Childrens Functional Health Pattern Assessment

Functional Health
Pattern Assessment
(FHP)
Pattern of Health
Perception and Health
Management:
List two normal assessment findings
that would be characteristic for each
age group.

Toddler

Preschool-Aged

School-Aged

Ericksons Developmental Stage:

Ericksons Developmental Stage:

Ericksons Developmental Stage:

Toddlers are normally

current on their
immunizations. They are
able to perform tasks like
brushing their teeth and
washing their hands.

Pre-schoolers start to
become more inquisitive
and want to know more
about their body parts
and the function. They
become upset over minor
injuries and may view as
punishment.

Because they are

dependent on their parents
they may have dental
cavities if good dental
habits are not enforced by
the parents. They are at
risk for nutritional
deficiencies if parents
dont encourage healthy
eating habits.
Toddlers are usually
weaned from the breast or
bottle. It is normal for a
toddler to become very
picky and have
fluctuations in their
appetite.
Tooth decay is a potential
problem at this stage
because of the bottle
drinking. Nutritional
deficiency is also normal
because of unhealthy
eating patterns.

There is an increased risk

for infections and
contagious diseases
because their immune
system is not fully
developed. There is an
increased risk for injury
due to the fact that they
do not fully comprehend
prevention of injury.
Pre-schoolers develop
food preferences and
often refuse new foods.
They are able to eat on
their own.

School-aged children
participate in self-care
such as personal hygiene,
measures to take to
prevent injury, and
importance of healthy
eating habits. They
understand the importance
of health and factors that
can cause illness.
They begin to notice body
defects like weight and
height. This is the stage
where the signs of vision
and hearing impairment
begin to show.

List two potential problems that a nurse

may discover in an assessment of each
age group.

(Edelman, 2014)

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.

(Edelman, 2014)

Nutritional deficiencies
may be present due to
preference of certain
food groups. Dental
cavities and infections
may appear due to poor
dental care habits.

2011. Grand Canyon University. All Rights Reserved.

School-aged children are

able to prepare meals for
themselves. They
understand the difference
between a heathy and
healthy meal.

There are a lot of cases of

obesity, diabetes and
anorexia at this stage. The
average school-aged child
does not meet dietary
recommendations.

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.

(Edelman, 2014)

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.

(Edelman, 2014)

Cognitive/Perceptual
Pattern:
List two normal assessment findings
that would be characteristic for each
age group.

Toddlers begin toilet

training and understand
the difference between
voiding and bowel
movements. Because of
the increased bladder
control they urinate less
frequently.

Pre-schoolers are capable

of independent toileting.
They are able to control
their bladder and bowel
movements better. They
are able to express their
elimination discomforts.

Constipation and diarrhea

may be present due to
transition from breast
milk. Toilet training may
be attempted before the
child is ready. Level of
understanding must be
assessed before toilet
training.
Toddlers are very active
when they are not
sleeping. They are able to
coordinate their large
muscle groups better and
are beginning to climb and
run. Routines that include
exercise are normal.
They do not like to share
when playing. Tantrums
are present because of
frustration and lack of
rest. They are at increased
risk for injury due to their
increased amount of
activity and exercise.

Bedwetting at nighttime
may continue to be a
problem. Forgetting to
flush the toilet and wash
their hands after going to
the restroom is common.

Toddlers often use

gestures to express
themselves because of
their limited vocabulary.
They are able to learn
about objects and
recognize them by name.

Pre-schoolers are
primarily playing at this
stage. They tend to
mimic the activity and
exercise patterns of their
parents or role models.
Active play should be
encouraged.
Hitting other children
and not sharing is
common during play at
this stage. Many times
kids are allowed to watch
too much television
which is not good.

School-aged children have

able to control their
bladder and bowel
movements. They are
able to communicate any
bladder or bowel issues
they may be experiencing.
They are more
independent when it
comes to elimination.
Bedwetting may still be
present. Because of this
the child may become
embarrassed. Complaints
of pain with urination and
bowel movements may be
present due to eating
habits or poor personal
hygiene habits.
School-aged children
understand the benefits of
activity and exercise. It is
common for kids at this
age to be part of an extracurricular activity or sport.

Because of technology
advancements many kids
are stuck on the computer
for hours which leads to
inactivity. Because they
are not part of an extracurricular activity or sport
they may be lacking social
skills.
Preschoolers are very
School-age children are
inquisitive and ask a lot
able to handle challenges
of questions. It is
and problems by
common for them to have reasoning. They are aware
imaginary friends. They
of others feelings. They
know the difference
understand about morals
between right and wrong. and ethics.

2011. Grand Canyon University. All Rights Reserved.

List two potential problems that a nurse

may discover in an assessment of each
age group.

(Edelman, 2014)

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.

(Edelman, 2014)

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.

(Edelman, 2014)

Because of their
frustrations they tend to
have frequent temper
tantrums. They are at risk
for developmental
problems due to
environmental factors and
injury.
Toddlers average sleep is
about 12 hours a day with
1 to 2 naps a day. Bedtime
and naptime routines are
extremely important at
this stage.

Preschoolers
imaginations tend to run
wild and often have a
difficult time making
decisions. They tend to
lie about bad behavior.

Preschoolers average
sleep is about 8 12
hours a day and they may
or may not nap.
Disturbed sleep patterns
at night are common
which may include
nightmares.
If the child does not get
They may wake up
the sleep he/she needs
frequently at night due to
they may become
nightmares. It is normal
overtired and misbehave.
for them to delay the
They may be unaware of
bedtime routine. They
how tired they actually are may become irritable due
because they are so active. lack of sleep.
Toddlers have a sense of
autonomy. They think
that they can do
everything by themselves.
They are learning
everyday through the use
of smell, taste and touch.

Because they think they

can do everything
themselves they are at risk
for injury. Temper
tantrums are a response to
their frustration with their
siblings, parents and other
kids.

Because of visual and

hearing problems their
may be learning problems
present. Because of lack
of guidance their may be
issues with reading,
writing or studying skills.
School-aged children
average sleep is about 8
12 hours a day without
naps. Most do not have
issues with sleeping.

Some children suffer from

sleep disturbances at night
such as nightmares due to
tv programs and movies.
Sleep walking is also a
problem and safety
measures must be
implemented.
Preschoolers are more
School-aged children have
aware of their actions and a desire to be accepted and
the results of their
have an increased desire
actions. They begin to
of competitiveness. They
relate more to other
view success as a way to
children. They begin to
enhance their selfexpress their likes and
perception in a positive
dislikes.
way. How others portray
them will depend on how
they view themselves.
They struggle with being If they are not encouraged
independent because they with positive thoughts
realize that they must still they will see themselves
rely on their parents.
in a negative way. Not
They are more sensitive
being accepted creates
to criticism and/or
issues with self-esteem
behaviors.
and self-worth.

2011. Grand Canyon University. All Rights Reserved.

Role-Relationship Pattern: Toddlers begin to

understand relationships.
List two normal assessment findings
They fear strangers but are
that would be characteristic for each
aware of who their family
age group.
members are. There is a
desire to be like their
List 2 potential problems that a nurse
siblings and to be able to
may discover in an assessment of each
age group.
do whatever they do.

Preschoolers begin to
understand gender
differences based on the
activities of their parents.
They use play to
experiment and
understand others roles
better.

School-aged children
begin develop outside
relationships but the
family is where they feel a
sense of security. They
understand their role in
the household and their
responsibilities.

Sibling rivalry is an issue

at this age. There is a fear
of strangers or anyone
unfamiliar to them.

Positive role models

should be surrounding
the children in order for
positive child
development. Divorce
may cause regression, or
irritability in the
preschooler.

Toddlers become curious

about their bodies. They
begin to discover their
genital organs and may
touch themselves
frequently. Because they
are exploring you might
see a toddler perform
masturbation.
It is important not to
confuse the child and
name everything by its
anatomical name. They
may touch themselves
inappropriately in front of
others.
Toddlers may regress at
times when they feel
overwhelmed. They may
throw temper tantrums if
they feel a sense of fear.
They tend to imitate their
parents coping
mechanisms.

Preschoolers know the

difference between males
and females. They are
very inquisitive about the
difference between males
and females and what the
functions are of the
organs.

