These are the functional patterns used for nursing diagnosis.
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GORDON FUNCTIONAL
HEALTH PATTERNS
(GFHP)
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Gordon'sfunctionalhealthpatterns
Proposed by Marjorie Gordon as a guide for establishing
and organizing a comprehensive nursing data base
Based on the belief that all human beings have in
common 11 functional health patterns that contribute to
their health.
The format addresses and reflects concepts of holism
The 11 categories make possible a systematic and
standardized approach to data collection, and enable the
nurse to determine the aspects of health and human
function:
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Functional health patterns
All human beings have in common certain
functional patterns that contribute to their health
,quality of life and achievement of human
potentials
These common patterns are the focus of nursing
assessment
Description and evaluation of health patterns
permit the nurse to identify functional patterns
( client's strengths) and dysfunctional patterns
(nursing diagnosis)
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For each pattern, combine subjective and objective
data to identify diagnosis and etiological
/contributing factors.
Health is measured by parameters and norms in
combination with a subjective client description.
Health-Defined within the context of functional
health patterns is the optimum level of functioning
that allows individuals , families and communities
to develop their potentials to the fullest
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Advantages
Guides collection of information on client
,client’s family and community
Encompasses a holistic approach and
Incorporates the concepts of client –
environment interaction
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The 11functional health patterns
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1:Health Perception-health Management:
Data collection is focused on the person's perceived level of
health and well-being, and on practices for maintaining
health. Actual or potential problems related to safety and
health management may be identified as well as needs for
modifications in the home or needs for continued care in the
home.
Describes the client’s perceived pattern of health and well
being and how her/his health is managed.
It includes the client’s perception of his/her health status and
its relevance to current activities and future planning
Habits that may be detrimental to health are also evaluated,
including smoking and alcohol or drug use
It also includes the general level of health care
behavior
Promotional activities
Self examinations-breast , testicular exams
Preventive practices
Medical and nursing perceptions
Follow up care.
The focus is the individual ,family and
community perceived level of health, well-being
and practices for promoting and maintaining
health
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Assessment of functional health perception-health
management patterns
Individualassessment
History
How has general health been
Previous and current health problems and diseases
Activities for promoting and maintaining health
Perceptions on causes of previous and current health or
disease status
Examination-General health status
Family assessment
History & Examination
Community assessment
History & examination
Sample NANDA nursing diagnosis
Health Maintenance, Ineffective
Infection, Risk for
Injury, Risk for
Risk for injury, Suffocation , Poisoning
Management of Therapeutic Regimen (Individual,
Family, Community), Ineffective
Management of Therapeutic Regimen, Readiness for
Enhanced
Surgical Recovery, Delayed
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2:Nutrition and Metabolism:
Assessment is focused on the pattern of food and
fluid consumption relative to metabolic need. The
adequacy of local nutrient supplies is evaluated.
Actual or potential problems related to fluid
balance, feeding difficulties tissue integrity, and
host defenses may be identified as well as
problems with the gastrointestinal system.
Assessment objective
To obtain data about typical pattern of food
and fluid consumption
Identify gross indicators of metabolic need
Individual assessment
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History
Typical daily food and
fluid intake
Weight loss/gain
Height
Discomforts with
eating ,swallowing
Diet preference or
restrictions
Appetite
Skin problems /lesions
and healing of wounds
Dental problems
Examination
Skin
Bony prominences
Oral mucous
membranes
Teeth
Actual weight and
height
Anthropometric
measurements
Temperature
Parenteral /enteric
feeding modes
Sample Nutritional Metabolic Patterns NANDA
Nursing Diagnoses
Risk for Infection
Impaired Oral Mucous
Membranes
Risk for Impaired Skin
Integrity
Impaired Swallowing
Ineffective
Thermoregulation
Impaired Tissue Integrity
Risk for Aspiration
Risk for Imbalanced
Body Temperature
Feeding Self-Care
Deficit
Fluid Volume Excess
Risk for Deficient Fluid
Volume
Hyperthermia
Imbalanced Nutrition:
Less than Body
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3:Elimination:
Data collection is focused on patterns of (bowel, bladder,
skin) functions.
Excretory problems such as incontinence, constipation,
diarrhea, and urinary retention may be identified.
Individual assessment
History
Bowel elimination-frequency ,character, discomfort,
use of laxatives
Urinary elimination-retention
Excessive perspiration
Body cavity drainage-suction
Examination-If indicated-Excreta amount &
characteristics
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4:Activity and Exercise:
Assessment is focused on the activities of daily living
requiring energy expenditure, including self-care
activities, exercise, recreation and leisure activities.
