Gordon's Functional Health Patterns: Family Assessment
With the various detailed questions related to the health perception, M. Houston perceives her level of health as generally healthy, but with numerous unhealthy patterns. With no history of colds/flu over the last few years, she denies ever taking flu vaccines, nor has her health ever been the cause for lost work hours. A smoker of at least 33 years, she currently reports smoking approximately 10 cigarettes per day, a significantly amount less compared to previous years.

Physician recommendations have been to stop smoking, but she reports this as, "not being easy but I never really tried to stop" (personal communication, Aside from the extensive smoking history, there were other health related entities to take into consideration. Weight management is a health concern where much focus was given. When obtaining information about the things that are most important for her health, maintaining a healthy weight was given highest priority second was blood pressure and cholesterol control. This was interesting because the family has a significant history for heart disease, and hypertension, both of which medications are being prescribed for. However, blood pressure and cholesterol control was not given as much priority as weight management.

Since years of elementary school, teachers have instructed their students on the importance of a good night’s rest. Somehow as adults we often forget these basic principles instilled in us. For years her family heard complaints of chronic fatigue, even after a four nights rest, regardless of activity or hour of sleep. Upon speaking with the primary care physician, Ms. Houston was given a referral for a sleep study to be performed. She was then diagnosed with sleep apnea, and prescribed a C-PAP machine at bedtime. The results were remarkable, first the chronic fatigue disappeared and secondly, she reported a 4-6 pound weight loss. The rationale was quite simple, if acknowledged, "I will wake at 2:00 or 4:00 AM, and snack on everything until I could fall back to sleep" .
In conjunction with the functions of elimination, there were complaints of chronic constipation, stress incontinence, and excessive perspiration. Of the three, constipation was the ill met with the longest problematic history. Dating back to her teenage years, Ms. Houston reported relying on laxatives for bowel movements, "every few days" The laxatives are still required, but now the intake of coffee daily assists with bowel movement patterns. According to the Scandinavian Journal of Gastroenterology, a study reported the effects of coffee and constipation. The findings reveal that coffee has the ability to stimulate defecation, alternatively according to the National Digestive Disease Clearinghouse; caffeinated coffee contributes to dehydration and constipation.

This conflict creates a cycle of imbalance of our body's ability to maintain healthy elimination patterns. Stress incontinence and excessive perspiration were two complaints quite common in women of similar age groups. The onset of stress incontinence was identified as troublesome years after childbirth. Believing the problem could be reversed a surgical procedure was performed, unsuccessfully. Excessive perspiration only became bothersome after the onset of menopause, some five years ago. There are currently no treatments sought to correct this discomfort, for fear of related side effects especially increase weight.

When assessing the activity levels, initially all appeared to be somewhat sedentary, however to my surprise the type of exercise is sufficient. According to Ms. Houston, "I walk one mile round-trip at a fast pace from the parking garage to my place of work, and gardening on the weekends" . The Center for Disease Control, recommends 2.5 hours gardening per week for health, with up to 150 calories burned well standing and gardening for 30 to 45 minutes. With the heightened concern of weight management, there was a degree of surprise no strict cardiac or aerobic classes were being taken.

There were not many deficits notice with data collection of the cognitive patterns. No new onset changes in memory were reported nor inabilities to learn new things. There was a fear identify however, of acquiring dementia later in life. There once was an episode Ms. Houston recalls, when her mother became disoriented due to low potassium levels. Before the potassium was identified as the culprit, dementia was being ruled out.Upon becoming an adult, there was no desire to find the cause of the hearing difficulty for fear of a required hearing aid. Aware of the many size variations available today, there still remains a fear of the stigma attached to wearing such devices. Glasses are worn recently for reading only, even though they were prescribed many years ago, only when migraines were thought to be the cause is when more compliance was exhibited.

This selection of questions regarding self-perception appeared to be the most revealing of all the data collected. In general, many of the questions answered surrounded fears and anxiety of how Ms. Houston was viewed by others. The remainder reflected her views of personal short comings, whether real or perceived, and displays a low self-image. Not to be confused with self-esteem, which appears to be intact, the self-image deficit has always required a little extra work, reassurance by parents, and prayer.

References
Ackley, B., & Ladwig, G. (2004). Nursing Diagnosis Handbook: A Guide to Care Plans. St. Louis: Mosby.
Gladwell, M. (2008). Outliers: the Story of Success (1st ed.). St. Louis, MO: Little, Brown, and Company.
Institute Of Medicine (2005). Food and Nutrition Board: DRI tables. Retrieved from http://iom.edu
Journal of Gastroenterology (2005). Scandinavian Journal of Gastroenterology. Retrieved from http://iom.edu
Nursing Outcomes Classification. (2009). In Mosby's Medical Dictionary (8th Ed.).