Mind Map of Functional Health Patterns

[erican3232]

i have this "mind map" due. it's based on assessment data i collected during 5 functional health patteren interviews. i copied and pasted the assingnments i completed after the interview's. now i have to squeeze all that plus interventions on one sheet of paper.... i have add, and she wants me to produce a picture of whats in my head! lol

if any one has any suggestions.... i have the map started but i need to come up with two highest priority nursing diagnoses and five interventions for both diagnoses... i will try to copy and past the mind map i have so far... but i don't think i'll be able to.

functional health pattern: health perception-health management pattern

on november 14, 2009, i conducted an interview on jw in her home in xxx, mi. jw is a forty-five-year-old, eastern european female who lives in her home with her three children. jw is alert, cooperative and pleasant. she is a single parent who is very involved with her children's activities. she has three children: one child completing high school, one in middle school and her youngest is in elementary school. jw has a master's degree and teaches kindergarten. she is a member of a lutheran church in the town where she lives. her home is neat, clean and free of clutter.

jw has no allergies and has not had any colds in the past year. she does not use illegal drugs, smoke or consume alcohol. she is responsible for her health care needs and is able to make all recommended appointments to her primary-care physician, endocrinologist, physical therapist and dentist. she is up-to-date on her immunizations and received the optional seasonal influenza and h1n1 vaccination november 24, 2009. jw has no problems obtaining prescribed medications, when i asked her about her ability to pay for her health care needs she stated, "i have excellent insurance."

jw expressed her concern with her general health: "fair, because of my thyroid, i have low energy, fatigue, and weight gain." she goes on to say, "i feel stressed at times and i try to slow down and relax" jw has hypothyroidism, plantar fasciitis and passed four kidney stones last year; jw has no current kidney stones. she manages her planter fasciitis with physical therapy, shoe inserts and by doing stretching exercises before she gets out of bed, randomly throughout the day, and prior to bed. she takes all prescribed medications and recommended vitamins at the correct times each day.

based on this interview, i formulated three functional health strengths, they are readiness for enhanced immunization status this diagnosis is appropriate because j.w is a kindergarten teacher who has children in three different schools. she has expressed her ability and desire to obtain the vaccinations recommended by the center for disease control. the other two functional health strengths are readiness for enhanced therapeutic regimen management and [color=#333333]health-seeking behaviors. theses pattern both fit because j.w. has expressed her desire to follow a stricter diet that was recommended by her endocrinologist. the latter was chosen because j.w is constantly seeking out medical advice from health care professionals. this was evident when she asked me for diet advice during our interview.

based on this interview, i formulated two functional health deficits, one is risk for ineffective therapeutic regimen management and deficient knowledge related to the weight loss process. these are fitting nursing diagnoses because j.w stated several times that she does not know what her doctor wants her to eat. her doctor recommended a low carbohydrate, low protein, low "sugar" and low sodium diet. j.w. has gained 30 pounds over the last two years and she has expressed her desire to lose weight.

functional health pattern: elimination pattern

on november 14, 2009, i conducted an interview with j.w. in her home in xxxxx, michigan. j.w. is a forty-five-year-old, eastern european female who lives in her home with her three children. j.w. is alert, cooperative and pleasant. she is a single parent who is very involved with her children's activities. she has three children: one child completing high school, one in middle school and her youngest is in elementary school. j.w. has a master's degree and teaches kindergarten. she is a member of a lutheran church in the town where she lives. her home is neat, clean and free of clutter. j.w. does not consume alcohol, smoke or use any illegal drugs.

j.w. has a medical diagnosis of hypothyroidism. according to j.w., her doctor recommended a low carbohydrate, low protein, low sugar and low sodium diet. j.w. takes all prescribed medications and vitamins for the treatment of hypothyroidism. each time j.w. consumes a prescribed medication or multivitamin, she consumes a full eight ounces of water.

i asked j.w. about her urination habits. she stated, "i need to drink more water. other than that, i don't have any problems in that area." after asking some pertinent negatives, j.w. informed me that she passed four kidney stones last year (she has no current kidney stones); she urinates an average of six times a day, mostly in the mornings and; she was constipated regularly until recently. j.w. stated, "i was constipated because of all the medication and vitamins i have to take for my thyroid." j.w. believes she is no longer constipated because she consumes six to eight glasses of water each day and eats mostly fresh fruits and vegetables.

j.w. has not used anything to aid her with bowel elimination for about three months now. she states that, since she has changed her diet to include more fresh fruit and vegetables, her stools have been soft and formed. she then went on to say, "my pee is always clear."[color=#231f20]j.w. reports for the past two to three weeks, she has had soft, formed stool at least every other day. she reports her stools as brown with no mucous or blood. j.w. has had hemorrhoids but denies having any problems with them in the past three months.

[color=#231f20]j.w. tries to walk every day for at least thirty minutes and goes on bike rides with her children in the summer months. while walking or bike riding, j.w. sweats from her forehead and underarm areas, but the sweat does not drip off her. during routine activities of daily living, she does not sweat.

based on this interview, i was able to formulate two nanda nursing problems that labeled j.w.'s health deficits. the first is functional incontinence and the second is perceived constipation. functional incontinence is an appropriate diagnosis for j.w. because she stated, "i dribbled a little bit a couple times this year because i had to go to the bathroom as soon as class started." j.w. consumes more than thirty-six ounces of water before her class begins at 0800. she often has to empty her bladder because she consumes a significant amount of water prior to starting work. however, j.w. is a kindergarten teacher and is unable to leave her classroom unless another teacher is present. when asked what she does when she begins to feel pressure, she stated, "i just hold it until i get a break." risk for constipation was formulated for j.w. because she stated she was not having difficulty defecating at the time this interview took place. however, she has suffered from constipation in the recent past and has hemorrhoids. she takes calcium, iron and multivitamin gel-coated capsules.

based on this interview, i formulated a health strength of readiness for enhanced urinary elimination. this is fitting because j.w. has had urinary incontinence in the past due to her inability to get to a restroom. j.w. stated it was embarrassing and expressed her desire to not let that happen anymore. j.w. said, "i think i'm going to see if i can schedule a time where someone will come and watch my kids for five minutes. then, i can run to the bathroom about two hours after class begins." the aforementioned, nanda approved diagnoses best support the assessment data that i collected.

functional health pattern: activity-exercise pattern

on november 27, 2009, i conducted an interview with j.w. in her home in xx, michigan. j.w. is a forty-five-year-old, eastern european female who lives in a single-family home with her children. she is a single parent who is very involved with her children and their activities. she has 3 children: one child completing high school, one in middle school and her youngest is in elementary school. j.w. has a master's degree and teaches kindergarten. she is alert, cooperative and very pleasant. her home is neat, clean and free of clutter. she does not smoke, use any illegal drugs or consume alcohol. j.w. is five feet tall and weighs ninety kilograms. she has a body mass index of thirty-nine. j.w. has gained thirty pounds over the last two years. she has expressed her desire to lose weight during this interview.

j.w. has the medical diagnoses: hypothyroidism and; planter fasciitis. she follows a strict diet and takes all prescribed medication and multivitamins to manage her hypothyroidism. she manages her planter fasciitis with physical therapy, shoe inserts and by doing stretching exercises before she gets out of bed, randomly throughout the day and prior to bed. she makes all recommended appointments with her podiatrist. j.w. has a treadmill, in the living room of her home, that she uses every evening for twenty minutes after supper. she states, "i like to walk because it helps my feet feel better. if i can't walk outside, i use my treadmill." she went on to say, "i bend and move with my kids all day," in reference to her work as a kindergarten teacher. j.w. proudly stated, "according to my podiatrist, i'm doing really good." despite having plantar fasciitis j.w.'s range of motion or balance is not impaired. she remains independent and fully mobile. she has smooth, coordinated muscle movement. j.w. stated she has no problems related to her cardiovascular system or with shortness of breath.

j.w. manages her single-family home and the daily routines of her family. she is the sole financial provider for herself and her children. she does all the shopping and cooks most meals. j.w.'s children assist her with some chores. she is very active with her children's activities. her children range from age's nine to seventeen and their activity schedule's change frequently. currently, j.w. goes to their dance classes, play rehearsal, orchestra concerts, voice lessons, cub scouts and is a troop leader of girl scouts. she is also visiting colleges, throughout michigan and it's neighboring states, with her seventeen-year-old child.

j.w. is an active member of a lutheran church in the town where she lives. she volunteers in the church's nursery on sundays and takes part in the planning and teaching of vacation bible school. during this interview, j.w. expressed, "i'm probably not going to volunteer on sunday's much longer. i am just to busy."

after careful review, i was able to formulate the following functional health deficits: risk for activity intolerance related pain secondary to plantar fasciitisand; fatigue related to a busy lifestyle and lack of energy secondary to hypothyroidism. j.w. has hypothyroidism and symptoms related to it. she expressed having a lack of energy, wanting more energy and feeling's of guilt for not preforming up to her usual standards for routine activities. j.w. stated that over the past two years her tolerance for activity and exercise has decreased and many times she just wants to relax. j.w. went on to say, "i'm not able to keep up with the house and kids like i used to. sometimes, i wish i had someone to help." j.w. stated several times during our interview: "i wish i had more energy,"and "i am always tired".

