UNIVERSIDAD DE MANILA
Republic of the Philippines
City of Manila
Name:_________________________________________
Instructor:______________________________________
Functional Health Patterns
1. Health Perception and Health
Management
2. Nutritional Metabolic Pattern
3. Elimination Pattern.
Public service through quality education.
Justice Cecilia Muñoz – Palma corner Mayor Antonio J. Villegas Street Mehan Gardens, Ermita, Manila, Philippines 1000
Tel. Nos. (+632)5336-6582/(+632)5336-8956/(+632)5336-8966 Fax No.(+632)336-6554 www.udm.edu.ph
COLLEGE OF HEALTH SCIENCES
DEPARTMENT OF NURSING
NCM 101 - HEALTH ASSESSMENT – RLE
Year/Section:_______________
FUNCTIONAL HEALTH PATTERN ASSESSMENT
Before During Illness/ Identified Nursing Problems
Illness/Hospitalization Hospitalization Nursing Diagnosis
The patient stated that he Noncompliance to treatment
Patient viewed health as a feels a little better and no regimen R/T
state in which he can longer needed to take  Lack/insufficient
perform his work daily and antibacterial medications knowledge about
with the absence of illness that he is supposed to medication treatment
and disease, he take for four more days protocol
considered himself as a since it is very costly. He  Lack/insufficient
healthy human being, if he verbalized to just take the financial resources
experience fever, cough antibiotic when he will not
and colds he takes OTC feel better again
drugs such as (Neozep,
Paracetamol and Solmux)
he rarely visited a doctor
to have a check up and
seek medical assistance.
He also used herbal
medicine such as oregano
and guava. Patient cannot
recall if he is fully
immunized.
The patient had no The patient has difficulty Impaired swallowing R/T
allergies to foods and swallowing due to poor weakness of the esophageal
drugs. He eats 3 meals a gag reflex. He has NGT muscles
day with snacks in and is on osteorized
between, he consumed 7- feeding q 4 hours . He has Risk for Aspiration RT
8 glasses (1680-1920ml) left sided body weakness Poor gag reflex
of water, he also had due to a stroke.,
coffee in the morning and
afternoon. At the age of
18 years old patient
started to drink alcohol
and stated that he had
drinks 2 times a week, he
took centrum as his
vitamins.
The client verbalized Impaired urinary elimination R/T
The patient usually voids urged to urinate but partial obstruction of the urethra
3-4 times a day, he experiences frequent or
defecated once a day urgent need to urinate,
daily, he didn’t experience increased frequency of
any problem in voiding urination at night
 UNIVERSIDAD DE MANILA
Republic of the Philippines
City of Manila
4. Activity and Exercise Pattern
5. Cognitive-Perceptual Pattern.
6. Sleep Rest Pattern.
7. Self-Perception-Self-Concept
Pattern
Public service through quality education.
Justice Cecilia Muñoz – Palma corner Mayor Antonio J. Villegas Street Mehan Gardens, Ermita, Manila, Philippines 1000
Tel. Nos. (+632)5336-6582/(+632)5336-8956/(+632)5336-8966 Fax No.(+632)336-6554 www.udm.edu.ph
and defecating. He never
used any chemical
laxatives and stool
softeners.
He stated that he did
some household chores at
home such as cleaning
their backyard and
gardening. As a soldier he
attended physical
exercise such as jogging ,
he also played
basketball.
The patient was oriented
to people, time and place,
responded to stimuli
verbally and physically.
He can speak and
understand Ibanag,
Ilocano and Tagalog. He
is a high school graduate
and able to read and
write.
The patient usually slept
7-8 hours, his earliest time
in going to sleep was at
8:00 pm and he woke up
at 4:00 am. Sometimes he
took naps at noon for
about 30 minutes. He
didn’t have any difficulties
going to sleep and not
used any medication to
promote sleep.
The client verbalizes Fear R/T outcome of medical
The patient was able to feeling of anxiousness treatment
express his feelings about that her operation will not
