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    Gorden Health Patterns

    Uploaded by

    Loyal Lovly
    Assessment of CA lungs

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Gorden Health Patterns

    Uploaded by

    Loyal Lovly
    1 views2 pages
    Assessment of CA lungs

    Original Title

    Gorden health patterns

    Copyright

    © © All Rights Reserved

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    PDF, TXT or read online from Scribd

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    Assessment of CA lungs

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    1 views2 pages

    Gorden Health Patterns

    Uploaded by

    Loyal Lovly
    Assessment of CA lungs

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    HISTORY FORM BASED ON GORDON’S FUNCTIONAL HEALTH PATTERNS

    (1)Health Perception and Health Management Pattern


    What is your opinion about health?
    Are you immunized about seven target diseases?
    Last immunization?
    Do you have any allergy? If yes then type of allergy.
    Any surgery in past? What type of surgery?
    Last physical examination & for what purpose.
    Are you using any medicine recently?
    Do you know about these medicines?
    (2) Nutrition and Metabolism Pattern
    What is your diet menu?
    Any food restriction regarding disease point of view?
    Any food restriction regarding religious point of view?
    Any food like or dislike?
    Any food allergy?
    (3) Elimination Pattern
    Urine:
    Color of urine: ---------------- Amount: ------------------ Frequency: ----------------- Odor:
    ----------------
    Any discharge: ------------------------
    Any urinary problem, dysuria, Anuria, Oliguria, polyuria.
    Defecation:
    Are you using any laxative? If yes which?
    Any problem during passing defecation?
    (4) Activity and Exercise Pattern
    Do you any breathing problem?
    In which apnea, hypoxia, hypoxemia, and hypercapnia:
    Do you have cough? (Productive or nonproductive):
    Any changes in heart beat during exercise?
    Do you feel pale during exercise?
    What type of exercise you do or any problem during exercise?
    (5) Cognition and Perception Pattern
    Orientation about time place and person.
    Any difficulty in sentence making?
    Loss of memory
    (6) Sleep and Rest Pattern
    Sleeping hour?
    Are you using nap (evening type sleeping?
    What do you feel after waking? (Fresh, headache, drowsy)
    Are you using any medication for sleeping?
    Do you have any exercise or walking at night?
    (7) Self-Perception and Self-Concept Pattern
    What is your self-perception about yourself?
    Are you satisfied with your self-body image?
    Do you like grooming?
    (8) Roles and Relationships Pattern
    What is your role in family?
    If you are in hospital then who will perform your responsibilities?
    All the family members are cooperative with you?
    Who is decision maker in your family?
    (9) Sexuality and Reproduction Pattern
    When you first notice changes in your menarche (first menses is called menarche)
    Do you have any sexual problem? (loss of libido)
    Active sex (direct sex with male and female)
    Passive sex (sex without male and female partner)
    Reproductive: Infertility
    (10) Coping and Stress Tolerance Pattern
    If you have stress then what is your coping mechanism towards stress?
    Crying, angry, violence
    What is your opinion regarding that?
    (11) Values and Belief Pattern
    What is your religion?
    Do you offer prayer?

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