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If a disease is not treated when it appears, it will develop with time according to the
seven stages of illness. The duration of each stage varies from person to person
depending on their constitution and condition. Sometimes these stages overlap.

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This is caused by a chaotic and ungrateful life. No harmony and no gratitude and
much animal and junk foods. A passing flu or general fatigue fall under this

Examples of this stage of illness

Passing colds, fatigue, lethargy.


This is caused by low judgment on many levels. Violating the order of the universe
has begun to have consequences. The patient has begun to feel that all is not well
with the world. The daily routine begins to get disrupted by pain and suffering.

Examples of this stage of illness

Constipation, diarrhea, hepatitis, migraines, polio, psoriasis, syphilis & gonorrhea,

typhoid & brucellosis, insomnia, HIV AIDS.


The disease has ascended into a more serious level. The pain and suffering are now
permanent and have begun to slowly change daily routine.

Examples of this stage of illness

Anemia, heart and artery disease, arthritis, chlamydia & candida, Irritable bowel
syndrome, eczema, gallstones, hepatitis, herpes, high blood pressure, kidney
stones, lyme disease, malaria & cholera, migraines, ovarian cysts, psoriasis,
syphilis & gonorrhea, hyper-thyroid & hypo-thyroid, tonsillitis, tuberculosis, peptic
ulcers, varicose veins,vitiligo, asthma, gout, uric acid, acne, HIV AIDS, diabetes
type II, lupus.


As toxic build up increases it begins to seep into the nervous system. Nervousness
and decreased concentration appear. Clarity of vision begins to deteriorate.
Examples of this stage of illness

Behcets diseaseR inflammatory bowel diseaseR epilepsyR advanced

hepatitisRadvanced lyme diseaseR multiple sclerosisR post-polio syndromeR
syphilis & gonorrheaR HIV AIDSR lupus


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As toxic build up continues, it begins to cause gradual but permanent damage and
deformations in the vital organs in the body. This is always associated with much
pain and suffering.

Examples of this stage of illness

Fibroids, gangrene, advanced hepatitis, liver cirrhosis, advanced lyme disease and
its neurological complications, advanced multiple sclerosis, thyroid nodules & goiter,
tuberculosis, ulcerative colitis &crohn's disease, gout, HIV AIDS-related illnesses,
cancer, diabetes type I, lupus, osteoporosis.

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As serious illness begins to affect the vital organs, psychological disturbances begin
to overwhelm the patient. Each organ is associated with a form of emotion. The
liver is associated with anger and dark thoughts, the kidneys with fear and
exclusiveness. Most psychological disorders are a consequence of getting to this
stage of physiological disease.

Examples of this stage of illness

Advanced multiple sclerosis, Alzheimer's disease, depression & major depression.


This is the last stage as the patient begins to realize that there is something terribly
wrong, and that possibly the end is near.

Examples of this stage of illness

All diseases lead to this stage if not treated properly and naturally in time.

0ealth Perception and Management

The following questions pertain to those asked by the nurse to provide an overview
of the individuals health status and health practices that are used to reach the
current level of health or wellness. -History (subjective data) -Client¶s general
health? -Any colds in past year? If appropriate: any absences from work/school? -
Most important things you do to keep healthy? -Use cigarettes, alcohol, drugs, -
Perform self exams, i.e. Breast/testicular self-examination? -Accidents at home,
work, school, driving? -In past, has it been easy to find ways to carry out doctor¶s
or nurse¶s suggestions? -(If appropriate) What do you think caused current illness?
What actions have you taken since symptoms started?? Have your actions helped? -
(If appropriate) What things are most important to your health? How can we be
most helpful? done exercise every what?

m tritional metabolic

This pattern describes nutrient intake relative to metabolic need. -History

(subjective data) -Typical Daily Food intake? (Describe) Use of supplements,
vitamins, types of snacks? -Typical Daily Fluid intake (Describe) -Weight loss/gain?
Height loss/gain? -Appetite? Breastfeeding?Infant feeding? -Food or Easing:
Discomfort, Swallowing difficulties, diet restrictions, able to follow? -Healing ± any
problems? -Skin problems: lesions? Dryness? -Dental problems? -Examination
(examples of objective data0 -Skin assessment, oral mucous membranes, teeth,
actual weight/height, temperature, -Abdominal Assessment


