Children’s Functional Health Pattern Assessment
Grand Canyon University:
NRS - 434V – Health Assessment
October 20, 2013

Children’s Functional Health Pattern Assessment Functional Health Pattern Assessment (FHP) | Toddler Erickson’s Developmental Stage: Autonomy vs. Shame and Doubt During the toddler years, children are gaining a better sense of control over their bodies, food choices, toys they play with and even the clothes they choose to wear. When they accomplish this, they have great sense of confidence, however if they do not accomplish this stage, they are left feeling doubtful and unsure (Cherry, 2013). | Preschool-Aged Erickson’s Developmental Stage: Initiative vs. GuiltDuring preschool age, kids are gaining a control to world by playing and interacting with others. When they fulfill their need of control and ability to socialize with others they do not lack self-doubt (Cherry, 2013). | School-Aged Erickson’s Developmental Stage: Industry vs. InferiorityDuring the school age years, children develop through social interactions, encouragement from parents, teachers and peers, and gain a sense of pride in their accomplishments. Without the right encouragement and play with others, they may not develop the self-confidence (Cherry, 2013). | 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. Can name and point to body parts such as legs, arms, and feet. 2. Relies on us (parents) for all health maintenance, but tries to brush his/her own teeth with parent supervision. | 1. Child can understand when they are sick and able to communicate with the parents. 2. Can identify if allergic to a food and can tell others. | 1. Understands that germs can cause illness. 2. Participates in health promotion by washing hands, using hand sanitizer and covering cough without being told to. | | 1. Toddler may appear dirty or un kept if the parents are not diligent on bath routines and teeth cleaning. 2. Rashes may be present in the toddler ages around genitals if the toddler is learning to potty train, but still having accidents and not telling their parents. | 1. Child may eat from another student/preschooler unaware that they are allergic to it. 2. Takes off seat belt when parents are not looking. | 1. Sees illness as a punishment. 2. Does not understand how important it is to rest when sick, would rather be playing. | 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. Toddler tries to feed themselves, using forks and spoons. 2. Toddler is learning what foods he/she likes and what foods they do not like. | 1. Able to eat all meals by themselves, just needs help cutting up foods. 2. Does not like to eat at every meal. | 1. Willing to try new things at dinner. 2. Contributes to making meals and is more likely to eat what they make. | | 1. Toddler may appear skinny or not growing at regular speed, due to lack of nutrition intact. 2. Sometimes food is used as a bribe, and the importance of nutritional value is not being taught. | 1. Is very picky about food and refuses to eat vegetables and fruits. 2. Loses weight because they are not eating the food prepared for them. | 1. Throws away fruit or vegetable at school lunch. 2. Eats fast food 30% of the week because of 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. | 1. Learning how to use a toilet and what going in the potty is. 2. Starting to introduce big boy/girl panties. | 1. Understands the feeling of having to go the restroom, can hold it for a few minutes. 2. Can sit on the toilet without help from parents. | 1. Can control bladder, hold it for a while until a restroom is close. 2. Shuts the door for privacy when using restroom, and wipes by themselves. | | 1. Forcing the toddler when not ready to start potty training. 2. Toddler does not understand the feeling of being wet or dirty. | 1. Hides accidents, scared they will get in trouble. 2. Cannot hold bladder when they get the urge to go to the bathroom. | 1. Has to wear pull ups at night, does not wake up to feeling of having to urinate. 2. Hides sheets and pajamas when having an accident at night because they are embarrassed to tell anyone. | 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 learned to climb, run, and even pedal a tricycle. 2. Toddler plays side by side other kids, but with their own toys. | 1. Child enjoys riding scooters outside and with other kids. 2. Is very active and likes to play outside rather than inside. | 1. Sports are becoming important, learning to play baseball. 2. Rides bikes with neighborhood kids after school. | | 1. Injuries from exploring beyond their safety zone – falls. 2. Does not get enough play time with other children, not learning how to socialize. | 1. Child wants to sit and watch cartoons instead of being active. 2. Injury occurs due to lack of supervision or guidance when riding bike or scooter. | 1. Parents do not encourage exercise. 2. Child becomes sedentary and instead of being outside, sits in front of the television after school. | 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. Can communicate in two to three word phrases. 2. Can bounce a ball over and over again. | 1. Able to speak in full sentences. 2. Can name different shapes, colors and letters. | 1. Can read and write clearly with little help. 2. Wears glasses to help with vision. | | 1. Does not use words to communicate. 2. Frequent ear infections affected hearing. | 1. Vision and hearing impaired learning and is delayed. 2. Unable to work in group settings at preschool and has to work one on one with teacher. | 1. Will not wear glasses at school, thinks they do not look good. 2. Afraid to ask for help in class, and falls behind in school work. | 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. Only takes one or two naps a day. 2. Sleeps with stuffed animal or blanket that make them feel safe and secure and helps them fall asleep. | 1. May not sleep during nap time at school. 2. Needs story or song at night to fall asleep. | 1. Gets between eight to ten hours of sleep each night. 2. Falls asleep easily and sleeps well throughout the night. | | 1. Busy days can affect a toddlers sleep pattern and nap times. 2. Daily routine is not set and schedule for naps and bedtime is affected. | 1. Needs to sleep with mom/dad and does not get enough rest. 2. Wakes up to nightmares and become very frightened. | 1. Allowed to watch television to late and does not get enough sleep at night. 2. Dreams or nightmares wake them up and unable to fall back to sleep. | 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. Experiences temper tantrums and tries to test parents. 2. Shows signs of independence and trying to do things on their own. | 1. Can conquer a task by themself, feels confident. 2. Experiences with make believe, trying to understand parent/kids role. | 1. Socializes and is involved with peers at school. 2. Feels excepted by friends and enjoys spending time riding bikes and skateboards after school with them. | | 1. Injuries when toddler tries to do things they are not capable of yet. 2. If limits are not set, toddler will push them and the wrong attention is given from the parent. | 1. Gets very agitated over a task and can not complete it alone, will feel bad about themselves. 2. Not given encouragement and child feels they did not do well. | 1. Does not feel confident in self to socialize with a group of kids. 2. Is picked on by another kids and becomes distant and avoids other children. | 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. Wants to be like and do what their older sibling are. 2. Can relate to and understand who their mother, father and brother/sister are. | 1. Relies on parents and grandparents for comfort and support. 2. When playing with dolls, punishes and praises them like their parents do. | 1. Chooses friend that they relate to and have the same interests. 2. Still looks up to Parent’s for guidance, but relies more on his/her own goals and desires. | | 1. Parents anger from the toddler provokes negative feeling. 2. Toddler feels shame and doubt because a new sibling gets all the attention. | 1. Does not understand why parents are divorced and does not have a mom and dad at home with them. 2. Cannot leave parents and experiences separation anxiety. | 1. Is not accepted into a group of friends and does not understand why. 2. Becomes jealous of other friends, and wants what they have to fit in. | 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. Toddlers start to pay attention to genitals and what they are. 2. They may explore and touch their genitals in curiosity. | 1. Understand the difference between male and female through hair, genitals and breasts. 2. Asks questions about genitals and why we have them. | 1. Locks the door when changing or showering for privacy. 2. Relates to parent of the same sex more. | | 1. Parents call genitals different names that confuse the toddler. 2. Parents are not comfortable talking or communicating what genitals are. | 1. Is taught not to talk about genitals and does not understand what they are. 2. Get punished for touching their privates in curiosity. | 1. Feels embarrassed or ashamed of puberty. 2. Does not open up to or talk to parents about things they hear at school about sexual talk. | 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. Toddler reacts to stress by crying or throwing a tantrum. 2. Toddler clings to their parents when something scares them or is unfamiliar. | 1. Asks for guidance from a teacher or parent when they have tried to fulfill a task but cannot. 2. Use a doll or other toy to put the blame on when in trouble. | 1. Focuses on deep breathing while standing up to bat at baseball. 2. Understands the importance of hard work before tests, and doesn’t wait till the last minute. | | 1. Toddler may not be given time to cry or show reaction before being punished. 2. Toddler shows aggression toward sibling. | 1. Still experiences temper tantrums to get what they wants. 2. Gets agitated when they can build something another kids does and shows aggression toward the other child. | 1. Cheats on a test because they did not study, and fears punishment if they do not do well. 2. Gets an anxiety attack during a stressful time. | 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. Can recite or sing some songs from religious affiliation. 2. Participates in prayer with family. | 1. Learns to share and take turns with other children. 2. Ask questions about death, is curious about it. | 1. Tells a teacher or parents when someone is treating them bad. 2. Attends bible study and participates in family prayer with a good understanding. | | 1. Does not participate in family prayer, and gets upset because they cannot remember the words. 2. Misbehaves to get attention that they need. | 1. Lies to parents and treats peers bad. 2. Does not share toys, and throws a fit when they have to. | 1. Cheats and steals from parents. 2. Teases and bullies another student. |

