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Functional Assessments




     Maria Carmela L. Domocmat, RN ,MSN
Functional Assessments
Gordon’s Functional Health Patterns
Katz Index of Independence
Barthel Index




           Maria Carmela L. Domocmat, RN ,MSN
GORDON’S FUNCTIONAL
HEALTH PATTERNS
      Maria Carmela L. Domocmat, RN ,MSN
Marjorie Gordon (1987) proposed
functional health patterns as a guide for
establishing a comprehensive nursing data
base.




           Maria Carmela L. Domocmat, RN ,MSN
These 11 categories make possible a
systematic and standardized approach to
data collection, and enable the nurse to
determine the following aspects of health
and human function:




            Maria Carmela L. Domocmat, RN ,MSN
1 Health Perception and Management
2 Nutritional metabolic
3 Elimination
4 Activity exercise
5 Sleep rest
6 Cognitive-perceptual
7 Self perception/self concept
8 Role relationship
9 Sexuality reproductive
10 Coping-stress tolerance
11 Value-Belief Pattern


  Maria Carmela L. Domocmat, RN ,MSN
1 Health Perception and Management
2 Nutritional metabolic
3 Elimination
4 Activity exercise
5 Sleep rest
6 Cognitive-perceptual




            Maria Carmela L. Domocmat, RN ,MSN
7 Self perception/self concept
8 Role relationship
9 Sexuality reproductive
10 Coping-stress tolerance
11 Value-Belief Pattern




              Maria Carmela L. Domocmat, RN ,MSN
(1) Health Perception and Health
          Management
 Data collection is focused on the person's
   perceived level of health and well-being, and
   on practices for maintaining health




              Maria Carmela L. Domocmat, RN ,MSN
Health Perception and Health
        Management
Habits that may be detrimental to health are
also evaluated, including smoking and alcohol
or drug use.
Actual or potential problems r/t
  safety & health management
  needs for modifications in the home or needs for
  continued care in the home.




            Maria Carmela L. Domocmat, RN ,MSN
(2) Nutrition and Metabolism
Assessment is focused on the
 pattern of food and fluid consumption relative
 to metabolic need.
 The adequacy of local nutrient supplies is
 evaluated.
 Actual or potential problems related to fluid
 balance, tissue integrity, and host defenses
 may be identified as well as problems with the
 gastrointestinal system.

            Maria Carmela L. Domocmat, RN ,MSN
(3) Elimination
Data collection is focused on excretory
patterns (bowel, bladder, skin).
Excretory problems such as incontinence,
constipation, diarrhea, and urinary
retention may be identified.




           Maria Carmela L. Domocmat, RN ,MSN
(4) Activity and Exercise
Assessment is focused on the
 activities of daily living requiring energy
 expenditure, including self-care activities,
 exercise, and leisure activities.
 The status of major body systems involved
 with activity and exercise is evaluated,
 including the respiratory, cardiovascular, and
 musculoskeletal systems.


            Maria Carmela L. Domocmat, RN ,MSN
Cognition and Perception. Assessment
is focused on the ability to comprehend
and use information and on the sensory
functions. Data pertaining to neurologic
functions are collected to aid this process.
Sensory experiences such as pain and
altered sensory input may be identified
and further evaluated.

            Maria Carmela L. Domocmat, RN ,MSN
Sleep and Rest. Assessment is focused
on the person's sleep, rest, and relaxation
practices. Dysfunctional sleep patterns,
fatigue, and responses to sleep
deprivation may be identified.




            Maria Carmela L. Domocmat, RN ,MSN
Self-Perception and Self-
Concept. Assessment is focused on the
person's attitudes toward self, including
identity, body image, and sense of self-
worth. The person's level of self-esteem
and response to threats to his or her self-
concept may be identified.


            Maria Carmela L. Domocmat, RN ,MSN
Roles and Relationships. Assessment is
focused on the person's roles in the world
and relationships with others. Satisfaction
with roles, role strain, or dysfunctional
relationships may be further evaluated.




            Maria Carmela L. Domocmat, RN ,MSN
Sexuality and
Reproduction. Assessment is focused on
the person's satisfaction or dissatisfaction
with sexuality patterns and reproductive
functions. Concerns with sexuality may he
identified.



            Maria Carmela L. Domocmat, RN ,MSN
Coping and Stress Tolerance.
Assessment is focused on the person's
perception of stress and on his or her
coping strategies Support systems are
evaluated, and symptoms of stress are
noted. The effectiveness of a person's
coping strategies in terms of stress
tolerance may be further evaluated.

