PATIENT & FAMILY

EDUCATION

Client education is an integral part of nursing

care.
It is the nurses responsibility to assist the
client to identify the learning needs and
resources that will restore and maintain an
optimal level of functioning.

FACTS RELATED TO PATIENT TEACHING

a.

Patient teaching is a function of nursing and a

legal requirement of nursing personnel. In some
states teaching is included in the legal definition
of nursing, making it a required function of
nursing personnel by law.

b. Patient teaching is defined as a system of

activities intended to produce learning. These
activities should help the patient meet individual
learning objectives. If they do not, the patient's
need should be reassessed and the activities
replaced by others.

c. Patient teaching is a dynamic interaction between

the nurse (teacher) and the patient (learner).
Both the teacher and the learner communicate
information, emotions, perceptions, and attitudes
to the other.
d. Before learning can occur, a relationship of trust
and respect must exist between the teacher and
learner. The learner trusts the teacher to have the
required knowledge and skills to teach and the
teacher respects the learner's ability to reach the
goals.

e. The goal of patient teaching is the patient's

active participation in health care and his
compliance with instructions. Once the nurse
begins instructing a patient (or
family/support persons), the teaching
process should continue until the participants
reach the goals, change the goals, or decide
that the goals will not help meet the learning
objectives.

Client teaching is done for a variety of

reasons, including:
Promotion of wellness
Prevention of disease/injury
Restoration of health
Facilitation of coping abilities

The teaching-learning process is a planned

interaction that promotes behavioral change
that is not a result of maturation or coincidence.
Teaching is an active process in which one
individual shares information with others to
provide them with the information to make
behavioral changes.
Teaching refers to all the activities used by a
teacher to assist the learner to absorb new
information; it consists of activities that promote
change.
Teaching is a goal-directed process that provides
the opportunity for learning.

Learning is the process of assimilating

information with a resultant change in
behavior.
Nurses and clients have shared
responsibilities in the teaching-learning
process.
Knowledge is power.

BARRIERS TO LEARNING
External Barriers
Environmental
Interruptions
Lack of privacy
Multiple stimuli

Sociocultural
Language
Value system
Educational
background

Internal Barriers
Environmental
Anxiety
Fear
Anger
Depression
Inability to
comprehend

Physiological
Pain
Fatigue
Sensory deprivation
Oxygen deprivation

STEPS IN THE TEACHINGLEARNING PROCESS

a. Assess the Patient's Learning Needs.

(1) Use all appropriate sources of information.
Review the patients medical records. Read the
history of medical problems as well as diagnoses,
physical examinations, documentation of the
nursing assessment, and the nursing
interventions that have been performed. The
patient and the family or support persons are the
best source of needs assessment information.
(2) Identify the knowledge, attitude, or skills
needed by the patient or family/support persons.
Learning can be divided into three domains:
cognitive, affective, and psychomotor. You may
categorize learning that is planned for the patient
into these three areas.

(a) Cognitive involves the storing and recalling

of new knowledge and information.
(b) Affective learning includes changes in
attitudes, values, and feelings.
(c) Psychomotor learning has occurred when a
physical skill has been acquired.

(3) Assess emotional and experiential readiness to

learn. Readiness is not the patient's physical
ability to learn. The readiness to learn in an adult
may be related to a social role. Being assured
that they are partners in the teaching-learning
process gives adult learners the sense of control
that they are accustomed to in their daily living.
(4) Assess the patient's ability to learn. The
teaching approach must be appropriate to the
developmental stage of the learner. You should
assess the patient's intellectual development,
motor development, psychosocial development,
and emotional maturity. Chronological age does
not guarantee maturity.

(5) Identify the patient's strengths. Learning

strengths are the patient's personal resources
such as psychomotor skills, above-average
comprehension, reasoning, memory, or successful
learning in the past. For example, if the patient
knows how to cook, this knowledge can be useful
when learning about a special diet.
(6) Use anticipatory guidance. Anticipatory
guidance focuses on psychologically preparing a
person for an unfamiliar or painful event. When
patients know what to expect, anxiety is reduced
and they are able to cope more effectively.

b. Diagnose the Learning Needs. Be realistic.

