DATA ORGANIZATION AND NORMS AND STANDARDS

FUNCTIONAL PATTERN NORMS AND STANDARDS Health Perception and Management S> Based from the given question How would you range your health status today? the client answered 5 ecause most of the time she feels stressed! "tress causes an+iety& and an+iety affects performance! -lso& stress affects a person(s thin#ing y filtering information .e!g!& only hearing the information you want to hear or missing all of the information/& which su sequently affects pro lem) solving a ility! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 67 p! 865/ "cientific or iomedical health is ased on the elief that life and life processes are controlled y physical and iochemical processes that can e manipulated y humans! 'he client with this view will elieve that illness is caused y germs& viruses& acteria& or a rea#down of the human machine& the ody! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! :68/ People who elieve that they have a ma;or influence on their own health status) that health is largely self) determined) are called internals! People who e+ercise internal control are more li#ely than others to ta#e the initiative on their own health care& e more #nowledgea le a out their health& and adhere to prescri ed health care regimens such as ta#ing medication& ma#ing and #eeping appointments with primary health care providers& maintaining diets& and giving up smo#ing! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 67 p! 8<9/

"he considers eing away from any #inds of illnesses as a form of eing healthy and as one of her health goals!

Her eliefs and practices a out eing healthy are y ta#ing $itamin %& drin#ing plenty of water and y ta#ing enough sleep! 'he patient usually visits her health care provider if ever there are pro lems with her health& most especially when she(s having severe asthma! "he also visits her dentist for a chec#) up every three months! 'he client is usually having her annual chec#) up at least three to four times a year so that she could have an idea on how to improve her health status and how to maintain her good health ha its! Her safety practice to #eep her health is y staying away from polluted places and y #eeping herself clean as much as possi le! *or her& these #inds of safety practices to #eep her health are effective! "he maintains her health y eating fruits and vegeta les and y trying to have an enough amount of rest! "he does not perform reast self) e+amination ecause she is not familiar of the steps on how to do it!

,t is easy for her to follow the things that her doctor suggests ecause she wants to have a

Monthly reast self) e+amination .B"3/ for women and monthly testicular self) e+amination .'"3/ for men can play an important role in early detection of disease& resulting in a greater chance of cure and less comple+ treatment! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 6<8=/ -dherence is the e+tent to which an individual(s ehavior .for e+ample& ta#ing medications& following diets& or ma#ing lifestyle changes/ coincides with medical or health advice!

healthy life! ,n the client(s feeling a out her health concerns& she ver ali1ed that& >#ey naman a#o pagdating sa mga health concerns& wala naman a#ong masyadong pinopro lema dun #asi as much as possi le sumusunod naman a#o sa mga dapat #ong gawin para malayo a#o sa sa#it! .'he client(s statement was relevant to the situation when she was as#ed a out this/!

.0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 67 p! 8<=/

*or her personal hygiene& she ta#es a ath for at least twice a day and rushes her teeth thrice a day! "he wears slippers at home and she washes her hands efore and after eating! "he uses deodorant and cologne to stay fresh the whole day! "he trims her nails once a wee#! ?hen it comes to ta#ing care of the ody& she stated that& syempre naman sinisugurado #ong malinis ang uong #atawan #o! 4aliligo a#o twice a day& nagtu) tooth rush a#o& #uma#ain a#o ng gulay at prutas& at umiinom ng maraming tu ig! 'he client doesn(t have any vices ut whether she li#e it or not& she could often smell the smo#e of cigarettes ecause of the surroundings in her school and she can(t ta#e away the fact that a lot of students in her school are smo#ers! Moreover& she(s aware of the effects of those things to her health! - out the presence of environmental contaminants& the client ver ali1ed that&>#ey naman sa ahay& malinis naman at walang lamo# o #ung anumang madumi! @un nga lang pag papunta na a#o sa school& dun madalas mas madaming dumi tulad na lang ng uso# sa sigarilyo at sasa#yan! Her environmental surroundings at home are well) lighted and well) ventilated so she doesn(t have any pro lems with it! @ung lugar #ung saan a#o na#atira& o#ey naman #ahit dorm siya! Maaliwalas naman at may enough space #aya #ompora le na rin a#o dun! 'he client has no pro lems when it comes to the environmental sanitation ecause they already have a clean water supply and clean toilet facilities! 'heir gar age is also collected y the gar age collector!

Personal hygiene is the self) care y which people attend to such functions as athing& toileting& general ody hygiene& and grooming! Hygiene is a highly personal matter determined y individual values and practices! ,t involves care of the s#in& hair& nails& teeth& oral and nasal cavities& eyes& ears& and perineal) genital areas! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 67 p! :=9/

- room temperature etween 9< degrees %elsius and 98 degrees %elsius .A5 degrees *ahrenheit and := degrees *ahrenheit/ is comforta le for most clients! Bood ventilation is important to remove unpleasant odors and stale air! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 67 p! :5A/ -dequate "treet lighting& safe water and sewage treatment& and regulation of sanitation in food uying and handling all contri ute to a healthy& ha1ard) free community! - safe and secure community strives to e free of e+cess noise& crime& traffic congestion& dilapidated housing& or unprotected cree#s and landfills!

@ung sa community naminC #umpleto naman yung facilities #aya wala a#ong pro lema tung#ol dun! @ung sa services naman na ino) offer ng munisipyo namin& medyo wala a#ong alam dun pero nangongole#ta ata sila ng asura araw) araw& said the client a out the place she is currently living in and a out the community and municipal services given to their place! *or indoor and outdoor clothing& the client stated that& Pag nasa ahay a#o& shorts at ') shirt pero pag nasa la as& pants at ') shirt! 'he client(s hygienic practices at home is that she sweep the floor twice a wee# and she ma#es sure that their trash is eing collected y the gar age collector everyday!

