NRS-429V: Family Centered Promotion
Family Health Assessment
Jacqueline Lawrence
April 14, 2013
Grand Canyon University
NRS-429V-Family-Centered Promotion
Professional nurses pushing families to take control over their health has always been a challenging issue. Encouraging individuals, families and communities to collaborate with health providers and join a shared approach at tackling health promotion together can be rewarding for all parties. Nursing theorist and professor, Marjory Gordon developed a functional health pattern assessment to provide a comprehensive patient assessment for nurses. (Current Nursing, 2011). Gordon’s principle guide nurses to collect subjective and objective data during an assessment and categorize the information into eleven functional …show more content…
health patterns. The patterns are then interpreted into nursing diagnoses to determine a patient or families level of understanding of health promotion, and offer the appropriate intervention to promote wellness. In this paper, the author has conducted a health assessment interview with the Taylor’s; a husband and wife family. A brief summary of the finding of each functional health pattern will be discussed. Also, five wellness nursing diagnoses based on the family’s assessment will be presented. Gordon’s eleven functional health patterns to be addressed are: Health Perception –Health Management, Nutritional-metabolic, Elimination, Activity-exercise, Sleep-rest, Cognitive-perceptual, Self-perception-self-concept, Role-relationship, Sexuality-reproductive, Value-belief, and Coping-stress tolerance pattern.
The Taylor’s married for 58 years, with four adult children and eight grandchildren. They presently live together in a three bedroom ranch style home. Mr. Taylor is a 78 year old retired truck driver, and Mrs. Taylor, a 75 year old retired environmental service worker. Mr. Taylor appears to be overweight; he walks with a limp and has a history of hypertension, high cholesterol, peripheral vascular disease, sleep apnea and is non-compliant with using his continuous positive airway pressure (CPAP) device at sleep. Mrs. Taylor on the other hand seemed averagely thin, with a history of hypertension and arthritis.
The interview began with an assessment of their values and perception of health.
Mrs. Taylor was found to have an acceptable concept on health; however her husband was thought to have a deficit in understanding how health maintenance works. He admitted he weighed 286 pounds, and was five feet, eleven inches tall. He stated that he attempted several diet plans in his past, and at his age he thinks it is pointless to watch what he eats. Mrs. Taylor commented in frustration, that she had tried everything in the book to help Mr. Taylor lose weight, but he continues to do whatever he wants to do. In defense, Mr. Taylor interjected, claiming that he has never forget taking his medications, and that he had never miss a doctor’s appointment. This pattern affects one’s lifestyle and ability to function, even when the person cannot see the problem. They feel they cannot manage their health or believe if they get involved it will be useless. (Edelman & Mandle, 2010). In this area, Mr. Taylor’s perception of health management appears erroneous, thinking that if he complies with taking his medication then that should suffice for health promotion in his …show more content…
book.
Under the nutritional-metabolic pattern assessment; this family eats all meals together. As Mrs. Taylor prepares most meals she disclosed a sample menu for the author to assess. They eat out twice a month but Mrs. Taylor is very conscious of counting calories. Mrs. Taylor eats three meals a day- properly portioned, and she stated she hardly snack in between meals but balances her meals with fruits and vegetables. Mr. Taylor was asked to describe his perception of nutrition; however he excused himself by admitting that his wife’s cooking is “amazing”, and that is his reason for weighing so much. His wife verbalized that her husband snacks on junk foods all the time and request double portions at meals. Daily fluid intake was about average and they both take a multivitamin every day. Mr. Taylor expressed that he would not mind losing weight and admitted he needs to try harder.
Both parties’ elimination patterns revealed no significant concerns, now that Mr. Taylor’s benign prostatic hyperplasia (BPH) is under control with medications that he takes daily. Mrs. Taylor’s exercise pattern consists of walking with a girlfriend twice a week and she enjoys gardening. Mr. Taylor admits he need to start exercising, however his leg bothers him from time to time. When asked to describe his energy level, he stated he often feels very tired at daytime. Immediately digging in into their sleep-rest pattern, the author learned that Mrs. Taylor sleep is uninterrupted because she sleeps in an adjacent bedroom next to the master where Mr. Taylor sleeps. Mr. Taylor has a history of sleep apnea, and has been non-compliant with using his CPAP at night for years, he admitted that his sleep pattern is constantly being interrupted and does not have the energy like he used to. “Sleep deprivation studies provide vivid demonstrations of the need for different types of sleep. Problems within this pattern may cause problems in other patterns” (Edelman & Mandle, 2010, p.157).