If there is not a strong

relationship between the
parents and child he/she
may become involved in a
gang or get in trouble. At
this age discipline can be
an issue and the
relationship between the
child and parents can be
strenuous.
School-aged children
begin develop breasts and
pubic hairs. They will be
curious about sex and will
begin to ask questions.

(Edelman, 2014)

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.

(Edelman, 2014)

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.

Questions should be
answered simply and
accurately to prevent
confusion. He/she may
play inappropriately with
toys.
Preschoolers will
verbalize their
frustrations. Play is very
important to reducing
their stress.

2011. Grand Canyon University. All Rights Reserved.

Sexual issues and

curiosity may cause
inappropriate behaviors.
They may go to their peers
with questions about
sexual practices which
puts them at risk for harm.
School-aged children may
talk with a friend or
engage in sports or
activities to cope with
stress. The family
environment provides a
sense of security for
coping with stress.

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.

Issues with the families

dynamics can develop
when the child has a
difficult temper. The child
may develop aggressive
behaviors such as kicking,
biting or punching.
Toddlers feel rules are
absolute and they fear
punishment. They will
learn rituals, songs and
prayers but they will not
understand the meaning of
them.
Child may feel confused
because adult is
inconsistent with the rules
and rewards. Child may
feel behaving bad will get
more attention from the
parent. Parents need to
remember to reward
positive behavior.

(Edelman, 2014)

They can sometimes

struggle with their
emotions and feelings.
They may have temper
tantrums to deal with
their frustrations.

Increased helplessness and

anxiety may be present
due to their inability to
deal with stress. Behavior
problems may arise.
Depression can also occur.

Preschoolers begin to
have thoughts of guilt
and conflict because of
the values and beliefs
instilled. They often
express their values and
beliefs with who they
want to be like when they
grow up.
Peers can influence their
beliefs or values. It is
important to surround the
kids with positive role
models so that they dont
influence negative
behaviors in the children.

School-aged children
develop values from
religion, cultural and
parental values taught.
They are able to make
decisions based on what
they have been taught
regarding morals and
ethics.
Peers can influence the
childs thoughts and make
them believe that what
they were taught is not
right. They might be
caught cheating because
of a desire to be the best.

Short Answer Questions

2011. Grand Canyon University. All Rights Reserved.

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.
When comparing and contrasting the similarities and differences expected across the
childhood age groups it is safe to say that the biggest similarity would be the significant role the
parents play. Whether it be the guidance or dependency they are fundamental to the well being
and developmental of the child. Without the parents teaching, discipline, values and beliefs the
child is left to learn from others which may or may not display positive behaviors. Amongst all
groups the children are moving toward a state of autonomy. They all looked to their parents for
coping with stress and looking to them for comfort. The importance of structure was also seen in
all categories.
Differences were seen depending of the level of the child. One of the biggest differences was
the fact that toddlers and preschoolers are more susceptible to contagious diseases that the
school-aged child is. Also, as the children transitioned into school-aged they required less sleep.
Naturally, because of their ages a school aged child would most like learn better through
discussion or example rather than a preschooler whom might learn best through playtime or story
time. As they grow older they able to express themselves and communicate more effectively.

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.
When dealing with children it is of the utmost importance to remember that you are not only
dealing with the child. The parent is part of the package. It is a completely different approach.
Children are often scared and look to their parents for comfort. You should allow the child to sit
with their parent first while asking the parent questions which would then allow the child time to
become a little more comfortable with the nurse. Naturally the health history would be provided
by the parent. When performing the health examination it is best to start with the lung sounds.
Before placing the stethoscope on the child you can allow the child to touch and listen to
his/herself before which will allow the child to feel like they are part of the assessment.
Education depends on the developmental level they are at. It is important to always take into
consideration the cultural beliefs of the family. Being culturally competent is extremely
important as a nurse because it prevents any unwarranted accusations.
2011. Grand Canyon University. All Rights Reserved.

References:
Edelman, C.(2014). Health Promotion Throughout the Life Span (8th ed.). Retrieved from Vital
Book
Jarvis, C.(2014). Physical Examination and Health Assessment [VitalSource Bookshelf version].
Retrieved from http://pageburstsls.elsevier.com/books/978-1-4377-0151-7

2011. Grand Canyon University. All Rights Reserved.