A.

DEMOGRAPHIC DATA

1. Clients Initials: C.Z.R.B
2. Gender: Female
3. Age and Birthdate: 17 years old, November 16, 1996
4. Marital Status: Single
5. Race and Nationality: Filipino
6. Religion: Christian
7. Address and Cellphone number: 712 Gemini St. Heritage Village, Tejero, General
Trias, Cavite, 09169229516

B. FUNCTIONAL ASSESSMENT

1. Health Perception Management Pattern

The client perceived herself as a healthy individual. She verbalized that she
includes vegetables and fruits in her diet, and consumes at least 8-10 glasses of water
a day. She denies going to clinics or hospitals for regular check-ups and only seeks
medical help when she is ill. Client seldom does exercises like jogging and going to
gym. She has also denied drinking alcoholic beverages or cigarette smoking. When
fever is experienced, she drinks over the counter medication Paracetamol to relieve it.
No other medicine is being taken as reported. She takes in vitamins but not regularly.

2. Nutritional Metabolic Pattern

The clients height is 4 feet and 11 inches and her weight is 47 kilograms. Her
blood pressure is 90/60 mmHg. She monitors her body weight every week. Clients food
preferences are fish, vegetables, and fruits. She eats three full meals and two snacks in
a day. She has verbalized consuming 8-10 glasses of water every day. During
weekdays, she usually eats at school canteens, and weekends, her mother buys the
groceries and cooks for her and her family.
3. Elimination Pattern

Client verbalized elimination of urine five to eight times a day and defecates
one or twice. Her urine is characterized as clear yellow. Her stool is golden brown and
formed.

4. Activity and Exercise Pattern

The client reported that she used to go on a regular exercise for two months
like working out in the gym and jogging but stopped because of the busy schedule. But
she sometimes finds time to jog, once in two weeks, for an hour around their village or
school grounds. She denies engaging to any strenuous activities.

5. Cognitive/ Perceptual Pattern

She has no history of dementia and no evidence of depression during the
course of interview and also reported that she does not experience short term memory
loss. Client wears eye glasses with both eyes having 75 % grades. She has no hearing
impairments.

6. Sleep/ Rest Pattern

Client verbalized having four to six hours of sleep during the weekdays and
eight to eleven during weekends. She does not usually rest or take naps in the
afternoon.

7. Self-Perception/ Self-Concept Pattern

The client has classified her as an extrovert type. She prefers and enjoys
mingling with other people and her friends than being alone. Her usual stressor is
school related stuff like school requirements. She relives her stress through relaxing like
watching television. Client has denied asking for assistance from psychologists, or
psychiatrists.

8. Role Relationship Pattern

The client is the eldest child in the family. She usually does household chores
and sometimes buys groceries. Her support system is her family and friends.

9. Sexuality/ Reproductive Pattern

She had her menarche when she was 12 years old. Her menstrual cycle is
regular and lasts for 7 to 8 days. She has reported experiences of dysmenorrhea during
menstruation but does not drink any medication to relieve it.

10. Coping and Stress Tolerance Pattern

The client denies going through depression during the interview. She feels
anxious and stressed because of school requirements most of the time. To cope with
these stressors, she takes a break first and relaxes before continuing to her work.

11. Value/ Belief Pattern

Client has denied any traditional health beliefs or practices. She usually seeks
medical care in the hospital or clinics.







DE LA SALLE HEALTH SCIENCES INSTITUTE
COLLEGE OF NURSING AND SCHOOL OF MIDWIFERY




FUNCTIONAL
ASSESSMENT



SUBMITTED BY:
CAMILLE ANNE L. BUEZON
BSN 3 2

SUBMITTED TO:
PROF. MARYLENE M. AGUNOD RN, MAN