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.

Children from toddler age to school-age look up to their parents for guidance and education in every aspect of their life. Promoting a positive self-esteem, helping them learn to cope with fears and stress and promoting optimal health is vital to the development into their teenage years, and it all starts with how and what they learn during the younger years. “The goal as a parent is to help your child feel competent and confident, and to help her develop a sense of passion and purpose” (Capetta, 2011). Without the building blocks to help promote and support a strong confident child, they may not know or understand how to deal with situations as they grow.
Toddlers and preschool age children are just learning what parts of their bodies are, and what real emotions feel like. Through these years they are pushing the limits and seeing what they can get away with as well as what positive feedback they are getting from their parents. When they enter the school-age, children often have a strong idea of their family life, and go outside of their comfort zone to look to other peers for social education. They take a lot of the values and beliefs that they have learned from their toddler and preschool years with them into this part of their life. Even though they have a good understanding of their body, they do start going through puberty and entering a whole new set of questions about themselves. It is so important at this time just as in earlier years to be there for kids and offer support, encouragement, and advice as they transition through life.

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.

“Health education is more effective when the nurse acknowledges and incorporates growth and developmental needs as well as the individual's prior understanding of and beliefs about health and health-related concepts” (Edelman & Mandle, 2010, P. 369). When assessing a child a nurse must take different steps as they would when assessing an adult. The age of the individual is critical to understand and know the proper ways to speak to and the order to assess. Children are often very scared of hospitals and doctor’s offices, and must be approached very slowly with technology and any needles. They need time to warm up the nurse and the health care team and feel secure. Parents should be allowed to stay with children during any assessment if the child wants them to be there, this will help the child feel secure. During this time, a nurse can talk soft and sit down to the child’s level, provide laughter and talk them through the procedure rather than surprising them.

References

Capetta, A. (2011). 7 Ways to raise a well-rounded kid. Retrieved from: http://www.parents.com/kids/development/social/raise-well-rounded-kids/#page=1
Cherry, K. (2013). Stages of psychosocial development. Retrieved from: http://psychology.about.com/od/psychosocialtheories/a/psychosocial.htm
Edelman, C., Mandle, C. (2010). Health Promotion Throughout the Life Span, 7th Edition. Mosby, 2010. VitalBook file.