.0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 67 p! :69/

- safe home requires well) maintained flooring and carpets& a nons#id athtu or shower surface& functioning smo#e alarms that are strategically placed& and #nowledge of fire escape routes! >utdoor areas such as swimming pools need to e safely secured and maintained! -dequate lighting& oth inside and out& will minimi1e the potential for accidents! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 67 p! :69/

Her usual activities done outdoors is playing volley all when she and her friends have e+tra time and mostly wal#ing! 'he client descri ed her health as& yun ang nagagawa #o ang lahat ng dapat #ong gawin nang walang saga al na #ahit ano& tulad ng sa#it! *or her& Difestyle affects health! 'he client has no pro lems with regards to healthcare financing! 'he client avoids eating seafood so that she would not have any allergy attac#s! Meron a#ong sugat sa left leg #o! 'inahi siya& mga 68 stitches yun! 4a asagan #asi a#o ng ote sa paa #aya ayunC nasugatan a#o! 'he client said& when she was as#ed if there are any important in;uries or illnesses in her life! 'he client doesn(t have any pets at home ecause of her asthma! -s much as possi le she avoids having furry pets at home! 'he client has appliances li#e air) conditioning unit& electric fan& television set& E$E player& computer& and everything that she needs! O> 3ducation a out safety precautions and in;ury prevention is a ma;or role of the nurse in promoting the health of young adults! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 67 p! 8F5/

 Body uilt& height& and weight& in relation to the client(s age& health and lifestyle) Proportionate& varies with lifestyle %lient(s posture and gait& standing& sitting& and wa#ing) %oordinated& Gela+ed& 3rect %lient(s overall hygiene and grooming) %lean& neat "igns of health or illness) Healthy appearance %lient(s attitude) - le to follow instructions %lient(s affectHmood7 appropriateness of the client(s responses) -ppropriate to the situation Iuantity and quality of speech) Jnderstanda le& moderate pace& low tone Gelevance and organi1ation of thoughts) Has a sense of reality& Dogical sequence 4utritional and Meta olic S> 'he client(s typical daily food inta#e is that she 4utrient requirements are different for men and consumes at least one to two cups of rice women ecause of ody composition and during rea#fast& lunch and dinner! reproductive functions! Because of menstruation& women require more iron than men do prior to menopause! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 698:/ Her typical daily fluid inta#e ranges from a out 'he healthy ody maintains a alance etween 6!F9 to 9!A= liters per day! "he consumes more the amount of fluid ingested and the amount of water than any other fluids li#e fruit ;uices mil# fluid eliminated! .0o1ier 2 3r (s *undamentals or chocolate drin#s! of 4ursing 5th 3dition $olume 97 p! 6955/ "he is more on read than rice and she prefers to eat wheat read rather than the ordinary read! Beliefs a out effects of foods on health and well) eing can affect food choices! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 698:/ People who elieve that they have a ma;or influence on their own health status) that health is largely self) determined) are called internals! People who e+ercise internal control are more li#ely than others to ta#e the initiative on their own health care& e more #nowledgea le a out their health& and adhere to prescri ed health care regimens such as ta#ing medication& ma#ing and #eeping appointments with primary health care providers& maintaining diets& and giving up smo#ing! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 67 p! 8<9/ -n individual(s health status greatly affects eating ha its and nutritional status! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 6985/ 4utrition is the sum of all the interactions etween an organism and the food it consumes! .0o1ier 2 3r (s *undamentals of

"he ta#es 3nervon Multivitamins .A5<mg/ ta let as her supplement efore she sleeps to #eep herself energetic and alert for the ne+t day!

"he usually eats on time and seldom eats late and whenever she does& it(s ;ust ecause there are some important wor# to e finished! *or the client& proper nutrition is eating lots of fruits li#e apples& oranges and ananas& and vegeta les!

'he client li#es to eat fried dishes& sweets& and meat and she also li#es to drin# pineapple ;uice! "he has a good appetite for sweet and spicy foods and she doesn(t prefer to eat itter foods!

4ursing 5th 3dition $olume 97 p! 6985/ People develop li#es and disli#es ased on associations with a typical food! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 6985/

Her food is always prepared well) done e+cept for the vegeta les ecause for her& the vegeta les should not e overcoo#ed! "he usually eats at school& in fast food restaurants and at home together with her friends and family! 'he client doesn(t have any pro lems when it comes to food udgeting! -dvertising is thought to influence people(s food choices and eating patterns to a certain e+tent! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 69=</ 3conomics) what& how much& and how often a person eats are frequently affected y socioeconomic status! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 6985/

"he has lost 9 pounds since -ugust 95& 9<<5! "he doesn(t have any discomforts when eating and she(s allowed to eat anything ut she has to ma#e sure that what she eats is ;ust the right amount of food! Her wounds heal easily whenever she has and she doesn(t have s#in pro lems& lesions& and her s#in is moist! "he doesn(t have any dental pro lems! O> "#in) Desions according to location& distri ution& si1e& shape& type structureK *rec#les& some irthmar#s& some flat and raised nevi7 no a rasions or other lesionsK 4o s#in pro lems Mouth) .lips/K Jniform pin# color& soft& moist& smooth te+ture& symmetry of contour& a ility to purse lips7 .mucosa/K Jniform color& moist& smooth& soft& glistening& and elastic te+ture7 .teeth/K 89 teeth7 smooth& white& shiny tooth enamel& smooth& and intact dentures7 .gums/K pin# gums& moist firm te+ture to gums& no retraction of gums 3limination S> 'he client defecates every other day or 'he frequency of defecation is highly individual& whenever she feels that there is an urge! varying from several times per day to two or three times per wee#! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 6895/

