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11 Funtional Health Pattern

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Health Promotion and the Individual



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Functional Health Patterns Assessment (Adult) Functional Health Patterns Assessment (Adult) d. Perceived ability (code for level) for: Feeding Dressing Cooking Bathing Grooming Shopping Toileting General mobility Bed mobility Home maintenance Functional Level Codes: Level 0: full self-care Level I: requires use of equipment or device Level II: requires assistance or supervision from another person Level III: requires assistance or supervision from another person and equipment or device Level IV: is dependent and does not participate 2. Examination a. Demonstrated ability (code listed above) for: Dressing Cooking Feeding Bathing Grooming Shopping Toileting General mobility b. Gait ________ Posture Absent body part? (Specify.) c. Range of motion (joints) Muscle firmness d. Hand grip Can pick up a pencil? e. Pulse (rate) (rhythm) Breath sounds f. Respirations (rate) (rhythm) Breath sounds g. Blood pressure h. General appearance (grooming, hygiene, and energy level)

1. History a. How has general health been? b. Any colds in past year? When appropriate: absences from work? c. Most important things you do to keep healthy? Think these things make a difference to health? (Include family folk remedies when appropriate.) Use of cigarettes, alcohol, drugs? Breast self-examination? d. Accidents (home, work, driving)? e. In past, been easy to find ways to follow suggestions from physicians or nurses? f. When appropriate: what do you think caused this illness? Actions taken when symptoms perceived? Results of action? g. When appropriate: things important to you in your health care? How can we be most helpful? 2. Examination—general health appearance

1. History a. Typical daily food intake? (Describe.) Supplements (vitamins, type of…...

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