Children’s Functional Health Pattern Assessment Functional Health Pattern Assessment (FHP) | Toddler Erickson’s Developmental Stage: Autonomy VS. Shame | Preschool-Aged Erickson’s Developmental Stage: Initiative VS. Guilt | School-Aged Erickson’s Developmental Stage: Industry VS. Inferiority | 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) Good weight gain of four to six pounds per year with a growth in height of 2-4 inches per year. 2) Will have several teeth at this stage and will imitate parents while learning to brush their own teeth. | 1) Good perception of body parts and can name them. 2) Has no illnesses or allergies | 1) School age child may think that they are sick because they are being punished. 2) They are aware of their own body and how it functions | | 1) Decrease weight due to lack of nutrition at this age kids are easily distracted may not want to sit for a meal. 2) Tooth decay from nursing bottle syndrome when the toddler teeth are in frequent contact with sugary drinks, juices and milk. | 1) Dental caries due to no dental care 2) Child has not had any past history of medical evaluations or immunizations. | 1) They may not have good hygiene which can lead to infections. 2) May learn poor health habits from people around them causing increase in illness. | 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)Weans from breast to bottle, starts on regular milk 2) Increases food intake regular meals followed by several snacks throughout the day | 1) skin color and texture are pink and dry with no excessive dryness to skin 2) Body weight is proportionate to height | 1) They know the difference between healthy and non-healthy foods. 2) Calorie consumption for the school age child is 1200-1800, may need more based on their activity level. | | 1) Iron deficiency caused by too much cow’s milk and not a balanced diet including meat 2) Constipation can be a problem due to decrease water intake and not enough fruits and vegetables. | 1) Body weight is above average for child, due to not eating a balanced diet. Too many sugary foods and drink. 2) May have multiple food allergies including peanuts, and milk. | 1) Decrease activity may cause obesity due to watching television or playing video games at home. 2) May be at risk for diabetes. The school age child tends to eat a diet with a higher sugar and fat content. | 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) will have a decrease in urination pattern as they begins to develop voluntary control of urination 2) regular bowel movements with no signs of constipation | 1)urinary elimination is normal with no signs of infections 2) bowels are normal function | 1) Has full control of bowel and bladder and knowledge of proper hygiene. 2) Constipation is normal at this stage as they tend to hold on to it. | | 1) Encopresis can be a potential problem for a child with chronic constipation, increase stress or intestinal issues. 2) Primary Enuresis is urinating in other places than the toilet. The toddler never establishes bladder control. This could be caused by a malformation in the urinary system. | 1) Preschooler is not able to toilet on their own and still has to wear diapers. May have problems with urinary system. 2) May have urinal or bowel incontinence. | 1) Enuresis can still be a problem at this age, may be an issue with the urinary structure 2) Encopresis can be an issue as the child tends to hold on to it for fear of a painful bowel movement. | 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) Toddler has increase energy. Spends most waking hours at play. 2) Interested in other children but will play side by side because they are not ready to share at this age. | 1) Will be able to dress themselves. 2) Able to tell stories, and play interactive games with other preschoolers. | 1) School age child is naturally active wanting to participate in many sporting activities. 2) Motor skills improve with increase in balance, coordination, and strength. | | 1) Toddler may have increase weight gain from decrease activity. 2) Decrease in cognitive development if toddler is kept in playpens or car seats for long periods of time. | 1) Preschooler may have a respiratory disease such as asthma that will limit physical activity. 2) Increase for injury due to preschooler being able to climb. | 1) School age child tend to be more sedentary which can lead to health related issues and obesity. 2) Feelings of inferiority or failure if they do not do well in there sporting activity. | 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) Receptive and expressive language skills develop, toddler uses two to three word phrases such as “my mommy”. 2) Has ritualistic behavior patterns to learn about their environment such as bouncing a ball 10 times. | 1) Visual capabilities are still developing and will be 20/20 by age six. 2) preschoolers still mimic adult language which helps expand their neuromotor capacity | 1) school age child should have all their senses intact and should master new concepts and ideas 2) Acknowledges other people’s feelings. | | 1) The toddler is not imitating parents or verbalizing words. Autism can be diagnosed at this age when a toddler has impaired cognition. 2) Hearing loss can happen due to severe middle ear infections. | 1) The Denver eye screening is used to test for strabismus and amblyopia. 2) Otitis media with effusion can cause hearing loss. | 1) Chronic serous otitis media can lead to hearing deficit 1) May have myopia which is nearsightedness and may have to wear glasses. | 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) Sleep decreases to 12 hours a day with 1-2 naps during the day. 2) Child can have night terrors at this stage | 1) Require bedtime ritual of reading books, or storytelling. 2) Normal for night terrors to still occur. | 1) should sleep 8-12 hours a day with no naps 2) School age child will have a bedtime set and will go to bed with no complaints. | | 1) May only sleep for 2-3 hours this could be related to disorders of initiating or maintaining sleep (DIMS). 2) A toddler who has less that the amount needed for this age range may have developmental delays. | 1) Children waking up in the night and going to sleep with the parents.2) increase fatigue and irritability due to disturb sleep from night terrors. | 1) May start to sleepwalk or sleep talk and may be due to increase fatigue, or stress. 2) Sleeping with parents may cause issues with socialization and development. | 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) Becomes less dependent upon parents, ventures away from parents. 2) Explores relationships with others. | 1) Builds self-esteem by accomplishing tasks. 2) Pretending to be a parent or baby helps them with their imagination. | 1) Has limited self-concept but develops with task completion. 2) Dependent on family to help build self esteem | | 1) Toddler does not acknowledge when called by name. May have sensory problems. 2) Does not want to leave parents side, will not assert independence. | 1) Preschoolers may feel in adequate if they do not perform tasks or help contribute to the family. 2) decrease self-esteem if preschooler does not get praise after performing tasks | 1) Decrease in self-worth by not being accepted by peers. 2) Chronic illness can interfere with relationships and self-esteem. | 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) Will develop roles for certain members of family such as mother is the comforter. 2) Will have a desire to be like sibling and want the sibling’s things. | 1) Preschoolers will question rules or expectations regarding parental control. 2) Preschoolers will admire and imitate their older siblings. | 1) School age children develop more relationships outside the home with increasing independence. 2) Take on added responsibility within the family unit. Helping out with chores, and pets. | | 1) A toddler who is withdrawn may have an attachment disorder 2) Afraid to leave the parents side, for fear they may not come back. | 1) Can have sibling rivalry due to increase imitation of sibling 2) Preschoolers may not play well with children their own age. | 1) Increase risk for gang involvement or risky business due to increase independence outside the home. 2) Strain on parent child relationship due to increase independence. | 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) Discovers genitalia and may masturbate 2) Learn toileting habits at this age. | 1) Preschooler recognizes female from male genders. 2) Preschoolers have curiosity about the other gender. | 1) School age children are going into puberty with pubic hair, breast development, and changes in voice for males. 2) Naturally curious about sex. | | 1) Chronic urinary infections could be cause from hydronephrosis. 2) Displays knowledge in sexual acts inappropriate for age level. May indicate abuse | 1) May have inappropriate sexual behaviors due to curiosity for the other gender. 2) Preschooler may have decrease self-esteem due to teasing regarding gender. | 1) Dress may be inappropriate to get attention from other gender 2) School age child is at risk for sexual transmitted diseases. Decrease knowledge of condoms, abstinence. | 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) May imitate parents and their reaction to stress 2) Child may regress to help cope with stress, such as wanting a pacifier after already being weaned from it. | 1) preschoolers may use defense mechanisms such as denial, repression, displacement to cope 2) Will play by themselves shutting others out. | 1) listening to music, talking to friends and being involved in activities 2) May use defense mechanisms such as regression, denial, repression and denial | | 1) Sudden onset of emotional outbursts that is not normal for the toddler 2) Toddler may isolate himself and withdrawal from activities. | 1) Preschooler will bang head on wall 2) They may bite themselves. | 1) May show signs of depression with frequent crying, lethargy, anorexia, withdrawal from support system. 2) School age child is more aggressive and angry, blaming others. | 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) Rules are absolute and behave out of fear of punishment 2) Will imitate family’s religious rituals and practice. | 1) May talk about what they want to be when they grow up. 2) Behavior is better as preschooler has more inner control. | 1) School age child knows there moral values and make decisions based on them. 2) Cultural and religious values influence the school age child moral development. | | 1) Child may act up and misbehave to get attention because parents usually give attention to child when they do something wrong not right. 2) Toddler is not rewarded for good behavior. | 1) May break rules and be more aggressive toward people due to immature conscious. 2) Inappropriate shows on television can negatively affect preschooler | 1) may start to lie, cheat or steal 2) can be disrespectful to their elders and parents |

Short Answer Questions

Address the following based on the above assessment findings. Expected answers will be 1-2 paragraphs in length. Cite and reference outside sources used.

1) Compare and contrast identified similarities as well as differences in expected assessment across the childhood age groups.
There are so many differences from the toddler stage to school age. The body and mind go through so many changes. Children are learning so much from being able to drink from a cup, control their bladder and bowels, brushing their teeth, learn values and beliefs, discover independence. There are so many challenges that they may face as they discover the environment around them. The people that they will meet on the playground, in the library, the store and at school, will help shape their lives. As you have seen that the toddler age child needs structure and guidance while they learn how to do everyday tasks on their own. The preschool child still needs structure and guidance but may start to do things on their own like pour their own milk to dressing themselves. The school age child is learning independence, learning how to be independent, seeking there self-concept and sense of identity.

2) Summarize how a nurse would handle physical assessments, examinations, education, and communication differently with children versus adults. Consider spirituality and cultural differences in your answer.
A nurse should always introduce themselves first then they need to be calm, speak softly and earn the child’s trust. Children need to know the step by step process of what will happen, they are usually scared and need reassurance. Get to know what they like, if a child brings in a stuff animal, ask the child what the name is. Let them know you care about them, and what they care about. They need to be involved as much as they can in their care. Their parents also need to be involved with whatever is going on with their child. Consider the families cultural differences and spirituality regarding treatment, examinations, assessments, communication.
When assessing an adult you should introduce yourself first, answer any questions they may have regarding their assessment, treatment and any education that may be given. Ask if they want anyone else involved with their treatment. Make sure all their questions are answered.

References

How a child develops. (2011, January 1). Retrieved from http://www.howkidsdevelop.com/developSkills.html Jarvis, C. (2012). Physical Examination & Health Assessment 6th ed. St. Louis, MI: Mosby.

Edelman, C., & Mandle, C., (2010). Health promotion through the life span. 7thed. St. Louis, MI: Mosby.