Pattern

1. Health Perception-Health Management

Before
Patient A.T. does not want any consultations or even go for checkups because he thinks that he is healthy and there is nothing wrong with him. He maintains a healthy body by exercising, playing basketball, billiards and helping in household chores. He easily gets bored when he is not doing anything. He has started smoking and drinking liquor (San Miguel beer and Marlboro Green) since he was 19 years old up to present. He is not allergic to any food or drug. His family does not have any history of hypertension, heart disease, cancer, asthma, diabetes or even tuberculosis.

Present
Patient A.T. considered himself not a healthy person due to present condition. He was diagnosed "Ruptured Globe OD" and had undergone Emergency Enucleation OD under General Anesthesia last July 15, 2013. He is expecting to recover from his present condition with the help of the health care providers attending to his needs. All of the medications prescribed to patient A.T. are available. Currently he is taking Tramadol, Amoxicillin, Moxifloxacin hydrochloride, Ciprofloxacin, Tranexamic Acid.

Interpretation
Patient A.T. cannot function normally like before because of his confinement and his hospital condition. His body image changed due to his accident and surgical procedure done.

Analysis
Enucleation refers to the surgical removal of an eye. Removal of an eye is considered a drastic and traumatic measure to most people. Although many patients who require this surgery have no vision in the affected eye, those who do have vision recognize that enucleation will result in instantaneous, permanent, total blindness of that eye. "

2.NutritionalMetabolic Management

Patient A.T.s life before his pre confinement stage was normal, he can eat whatever he wants. He eats fruits like apples and bananas, fish and also vegetables most of the time. He rarely eat meats. He drinks alcoholic drinks. He drinks 2 bottles of San Miguel 2-3 times a week.

During hospitalization, the patient is on Diet As Tolerated. He eats fruits like apples and oranges. He also eats bread instead of rice. He said he loses his appetite due to uncomfortable feeling.

Patient A.T.s nutritional and metabolic status has been changed due to his confinement and his medical health condition. His preconfinement status is totally affected.

An individuals health status greatly affects eating habits and nutritional status (Fundamentals of Nursing by Kozier p. 1178) The patient was brought to the hospital because of ruptured globe right eye due to accident and burn of facial area including the neck.

3.Elimination Pattern

Bowel Patient A.T. defecates two times a day without experiencing discomforts, usually morning and afternoon. Stool is brown in color and is well-formed.

Bowel Patient defecates once a day but not every day. Stool is soft, is minimal in amount and is brown in color.

Bowel There was a change in the frequency, consistency and amount of stool.

Bladder Patient A.T. voids usually 6-8 times a day. Urine is yellow in color. No pain when voiding.

Bladder Patient voids 3-4 times a day without pain and discomfort.

Bladder There was a change in the frequency, and amount.

4. Activity, Leisure and Recreation Pattern

In the morning, Patient A.T.s daily activities include collection of water for the days use. In the afternoon after lunch, Patient A.T. likes playing basketball and billiards. His leisure activities include playing the basketball and cards, watching television programs and listening to radio music.

Patient A.T.'s activities in the hospitals are ambulation, deep breathing exercise, taking a bath or personal hygiene.

During confinement in the hospital, there is limitation in his activities of daily living and a disruption in his leisure and recreation pattern.

5. Sleep and Rest Pattern

Patient A.T. puts himself to sleep by watching primetime television programs. He does not have usual time of sleep. He sleeps for long period of time. He feels rested when sleeping and he thinks that his energy is sufficient for his activities.

Patient A.T. complained difficulty sleeping and sleeps for short period of time (3-4hours) due to pain and unfamiliar to the environment. He don't feel rested and comfortable.

Patient A.T.'s sleep and rest pattern was changed when he was admitted due to Ruptured Global OD. His usual routine of watching television programs to put himself to sleep changed because he need not do anything to fall asleep. And pain is also a big factor for disturbances of sleep.

Illness that causes pain or physical distress can result in sleep problems. People who are ill require more sleep than normal and the normal rhythm and wakefulness is often disturbed. (Fundamentals of Nursing, 7th ed by Barbara Kozier, et al, p. 1117). There is disruption of the sleepwake cycle because of the patients disease.

6. CognitivePerceptual Pattern

Patient is a high school graduate from Batangas Province Science High School in Batangas. He also takes a Vocational course of Automative Manpower. He can read and write. He can speak and understood by others.

Because of Patient A.T.s present condition, he has difficulty in seeing because his right eye was already blind. He heard presence of pressure in his right ear. Patient is unable to read and write at present. He can speak and is understood by others.

There was a change in cognitive and perceptual pattern in terms of reading, writing, hearing and speaking due Enucleated eye.

7. Self-PerceptionSelf-Concept Pattern

Patient A.T. is a friendly person; he loves to socialize with his friends in their neighborhood. He considered himself as a holistic human being as long as his complete, healthy and his family is always there for him. He wants to have good health and live his life to the fullest.

He don't considered himself as a holistic person. He have many regrets in his life. He thinks that he can't function well than before.

Due to his present condition, there is a change to the level of patient self-perception and self-concept because he can't accept that he only got one eye.

Events or situations may change the level of self-concept over time. Illness and trauma can also affect the selfconcept. (Fundamentals of Nursing 7th ed by Barbara Kozier p.959 & 962)

8. Role Relationship

Patient can speak and understand English, Tagalog and Batangan. He can clearly express himself. He has 11 siblings and they were all close to each other. They all lived in Batangas with their parents. Patient is very active and usually socializes with his neighbors.

Patient A.T.'s family does not know what happened to him. he does not want to tell them what happened because he left Batangas without permission from his parents.

The patient wants to be independent for a change.

9. SexualityReproductive Pattern

Patient A.T. is single and has no girlfriend. He is not engaged to sexual activity due to personal reason.

The patient don't perform sexual activity.

Patient A.T. does not want to talk about it.

10. Coping and Stress Tolerance

When he is anxious, patient A.T. wants to be alone. He does not show his emotions. When he is stressed, he prefers to drinks liquor like beers or just eats. When it comes to problem, he let himself think immediately for a solution.

The recent hospitalization was a traumatic experience for patient A.T., there have been many changes occurred that made it difficult for him to adjust. He cannot communicate effectively. The removal of his right eye affects his well-being.

Due to his condition, patient A.T. does not have any outlet to divert his feelings unlike before he can watch television, or diverting it through drinking liquor and smoking to alleviate his stress.

According to Folkman and Lazaruz, coping is the cognitive and behavioral effort to manage specific external and/or internal demands that are appraised as taxing or exceeding the resources of the person(Fundamentals Of Nursing by Kozier P. 1020).

11. Values-Belief Pattern

Patient A.T. is a Roman Catholic. According to the client, he goes to the mass every Sunday in Pangasinan with his family. When he went here in Manila, he rarely goes to mass.

According to the patient, there are no practices that affect his hospitalization. He follow therapeutic regimen and a strong faith to God accounts for his fast progress.

After what happened, patient A.T. is now seeking for medical assistance. Religious effort is still a part of patient A.T.s life.