1.

Patterns of Functioning

a. Breathing Patterns
Respiratory Problems: None
Usual Remedy: N/A
Manner of Breathing: with crackles

b. Circulation
Usual Blood Pressure: 100/70 - 90/60 mmHg
Any history of chest pain, palpitations, coldness of extremities, etc. None

c. Sleep Patterns
Usual bedtime:
Number of pillows:
Bedtime Rituals:
Problems regarding sleep:
Usual remedy:

d. Drinking Patterns
Kinds in Fluid in 24 hours/ Amount in mL or Number of Bottles:

Kind of Fluid Amount

water 2000 - 2500 ml

milk 240 - 300 ml

TOTAL: 2240 - 2800 ml

e. Eating Patterns

Usual Food Taken Time

(quantify) (range)

Breakfast

Lunch

Dinner

Snacks

Food Likes: leche flan

Food Dislikes:

f. Elimination Patterns
1. Bowel Movement
Frequency:
Problems or Difficulties: None
Usual Remedy: N/A
 2. Urination
Frequency:
Problems: None
Usual Remedy: N/A

g. Exercise:

h. Personal Hygiene
1. Bath
Type:
Frequency:
Time of Day:

2. Oral Care
Frequency:
Care of Dentures:

3. Shaving:
Frequency:

4. Use of Cosmetics:

i. Recreation:

j. Health Supervision: