Health Perception and Management

 How is your general health? Can you scale it from 1 to 10? 1 is when you feel sick the
most and 10 is when you feel the healthiest. 8/10
 Do you have any colds or cough in the past year? YES
 Do you have absences in your school? YES
 What are most important things you do that keeps you healthy? EXERCISING AND
TAKING MY VITAMINS
 Do you use cigarettes, alcohols, and drugs? ALCOHOL, OCCASIONALLY ONLY
 Any surgery in past? What type of surgery? YES, SURGICAL SUTURE
 Do you have any allergy? If yes, then type of allergy. YES, ALLERGIC RHINTIS (DUST
AND POLLEN)
 Last immunization? FLU VACCINE
 Any colds in the past year? If appropriate, absences from work/school? YES, NONE
 Accidents (home, work, driving)? Falls? YES

Nutritional metabolic

 How many times do you eat per day? 3 TIMES A DAY

 Can you recall of the food you intake for the past 3 weeks? NOODLES (PALABOK
AND SPAGHETTI), CHICKEN, BURGER STEAK AND FISH.
 What did you have for breakfast, Lunch, Dinner? BREAKFAST: NONE. LUNCH:
AMPALAYA WITH 1 CUP OF RICE. DINNER: CORNBEEF WITH 1 CUP OF RICE.

 Do you eat snacks? YES

 What are your food preferences? TASTE AND CONVENIENCE
 Do you have food allergies? NONE
 Are there any food preparations that is based on your religion or cultural setting?
NONE
 How about your appetite? NORMAL
 Do you experience a change in appetite? SOMETIMES WHEN I AM STRESSED
 Did you experience a sudden weight loss? NO
 When you’re eating, do you experience chewing or swallowing problems? NONE
 How about Heartburn or indigestion? NONE
 How was it relieved? N/A
 Do you experience healing problems? NONE
 Are there any dental problems? NONE
 Do you take vitamins? How about food supplements? YES
 Do you also drink herbal medicines? NO

Elimination-excretion patterns

 How often do you defecate? THREE TIMES A WEEK

 Can you describe me your stool? SOFT TO FIRM IN TEXTURE
 Do you experience discomfort or any pain when you defecate? NO
  Have you had bleeding in your stool? NO
 How about hemorroids? NONE
 Did you experience constipation? Is it acute or chronic? NO
 How about diarrhea? Is it acute or chronic? YES, ACUTE
 Are you using any laxative? If yes which? NO
 How often do you urinate within a day? 4 TIMES A DAY
 What is the color of your urine? YELLOWISH
 Do you experience problem in urinating? NO
 Do you also experience loss of control in your bladder? NO
 Have you had any history of kidney or bladder disease? NO
 How about in your perspiration, do you experience excessive perspiration? NONE
 How about odor problems? NONE

Activity and exercise

 Do you any breathing problem? (In which apnea, hypoxia, hypoxemia, hypercapnia.)
NONE
 Do you have cough? (Productive or non-productive) NONE
 Any changes in heart beat during exercise? NONE
 Do you feel pale during exercise? NO
 What type of exercise you do or any problem during exercise? AEROBIC AND
STRENGTHENING, NO PROBLEMS
 Since you are still a student, do you still have sufficient energy for the desired or
required activities? How about your exercise pattern? Do you still exercise regularly?
SOMETIMES I DO NOT HAVE THE SUFFICIENT ENERGY TO PURSUE MY EXERCISE
PATTERN AND REQUIRED ACTIVITIES
 What kind of exercises do you usually take? AEROBIC AND STRENGTHENING
 What are your leisure activities? CLEANING AND MEDITATING
 Do you have hobbies? Listening to music and watching movies
 Can you rate your activity level? Like from sedentary to very active? ACTIVE
 Tell me about your Activity diary. You can recall about the things you did the
moment you wake up in the morning.
First, when I wake up, I play with my dog and will make myself a hot chocolate
drink. After that I will rest and will prepare the food for lunch. After eating, I will
wash the dishes and clean the dirty kitchen. I will rest and will clean the house.
After cleaning I will eat dinner and take shower. I will do my assignments activities
in school and will pray before I sleep.
Sleep and Rest

 Can you tell me about your sleeping schedule? NOT CONSISTENT

 How many hours do you sleep? 5-6 HOURS
 Do you take naps? SOMETIMES
 Have you experience difficulty in falling asleep? Like how many minute or hours do it
take before you can sleep? YES, 2 HOURS
 What are your sleeping rituals? LISTENING TO MUSIC
  Have you also experience difficulty in staying asleep? What are the reasons for that?
YES, OVERTHINKING
 How about when you wake up, do you feel more rested or groggy? NO
 How many pillows do you have? 3 PILLOWS
 When you’re having difficulty in falling asleep, do you drink any medications or
herbals that can affect your sleep? NO
 Have you had insomnia before? YES
 Do you take relaxation techniques? YES
 Are you using any medication for sleeping? NO

