1. Health Promotion and the Individual CHAPTER 6 161
Functional Health Patterns Assessment (Adult)
Box 6-1 Functional Health Patterns Assessment (Adult)
HEALTH PERCEPTION-HEALTH MANAGEMENT PATTERN d. Perceived ability (code for level) for:
1. History Feeding Dressing Cooking
a. How has general health been? Bathing Grooming Shopping
b. Any colds in past year? When appropriate: absences Toileting General mobility
from work? Bed mobility Home maintenance
c. Most important things you do to keep healthy? Think Functional Level Codes:
these things make a difference to health? (Include Level 0: full self-care
family folk remedies when appropriate.) Use of ciga- Level I: requires use of equipment or device
rettes, alcohol, drugs? Breast self-examination? Level II: requires assistance or supervision from
d. Accidents (home, work, driving)? another person
e. In past, been easy to find ways to follow suggestions Level III: requires assistance or supervision from
from physicians or nurses? another person and equipment or device
f. When appropriate: what do you think caused this ill- Level IV: is dependent and does not participate
ness? Actions taken when symptoms perceived? Re- 2. Examination
sults of action? a. Demonstrated ability (code listed above) for:
g. When appropriate: things important to you in your Feeding Dressing Cooking
health care? How can we be most helpful? Bathing Grooming Shopping
2. Examination—general health appearance Toileting General mobility
b. Gait ________ Posture Absent body part?
NUTRITIONAL-METABOLIC PATTERN (Specify.)
1. History c. Range of motion (joints) Muscle
a. Typical daily food intake? (Describe.) Supplements (vi- firmness
tamins, type of snacks)? d. Hand grip Can pick up a pencil?
b. Typical daily fluid intake? (Describe.) e. Pulse (rate) (rhythm) Breath
c. Weight loss or gain? (Amount.) Height loss or gain? sounds
(Amount.) f. Respirations (rate) (rhythm) Breath
d. Appetite? sounds
e. Food or eating: Discomfort? Swallowing? Diet g. Blood pressure
restrictions? h. General appearance (grooming, hygiene, and energy
f. Heal well or poorly? level)
g. Skin problems: Lesions? Dryness?
h. Dental problems? SLEEP-REST PATTERN
2. Examination 1. History
a. Skin: Bony prominences? Lesions? Color changes? a. Generally rested and ready for daily activities after
Moistness? sleep?
b. Oral mucous membranes: Color? Moistness? Lesions? b. Sleep onset problems? Aids? Dreams (nightmares)?
c. Teeth: General appearance and alignment? Dentures? Early awakening?
Cavities? Missing teeth? c. Rest-relaxation periods?
d. Actual weight, height. 2. Examination
e. Temperature. a. When appropriate: Observe sleep pattern.
f. Intravenous feeding–parenteral feeding (specify)?
COGNITIVE-PERCEPTUAL PATTERN
ELIMINATION PATTERN 1. History
1. History a. Hearing difficulty? Hearing aid?
a. Bowel elimination pattern? (Describe.) Frequency? b. Vision? Wear glasses? Last checked? When last
Character? Discomfort? Problem in control? changed?
Laxatives? c. Any change in memory lately?
b. Urinary elimination pattern? (Describe.) Frequency? d. Important decision easy or difficult to make?
Problem in control? e. Easiest way for you to learn things? Any difficulty?
c. Excessive perspiration? Odor problems? f. Any discomfort? Pain? When appropriate: How do you
d. Body cavity drainage, suction, and so on? (Specify.) manage it?
2. Examination—when indicated: examine excreta or drain- 2. Examination
age color and consistency. a. Orientation.
b. Hears whisper?
ACTIVITY-EXERCISE PATTERN c. Reads newsprint?
1. History d. Grasps ideas and questions (abstract, concrete)?
a. Sufficient energy for desired or required activities? e. Language spoken.
b. Exercise pattern? Type? Regularity? f. Vocabulary level. Attention span.
c. Spare-time (leisure) activities? Child: play activities?
From Gordon, M. (1994). Nursing diagnosis: Process and application (3rd ed.). St. Louis: Mosby; Gordon, M. (2000). Manual of nursing diagnosis: 1995-
1996. St. Louis: Mosby.

2. 162 UNIT TWO Assessment for Health Promotion
Functional Health Patterns Assessment (Adult)—cont’d
Box 6-1 Functional Health Patterns Assessment (Adult)—cont’d
SELF-PERCEPTION—SELF-CONCEPT PATTERN SEXUALITY-REPRODUCTIVE PATTERN
1. History 1. History
a. How describe self? Most of the time, feel good (not so a. When appropriate to age and situations: Sexual rela-
good) about self? tionships satisfying? Changes? Problems?
b. Changes in body or things you can’t do? Problem to b. When appropriate: Use of contraceptives? Problems?
you? c. Female: When menstruation started? Last menstrual
c. Changes in way you feel about self or body (since ill- period? Menstrual problems? Para? Gravida?
ness started)? 2. Examination
d. Things frequently make you angry? Annoyed? Fearful? a. None unless problem identified or pelvic examination
Anxious? is part of full physical assessment.
e. Ever feel you lose hope?
2. Examination COPING-STRESS TOLERANCE PATTERN
a. Eye contact. Attention span (distraction). 1. History
b. Voice and speech pattern. Body posture a. Any big changes in your life in the last year or two?
c. Nervous (5) or relaxed (1); rate from 1 to 5. Crisis?
d. Assertive (5) or passive (1); rate from 1 to 5. b. Who’s most helpful in talking things over? Available to
you now?
ROLES-RELATIONSHIPS PATTERN c. Tense or relaxed most of the time? When tense, what
1. History helps?
a. Live alone? Family? Family structure (diagram)? d. Use any medicines, drugs, alcohol?
b. Any family problems you have difficulty handling (nu- e. When (if) have big problems (any problems) in your
clear or extended)? life, how do you handle them?
c. Family or others depend on you for things? How man- f. Most of the time is this (are these) way(s) successful?
aging? 2. Examination: None.
d. When appropriate: How family or others feel about ill-
ness or hospitalization? VALUES-BELIEFS PATTERN
e. When appropriate: Problems with children? Difficulty 1. History
handling? a. Generally get things you want from life? Important
f. Belong to social groups? Close friends? Feel lonely plans for the future?
(frequency)? b. Religion important in life? When appropriate: Does this
g. Things generally go well at work? (School?) help when difficulties arise?
h. When appropriate: Income sufficient for needs? c. When appropriate: Will being here interfere with any
i. Feel part of (or isolated in) neighborhood where living? religious practices?
2. Examination 2. Examination: None.
a. Interaction with family member(s) or others (if present). 3. Other concerns
a. Any other things we haven’t talked about that you
would like to mention?
b. Any questions?
From Gordon, M. (1994). Nursing diagnosis: Process and application (3rd ed.). St. Louis: Mosby; Gordon, M. (2000). Manual of nursing diagnosis: 1995-
1996. St. Louis: Mosby.