           Maria Carmela L. Domocmat, RN ,MSN
Values and Belief. Assessment is
focused on the person's values and beliefs
(including spiritual beliefs), or on the goals
that guide his or her choices or decisions.




             Maria Carmela L. Domocmat, RN ,MSN
Maria Carmela L. Domocmat, RN ,MSN
Maria Carmela L. Domocmat, RN ,MSN
Maria Carmela L. Domocmat, RN ,MSN
Maria Carmela L. Domocmat, RN ,MSN
Maria Carmela L. Domocmat, RN ,MSN
Critical Thinking Exercise 2:
      Clustering of Data




        Maria Carmela L. Domocmat, RN ,MSN
On a separate piece of paper, cluster the
following data according to Gordon’s
Functional Health Patterns.
When you organized these data, you have
found that some categories had no data
listed. If this happens to you in the clinical
area, what should you do?


             Maria Carmela L. Domocmat, RN ,MSN
Case history
Age 36
Married, has three small children
Occupation: landscape architect and
homemaker
Religion: Baptist




           Maria Carmela L. Domocmat, RN ,MSN
Case history
Medical diagnosis: Pneumonia
T: 38.3; P: 100; R: 28; :BP: 104/68
States she is concerned about how her
husband is caring for the children, that “it
is tough on him.”




             Maria Carmela L. Domocmat, RN ,MSN
States she feels weak and tired all the
time but can’t seem to rest because she
keeps coughing all the time.
Appetite poor. Has eaten less than half of
regular meals. Is forcing fluids well
(1000ml per shift)



            Maria Carmela L. Domocmat, RN ,MSN
Before illness, she smoked a pack of
cigarettes a day but has not smoked since
hospitalization
States she always has been in good
health and never had to be hospitalized
(even gave birth at home)



           Maria Carmela L. Domocmat, RN ,MSN
States that all of the tests that have to be
done make her nervous; she is worried
about getting AIDS from needle sticks.
Lungs have bilateral rhonchi; she coughs
up thick yellow mucus




             Maria Carmela L. Domocmat, RN ,MSN
Chest x-ray shows improvement over the
last 2 days
White blood cell count is elevated at
16,000.




