SOUTHWESTERN UNIVERSITY PHINMA

College of Nursing

HEALTH ASSESSMENT LABORATORY

SELF- DIRECTED LEARNING 1

HEALTH HISTORY TAKING AND GORDON’S

FUNCTIONAL HEALTH PATTERNS

Badana, Danica Kaye B.

Domogho, Krisha Irene L.
Elumbaring, Franchesca Eve Lynne N.
Limalima, Sidney B.
Maquiwag, Mary Lou B.
Papasin, Christlyn Mae P.
A4

CLINICAL INSTRUCTOR
MR. MERCADO
PATIENT 1

HEALTH HISTORY:

a. Biographic Data

Name: Elaine Villacora

Gender: Female

Birthdate: December 07, 2000

Birthplace: Pagadian City

Age: 22

Address: Urgello Cebu City

Educational Level: 4th year- Dentistry

Marital Status: Single

Occupation: Student

Nationality: Filipino

Religion : Roman Catholic

Source of Data: Interview

Data and Time of Admission: 1/25/2023, 10:00 AM

Attending Physician:

Diagnosis: Insomnia

b. Past Medical History

The patient stated that she had experienced convulsions at the age of nine, which
led to one hospitalization. She was totally immunized as a newborn and had a Pfizer
immunization for COVID. She has no birthing issues and only suffers from chicken
pox and convulsions as her childhood illnesses. She claimed to be healthy at the
moment, to have undergone no surgeries, and to have only experienced one
accident—a car accident. She claimed she was pain-free at the time and disclosed
that she is allergic to chicken, seafood (shrimp), and alcohol. She also mentioned
that she takes cetirizine for allergies and only uses ointment as a self-medication .
c. Family Health History and Genogram

The patient stated that her great grandmother, who is 63 years old and has died, had
diabetes. Her grandfather, who is 82 years old, has had a stroke, arthritis and is
currently bedridden.

d. Psychosocial Health History

The patient reported that after she wake up she sometimes eat breakfast because
usually the moment she wakes up she just sit and surf the internet. She usually eats
fast foods, oily, and sweet foods and she also drink at least 10 glasses of water a day
reason why she urinate at least 6 times a day and defecate once a day. The patient
reported that she only has caffeine intake whenever she tries to study. She has 5
hours of sleep every day which explains why she doesn't feel rested. The patient
stated that walking and stretching is her daily exercise, her only hobby is to watch
tiktok and doesn't have any religious beliefs observed. She claimed that her
environment is not toxic, she also stated that one of her stressor is academic and her
coping mechanism is to thrift shop and eat with friends. She stated that her roles in
her family and society are youngest daughter and a student. She is concerned about
her body image and she thinks that she is not capable of doing things she used to be
capable of. One of her Self-care activities is to take a bath everyday and have a
regular dental check ups. The patient reported that she is an impulsive decision
maker.
GORDON’S FUNCTIONAL HEALTH PATTERN INCLUDING:

a. General Survey

The patient's height is 4'10", weight is 45 kg, waist and hip measurements are 23 to
24 cm, mid arm circumference is 8 cm, optimal weight is 48 kg, and BMI is 18.8.
While The patient's temperature is 36degrees, heart rate is 82, respiratory rate is 16,
blood pressure is 130/70, and the pain scale is zero.

Remarks: When I compute her height and weight, her body image index comes out
to be 20.7, which puts her in the normal level. And the vital signs are all normal

b. Health Perception and Health Management

The patient is oriented of the time, place, and people around her while undergoing
the assessment. She is cooperative and aware, and both current and remote
memories come easily to her. Her hearing, taste, and eyesight are all normal. Her
blunt, sharp, light touch, proprioception, cold, numbness and tingling are all normal.
while the Right and left nostrils are both fully functional when it comes to his smell.
Cranial nerves, cerebellar exam, reflexes are all normal, and no enlarged lymph
nodes in the neck She does not smoke, drink, or take drugs, and he normally has
decent health. She also doesn't have any ongoing medical conditions. Has received
all of his vaccinations, thus he has not sought out a medical assistant previously. She
rates the living conditions as good even though she is still a student and has no job.
and isn't difficult to find in terms of groceries, healthcare facilities, telephones,
pharmacies, and transportation. Despite not adhering to the recommended schedule,
she consumes a vitamin C (potency C) supplement of 500mg. In the previous year,
she had no mishaps, falls that resulted in injuries, and no issues with cutting.
Additionally, she doesn't regularly exercise. If only under stress, she felt dizzy.

