Fundamentals of Nursing I

Introduction:

Gordon’s Functional Health Patterns framework provides a way of looking at your patient and the data. It is useful for organising collected data. This framework has addressed the physical, psychosocial, and spiritual needs of a patient in a holistic approach.

Topic Learning Outcome (TLOs):

By the end of this topic, you should be able to:

1. Explain the significance of using Gordon’s functional health patterns.
2. Describe the 11 functional health patterns by Marjory Gordon.
3. Demonstrate satisfactory skills in gathering data using Gordon’s functional.

Gordon’s Functional Health Patterns

Gordon’s Functional Health Patterns guide in Organizes data into 11 functional groups that contribute to a person’s overall health and well-being, quality of life, and attainment of human potential. A Theory neutral as it’s not aligned or built from any nursing theories), and can be used without conflict alongside other principles, theories or care models including self-assessment. This framework is wide utility in nursing practice because of Covers the entire life-span, does not require a license and Evidence-based.

11 Gordon’s Functional Health Patterns as following:

1. Health perception – health management

2. Nutrition – metabolic
3. Elimination
4. Activity – exercise

5. Sleep – rest
6. Cognitive – perceptual
7. Self-perception – self-concept

8. Coping – stress tolerance
9. Role – relationship
10. Sexuality – reproduction
11. Value – belief

 

However, NANDA separate the Cognitive – perceptual pattern into 2 pattern which are Cognitive Pattern and Sensory—Perceptual Pattern.

 

Here, is the explanation and guide of question for each functional health pattern when you want to collect data from a patient.

 

Health Perception-Health Management Pattern

·         Determine how the client perceives and manages his or her health. Compliance with current and past nursing and, medical recommendations. The client's ability to perceive the relationship between activities of daily living and health.

·         Client's Perception of Health: Describe your health.

·         Client's Perception of Illness: Describe your illness or current health problem.

·         Health Management and Habits: Tell me what you do when you have a health problem.

·         Compliance with Prescribed Medications and Treatments; Have you been able to take your prescribed medications? If not, what caused your inability to do so?

·         Wellness Diagnoses: Effective Management of Therapeutic Regimen

·         Risk Diagnoses: Risk for Injury & Risk for Trauma  

·         Actual Diagnoses: Altered Growth and Development; Ineffective Management of Therapeutic Regimen: Individual; Ineffective Management of Therapeutic Regimen: Family

 

 

Nutritional—Metabolic Pattern

•      Determine the client's dietary habits and metabolic needs, such as assess the conditions of hair, skin, nails, teeth and mucous membranes.

•      Dietary and Fluid Intake:

•      Describe the type and amount of food you eat at breakfast, lunch, and supper on an average day.

•      Do-you take any vitamin supplements? Describe.

•      Do you find it difficult to tolerate certain foods? Specify.

•      Do you ever experience nausea and vomiting? Describe.

•      Do you ever experience abdominal pains? Describe.

•      Condition of Skin

•      Describe the condition of your skin.

•      How well and how quickly does your skin heal?

•      Do you have any skin lesions? Describe.

•      Do you have any itching? What do you do for relief?

•      Condition of Hair and Nails

•      Have you had difficulty with scalp itching or sores?

•      Do you use any special hair or scalp care products?

•      Have you noticed any changes in your nails? Color Cracking? Shape? Lines?

•      Metabolism

•      What would you consider to be your "ideal weight"?

•      Have you had any recent weight gains or losses?

•      Do you have any intolerance to heat or cold?

•      Have you noted any changes in your eating or drinking habits? Explain.

•      Have you noticed any voice changes?

•      Assess the client's temperature, pulse, respirations, and height and weight.

•      Wellness Diagnoses

•      Opportunity to enhance nutritional metabolic pattern

•      Opportunity to enhance effective breastfeeding

•      Opportunity to enhance skin integrity

•      Risk Diagnoses

•      Risk for Altered Body Temperature

•      Hypothermia

•      Risk for Infection

•      Risk for altered nutrition less than body requirements.

•      Risk for Aspiration

•      Actual Diagnoses

•      Fluid Volume Deficit

•      Fluid Volume Excess

•      Altered Nutrition: Less than body requirements

•      Altered Nutrition: More than body requirements

•      Ineffective Breastfeeding

•      Altered Oral Mucous Membrane

•      Impaired Skin Integrity.

 

 

Elimination Pattern

•      Determine adequacy of the client's bowel and bladder. The client's bowel and urinary habits. Identify Bowel or urinary problems, such as use of urinary or bowel elimination devices.

•      Bowel Habits

•      How frequent are your bowel movements?

•      Do you use laxatives? What kind and how often do you use them?

•      Do you use enemas or suppositories? How often and what kind?

•      Do you have any discomfort with your bowel movements? Describe.

•      Bladder Habits

•      How frequently do you urinate?

•      What is the amount and color of your urine?

•      Do you have any of the following problems with urinating:

•       Pain? Blood in urine? Difficulty starting a stream? Incontinence? Voiding frequently at night? Voiding frequently during day? Bladder infections?

•      Have you ever had a urinary catheter? Describe. When? How long?

•      Wellness Diagnoses

•      Opportunity to enhance adequate bowel elimination pattern

•      Opportunity to enhance adequate urinary elimination pattern

•      Risk Diagnoses

•      Risk for constipation

•      Risk for altered urinary elimination

•      Actual Diagnoses

•      Altered Bowel Elimination Constipation

•      Diarrhea

•      Bowel Incontinence

•      Altered Urinary Elimination Patterns of Urinary Retention

•      Total Incontinence

•      Stress Incontinence

 

Activity—Exercise Pattern

•      An assessment is made of any factors that affect or interfere with the client's routine activities of daily living. Activities of daily living, including routines of exercise, leisure, and recreation. It is necessary for personal hygiene, cooking, shopping, eating, maintaining the home, and working.

·         Activities of Daily Living

•      Describe your activities on a normal day (Including hygiene activities, eating activities).

•      Do you have difficulty with any of these self-care activities? Explain.

•      Does anyone help you with these activities? How?

•      Do you use any special devices to help you with your activities?

•      Does your current physical health affect any of these activities e.g. dyspnea, shortness of breath, palpations, chest pain. pain, stiffness, weakness)? Explain.

 

 

·         Occupational Activities

•      Describe what you do to make a living.

•      Do you feel it has affected your health?

•      How has your health affected your ability to work?

·         Assess client’s Thoracic and Lung; Peripheral Vascular and Musculoskeletal system

Wellness Diagnoses          

•      Opportunity to enhance effective cardiac output

•      Opportunity to enhance effective self-care activities

•      Opportunity to enhance adequate tissue perfusion

•      Opportunity to enhance effective breathing pattern

Risk Diagnoses

•      Risk for Disorganized Infant Behavior

•      Risk for Peripheral Neurovascular Dysfunction

•      Risk for altered respiratory function

Actual Diagnoses

•      Activity Intolerance

•      Impaired Gas Exchange

•      Ineffective Airway Clearance

•      Ineffective Breathing Pattern

•      Impaired Physical Mobility

•      Inability to Sustain Spontaneous Ventilation

•      Altered Tissue Perfusion

 

Sleep—Rest Pattern

·         Determine the sleep and rest quality of a client.

·         Sleep Habits:

·         How would you rate the quality of your sleep?

·         Special Problems

·         Do you ever experience difficulty with falling asleep? Remaining asleep?

·         Do you ever feel fatigued after a sleep period?

·         Sleep Aids

·         What helps you to fall asleep? medications? reading? relaxation technique? Watching TV? Listening to music?

·         Observe appearance of your client, such as pale and puffy eyes with dark circles.

·         Observe behavior of your client, such as yawning, dozing during day, irritability and short attention span.

·         Wellness Diagnosis: Opportunity to enhance sleep

·         Risk Diagnosis: Risk for sleep pattern disturbance

·         Actual Diagnosis: Sleep Pattern Disturbance.

 

 

7- Sensory—Perceptual Pattern

•      Describe your ability to see, hear, feel, taste, and smell.

•      Describe any difficulty you have with your vision, hearing, and ability to feel (e.g., touch, pain, heat, cold), taste (salty, sweet, bitter, sour), or smell.

Pain Assessment: Complete Symptom Analysis on client.

Special Aids:

•       What devices (e.g., glasses, contact lenses, hearing aids)

•      Describe any medications you take to help you with these problems.

