy vs. Shame (Edelman, Kudzma,&Mandle, 2010) | Preschool-Aged Erickson’s Developmental Stage: Initiative vs. Guilt (Edelman, Kudzma,&Mandle, 2010) | School-Aged Erickson’s Developmental Stage: Industry vs. Inferiority (Edelman, Kudzma,&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. | Child learns to be more independent and acquires new skills. He/she relies on the caregiver for the health management. -Choosing a toy to play with. -Not afraid to walk away from their parent | Child explores his/her interpersonal skills via initiating activities, know parts of their body. -Able to verbalize pain -Leading others | Child develops sense of pride in his/her achievements, understand the need for healthy checkups. -Know how to read and write -Confident and able to achieve goals. | | -Accidental injuries -Poor dental hygiene | -Feeling guilty for being nuisance. -Become slow in interacting with others | - Feeling of inferiority -Frequent illnesses | 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. | Calcium and Iron intake is essential. -Drinks from a cup -Able to hold a fork/spoon | Child depends on the caregiver to make well balanced meal choice. -Knows what food he/she likes -Prefers to eat unhealthy snacks vs. nutritious meal | Able to differentiate between healthy and unhealthy meal. -Chooses nutritious meal -Consumes adequate amount of calories | | -Risk for aspiration -Prolonged potty training | -At risk for obesity -At risk for malnourishment | -Obesity and malnourishment due to the poverty -Not having access to healthy meal due to the parents busy schedule | 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. | Bowel and bladder control teaching begins -Partially potty trained -Needs to be reminded to use a bathroom every two to three hours | Toilet training is almost complete -Follow hygiene rules after toileting -May fail do wipe themselves properly | Child has a full control over the bladder and bowel. -Ability to perform personal hygiene well independently -Established toileting pattern | | -Risk for failure/delay in toilet training -Inability to control his/her bladder when asleep | -Night time incontinence -Child may feel uncertain after having an accident at school | -Constipation or stool incontinence -Pain while voiding | 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. | Generally very active -Repeats same activity -Learns to walk and run | Play is a big part of everyday activity -Coordination is increased. -Likes to play with other children. | Activity and exercise are vital for the healthy lifestyle -Involved in sports -Well coordinated and active | | -Injuries related to an accident -Toddler does not show any interest in activities that are outdoors | -Shows their anger in the drawing or play -Inability to play with other kids, social isolation. | -Spends a lot of time watching television or playing video games -Feels pressured by the parents to be successful in sports | 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. | Toddlers are egocentric -Understands object permanence. -Recognized pictures and knows names of the common objects | Preschoolers are very involved in interactive play -He/she asks a lot of questions -Space oriented | Child as this age is aware that other people may different opinions and feelings. -Knows the difference between right and wrong -Has an idea about life and death | | -Developmental delay, lack of interest -Hearing and vision impairment | -Inability to repeat and tell the story -May have imaginary friends that he/she blames for misbehavior | -Low self-esteem due to the learning disability -Inability to make friends and feeling isolated | 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. | Requires one to two naps a day, and at least twelve hours of sleep -Toddler sleeps with a favorite toy -Takes a bath and requires a bed time story | Getting up to eight hours of sleep is enough -Reads a book before falling asleep -May ask to have a lamp on and keep the bedroom door open | Does not require naps, eight hours of asleep is enough -Sleep-Rest pattern is well established. -Bedtime is not stressful. | | -Does not sleep in his/her own bed -Talks in her/his sleep , has nightmares | -Goes to be late -Complains of being hungry, thirsty, and needing to use a bathroom. | -Bed wetting at night time -Talking in his/her sleep after watching a lot of television or playing video games | 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. | Toddlers learn to be more independent -He/she can follow directions and answer questions -What they think is controlled by what they see and hear. | Sense of self is incomplete -Choose their own clothes -Feel socially accepted and successful | Continue to grow physiologically and cognitively -Confident with good self –esteem -Competitive and perfectionist | | -He/she may have temper tantrums to proof having a power over a parent -Conflict between a parent and toddler over autonomy limits. | -May feel inadequate if unable to dress by themselves -Very sensitive and easily offended | -Low self-esteem and poor hygiene -Concerned about what their peers think and try to blend in | 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. | Trust their parents and family members -Afraid of strangers -Shows interest in their caregiver’s belongings. -Don’t like to share their things -May feel unwanted with the birth of the brother or sister | Friends and family are very important -Love to play with peers -Understand the difference between male and female roles when it comes to activities and responsibilities -Preschooler who has older siblings may have difficulty playing with his/her peers -Can be influenced negatively by social media | Child at the school age knows his/her role in the family and among friends -Take care of the siblings, look after them -Are more responsible within the family -Child that plays alone is at risk for social and emotional issues -Prefer to spend more time with friends than family | | | | | 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. | Become curious about genital organs -Ask parent about their genital organs during the bath time or diaper change -May masturbate | Understand gender difference in general -Prefer to play with the same sex friends -May be interested about the opposite gender | Adjusting to body changes -Want to know about sex -Highly aware and interested in body changes | | -At risk for sexual abuse -May touch other child inappropriately | -At risk for feeling embarrassed when showing interest in sexual information -May feel they belong to the other gender and struggle with it | -At risk for obtaining wrong information from peers -May seek sexual attention and be at risk for sexual abuse | 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. | Temperament is their style of coping -Temper tantrums are common -Staying close to the caregiver from fear | Use coping mechanisms -May show separation anxiety and projection -Use their toys or a blanket as a security source | Coping is achieved through the use of defense mechanisms -Sports and exercise helps them control their behavior -Some use music and humor to cope | | -May show aggression -Inability to cope or adjust can cause regression in the development | -Withdrawn child may be at risk for emotional and developmental problems -Persistent refusal to follow directions | -Unstable family environment makes coping difficult -Peer pressure , drug and alcohol use may cause them to commit suicide | 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. | Learning family values -Good behavior followed by a positive respond -Well balanced discipline and praise -No consequence for a bed behavior may encourage it-Forgetting to reward good behavior may have a negative affect | Verbalize their values -Learn to control their emotions and behavior -Express who they admire and mimic them -Inappropriate television shows and computer games -Disrespecting teachers and breaking the rules | Able to differentiate right from wrong -Having a strong family values -Being able to make ethical and moral decisions -Disrespect to other people is a big concern -Acting inappropriately because of the peer pressure | | | | |

