FRAGILE X SYNDROME IHP Student's Name * First Middle Last Suffix This field is required. Please complete the following fields: First,Last. PhotoAccepted file types: jpg, gif, png, jpeg, Max. file size: 100 MB.DoB Month Incorrect Value for Month field Day Incorrect Value for Month field Year Incorrect Value for Month field Please enter a valid date. GR/LevelDaycareEEPKKN010203040506070809101112Post-GraduateWould you like to add the student's ID number? Yes No ID Campus/Building Would you like to add the student's homeroom number and teacher's name? 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Yes No ContactContact Name Add RemoveRelationship Add RemoveContact Phone Number Add RemoveContact Phone Type Add RemoveContact Phone Number Add RemoveContact Phone Type Add RemoveContact Name RelationshipChoose one:ParentGuardianOtherContact Phone Number Contact Phone TypeChoose OneHomeMobileWorkFaxContact Phone Number Contact Phone TypeChoose OneHomeMobileWorkFax Add More Treating Physician Add RemovePhysician Phone Number Add RemovePhysician Fax Number Add RemoveTreating Physician Physician Phone Number Physician Fax Number Add More Preferred Hospital City MEDICAL DIAGNOSIS(ES)Add a medication or procedure? Yes No MEDICATIONS/PROCEDURES Medication/Procedure Strength Dose ModeChoose one:OralTopicalInhaledIntranasalSQNebulizerSublingualRectalIMIVSched/PRN?Choose OneScheduledPRNTime Frequency If PRN, administer for Medication/Procedure Add RemoveStrength Add RemoveDose Add RemoveMode Add RemoveSched/PRN? Add RemoveTime Add RemoveFrequency Add RemoveIf PRN, administer for Add Remove Add More MEDICAL HISTORYASSESSMENT NursingList InterventionList OutcomesList Nursing Diagnosis: Delayed Growth and Development Related to cognitive delays Related to sensory processing difficulties Related to poor fine and gross motor coordination Interventions The school nurse will collaborate with occupational, speech, and physical therapists for comprehensive support. The school nurse will engage in sensory integration therapy to enhance sensory processing. The school nurse will provide a structured environment with visual and verbal cues to promote learning. Expected Outcomes The student will show gradual improvement in meeting developmental milestones. The student will develop fine and gross motor skills to a functional level. The student will demonstrate improved sensory integration and response. Nursing Diagnosis: Impaired Social Interaction Related to difficulty understanding social cues Related to shyness or anxiety in social settings Related to communication impairments Related to repetitive behaviors Interventions The school nurse will facilitate social skills training with a focus on interpreting non-verbal cues. The school nurse will introduce structured play sessions to improve peer interactions. The school nurse will utilize visual aids like social stories to help the student understand social norms. The school nurse will collaborate with teachers and parents to create a supportive and inclusive classroom environment. Expected Outcomes The student will engage in positive social interactions with peers and adults. The student will demonstrate improved understanding of social cues and norms. The student will participate in group activities with minimal anxiety or behavioral disruptions. Nursing Diagnosis: Impaired Verbal Communication Related to cognitive and speech delays Related to sensory processing difficulties Related to receptive and expressive language impairments Interventions The school nurse will work closely with a speech-language pathologist to implement communication strategies. The school nurse will use alternative communication methods such as pictures, symbols, or electronic devices. The school nurse will encourage verbal expression through repetitive, structured exercises. The school nurse will minimize background noise and distractions to help the student focus during communication attempts. Expected Outcomes The student will use verbal and/or non-verbal communication methods effectively in the classroom setting. The student will improve receptive and expressive communication skills over time. The student will participate in classroom discussions and activities using preferred communication methods. Nursing Diagnosis: Anxiety Related to cognitive and social impairments Related to sensory overload Related to changes in routine Related to fear of unfamiliar situations or environments Interventions The school nurse will establish a predictable routine with visual schedules to reduce anxiety. The school nurse will provide calming strategies like deep breathing, sensory toys, or quiet spaces for the student to self-regulate. The school nurse will use desensitization techniques to gradually expose the student to new situations. The school nurse will encourage consistent support from trusted staff members to provide reassurance. Expected Outcomes The student will demonstrate reduced anxiety in daily school activities. The student will effectively use coping strategies during stressful situations. The student will adjust to changes in routine with minimal distress. Nursing Diagnosis: Risk for Injury Related to poor motor coordination and balance Related to sensory processing difficulties Related to impulsivity or hyperactivity Interventions The school nurse will ensure a safe physical environment with minimal hazards in the classroom and school areas. The school nurse will supervise during activities that require fine motor skills or coordination. The school nurse will incorporate regular physical activities that improve balance and coordination. The school nurse will educate staff and parents about the student’s risk factors and implement preventive safety measures. Expected Outcomes The student will remain free from injury during school activities. The student will improve balance and coordination over time. The school environment will remain safe and supportive for the student. Would you like to add another nursing diagnosis? Yes No Nursing DiagnosisNursing DiagnosisAdd your own nursing diagnosisInterventionsAdd your own nursing interventionsExpected OutcomesAdd your own expected outcomesNursing Diagnosis Add RemoveInterventions Add RemoveExpected Outcomes Add Remove Add More EVALUATIONNOTESIHP Developed ByName First Last Title Date Month Day Year Please enter a valid date. Do you want to include physician and parent signature lines? Yes Download IHP Clicking this button will download this IHP to your computer and return you to the blank IHP. Return Clicking this button will return you to the IHP to make changes.