 'here are no recent environmental changes in her defecation! -ccording to her& her feces is color rown& the te+ture is smooth& it has no foul odor& and it is semi) formed in consistency! "he also stated that& 'here are no changes in the characteristics of my feces recently in the past two years! 'here are also no changes in my owel elimination pattern! ?ala naman a#ong pro lema sa pagdumi #o! CBasta dapat nasa ayos ang pag#ain #o para hindi a#o mahirapan dumumi! Eapat din uminom ng maraming tu ig para mas maganda ang digestion& hindi #asi pwedeng umasa #a na lang sa pag) inom ng #ahit anong flids o #ahit anong gamot na pampaayos ng digestion! 3ffective naman yung mga ginagawa #ong yun para sa L#in #aya hindi a#o nag#a#aroon ng constipation! 'he client said! "he urinates for appro+imately five to eight times a day! 'here are no changes in her urinary elimination pattern since pu erty until this current time! "he urinates every two to three hours or whenever she feels the urge or whenever she feels nervous or cold! 4ormal feces are made of a out :5M water and 95M solid materials! 'hey are soft ut formed! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 6895/

"ufficient ul# .cellulose& fi er/ in the diet is necessary to provide fecal volume! Bland diets and low) fi er diets are lac#ing in ul# and therefore create insufficient residue of waste products to stimulate the refle+ for defecation! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 689A/

"he sometimes hesitates to urinate whenever she(s in the middle of an e+amination!

Her urine is clear to light yellow and& it has no foul odor!

'he amount of urine that she eliminates daily is from 6!5<D to 6! A5D! "he doesn(t feel any discomfort or pain when urinating or when controlling it! "he eliminates her urine continuously and she doesn(t have any pro lems or trou les in getting to the athroom in time or feeling of urine! "he has also no difficulty in starting her urine stream! "he has no accidental lea#age of urine and she has not encountered any #ind of urinary tract illness! *or her& a normal urinary elimination is every

Jrinary frequency is voiding at frequent intervals& that is& more than = to A times per day! -n increased inta#e of fluid causes an increase in the frequency of voiding! %onditions such as J',& stress and pregnancy can cause frequent voiding of small quantities .5< to 6<<mD/ of urine! 'otal fluid inta#e and output may e normal! ?hen emptying of the ladder is impaired& urine accumulates and the ladder ecomes over distended& a condition #nown as urinary retention! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 69F9/ 4ormal urine consists of FAM water and =M solutes! >rganic solutes include urea& ammonia& creatinine& and uric acid! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 69F9/ 4ormally& the #idneys produce urine at a rate of appro+imately A<mD per hour or a out 65<<mD per day! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 69F9/

,ncreasing

fluid

inta#e

increases

urine

two to three hours! Moreover& she also ver ali1ed that& 'o e a le to achieve this& you have to drin# lots of fluid and it also depends on the #ind of fluid that you will drin# as to when you will again feel the urge to urinate! *or her& she finds it more effective to do those #inds of practices! Dastly& the client has no e+cessive perspiration and has no odor pro lems!

production& which in turn stimulates the micturition refle+! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 69F:/

O> 4ormal Jrine %haracteristics) color& clarityK straw& am er& transparent7 odorK faint aromatic7 sterilityK no microorganisms present7 pHK =!5) 57 specific gravityK 6!<6<) 6!<957 glucose& #etone odies .acetone/& loodK not present! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 69F8/ 4ormal *ecal %haracteristicsK colorK adult) rown7 shapeK cylindrical .contour of rectum/ a out 9!5cm .6in/ in diameter in adults7 amountK varies with diet .a out 6<<) =<<g per day/7 odorK aromatic) affected y ingested food and person(s own acterial flora! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 6895/ -ctivity)3+ercise S> 'he client(s daily activities are constant or ;ust the same everyday! "he spends most of her time everyday in school! N4aglala#ad a#o for at least 8< minutes tuwing papaso# a#o sa school! Para sa#in& pwede na yun na e+ercise! C-ctually& #ulang talaga ang oras #o o sa ihin na nating wala na rin a#ong oras para dun sa e+ercise #asi mas madami pang school wor# na ini igay ngayong semester na Oto! C"yempre& hindi rin a#o satisfied sa #ung ano mang e+ercise ang nagagawa #o sa isang araw #asi #ulang nga yung oras!N NMinsan di #o na #ina#ayang mag) engage pa sa i ang physical activities #asi stressed at pagod na rin a#o galing school! Minsan nag a asa na lang a#o ng mga pa orito #ong li ro! %onsidered #o na rin Oto as a ho y& marami naman a#ong li ro sa ahay #aya pag wala a#ong masyadong ginagawa& -ctivity tolerance is the type and amount of e+ercise or daily living activities an individual is a le to perform without e+periencing adverse effects! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 66<:/ - normal wal#ing pace is :< to 6<< steps per minute! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 669=/

