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Running head: PEDIATRIC HEALTH PROMOTION 1
Pediatric Health Promotion
Emmah Kargbo.
NSG 200.
11/23/2020.
PEDIATRIC HEALTH PROMOTION 2
Pediatric Health Promotion
Health promotion refers to the approach integrated into the health care system to allow
people to increase control over, as improve their health. In that regard, health promotion
emphasizes more on environmental and social interventions than individual behaviour (Daley et
al., 2020). In this assessment, the client to be considered is Peter James, an 18-year-old male.
Peter is in the adolescent stage, and he has demonstrated several behaviours that depict that he
has met the developmental milestone of a person in the adolescent stage. For example, he
describes volatile emotions, develops a sense of independence, develops an interest in a romantic
relationship, develops a commitment to education, and spend a lot of time with his peers. In
other words, the client is mature in the sense that he can distinguish between right and wrong
when making judgments and decisions.
It is also essential to examine different developmental theories on human growth and
development based on the adolescent agent of the client. Some of these theories include Erick
Erikson theory, social learning theory, and Maslow Hierarchy of Needs. According to Erikson,
human personality changes in a predetermined order. Therefore, there are different stages of
psychosocial development that depict the development of a person from infancy to adulthood. In
each stage, the experience for each individual makes him or her face psychosocial crisis to
demonstrate personality development.
Erikson psychosocial theory has eight stages of development that explain changes in
different stages of human development. In this case, the client is 18 years old in the adolescent
stage. According to Erikson, the psychosocial stage for an adolescent is known as identity vs role
confusion (Gross, 2020). This is the 5th stage that Erikson uses to demonstrate how adolescent
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develop based on their behaviours and other aspects. The stage mainly explores psychosocial
develop for persons aged between 12 to 18 years. As children transform to adulthood, this stage
is paramount in shaping their future in terms of roles in adulthood.
Moreover, Erikson considers this stage as “role confusion” because adolescents will see
changes in their body (Gross, 2020). They also become responsible when they develop both
mentally and physically, such that they explore different social roles. However, the 5th
psychosocial stage also focuses on the identity crisis that may affect adolescents as they
determine their identity. This explains why adolescents explore different lifestyles to understand
their real identity.
More importantly, the adolescent stage can be explored through Maslow’s Hierarchy of
Needs. Mainly, this theory consists of five components that demonstrate survival. The relevance
of this theory at the adolescent stage is the component at the bottom of the pyramid called “basic
needs” (Crandall et al., 2020). In that regard, adolescents require basic needs from their health,
growth, and development. Therefore, they require food for physical growth and mental
development. This theory also consists of “safe needs” that can be used in adolescent stage to
ensure they reside in a safe environment that will facilitate their transformation to adulthood.
Maslow’s theory also expresses the importance of “social needs”. These needs are
relevant in the adolescent stage because they require attention and love from parents, peers,
siblings, and the community. The “esteem needs” also influence the development of adolescents.
The environment for adolescents is determined by the impact of this component, especially when
making decisions. Overall, Maslow’s theory explores how “self- actualization” affects human
development (Crandall et al., 2020). It is relevant in the adolescent stage because they focus on
their identity in life.
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The last theory that explores human development at the adolescent stage is the social
learning theory. This theory argues that people develop new behaviours through imitation and
observation. In that regard, adolescents can develop new behaviours by imitating other people by
watching what they do (Pringle et al., 2018). However, some behaviours achieved through social
learning theory can mislead adolescents. Therefore, it is paramount to guide them to ensure they
only observe and imitate the right actions.
Consequently, health promotion for a client at the adolescent stage is paramount and
proper communication is a crucial skill for completing the assessment. Therefore, at 18 years
old, the client can be distracted by many factors. It is essential to embrace effective
communication to ensure the client develop confidence, respect, and trust. It is also paramount to
ensure that client has consent about the assessment and assure him that data collected will be
handled with ultimate privacy and confidentiality (Daley et al., 2020). More importantly, it is
essential to inform the client the reason for asking personalized questions and how they help in
health promotion. The client can choose to be assessed in the absence of the parent to ensure they
fully open up without fear of intimidation and to promote privacy.
Client:
P J, is The client in the health promotion assessment. He is 18 years old. In the interview,
the client’s father will be present as an informant. It is also paramount to acknowledge that PJ,
completed the required documentation such as Guidelines for Adolescent Prevention Survey.
Health History:
Biographic Data:
The client, P J, is 18 years old. He was born on 14th November 2002 as an AfricanAmerican.
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Reason for Seeking Care: Well Visit
History of Present Illness: The client has no record of depression.
Present Health Status: The client is taking antidepressants such as citalopram and escitalopram.
The client is also receiving cognitive behaviour therapy.
Past Health History: The client has no history of any medical condition. All physical
examinations for vision, immunization, dental health, and other requirements are up to date.
Family History:
Brother: 16 years old, asthmatic
Sister: 13-year old, type 1 diabetes
Father: 57 years old, Rheumatoid arthritis
Mother: 55 years old, Hypertension
Paternal Grandfather: 82 years old, type 2 diabetes
Paternal Grandmother: 78 years old, type 2 diabetes
Maternal Grandfather: 80 years old, stroke
Maternal Grandmother: 77 years old, Kidney failure
Person Status:
Client’s father describes him as “sharp, diligent, and intelligent”. During the interview,
the client was restless and lost concentration in the larger part of the interview. When asked
“what is going on?” He replied with a loud voice, “I am ok!” Then the client expressed sadness
and his mood changes almost immediately.
