Here is a prioritized list of the patient's problems: 1. Constipation r/t obstruction 2. Acute Pain r/t obstruction 3. Acute pain r/t surgical incision 4. Altered comfort secondary to pain 5. Fatigue r/t post-operative experience 6. Impaired Skin Integrity r/t surgery 7. Altered Health Maintenance r/t choice of health practices 8. Health-Seeking Behavior r/t concern for health status 9. High Risk for Injury r/t developmental age 10. Readiness for enhanced ability to eliminate waste products r/t post-operative experience

1. Gordon’s Functional
Health Pattern

2. A. Health Perception and Management
Prior to admission:
•Can only recall being immunized with BCG and DPT
•Rarely visits a doctor to have a check-up and seek for
medical assistance
•Uses herbal medicines such as oregano, guava, bitter
gourd, and ginger
•Buys and takes over the counter drugs such as Solmux,
Neozep, Biogesic, Mefenamic acid, Diatabs, and
Loperamide.
•Stopped taking multivitamins Enervon
•When sick, goes to the manghihilot or just waits for
the sickness to heal

3. •Practices healthy lifestyle and depends on fruits and
vegetables
•No vices since young such as drinking alcoholic
beverages and smoking cigarette
•After experiencing difficulty in defecating, she
decided to see a physician
During hospitalization:
•Oriented
•Conscious and coherent
•Concerns for her surgical site after incision and repair
•Willing to accept and listen to health teachings
•Shows interest to recover easily and fast
•Always prays to God

4. B. Nutrition/ Metabolism
Prior:
•Eats more of fruits and vegetables
•Eats her meals 3x a day with snack in between
•Can drink up to 1.5L of water or 4-5 glasses a day
•Drinks coffee in the morning and in the afternoon
•Claimed to be allergic on shrimps and claimed to have
good appetite

5. During:
•Weight: 41 kg
•Height: 4 ft and 10 in
•Normal Body Mass Index; BMI = 18.89 kg/m2
•Average Body Temperature is 360 C
•Able to fast in preparation for surgical procedure
•Before operation, being infused with an IVF of D5NM 1L x
160 hooked at her left cephalic vein
•After operation, being infused with an IVF of PLR 1L x 8
hours as main line hooked at her left cephalic vein with a
side drip of PNSS 500mL + 2 ampules Voltaren at 20cc/hr
and an IVF of PNSS 1L x KVO hooked at her right cephalic
vein with a side drip of 2units PRBC
•On NPO

6. C. Elimination
Prior:
•She voids 4-5 times a day
•Her urine color is yellow which is dark most of the times
•There is no burning sensation/ pain felt during urination
•She usually moves her bowel every morning
•With brown and formed stools. But recently, she is having
difficulty in defecating
•The impression to the result of the ultrasound of her whole
abdomen is to consider ileus; partial obstruction and fecal
stasis

7. During:
•No pain or burning sensation during urination
•Before operation, she experienced vomiting with
yellowish vomitus and hasn’t move her bowel all
throughout the 8 hour shift
•After undergoing the surgical procedure, a nasogastric
tube is used which is attached to a drainage bottle; a
colostomy is present attached to a colostomy bag
•After operation, a foley catheter was used which is
attached to the uro bag draining well with dark yellow
urine with an output of 175 cc was taken after the shift

8. D. Activity/Exercise
Prior:
•The patient ambulates within the house
•She does household chores
•She takes a walk at their subdivision to visit the
neighbors and buy at the store
•She does simple exercises on the upper and lower
extremities by means of shaking and stretching
•Able to bathe herself

9. During:
•Reaction to stimuli are slower
•Decreased strength; becomes weak in prolonged activities
•Decreased speed of movement
•Limited range of motion
•Radial pulse rate easily palpable and heard
•PR: 70 bpm
•RR:18 cpm
•BP: 110/80 mmHg
•Before operation, patient can turn to sides with slight
discomfort and can ambulate with assistance
•After operation, patient is on bed rest; flat on bed and
shows evidence of weakness
•Steady and in deep sleep for 4 hours

10. E. Sexuality/ Reproductive
•Married
•A mother of 4 children
•Menarche was on the year 1938 when she was 11 years
old
•On her menopausal stage
•She has no history of Sexually Transmitted Disease or
any disease affecting her genitals

11. F. Cognitive/Perceptual
Prior:
•No sensory deficits but functions are diminished due to age
•Oriented to people, time, and place
•Responds to stimuli verbally and physically
•Pain felt radiating on the abdomen
During:
•Pre-operative Phase
•Before operation, she verbalized, “Sakit kaayo akong tiyan
tapos butod ko. Magbalik-balik ang sakit.”