           Maria Carmela L. Domocmat, RN ,MSN

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functional assessments

  • 1. Functional Assessments Maria Carmela L. Domocmat, RN ,MSN
  • 2. Functional Assessments Gordon’s Functional Health Patterns Katz Index of Independence Barthel Index Maria Carmela L. Domocmat, RN ,MSN
  • 3. GORDON’S FUNCTIONAL HEALTH PATTERNS Maria Carmela L. Domocmat, RN ,MSN
  • 4. Marjorie Gordon (1987) proposed functional health patterns as a guide for establishing a comprehensive nursing data base. Maria Carmela L. Domocmat, RN ,MSN
  • 5. These 11 categories make possible a systematic and standardized approach to data collection, and enable the nurse to determine the following aspects of health and human function: Maria Carmela L. Domocmat, RN ,MSN
  • 6. 1 Health Perception and Management 2 Nutritional metabolic 3 Elimination 4 Activity exercise 5 Sleep rest 6 Cognitive-perceptual 7 Self perception/self concept 8 Role relationship 9 Sexuality reproductive 10 Coping-stress tolerance 11 Value-Belief Pattern Maria Carmela L. Domocmat, RN ,MSN
  • 7. 1 Health Perception and Management 2 Nutritional metabolic 3 Elimination 4 Activity exercise 5 Sleep rest 6 Cognitive-perceptual Maria Carmela L. Domocmat, RN ,MSN
  • 8. 7 Self perception/self concept 8 Role relationship 9 Sexuality reproductive 10 Coping-stress tolerance 11 Value-Belief Pattern Maria Carmela L. Domocmat, RN ,MSN
  • 9. (1) Health Perception and Health Management Data collection is focused on the person's perceived level of health and well-being, and on practices for maintaining health Maria Carmela L. Domocmat, RN ,MSN
  • 10. Health Perception and Health Management Habits that may be detrimental to health are also evaluated, including smoking and alcohol or drug use. Actual or potential problems r/t safety & health management needs for modifications in the home or needs for continued care in the home. Maria Carmela L. Domocmat, RN ,MSN
  • 11. (2) Nutrition and Metabolism Assessment is focused on the pattern of food and fluid consumption relative to metabolic need. The adequacy of local nutrient supplies is evaluated. Actual or potential problems related to fluid balance, tissue integrity, and host defenses may be identified as well as problems with the gastrointestinal system. Maria Carmela L. Domocmat, RN ,MSN
  • 12. (3) Elimination Data collection is focused on excretory patterns (bowel, bladder, skin). Excretory problems such as incontinence, constipation, diarrhea, and urinary retention may be identified. Maria Carmela L. Domocmat, RN ,MSN
  • 13. (4) Activity and Exercise Assessment is focused on the activities of daily living requiring energy expenditure, including self-care activities, exercise, and leisure activities. The status of major body systems involved with activity and exercise is evaluated, including the respiratory, cardiovascular, and musculoskeletal systems. Maria Carmela L. Domocmat, RN ,MSN
  • 14. Cognition and Perception. Assessment is focused on the ability to comprehend and use information and on the sensory functions. Data pertaining to neurologic functions are collected to aid this process. Sensory experiences such as pain and altered sensory input may be identified and further evaluated. Maria Carmela L. Domocmat, RN ,MSN
  • 15. Sleep and Rest. Assessment is focused on the person's sleep, rest, and relaxation practices. Dysfunctional sleep patterns, fatigue, and responses to sleep deprivation may be identified. Maria Carmela L. Domocmat, RN ,MSN
  • 16. Self-Perception and Self- Concept. Assessment is focused on the person's attitudes toward self, including identity, body image, and sense of self- worth. The person's level of self-esteem and response to threats to his or her self- concept may be identified. Maria Carmela L. Domocmat, RN ,MSN
  • 17. Roles and Relationships. Assessment is focused on the person's roles in the world and relationships with others. Satisfaction with roles, role strain, or dysfunctional relationships may be further evaluated. Maria Carmela L. Domocmat, RN ,MSN
  • 18. Sexuality and Reproduction. Assessment is focused on the person's satisfaction or dissatisfaction with sexuality patterns and reproductive functions. Concerns with sexuality may he identified. Maria Carmela L. Domocmat, RN ,MSN
  • 19. Coping and Stress Tolerance. Assessment is focused on the person's perception of stress and on his or her coping strategies Support systems are evaluated, and symptoms of stress are noted. The effectiveness of a person's coping strategies in terms of stress tolerance may be further evaluated. Maria Carmela L. Domocmat, RN ,MSN
  • 20. Values and Belief. Assessment is focused on the person's values and beliefs (including spiritual beliefs), or on the goals that guide his or her choices or decisions. Maria Carmela L. Domocmat, RN ,MSN
  • 21. Maria Carmela L. Domocmat, RN ,MSN
  • 22. Maria Carmela L. Domocmat, RN ,MSN
  • 23. Maria Carmela L. Domocmat, RN ,MSN
  • 24. Maria Carmela L. Domocmat, RN ,MSN
  • 25. Maria Carmela L. Domocmat, RN ,MSN
  • 26. Critical Thinking Exercise 2: Clustering of Data Maria Carmela L. Domocmat, RN ,MSN
  • 27. On a separate piece of paper, cluster the following data according to Gordon’s Functional Health Patterns. When you organized these data, you have found that some categories had no data listed. If this happens to you in the clinical area, what should you do? Maria Carmela L. Domocmat, RN ,MSN
  • 28. Case history Age 36 Married, has three small children Occupation: landscape architect and homemaker Religion: Baptist Maria Carmela L. Domocmat, RN ,MSN
  • 29. Case history Medical diagnosis: Pneumonia T: 38.3; P: 100; R: 28; :BP: 104/68 States she is concerned about how her husband is caring for the children, that “it is tough on him.” Maria Carmela L. Domocmat, RN ,MSN
  • 30. States she feels weak and tired all the time but can’t seem to rest because she keeps coughing all the time. Appetite poor. Has eaten less than half of regular meals. Is forcing fluids well (1000ml per shift) Maria Carmela L. Domocmat, RN ,MSN
  • 31. Before illness, she smoked a pack of cigarettes a day but has not smoked since hospitalization States she always has been in good health and never had to be hospitalized (even gave birth at home) Maria Carmela L. Domocmat, RN ,MSN
  • 32. States that all of the tests that have to be done make her nervous; she is worried about getting AIDS from needle sticks. Lungs have bilateral rhonchi; she coughs up thick yellow mucus Maria Carmela L. Domocmat, RN ,MSN
  • 33. Chest x-ray shows improvement over the last 2 days White blood cell count is elevated at 16,000. Maria Carmela L. Domocmat, RN ,MSN