Erickson's Functional Health Pattern Assessment Paper
Children’s Functional Health Pattern Assessment
Functional Health Pattern Assessment (FHP)
Toddler
Erickson’s Developmental Stage:
Autonomy vs. Shame/Doubt
(Edelman & Mandle, 2010)
Preschool-Aged
Erickson’s Developmental Stage:
Initiative vs. Guilt
(Edelman & Mandle, 2010)
School-Aged
Erickson’s Developmental Stage:
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.
When a toddler feels sick, they will let their caregiver know that they do not feel good. Toddlers are very dependent on their caregiver or parents for their health management needs. …show more content…
With the assistance of their caregiver or parents two of the basic health promotional activities a toddler can perform are
Brushing their teeth and wash their hands.
Preschoolers at this stage are able to verbalize when they are in pain.
Preschoolers begin to become curious about their bodies and how it functions.
Preschoolers have a very accurate knowledge of their external body parts.
Preschoolers view their body as being hollow.
School aged children have a keen awareness of how their body functions and when and where it hurts.
School aged children understand and define health and the factors that cause them to be sick in an abstract manner. They recognize and understand why well health checks and exams are important.
The school aged child’s cultural influences contribute to their perception of illness.
There is generally no history or record of health screenings.
If a toddler’s dental hygiene is neglected dental caries can be a common issue.
When the parent lacks the proper knowledge, there can be a potential for poor health maintenance in their toddler.
Environmental hazards and accidental exposures puts the toddler at risk for injury.
Body image issues and a sense of vulnerability can be an issue for preschoolers because they are aware of the differences between them and other preschoolers.
Fear of death and mutilation is a fear factor for preschoolers and can cause anxiety for them.
Immunizations are important during the preschool age. If immunizations on not up to date they are at risk for infections and other health issues.
Poor hygiene and lack of interest in their appearance becomes a potential problem for the school aged child.
The school aged child imitate their parents and caregivers at this age and can pick up poor habits concerning their health.
The development of the school aged child exposes this age group to frequent illnesses, accidental injuries, and poor dental hygiene causing dental cavities. This can be brought on by the caregivers or parents culture and health beliefs.
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.
Toddlers are able to feed themselves at this stage with a spoon are able to drink liquids from a cup using their hands.
Weaning from breastfeeding and bottles starts at this age and toddlers transition to holding cups and spoons.
Toddlers are able to eat hand held finger foods and use their meal time to show assertiveness and their individual control.
Caregivers of preschoolers provide meals and snacks that are nutritious.
Food preferences begin during this stage.
Preschoolers begin to help with folding towels and socks and washing fruits and they enjoy helping to set the table at meal times.
At this age children are able to tell the difference between healthy foods and unhealthy food choices.
School aged children develop a sense of healthy and unhealthy food and given the choice will choose a well-balanced diet over a poor diet.
It is recommended that school aged children consume 1200 to 1800 calories per day.
Toddlers may experience difficulty chewing or swallowing food
Signs of food allergies in toddlers may include vomiting.
Mineral and vitamin deficiencies are common in toddlers while they transition from their mother’s breast milk to vitamin enriched whole milk from cows.
Toddlers get dental caries when put to bed at night drinking milk or juice from the bottle at bedtime places the toddler at risk.
Preschoolers are at risk for being obese or underweight.
Preschoolers are at risk for eating excessive amounts of junk food.
This age child is at risk for getting allergies, but allergies usually are developed before they become two years old.
Because preschoolers frequently eat at daycare and babysitters they do not always eat well balanced nutritious meals.
Anorexia and obesity may affect school-aged children.
Cultural factors and a lack of access to food may be the contributing factor to poor nutrition in this child, especially if the child lives in a poverty stricken family.
Families of school aged children can live very busy lives leading to skipped meals and sometimes fast food meals this places them at risk for metabolic disorders and 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.
Toilet training starts at this age.
Checking toddlers for signs of potty training is important at this age. Keeping the toddler dry and checking for wetness every two or more hours.
At this age the preschooler is independent at toileting.
Hand washing after toileting is independent in the preschooler, but they may need frequent reminding to flush the toilet when done.
At the age of five, this child has complete control of their bowel and bladder. They are also able to wipe themselves, flush the toilet, pick out their clothing, dress, and wash hands independently.
This aged child is very private about their personal hygiene and toileting time.
Bowel and bladder patterns become similar to an adults at this age.
The toddler can become very frustrated if the caregiver pushes toilet training before the toddler is ready.
Potential for failure in toilet training if the toddler experiences the caregivers stress during this time.
Not all preschoolers are toilet trained and punishing or teasing this aged child can cause emotional issues.
