Chapter (3)
Functional Health Pattern
Faculty of Nursing-IUG
Definition of (NANDA)
The
North
American
Nursing
Diagnosis
Association (NANAD 1994) defines a nursing
diagnosis as “A clinical judgments about
individual, family or community response to
actual and potential health problems and life
responses”
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Functional health pattern (NANDA)
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1- Health Perception-Health Management Pattern
2- Nutritional—Metabolic Pattern
3- Elimination Pattern
4- Activity—Exercise Pattern
5- Sexuality—Reproduction Pattern
6- Sleep—Rest Pattern
7- Sensory—Perceptual Pattern
8- Cognitive Pattern
9- Role—Relationship Pattern
10- Self-Perception-Self-Concept Pattern
11- Coping-Stress Tolerance Pattern
12-Value—Belief Pattern
Health Perception-Health Management
Pattern
1- Determine how the client perceives and manages his or her
health.
2- Compliance with current and past nursing and, medical
recommendations.
3- The client's ability to perceive the relationship between
activities of daily living and health.
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Subjective Data
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?
Objective Data
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Refer to General Physical Survey
Associated Nursing Diagnoses
Wellness Diagnoses
Effective Management of Therapeutic Regimen
Risk Diagnoses
Risk for Injury
Risk for Suffocation
Risk for Trauma
Actual Diagnoses
Altered Growth and Development
Ineffective Management of Therapeutic Regimen: Individual
Ineffective Management of Therapeutic Regimen: Family
Ineffective Management of Therapeutic Regimen: Community
Noncompliance
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Nutritional-Metabolic Pattern
Assessing the client's nutritional-metabolic pattern is to determine the
client's dietary habits and metabolic needs. The conditions of hair,
skin, nails, teeth and mucous membranes are assessed.
Subjective Data
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.
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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?
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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?
Objective Data
Assess the client's temperature, pulse, respirations, and height and
weight.
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Wellness Diagnoses
0pportunity 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
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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.
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Elimination Pattern
Adequacy of the client's bowel and bladder.
The client's bowel and urinary habits.
Bowel or urinary problems.
Use of urinary or bowel elimination devices.
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Subjective Data
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.
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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?
Objective Data
Refer to abdominal assessment, and the rectal assessment.
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Associated nursing-Diagnoses
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
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Actual Diagnoses
Altered Bowel Elimination Constipation
Diarrhea
Bowel Incontinence
Altered Urinary Elimination Patterns of Urinary Retention
Total Incontinence
Stress Incontinence
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Activity-Exercise Pattern
Activities of daily living, including routines of exercise, leisure, and
recreation.
Activities necessary for personal hygiene, cooking, shopping, eating,
maintaining the home, and working.
An assessment is made of any factors that affect or interfere with the
client's routine activities of daily living.
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Subjective Data
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?
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Objective Data
Refer to Thoracic and Lung Assessment
Cardiac Assessment
PeripheralVascular Assessment
Musculoskeletal Assessment
Associated Nursing Diagnoses
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
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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
Disuse syndrome
Impaired Physical Mobility
Inability to Sustain Spontaneous Ventilation
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Altered Tissue Perfusion
Sexuality-Reproduction Pattern
Subjective Data
1- Female
Menstrual history:
Last cycle begin?
Duration ?
Any change or abnormality ?
Describe any mood changes or discomfort before, during, or after
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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
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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.
Objective Data
Refer to Breast Assessment, d Abdominal Assessment, and urinaryReproductive Assessment
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Associated nursing Diagnoses
Wellness Diagnosis:
Opportunity to enhance sexuality patterns
Risk-Diagnosis
Risk for altered sexuality pattern
Actual Diagnoses
Sexual Dysfunction, Altered Sexuality Patterns
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Sleep-Rest Pattern
Subjective data
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?WatchingTV? Listening to music?
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Objective Data
1. Observe appearance
a. Pale b. Puffy eyes with dark circles
2. Observe behavior
a.Yawning
b. Dozing during day
c. Irritability
d. Short attention span
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Associated nursing Diagnoses
Wellness Diagnosis:
Opportunity to enhance sleep
Risk Diagnosis
Risk for sleep pattern disturbance
Actual Diagnosis:
Sleep Pattern Disturbance.
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Sensory-Perceptual Pattern
Subjective Data
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
Special Aids:
What devices (e.g., glasses, contact lenses, hearing aids)
Describe any medications you take to help you with these problems.
Objective Data
Refer to the section on Nose and Sinus Assessment, Eye Assessment,
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and Ear Assessment.
Associated Nursing Diagnoses
Wellness Diagnosis:
Opportunity to enhance comfort level
Risk Diagnoses
Risk for pain
Actual Diagnoses
Pain
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Cognitive Pattern
Subjective Data
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:
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Describe how you feel when faced with a decision.
Objective Data
Refer to the Mental Status Assessment
Associated nursing Diagnoses
Wellness Diagnosis: Opportunity to enhance cognition
Risk Diagnosis:
Risk for altered thought processes
Actual Diagnoses:
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Acute confusion
Chronic Confusion
Knowledge Deficit (Specify)
Impaired Memory
Role-Relationship Pattern
Subjective Data
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.
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Objective Data
1. Outline a family genogram for your client.
2. Observe your client's family members.
Associated Nursing Diagnoses
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
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Coping-Stress Tolerance Pattern
Subjective Data
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.
Objective Data
Refer to the Mental Status Assessment.
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Associated nursing Diagnoses
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
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Value-Belief Pattern
Subjective Data
Values, 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.
Objective Data
Observe religious practices
Bible , clergy
Observe client's behavior for signs of spiritual distress
Anxiety, Anger , Depression , Doubt, Hopelessness and Powerlessness
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Associated Nursing Diagnoses
Wellness Diagnosis:
Potential for Enhanced Spiritual Well-Being
Risk diagnosis:
Risk for spiritual distress
Actual Diagnosis:
Spiritual disturbance (distress of the human spirit).
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