1) The document provides an assessment of functional health patterns in children across three age groups: toddlers, preschool-aged, and school-aged children. For each age group and pattern, it lists two normal assessment findings and two potential problems a nurse may discover. 2) Patterns assessed include functional health, nutritional-metabolic, elimination, activity and exercise, cognitive/perceptual, sleep and rest, self-perception, role-relationships, sexuality/reproduction, coping and stress tolerance, and values and beliefs. 3) Similarities across age groups include parental influence on health values and beliefs. Differences include developmentally appropriate assessments findings for things like toileting, nutrition, motor skills

1. Children’s Functional Health Pattern Assessment
Functional Health
Pattern Assessment
(FHP)
Toddler
Erickson’s Developmental Stage:
Autonomy versus shame
and doubt
Preschool-Aged
Erickson’s Developmental Stage:
Initiative versus guilt
School-Aged
Erickson’s Developmental Stage:
Industry versus 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. Dependent on parental
figures for health
management
2. May request health
management activities but
only because they are part
of a routine set by parental
figures.
1. Becomes upset over
minor injuries
2. Pain and illness
viewed as punishment
1. Perceiving symptoms
2. Abstract causes of
illness including karma,
evil eye, and etc
1. May not be receiving
proper care due to parental
figures health perception
2. May be subject to
environmental health
concerns such as lead,
poisoning and iron
deficiency if parental
figures are unaware of
concerns
1. Not Brushing their
own teeth
2. Not selecting
appropriate clothing for
weather
1. No understanding of the
germ, punishment or
external forces theories
2. Cavities caused by not
brushing teeth
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. Eating a variety of
healthy finger foods
2. No longer being
breastfed
1. 5 servings of fruit or
vegetables per day
2. 20-25 grams of fiber
daily
1. 1200-1800 calories
daily
2. May still dislike
vegetables
1. Cavities from use of
juice at bedtime
2. Iron Deficiency
1. High salt and sugar
intake
2. Food allergies
1. Diabetes, anemia,
hypertension
2. Food insecurity
Pattern of Elimination:
List two normal
assessment findings that
would be characteristic for
each age group.
1. Toilet training
2. Ability to maintain a
dry diaper for two hours
1. Independent toileting
2. Forgetting to flus or
wash hands
1. Bladder and bowel
control
2. Enuresis under 6 years
old
1. Inability to
communicate voiding
sensation
1. Bedwetting
2. Encopresis
1. Diurnal enuresis
2. Complete incontinence

2. List two potential
problems that a nurse may
discover in an assessment
of each age group.
2. Inability to walk and
retrieve objects from the
floor by stooping
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. Parallel Play
2. Ability to dress and
undress themselves in
simple clothing
1. Increased motor skill
coordination
2. Modeling behavior
1. Participation is sports
2. Ability to pedal a
bicycle
1. More than 2 hours spent
in front of the television
2. Lack of want to explore
their surroundings and
learn new things
1. Inability to separate
from their parents
2. Inability to dress
themselves
1. Inability to dress
themselves by age 5
2. Lack of hand eye
coordination by age 10
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. Egocentrism
2. Object permanence
1. Concrete thought
process
2. Centering
1. Cooperative actions
2. Basic math skills
1. Having an
understanding of less than
approximately 400 words
2. Lack of a spectrum of
interests and activities
could be indicative of
Autism
1. Amblyopia
2. Heterotropia
1. Egocentric
2. Inability to classify
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
1. 12 hours of sleep per 24
hour period
2. Rituals before bed time
1. Getting 8-12 hours of
sleep a night
2. Prolonging bedtime up
to 30 minutes
1. Receive 8-12 hours of
sleep per night
2. No longer need naps
1. Night terrors
2. Lack of security objects
such as a blanket or
stuffed animal
1. Less than 30-60
minute naps
2. Not having a bedtime
ritual
1. Sleepwalking
2. Sleep talking