•      Perform assessment on Eye Ear Nose and Sinus

•      Wellness Diagnosis: Opportunity to enhance comfort level

•      Risk Diagnoses: Risk for pain

•      Actual Diagnoses: Pain

5- Sexuality—Reproduction Pattern

Menstrual history:

•      Last cycle begins?

•      Duration?

•      Any change or abnormality?

•      Describe any mood changes or discomfort before, during, or after your cycle

Obstetric history

•      How many times have you been pregnant?

•      Describe the outcome of each of your pregnancies.

•      If you have children, what are the ages and sex of each?

•      Explain any health problems or concerns you had with each pregnancy. If pregnant now.

Contraception

•      What do you or your partner do to prevent pregnancy?

•      Describe any discomfort or undesirable effects this method produces.

•      Have you had any difficulty with fertility? Explain

Special problems

•      Do you have or have you ever had a sexually transmitted disease? Describe.

•      Describe any pain, burning, or discomfort you have while voiding.

•      Perform assessment of Breast, Abdominal, and urinary-Reproductive for your client.

•      Wellness Diagnosis: Opportunity to enhance sexuality patterns

•      Risk-Diagnosis: Risk for altered sexuality pattern

•      Actual Diagnoses: Sexual Dysfunction, Altered Sexuality Patterns

 

 

 

 

 

 

8- Cognitive Pattern

·         Ability to Understand: Explain what your doctor has told you about your health.

·         Ability to Communicate: Can you tell me how you feel about your current state of health?

·         Ability to Remember: Are you able to remember recent events and events of long ago? Explain.

·         Ability to Make Decisions: Describe how you feel when faced with a decision.

·         Perform Mental Status Assessment for your client.

·         Wellness Diagnosis: Opportunity to enhance cognition

·         Risk Diagnosis: Risk for altered thought processes

·         Actual Diagnoses: Acute / Chronic confusion; Knowledge Deficit (Specify) and Impaired Memory

 

 

 

9- Role—Relationship Pattern

Perception of Major Roles and Responsibilities in Family

•      Describe your family.

•      Are there any major problems now?

Perception of Major Roles and Responsibilities at Work

•      Describe your occupation.

•      What is your major responsibility at work?

Perception of Major Social Roles and Responsibilities

•      Describe your neighborhood and the community in which you live.

·         Outline a family genogram for your client and observe your client's family members.

Wellness Diagnoses:

•      Opportunity to enhance effective relationships

•      Opportunity to enhance effective communication

Risk Diagnoses:

•       High risk for Loneliness

•       Risk for Altered Parent/Infant/Child Attachment

Actual Diagnoses:

•       Impaired Verbal Communication

•       Impaired Social Interaction: Social Isolation

 

 

 

 

10- Self-Perception-Self-Concept Pattern

•      Describe self-concept and perception of self-worth, self-competency, body image and mood state. Example: Body comfort, body image, feeling state, attitudes about self-perception of abilities.

•      Observe body posture, eye contact and voice tone of your client.

 

11- Coping-Stress Tolerance Pattern

Perception of Stress and Problems in Life

•      Describe what you believe to be the most stressful situation in your Life.

•      How has your illness affected the stress you feel?

Coping Methods and Support Systems:

•      What do you usually do first when faced with a problem?

•      What helps you to relieve stress and tension?

•      Do you use medication, drugs, or alcohol to help relieve stress?    Explain.

•      Perform Mental Status Assessment for your client.

Wellness Diagnoses

•      Opportunity to enhance effective individual coping.

•      Opportunity to enhance family coping

Risk Diagnoses:

•      Risk for self-harm

•      Risk for suicide

Actual Diagnoses:

•      Ineffective Individual Coping

•      Ineffective Family Coping: Disabling

 

12- Value—Belief Pattern

Determine client’s Goals, and Philosophical Beliefs.

 

Religious and Spiritual Beliefs: Are there certain health practices or restrictions that are important for you to follow while you are ill or hospitalized? Explain.

•      Observe client’s religious practices, such as Bible

•      Observe client's behavior for signs of spiritual distress, such as Anxiety, Anger, Depression, Doubt, Hopelessness and Powerlessness

•      Wellness Diagnosis: Potential for Enhanced Spiritual Well-Being

•      Risk diagnosis: Risk for spiritual distress

•      Actual Diagnosis: Spiritual disturbance (distress of the human spirit).