At this age the preschooler may forget to wash their hands or flush the toilet after using it. Not all motor skills are developed and this aged child may not have proper hygiene skills.
Some school-aged children may experience elimination issues. Bedwetting and stool incontinence can still be a problem after age four.
The school-aged child sometimes suffers from constipation issues and may complain of pain when going to the bathroom.
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.
Toddlers can be very active when not sleeping, this provides new opportunities for new skills.
There are many advancement stages the toddler goes through such as walking, running, climbing and learning to ride a tricycle.
The primary activity of the preschooler is play. This aged child loves to explore and is very independent and is able to demonstrate increased coordination. Activities performed by the preschooler include dress up. This aged child may even have an imaginary friend.
Some four year olds when playing with other children usually have no problems when leaving their caregivers.
This aged child is naturally physically active. This aspect of health and health promotion is very important at this stage.
This child goes through Tremendous motor skill changes occur during this time, this allows the school-aged child to partake in different activities that benefits and helps the child to become stronger and better at balancing activities.
Toddlers are at risk for injury due to doing things that they are not fully developed for.
Drowning and poisoning are some of the dangers that the toddler is at risk for due to their curiosity.
Toddlers may show no interest in outdoor activities.
Social dysfunction is a risk factor for preschoolers who play by themselves.
Decreased learning due to too much non-educational television becomes an issue for the preschooler and places them at risk for social dysfunction.
The Preschooler who expresses anger while they play are at risk for transferring this behavior in real life situations as they age.
This age child at risk for issues with lack of physical activity due to playing video games and non-physical activities. Poor nutrition and unhealthy diets places this aged child at risk for obesity.
This child is at risk for physical and psychological pressure from their caregivers to become active in sports related activities.
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.
At this age the toddler is able to identify parts of their body and can interpret objects and how they work.
Toddlers can recognize objects by name such as baby, doggie, kitty, and bottle.
Play is related to real life events at this age. This age also has a secure sense of self and is more social. Interactive play is more predominate at this age.
The preschooler is more curious which results in asking many questions.
This age child is aware of other people’s feelings.
This aged child can be encouraged or discouraged by their environment.
This child spends a great deal of time in environments that help the school aged child master new ideas and concepts. The school aged child has a basic understanding of ethics and is able to understand the difference between rights and wrong.
This aged child is at risk for developing developmental issues due to a lack of knowledge that their caregiver has about psychosocial development and misunderstanding their toddler’s behaviors. Toddlers develop differently and at different times.
This aged child could be at risk for injury due to the physical and developmental changes.
Early preschool aged children have difficulty conveying what they mean and may not be able to form complete sentences.
This aged child may blame their make believe friends for their bad behavior.
The preschoolers brain is not fully developed and experience memory issues.
Some school aged children experience difficulty in their school studies. These difficulties can cause the child to develop behavioral issues and self-esteem issues due to their inability to perform on a adequate level.
If undetected and appropriate interventions are not taken, this child will develop learning problems as they grow older.
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.
Toddlers nap at least one to two times during the day and average 12 hours of sleep daily.
Routine is important for toddlers. This aged child will try to avoid taking naps and bedtime by asking for drinks of water or asking questions.
This aged child usually gets around 8 to 12 hours of sleep during the night and require fewer naps as they get older.
This aged child usually has a night time ritual before going to bed such as reading or quiet time.
The school aged child does not require a nap and usually sleeps 8 to 12 hours nightly.
Bedtime is easier for this aged child with fewer difficulties than the toddler or preschool aged child.
Becoming overly tired causes this aged child difficulties when trying to fall asleep. This can cause the child to become less active during the day.
Toddlers who sleep longer than 12 hours may experience development issues or other health problems.
Night terrors are an issue for some toddlers.
Caregivers should encourage their toddler to go back to sleep by soothing them.
Some preschoolers still experience nightmares that may be reoccurring.
Some preschoolers may not be able to sleep at night causing fatigue and issues with concentrating during the day.
It is common for this aged child to wake up during the night. It is important that the caregiver encourage the preschooler to stay in their own room and bed.
The school-aged child may suffer from sleepwalking, sleep talking and other sleep disturbances such as wetting the bed.
Sleepwalking can cause injuries in the school aged child. Caregivers must take measures to keep this child safe during these disturbances.
Socialization and other developmental issues can occur if the school-age child sleeps with their siblings or caregivers.
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 know their name and can respond to it when called. They can walk and can feed themselves.
Toddlers act upon things that they see, hear, or experience.
Toddlers must relinquish their dependence to their caregivers before they can exert autonomy.
Task oriented and social experience help preschoolers develop their sense of self.
Preschoolers feel successful through social acceptance.
