Help with Gordon Functional Health Pattern

  1. 0
    hello i am writing a developmental paper about a a one year old child who was born with tetrology of fallot. the infant has recently had her second surgery for repair of the defect, and is hospitalized in the picu. the child develops congestive heart failure while in the unit; she also develops an irregular heartbeat (atrial fibrillation). she is the second child in the family; the parents have a healthy three year old.
    question: what would be an appropriate gordon functional health pattern for this infant.

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  2. 12 Comments...

  3. 1
    marjory gordon was the first president of nanda. the division of the nanda taxonomy is based upon her 11 functional health patterns although it has been slightly tweaked in the years since. she developed the concept of the functional health patterns as a method to assess the patient prior to determining the patient's nursing problems. the nursing diagnoses are the shortened labels of nursing problems. assessment is designed to reveal the symptoms, or abnormal data, a patient has. it is that abnormal data (symptoms) that serves as proof, or evidence, to support the choice of a nursing diagnosis you use. every nursing diagnosis has a list of defining characteristics (symptoms)

    your question: what would be an appropriate gordon functional health pattern for this infant? i don't know, and neither will anyone else that understands what this is all about. you need to perform a complete assessment of the 11 functional health needs on this patient in order to determine which one would be an appropriate one that establishes a nursing problem for which you can develop nursing interventions. this is just a specific assessment technique your school wants you to use to collect data prior to determining the patient's problem. you still need to follow the steps of the nursing process here. those steps are:
    1. assessment (collect data based on gordon's 11 functional health needs, look up information about your patient's medical diseases/conditions to learn about the signs and symptoms and pathophysiology, look up information about the normal developmental stages of children and assess your one year old's accomplishments against that)
    2. determination of the patient's problem(s)/nursing diagnosis (make a list of the abnormal assessment data, match your abnormal assessment data to likely nursing diagnoses, decide on the nursing diagnoses to use)
    3. planning (write measurable goals/outcomes and nursing interventions)
    4. implementation (initiate the care plan)
    5. evaluation (determine if goals/outcomes have been met)
    here are links to sites that have some information of what to ask in doing the assessment of the various categories of need:
    lulu997RN likes this.
  4. 0
    the only problem is my instructor made up this patient. we have not even had our peds rotation yet, so i do not know what to make up as the (Gordon functional health pattern) assessment for this one a 1 year old. i need serious help!
    Daytonite the links will help me alot thank u!!
  5. 1
    We use Gordon's functional health patterns while we are in fundamentals, we use the Doenges book.


    Since this is hypothetical, why instructors give hypothetical patients without "assessment info" I don't know, I would suggest getting information about the disease and what it does "typically" to a child at that age. Maybe go to a Pediatric website and do some digging.
    lulu997RN likes this.
  6. 1
    Quote from nurz2be
    We use Gordon's functional health patterns while we are in fundamentals, we use the Doenges book.


    Since this is hypothetical, why instructors give hypothetical patients without "assessment info" I don't know, I would suggest getting information about the disease and what it does "typically" to a child at that age. Maybe go to a Pediatric website and do some digging.
    I don't know why instructors do that either. It teaches us to use the nursing process wrong. It also reinforces that the nursing diagnosis hinges on the medical diagnosis, when it doesn't. Your instructor probabaly wants you to think of possible nursing diagnoses that are associated.

    For example:

    1. 1 year old with heart condition (this list is not complete, FYI)

    Health Perception Health Management Pattern
    Growth and Development, Delayed
    Injury, Risk for

    Activity Exercise Pattern
    Activity intolerance
    Cardiac Output, Decreased
    Mobility, Impaired Physical
    Tissue Perfusion, ineffective: Cardiopulmonary

    Nutritional-Metabolic Pattern
    Thermoregulation, Ineffective
    Infection, Risk for
    Tissue Integrity, Impaired
    Skin Integrity, Impaired

    2. 2nd child, first one healthy.

    Cognitive-Perceptual Pattern
    Parenting: Impaired
    Social isolation
    Comfort, Impaired
    Acute Pain

    Role-Relationship Pattern
    Family Processes, Interrupted
    Caregiver role strain
    Parenting, Impaired
    Social Interaction, Impaired
    Coping-Stress Tolerance Pattern

    On and on....

    We had to do this with hypothetical patients. We didn't have to list everything but we had to list what we would look for. Quite frankly how we were supposed to do that when we were not given assessment data other than what you have? It was more of a brain storming thing.

    I think this is why I sometimes feel NANDA and nursing dx are a joke. Because the way I was taught was just stupid. We were given the same hypothetical patient and came up with EVERYTHING you could thing of for a nursing diagnoses... and to me that just seemed like quackery. On one hand I am very proud of our nursing autonomy and think it is cool that we have our own language. But the way I was taught was just bunk.

    Our instructors gave us a hypothetical patient....we listed as many possible nursing dx and then we were suppose to "pick one" and write a care plan. What would our goals be...interventions, outcomes,...etc... Just by the instructor saying you have a 70 year old man who just had a heart attack. GO!

    Of course that was just during our fundamentals class. Clinical care plans were all together different.
    lulu997RN likes this.
  7. 0
    Thank you PsychNursewannaBe. This helps a lot and thank you for feeling my pain!
  8. 0
    thank you psychnursewannabe! this is a great help. and thank u for feeling my pain!
  9. 0
    Quote from lulu997
    thank you psychnursewannabe! this is a great help. and thank u for feeling my pain!
    You're welcome! Good luck and keep the Advil handy. LOL

  10. 1
    first, i'd begin looking up tetrology of fallot. write out the etiology, signs/symptoms, impact on body systems, sugggested n. internentions, etc. actually your can use daytonight's
    critical thinking flow sheet for nursing students

    as a guide to do this. then, design your n diagnoses around these signs and symptoms. look up congestive heart failure. there are distinctive signs/symptoms that will fit into several n diagnoses. this is also true of cardiac arrhythmias. i'm assuming with the one year old, there is a very concerned and anxious parent, who might work while having a hospitalized child? that is another possible n. diagnosis. after you tailor your diagnoses to your symptoms, a good care plan book will provide you with interventions, and rationales to go with them - and your done! good luck!
    lulu997RN likes this.
  11. 0
    Thank you Annie09 you rock!!. you all are definitely guiding me in the right direction.


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