Cognitive-perceptual pattern area showed that Mr.
and Mrs. Taylor wear glasses; they follow up annually with their ophthalmologist. They both denied any hearing problems and have their hearing tested yearly as well. They were both able follow directions, retain information and converse in stimulating conversation with clear speech patterns observed. In their spare time the Taylor’s engages in games of chess, and dominoes with family and friends. Exploration of the couple’s self-concept patterns was examined. Mrs. Taylor thoughts expressed that the process of aging can be a difficult if you allow it, and Mr. Taylor’s responded that he would probably feel better with himself if he could lose some weight, and be able to take walks with his wife. “Individuals who feel good about themselves look and act differently from those who feel unable to accomplish anything worthwhile, patterns of eating, sleeping, and activity usually change if self-concept changes” (Edelman & Mandle. 2010, p.159). The roles-relationship patterns in the Taylor family were evidenced by the respect and love they have for each other during this interview. As stated by Mr. Taylor, “she is my best friend and we do everything
together”. Questions regarding the couple’s sexuality-reproductive pattern were evaded by the couple. The author sensed that the couple was not 100 percent comfortable discussing this topic and was therefore encouraged to speak with their provider with any pressing concerns in this area. Mr. Taylor comically responded that they have four children, Mrs. Taylor also joined in the humor. The final pattern to discuss was the coping-stress pattern. Mrs. Taylor verbalizes she handles stress through talking with her husband and children. Mr. Taylor response was equally the same with an addition of him playing dominoes and having an occasional drink with his eldest son and buddies. Both deny the use of anti-anxiety medications. Value-belief pattern was found to be intact.
In conclusion of this interview with the Taylor’s, an evaluation was conducted. A total of five wellness diagnoses were developed based on the family’s responses, patterns, and readiness to begin engaging in interventions to help them start a healthier lifestyle. The five diagnoses are: (1) Readiness for enhanced nutrition. (2) Readiness for enhanced management of therapeutic regimen. (3) Potential for enhanced physical fitness by decreasing weight and increasing muscle tone. (4) Potential for enhanced rest pattern by increasing effective sleep cycles. (5) Potential for enhanced self -esteem by increasing positive thoughts about self.
References
Current Nursing. (2011). Functional health patterns. Retrieved on April 8, 2013 from: http://nursingplanet.com/theory/functional_health_patterns.html Edelman,C., Mandle, C,L. (2010). Health promotion throughout the life span. (7th ed), pp.152-159. Mosby.
Jacqueline Lawrence
April 14, 2013
Grand Canyon University
NRS-429V-Family-Centered Promotion
Professional nurses pushing families to take control over their health has always been a challenging issue. Encouraging individuals, families and communities to collaborate with health providers and join a shared approach at tackling health promotion together can be rewarding for all parties. Nursing theorist and professor, Marjory Gordon developed a functional health pattern assessment to provide a comprehensive patient assessment for nurses. (Current Nursing, 2011). Gordon’s principle guide nurses to collect subjective and objective data during an assessment and categorize the information into eleven functional …show more content…
health patterns. The patterns are then interpreted into nursing diagnoses to determine a patient or families level of understanding of health promotion, and offer the appropriate intervention to promote wellness. In this paper, the author has conducted a health assessment interview with the Taylor’s; a husband and wife family. A brief summary of the finding of each functional health pattern will be discussed. Also, five wellness nursing diagnoses based on the family’s assessment will be presented. Gordon’s eleven functional health patterns to be addressed are: Health Perception –Health Management, Nutritional-metabolic, Elimination, Activity-exercise, Sleep-rest, Cognitive-perceptual, Self-perception-self-concept, Role-relationship, Sexuality-reproductive, Value-belief, and Coping-stress tolerance pattern.
The Taylor’s married for 58 years, with four adult children and eight grandchildren. They presently live together in a three bedroom ranch style home. Mr. Taylor is a 78 year old retired truck driver, and Mrs. Taylor, a 75 year old retired environmental service worker. Mr. Taylor appears to be overweight; he walks with a limp and has a history of hypertension, high cholesterol, peripheral vascular disease, sleep apnea and is non-compliant with using his continuous positive airway pressure (CPAP) device at sleep. Mrs. Taylor on the other hand seemed averagely thin, with a history of hypertension and arthritis.
The interview began with an assessment of their values and perception of health.