This aged child expresses their likes and dislikes in the clothes they wear and usually prefer to dress themselves.
Physiological growth, cognitive, and social development is how this aged child explores and grows.
School aged children typically has a positive self-esteem.
Desires to master things and competiveness is desired by the school aged child.
Autonomy is important for the toddler causing conflict between the toddler and caregiver due to lack of understanding by the caregiver.
Temper tantrums can be seen in toddlers. Confrontation is powerful between siblings and caregivers as they learn the differences between themselves and others.
The toddler may develop sensory or developmental issues.
These can be identified if when called by name the child does not respond.
Guilt and inadequacy may be some of the feelings a preschooler feels if they are unable to perform certain tasks related to self-care needs.
This aged child may become embarrassed by certain actions.
Criticism by others can cause the preschooler to become sensitive and emotional.
Peer groups can cause low self-esteem and cause self-worth issues and affect their sense of belonging in the school aged child.
Not caring about their appearance and poor hygiene can be seen in this aged child.
School aged children worry how their peers feel about their illnesses or disabilities.
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.
This aged child knows who their family members are and has developed a relationship with them based on how they treat the toddler and what they do for the toddler.
Toddlers are interested in what their caregivers are doing and tend to gravitate to them.
Some toddlers are afraid of
strangers.
Family is very important to the preschooler, but as the preschooler develops, peers and play become just as important.
Affection can be shown to loved ones by preschoolers.
This child understands gender expectations related to activities and work.
Friendships and relationships start developing outside the family at this age.
The family environment is important and provides the school aged child with a sense of security and aides in building new coping skills.
The child’s role in the family, family interaction, and additional responsibilities can be seen at this age.
Regression can be seen in the toddler when a younger sibling joins their family.
Strong attachment to one caregiver can be seen at this stage causing issues such as crying when left with other caregivers.
Sibling rivalry can be an issue at this age and can cause frustration for the whole family.
Sensory or developmental problems can become an issue and can be evident in the child that plays by themselves or shows no emotions.
This aged child may not play well with other children of the same age group, but may relate better with older children.
The preschooler is influenced by negativity caused by inaccurate male and female roles portrayed and viewed.
Just like preschoolers the school aged child may be at risk for sensory or developmental problems and can be evident in the child who plays by themselves or shows no emotions.
Setting limits and defining expected behaviors is important to this aged child and if not careful this child is at risk for problems with their caregivers.
Spending time with friends may be more important and satisfying to this aged child than spending time with 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.
The toddler will begin to explore their genitals. Masturbation may occur at this age and is normal.
Curiosity about genital organs can be seen at this age.
Preschoolers are able to recognize the difference between genders and usually prefer same gender friendships.
Curiosity about the opposite gender can be seen at this age.
The onset of puberty can be seen at this age. Awareness of their own body and sexual identity is also increased at this age.
Sex is a natural curiosity at this age.
Medical issues may be an issue, especially if the toddler cries during urination or bowel movements.
The toddler’s caregiver’s sexual values and taboos can expose the toddler to potential problems.
Correct terminology should be used when describing the child’s genitals to avoid potential problems.
The toddler needs taught appropriate behaviors about inappropriately touching themselves or others.
Questions about the preschoolers interest in sexual information should be answered with simple accurate answers, the preschooler should not be teased to prevent potential problems.
Gender identity can be an issue for the preschooler. Negative body image is also an issue and the preschooler may struggle with these.
Children of this age need to be appropriately directed in social and sexual behaviors if found playing inappropriately with toys.
Potential problems can occur at this age if caregivers are not able to discuss sexual issues accurately and appropriately. This age child will typically discuss these subjects with their peers. Discussing these issues with their peers can lead to unsafe sexual practices causing risk for physical or emotional and social harm.
This age child may dress promiscuously to gain sexual attention.
Homosexual school age children suffer challenges with gender roles.
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 can be the foundation of the toddler’s ability to cope.
With each new stressor the toddler finds new ways to cope. Tantrums may be how the toddler controls the situation. Another way the toddler controls situations is by clinging to their caregiver when they are afraid.
Like toddlers, preschoolers may display the same coping mechanisms when dealing with separation anxiety. They may regress, display denial, and become repressed.
Security blankets or dolls may be the preschooler’s safety totem.
Preschoolers have certain activities that they prefer.
Caregivers teach preschoolers how to organize their body’s environments and abilities through positive interactions and enforcement.
The use of the defense mechanism, repetition, humor, exercise, and controlling behaviors is how the school aged child copes.
Listening to music and talking to their peers and engaging is extracurricular activities is another way this age child copes.
Part of the developmental process in school aged children is coping.
This aged child who has difficult temperaments become less adaptable and display more negative moods. Aggressive behaviors such as biting or kicking may regress to an earlier age or stage.
Caregivers can feel less effective in their roles when these behaviors surface.
Regressive behaviors such as tantrums and disobedience are also seen in preschoolers.
Withdrawn daydreaming may indicate sensory or developmental issues in this aged child.
Life stressors for the school aged child include competition, failure in school, homework, and peer pressure.
Homelessness, death of a parent, or divorce, hospitalization, learning difficulties place this aged child at risk for depression. This aged child may turn to self-harm or drugs and alcohol.
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.
Toddlers respond to positive feedback with good behaviors. Positive values and beliefs are expressed with healthy behaviors.
Values such as right and wrong and beliefs are family traits learned by the toddler. Discipline and praise should be intermixed by the caregiver of a toddler.
Actions and behaviors are internal controls demonstrated by the preschooler.
Caregivers teach preschoolers about religious believes, prayer, and church.
Role playing of who a preschooler wants to be as an adult and their values are expressed at this age.
School-age children’s ethical and moral development and their parent’s values, culture and religious beliefs are influenced at this age.
School aged children know the difference from right and wrong and can make ethical and moral decisions.
Misbehaving may be the only time parents attend to their toddler.
Some caregivers do no discipline their child or use positive reinforcement when their toddler is misbehaving.
Good behavior should be awarded by the toddler’s caregiver. Bad behavior should be given minimal attention by the caregiver.
Just like toddlers, preschoolers do not have a fully developed conscience. Internal controls are limited by immaturity of the toddler and are less consistent. This can cause the preschooler to break rules set by their caregiver and cause the toddler to be disrespectful to their caregiver and the people around them.
Preschoolers can be negatively influenced by television and their peers.
Negative peer pressure can cause a school aged child to disregard their taught morals so that they fit in or look good to their peers.
This child may lie because of lack of understanding, exaggerations or fantasies.
Some school aged children may have no respect for their caregivers or other people in their lives.
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.
As children grow from the toddler stage through preschool and into the school aged stage, they can be faced with many challenges that they need to learn to overcome. Growth and development has a lot to do with the people in their lives and the environment that they live in and is guided by their cultures value and belief system and religion.
Differences in the developmental phase can be seen in how the child acts to each phase of the health assessment pattern. Structure is more important to the toddler and preschool aged child. Rituals and routines are important to these two stages. The school aged child builds self-esteem, self-worth, and a sense of identity from the values and behaviors that they have learned as a toddler and preschooler. Autonomy and self-expression has many similarities. Good and bad behaviors continue to grow as the child does.
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.
Nurses must remember that when they care for a child they really are caring for the parents too. When assessing a child there are many challenges, the nurse must approach the child differently than they do an adult. It is important for the nursing staff to interact with the parent or caregiver when working with a toddler or preschooler. This gives the toddler or preschooler an opportunity to see the nurse and parent or caregiver interact and can see the trust that the caregiver has in the nurse. The parent or caregiver will provide the majority of the child’s health history to the nursing staff.
It is important for the nurse to interview both the child and parent or caregiver at the same time. The parent or caregiver should be present for all exams. The nursing staff must be cognitive of both the verbal and nonverbal body expressions of the child. They must also be aware of the child and families cultural and spiritual feelings and must take these into consideration when caring for the child. It is important that the nurse assures the parent or caregiver knows that the child feels safe and comfortable with the care provided during each step of the care provided.
Some of the strategies a nurse may include in the care of the child include a complete understanding of the different developmental stages that each child goes through. Making sure that the nurse and child are at eye level during the assessment is important. The nurse should speak to the child using words that the child is able to understand. Allowing the child to hold the assessment instruments is important in building a positive relationship with the child and helps with the assessment and helps the child feel that they are involved in their care. Videos and reading material can help the nurse divert the child’s attention away from the nurse while the nurse performs the assessment.
References:
Edelman, C., & Mandle, C., (2010). Health Promotion Through The Life Span. 7th ed. St. Louis, MI: Mosby.
GCU Lecture note (2015). Retrieved from
https://lc-ugrad1.gcu.edu/learningPlatform/loudBooks/loudbooks.html?operation=innerPage&topicMaterialId=5818e34e-95d5-48f1-a9ea-06d4291326e4&contentId=0b508ee7-267e-4873-b626-f37a8567b423&viewPage=current¤tTopicname=Health%20Assessment%20of%20the%20Toddler,%20Preschool,%20and%20School-Aged%20Child
Jarvis, C. (2012). Physical Examination & Health Assessment 6th ed. St. Louis, MI: Mosby.
Physical Examination and Health Assessment. Retrieved from
http://gcumedia.com/digital-resources/elsevier/2015/physical-examination-and-health-assessment_ebook_7e.php
Functional Health Pattern Assessment (FHP)
Toddler
Erickson’s Developmental Stage:
Autonomy vs. Shame/Doubt
(Edelman & Mandle, 2010)
Preschool-Aged
Erickson’s Developmental Stage:
Initiative vs. Guilt
(Edelman & Mandle, 2010)
School-Aged
Erickson’s Developmental Stage:
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.
When a toddler feels sick, they will let their caregiver know that they do not feel good. Toddlers are very dependent on their caregiver or parents for their health management needs. …show more content…
With the assistance of their caregiver or parents two of the basic health promotional activities a toddler can perform are
Brushing their teeth and wash their hands.
Preschoolers at this stage are able to verbalize when they are in pain.
Preschoolers begin to become curious about their bodies and how it functions.
Preschoolers have a very accurate knowledge of their external body parts.
Preschoolers view their body as being hollow.
School aged children have a keen awareness of how their body functions and when and where it hurts.
School aged children understand and define health and the factors that cause them to be sick in an abstract manner. They recognize and understand why well health checks and exams are important.
The school aged child’s cultural influences contribute to their perception of illness.
There is generally no history or record of health screenings.
If a toddler’s dental hygiene is neglected dental caries can be a common issue.
When the parent lacks the proper knowledge, there can be a potential for poor health maintenance in their toddler.
Environmental hazards and accidental exposures puts the toddler at risk for injury.
Body image issues and a sense of vulnerability can be an issue for preschoolers because they are aware of the differences between them and other preschoolers.
Fear of death and mutilation is a fear factor for preschoolers and can cause anxiety for them.
Immunizations are important during the preschool age. If immunizations on not up to date they are at risk for infections and other health issues.
Poor hygiene and lack of interest in their appearance becomes a potential problem for the school aged child.
The school aged child imitate their parents and caregivers at this age and can pick up poor habits concerning their health.
The development of the school aged child exposes this age group to frequent illnesses, accidental injuries, and poor dental hygiene causing dental cavities. This can be brought on by the caregivers or parents culture and health beliefs.
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.
Toddlers are able to feed themselves at this stage with a spoon are able to drink liquids from a cup using their hands.
Weaning from breastfeeding and bottles starts at this age and toddlers transition to holding cups and spoons.
Toddlers are able to eat hand held finger foods and use their meal time to show assertiveness and their individual control.
Caregivers of preschoolers provide meals and snacks that are nutritious.
Food preferences begin during this stage.
Preschoolers begin to help with folding towels and socks and washing fruits and they enjoy helping to set the table at meal times.
At this age children are able to tell the difference between healthy foods and unhealthy food choices.
School aged children develop a sense of healthy and unhealthy food and given the choice will choose a well-balanced diet over a poor diet.
It is recommended that school aged children consume 1200 to 1800 calories per day.
Toddlers may experience difficulty chewing or swallowing food
Signs of food allergies in toddlers may include vomiting.
Mineral and vitamin deficiencies are common in toddlers while they transition from their mother’s breast milk to vitamin enriched whole milk from cows.
Toddlers get dental caries when put to bed at night drinking milk or juice from the bottle at bedtime places the toddler at risk.
Preschoolers are at risk for being obese or underweight.
Preschoolers are at risk for eating excessive amounts of junk food.
This age child is at risk for getting allergies, but allergies usually are developed before they become two years old.
Because preschoolers frequently eat at daycare and babysitters they do not always eat well balanced nutritious meals.
Anorexia and obesity may affect school-aged children.
Cultural factors and a lack of access to food may be the contributing factor to poor nutrition in this child, especially if the child lives in a poverty stricken family.
Families of school aged children can live very busy lives leading to skipped meals and sometimes fast food meals this places them at risk for metabolic disorders and 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.
Toilet training starts at this age.
Checking toddlers for signs of potty training is important at this age. Keeping the toddler dry and checking for wetness every two or more hours.
At this age the preschooler is independent at toileting.
Hand washing after toileting is independent in the preschooler, but they may need frequent reminding to flush the toilet when done.
At the age of five, this child has complete control of their bowel and bladder. They are also able to wipe themselves, flush the toilet, pick out their clothing, dress, and wash hands independently.
This aged child is very private about their personal hygiene and toileting time.
Bowel and bladder patterns become similar to an adults at this age.
The toddler can become very frustrated if the caregiver pushes toilet training before the toddler is ready.
Potential for failure in toilet training if the toddler experiences the caregivers stress during this time.
Not all preschoolers are toilet trained and punishing or teasing this aged child can cause emotional issues.
At this age the preschooler may forget to wash their hands or flush the toilet after using it. Not all motor skills are developed and this aged child may not have proper hygiene skills.
Some school-aged children may experience elimination issues. Bedwetting and stool incontinence can still be a problem after age four.
The school-aged child sometimes suffers from constipation issues and may complain of pain when going to the bathroom.
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.
Toddlers can be very active when not sleeping, this provides new opportunities for new skills.
There are many advancement stages the toddler goes through such as walking, running, climbing and learning to ride a tricycle.
The primary activity of the preschooler is play. This aged child loves to explore and is very independent and is able to demonstrate increased coordination. Activities performed by the preschooler include dress up. This aged child may even have an imaginary friend.
Some four year olds when playing with other children usually have no problems when leaving their caregivers.
This aged child is naturally physically active. This aspect of health and health promotion is very important at this stage.
This child goes through Tremendous motor skill changes occur during this time, this allows the school-aged child to partake in different activities that benefits and helps the child to become stronger and better at balancing activities.
Toddlers are at risk for injury due to doing things that they are not fully developed for.
Drowning and poisoning are some of the dangers that the toddler is at risk for due to their curiosity.
Toddlers may show no interest in outdoor activities.
Social dysfunction is a risk factor for preschoolers who play by themselves.
Decreased learning due to too much non-educational television becomes an issue for the preschooler and places them at risk for social dysfunction.
The Preschooler who expresses anger while they play are at risk for transferring this behavior in real life situations as they age.
This age child at risk for issues with lack of physical activity due to playing video games and non-physical activities. Poor nutrition and unhealthy diets places this aged child at risk for obesity.
This child is at risk for physical and psychological pressure from their caregivers to become active in sports related activities.
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.
At this age the toddler is able to identify parts of their body and can interpret objects and how they work.
Toddlers can recognize objects by name such as baby, doggie, kitty, and bottle.
Play is related to real life events at this age. This age also has a secure sense of self and is more social. Interactive play is more predominate at this age.
The preschooler is more curious which results in asking many questions.
This age child is aware of other people’s feelings.
This aged child can be encouraged or discouraged by their environment.
This child spends a great deal of time in environments that help the school aged child master new ideas and concepts. The school aged child has a basic understanding of ethics and is able to understand the difference between rights and wrong.
This aged child is at risk for developing developmental issues due to a lack of knowledge that their caregiver has about psychosocial development and misunderstanding their toddler’s behaviors. Toddlers develop differently and at different times.
This aged child could be at risk for injury due to the physical and developmental changes.
Early preschool aged children have difficulty conveying what they mean and may not be able to form complete sentences.
This aged child may blame their make believe friends for their bad behavior.
The preschoolers brain is not fully developed and experience memory issues.
Some school aged children experience difficulty in their school studies. These difficulties can cause the child to develop behavioral issues and self-esteem issues due to their inability to perform on a adequate level.
If undetected and appropriate interventions are not taken, this child will develop learning problems as they grow older.
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.
Toddlers nap at least one to two times during the day and average 12 hours of sleep daily.
Routine is important for toddlers. This aged child will try to avoid taking naps and bedtime by asking for drinks of water or asking questions.
This aged child usually gets around 8 to 12 hours of sleep during the night and require fewer naps as they get older.
This aged child usually has a night time ritual before going to bed such as reading or quiet time.
The school aged child does not require a nap and usually sleeps 8 to 12 hours nightly.
Bedtime is easier for this aged child with fewer difficulties than the toddler or preschool aged child.
Becoming overly tired causes this aged child difficulties when trying to fall asleep. This can cause the child to become less active during the day.
Toddlers who sleep longer than 12 hours may experience development issues or other health problems.
Night terrors are an issue for some toddlers.
Caregivers should encourage their toddler to go back to sleep by soothing them.
Some preschoolers still experience nightmares that may be reoccurring.
Some preschoolers may not be able to sleep at night causing fatigue and issues with concentrating during the day.
It is common for this aged child to wake up during the night. It is important that the caregiver encourage the preschooler to stay in their own room and bed.
The school-aged child may suffer from sleepwalking, sleep talking and other sleep disturbances such as wetting the bed.
Sleepwalking can cause injuries in the school aged child. Caregivers must take measures to keep this child safe during these disturbances.
Socialization and other developmental issues can occur if the school-age child sleeps with their siblings or caregivers.
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 know their name and can respond to it when called. They can walk and can feed themselves.
Toddlers act upon things that they see, hear, or experience.
Toddlers must relinquish their dependence to their caregivers before they can exert autonomy.
Task oriented and social experience help preschoolers develop their sense of self.
Preschoolers feel successful through social acceptance.
This aged child expresses their likes and dislikes in the clothes they wear and usually prefer to dress themselves.
