GORDON’S FUNCTIONAL HEALTH PATTERN GUIDE

1. Health Perception and Management Pattern

• Reasons for hospitalization/ chief complaints

• Previous hospital experience

• Expectations from this hospitalization

• Anything liked or disliked about the care

• Feelings about the examination and treatments

• Things done to promote and manage health

• Patient’s statement of general appearance, condition of hair, skin, nails, etc

• Tobacco/cigarette/drugs/caffeine use

• Medications taken as maintenance

• Allergies

• When you become ill, whose help do you seek first?

• When a physician prescribes a treatment, diet or medication for you, how

closely do you follow his instruction?

• Do you have regular medical and dental check ups? How often?

2. Nutrition and Metabolic Pattern

• Special diet/supplements

• Pattern of daily food/fluid intake (number of meals, type, amount of fluid per
day)

• Usual appetite

• Nausea and Vomiting

• Weight loss or weight gain

• GI pain
 • Condition of oral mucous membrane

• Dental condition/ use of dentures

• Skin condition (warm, dry, cool, moist, etc)

• Turgor (supple, firm, dehydrated)

• Color (fair, pale, cyanotic, jaundiced, mottled)

• Presence of edema

• Wounds/ drains / dressing

• Skin problems

• Intravenous fluids/Total Parenteral Nutrition (type, rate)

3. Elimination Pattern

• What is your usual urinary pattern? (frequency, characteristics, pain upon

urination, color, smell, amount, incontinence, nocturia)

• Do you have abdominal tenderness or distention?

• What is your usual bowel pattern? (frequency, character, color, amount)

• Do you have constipation?

• Do you use anything to manage your bowel movement?

• Presence of stoma

• Bowel sounds

• Do you have excessive perspiration/ nocturnal sweats?

4. Sleep and Rest Pattern

• What time do you usually sleep?

• What routine do you go through in preparing for bed?

• Do you have any trouble sleeping?

• Has anything helped you to sleep better?

 • Do you take naps during the day? What time?

5. Activity / Exercise Pattern

• What do you usually do for exercise?

• How often do you do this?

• How much exercise is involved in your usual day?

• Are you right or left handed?

• Do you ever have chills? Fever? Night sweats?

• Do you ever feel lightheaded?

ADL

• What kind of bath do you prefer? What time of day?

• What skin preparation do you use? (soap, lotion)
• When do you brush your teeth?
• What brand of toothpaste do you use? Mouthwash?
• Do you have dentures, bridgework? What do you use for cleaning?

6. Cognitive/Perceptual Pattern

• Do you have any problems with seeing? Hearing? Speaking?

• Do you wear glasses/ contact lenses/ hearing aids?

• What other languages do you speak?

• Do you ever have pain or discomforts? Describe. What do you do for relief?

7. Value / Belief Pattern

• Which church do you attend?

• Would you describe yourself as active / passive in your going to church?

• What devotional literature do you usually read?

• If you wish your clergyman to visit you, what is his name?

• Do you have religious beliefs we should consider in planning your care?

 • Will illness / hospitalization interfere with any spiritual or religious
practices / family traditions? If yes, describe briefly.

8. Coping / Stress Pattern

• What do you do when you face particularly stressful experience?

• What do you do when you are upset?

• Whose counsel do you seek?

• What do you do for recreation? Hobbies?

• What would you like to do for diversion while ill?

9. Role / Relationship Pattern

• What is your occupation?

• What is your usual working hours?

• What do you like to do to keep in touch with relatives and friends?

• What is your position in the family?

10. Self-Perception / Self-Concept Pattern

• Statement of patient’s general appearance

• Are there any ways you feel differently about yourself since you’ve been
hospitalized/ill?

• Description of nonverbal behavior of patient

11. Sexuality/ Reproductive Pattern

• State whether single/married/separated

• Is there any problem with menstruation/pregnancy or use of birth control

measures?

• Do you do monthly self-breast exam/ self-testicular exam?

• Is there presence of vaginal discharge/bleeding/lesion?