Children’s Functional Health Pattern Assessment

Inesa Hovhannisyan

Grand Canyon University: NRS 434V

03/22/2015

Children face many difficulties when they go through toddler, preschool, and school age

(Edelman, Kudzma, & Mandle, 2010). They learn to cope with these challenges and overcome

them. Family values and culture, friends and peers have a tremendous influence on the child’s

growth and development. Children need well established routine and structure during their early

childhood years. As they become older, children establish sense of identity. They have their

opinion and want autonomy, able to differentiate right from wrong.

Children need a different approach then adult patients (Jarvis, 2012). Nurse needs to be

able to communicate with the child and the parent. Establishing rapport with the parent will help

the child to trust the nurse. Parent is the primary source that provides health history and related

information during the child’s toddler and preschool years. Involve them in the plan of care and

the goal. Caregiver needs to be present during the assessment, examination, and education. The

nurse should observe closely for any signs of mistrust between a child and a parent, recognize

nonverbal cues. Cultural and spiritual differences and values need to be considered and

respected. In order to have a good outcome, parent and a child need to trust their healthcare

provider.

References

Edelman, C., Kudzma, E., & Mandle, C. (2010). Health Promotion Throughout the Life Span,

7th Edition. [VitalSource Bookshelf version]. Retrieved from

http://pageburstls.elsevier.com/books/9780323056625/id/B9780323056625000061_c003

Jarvis, C. (2012). Physical Examination and Health Assessment, 6th Edition. [VitalSource

Bookshelf version]. Retrieved from http://pageburstls.elsevier.com/books/978-1-4377-

0151-7/outline/9