Physiological growth, cognitive, and social development is how this aged child explores and grows.
School aged children typically has a positive self-esteem.
Desires to master things and competiveness is desired by the school aged child.
Autonomy is important for the toddler causing conflict between the toddler and caregiver due to lack of understanding by the caregiver.
Temper tantrums can be seen in toddlers. Confrontation is powerful between siblings and caregivers as they learn the differences between themselves and others.
The toddler may develop sensory or developmental issues.
These can be identified if when called by name the child does not respond.
Guilt and inadequacy may be some of the feelings a preschooler feels if they are unable to perform certain tasks related to self-care needs.
This aged child may become embarrassed by certain actions.
Criticism by others can cause the preschooler to become sensitive and emotional.
Peer groups can cause low self-esteem and cause self-worth issues and affect their sense of belonging in the school aged child.
Not caring about their appearance and poor hygiene can be seen in this aged child.
School aged children worry how their peers feel about their illnesses or disabilities.
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.
This aged child knows who their family members are and has developed a relationship with them based on how they treat the toddler and what they do for the toddler.
Toddlers are interested in what their caregivers are doing and tend to gravitate to them.
Some toddlers are afraid of
strangers.
Family is very important to the preschooler, but as the preschooler develops, peers and play become just as important.
Affection can be shown to loved ones by preschoolers.
This child understands gender expectations related to activities and work.
Friendships and relationships start developing outside the family at this age.
The family environment is important and provides the school aged child with a sense of security and aides in building new coping skills.
The child’s role in the family, family interaction, and additional responsibilities can be seen at this age.
Regression can be seen in the toddler when a younger sibling joins their family.
Strong attachment to one caregiver can be seen at this stage causing issues such as crying when left with other caregivers.
Sibling rivalry can be an issue at this age and can cause frustration for the whole family.
Sensory or developmental problems can become an issue and can be evident in the child that plays by themselves or shows no emotions.
This aged child may not play well with other children of the same age group, but may relate better with older children.
The preschooler is influenced by negativity caused by inaccurate male and female roles portrayed and viewed.
Just like preschoolers the school aged child may be at risk for sensory or developmental problems and can be evident in the child who plays by themselves or shows no emotions.
Setting limits and defining expected behaviors is important to this aged child and if not careful this child is at risk for problems with their caregivers.
Spending time with friends may be more important and satisfying to this aged child than spending time with 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.
The toddler will begin to explore their genitals. Masturbation may occur at this age and is normal.
Curiosity about genital organs can be seen at this age.
Preschoolers are able to recognize the difference between genders and usually prefer same gender friendships.
Curiosity about the opposite gender can be seen at this age.
The onset of puberty can be seen at this age. Awareness of their own body and sexual identity is also increased at this age.
Sex is a natural curiosity at this age.
Medical issues may be an issue, especially if the toddler cries during urination or bowel movements.
The toddler’s caregiver’s sexual values and taboos can expose the toddler to potential problems.
Correct terminology should be used when describing the child’s genitals to avoid potential problems.
The toddler needs taught appropriate behaviors about inappropriately touching themselves or others.
Questions about the preschoolers interest in sexual information should be answered with simple accurate answers, the preschooler should not be teased to prevent potential problems.
Gender identity can be an issue for the preschooler. Negative body image is also an issue and the preschooler may struggle with these.
Children of this age need to be appropriately directed in social and sexual behaviors if found playing inappropriately with toys.
Potential problems can occur at this age if caregivers are not able to discuss sexual issues accurately and appropriately. This age child will typically discuss these subjects with their peers. Discussing these issues with their peers can lead to unsafe sexual practices causing risk for physical or emotional and social harm.
This age child may dress promiscuously to gain sexual attention.
Homosexual school age children suffer challenges with gender roles.
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 can be the foundation of the toddler’s ability to cope.
With each new stressor the toddler finds new ways to cope. Tantrums may be how the toddler controls the situation. Another way the toddler controls situations is by clinging to their caregiver when they are afraid.
Like toddlers, preschoolers may display the same coping mechanisms when dealing with separation anxiety. They may regress, display denial, and become repressed.
Security blankets or dolls may be the preschooler’s safety totem.
Preschoolers have certain activities that they prefer.
Caregivers teach preschoolers how to organize their body’s environments and abilities through positive interactions and enforcement.
The use of the defense mechanism, repetition, humor, exercise, and controlling behaviors is how the school aged child copes.
Listening to music and talking to their peers and engaging is extracurricular activities is another way this age child copes.
Part of the developmental process in school aged children is coping.
This aged child who has difficult temperaments become less adaptable and display more negative moods. Aggressive behaviors such as biting or kicking may regress to an earlier age or stage.