3. discover in an assessment
of each age group.
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. Saying “No” even
when the toddler wants an
object
2. Temper Tantrums
1. Increase in
imagination
2. Developing a sense of
initiative
1. Developing a sense of
worth
2. Mastering a skill
1. Continued Dependency
2. Lack of exploring
surroundings and
relationships
1. Low self-esteem
2. Lack of task or social
ordinated tasks
1. Inferiority
2. Lack of self-concept
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. Imitating behavior
2. Associated people with
their roles in regards to
the toddler.( Example:
mom feeds the toddler and
dad plays with them)
1. Regression
2. Continued sibling
fighting even after
established rules and lack
of gain for the toddler
1. Understanding gender
expectations
2. Imitating older siblings
1. Not viewing the family
as an important aspect of
their life
2. Not using play as a
stress reducer
1. Increased independence
2. Socialization skills
increase
1. Gang involvement
2. Lack of limit setting in
the home
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. Genitalia exploration
2. Masturbation
1. Questioning the
opposite sex’s genitalia
function
2. Identifying with their
own gender
1. Exploratory behavior
2. Menstrual cycles
1. Alternative names for
genitalia
2. Evidence of sexual
abuse
1. Lack of support from
parental figures about
sexual curiosity
2. Negative body image
1. Sexual abuse
2. STIs
Pattern of Coping and
Stress Tolerance:
List two normal
assessment findings that
1. Imitation of parental
figures behavior
2. Regression during
periods of stress
1. Projection
2. Denial
1. Recognize symptoms of
stress
2. Ability to develop
coping mechanisms

4. 1) Compare and contrast identified similarities as well as differences in expected assessment
across the childhood age groups.
While researching the expected assessment findings in the toddler, pre-school, and school
age groups many similarities are found in the value section. In all of the age groups,
children’s values are generally determined by their parental figures. This includes morals as
well as health. The ageless, nature versus nurture question immediately comes to mind in
regards to morals and health values. The evidence seems to point to all values being a learned
behavior that a healthcare provider must address with the parental figures in order to ensure
success for the child. The remaining assessment findings were expected as a health care
provider with a background in pediatrics.
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 assessing a child, the healthcare provider must determine the cultural beliefs of the
parents before beginning. In some cultures, it is an absolute sin to touch a child and could
lead to illness. In other cultures, the healthcare provider would need to address only the
would be characteristic for
each age group.
List two potential
problems that a nurse may
discover in an assessment
of each age group.
1. Violent behavior
towards siblings
2. Lack of preparation for
stressful events
1. Increase in temper
tantrums
2. Extreme regression
1. Somatization
2. Depression
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. Sense of security
2. Learned values and
beliefs from parental
figures
1. More interest in life
and death
2. Expressing values by
stating whether or not
they like the activity or
object
1. Concern for group
values by approximately
age 13
2. Following the rules to
avoid trouble until 10-13
years of age
1. Receiving attention
from parental figures
when misbehaving only
2. Parental; figures
expecting the toddler to
understand religious
traditions because they
have memorized words
1. Guilt
2. Low self esteem
1. Stealing
2. Cheating

5. matriarch or patriarch about the child’s care. Healthcare providers should simply ask the
parental figure if there are any special considerations prior to performing the assessment as
they would ask any adult. Toddlers and preschool children should be on or near their parental
figures lab to encourage a feeling of safety and security. These children should also be given
choices during the assessment to promote autonomy and self-esteem. School age children
have a general understanding of their health and can answer health related questions without
issue, but a parent should always be present to assist unless abuse is suspected.
Reference:
Edelman, C. L., Mandle, C. L., Kudzma, E. C., M, C. L., Carole Lium Edelman APRN MS
CS BC CMC, & Carol Lynn Mandle PhD AP RN CNS FNP (2013). Health promotion
throughout the life span (HEALTH PROMOTION THROUGHOUT THE LIFESPAN (
EDELMAN)) (7th ed.). Philadelphia, PA, United States: Elsevier Health Sciences. (pp. 455-
544)