Clinical Applications of Nursing Diagnosis: Adult, Child, Women's, Psychiatric, Gerontic, and Home Health Considerations

897 Pages·2007·4.07 MB·English

by  Dr Helen Cox

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N D
URSING IAGNOSES
ACCEPTED FOR USE AND RESEARCH (2007-2008)
Health Maintenance, ineffective, 42 Sensory Perception, disturbed: (specify: visual,
Health-Seeking Behaviors (specify), 49 auditory, kinesthetic, gustatory, tactile,
Home Maintenance, impaired, 360 olfactory), 497
Activity Intolerance [specify level], 283
Hope, readiness for enhanced, 523 Sexual Dysfunction, 725
Activity Intolerance, risk for, 283
Hopelessness, 562 Sexuality Pattern, ineffective, 731
Airway Clearance, ineffective, 292
Hyperthermia, 176 Skin Integrity, impaired, 216
Allergy Response, latex, 70
Hypothermia, 182 Skin Integrity, risk for impaired, 216
Allergy response, latex, risk for, 70
Sleep, readiness for enhanced, 437
Anxiety [specify level], 530 Identify, disturbed personal, 575
Sleep Deprivation, 425
Anxiety, death, 548 Infant Behavior, disorganized, 365
Social Interaction, impaired, 684
Aspiration, risk for, 136 Infant Behavior, organized, readiness
Social Isolation, 688
Attachment, risk for impaired for enhanced, 365
Sorrow, chronic, 695
parent/infant/child, 659 Infant Behavior, risk for disorganized, 365
Spiritual Distress, 812
Autonomic Dysreflexia, 299 Infant Feeding Pattern, ineffective, 186
Spiritual Distress, risk for, 818
Autonomic Dysreflexia, risk for, 299 Infection, risk for, 54
Spiritual Well-Being, readiness for enhanced, 824
Injury, risk for, 59
Body Image, disturbed, 541 Stress Overload, 740
Injury, risk for perioperative positioning, 96
Body Temperature, risk for imbalanced, 139 Suicide, risk for, 791
Intracranial Adaptive Capacity, decreased, 450
Bowel Incontinence, 236 Surgical Recovery, delayed, 107
Breastfeeding, effective, 144 Knowledge, deficient [Learning Need] Swallowing, impaired, 209
Breastfeeding, ineffective, 148 [specify], 474
Therapeutic Regimen Management, effective, 75
Breastfeeding, interrupted, 152 Knowledge [specify], readiness for enhanced, 474
Therapeutic Regimen Management, ineffective, 80
Breathing Pattern, ineffective, 307
Lifestyle, sedentary, 381 Therapeutic Regimen Management, ineffective
Cardiac Output, decreased, 313 Loneliness, risk for, 569 community, 80
Caregiver Role Strain, 618 Therapeutic Regimen Management, ineffective
Memory, impaired, 482
Caregiver Role Strain, risk for, 618 family, 80
Mobility, impaired bed, 304
Communication, impaired verbal, 626 Therapeutic Regimen Management, readiness for
Mobility, impaired physical, 373
Communication, readiness for enhanced, 626 enhanced, 92
Mobility, impaired wheelchair, 415
Conflict, parental role, 463 Thermoregulation, ineffective, 213
Confusion, acute, 454 Nausea, 189 Thought Processes, disturbed, 506
Confusion, risk for acute, 454 Noncompliance, [Adherence, ineffective] Tissue Integrity, impaired, 216
Confusion, chronic, 454 [specify], 80 Tissue Perfusion, ineffective (specify type: cerebral,
Constipation, 240 Nutrition, less than body requirements, cardiopulmonary, renal, gastrointestinal,
Constipation, perceived, 240 imbalanced, 194 peripheral), 396
Constipation, risk for, 240 Nutrition, more than body requirements, Transfer Ability, impaired, 406
Coping, defensive, 771 imbalanced, 204
Unilateral Neglect Syndrome, 514
Coping, ineffective, 772 Nutrition, readiness for enhanced, 193
Urinary Elimination, readiness for enhanced, 252
Coping, readiness for enhanced, 767 Nutrition, more than body requirements, risk for
Urinary Incontinence, functional, 254
Coping, ineffective community, 756 imbalanced, 204
Urinary Incontinence, reflex, 254
Coping, readiness for enhanced community, 756
Oral Mucous Membrane, impaired, 216 Urinary Incontinence, stress, 254
Coping, compromised family, 760
Urinary Incontinence, total, 254
Coping, disabled family, 760 Pain, acute, 483
Urinary Incontinence, urge, 255
Coping, readiness for enhanced family, 767 Pain, chronic, 483
Urinary Incontinence, risk for urge, 255
Parenting, impaired, 662
Death Syndrome, risk for sudden infant, 111 Urinary Retention [acute/chronic], 263
Parenting, readiness for enhanced, 662
Decisional Conflict (specify), 463
Parenting, risk for impaired, 662 Ventilation, impaired spontaneous, 393
Denial, ineffective, 781
Perioperative Positioning, risk for, 96 Ventilatory Weaning Response, dysfunctional, 332
Dentition, impaired, 155
Peripheral Neurovascular Dysfunction, risk for, 370 Violence, [actual/] risk for other-directed, 700
Development, risk for delayed, 353
Poisoning, risk for, 60 Violence, [actual/] risk for self-directed, 700
Diarrhea, 248
Post-Trauma Syndrome [specify stage], 785
Disuse Syndrome, risk for, 321 Walking, impaired, 408
Post-Trauma Syndrome, risk for, 785
Diversional Activity, deficient, 327 Wandering [specify sporadic or continual], 411
Powerlessness [specify level], 579
Energy Field, disturbed (revised), 36 Powerlessness, risk for, 579 [ ] author recommendations
Environmental Interpretation Syndrome, Protection, ineffective, 100
Used with permission from NANDA International:
impaired, 469
Rape-Trauma Syndrome, 717 Definitions and Classification, 2007-2008. NANDA,
Failure to Thrive, adult, 127 Rape-Trauma Syndrome: compound reaction, 717 Philadelphia, PA 2007
Falls, risk for, 336 Rape-Trauma Syndrome: silent reaction, 717
New from NANDA 2007-2008
Family Processes: alcoholism, dysfunctional, 635 Religiosity, impaired, 802
Blood Sugar, risk for unstable
Family Processes, interrupted, 635 Religiosity, risk for impaired, 802
Comfort, readiness for enhanced
Family Processes, readiness for enhanced, 635 Religiosity, readiness for enhanced, 807
Contamination
Fatigue, 340 Relocation Stress Syndrome, 673
Contamination, risk for
Fear (specify focus), 553 Relocation Stress Syndrome, risk for, 673
Decision-Making, readiness for enhanced
Fluid Balance, readiness for enhanced, 158 Role Performance, ineffective, 678
Glucose, risk for unstable level
[Fluid Volume, deficient hyper/hypotonic]
Self-Care Deficit: bathing/hygiene, 386 Health Behavior, risk prone
Fluid Volume, deficient [isotonic], 161
Self-Care Deficit: dressing/grooming, 386 Human Dignity, risk for compromised
Fluid Volume, excess, 167
Self-Care Deficit: feeding, 386 Immunization Status, readiness for enhanced
Fluid Volume, risk for deficient, 161
Self-Care Deficit: toileting, 386 Insomnia
Fluid Volume risk for imbalanced, 173
Self-Care, readiness for enhanced, 386 Liver Function, risk for impaired
Gas Exchange, impaired, 346 Self-Concept, readiness for enhanced, 586 Moral Distress
Grieving, 646 Self-Esteem, chronic low, 590 Power, readiness for enhanced
Grieving, complicated, 654 Self Esteem, situational low, 590 Suffocation, risk for
Grieving, risk for complicated, 654 Self Esteem, risk for situational low, 590 Trauma, risk for
Growth, risk for disproportionate, 353 Self-Mutilation, 598 Urinary Elimination, impaired
Growth & Development, delayed, 353 Self-Mutilation, risk for, 598 Urinary Incontinence, overflow
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C ’ C
OX S LINICAL
A
PPLICATIONS OF
N D
URSING IAGNOSIS
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C ’ C
OX S LINICAL
A
PPLICATIONS OF
N D
URSING IAGNOSIS
Adult, Child, Women’s, Mental Health,
Gerontic, and Home Health Considerations
Susan A. Newfield, PhD, RN, APRN, BC
Associate Professor
West Virginia University
Morgantown, West Virginia