nag a asa na lang a#o! -yo#o #asi ng masyadong na#a#apagod na gawain #asi palagi na nga a#ong pagod dahil sa wor# e!N the client said! 'he client also en;oys swimming as one of her leisure activities! "he en;oys this #ind of activity once in a while to feel more rela+ed and peaceful! *or her& it is important to have leisure activities ecause it ma#es her physically fit and healthy! 'he client prefers to sleep during her spare time so that she could catch up with the num er of sleeping hours that she lost! 'he client ver ali1ed that& N-ng daming nag ago ngayon& #ung last year may time pa a#o para sa i a #o pang mga agay na gusto #ong gawin& ngayon halos wala na a#ong time para sa i ang mga agay& tulad na lang ng pamamasyal! Eahil na rin sa marami na a#ong ginagawa& hindi a#o na o) ore!N NMadami namang mapag#a#aa alahan sa ahay e& may t!v! #ami #aya lang& hindi lang talaga a#o pala) nood& may player naman a#ong pwedeng pa#inggan ang music at may internet din naman!N 3ven though the client has so much wor#& she mentioned that there was nothing changed in her physical appearance! 'he only thing that has changed is that she sheOs getting tired everyday ecause of school wor#! >n a scale of 6) 6<& with 6 eing the lowest and 6< eing the highest& the client rated her stress level as F and ver ali1ed that& N3 so rang dami ng pinipagawa a naman& #ung hindi #a a maover) stressed nun!N "tress causes an+iety& and an+iety affects performance! -lso& stress affects a person(s thin#ing y filtering information .e!g!& only hearing the information you want to hear or missing all of the information/& which su sequently affects pro lem) solving a ility! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! :68/ ,sotonic .dynamic/ e+ercises are those in which the muscle shortens to produce muscle contraction and active movement! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 66<:/

4oise and temperature are the factors which contri ute to the client(s fatigue! 'he client has no recent negative life events that had their impact on her day) to) day activities! "he doesn(t easily get tired ut when it comes

to restoring her energy after resting& she ver ali1ed that& 4o& #elangan sapat yung energy #o para sa awat araw! 'he client doesn(t have complaints now than efore! any physical

"he also mentioned that since she is still a college student and has no ;o & her wor# is ;ust to study and sometimes do household chores at home! O> Body uilt& height& and weight& in relation to the client(s age& health and lifestyle) Proportionate& varies with lifestyle7 %lient(s posture and gait& standing& sitting& and wa#ing) %oordinated& Gela+ed& 3rect7 signs of distress& in posture or facial e+pression) 4o signs of distress7 "igns of health or illness) Healthy appearance "leep) Gest S> 'he client is a le to sleep for at least four to -dolescents .69 to 65 years of age/ require F to seven hours a day! 6< hours of sleep each night7 however& few actually get that much sleep! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 66A5/ "he usually sleeps at one o( cloc# in the ,nsufficient sleep) healthy individuals who morning and wa#es up at seven o( cloc# in the o tain less sleep than they need will e+perience morning! sleepiness and fatigue during the daytime hours! .0o1ier 2 3r (s *undamentals of ! 4ursing 5th 3dition $olume 97 p! 66:8/ 'he client feels rela+ed and refreshed %omfort measures are essential to help the whenever she gets to sleep for five to eight and client fall asleep and stay asleep& especially if a half hours and she feels la1y whenever she the effects of the person(s illness interfere with only gets to sleep for five to si+ hours! the sleep! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 66:5/ "he ta#es a nap efore studying her lessons! - short daytime nap .e!g!& 65) 8< minutes/& can "he ta#es a nap in the afternoon if she has free e restorative and not interfere with nighttime time in school and at night efore she does her sleep! .0o1ier 2 3r (s *undamentals of assignments at home for a out thirty minutes& 4ursing 5th 3dition $olume 97 p! 66::/ ut sometimes it e+ceeds up to an hour and thirty minutes ecause of tiredness! 'he client manages to find time for other activities li#e church wor#& household chores& and going out with friends! 'he client doesn(t engage in self) reflection! Geflection is thin#ing from a critical point of view& analy1ing why one acted in a certain way& and assessing the results of one(s actions! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 67 p! =5=/

'here have een no nota le changes in her past and present set of activities!

 'here are no changes with her sleep pattern! @ung sleeping environment #o& o#ey naman siya& wala naman a#ong pro lema dun in a way na wala namang maingay sa pagtulog #o! 3nvironment can promote or hinder sleep! -ny change) for e+ample& noise in the environment) can inhi it sleep! 'he a sence of usual stimuli or the presence of unfamiliar stimuli can prevent people from sleeping! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 66:</ - parasomnia is ehavior that may interfere with sleep and may even occur during sleep! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 66:=/ Most people are accustomed to edtime rituals or pre) sleep routines that are conductive to comfort and rela+ation! -ltering or eliminating such routines can affect a client(s sleep! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 66::/ 'he ma;or goal for clients with sleep distur ances is to maintain .or develop/ a sleeping pattern that provides sufficient energy for daily activities! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 66:A/ %affeine) containing everages act as stimulants of the central nervous system! Erin#ing everages containing caffeine in the afternoon or evening may interfere with sleep! Motivation can increase alertness in some situations! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 66:6/

CHindi rin a#o nagsi) sleep tal# o nananaginip ng #ung anu) ano pag tulog a#o! CHindi naman mahirap ma#atulog at mas na#a#atulong sa a#in yung pa#i#inig sa music para ma#atulog a#o nang mahim ing!

'he client(s sleep pattern has no interruptions and she usually wa#es up at the same time& not unless when she(s really tired and when she really lac#s sleep! "he sleeps with her friends and or group mates whenever there are overnight activities to e done li#e school wor#& ut most of the time she sleeps in her dorm! 'his started when she was already in college! "he doesn(t use any #ind of drugs that affect her sleep ut she drin#s coffee whenever there are overnight school wor#s! 'he client was a le to fulfill her responsi ilities fully!

