Gordon’s functional Health Pattern
Health Perception –Health Maintenance Pattern
Client’s description of general health
Health Practices ,may include those related to managing a chronic illness
Use of Alcohol, tobacco and other substances
Home,School and Occupational Safety
Client’s description of the cause of the illness (if present) and actions taken to manage
it.
Nutritional-Metabolic Pattern
Does the Client seem well nourished and well developed in general appearance?
Is the client overweight or underweight for the age and height ? Weight Changes over
last 6 months?
What is the client’s usual dietary pattern?Describe typical daily food and fluid intake.
Does the client adhere to a special diet?
How does the client’s skin look? Are their lesions? Is the skin dry?
What is the client’s body temeperature?
What was the client’s recent cholesterol level?
Does the client have diabetes or a family history of diabetes?
Does the client have dental problems? Swallowing Problems?
History of gastrointestinal or endocrine problems?
Elimination Pattern
What are your usual bowel and bladder habits?
What are the frequency, consistency and color of your stool?
Do you have difficulty with urination?
Do you experience incontinence?
How would you describe your use of laxatives or other aids to elimination
Do you have a history of bowel or bladder problems?
Activity-Exercise Pattern
What are your usual daily activities?
What is your general level of physical fitness?
Do you have a history of cardiac or respiratory problems?
What activities are you the most pleasure?
Do you need help with home maintenance?
What is your activity intolerance
What is your usual pattern of exercise?
Do you lead a sedentary lifestyle?
Are you satisfied with your level of activity?
Do you smoke? How many packs per day? For how many years?
Are you able to feed yourself ,bathe ,go to the toilet ,groom yourself and move about in
bed?
Can you do the shopping and cooking ,maintain your home and achieve general
mobility?
Do you use a cane or walker or need help for walking?
Sleep Rest Pattern
What is your usual pattern of sleep? Rituals?Reading?
toothbrushing.stretching,meditation,watching TV?
Do you feel rested in the morning?
Do you use sleeping aids?
Are you able to sleep through the night?
Do you have trouble falling asleep?
Cognitive-Perceptual Pattern
Do you have any difficulty with vision? Do you used glasses for reading or distance
vision?
Do you have any difficulty with hearing? Do you use a hearing aid?
What is your name? Where do you live? What brought you to the hospital? What day is
it?
How long have you been here? Pain/Discomfort? Heat/ Cold intolerance?
Self Perception Self Concept Pattern
What can you tell about yourself?
How will this hospitalization affect your life?
How would you describe your support systems?
Who relies on you?
Where do you go for moral support?
What do you do to take care of yourself?
How do you feel about being ill? In the hospital?
Do you have anxiety? How does it affect you?
Do you have a history of anxiety disorders? Have you used psychotropic drugs? Alcohol?
Street drugs?
Role Relationship Pattern
Who are the member of your household?
How would you characterize the strength of your marriage?
Is your family dependent on you? How are they managing your hospitalization or
illness?
What are the ages of your children? Where do they live?
Do close family ties characterize your family?
When someone is ill,how does your family offer support?
Do you have