Describes the function of the bowel, bladder and skin. Through this pattern the
nurse is able to determine regularity, quality, and quantity of stool and urine. -
History (subjective data) -Bowel elimination pattern (describe) Frequency,
character, discomfort, problem with bowel control, use of laxatives (i.e. type,
frequency), etc. -Urinary elimination pattern (describe) Frequency, problem with
bladder control? (Describe) -Excess perspiration? Odour problems? -Body cavity
drainage, suction, etc.? -Examination (examples of objective data) -If indicated,
examine excretions or drainage for characteristics, colour, and consistency -
Abdominal assessment

Activity exercise
This pattern centers on activity level, exercise program, and lesire activities. -
History (subjective data) -Sufficient energy for desired and/or required activities? -
Exercise pattern? Type?regularity? -Spare time (leisure) activities? (Child-play
activities) -Perceived ability for Feeding, Grooming, Bathing, General mobility,
toileting, home maintenance, bed mobility, dressing and shopping. -Examination
(examples of objective data) -Demonstrate ability for above criteria -Gait?
Posture?Absent body part? -Range of motion (ROM) joints? -Hand grip? Can pick up
pencil -Respirations? -Blood pressure -General appearance -Musculoskeletal,
cardiac and Respiratory Assessments

cleep rest

-Assesses sleep and rest patterns. -History (subjective data) -Generally rested and
ready for activity after sleep? -Sleep onset problems? Aids?Dreams (Nightmares)
Early awakening -Rest-relaxation periods? -Examination (example of objective
data) -Observe sleep pattern and rest pattern

Cognitive-percept al

Assesses the abiltity of the individual to understand and follow directions, retain
information, make decisions, and solve problems. Also asesses the five senses. -
History (Subjective data) -Hearing difficulty? Hearing Aid? -Vision? Wears glasses?
Last checked? When last changed? -Any change in memory? Concentration? -
Important decisions easy/difficult to make? -Easiest way for you to learn things?
Any difficulty? -Any discomfort? Pain? IF appropriate ± PQRST questions PQRST P ±
Palliative, Provocative Q- Quality or quantity R ± Region or radiation S- Severity or
scale T -timing (Morton, 1977) COLDSPA C- Character O- Onset L- Location D-
Duration S ± Severity P- Pattern Associated factors (Weber, 2003)

-Examination (examples of objective data) -Orientation -Hears whispers? -Reads

newsprint? -Grasps ideas and questions (abstract, concrete) -Language spoken -
Vocabulary level -Attention span

celf perception/self concept

-History (subjective data) -How do you describe yourself? Most of the time, feel
³good´ (not so good) about self? -Changes in body or things you can do? Problems
for you?

-Changes in the way you feel about self or body (generally or since illness started)?
-Things frequently make you angry? Annoyed? Fearful?Anxious? Depressed? Not
able to control things? What helps? -Ever feel you lose hope?
-Examination (examples of objective data) -Eye contact. Attention span
(distraction?) -Voice and speech pattern. Body posture. -Client nervous (5) or
relaxed (1) (rate scale 1-5) -Client assertive (5) or passive (1) (rate scale `-5)

role relationship

-History (subjective data) -Live alone? Family?Family structure? -Any family

problems you have difficulty handling (nuclear/extended family)? -Family or others
depend on you for things? How well are you managing? -If appropriate ± How
families/others feel about your illness? Problems with children? -Belong to social
groups? Close friends? Feel lonely? (Frequency) -Things generally go well at work?
School? -If appropriate ± income sufficient for needs? -Feel part of (or isolated in)
your neighbourhood?

-Examination (examples of objective data) -Interaction with family members or

others if present

cex ality reprod ctive

-History (subjective data) -If appropriate to age and situation ± Sexual relationships
satisfying? Changes?Problems? -IF appropriate ± Use of contraceptives? Problems?
-Female ± when did menstruation begin? Last menstrual period (LMP)? -Any
menstrual problems? Gravida/Para if appropriate)

-Examination (examples of objective data) -None unless a problem is identified or a

pelvic examination is warranted as port of full physical assessment (advanced
nursing skill)

Coping-stress tolerance

-History (subjective data) -Any big changes in your life in last year or two? Crisis? -
Who is most helpful in talking things over? Available to you now? -Tense or relaxed
most of the time> When tense, what helps? -Use any medications, drugs, alcohol to
relax? -When (if) there are big problems in your life, how do you handle them? -
Most of the time, is this (are these) ways successful?

-Examination -None

Val e-Belief Pattern

-History (subjective data) -Generally get things you want from life? Important plans
for future? -Religion important to you? If appropriate - Does this help when
difficulties arise? -If appropriate ± will being here interfere with any religious
practices? -Examination -None