Mrs. Taylor was found to have an acceptable concept on health; however her husband was thought to have a deficit in understanding how health maintenance works. He admitted he weighed 286 pounds, and was five feet, eleven inches tall. He stated that he attempted several diet plans in his past, and at his age he thinks it is pointless to watch what he eats. Mrs. Taylor commented in frustration, that she had tried everything in the book to help Mr. Taylor lose weight, but he continues to do whatever he wants to do. In defense, Mr. Taylor interjected, claiming that he has never forget taking his medications, and that he had never miss a doctor’s appointment. This pattern affects one’s lifestyle and ability to function, even when the person cannot see the problem. They feel they cannot manage their health or believe if they get involved it will be useless. (Edelman & Mandle, 2010). In this area, Mr. Taylor’s perception of health management appears erroneous, thinking that if he complies with taking his medication then that should suffice for health promotion in his …show more content…
book.
Under the nutritional-metabolic pattern assessment; this family eats all meals together. As Mrs. Taylor prepares most meals she disclosed a sample menu for the author to assess. They eat out twice a month but Mrs. Taylor is very conscious of counting calories. Mrs. Taylor eats three meals a day- properly portioned, and she stated she hardly snack in between meals but balances her meals with fruits and vegetables. Mr. Taylor was asked to describe his perception of nutrition; however he excused himself by admitting that his wife’s cooking is “amazing”, and that is his reason for weighing so much. His wife verbalized that her husband snacks on junk foods all the time and request double portions at meals. Daily fluid intake was about average and they both take a multivitamin every day. Mr. Taylor expressed that he would not mind losing weight and admitted he needs to try harder.
Both parties’ elimination patterns revealed no significant concerns, now that Mr. Taylor’s benign prostatic hyperplasia (BPH) is under control with medications that he takes daily. Mrs. Taylor’s exercise pattern consists of walking with a girlfriend twice a week and she enjoys gardening. Mr. Taylor admits he need to start exercising, however his leg bothers him from time to time. When asked to describe his energy level, he stated he often feels very tired at daytime. Immediately digging in into their sleep-rest pattern, the author learned that Mrs. Taylor sleep is uninterrupted because she sleeps in an adjacent bedroom next to the master where Mr. Taylor sleeps. Mr. Taylor has a history of sleep apnea, and has been non-compliant with using his CPAP at night for years, he admitted that his sleep pattern is constantly being interrupted and does not have the energy like he used to. “Sleep deprivation studies provide vivid demonstrations of the need for different types of sleep. Problems within this pattern may cause problems in other patterns” (Edelman & Mandle, 2010, p.157).
Cognitive-perceptual pattern area showed that Mr.
and Mrs. Taylor wear glasses; they follow up annually with their ophthalmologist. They both denied any hearing problems and have their hearing tested yearly as well. They were both able follow directions, retain information and converse in stimulating conversation with clear speech patterns observed. In their spare time the Taylor’s engages in games of chess, and dominoes with family and friends. Exploration of the couple’s self-concept patterns was examined. Mrs. Taylor thoughts expressed that the process of aging can be a difficult if you allow it, and Mr. Taylor’s responded that he would probably feel better with himself if he could lose some weight, and be able to take walks with his wife. “Individuals who feel good about themselves look and act differently from those who feel unable to accomplish anything worthwhile, patterns of eating, sleeping, and activity usually change if self-concept changes” (Edelman & Mandle. 2010, p.159). The roles-relationship patterns in the Taylor family were evidenced by the respect and love they have for each other during this interview. As stated by Mr. Taylor, “she is my best friend and we do everything
together”. Questions regarding the couple’s sexuality-reproductive pattern were evaded by the couple. The author sensed that the couple was not 100 percent comfortable discussing this topic and was therefore encouraged to speak with their provider with any pressing concerns in this area. Mr. Taylor comically responded that they have four children, Mrs. Taylor also joined in the humor. The final pattern to discuss was the coping-stress pattern. Mrs. Taylor verbalizes she handles stress through talking with her husband and children. Mr. Taylor response was equally the same with an addition of him playing dominoes and having an occasional drink with his eldest son and buddies. Both deny the use of anti-anxiety medications. Value-belief pattern was found to be intact.
In conclusion of this interview with the Taylor’s, an evaluation was conducted. A total of five wellness diagnoses were developed based on the family’s responses, patterns, and readiness to begin engaging in interventions to help them start a healthier lifestyle. The five diagnoses are: (1) Readiness for enhanced nutrition. (2) Readiness for enhanced management of therapeutic regimen. (3) Potential for enhanced physical fitness by decreasing weight and increasing muscle tone. (4) Potential for enhanced rest pattern by increasing effective sleep cycles. (5) Potential for enhanced self -esteem by increasing positive thoughts about self.
References
Current Nursing. (2011). Functional health patterns. Retrieved on April 8, 2013 from: http://nursingplanet.com/theory/functional_health_patterns.html Edelman,C., Mandle, C,L. (2010). Health promotion throughout the life span. (7th ed), pp.152-159. Mosby.