Remarks: The patient’s mental status, vision, taste, touch, smell, cranial nerves,
cerebellar exam and flexes are normal after being evaluated and the result met
expectations.

c. Nutritional and Metabolic Pattern

The patient's skin is warm to the touch, there are no lesions or rashes, and the skin
turgor is supple and pink in color upon examination. His mouth is moist, he has no
lesions, his teeth are normal, he does not have dentures, his gums are normal, and
his tongue is normal. The eyes are moist, the conjunctiva is pink, and no lesions
are present. There is no edema, the thyroid is normal, there is no jugular vein
distention, and there is a gag reflex. The patient can easily walk and turn and is
dressed appropriately for the weather. The patient does not usually eat breakfast
and lunch. She eats only rice, oily foods, fast foods, and biscuits or bread for
snacks. The average fluid intake per day is 2-3 glasses of water and 1-2 cups of
coffee. She also stated that she likes eggs, chicken, and fries but dislikes
vegetables. Additionally, she stated that she had a problem with indigestion but it
did not happen too often.

Remarks: The patient appears to be in good wellbeing, with normal skin, teeth,
hair, nails, and mucous membranes despite her fluid intake is usually 2-3 glasses
per day only and no edema or lesions. However, local nutrient supplies are
insufficient because, as she mentioned, she only eats once or twice a day and eats
only rice, oily foods, fast foods, and sweet foods and does not eat vegetables
because she dislikes them.

d. Elimination Pattern

The patient usually experiences twice bowel movements a day. The appearance of
her stool is usually soft and brown in color. She doesn’t use any assistive devices to
bowel movement. She urinates about 2 times a day. The appearance of his urine is
from clear to yellowish. She has no urination problems nor uses any assistive
devices to urinate.

Remarks: The patient's bowel movements and urination are normal. The excretory
system works on a regular basis. There are no changes or disturbances in the time-
pattern, mode of excretion, quality, or quantity. There were also no devices in place
to assist excretion. There are no excretion problems such as incontinence,
constipation, or urinary retention

e. Activity- Exercise Pattern

Upon assessing the patient's activity-exercise pattern, the result of the

cardiovascular are of that, the cyanosis is absent and does not indicate any
anomalies. Her pulses can be easily palpated. The patient's extremities were warm
in regards to the temperature, her capillary refill is typical and pinkish in color and
took about 3 seconds to refill. The Homan's sign is negative, nails are normal and
are transparent, shiny, and firm in texture, the hair is normal and is equally
distributed throughout the scalp, claudication is not present. In the patient's heart,
there were no anomalies in the heart's sound or rhythm, and the PMI is situated
medially to the midclavicular line at the fifth intercostal space. On the patient's
respiratory, the results are: breathing rate is 15 and depth is deep, both of which
indicate a typical respiratory response. Because the patient is not coughing at the
moment, the sputum cannot be described, the patient's fremitus is not present, and
the chest excursion is equal. There were no abnormal sounds detected when
auscultating the chest. On the musculoskeletal side of the patient, range of motion
is not limited and is normal, there is a total movement of the patient's joint. The
patient's gait and balance are normal.

Remarks: After being assessed, the patient appears to not have any abnormalities
with her activity-exercise pattern. The outcomes were consistent with expectations

f. Sleep- Rest Pattern

According to the patient, in her usual night habits, she stated that she sleeps 5–6
hours every night and feels relaxed after waking up, though irregularly annoyed.
She also claimed that although she has trouble falling asleep, once asleep, she
stays asleep uninterrupted for a period of time. Insomnia does not, however,
appear to be a problem for the patient. The patient uses breathing techniques to
promote relaxation and ease sleepiness.

Remarks: The patient has an ineffective sleep pattern. Her signs and symptoms of
awakening at a time desired, waking up irritably at times, and a vocal report of
difficulty falling asleep are apparent indicators of this pattern

g. Cognitive- Perceptual Pattern

During the assessment the patient does not show any overt signs of pain. Patient
stated that her decision making is easy and inclined to make decisions rapidly.
Patient said that she can define what current problem is and restate current
therapeutic regimen.

Remarks: Patient is able to know what stress she is facing and how to deal with
them, with coping strategies.

h. Self- Perception, Self- Concept Pattern

During the interview the patient appears to be calm. There are no changes in the
physiologic parameter changes such as no face reddened, no voice volume
changed, and no voice quality change. Body language of the patient during the
interview is she observed good posture, keeps eye contact, and shows interest. The
major concern of the patient at the current time was her studies and her sleeping
schedule. Patient said the she is overwhelmed by the activities which causes her to
sleep late. Patient views her self in neutral. She believes that she will have
problems dealing with her current health situation because of sleep schedule and
her nutrition.

Remarks: Patient’s major concern is her studies and sleeping patient, patient’s view
herself in neutral; and believes that the admission will result and cause any lifestyle
and body changes.
i. Role-Relationship Pattern

The patient in speaks in Cebuano and Filipino. There are no speech issues during the
interview, and the patient participates fully and answers all the questions. The patient
initially remained silent when asked about her family before responding that she has
no complaints about them. The patient, who was born and raised in Pagadian City, is
currently staying in a dormitory close to the school.

Remarks: The patient has no stressful or dysfunctional relationships. Role behavior

that is consistent with role expectations and productive in social interactions with
persons, groups, or organizations. Her social involvement consists of interactions with
others and participation in activities.

j. Sexuality- Reproductive Pattern

The patient claims that her periods are regular. She said she is still satisfied with
her sexual relationship despite the fact that she has no significant other.

Remarks: The patient has an ineffective sexual pattern. There is an ineffective or

absent role model in her significant other and a fear of pregnancy and contracting a
sexually transmitted disease.

k. Coping- Stress Tolerance

The patient did not show any overt signs of stress throughout the assessment,
although she did have a stressful event when she was involved in a motor accident.
She rates her general stress management as Fair, and two of her coping
mechanisms include going thrift shopping and eating. Even though her family
doesn't attend counseling, she claimed to be happy with the support she received
from them because they made an attempt to understand her while she was under
stress.

Remake: Although the patient believes she does a good job of managing stress, her
coping mechanisms may indicate a stress intolerance that is addressed through
stress eating, going out, and thrift store shopping as diversionary initiatives.

l. Value- Belief Pattern

The patient displays no signs of mood alterations throughout the interview. She
asserted that she was content with the direction her life had taken and that this
admission would not have an impact on her future plans or her spiritual or religious
beliefs. She is a Roman Catholic and does not have any dietary limitations because
of her religion. She would not want a priest to come and visit her during her time in
admissions but claimed that her religion and religious beliefs helped her in dealing
with problems.

Remake: Patient stated that her religious belief has helped her in dealing with her
problems and does not follow any certain rules in dietary intake.
PROBLEM LIST

Number of Priority Focus/ Nursing Diagnosis

1 Insomnia/Disturbed sleep pattern related to metabolic
disease as evidenced by dark shadows under the eyes,
irritable, look of tiredness and lack of energy in the
morning
2 Imbalanced Nutrition: Less Than Body Requirements
related to knowledge deficit of appropriate foods to eat
and inability to absorb nutrients
3 Risk for disturbed personal identity related to low self-
esteem complex factors (lacks of self confidence,
unmotivated, shy, rejects positive feedback about self and
confusion about self)
Ineffective coping related to lack of sufficient coping
behaviors and outside compounding stressors
(relationships, deadlines, schedules)
5 Ineffective sexual patterns related to discomforts caused
by a fear of pregnancy and contracting a sexually
transmitted disease.
FDAR

DATE FOCUS TIME DAR

01/25/23 Trouble sleeping 10 am D: “mag lisod kog ka tug” as
patient stated. Patient is a
student who has a lot of
activities which made her stay
up all night. She also yawns
during the interview which can
be a sign of sleepiness.

A: First, advise patient to try

and establish a regular sleep
schedule. Go to bed and wake
up at the same time every day,
even on weekends. This will help
to regulate your body’s natural
sleep rhythm. Second, is to
create a relaxing bedtime
routine. This could involve
taking a warm bath, reading a
book, or stretching. Doing the
same thing every night will
signal to your body that it is
time to wind down and sleep.
Third, create a sleep-friendly
environment in your bedroom.
Make sure that the temperature
is cool, the lighting is dim, and
the noise level is low. This will
help your body to relax and fall
asleep more easily. Finally,
avoid caffeine and alcohol before
bed. Both of these substances
can interfere with sleep. If you
follow these recommendations,
you should be able to sleep
more easily and wake up feeling
rested and refreshed.