Gole performance relates what a person in a particular role does to the ehaviors e+pected of that role! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 6<<A/ %ognitive)Perceptual Eetecting sensory pro lems early is one step toward preventing serious pro lems! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! F55/ Physical assessment determines whether the senses are impaired! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! F5=/ $isual impairment increases the ris# of depression among older adults living in the community! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! FF</ "ensory aids are availa le for clients who have visual and hearing deficits! ,n all situations& the

S> 'he client is a le to write& spea#& and read clearly and properly! "he has no significant changes in the different senses of her ody! "he has no difficulty in her vision and she doesn(t ta#e any medications for it! "he doesn(t wear glasses nor contact lenses for her eyes! "he hasn(t had her eyes e+amined since her enrollment for college last summer of 9<<:!

 'o ta#e care of her vision& she avoids reading when she is lying down! 'he client has no difficulty in her hearing!

"he doesn(t use any medications and she doesn(t use any hearing aid! "he hasn(t had her ears e+amined since her enrollment for college last summer of 9<<:!

'here are no changes in her sense of smell and taste! "he doesn(t ta#e any medications!

assistance of support people needs to e enlisted whenever possi le to help the client deal with the deficit! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! F5F/ Geading is often a leisure activity and its loss can affect a person(s quality of life! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! FF9/ %lients with hearing impairments who are una le to hear the alarms of ,$ pumps and cardiac monitors need to e assessed frequently! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! FF9/ "ensory aids are availa le for clients who have visual and hearing deficits! ,n all situations& the assistance of support people needs to e enlisted whenever possi le to help the client deal with the deficit! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! F5F/ %lients with an impaired sense of smell need to e taught a out the dangers of cleaning with chemicals such as ammonia! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! FF8/

"he goes to the dentist every three months for her oral chec#) up! 'he client doesn(t feel any pain! -lthough pain is a universal e+perience& the nature of the e+perience is unique to the individual ased& in part& on the type of pain e+perienced& the psychosocial conte+t or meaning& and the response needed! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 665:/ 'he nurse assesses the client(s recall of information presented seconds previously .immediate recall/& events or information from earlier in the day or e+amination .recent memory/& and #nowledge recalled from months or years ago .remote or long) term memory/! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 67 p! A=8/ -n important aspect of learning is the individual(s desire to learn and to act on the learning& referred to as compliance! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 67 p! =55/ %lients with an impaired sense of touch may not e aware of hot temperatures& which can cause urns& or pressure on ony narcotics& and sedatives often increasing the ris# for delirium! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! FF=/

?ala namang nag ago sa memory #o pero umiinom a#o ng supplement& yung MemoplusC iniinom #o yun tuwing umaga ago a#o pumaso# sa school #aya lang& parang wala naman a#ong naramdamang pani ago nung ininom #o yun! Banun pa rin naman! 'he client said a out her memory! 'he client ver ali1ed that& Para sa#in& mas madaling matuto #apag naririnig #o at na#i#ita #o ang itinuturo sa#in! -yunC satisfied naman a#o dun! 'here are no changes in her sense of touch and she doesn(t ta#e any medications!

"a schoolC ayus naman! ?ala namang masyadong pro lema dun #undi marami lang talagang #elangang ipasang paper wor#s at reports pero& na#a#araos naman a#o #ahit papano #asi natatapos #o naman ang lahat on time!

-n optimal learning environment facilitates learning y reducing distraction and providing physical and psychologic comfort! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 67 p! =F6/ 'he #nowledge or s#ill to e learned must e personally relevant to the learner! %lients learn more easily if they can connect the new #nowledge to that which they already #now or have e+perienced! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 67 p! =F</

CPag may pro lema sa school& madali #o lang naman na naso) solve yun #asi nandyan naman ang classmates #o& minsan sa #anila na lang a#o nagtatanong #ung meron a#ong hindi nage) gets tapos sa#a #o na lang siya pinag) aaralan! 'he client mentioned a out her school performance!

O> 4ear visionK - le to read newsprint at 6= in7 *ar visionK Deft 9<H9<& Gight 9<H9<& Both 9<H9< Gesponse to normal voice tonesK 4ormal voice tones audi le7 ?atch tic# testK - le to hear tic#ing in right ear7 - le to hear tic#ing in left ear7 ?e er(s testK "ound is heard in oth ears or is locali1ed at the center of the head .we er )/7 Ginne testK Deft -%>B%& Gight -%>B%& Ginne .P/ Patency of oth nasal cavitiesK -ir moves freely as the client reathes through the nares "#in turgorK "#in springs ac# to previous state when pinched after half a second7 "#in temperatureK Jniform in the upper and lower e+tremities7 "#in moistureK Moist in the s#in folds "elf)Perception "elf)%oncept S> 'he client ver ali1ed& , feel good a out myself "elf) esteem is one(s own worth that is how that naman at wala namang nag ago sa #atawan person(s standards and performances compare #o at sa mga agay na #aya #ong gawin! to others and to one(s ideal self! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 6<<A/ C?ala rin naman a#ong physical changes o 'he image of physical self& or ody image& is alterations! how a person perceives the si1e& appearance& and functioning of the ody and its parts! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 6<<5/ C'ung#ol sa relationship #o sa i aC o#ey naman siya in a way na pantay) pantay lang ang pagtingin #o sa #anila! C'apos& pag may gusto a#ong sa ihin& sinasa i #o rin naman sa #anila at satisfied naman a#o dun sa ganung paraan #asi nagagawa #ong i) e+press ang sarili #o! -n individual(s resources are internal and e+ternal! 3+amples of internal resources include confidence and values& whereas e+ternal resources include support networ#& sufficient finances and organi1ations! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 6<<:/