When a lack of knowledge, attitude, or skill
hinders a patient's self-promotion of health,
the nurse diagnoses the deficit. Confirm your
diagnosis with the family.

c. Develop a Teaching Plan. Planning ensures the

most efficient use of your time and increases the
patient's chances for learning. A teaching plan
follows the steps of the nursing process.
(1) Develop measurable learner objectives for each
diagnosis of a learning need.
(a) Identify short-term and long-term objectives.
(b) Prioritize the objectives.
(c) Determine who should be included in the
teacher-learning process (family members,
friends, or other support persons). For example,
the person who cooks for the patient is asked to
participate in any nutritional teaching.
(d) Include the patient in planning. Ask his
permission to involve family members or others.

(2) Create a teaching plan. One nurse or

several nurses can prepare and use a
teaching plan. There are standardized
teaching plans available for major topics of
health teaching (some for computer use).
Individualize the standardized plans to the
patient's needs and abilities.

(a)

Match content with the appropriate teaching

strategies and learner activities. For example,
content explaining why certain treatments and
medications are needed may be matched with
printed or audiovisual materials. Children
respond well to teaching strategies that permit
them to participate actively.

(b) Schedule teaching within the limits of time

constraints. Shorter, more frequent sessions allow
the patient to digest the new information and
prevents him from becoming tired or
uncomfortable due to his illness.

(c) Decide on group or individual teaching and

formal or informal teaching. Some learner
objectives are met more readily in a one-to-one
encounter (i.e., colostomy care) while others are
met more easily in a group discussion with other
patients that have similar problems. Formal
teaching is the planned teaching done to fulfill
learner objectives. Informal teaching occurs
during nursing interactions with the patient and
his family.

(d) Formulate a verbal or written contract with

the patient. The contract is informal and is
not legally binding; however, such an
agreement serves to motivate both the
patient and the nurse to attain the learning
objectives. It points out the responsibilities
of both the nurse (teacher) and the patient
(learner).

d. Implement the Teaching Plan. The

implementation phase may be only a
few minutes or the sessions may
extend over a period of days, or
perhaps months. Use interpersonal
skills as well as effective
communication techniques. Do not use
technical and medical terms unless the
patient has a medical background, but
avoid a condescending attitude.

GUIDELINES

FOR

TEACHING CHILDREN

Make sure the client is comfortable.

Encourage caregiver participation.
Assess developmental level. Do not equate
age with developmental level.
Assess clients learning readiness and
motivation.

Assess clients psychological status.

Determine self-care abilities of client and
caregiver.
Use play, imitation, and role playing to make
learning fun and meaningful.
Use different visual stimuli such as books,
chalkboards, and videos to convey information
and check understanding.

Use terms that are easily understood by the client

and caregiver.
Provide frequent repetition and reinforcement.
Develop realistic goals that are consistent with
developmental abilities.
Verify clients understanding of information
presented.

GUIDELINES FOR
TEACHING ADOLESCENTS
Show respect for adolescents by recognizing
that they still have to gain the knowledge
and experience of adulthood while struggling
to break away from the grasp of childhood.
Boost adolescents confidence by asking their
input and opinions on health care matters.
Encourage adolescents to explore their own
feelings about self-concept and
independence.
Be sensitive to the peer pressure many
adolescents face.

Help adolescents identify their positive qualities

and build on those.
Use language that is clear yet appropriate to the
health care setting.
Gear teaching to the adolescents developmental
level.
Engage adolescents in problem-solving activities
to encourage independent and informed decision
making.

GUIDELINES FOR
TEACHING OLDER ADULTS
Make sure the client is comfortable. Pain,
fatigue, and hunger can impair learning.
Assess clients learning readiness and
motivation; also assess developmental level.
Do not equate age with developmental level.
Assess clients psychological status.
Depression, severe anxiety, and denial
interfere with learning.

 Determine clients self-care abilities.

Use terms that are easily understood by the
client.
Avoid talking down to the client; a condescending,
paternalistic manner impedes learning.
Determine the time of day in which the client is
better able to concentrate.
Assess for perceptual impairments and
individualize teaching strategies accordingly

TYPES OF LEARNING

Three domains, or types of

learning, have been identified as
cognitive, affective, and
psychomotor.

a.

(1) The cognitive domain includes intellectual skills

such as thinking, knowing, and understanding.
When the patient stores and recalls information,
he is using the cognitive domain. For example,
after attending classes on the low sodium diet a
patient states how salt affects the blood pressure.
(2) The affective domain includes feelings,
emotions, interests, attitudes, and appreciations.
An example would be a patient's acceptance of
having a colostomy and maintaining his selfesteem.
(3) The psychomotor domain involves motor skills.
An example would be a patient demonstrating
clean technique when changing her dressing.
b. Nurses should include each of these three
domains in patient teaching plans

DIAGNOSTIC TESTS

ROUTINE LABORATORY TESTS

ROUTINE URINALYSIS

A urinalysis is a group of manual and/or

automated qualitative and semi-quantitative tests
performed on a urine sample.

Purpose:
Routine urinalyses are performed for several
reasons:
general health screening to detect renal and
metabolic diseases
diagnosis of diseases or disorders of the kidneys
or urinary tract
monitoring of patients with diabetes

TEST NORMAL VALUES

Color
Pale yellow to amber
Turbidity
Clear to slightly hazy
Specific Gravity
1.015-1.025
Ph
4.5-8.0
Glucose
Negative
Ketones
Negative
Blood
Negative
Protein
Negative
Bilirubin
Negative

Urobilinogen
Nitrate for Bacteria
Leukocyte Esterase
Casts

0.1-1.0
Negative
Negative
Occasional hyaline
casts
Negative or rare

Red Blood Cells

Epithelial Cells

Few

Crytals
Acid Urine,
Amorphous urates,
Uric acid,
Calcium oxalate,
Sodium acid Urates
Alkaline Urine
Amorphous phosphates
Calcium phosphate
Ammonium blurate
Triple phosphates
Calcium carbonate
White Blood Cells Negative or rare

COLLECTION OF URINE SPECIMENS

Containers

for the collection of urine should be:

a. wide-mouthed.
b. clean.
c. dry.

TYPES OF URINE SPECIMEN

1. Early morning urine specimen
This is the specimen of choice for urinalysis and
microscopic analysis, since the urine is generally
more concentrated (due to the length of time the
urine is allowed to remain in the bladder) and,
therefore, contains relatively higher levels of
cellular elements and analytes such as protein, if
present. Also called an 8-hour specimen, the first
morning specimen is collected when the patient first
wakes up in the morning, having emptied the
bladder before going to sleep.

TYPES OF URINE SPECIMEN

2. Random urine specimen
A random urine sample, taken at any time of the
day, will enable the laboratory to screen for

substances which are indicators of kidney infection.

Random specimens can sometimes give an
inaccurate view of a patient's health if the
specimen is too diluted and analyte values are
artificially lowered.

TYPES

OF URINE SPECIMEN

3. 24-Hour urine specimen

The 24-hour urine specimen is collected in a clear 2litre bottle with a stopper. On the first morning the
patient gets up and urinates; this urine is not
collected. All the urine passed during the rest of the
day and night is collected in the bottle. The next
morning the patient gets up and collects the first
urine of the morning in the bottle. The bottle
should then be taken immediately to the laboratory.
Measure the volume of urine with a measuring
cylinder and record it.

TYPES OF URINE SPECIMEN

4. Midstream urine specimen

While passing urine, the patient places an open

container in the stream of urine and collects
about 20 ml of urine. The container should be
covered immediately. This is the preferred type
of specimen for culture and sensitivity testing

because of the reduced incidence of cellular and

microbial contamination.

TYPES OF URINE SPECIMEN

5. Catheterization specimen:
Collection of urine using a catheter must be carried
out by a qualified physician or nurse. The procedure
is used for certain bacteriological tests, mainly in
women.

TYPES OF URINE SPECIMEN

6. Urine specimens from infants
Urine can be collected into a plastic bag with an
adhesive mouth. The bag is left in place for 13
hours, depending on the examination requested.