12. •She rated pain as 8, from a pain scale of 1-10, 10 as the
highest possible pain perceived
•She claimed that pain starts at the right upper quadrant
and radiates all throughout the abdomen
•Claimed pain to be intermittent
•In normal thought process
Post-operative Phase
•“Akong tahi, nagasakit pa.”, as verbalized
•Felt pain around the surgical site
•Slight facial grimacing
•Can respond to stimuli verbally and physically with
weakness noted
•Believes that pain felt is due to post-operative experience

13. G. Roles/Relationship
Prior:
•Married
•With 4 children
•Lives with the youngest child
•Close to her grandchildren
•Loves her family so much
•Well – supported and loved by her family with close
relationship
During:
•Well – supported by the family
•Still plays the role of a mother despite condition by means
of reminding important matters to her children

14. H. Self-Perception/Self-Concept
Prior:
•Manages to practice healthy lifestyle so as not to seek medical
assistance
•Recently, she believed that admission will be helpful to assist her in her
needs, to alleviate the pain she felt, and to correct her bowel
•Hopeful to be relieved and treated
During:
•Though weak, she still manages to appear calm and relaxed
•Agreed to be operated and undergo surgery and gives her trust to the
surgical team
•Hopeful and positive to have a successful operation
•Before operation, she prays all the time
•She desires that no complications will arise after the surgery
•Major concern is her recovery

15. I. Value/Belief
Prior:
•A Roman Catholic
•Have strong faith in God
•She always brings with her the rosary and always prays at
night
•She goes to the church with her youngest child and her
grandchildren to attend the mass every Sunday
During:
•No restrictions in the procedure brought by religion
•The admission and surgery don’t interfere with spiritual
practices

16. J. Coping/Stress
Prior:
•Copes up with stress by doing household chores and by
taking a nap or sleep
•Copes up with problems by talking about it with the family
and finds ways to resolve it together
•No traumatic events experienced before
•Reason for admission is to alleviate the pain and correct
her bowel
•Went to hospital and sought for medical assistance after
experiencing inability of defecating
During:
•Takes a nap and rests when tired
•Verbalizes desires to recover
•Able to accept situation by cooperating with the medical
advices and procedures

17. K. Sleep/Rest
Prior:
•Can sleep for 7-9 hours per night
•Straight hours of sleep
•Her earliest time in going to sleep is at 9:30 PM
•Latest time in waking up is at 6:30 AM
•She sometimes takes a nap at noon for about 1-3 hours
•No difficulties in going to sleep
•Doesn’t uses any medication to promote sleep
During:
•Sleeps at 8:00 PM
•Wakes up at 6:00 AM
•Can consume 10 hours of sleep
•Sometimes, she is distracted and sleep is interrupted due
to pain, administration of medication and visitors
•With rest intervals, usually naps for 4 hours

18. L. Medication History
Prior:
•Took Bentyl and Loperamide
During:
•Pre-operative Phase
•IVF of D5NM 1L x 160
•Completed 6 doses of Kalium Durule 1 tab TID
•Completed 3 doses of Senokot Forte 2 tabs BID
•Administered with Motillium 10 mg 1 tab TID
•Nexium 40 mg 1 tab OD
•Lactulose 30 cc

19. Post-operative Phase
•IVF of PLR 1L x 8 hours as main line with a side drip of
PNSS 500mL + 2 ampules Voltaren at 20cc/hr
•PNSS 1L x KVO with a side drip of 2units PRBC
•On NPO
•Administered with Cefuroxime 750 mg q80 IVTT
•Metronidazole 500 mg q80 @ am
•Omepron OD 40 mg IVTT
•Voltaren 20 cc/hr
•2nd dose of 12 doses Nalbuphine 5 mg q60 IVTT
•Nebulized with Convibent q80

20. Problem List
Problem Date Time Date
Identified Resolved
1. Constipation r/t obstruction 12-13-10 8:30 AM 12-13-10
as manifested by difficulty
and inability to defecate,
abdominal distention, result
of diagnostic test, and
vomiting
2. Acute Pain r/t obstruction as 12-13-10 8:35 AM 12-13-10
manifested by pain rate of
8, from a pain scale of 1-
(Monitori
10, 10 as the highest ng)
possible pain perceived,
claims of intermittent
radiating pain on the
abdomen, and abdominal
distention

21. 3. Altered Health Maintenance 12-13-10 9:30 AM 12-13-10
r/t choice of health
practices as manifested by
not seeking medical
assistance if ill
4. Health-Seeking Behavior r/t 12-13-10 9:35 AM 12-13-10
concern for health status as
manifested by healthy lifestyle
and desire to be treated and to
recover
5. High Risk for Injury r/t 12-13-10 10:00 AM 12-13-10
developmental age as
manifested by decreased
strength, weakening, and
limited range of motion
6. Acute pain r/t surgical 12-14-10 8:30 AM 12-14-10
incision as manifested by
verbalization of perceived pain (Monitorin
around the surgical site, and g)
slight facial grimacing

22. 7. Altered comfort secondary to 12-14-10 8:35 AM 12-14-10
pain as manifested by frequent
sighing and complaints of pain
8. Fatigue r/t post-operative 12-14-10 9:00 AM 12-14-10
experience as manifested by
evidence of weakness and
deep sleep
9. Impaired Skin Integrity r/t 12-14-10 9:15 AM Not yet
surgery as manifested by resolved
presence of surgical incision
and colostomy
10. Readiness for enhanced 12-14-10 10:30 AM 12-14-10
ability to eliminate waste
products r/t post-operative
experience as manifested by
proper management and
cooperation

23. Prioritization