Caregivers can feel less effective in their roles when these behaviors surface.
Regressive behaviors such as tantrums and disobedience are also seen in preschoolers.
Withdrawn daydreaming may indicate sensory or developmental issues in this aged child.
Life stressors for the school aged child include competition, failure in school, homework, and peer pressure.
Homelessness, death of a parent, or divorce, hospitalization, learning difficulties place this aged child at risk for depression. This aged child may turn to self-harm or drugs and alcohol.
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.
Toddlers respond to positive feedback with good behaviors. Positive values and beliefs are expressed with healthy behaviors.
Values such as right and wrong and beliefs are family traits learned by the toddler. Discipline and praise should be intermixed by the caregiver of a toddler.
Actions and behaviors are internal controls demonstrated by the preschooler.
Caregivers teach preschoolers about religious believes, prayer, and church.
Role playing of who a preschooler wants to be as an adult and their values are expressed at this age.
School-age children’s ethical and moral development and their parent’s values, culture and religious beliefs are influenced at this age.
School aged children know the difference from right and wrong and can make ethical and moral decisions.
Misbehaving may be the only time parents attend to their toddler.
Some caregivers do no discipline their child or use positive reinforcement when their toddler is misbehaving.
Good behavior should be awarded by the toddler’s caregiver. Bad behavior should be given minimal attention by the caregiver.
Just like toddlers, preschoolers do not have a fully developed conscience. Internal controls are limited by immaturity of the toddler and are less consistent. This can cause the preschooler to break rules set by their caregiver and cause the toddler to be disrespectful to their caregiver and the people around them.
Preschoolers can be negatively influenced by television and their peers.
Negative peer pressure can cause a school aged child to disregard their taught morals so that they fit in or look good to their peers.
This child may lie because of lack of understanding, exaggerations or fantasies.
Some school aged children may have no respect for their caregivers or other people in their lives.
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.
As children grow from the toddler stage through preschool and into the school aged stage, they can be faced with many challenges that they need to learn to overcome. Growth and development has a lot to do with the people in their lives and the environment that they live in and is guided by their cultures value and belief system and religion.
Differences in the developmental phase can be seen in how the child acts to each phase of the health assessment pattern. Structure is more important to the toddler and preschool aged child. Rituals and routines are important to these two stages. The school aged child builds self-esteem, self-worth, and a sense of identity from the values and behaviors that they have learned as a toddler and preschooler. Autonomy and self-expression has many similarities. Good and bad behaviors continue to grow as the child does.
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.
Nurses must remember that when they care for a child they really are caring for the parents too. When assessing a child there are many challenges, the nurse must approach the child differently than they do an adult. It is important for the nursing staff to interact with the parent or caregiver when working with a toddler or preschooler. This gives the toddler or preschooler an opportunity to see the nurse and parent or caregiver interact and can see the trust that the caregiver has in the nurse. The parent or caregiver will provide the majority of the child’s health history to the nursing staff.
It is important for the nurse to interview both the child and parent or caregiver at the same time. The parent or caregiver should be present for all exams. The nursing staff must be cognitive of both the verbal and nonverbal body expressions of the child. They must also be aware of the child and families cultural and spiritual feelings and must take these into consideration when caring for the child. It is important that the nurse assures the parent or caregiver knows that the child feels safe and comfortable with the care provided during each step of the care provided.
Some of the strategies a nurse may include in the care of the child include a complete understanding of the different developmental stages that each child goes through. Making sure that the nurse and child are at eye level during the assessment is important. The nurse should speak to the child using words that the child is able to understand. Allowing the child to hold the assessment instruments is important in building a positive relationship with the child and helps with the assessment and helps the child feel that they are involved in their care. Videos and reading material can help the nurse divert the child’s attention away from the nurse while the nurse performs the assessment.
References:
Edelman, C., & Mandle, C., (2010). Health Promotion Through The Life Span. 7th ed. St. Louis, MI: Mosby.
GCU Lecture note (2015). Retrieved from
https://lc-ugrad1.gcu.edu/learningPlatform/loudBooks/loudbooks.html?operation=innerPage&topicMaterialId=5818e34e-95d5-48f1-a9ea-06d4291326e4&contentId=0b508ee7-267e-4873-b626-f37a8567b423&viewPage=current¤tTopicname=Health%20Assessment%20of%20the%20Toddler,%20Preschool,%20and%20School-Aged%20Child
Jarvis, C. (2012). Physical Examination & Health Assessment 6th ed. St. Louis, MI: Mosby.
Physical Examination and Health Assessment. Retrieved from
http://gcumedia.com/digital-resources/elsevier/2015/physical-examination-and-health-assessment_ebook_7e.php