The status of major body systems involved with activity and
exercise is evaluated, including the respiratory,
cardiovascular, and musculoskeletal systems
Individual assessment.
History
Sufficient energy for required activities
Exercises
Recreational activities
Perceived ability for ADLs-Functional level assessment
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Level 0:Full self care
Level 1:Requires use of equipment
Level11:Requires assistance or supervision
Level 111:Requires assistance from another and use of
equipment device
Level IV: Is dependant and does not participate
Examination
Demonstrated ability to perform ADLs
Gait
Posture
Range of motion-Joints
Muscle strength
Blood pressure
Pulse and respirations
General appearance (grooming, Hygiene ,energy level)
Individual assessment
History
Hearing difficulty,
hearing aids
Vision-use of glasses
Any change in
memory
Ability to make
decisions
Learning difficulties
Examination
MSE
Hearing tests
Tests of vision
Reading tests
Language
spoken
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Cognitive-perceptual Patterns NANDA
Nursing Diagnoses-examples
Acute Confusion
Impaired Verbal Communication
Acute Pain
Risk for Peripheral Neurovascular Dysfunction
Ineffective Protection
Disturbed Sensory Perception
Disturbed Thought Processes
Decisional Conflict
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6:Sleep and Rest.
Assessment is focused on the person's sleep, rest,
and relaxation practices.
The objective is to describe effectiveness of the
pattern from the client’s perspective
Data on sleep characteristics during 24-period is
collected to include whether the client feels
rested
Dysfunctional sleep patterns, fatigue, and
responses to sleep deprivation may be identified.
Individual assessment
History
Sleep onset problems
Sleeping aids
Early awakening
Rest-relaxation periods
Sleep interruptions-dreams
Generally rested and ready for daily activities
Examination
Sleeping times & presence of sleep pattern
Interruptions during sleep
Prescribed nocte drugs
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7.Self-Perception and Self-Concept: Assessment
is focused on the person's attitudes toward self, including
identity, body image, and sense of self-worth. The person's
level of self-esteem and response to threats to his or her self-
concept may be identified.
Individual assessment
History
Clients feelings towards self most of the time
Changes in body or things client can do
Changes in ways client feels about self or image since illness
started
Sources of anger, annoyance, fearful
Any hopelessness
Self-perception And Self-concept Pattern-
Sample NANDA nursing diagnosis
Body Image, Disturbed
Loneliness, Risk for
Personal Identity, Disturbed
Self-Concept, Readiness for Enhanced
Self-Esteem, Chronic Low, Situational
Low,
Risk for Situational Low
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8:RolesandRelationships:
Assessmentisfocusedontheperson's
rolesengagementandrelationships
withothers.
Includes perception of the current
major roles and responsibilities
Satisfaction with roles, role strain, or
dysfunctional relationships within the
family and socially may be identified.
Sample NANDA Nursing Diagnosis
Caregiver Role Strain, Risk for and Actual
Communication, Readiness for Enhanced
Family Process, Interrupted
Family Process, Readiness for Enhanced
Parent, Infant, and Child Attachment, Impaired,
Risk for
Parenting, Impaired, Risk for and Actual
Parenting, Readiness for Enhanced
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9:Sexuality and Reproduction:
Assessment is focused on the person's satisfaction or
dissatisfaction with sexuality patterns and reproductive
functions. Concerns with sexuality may he identified.
Individual assessment
History-consider age and situation
Sexual relationships and whether satisfying, any
Changes
Use of contraceptives
Menarche and menopause / andropose
LMP, dysmenorrhea,parity
Examination-Antenatal, pelvic examination & genital
examination if appropriate
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11.Values and Belief.
Assessment is focused on the person's values and
beliefs (including spiritual beliefs), or on the goals
that guide client’s choices or decisions.
It includes what is perceived as important in life
and perceived conflicts in values, beliefs or
expectations that are health related.
History
Important plans for the future
Importance Religion in life
Health actions that contradict beliefs
Sample NANDA nursing Diagnosis
Impaired Religious faith, Risk for and Actual
Spiritual Distress, Risk for and Actual
Spiritual Well-Being, Readiness for Enhanced
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REFERENCES AND FURTHER READINGS
FullerJillAyers-SchellerJenipher:HealthAssessmenta
NursingApproach.J.B.-Lippincottcompany
GordonMarjory-NursingDiagnosis:process&applications
Mosby
Websitesandrelevanttexts
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