 CBusto #o ding maging nurse alang arawC #elangan #o nga lang mag) aral nang ma uti para matupad yon! 'he client li#es to e with people who #now how to appreciate things and it is also important for her that they also #now how to communicate with people very well! -n e+ample is that the client li#es to e with people who have a sense of humor! 'he client states a out her mood that& 0almado a#ong tao at nag) ii a lang ang mood #o pag so rang dami na ng tinatra aho #o at pag tuwing maiinit ang panahon minsan& eto na rin ang mga factors na nagpapasama ng araw #o o #aya na#a#apag) pagalit sa#in! CPag ad trip a#o& madalas na nananahimi# na lang a#o #aya yung mga tao sa paligid #o& nanini ago sa#in! CPositive thin#er a#o #aya #ung ire) rate #o ang sarili #o& siguro 5& #asi #aya #og dalhin ang sarili #o! Para sa#in& #untento na a#o sa sarili #o at #ung anuman ang pag) uugali na meron a#o ngayon #asi hindi naman a#o nag#a#a) pro lema tung#ol dun! "atisfied na #o sa mood na madalas meron a#o #asi di naman siya na#a#asaga al sa mga ginagawa #o! CPro lematic naman a#o pag may ma a ang grades a#ong na#u#uha! LC0ung may nag) o) offer naman sa#in ng tulong& e di syempre tinatanggap #o para mas magaan ang tra aho! Gole) Gelationship S> 'he client lives in a dorm for now ecause of ,ndividuals who live y themselves represent a her studies ut she has closer relationship with significant portion of today(s society! ,n her relatives in the father(s side! .the patriarchal younger adults 65 to 8= years of age& a out family is one in which the authority is vested in 6<M live alone with little variation etween the oldest male in the family& often the father) males and females! .0o1ier 2 3r (s %ultural -nthropologyK Philippine Perspective *undamentals of 4ursing 5th 3dition $olume 67 yK G! "antico Golda 2 ,!"! Panopio/ p! =86/ >#ey naman ang relationship #o sa family #o #asi #omporta le naman a#ong #asama sila at isa pa& mas secured ang pa#iramdam #o pag malapit sila sa#in! C'apos& #ahit sino samin na lang ang nag) ,) 'he effectiveness of family communication determines the family(s a ility to function as a cooperative& growth) producing unit! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition - young child(s values are largely influenced y the family and culture! Dater on& peers influence the child and there y affect the sense of self! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 6<<:/ Personal identity is the conscious sense of individuality and uniqueness that is continually evolving throughout life! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 6<<5/ - coping strategy .coping mechanism/ is a natural or learned way of responding to a changing environment or specific pro lem or situation! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 6<A5/ Persons with a positive self) concept tend to find contentment in their level of success! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 6<<:/

"tressors can strengthen the self) concept as an individual copes successfully with pro lems! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 6<<:/

initiate ng activity tulad ng pagputa sa mall pero pag outing syempre parents! 'he client said a out her relationship with her family! C"yempre tinutulungan a#o ng lahat ng family mem ers #o at hindi nila a#o pinapa ayaan anu(t anuman! CHindi rin a#o natata#ot na sa ihin #ung ano ang nararamdaman #o! C4afu) fulfill #o naman ang role #o sa family #o #ahit papaano #ahit na madami a#ong ginagawa! C0ung may family conflicts& dinadaan na lang namin sa usapan para maayos na ma) solve! C?ala din #aming situational crisis na dinanas #asi nga palagi #aming masaya! 'here is also sufficient income for their needs and she feels li#e a part of the community that they are living in!

$olume 67 p! =8=/

Messages are constantly eing communicated among family mem ers& oth ver ally and nonver ally! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 67 p! =8=/ Gole performance relates what a person in a particular role does to the ehaviors e+pected of that role! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 6<<A/ *amily coping mechanisms are the ehaviors of families use to deal with stress or changes imposed from either within or without! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 67 p! =85/ "ociologic factors) poverty is a ma;or pro lem that affects not only the family ut also the community and society! 0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 67 p! =8A/

"e+ual) reproductive S> 'he client e+presses herself as a woman y Bender) role ehavior is the outward wearing clothes that are appropriate for women e+pression of a person(s sense of maleness or li#e her! femaleness as well as the e+pression of what is perceived as gender) appropriate ehavior! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 6<98/ "he is also comforta le in the gender in which Bender identity is one(s self) image as a female she elongs and she doesn(t have any or male! .0o1ier 2 3r (s *undamentals of pro lems with regards to this #ind of matter! 4ursing 5th 3dition $olume 97 p! 6<98/ Her relationship with the opposite se+ is normal in a way that she is comforta le with communicating with them! "he can go with any ody& whether male or female may it e! Gight now& she has someone significant in her life and she feels satisfied with it! "he first had her menstrual period when she was in Brade A! ,t happened in the year 9<<< and she was eleven years old at that time! Her menstrual period happens every second wee# of the month and she consumes at least three - positive se+ self) concept ena les to form intimate relationships throughout life! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 6<98/ Menarche .onset of menstruation/ occurs in girls! ! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 67 p! 85=/

to four pads a day! "he doesn(t have any menstrual pro lems! Eysmenorrheal .painful menstruation/ is prevalent among adolescent females! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 6<6F/ Monthly reast self) e+amination .B"3/ for women and monthly testicular self) e+amination .'"3/ for men can play an important role in early detection of disease& resulting in a greater chance of cure and less comple+ treatment! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 6<8=/

"he doesn(t perform reast self) e+amination! ."he does not perform reast self) e+amination ecause she is not familiar of the steps on how to do it!) health perception and management pattern/

O> Breast and -+illae) "i1e& symmetry& contour or shapeK *emalesK rounded shape& slightly unequal in si1e7 generally symmetric7 Jniform s#in color.same appearance as s#in of a domen or ac#/7 s#in smooth intact7 diffuse symmetric hori1ontal or vertical vascular pattern in light)s#inned people7 striae. stretch mar#s/7 moles and nevi7 Gound or oval and ilaterally the same7 colors varies widely7 form light pin# to dar# rown7 irregular placement of se aceous glands on the surface of the areola.Montgomery(s tu ercles/7 Gound& everted& and equal in si1e7 similar in color7 soft and smooth7 oth nipples point at the same direction7 4o tenderness& masses& nodules or nipple discharge7 4o tenderness& masses& nodules or nipple discharge %oping "tress 'olerance S> ,n relation to stress& here is what the client has 'ime management) people who manage their stated! 4a#a#a) stress sa#in pag hindi #o na time effectively usually e+perience less stress alam #ung ano ang uunahin #o pag so rang ecause they feel more in control of their dami na ng gawain! circumstances! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 6<:6/ C"a mga ganung sitwasyon& pinipilit #ong - coping strategy .coping mechanism/ is a #umalma& na#i#inig a#o sa music o #aya natural or learned way of responding to a nananahimi# para ma#apag) isip) isip! Banito changing environment or specific pro lem or din ang ginagawa #o #apag may mala#ing situation! .0o1ier 2 3r (s *undamentals of pro lema a#ong naencounter! Para sa#in& it(s 4ursing 5th 3dition $olume 97 p! 6<A5/ effective at na#a#atulong talaga para gumaan ang pa#iramdam! Hindi naman a#o tense palagi #aya o#ey pa naman a#o! C"iguro ang taong pina#a) na#a#atulong sa#in sa lahat ng agay e ang nanay #o tapos sumunod ang mga friends #o! CPag may lumalait sa#in& wala a#ong pa#ialam #asi ang sa#in lang& ahala na sila sa %risis counseling focuses on solving immediate pro lems and it involves individuals& groups& or families! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 6<:8/ 3+ternal stressors originate outside the individual& for e+ample& a move to another city&

uhay nila at isa pa& hindi mo naman mapi) please ang lahat ng tao sa paligid mo e!

CPag may failure naman& tinatanggap #o na lang at iniisip #o na lang na sa susunod alam #o na ang gagawin #o sa susunod na malagay ulit a#o sa ganung sitwasyon! O> %lient(s attitude) - le to follow instructions %lient(s affectHmood7 appropriateness of the client(s responses) -ppropriate to the situation Iuantity and quality of speech) Jnderstanda le& moderate pace& low tone Gelevance and organi1ation of thoughts) Has a sense of reality& Dogical sequence $alues Belief S> 'he client is part of the religious group& Iglesia -lthough people derive values from society and ng Diyos kay Cristo Jesus and Haligi at Suhay their individual su groups& they internali1e ng Katotohanan, and she finds it interesting some or all of these values and perceive them and satisfying. as personal values! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 67 p! 5</ "he e+presses her faith y attending their Beliefs .or opinions/ are interpretations or church activities! "he elieves that faith could conclusions that people accept as true! 'hey help her in anyway of her life! >n a scale of 6) are ased more on faith than fact and may or 6<& she rates the importance of her religious may not e true! Beliefs do not necessarily elief or practice as 5 ecause it gives her involve values! .0o1ier 2 3r (s *undamentals energy to face every challenges that she might of 4ursing 5th 3dition $olume 67 p! 5</ e encountering each day! *or her& health is very important so that you could live life as you want it to e! Di#e for e+ample& you can do all of the things that you would li#e without any restrictions or hindrances and you could sociali1e with others easily and so that many people will li#e you! 3thics) . / the practices or eliefs of a certain group .e!g!& medical ethics& nursing ethics/! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 67 p! 58/ -utonomy refers to the right to ma#e one(s own decisions! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 67 p! 55/

a death in the family& or pressure from peers! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 6<A6/ "ituational stressors are unpredicta le and may occur at any time during life! .0o1ier 2 3r (s *undamentals of 4ursing 5th 3dition $olume 97 p! 6<A6/

PROBLEM IDENTIFICATION
CLUSTERED CUES S> Based from the given question How would you range your health status today? the client answered 5 ecause most of the time she feels stressed! INFERENCES Health Perception and Management Eistur ed energy field related to situational factors due to stress DIAGNOSTIC STATEMENTS

,nstruct in use of stress) reduction activities .e!g!& centeringH meditation& rela+ation e+ercises/ to promote harmony etween mind) ody) spirit! >4urse(s Poc#et Buide 66th 3dition

 "he does not perform reast self) e+amination ecause she is not familiar of the steps on how to do it!

,neffective health maintenance related to unachieved developmental tas#s

p!956 Provide information a out individual health care needs using client(sH ">(s preferred learning style .e!g! pictures& words& video& internet/ to assist the client in understanding own situation and enhance interestH involvement in meeting own health needs! >4urse(s Poc#et Buide 66th 3dition p!8AF Eiscuss protective actions for specific ad air days .e!g! limitingH avoiding outdoor activities/ especially in sensitive groups .e!g!& children who are active outdoors& adults involved in moderate or strenuous outdoor activities& persons with respiratory diseases/! >4urse(s Poc#et Buide 66th 3dition p!96< Promote community education programs geared to increasing awareness of safety measures and resources availa le to the individual .e!g!& correct use of child safety seats& icycle helmets& home ha1ard information& firearm safety& fall prevention& %PGH first aid& etc!/ >4urse(s Poc#et Buide 66th 3dition p!=6:

- out the presence of environmental contaminants& the client ver ali1ed that&>#ey naman sa ahay& malinis naman at walang lamo# o #ung anumang madumi! @un nga lang pag papunta na a#o sa school& dun madalas mas madaming dumi tulad na lang ng uso# sa sigarilyo at sasa#yan! Meron a#ong sugat sa left leg #o! 'inahi siya& mga 68 stitches yun! 4a asagan #asi a#o ng ote sa paa #aya ayunC nasugatan a#o! 'he client said& when she was as#ed if there are any important in;uries or illnesses in her life!

contamination pollution

due

to

air

in;ury related to internal ris# factors due to ro#en s#in .physical/

O> Perception of changes in patterns of energy flow& such asK movement .wave& spi#e& tingling& dense& flowing/& sounds .tone& words/& temperature change .warmth& coolness/& visual changes .image& color/& disruption of the field .deficient& hole& spi#e& ulge& o struction& congestion& diminished flow in energy field/! Eemonstrated lac# of

#nowledge regarding health practices!

asic

PollutionK .Ma;or DocationsK air& water& soil7 ma;or agentsK as estos& radon& to acco Qsmo#eR& heavy metal& lead& noise& e+haust! 3limination S> "he sometimes hesitates to urinate whenever she(s in the middle of an e+amination! .hesitancy) 4urse(s Poc#et Buide p! :96/ O> Getention ,mpaired urinary elimination -scertain client(s previous pattern of elimination for comparison with current situation! -s# a outH note reports of pro lems .e!g!& frequency& urgency& painful urination7 lea#ingHincontinence7 changes in si1eH force of urinary stream7 pro lems emptying ladder completely7 nocturiaH enuresis! >4urse(s Poc#et Buide p!:98) :9=

-ctivity)3+ercise S> C-ctually& #ulang talaga ang oras #o o sa ihin na nating wala na rin a#ong oras para dun sa e+ercise #asi mas madami pang school wor# na ini igay ngayong semester na Oto! "yempre& hindi rin a#o satisfied sa #ung ano mang e+ercise ang nagagawa #o sa isang araw #asi #ulang nga yung oras!N NMinsan di #o na #ina#ayang mag) engage pa sa i ang physical activities #asi stressed at pagod na rin a#o galing school! .ver al report of fatigueH wea#ness) 4urse(s Poc#et Buide p!:</ C-yo#o #asi ng masyadong na#a#apagod na gawain #asi palagi na nga a#ong pagod dahil sa wor# e!N the client said! .ver ali1es preference for activities low in physical activities) 4urse(s Poc#et Buide p!==6/ 'he only thing that has "edentary lifestyle related to lac# of time "chedule ample time to perform e+ercise activities alanced with adequate rest periods! >4urse(s Poc#et Buide p!==9

-ctivity ,ntolerance related to generali1ed wea#ness

Plan care to carefully alance rest periods with activities to reduce fatigue! >4urse(s Poc#et Buide p!:9

"edentary lifestyle related to lac# of training for accomplishment of physical e+ercise

Eeficient Eiversional -ctivity

Eetermine client(s actual a ility to participate in e+erciseH activities& noting attention span& physical limitationsH tolerance& level of interestH desire& and safety needs! ,dentifies arriers that need to e addressed! >4urse(s Poc#et Buide p!==8 Geview history of lifelong

changed is that she sheOs getting tired everyday ecause of school wor#! .changes in a ilitiesH physical limitations) 4urse(s Poc#et Buide p!9:A/ >n a scale of 6) 6<& with 6 eing the lowest and 6< eing the highest& the client rated her stress level as F and ver ali1ed that& N3 so rang dami ng pinipagawa a naman& #ung hindi #a a maover) stressed nun!N 4oise and temperature are the factors which contri ute to the client(s fatigue! .perceived need for additional energy to accomplish routine tas#s7 increase in rest requirements) 4urse(s Poc#et Buide p!8<5/ O> Dac# of energy %hooses a daily routine lac#ing physical e+ercise

related to fatigue physical limitations

and

activities and ho ies client has en;oyed! Eiscuss reasons client is not doing these activities now and determine whether client canH would li#e to resume these activities! >4urse(s Poc#et Buide p!9::

*atigue related environmental factors noise and stress

to li#e

Eiscuss lifestyle changesH limitations imposed y fatigue state! >4urse(s Poc#et Buide p!86<

"leep) Gest S> 'he client is a le to sleep for at least four to seven hours a day! "he usually sleeps at one o( cloc# in the morning and wa#es up at seven o( cloc# in the morning! O> ina ility to concentrate %oping "tress 'olerance S> ,n relation to stress& here is what the client has stated! 4a#a#a) stress sa#in pag hindi #o na alam #ung ano ang uunahin #o pag so rang dami na ng gawain! .e+presses difficulty in functioningH pro lems with decision ma#ing) 4urse(s Poc#et Buide p!A5F/ "tress overload ,ncorporate strengthsH assets and past coping strategies that were successful for client! Geinforces that client is a le to deal with difficult situations! "leep deprivation related to inadequate daytime activity! Eetermine client(s usual sleep pattern and e+pectations! Provides comparative aseline! >4urse(s Poc#et Buide 66th 3dition p!A89