R: Patient is able to sleep with

the recommended time.
PATIENT 2

HEALTH HISTORY:

a. Biographic Data

Name: Joram Gil

Gender: Male

Birthdate: October 18, 2003

Birthplace: Ozamis City

Age: 19

Address: Urgello Cebu City

Educational Level: 1st- Pharmacy

Marital Status: Single

Occupation: Student

Nationality: Filipino

Religion: 7th day Adventist

Source of Data: Primary

Data and Time of Admission: 1/25/2023, 11:00 AM

Attending Physician:

Diagnosis: Acute pain related to migraine

b. Past Medical History

The patient acknowledges that he has previously had a fever and been hospitalized.
The patient claimed that, prior to his present hospitalization, he had only had fever,
a cough, and a cold. He was had a COVID-19 Pfizer and fully immunized. He is
sensitive to dust, pollen, and peanuts. He takes cetirizine for his allergies as part of
his prescription.
c. Family Health History and Genogram

The patient revealed that in their family's history, his aunt, who is 54 years old, is a
Stage 3 lymphoma survivor and is still alive. His 48-year-old father, who is still alive,
also has diabetes.

d. Psychosocial Health History

As part of his daily living, in the morning, he wakes up, pray, takes a bath and goes
to school for class. In the afternoon, he takes lunch after class runs errands and play
instrument. In the evening, he studies and do the assigned tasks. In his diet, he
claims that he doesn't eat pork and intakes at least 2L of water. He drinks caffeine
and urinates 5 times a day and defecate 2x a day. After a sleep, he is feeling rested.
He is not physically active and play instrument during his leisure time. In terms of
his religious belief, it is a part of them to not eat pork and shell fish. He adapts well
in his environment and home. When he became stress with his study, he manages it
by stress eating and playing instrument. According to him, his role is a student,
musician, and a son He has heath care activities such as proper hygiene. In his
developmental level, he has sensory abilities and adaptive skills
GORDON’S FUNCTIONAL HEALTH PATTERN INCLUDING:

a. General Survey

The patient's height is 4'10", weight is 46 kg, waist and hip measurements are 23 to
24 cm, mid arm circumference is 8 cm, optimal weight is 50 kg, and BMI is 17. While
The patient's temperature is 37 degrees, heart rate is 88, respiratory rate is 12, blood
pressure is 120/75, and the pain scale is zero.

Patient: When I compute his height and weight, his body image index comes out to
be 17, which puts him in the underweight level. And also the vital signs are all normal

b. Health Perception and Health Management

The patient is oriented of the time, place, and people around him while undergoing
the assessment. He is cooperative and aware, and both current and remote memories
come easily to him. his vision is 150/150. And He has a normal hearing and taste,
His blunt, sharp, light touch, proprioception, cold, numbness and tingling are all
normal. While the Right and left nostrils are both fully functional when it comes to
his smell. Cranial nerves, cerebbellar exam, reflexes are all normal, and no enlarged
lymph nodes in the neck He does not smoke, drink, or take drugs, and he normally
has decent health. He also doesn't have any ongoing medical conditions. Has received
all of his vaccinations, thus he has not sought out a medical assistant previously. He
rates the living conditions as good even though he is still a student and has no job.
and isn't difficult to find in terms of groceries, healthcare facilities, telephones,
pharmacies, and transportation. Despite not adhering to the recommended schedule,
he consumes a vitamin C (Scott C) supplement of 1 mg. In the previous year, he had
no mishaps, falls that resulted in injuries, and no issues with cutting. Additionally, he
doesn't regularly exercise. If only under stress, he felt dizzy.

Remarks: The patient's vision has 150/150 and his mental status down to reflexes
seemed to be normal after being evaluated, and the results met expectations.

c. Nutritional and Metabolic Pattern

The patient's skin is warm to the touch, there are no lesions or rashes, and the skin
turgor is supple and pink in color upon examination. His mouth is moist, he has no
lesions, his teeth are normal, he does not have dentures, his gums are normal, and
his tongue is normal. The eyes are moist, the conjunctiva is pink, and no lesions are
present. There is no edema, the thyroid is normal, there is no jugular vein distention,
and there is a gag reflex. The patient can easily walk and turn and is dressed
appropriately for the weather. The patient usually eats rice for breakfast, fish or
chicken for lunch and dinner. He eats biscuits or bread for snacks. He typically drinks
2-8 glasses of water per day and only 1 cup of coffee when he has exams. He has no
problems with his appetite. He has no history of a specially prescribed diet. He also
stated that religious practices inhibit him from eating pork and shellfish. He also
stated that he likes burgers. He is lactose intolerant. He takes vitamins, particularly
vitamin C. (Scotts C). There is a peanut allergy and no difficulty chewing or
swallowing.

Remarks: The patient appears to be in good wellbeing, with normal skin, teeth, hair,
nails, and mucous membranes and no edema or lesions. Food and fluid consumption
patterns are normal and adequate. He takes vitamin C, which aids in nutrient
absorption.

d. Elimination Pattern

The patient usually experiences twice bowel movements a day. The appearance of
his stool is usually a mix of hard and soft. He doesn't use any assistive devices to
bowel movement. But he mentioned that he had diarrhea yesterday (January 24,
2023). He usually urinates about 5 times a day. The appearance of his urine is from
clear to yellowish. He has no urination problems nor uses any assistive devices to
urinate.

Remarks: The patient's bowel movements and urination are normal. The excretory
system functions normally. There are no changes or disturbances in the time-pattern,
mode of excretion, quality, or quantity. There were also no devices in place to assist
excretion. He mentioned diarrhea as an excretory problem, but incontinence,
constipation, and urinary retention are not present

e. Activity- Exercise Pattern

Upon assessing the patient's activity-exercise pattern, the result of the cardiovascular
are of that, the cyanosis is absent and does not indicate any anomalies. His pulses
can be easily palpated. The patient's extremities were warm in regards to the
temperature, his capillary refill is typical and pinkish in color and took about 3 seconds
to refill. The Homan's sign is negative, nails are normal and are transparent, shiny,
and firm in texture, the hair is normal and is equally distributed throughout the scalp,
claudication is not present. In the patient's heart, there were no anomalies in the
heart's sound or rhythm, and the PMI is situated medially to the midclavicular line at
the fifth intercostal space. On the patient's respiratory, the results are: breathing
rate is 15 and depth is deep, both of which indicate a typical respiratory response.
Because the patient is not coughing at the moment, the sputum cannot be described,
the patient's fremitus is not present, and the chest excursion is equal. There were no
abnormal sounds detected when auscultating the chest. On the musculoskeletal side
of the patient, range of motion is not limited and is normal, there is a total movement
of the patient's joint. The patient's gait and balance are normal.
Remarks: After being assessed, the patient appears to not have any abnormalities
with her activity-exercise pattern. The outcomes were consistent with expectations.

f. Sleep- Rest Pattern

According to the patient, in his usual night habits, he stated that he sleeps 5 hours
every night, naps in the afternoon, and feels rested and relaxed upon waking up from
sleep. The patient claimed to be getting regular rest, had no trouble falling asleep,
and even got up early when his alarm went off. The patient neither displays
symptoms of insomnia nor uses any sort of medication or method to promote
sleepiness.

Remark: While the patient's sleep and rest patterns appear to be unproblematic, the
amount of time spent sleeping is insufficient and falls short of the recommended
minimum of 7-9 hours each night, sleeping just 5 hours instead of the amount needed
by the body.

g. Cognitive- Perceptual Pattern

Patient did not show any signs of overt pain. He stated the he is experiencing
migraine. The location of the pain is on his temporal, on the scale of 8/10, he
experiences this whenever he is pulling an “all nighter” or studying late at night, this
last about 5-8 hours and he uses liniments and sleep to ease the pain. Patient stated
that his decision making is easy and inclined to make decision is rapid. Patient can
identify what current problem is and can restate therapeutic regimen.

Remarks: Patient is able to know what stress he is facing and how to deal with them,
with coping strategies.

h. Self- Perception, Self- Concept Pattern

During the assessment patient appears to be anxious. He has no reddened face, no

voice volume changed, and no change in the quality of voice. Body language of the
patient during the interview is he observed shaking of legs, tapping on legs, but
shows interest. The major problem of the patient is he is experiencing migraine ever
night. Patient views himself in neutral.

