PATIENT INFORMATION

Age- 20

Birthdate- Oct 28 1999

Gender- F

Address- Butuan City

Date of assessment- September 20

Birth place- Butuan City

Religion- Born Again

Nationality- Filipino

Educational level- College

Weight- 96

Height- 171 cm

Civil status- Single

PARENTS INFORMATION

Father Mother
Birthdate Dec. 15, 1970 Dec. 16, 1972
Age 49 47
Occupation Business Man Business woman
Religion Born Again Born Again
Address Butuan City Butuan City

SIBLING INFORMATION

SIBLING 1 SIBLING 2
Birthdate Nov. 18, 2003 June 18, 2009
Age 16 11
Sex Male Female
Educational Attainment Junior High School Elementary
 1. Kanus a mana nag start ang symptoms? -3 years old

2. Pilay duration ato? Days, weeks month? weeks

3. Unsay sevirity ato? If ipa-rate ka from 1-10 unsa man sya? Unsaon man nimu pag describe sa
symptoms? 5 but if I start to panic and hyperventilate then Probably 7.

4. How often mo occur imong condition? Unsay maka trigger? I cannot really say how often because
it can happen anytime. My triggers are smoky areas (like areas where people smoke, bbq Station, a
house that uses katol) , if I'm in a dusty area, if I have Colds that clogs my nose, if I eat too much
chicken, if I'm near a cat and chemical fragrant sprays (like baygon and unnatural air freshener, ).

System na na feel

●Cardiovascular- nakafeel baka ug chest pain/ palpitation?

Palpitation happens to me whenever I'm having severe asthma attacks because I start to panic and find
my medicine. Chest pain normally happens when my asthma attack starts to happen.

●Respiratory

Gaka experience baka ug cough, wheezes(kanang sound while ga ginhawa ka like whistle bitaw), chest
pain, dyspnea(kanang shortness of breath or maglisod kag ginhawa)

- yes, that's how I know that I'm having asthma attack when I start wheezing at the same time have
chest pain and I can't breathe well anymore.

●Gastrointestinal

Loss of appetite/ nausea/ vomiting/indigestion/weight loss/abdominal pain/bowel habit

- no, I never experienced those because of asthma.

●Urinary

Volume of urine passed/frequency/ dysuria/ urgency/ incontinence

- none

●CNS

Vision/ headache/loss of conciousness/confusion

- a slight headache, maybe because of panicking but If I remain calm then it doesn't happen.
●Musculoskeletal

Bine and joint pain/ muscular pain

- I have joint pain because I have patella Maltracking but it has nothing to do with my asthma.

●Dermatology

Rashes/skin breaks /ulcers

- none.

Gordons

1. Health Perception and Management Pattern

-Have you ever been admitted to the hospital? Yes or no? If yes, what is the reason.

- no

-Did you take any medication at home? Yes or no, if yes, what is the reason for taking medication?

- yes, ventolin. I will not be relived without any medication.

-How the medication given? Liquid in spoon? Liquid in cup? Tablet? Specify.

- it is by 2.5 mg or 5 mg

- we don't take it orally like a pill or a syrup but it is a solution for inhalation which means we used a
nebulizer to inhail the solution. It is breathed in through the mouth.

-Do you have trouble in taking medication? Yes or no? If yes, what do you do?

- no.

2. Nutritional-Metabolic Pattern

-What time do you usually eat your breakfast? Lunch? And dinner?

- 7am

-do your family member eat together? Yes? No? Sometimes?

- yes

-what is your favorite food?

- pasta

3. Elimination Pattern
-How many times you urinate(sa isa ka adlaw)?

- 5-7 times

-what is the usual pattern elimination? (When ka gakalibang, example kanang everyday ba, once a
week, twice a week, or 1 month)

- 2-3 times a day

-do you have problem when you urinate and eliminate? Yes or no? And why?

- no, what I know I'm normal in urinating and elimainate because I am aware that my water intake is
pretty good.

4. Sleep-rest Pattern

-what time you usually sleep? And awake?

10:30 - 5:30

-what is your nap schedule?

None

-do you have special routine before you sleep? Yes or no?

What is your routine?

- devotionals and prayer

- stop using phone 30 min before bed.

5. Activity exercise pattern

-what is your schedule during the day?

8-9 pm school works

-what is your habit?

-listening to podcast, gardening and cooking

-bathing schedule?

8 am

-do you have dental habit (kanang like hilig baka magkitkit ug koko/ballpen/lapis, ga toothbrush baka,
gagamit bakag mouthwash or dental floss)?

Toothbrush 3 times a day with tongue scrapper and dental floss.

6. Cognitive-Perceptual Pattern
-do you have hearing difficulties?

No

-do you have vision problem?

Yes, High astigmatism

7.Self-Perception Pattern

-what makes you angry? Anxious? Sad? Fearful or afraid of?

- loud voices

8. Role- Relationship Pattern

-who usually take care of you if your condition trigger?

- at this age no one.

9. Coping- Stress Tolerance Pattern

-how you handle your condition?

- I always try to put in my mind I can never solve anything emotionally but I have to take action
immediately.

10. Value Belief Pattern

-what is your religion?

- born again

-what are your religion practices?

- nothing, I just focus on my relationship with God.