Mittie D. Hinz, MSN, MBA, RNC
Partner
DXT Consulting
San Antonio, Texas
Program Administrator
Hamot For Women
Hamot Medical Center
Erie, Pennsylvania
Fifth Edition
Donna Scott Tilley, RN, PhD, CNE
Associate Professor
Texas Christian University
Fort Worth, Texas
Kathryn L. Sridaromont, RN, C, MSN
Assistant Professor
Texas Tech University Health Sciences Center
Lubbock, Texas
Patricia Joy Maramba, MSN, RN, APRN, BC
Senior Lecturer
West Virginia University
Morgantown, West Virginia
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Library of Congress Cataloging-in-Publication Data
Cox’s clinical applications of nursing diagnosis : adult, child, women’s, mental health,
gerontic and home health considerations / Susan A. Newfield … [et al.]. — 5th ed.
p. ; cm.
Rev. ed. of: Clinical applications of nursing diagnosis. 4th ed. c2002.
Includes bibliographical references and index.
ISBN-13: 978-0-8036-1655-4
ISBN-10: 0-8036-1655-4
1. Nursing diagnosis. 2. Nursing assessment. 3. Nursing. I. Cox, Helen C. II. Newfield, Susan A.
III. Clinical applications of nursing diagnosis. IV. Title: Clinical applications of nursing diagnosis.
[DNLM: 1. Nursing Diagnosis. 2. Nursing Process. WY 100.4 C879 2007]
RT48.6.C6 2007
610.73—dc22 2007009325
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00Newfield (F)-FM 4/18/07 7:31 PM Page v
To Dr. Helen Cox, colleague, mentor, and friend, on her retirement. You took ambitious,
naive, young faculty members and turned us into authors and for that, we will be
eternally grateful.
To the memory of Dr. Mary Ann Lubno, colleague and friend.
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P F E
REFACE TO THE IFTH DITION
Although the fifth edition of this book has seen many author changes, our commitment
and direction was clearly stated by, Dr. Helen Cox, in the preface to the fourth edition. We
continue our commitment to providing a nursing focus to the process of nursing care.
The fifth edition reflects seventeen new and six revised diagnoses accepted by
NANDA in 2003 and 2005 and updated information in each chapter. The chapter formats
remain the same. We have revised the integration of NANDA, NIC, and NOC terminology
to assist with understanding their integration. NANDA, NIC, and NOC concepts are
placed in charts which identify the linkages that can be found at the beginning of each
chapter. Evaluation guidance has also been revised. We provided a master evaluation flow
chart in Chapter 1 rather than providing one at the end of each care plan.
Two significant trends have impacted the practice of nursing since the fourth edition;
decreasing length of stay and increased emphasis on evidence based practice. The length
of stay continues to decrease and this is reflected in our revision of goals, interventions,
and discharge planning. As we developed care plans, current average length of stay for the
setting was the litmus test for our selection of interventions. The interventions for each
diagnosis reflect both current research in the area and recommended NIC interventions.
If you are new to nursing diagnosis, we encourage you to begin your journey with
reading Chapter 1. Taking a few minutes to do this will provide you with an understanding
of the authors’thought processes that will facilitate your use of the book.
We continue to appreciate the comments from nursing faculty, staff and students
who use the book. Your thoughtful comments have inspired each edition and we urge you
to continue to support us in this way. It is our sincerest wish that this book will continue
to provide a map for your journey in providing excellent client care.
Susan A. Newfield, PhD, RN, APRN, BC
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