The client is the basketball captain in his school and has propelled his to best performance in the
last competition. However, the client indicated on the Guidelines for Adolescent Prevention
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Survey, his plans to quit basketball because he lost interest in the game, despite being the best
player in the region.
Family and Social Relationships:
The client states that his relationship with his family is not good. Although his siblings
are the best, his father and mother engage in domestic conflict most of the times. His father is
violent, and the family faces domestic violence that affects the welfare of the family. The client
also claims that he spends most of his time with two close friends whenever his family has
domestic violence. The client also states he is a romantic relationship with a 17-year-old girl he
met in a piano training program in the community centre.
Diet and Nutrition:
The client does not like eating fast foods and prefers to eat food prepared by his mother at
home. He also likes eating organic vegetables and fruits for breakfast. For both lunch and dinner,
the client eats rice with fish and blended juice. The client stated in the interview that his organic
diet to help him lose body weight.
Sleep:
The client acknowledges that his sleeping pattern has changed in the last six months. He
states that sleep deprivation has affected his daily activities at school. Despite going to bed at 10
pm, the client expresses that his only sleep for 4 hours due to sleep deprivation.
Mental Health:
The client claims that for the past six months, his depression level has increased. He even
claims that suicidal thoughts have been haunting him for that period. He also experiences
sadness and mood swings. He claims that her depression is caused by domestic violence
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experienced in his family. He also claims that basketball used to relieve his stress, but in the past
six months, the depression level has increased. He even decided to quit playing basketball.
Sexuality:
The client states that he started feeling attracted to girls at the age of 12 years. His male
reproductive organs are fully developed. Although he is in a romantic relationship with a girl, he
is not engaging in a sexual relationship. He is only attracted to the opposite sex, which means he
is heterosexual.
Development:
In terms of personal development, the Bright Futures Pre-Visit Questionnaire indicates
the following aspects of the client.
 He understands the importance of eating healthy food to prevent adverse impacts
associated with fast foods.
 He has great friends who support him whenever his family engages in domestic violence.
 He is excellent in co-curricular activities such as basketball.
 He is independent and makes personal choices.
 He is also excellent at playing the piano.
Health Promotion Activities:
The client plays the piano every evening as a way to control stress. He also played
basketball to improve his mental health. He does not abuse substances such as alcohol and
narcotic drugs.
Home Environment:
The home environment is safe, and only a few criminal activities are reported. The
environment is also clean, with no pollution identified in the area. Also, the public park is
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excellent for physical exercise. His home is also equipped with sustainable water supply,
electricity, heating system during winter, and cooling system during summer.
General Survey:
The client has a black skin colour which demonstrates his African-American ethnicity.
He does not maintain eye contact and seems restless due to lack of concentration. There are signs
of acute distress and prefer spending time alone at school but only socialize with at least three
friends at home environment.
Vital Signs:
Temperature: 96.3 F, Oral
Blood Pressure: 115/70, Sitting
Pulse: 72 beats/min
Respiratory Rate: 15 beats/min
Weight: 76. 5 kg
Height: 60 inches or 1.524 meters
BMI: 32.94 kg/m2, he is overweight
Pain:
The client rated his pain level at 3. At 0, it indicates that there is no pain while 10 means
the worst pain. Therefore, at 3, the client was having moderate pain.
Analysis of Data:
Based on GAPS, health history interview, pre-visit questionnaire, general survey, and
vital signs, it is possible to determine the wellness of the client. First, the client claims that
domestic violence exposes him to depression. His BMI is high at 32.94 kg/m2, which indicate he
is overweight. He also expresses restless, lack of concentration, and sadness as signs of
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depression. Therefore, the care plan involves addressing depression caused by domestic violence.
It is also essential to improve his BMI level to a normal healthy weight.
Nursing Diagnosis:
The client has chronic depression, as evidenced by suicidal thoughts as expressed by the
client.
Goal:
The goal involves engaging his parents to end domestic violence to ensure the client
experience an excellent home environment and family love.
Objective 1: The client identifies ways to improve mental health and implement them.
Objective 2: The client identifies strategies to reduce body weight and implement them.
Objective 3: The client should resume playing basketball to reduce stress and depression.
Interventions:
1. It is essential to encourage the client to engage in activities that reduce depression.
2. It is essential to engage the client through active listening to motivate him on how to
reduce depression.
3. Mainly, privacy and confidentiality should be considered when engaging the client.
4. His parents should be engaged to end domestic violence that affects the mental health.
Evaluation:
1. It is vital to review the journey when the client visits next time to determine if there is
any improvement.
2. The client can continue feeding on a healthy diet to manage his weight.
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References
Crandall, A., Powell, E. A., Bradford, G. C., Magnusson, B. M., Hanson, C. L., Barnes, M. D., …
& Bean, R. A. (2020). Maslow’s Hierarchy of Needs as a Framework for Understanding
Adolescent Depressive Symptoms over Time. Journal of Child and Family
Studies, 29(2), 273-281.
Daley, A. M., Lestishock, L., & White, P. H. (2020). Pediatric Nurse Practitioners’ Perspectives
on Engaging Adolescents to Shift from Pediatric to Adolescent-Focused Health Care
Services. Journal of Pediatric Health Care, 34(6), 550-559.
Gross, Y. (2020). Erikson’s Stages of Psychosocial Development. The Wiley Encyclopedia of
Personality and Individual Differences: Models and Theories, 179-184.
Pringle, J., Doi, L., Jepson, R., & McAteer, J. (2018). Developing an evidence and theory based
intervention that seeks to promote positive adolescent health and education
outcomes. The Lancet, 392, S73.