Cognitive-Perception

 Did you have history of brain injury, trauma, stroke? NO

 Do you experience fainting or dizziness? YES
 How about headaches, how often do you have them? YES, I OFTEN HAVE THEM
WHEN I AM FACING MY LAPTOP IN A LONG PERIOD OF TIME.
 Is there any tingling/numbness/weakness sensations in any parts of your body?
NONE
 Do have any troubles in concentrating and memorizing? NONE
 Can you tell me what are your ways to learn? (Visual, auditory, tactile) VISUAL
 How about in vision, do you think your vision changed? Are you experiencing any
hearing loss or change? Is it sudden or gradual? NONE
 Is there any changes in your sense of smell? NONE
 How about in sense of taste? NONE
 Any change in memory lately? NONE
 Important decision easy or difficult to make? DIFFICULT
 Easiest way for you to learn things? Any difficulty? IN A VISUAL WAY

Self perception/self concept

 How do you describe yourself? (Like are you more positive or negative?) NEGATIVE
 Most of the time, do you feel good or not so good about yourself? NOT SO GOOD
 How would you rate your selfesteem, 1 to 10 with 10 being the highest) 5/10
 Can you tell me if you have problematic moods? (depressed, guilt, unreal,
ups/downs, apathetic, separated from the world, detached) UPS/DOWNS
 What are the things that frequently make you angry? Annoyed? Fearful? Anxious?
Depressed? MY MISTAKES AND THE FUTURE
 Are there any changes about the things you can do? (Do you take it as a problem or
no) YES, I TAKE IT AS A PROBLEM
 Have you experience lately some changes in the way you feel about yourself
(generally or since illness started?) YES, SINCE ILLNESS STARTED
 Are you a nervous person? YES
 Are your feelings easily hurt? SOMETIMES
  Can you tell me about what you do whenever you feel like you can’t control some
things? CRY, I AM DOING THE 5-4-3-2-1 COPING TECHNIQUE RULE AND THE
INHALE AND EXHALE BREATHING EXERCISE.
 Okay so what do you think helps? SOMEONE TO TALK TO AND SUPPORT SYSTEM
 Did you ever lose hope, like in life, in some things that are important to you? YES

Role and relationship

 Can you describe me your role within your family? THE ELDEST, RESPONSIBLE IN THE
HOUSEHOLD AND TO MY SIBLINGS SCHOOL RELATED ACTIVITES.
 Do you have any family problems you have difficulty handling? NONE
 Is there a family member that depends on you on some things? NONE
 If yes, how well are you managing? N/A
 How does your families/friends feel about your illness? THEY DO NOT KNOW
 Can you tell me your perception with your family members? SUPPORTIVE
 Have you experience feeling isolated within your family? NONE
 Do you have problems with children? NONE
 Do you belong to a social group? Is it big or small? SMALL
 Do you have close friends? YES
 When you are lonely, do you approach them? YES
 Can you describe me about your studies? FINE AND STILL PURSUING
 Do you also have a group of friends in your neighborhood? NONE

Sexuality and Reproduction

 Have you been in a sexual relationship? NONE

 If yes, are you sexually active? NO
 If yes, Do you use contraceptives? Like? NO
 For females, when menstruation started? Last menstrual period? Menstrual
problems? MY MENSTRUATION STARTED WHEN I WAS GRADE 5 IN YEAR 2012, MY
LAST MENSTRUAL PERIOD IS LAST MONTH JUNE 2021. NO MENSTRUAL PROBLEMS.
 Are there any sexual concerns or difficulties? Like for example, relationship problems
and role problems? NONE
 Have you been diagnosed with problems connected to your reproductive organ?
NONE

Coping-stress tolerance

 Any big changes in your life in the last year or two? Crisis? YES
 What are the things that makes you angry? MY MISTAKES
 What are your stressors in your life? SCHOOL
  If you are stressed with something right now, how would you describe your stress
level? IF I WOULD RATE IT, 9/10
 How do you manage anger or stress? I MEDITATE
 When you are stressed, do you talk about it with someone? YES
 When you are tensed, what are the things that helps? CALM ENVIRONMENT
 Do you take any medications, drugs, alcohol to relax? NO

Value-Belief Pattern

 What is the most important to you in your life? FAMILY, FRIENDS AND MY DREAMS
 Do you get things you want from life? YES
 What plans in the future do you want to accomplish? FINISH MY STUDIES AND
MIGRATE ABROAD WITH MY FAMILY
 What is your perception about religion? MIND-OPENING
 If believer, does talking with God help you when you are having hardships? YES, IT
MAKES MYSELF MORE CALM
 What gives you strength and hope? MY FAMILY
 Is there any health beliefs/values you want to share or inquire? NONE