his condition, he felt turn out well.
(nocturia), difficulty
starting urination, weak
urine stream or a stream
that stops and starts.,
dribbling at the end of
urination.
Inability to completely
empty the bladder.
His pelvic UTZ shows
hypertrophy of the
prostate partially blocking
the urethra
The client experiences
difficulty in getting out of Ineffective breathing
bed and when going to pattern R/T physical
the toilet. Most of the exertion
times he felt dizzy and
weak that he needs Activity intolerance R/T
assistance when moving to weakness and dizziness
in bed.
He finds it difficult to feed Self-care deficit R/T to
himself and brush his fatigue and difficulty of
teeth. He easily feels tired breathing
and observed to have
increased respiratory
effort (RR-36)and use of
accessory muscles for
breathing after toileting.
Patient unable to Impaired memory R/T acute
recognize significant other pathologic changes in brain
present in the room. Does functioning.
not recall significant dates
like her birthday and
anniversaries. Relatives
claimed that it started
after having seizure.
The patient complains of Sleep deprivation R/T
not having sufficient sleep
for the past 2 days due to
various nursing
procedures and activities
in the ward. She feels
lightheaded and tired.
There are dark circles
around her eyes
Anxiety R/T unfamiliarity with
 UNIVERSIDAD DE MANILA
Republic of the Philippines
City of Manila
8. Role-Relationship Pattern.
9. Sexuality and Reproduction.
10. Coping-Stress Tolerance
Pattern.
11. Value-Belief Pattern
Public service through quality education.
Justice Cecilia Muñoz – Palma corner Mayor Antonio J. Villegas Street Mehan Gardens, Ermita, Manila, Philippines 1000
Tel. Nos. (+632)5336-6582/(+632)5336-8956/(+632)5336-8966 Fax No.(+632)336-6554 www.udm.edu.ph
annoyed about his medical treatment
condition, but he also
wanted to feel better, he
was contented seeing his
family, grateful of their
support, love and care.
The things that made him
stressed were problems
caused by pressure at
work and sometimes by
his family.
The patient assumed the The client verbalized that Dysfunctional family processes
role of a father to his child he can not ask for support R/T
and a husband to his wife. from his family because of
He stated that he had no a recent marital issue with
enough time spent with his spouse. He is living
his family due to his work, alone and recently has
but they were able to been out of job.
maintain good
communication. There
were no conflicts among
them and shared his ideas
when it comes to decision
making.
The patient was
circumcised when he was
10 years old, got married
at the age of 24 years old.
They have a 1-year-old
baby girl.
The patient coped up with
stress by watching tv,
cleaning their backyard
and gardening. When they
had problems in the
family, they resolved it by
means of talking to each
other. The patient had a
traumatic event before
when he witnessed the
death of his co-soldier
during a call of duty.
The patient’s religious
affiliation is Roman
Catholic, he seldom went
 UNIVERSIDAD DE MANILA
Republic of the Philippines
City of Manila

to church due to his job

but never forgotten to
pray. He usually went to
church with his wife and
child. He also believes in
quack doctors.

Grading Criteria

Criteria Excellent Very Satisfactory Satisfactory Poor

16-20 11-15 6-10 1-5
Accuracy of Data
Completeness of
Data
Organization and
Coherence
Grammar and
Mechanics
Clarity and
Neatness
Subtotal
Total Score: ___________________

Conformed: Evaluated by:

___________________________________ ____________ _________________________________

Student Date: Instructor

Public service through quality education.

Justice Cecilia Muñoz – Palma corner Mayor Antonio J. Villegas Street Mehan Gardens, Ermita, Manila, Philippines 1000
Tel. Nos. (+632)5336-6582/(+632)5336-8956/(+632)5336-8966 Fax No.(+632)336-6554 www.udm.edu.ph