Gordon's 11 functional health

• Marjorie Gordon (1987) proposed functional health patterns as a guide for establishing a comprehensive nursing data base.
• health perception and management Describes the client’s perceived health & well being and how health is managed.
• Nutritional / metabolic This pattern describes food and fluid consumption relative to metabolic need & pattern indicators of local nutrient supply.
• diet recall is a method of assessing dietary intake by asking participants to recall what they have eaten in the past
• elimination Describes the pattern of excretory function (bowel, bladder, skin).
• activity/exercise This pattern describes activity level, exercise program, and leisure activities.
• sleep/rest Describes patterns of sleep, rest, and relaxation.
• cognitive/perceptual Describes the ability of the individual to understand and follow directions, retain information, make decisions, and solve problems. Also assesses the five senses.
• self perception/self concept Describes client’s self-worth, comfort, body image, feeling state.
• values/belief pattern Describes the patterns of values, beliefs (including spiritual), and goals that guides the client’s choices or decisions.
• two types of exercise: isometric and isotonic
• repression is unconscious mechanism employed by the ego to keep disturbing or threatening thoughts from being conscious
• denial involves blocking external events from awareness. if some situation is just too much to handle, the person just refuses to experience it.
• projection involves individuals attributing their own unacceptable thoughts, feeling, and motives to another person
• displacement satisfying an impulse with a substitute object
• regression is a movement back in psychological time when one is faced with stress
• sublimation satisfying an impulse with a substitute object. in a socially acceptable way.
• complete health history Provides foundation for identifying health problems and provides a focus for the physical assessment. Should begin with an explanation to the client of why the information is being requested.
• biographical data Includes information that identifies the client and who provided the information.
• reason(s) for seeking health care “What is your major health problem or concerns at this time?” -also known as client’s chief complaints( CC)
• history of present health concern includes questions that provide detailed descriptions of the client’s present health problem
• To gather a comprehensive history of present concern as a nurse you may use the following mnemonic to organize data: PQRST OR COLDSPA
• C-character

  O-Onset

  L-location

  D-duration

  S-severity

  P-pattern

  A-associated factors
• P-precipitating factors

  Q-quality/character

  R-Region/Radiation

  S-Severity

  T-time/duration
• past health history: elicit data related to the client’s strengths and weaknesses in his health history. data obtained in this section aids the nurse to identify risk factors that stem from previous health problems (risk factors may be to the client or significant others)
• family health history: focuses on health problems that seem to run in families or those that are genetically based should include as many genetic relatives as the client can recall include maternal and paternal grandparents, aunts and uncles on both sides, parents, siblings and the client’s children
• lifestyle and health practices Describe how they are managing their lives, their awareness of healthy versus toxic living patterns Elicits data in the client related to his strengths and weaknesses
• developmental level Focuses on growth and development of an individual throughout the lifespan Freuds theory of psychosexual devt Erik eriksons psychosocial devt Piaget theory of cognitive devt Kholberg theory of moral devt
• personal-social – tasks which indicate the child’s ability to get along with people and to take care of himself
• fine motor adaptive – tasks which indicate the child’s ability to see and use his hands to pick up objects and to draw
• Language – tasks which indicate the child’s ability to hear, follow directions and to speak
• Gross motor – tasks which indicate the child’s ability to sit, walk and jump
• differentiate findings that result from the usual “wear and tear”/degenerative processes and those that indicate pathologic process
• “frail elderly”– vulnerability of aged people to be in poorer health, to have more chronic disabilities and to function less independently
• geriatric syndromes – the unique way in which a disease presents in a frail elderly.
• Geriatric syndromes include

  Sleep disorders

  Problems with eating or feeding

  Incontinence (bladder and bowel)

  Confusion

  Evidence of falls

  Skin breakdown
• functional assessment – an evaluation of the person’s ability to carry out the basic self-care activities of daily living (ADLs) such as bathing, eating, grooming and toileting
• functional assessment also includes those activities necessary for well-being and survival as an individual in a society (instrumental activities of daily living
• Basic ADLs consists of self-care task: personal hygiene, continence management, dressing, feeding, ambulating, toileting
• Instrumental ADLs not necessary for fundamental functioning, but they let an individual live independently in a community: companionship and mental support, transporting and shopping, preparing meals, managing household, managing medication and finances, communicating with others