Remarks: Patient’s major concern is his migraine, patient’s view himself in neutral;
and believes that the admission will result and cause any lifestyle and body changes
i. Role-Relationship Pattern

The patient in speaks in Cebuano and Filipino. There are no speech issues during the
interview, and the patient participates fully and answers all the questions. The patient
initially remained silent when asked about her family before responding that she has
no complaints about them. The patient, who was born and raised in Pagadian City, is
currently staying in a dormitory close to the school.

Remarks: The patient is experiencing social isolation, or the feelings of aloneness

attributed to interpersonal interaction below the level desired or required for personal
integrity. He is casually tapping his feet during the interview. The nurse can observe
for inconsistent communication, a lack of understanding of humor or sarcasm, or a
dislike of being touched as barriers to adequate socialization. Patients often divulge
information when living far away from family or having difficulties in personal
relationships.

j. Sexuality- Reproductive Pattern

The patient claimed that he has no issues with his prostate. The patient is content
with his sexual relationship despite not having significant other.

Remarks: The patient has an ineffective sexual pattern. There is an ineffective or

absent role model in her significant other. He is also having a concern regarding own
sexuality and is not able to express fully. The patient is aware of her sexual
functioning as a man.

k. Coping- Stress Tolerance

During the assessment, the patient displays no overt signs of stress and had a
stressful event which was when he first started to do a piano recital years ago. His
way in dealing with stress is to sleep and divert all his attention in playing musical
instruments and he rates his typical approach to stress as Good. Even though his
family doesn't attend counseling, he claimed to be happy with the support received
from them because they are considerate, empathetic, and supportive, especially
during times of stress.

Remarks: Even though the patient shows no overt indications of stress, his coping
mechanism of diverting his tension into sleeping and playing music signals the
presence of an ineffective denial, in which he consciously attempts to ignore the
knowledge of being stressed to reduce anxiety.
l. Value- Belief Pattern

When talking about values and beliefs, the patient doesn't appear to be experiencing
any mood changes. The patient claimed that he was happy with the course of his life
and that this admission wouldn't affect his future plans and his spiritual or religious
beliefs. The patient is a 7th Day Adventist, which explains why consuming dishes
including pork and shellfish is prohibited. He would appreciate it if their pastor will
come to see him because his religion and their religious beliefs helped him in dealing
with stress in the past by praying and advising him on what's best.

Remarks: His beliefs and value helped him in dealing with stress. The patient follows
certain rules that his religion practices.
PROBLEM LIST

NUMBER OF PRIORITY FOCUS/ NURSING DIAGNOSIS

1 Acute pain related to migraine evidence by stress and
pulsating sensation
2 Diarrhea related to the presence of toxins or ingestion
of suspected contaminated food.
3 Imbalanced Nutrition: Less Than Body Requirements
related to inability to ingest, digest or metabolize
nutrients as evidenced by weight loss, poor muscle
tone, and underweight
4 Risk for loneliness/ social isolation related to lack of
interpersonal interaction below the level desired or
required for personal integrity.
5 Ineffective sexual patterns related to expressions of
concern regarding own sexuality.
FDAR

DATE FOCUS TIME DAR

01/25/23 Migraine 11PM D: Patient stated that he is

experiencing headache
specifically in his posterior
temporal area. When he
has migraine he often
vomits.

A: Recommend patient
with the following: First,
it's important to identify
any triggers and avoid
them if possible. Common
triggers include stress,
bright lights, and certain
foods. If you can identify
your triggers, you can take
steps to avoid them.
Second, you should try to
get regular sleep and
exercise. Both of these
help to reduce stress,
which can trigger
migraines. Exercise also
helps to improve your
overall health, which can
help to reduce the
frequency of migraines.
Third, you should talk to
your doctor about
medication. There are a
number of different
medications that can help
to reduce the pain of
migraines and prevent
attacks. Your doctor can
help you to find the right
medication for you.
Fourth, you can try
alternative therapies.
Some people find that
acupuncture or massage
can help to reduce the
pain of migraines. There
are also a number of
herbal remedies that can
be effective.

R: Patient reported that

there was a relief from the
pain he is experiencing.
DOCUMENTATION: