This document provides an overview of NANDA (North American Nursing Diagnosis Association) and functional health patterns. It defines NANDA as clinical judgments about individual, family or community responses to actual or potential health problems. It lists the 12 functional health patterns which are tools for nursing assessment: health perception, nutritional, elimination, activity, sexuality, sleep, sensory, cognitive, role relationships, coping, values and beliefs. For each pattern, it provides examples of subjective and objective data to collect and potential nursing diagnoses. The overall document serves as a guide for nursing students to learn about assessment and formulation of nursing diagnoses.

1. UNIT II-Overview of NANDA and Overview of
Functional Health Patterns
BY
SEHRISH NAZ
RN, Post RN, MSN
Lecturer, Institute of Nursing Sciences, Khyber Medical University
Subject: Adult Health Nursing

2. At the end of the unit, students will be able to:
• Define NANDA
• Formulate nursing diagnosis
• Define Functional health patterns
• Discuss the purpose of utilizing FHP as a tool for
assessment for patients
• Enumerate the Functional health patterns and their basic
concepts
• Obtain history taking and physical examination of the
client through utilizing
• FHP Formulate nursing diagnosis based on FHP
assessment tool Identify altered physiological functions
based on FHP.
2/8/2020 Post RN semester 1 AHN 2

3. Definition of (NANDA)
The North American Nursing Diagnosis
Association (NANAD 1994) defines a nursing
diagnosis as “A clinical judgments about
individual, family or community response to
actual and potential health problems and life
responses”
2/8/2020 Post RN semester 1 AHN 3

4. Functional health pattern (NANDA)
1- Health Perception-Health Management Pattern
2- Nutritional—Metabolic Pattern
3- Elimination Pattern
4- Activity—Exercise Pattern
5- Sexuality—Reproduction Pattern
6- Sleep—Rest Pattern
7- Sensory—Perceptual Pattern
8- Cognitive Pattern
9- Role—Relationship Pattern
10- Self-Perception-Self-Concept Pattern
11- Coping-Stress Tolerance Pattern
12- Value—Belief Pattern
2/8/2020 Post RN semester 1 AHN 4

5. Health Perception-Health Management
Pattern
1- Determine how the client perceives and
manages his or her health.
2- Compliance with current and past nursing
and, medical recommendations.
3- The client's ability to perceive the
relationship between activities of daily
living and health.
2/8/2020 Post RN semester 1 AHN 5

6. Subjective Data
 Client's Perception of Health:
Describe your health.
 Client's Perception of Illness
Describe your illness or current health problem.
 Health Management and Habits
Tell me what you do when you have a health problem.
 Compliance with Prescribed Medications and Treatments
Have you been able to take your prescribed medications?
If not, what caused your inability to do so?
2/8/2020 Post RN semester 1 AHN 6
Objective Data
Refer to General Physical Survey

7. Associated Nursing Diagnoses
 Wellness Diagnoses
Effective Management of Therapeutic Regimen
 Risk Diagnoses
Risk for Injury
Risk for Suffocation
Risk for Trauma
 Actual Diagnoses
Altered Growth and Development
Ineffective Management of Therapeutic Regimen: Individual
Ineffective Management of Therapeutic Regimen: Family
Ineffective Management of Therapeutic Regimen: Community
Noncompliance
2/8/2020 Post RN semester 1 AHN 7

8. Nutritional-Metabolic Pattern
Assessing the client's nutritional-metabolic pattern
is to determine the client's dietary habits and
metabolic needs. The conditions of hair, skin,
nails, teeth and mucous membranes are assessed.
Subjective Data
 Dietary and Fluid Intake
Describe the type and amount of food you eat at breakfast, lunch,
and supper on an average day.
Do-you take any vitamin supplements? Describe.
Do you find it difficult to tolerate certain foods? Specify.
Do you ever experience nausea and vomiting? Describe.
Do you ever experience abdominal pains? Describe.
2/8/2020 Post RN semester 1 AHN 8

9. Condition of Skin
Describe the condition of your skin.
How well and how quickly does your skin heal?
Do you have any skin lesions? Describe.
Do you have any itching? What do you do for relief?
Condition of Hair and Nails
Have you had difficulty with scalp itching or sores?
Do you use any special hair or scalp care products?
Have you noticed any changes in your nails? Color
Cracking? Shape? Lines?
2/8/2020 Post RN semester 1 AHN 9

10. Metabolism
What would you consider to be your "ideal weight"?
Have you had any recent weight gains or losses?
Do you have any intolerance to heat or cold?
Have you noted any changes in your eating or
drinking habits? Explain.
Have you noticed any voice changes?
2/8/2020 Post RN semester 1 AHN 10
Objective Data
Assess the client's temperature, pulse, respirations, and height
and weight.

11. Wellness Diagnoses
Opportunity to enhance nutritional metabolic pattern
Opportunity to enhance effective breastfeeding
Opportunity to enhance skin integrity
Risk Diagnoses
Risk for Altered Body Temperature
Hypothermia
Risk for Infection
Risk for altered nutrition less than body requirements .
Risk for Aspiration
2/8/2020 Post RN semester 1 AHN 11

12. Actual Diagnoses
Fluid Volume Deficit
Fluid Volume Excess
Altered Nutrition: Less than body requirements
Altered Nutrition: More than body requirements
Ineffective Breastfeeding
Altered Oral Mucous Membrane
Impaired Skin Integrity.
2/8/2020 Post RN semester 1 AHN 12

13. Elimination Pattern
Adequacy of the client's bowel and bladder.
The client's bowel and urinary habits.
Bowel or urinary problems.
Use of urinary or bowel elimination devices.
2/8/2020 Post RN semester 1 AHN 13

14. Subjective Data
Bowel Habits
How frequent are your bowel movements?
Do you use laxatives? What kind and how often do you use
them?
Do you use enemas or suppositories? How often and what
kind?
Do you have any discomfort with your bowel movements?
Describe.
2/8/2020 Post RN semester 1 AHN 14

15. Bladder Habits
How frequently do you urinate?
What is the amount and color of your urine?
Do you have any of the following problems with urinating:
 Pain? Blood in urine? Difficulty starting a stream?
Incontinence? Voiding frequently at night? Voiding
frequently during day? Bladder infections?
 Have you ever had a urinary catheter? Describe. When?
How long?
Objective Data
Refer to abdominal assessment, and the rectal assessment.
2/8/2020 Post RN semester 1 AHN 15

16. Associated nursing-Diagnoses
Wellness Diagnoses
Opportunity to enhance adequate bowel elimination pattern
Opportunity to enhance adequate urinary elimination pattern
Risk Diagnoses
Risk for constipation
Risk for altered urinary elimination
2/8/2020 Post RN semester 1 AHN 16

17. Actual Diagnoses
Altered Bowel Elimination Constipation
Diarrhea
Bowel Incontinence
Altered Urinary Elimination Patterns of Urinary
Retention
Total Incontinence
Stress Incontinence
2/8/2020 Post RN semester 1 AHN 17

18. Activity-Exercise Pattern
Activities of daily living, including routines of exercise,
leisure, and recreation.
Activities necessary for personal hygiene, cooking,
shopping, eating, maintaining the home, and working.
An assessment is made of any factors that affect or interfere
with the client's routine activities of daily living.
2/8/2020 Post RN semester 1 AHN 18

19. Subjective Data
 Describe your activities on a normal day (Including hygiene activities, eating
activities).
 Do you have difficulty with any of these self-care activities? Explain.
 Does anyone help you with these activities? How?
 Do you use any special devices to help you with your activities?
 Does your current physical health affect any of these activities e.g. dyspnea,
shortness of breath, palpations, chest pain. pain, stiffness, weakness)? Explain.
Occupational Activities
 Describe what you do to make a living.
 Do you feel it has affected your health?
 How has your health affected your ability to work?
2/8/2020 Post RN semester 1 AHN 19

20. Objective Data
Refer to Thoracic and Lung Assessment
Cardiac Assessment
Peripheral Vascular Assessment
Musculoskeletal Assessment
Associated Nursing Diagnoses
Wellness Diagnoses
Opportunity to enhance effective cardiac output
Opportunity to enhance effective self-care activities
Opportunity to enhance adequate tissue perfusion
Opportunity to enhance effective breathing pattern
2/8/2020 Post RN semester 1 AHN 20

21. Risk Diagnoses
Risk for Disorganized Infant Behavior
Risk for Peripheral Neurovascular Dysfunction
Risk for altered respiratory function
Actual Diagnoses
 Activity Intolerance
 Impaired Gas Exchange
 Ineffective Airway Clearance
 Ineffective Breathing Pattern
 Disuse syndrome
 Impaired Physical Mobility
 Inability to Sustain Spontaneous Ventilation
 Altered Tissue Perfusion
2/8/2020 Post RN semester 1 AHN 21

22. Sexuality-Reproduction Pattern
Subjective Data
1- Female
Menstrual history:
Last cycle begin?
Duration ?
Any change or abnormality ?
Describe any mood changes or discomfort
before, during, or after your cycle
2/8/2020 Post RN semester 1 AHN 22

23. Obstetric history
 How many times have you been pregnant?
 Describe the outcome of each of your pregnancies.
 If you have children, what are the ages and sex of each?
 Explain any health problems or concerns you had with
each pregnancy. If pregnant now .
Contraception
 What do you or your partner do to prevent pregnancy?
 Describe any discomfort or undesirable effects this method
produces.
 Have you had any difficulty with fertility? Explain
2/8/2020 Post RN semester 1 AHN 23

24. Special problems
Do you have or have you ever had a sexually
transmitted disease? Describe.
Describe any pain, burning, or discomfort you
have while voiding.
Objective Data
Refer to Breast Assessment, d Abdominal
Assessment, and urinary-Reproductive
Assessment
2/8/2020 Post RN semester 1 AHN 24

25. Associated nursing Diagnoses
Wellness Diagnosis:
Opportunity to enhance sexuality patterns
Risk-Diagnosis
Risk for altered sexuality pattern
Actual Diagnoses
Sexual Dysfunction, Altered Sexuality Patterns
2/8/2020 Post RN semester 1 AHN 25

26. Sleep-Rest Pattern
Subjective data
Sleep Habits:
How would you rate the quality of your sleep?
Special Problems
Do you ever experience difficulty with falling asleep?
Remaining asleep? Do you ever feel fatigued after a sleep
period?
Sleep Aids
What helps you to fall asleep? medications? reading?
relaxation technique? Watching TV? Listening to music?
2/8/2020 Post RN semester 1 AHN 26

27. Objective Data
1. Observe appearance
a. Pale b. Puffy eyes with dark circles
2. Observe behavior
a. Yawning
b. Dozing during day
c. Irritability
d. Short attention span
2/8/2020 Post RN semester 1 AHN 27

28. Associated nursing Diagnoses
Wellness Diagnosis:
Opportunity to enhance sleep
Risk Diagnosis
Risk for sleep pattern disturbance
Actual Diagnosis:
Sleep Pattern Disturbance.
2/8/2020 Post RN semester 1 AHN 28

29. Sensory-Perceptual Pattern
Subjective Data
Describe your ability to see, hear, feel, taste, and smell.
Describe any difficulty you have with your vision, hearing,
and ability to feel (e.g., touch, pain, heat, cold), taste
(salty, sweet, bitter, sour), or smell.
Pain Assessment
Complete Symptom Analysis
Special Aids:
What devices (e.g., glasses, contact lenses, hearing aids)
Describe any medications you take to help you with these
problems.
Objective Data
Refer to the section on Nose and Sinus Assessment, Eye
Assessment, and Ear Assessment.
2/8/2020 Post RN semester 1 AHN 29

30. Associated Nursing Diagnoses
Wellness Diagnosis:
Opportunity to enhance comfort level
Risk Diagnoses
Risk for pain
Actual Diagnoses
Pain
2/8/2020 Post RN semester 1 AHN 30

31. Cognitive Pattern
Subjective Data
Ability to Understand:
Explain what your doctor has told you about your health.
Ability to Communicate:
Can you tell me how you feel about your current state of
health?
Ability to Remember:
Are you able to remember recent events and events of
long ago? Explain.
Ability to Make Decisions:
Describe how you feel when faced with a decision.
2/8/2020 Post RN semester 1 AHN 31

32. Objective Data
Refer to the Mental Status Assessment (GCS)
Associated nursing Diagnoses
Wellness Diagnosis: Opportunity to enhance cognition
Risk Diagnosis: Risk for altered thought processes
Actual Diagnoses:
Acute confusion
Chronic Confusion
Knowledge Deficit (Specify)
Impaired Memory
2/8/2020 Post RN semester 1 AHN 32

33. Role-Relationship Pattern
Subjective Data
Perception of Major Roles and Responsibilities in Family
Describe your family.
Are there any major problems now?
Perception of Major Roles and Responsibilities at Work
Describe your occupation.
What is your major responsibility at work?
Perception of Major Social Roles and Responsibilities
Describe your neighborhood and the community in which
you live.
2/8/2020 Post RN semester 1 AHN 33

34. Objective Data
1. Outline a family genogram for your client.
2. Observe your client's family members.
Associated Nursing Diagnoses
Wellness Diagnoses:
Opportunity to enhance effective relationships
Opportunity to enhance effective communication
Risk Diagnoses:
High risk for Loneliness
Risk for Altered Parent/Infant/Child Attachment
Actual Diagnoses:
Impaired Verbal Communication
Impaired Social Interaction: Social Isolation
2/8/2020 Post RN semester 1 AHN 34

35. Coping-Stress Tolerance Pattern
Subjective Data
Perception of Stress and Problems in Life
Describe what you believe to be the most stressful
situation in your Life.
How has your illness affected the stress you feel?
Coping Methods and Support Systems:
What do you usually do first when faced with a problem?
What helps you to relieve stress and tension?
Do you use medication, drugs, or alcohol to help relieve
stress? Explain.
Objective Data
Refer to the Mental Status Assessment.
2/8/2020 Post RN semester 1 AHN 35

36. Associated nursing Diagnoses
Wellness Diagnoses
Opportunity to enhance effective individual coping.
Opportunity to enhance family coping
Risk Diagnoses:
Risk for self-harm
Risk for suicide
Actual Diagnoses:
Ineffective Individual Coping
Ineffective Family Coping: Disabling
2/8/2020 Post RN semester 1 AHN 36

37. Value-Belief Pattern
Subjective Data
Values, Goals, and Philosophical Beliefs
Religious and Spiritual Beliefs:
Are there certain health practices or restrictions that
are important for you to follow while you are ill or
hospitalized? Explain.
Objective Data
Observe religious practices
Bible , clergy
Observe client's behavior for signs of spiritual distress
Anxiety, Anger , Depression , Doubt, Hopelessness and
Powerlessness
2/8/2020 Post RN semester 1 AHN 37

38. Associated Nursing Diagnoses
Wellness Diagnosis:
Potential for Enhanced Spiritual Well-Being
Risk diagnosis:
Risk for spiritual distress
Actual Diagnosis:
Spiritual disturbance (distress of the human spirit).
2/8/2020 Post RN semester 1 AHN 38

39. References
1. Dillon PM., Nursing Health Assessment; A Critical
Thinking, Case Studies Approach, 2nd ed. Copyright
© 2007 by F. A. Davis.
2. Kozier & Erb, G. K., (2015). Fundamentals of
Nursing: Concept, process and practice (10th ed.).
Addison.
3. Wesley.Bruner, L.S., & Suddarth, D.S. (2015). Text
book of Medical-Surgical Nursing (14 Ed.).
Philadelphia: Lippincott.
2/8/2020 39Post RN semester one

40. Thanks for
Attention
2/8/2020 Post RN semester 1 AHN 40