STORAGE OF URINE:
1.

Preservatives of urine for Urinalysis:

it is recommend testing urine within two hours
of its collection. However, refrigeration or
chemical preservation of urine specimens may be
utilized if testing or refrigeration within a twohour window is not possible. A variety of urine
preservatives (tartaric and boric acids being the
most common) are available that allow urine to
be kept at room temperature while still providing
results comparable to those of refrigerated urine.

Generally, the length of preservation capacity ranges

from 24 to 72 hours. When a specimen is directly
transferred from a collection cup into a preservative
tube, it provides a stable environment for the specimen
until testing can be reduces the risk of bacterial

overgrowth. Non-additive tubes (those not containing

any chemical preservatives) can be used for urinalysis,
but must be handled following strict timing and
refrigeration guidelines.

STORAGE OF URINE:
2. Preservatives for Culture and Sensitivity (C&S)
Testing:
The most common preservative used for culture and

sensitivity is boric acid, which comes in tablet,

powder form.

STOOL ANALYSIS
A stool analysis is a series of tests done on a
stool (feces) sample to help diagnose certain
conditions affecting the digestive tract.
These conditions can include infection (such
as from parasites, viruses, or bacteria), poor
nutrient absorption, or cancer

Stool analysis
Normal:
The stool appears brown, soft, and well-formed in
consistency.
The stool does not contain blood, mucus, pus,
harmful bacteria, viruses, fungi, or parasites.
The stool is shaped like a tube.
The pH of the stool is about 6.
The stool contains less than 2 milligrams per
gram (mg/g) of sugars called reducing factors.

Abnormal:
The stool is black, red, white, yellow, or green.
The stool is liquid or very hard.
There is too much stool.
The stool contains blood, mucus, pus, harmful
bacteria, viruses, fungi, or parasites.
The stool contains low levels of enzymes, such as
trypsin or elastase.
The pH of the stool is less than 5.3 or greater than
6.8.
The stool contains more than 5 mg/g of sugars called
reducing factors; between 2 and 5 mg/g is considered
borderline.
The stool contains more than 7 g of fat (if your fat
intake is about 100 g a day).

WHAT AFFECTS THE TEST

Taking medicines such as antibiotics,

antidiarrheal medications, barium, bismuth, iron,
ascorbic acid, nonsteroidal anti-inflammatory
drugs (NSAIDs), and magnesium.
Eating certain foods. For example, a diet high in
red meat can cause false-positive results in
testing for hidden (occult) blood.
Contaminating a stool sample with urine,
menstrual blood, bleeding hemorrhoids, or
chemicals found in toilet paper and paper towels.
Exposing the stool sample to air or room
temperature or failing to send the sample to a
laboratory within 1 hour of collection.

COMPLETE BLOOD COUNT

The CBC is used as a broad screening test to
check for such disorders as anemia, infection, and
many other diseases.
It is actually a panel of tests that examines
different parts of the blood

A complete blood count (CBC) is a series of tests

used to evaluate the composition and
concentration of the cellular components of blood

White blood cell (WBC) count is a count of the

actual number of white blood cells per volume of
blood. Both increases and decreases can be
significant.
White blood cell differential looks at the types of
white blood cells present. There are five different
types of white blood cells, each with its own
function in protecting us from infection.
The differential classifies a person's white blood
cells into each type: neutrophils (also known as
segs, PMNs, granulocytes, grans), lymphocytes,
monocytes, eosinophils, and basophils.

Red blood cell (RBC) count is a count of the

actual number of red blood cells per volume
of blood.
Both increases and decreases can point to
abnormal conditions.

Hemoglobin measures the amount of oxygencarrying protein in the blood.

Hematocrit measures the percentage of red blood
cells in a given volume of whole blood.
The platelet count is the number of platelets in a
given volume of blood. Both increases and
decreases can point to abnormal conditions of
excess bleeding or clotting.

Mean platelet volume (MPV) is a machinecalculated measurement of the average size

of platelets.
New platelets are larger, and an increased
MPV occurs when increased numbers of
platelets are being produced.
MPV gives information about platelet
production in the bone marrow.

Mean corpuscular volume (MCV) is a measurement of

the average size of RBCs.
The MCV is elevated when RBCs are larger than
normal (macrocytic), for example in anemia caused by
vitamin B12 deficiency.
When the MCV is decreased, RBCs are smaller than
normal (microcytic) as is seen in iron deficiency
anemia or thalassemias.
Mean corpuscular hemoglobin (MCH) is a calculation of
the average amount of oxygen-carrying hemoglobin
inside a red blood cell. Macrocytic RBCs are large so
tend to have a higher MCH, while microcytic red cells
would have a lower value.

Mean corpuscular hemoglobin concentration (MCHC) is

a calculation of the average concentration of
hemoglobin inside a red cell.
Decreased MCHC values (hypochromia) are seen in
conditions where the hemoglobin is abnormally diluted
inside the red cells, such as in iron deficiency anemia
and in thalassemia.
Increased MCHC values (hyperchromia) are seen in
conditions where the hemoglobin is abnormally
concentrated inside the red cells, such as in burn
patients and hereditary spherocytosis, a relatively rare
congenital disorder.

Red cell distribution width (RDW) is a

calculation of the variation in the size of
RBCs. In some anemias, such as pernicious
anemia, the amount of variation
(anisocytosis) in RBC size (along with
variation in shape poikilocytosis) causes an
increase in the RDW

What Abnormal Results Mean:

High numbers of RBCs may indicate:
Low oxygen tension in the blood
Congenital heart disease
Cor pulmonale
Pulmonary fibrosis

Polycythemia vera
Dehydration (such as from severe diarrhea)
Renal (kidney) disease with high erythropoietin
production

Low numbers of RBCs may indicate:

Blood loss

Anemia (various types)

Hemorrhage

Bone marrow failure (for example, from radiation,

toxin, fibrosis, tumor)
Erythropoietin deficiency (secondary to renal disease)
Hemolysis (RBC destruction)
Leukemia
Multiple myeloma
Malnutrition (nutritional deficiencies of iron, folate,
vitamin B12, or vitamin B6)

Low numbers of WBCs (leukopenia) may

indicate:
Bone marrow failure (for example, due to
infection, tumor or fibrosis)
Presence of cytotoxic substance
Autoimmune/collagen-vascular diseases (such as
lupus erythematosus)
Disease of the liver or spleen
Radiation exposure

High numbers of WBCs (leukocytosis) may

indicate:
Infectious diseases
Inflammatory disease (such as rheumatoid
arthritis or allergy)
Leukemia
Severe emotional or physical stress
Tissue damage (SUCH AS burns)

Low hematocrit may indicate:

Anemia (various types)
Blood loss (hemorrhage)
Bone marrow failure (for example, due to radiation,
toxin, fibrosis, tumor)
Hemolysis (RBC destruction) related to transfusion
reaction
Leukemia
Malnutrition or specific nutritional deficiency
Multiple myeloma
Rheumatoid arthritis

High hematocrit may indicate:

Dehydration
Burns
Diarrhea

Polycythemia vera
Low oxygen tension (smoking, congenital heart
disease, living at high altitudes)

Low hemoglobin values may indicate:

Anemia (various types)
Blood loss

Collecting tubes are universally color coded as

follows:
Redno additive
LavenderEDTA
(ethylenediaminotetraacetic acid)
Light bluesodium citrate
Greensodium heparin
Graypotassium oxalate
Blacksodium oxalate

CBC

WBC

RBC
Male
Female

5,000 10,000 CU MM

4.7 6.1x10/uL
4.2 5.4x10/uL

Hgb
Male
Female
Child
HCT
Male
Female
Child
PLATELET

14 18 g/dl
12 16 g/dl
10 15 g/dl
42% - 52%
37% - 47%
29% - 44%
150,000 400,00/cu mm

2009-2011 NURSING DIAGNOSES

ORGANIZED ACCORDING TO A NURSING
FOCUS
BY DOENGES/MOORHOUSE DIAGNOSTIC
DIVISIONS

* = New diagnoses
+ = Revised diagnoses

BLOOD CHEMISTRY

ACTIVITY/RESTAbility to engage in necessary/desired activities

of life (work and
leisure) and to obtain adequate sleep/rest
Activity Intolerance
Activity Intolerance, risk for
*Activity Planning, ineffective
Disuse Syndrome, risk for
Diversional Activity, deficient
Fatigue
Insomnia
Lifestyle, sedentary
Mobility, impaired bed
Mobility, impaired wheelchair
Sleep, readiness for enhanced
Sleep Deprivation
+Sleep Pattern, disturbed
Transfer Ability, impaired
Walking, impaired

CIRCULATIONAbility to transport oxygen and

nutrients necessary to meet cellular
needs
Autonomic Dysreflexia
Autonomic Dysreflexia, risk for
*Bleeding, risk for
Cardiac Output, decreased
Intracranial Adaptive Capacity, decreased
*Perfusion, ineffective peripheral tissue
*Perfusion, risk for decreased cardiac tissue
*Perfusion, risk for ineffective cerebral tissue
*Perfusion, risk for ineffective gastrointestinal
*Perfusion, risk for ineffective renal
*Shock, risk for

EGO INTEGRITYAbility to develop and use skills and

behaviors to integrate and
manage life experiences
Anxiety [specify level]
Anxiety, death
Behavior, risk-prone health
Body Image, disturbed
Conflict, decisional (specify)
+Coping, defensive
Coping, ineffective
Coping, readiness for enhanced
Decision Making, readiness for enhanced
Denial, ineffective
Dignity, risk for compromised human
Distress, moral
Energy Field, disturbed
Fear
Grieving

CONT

Grieving, complicated
Grieving, risk for complicated
Hope, readiness for enhanced
Hopelessness
+Identity, disturbed personal
Post-Trauma Syndrome
Post-Trauma Syndrome, risk for
Power, readiness for enhanced
Powerlessness
Powerlessness, risk for
Rape-Trauma Syndrome
[Rape-Trauma Syndrome: compound reaction-retired
2009]
[Rape-Trauma Syndrome: silent reaction-retired 2009]
*Relationships, readiness for enhanced

CONT

Religiosity, impaired
Religiosity, ready for enhanced
Religiosity, risk for impaired
Relocation Stress Syndrome
Relocation Stress Syndrome, risk for
*Resilience, impaired individual
*Resilience, readiness for enhanced
*Resilience, risk for compromised
Self-Concept, readiness for enhanced
+Self-Esteem, chronic low
Self-Esteem, situational low
Self-Esteem, risk for situational low
Sorrow, chronic
Spiritual Distress
Spiritual Distress, risk for
Spiritual Well-Being, readiness for enhanced

ELIMINATIONAbility to excrete waste products

Bowel Incontinence
Constipation
Constipation, perceived
Constipation, risk for
Diarrhea
*Motility, dysfunctional gastrointestinal
*Motility, risk for dysfunctional gastrointestinal
Urinary Elimination, impaired
Urinary Elimination, readiness for enhanced
Urinary Incontinence, functional
Urinary Incontinence, overflow
Urinary Incontinence, reflex
Urinary Incontinence, risk for urge
Urinary Incontinence, stress
[Urinary Incontinence, total-retired 2009]
Urinary Incontinence, urge
Urinary Retention [acute/chronic]

FOOD/FLUIDAbility to maintain intake of

and utilize nutrients and liquids to meet
physiological needs
Breastfeeding, effective
Breastfeeding, ineffective
Breastfeeding, interrupted
Dentition, impaired
*Electrolyte Imbalance, risk for
Failure to Thrive, adult
Feeding Pattern, ineffective infant
Fluid Balance, readiness for enhanced
[Fluid Volume, deficient hyper/hypotonic]

CONT

Fluid Volume, deficient [isotonic]

Fluid Volume, excess
Fluid Volume, risk for deficient
+Fluid Volume, risk for imbalanced
Glucose, risk for unstable blood
+Liver Function, risk for impaired
Nausea
Nutrition: less than body requirements,
imbalanced
Nutrition: more than body requirements,
imbalanced
Nutrition: risk for more than body requirements,
imbalanced
Nutrition, readiness for enhanced
Oral Mucous Membrane, impaired
Swallowing, impaired

HYGIENEAbility to perform activities of

daily living
Self-Care, readiness for enhanced
Self-Care Deficit, bathing
Self-Care Deficit, dressing
Self-Care Deficit, feeding
Self-Care Deficit, toileting
*Neglect, self

NEUROSENSORYAbility to perceive, integrate, and

respond to internal and external
cues
Confusion, acute
Confusion, risk for acute
Confusion, chronic
Infant Behavior, disorganized
Infant Behavior, readiness for enhanced organized
Infant Behavior, risk for disorganized
Memory, impaired
Neglect, unilateral
Peripheral Neurovascular Dysfunction, risk for
Sensory Perception, disturbed (specify: visual, auditory,
kinesthetic, gustatory, tactile,
olfactory)
Stress Overload
[Thought Processes, disturbed-retired 2009]

PAIN/DISCOMFORTAbility to control
internal/external environment to
maintain
comfort
*Comfort, impaired
Comfort, readiness for enhanced
Pain, acute
Pain, chronic

RESPIRATIONAbility to provide and use

oxygen to meet physiological needs
Airway Clearance, ineffective
Aspiration, risk for
Breathing Pattern, ineffective
Gas Exchange, impaired
Ventilation, impaired spontaneous
Ventilatory Weaning Response, dysfunctional

SAFETYAbility to provide safe, growth-promoting

environment
Allergy Response, latex
Allergy Response, risk for latex
Body Temperature, risk for imbalanced
Contamination
Contamination, risk for
Death Syndrome, risk for sudden infant
Environmental Interpretation Syndrome, impaired
Falls, risk for
Health Maintenance, ineffective
Home Maintenance, impaired
Hyperthermia
Hypothermia
Immunization Status, readiness for enhanced
Infection, risk for
Injury, risk for

CONT
Injury, risk for perioperative positioning

*Jaundice, neonatal
*Maternal/Fetal Dyad, risk for disturbed
Mobility, impaired physical
Poisoning, risk for
Protection, ineffective
Self-Mutilation
Self-Mutilation, risk for
Skin Integrity, impaired
Skin Integrity, risk for impaired
Suffocation, risk for
Suicide, risk for
Surgical Recovery, delayed
Thermoregulation, ineffective
Tissue Integrity, impaired
Trauma, risk for
*Trauma, risk for vascular
Violence, [actual/] risk for other-directed
Violence, [actual/] risk for self-directed
Wandering [specify sporadic or continual]

SEXUALITY[Component of Ego Integrity

and Social Interaction] Ability to meet
requirements/characteristics of male/female
role
*Childbearing Process, readiness for
enhanced
Sexual Dysfunction
Sexuality Pattern, ineffective

SOCIAL INTERACTIONAbility to establish

and maintain relationships
Attachment, risk for impaired
Caregiver Role Strain
Caregiver Role Strain, risk for
Communication, impaired verbal
Communication, readiness for enhanced
Conflict, parental role
Coping, ineffective community
Coping, readiness for enhanced community
Coping, compromised family
Coping, disabled family

CONT

Coping, readiness for enhanced family

Family Processes, dysfunctional
Family Processes, interrupted
Family Processes, readiness for enhanced
Loneliness, risk for
Parenting, impaired
Parenting, readiness for enhanced
Parenting, risk for impaired
Role Performance, ineffective
Social Interaction, impaired
Social Isolation

TEACHING/LEARNINGAbility to incorporate and use

information to achieve healthy lifestyle/optimal wellness
Development, risk for delayed
Growth, risk for disproportionate
Growth and Development, delayed
+Health Behavior, risk-prone
+Health Management, ineffective self
Knowledge, deficient (specify)
Knowledge (specify), readiness for enhanced
Noncompliance [Adherence, ineffective] [specify]
[Therapeutic Regimen Management, effective-retired 2009]
Therapeutic Regimen Management, ineffective
[Therapeutic Regimen Management, ineffective communityretired 2009]
Therapeutic Regimen Management, ineffective family
Therapeutic Regimen Management, readiness for enhanced