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2. Nutritional-Metabolic Pattern
a. Describe your Family’s typical daily food intake? Do you consider your family healthy
eaters?
b. Describe your family’s typical daily fluid intake? Do you drink alcohol?
c. Does anyone consider themself over or under weight? Is there any unexplained weight
gain or loss?
3. Elimination Pattern
a. Describe your family’s regular bowel elimination pattern? Frequency? Character?
Discomfort? Difficulty?
b. Describe your family’s regular urinary elimination pattern? Frequency? Discomfort?
Problems with control?
4. Activity-Exercise Pattern
a. Do you exercise? What type? How often? If not, why?
b. What do you like to do in your spare time? What sports do you participate in?
5. Sleep-Rest Pattern
a. Do you feel that you are generally well rested and able to perform your daily activities?
b. How well do you fall asleep? Stay asleep? Do you use any aids to help you sleep?
c. Do you awaken feeling rested and ready to take on the day?
6. Cognitive-Perceptual Pattern
a. Does anyone have any difficulty hearing others?
b. Does anyone have difficulty seeing? Do you have routine eye exams?
c. How do you learn best? Preference for visual or audio aids? Do you have difficulty
learning?
9. Sexuality-Reproductive Pattern
a. Parents: How would you describe your sexual relationship? Satisfying? Changes?
Problems?
b. Female: Describe menstruation cycle. Problems? Last menstrual period? Para? Gravida?