readiness for enhanced self-care, was formulated as a wellness diagnosis for j.w. because she has been able to obtain information about her medical diagnoses and how to treat them. j.w. is knowledgeable about her role as a parent and teacher. she works very hard to care for her health but does want to work on weight loss. during this interview, j.w. stated, "i think i'm going to have "child b" and "child c" stay over night at their aunt's house, once or twice a month. hopefully, i will be able to catch-up on things and rest."

functional health pattern: sleep-rest

on december 4, 2009, i conducted an interview with j.w. in her home in xx, michigan. j.w. is a forty-five-year-old, eastern european female who lives in a single-family home with her children. she is a single parent who is very involved with her children and their activities. j.w. has a master's degree and teaches kindergarten. she is an active member of a lutheran church in the town where she lives. she is alert, cooperative and very pleasant. j.w.'s home is neat, clean and free of clutter. she does not smoke, use any illegal drugs or consume alcohol. she has the medical diagnoses: hypothyroidism and; planter fasciitis. she follows a strict diet and takes all prescribed medication and multivitamins to manage her hypothyroidism. she manages her planter fasciitis with physical therapy, shoe inserts and by doing stretching exercises.

j.w. doesn't have time to rest or relax during the day. she doesn't like to rest because then she will be tired and not want to do anything for the rest of the day. j.w. does have some quiet periods during the day however, they consist of driving, household chores, or completing work. j.w. admits, "i wish i had more energy," and "i am always tired." she goes on to say, " i think i sleep enough, i'm just tired because of my thyroid."

j.w. sleeps about eight hours on the weekdays and eight to ten hours on the weekend. she said, "i never really feel rested, even if i get to take a nap." she mentioned her two youngest children are going to start staying over night at their aunt's house, once or twice a month. she stated she would use that time to catch-up on things and rest. j.w. mentioned that if she doesn't stay active throughout the day she gets sleepy. when asked about feelings of sleepiness in a car she said, "i could never fall asleep driving. i can't even sleep in a car when someone else is driving. i guess i only feel like dozing off when i'm at home... in between activities." j.w. scored an eleven (mild sleepiness) on the epworth daytime sleepiness scale. she said that once she falls asleep she stays asleep.

j.w. prepares for bed at about 0800. then, she reads a chapter out of a book to her children prior to them going to sleep and prior to her walking. while she is walking, her children get ready for bed. j.w. stated, "i keep a pad of paper on my tread mill so, i can make a to-do list. once i make the list, i forget about it until the next morning." when she is done walking, she places her to-do list in her planner, and says goodnight to her children. j.w. goes to her room turns on her fan, and begins stretching. j.w. stated, "after i walk on my tread mill, i stretch and then go to bed. if i walk and stretch, just prior to going to bed i can fall asleep because my feet won't bother me. no matter how late it is i will walk and stretch before bed, otherwise i won't sleep. j.w. does not take sleep aids. her bedroom is conductive to sleep. she states her bed is, "very warm and comfortable."

after clustering this interview data, i formulated the wellness diagnosis, readiness for enhanced sleep. this diagnosis is supported because j.w. has established a sleep routine that promotes sleep without the use of pharmaceuticals. her bedtime routine in-cooperates exercise, stretching and relaxation. it also allows for alone time and family time. she writes things down for the next day so she doesn't have to think about them while relaxing or falling asleep. she is making time to rest biweekly by having her two younger children spend time with a family member. j.w. has been working with her endocrinologist to learn how to manage her feelings of being tired.

j.w. states the quality of her sleep is good. in her opinion, her feeling's of wanting more energy and being tired are attributed to her thyroid, not inadequate sleep. j.w. and health care providers are currently working on decreasing these symptoms. therefore, no functional deficits related to the sleep-rest pattern are applicable for j.w at this time.

functional health pattern: cognitive-perceptual pattern

on december 4, 2009, i conducted an interview with j.w. in her home in marshall, michigan. j.w. is a forty-five-year-old, eastern european female who lives in a single-family home with her three children. she is a single parent who is very involved with her children and their activities. she is alert and oriented to person, place, time and situation. she is cooperative and very pleasant. her home is neat, clean and free of clutter. she does not smoke, use any illegal drugs or consume alcohol.

j.w. has the medical diagnoses: hypothyroidism and; planter fasciitis. she follows a strict diet and takes all prescribed medication and multivitamins to manage her hypothyroidism. she manages her planter fasciitis with physical therapy, shoe inserts and stretching exercises. j.w. believes, her hypothyroidism caused her to gain 30 pounds (within the last two years) and, the weight gain caused her planter fasciitis. she expressed her desire to lose weight to her health care professionals. she stated, "my endocrinologist told me to eat a diet low in carbohydrates, low in fat, low in sodium, low in sugar, and low in protein. i don't know what i can eat."

j.w. has a master's degree and teaches kindergarten. english is her first language but she considers herself to be fluent in spanish, as well. j.w. states, " i learn best by hearing and reading. she enjoys reading but does not keep books or any other reading material in her room. j.w. does not have any hearing or vision problems. she is able to initiate, understand, maintain and appropriately respond to conversation. when comparing herself to those in her age group and educational level, j.w. feels she is of average intellect. she also feels her short-term and long-term memory are appropriate for her age. she had no concerns over her ability to recall information or events accurately.

based on this interview, i formulated two functional health deficits, they are: deficient knowledge and; acute pain. deficient knowledge is appropriate because j.w. verbally expressed her lack of knowledge pertaining to the diet that was recommended for her. acute pain of the heel was formulated for j.w. because she has pain that is mild to moderate in intensity and been present less than six months. when asked about pain, j.w. stated, "my heel aches especially in the morning. the pain was a four or five when it first started three months ago. this morning it was two, right now it's a one. my plantar fasciitis has been getting better."

after careful review, i formulated the wellness diagnosis readiness for enhanced comfort for j.w. this is appropriate for her because she experiences pain secondary to plantar fasciitis and has expressed her desire to improve her comfort. she stated "i keep doing my physical therapy because it helps relieve the pain." she purchased the recommended shoes and uses the shoe-inserts prescribed to her. she has also taken measures to ensure sufficient time to carry out recommended physical therapy.

any suggestions!??? .....anyone?

[erican3232]

I don't know what happened with the formatting. Sorry.

[Daytonite, BSN, RN]

i find a lot of repetition of information in these write-ups of yours. the purpose of mind mapping is to keep things shortened and concise. that means dropping out extraneous words.

you have come up with these nursing diagnoses:

• readiness for enhanced immunization status
  
• readiness for enhanced therapeutic regimen management (if she does not want to work on dieting then this is an inappropriate diagnosis)
  
• health-seeking behaviors
  
• risk for ineffective therapeutic regimen management
  
• deficient knowledge related to the weight loss process
  
• functional incontinence (this is urinary)
  
• perceived constipation
  
• risk for constipation
  
• readiness for enhanced urinary elimination
  
• risk for activity intolerance related pain secondary to plantar fasciitis
  
• fatigue related to a busy lifestyle and lack of energy secondary to hypothyroidism
  
• readiness for enhanced self-care
  
• readiness for enhanced sleep
  
• deficient knowledge
  
• acute pain
  
• readiness for enhanced comfort
  

first, many of these are not nanda-approved diagnoses.

second, priority would be done by maslow's hierarchy of needs. "readiness for" diagnoses are self-actualization needs and are at the top of maslow's pyramid, thus, of less importance than physiological needs. "risk for" diagnoses are potential problems and land at the bottom of diagnostic lists below actual problems. the sequencing of these diagnoses would be:

1. functional incontinence (this is urinary)
   
2. perceived constipation
   
3. fatigue related to a busy lifestyle and lack of energy secondary to hypothyroidism
   
4. acute pain
   
5. health-seeking behaviors
   
6. deficient knowledge related to the weight loss process
   
7. deficient knowledge (the topic of the knowledge to be taught needs to be specified)
   
8. readiness for enhanced urinary elimination
   
9. readiness for enhanced self-care
   
10. readiness for enhanced sleep
    
11. readiness for enhanced immunization status
    
12. readiness for enhanced therapeutic regimen management (if she does not want to work on dieting then this is an inappropriate diagnosis)
    
13. readiness for enhanced comfort
    
14. risk for activity intolerance related pain secondary to plantar fasciitis
    
15. risk for constipation
    
16. risk for ineffective therapeutic regimen management
    

your top two diagnoses would be functional incontinence (her urinary dribbling)and perceived constipation (this is self-explanatory). these are both actual physiological problems that are present and need to be addressed first before any of the others. however, re-read your write-ups. most of your reasons for choosing the diagnoses that you have are wrong. why is a diagnosis chosen? it is because your assessment information matches the defining characteristics and definition of that particular diagnosis. because you are not using nanda-approved diagnoses for some of these, you need to explain what those are because you do not clarify that in your write ups. fortunately, functional urinary incontinence and perceived constipation are approved nanda diagnoses and taxonomy information (definition, defining characteristics and related factors) for one of them is available on this website if you do not have a care plan book with the information or a copy of taber's cyclopedic medical dictionary (the taxonomy is in the appendix of current editions):

• functional urinary incontinence