Pattern 1: Perception—Health Management
NANDA	NOC	NIC	ACTIVITIES
[00004] Risk of infection	[0703] Severity of infection [1902] Risk Control	[6540] Infection Control	-Teach caregivers proper handwashing -Instruct the patient on the correct hand washing techniques. -Administer antibiotic treatment when appropriate. -Teach the patient and family to avoid infections.
[00035] Risk of injury	[1912] Falls [1910] Safe Home Environment [0200] Ambulate [1828] Knowledge: Fall Prevention [1926] Safe Wandering [0202] Balance [0208] Mobility [0212] Coordinated Movement	[6490] Fall Prevention [3520] Care of pressure ulcers	-Identify cognitive or physical deficits of the patient that may increase the possibility of falls in a given environment. -Control gait, balance and fatigue when walking. -Teach the patient how to fall to minimize the risk of injury -Use an established risk assessment tool to assess the individual’s risk factors (Braden scale). -Closely monitor any reddened area. -Apply protective barriers, such as absorbent creams or compresses, to remove excess moisture, as appropriate. -Inspect the skin of bony prominences and other pressure points when changing position at least once a day. -Apply protectors for the elbows and heels, as appropriate. -Teach family members/caregiver to watch for signs of skin breaks, as appropriate.
[00036] Choking Hazard	[0403] Respiratory Status: Ventilation	[3140] Airway management [3350] Respiratory Monitoring	-Position the patient to maximize ventilation potential. -Perform chest physiotherapy, if indicated. -Remove secretions by encouraging coughing or by suction. -Teach the patient to use the prescribed inhalers, if applicable. Use fun techniques to stimulate deep breathing in children (make soap bubbles; blow a whistle, harmonica, balloons; have a contest blowing ping-pong balls, feathers, etc.). -Monitor respiratory status and oxygenation, as appropriate. -Monitor the frequency, rhythm, depth and effort of the breaths. -Evaluate chest movement, observing symmetry, use of accessory muscles and intercostal and supraclavicular muscle retractions. -Watch for noisy breathing, such as stridor or snoring
Pattern 2: Nutritional—Metabolic
NANDA	NOC	NIC	ACTIVITIES
[00002] Nutritional imbalance: lower than body needs	[1100] Oral Health [0303] Self-care: eating	[1100] Nutrition Management	-Determine the nutritional status of the patient and their ability to meet nutritional needs. -Identify the patient’s food allergies or intolerances. -Instruct the patient on nutritional needs (i.e., discuss dietary guidelines and food pyramids).
[00046] Impaired skin integrity	[1101] Tissue Integrity: Skin and Mucous Membranes	[3520] Care of pressure ulcers [3590] Skin Watch [840] Position Change [1660] Foot care [940] Traction/Immobilization Care	-Use an established risk assessment tool to assess the individual’s risk factors (Braden scale). -Closely monitor any reddened area. -Apply protective barriers, such as absorbent creams or compresses, to remove excess moisture, as appropriate. -Place on a suitable therapeutic mattress/bed. -Place in the specified therapeutic position. -Instruct the patient/family on the importance of foot care. -Cut toenails of normal thickness when they are soft, with a nail clipper and using the curve of the finger as a guide. -Refer to the podiatrist to cut thick nails, as appropriate.
[00047] Risk of deterioration of skin integrity	[1902] Risk Control	[3540] Prevention of pressure ulcers [3590] Skin Watch	-Use an established risk assessment tool to assess the individual’s risk factors (Braden scale). -Closely monitor any reddened areas.
[00048] Deterioration of the dentition	[1100] Oral Health [0308] Self-care: oral hygiene	[1710] Maintenance of oral health [1730] Restoration of oral health [5510] Health education	-Establish an oral care routine. -Identify the risk of developing stomatitis secondary to drug therapy. -Teach the person to brush their teeth, gums and tongue.
[00197] Risk of dysfunctional gastrointestinal motility	[0501] Intestinal elimination [1902] Risk Control	[200] Promotion of exercise [6650] Surveillance	-Determine the individual’s motivation to start/continue with the exercise program. -Explore obstacles to exercise. -Help the individual to establish the short and long term goals of the exercise program. -Monitor the individual’s response to the exercise program.
[00315] Delayed infant motor development	[0208] Mobility [1308] Adaptation to physical disability	[6490] Fall Prevention [6650] Surveillance [200] Promotion of exercise	-Identify cognitive or physical deficits of the patient that may increase the possibility of falls in a given environment. -Control gait, balance and fatigue when walking. -Monitor the individual’s response to the exercise program. -Determine the individual’s motivation to start/continue with the exercise program.
Pattern 3: Elimination
NANDA	NOC	NIC	ACTIVITIES
[00011] Constipation	[0501] Intestinal elimination [2102] Pain Level [1621] Adherence behavior: healthy diet [0208] Mobility	[450] Management of constipation/faecal impaction [466] Enema Administration [200] Promotion of exercise	-Monitor the appearance of signs and symptoms of constipation. -Identify the factors (medications, bed rest and diet) that can cause or contribute to constipation. Administer enema or irrigation, when appropriate. -Determine the individual’s motivation to start/continue with the exercise program.
[00016] Impaired urinary elimination	[0503] Urinary elimination [1608] Symptom Control	[590] Management of urinary elimination [6540] Infection Control	-Observe for signs and symptoms of urinary retention. -Identify the factors that contribute to episodes of incontinence. -Explain to the patient the signs and symptoms of urinary tract infection. -Teach caregivers proper handwashing -Instruct the patient on the correct hand washing techniques. -Administer antibiotic treatment when appropriate. -Teach the patient and family to avoid infections.
Pattern 4: Activity—Exercise
NANDA	NOC	NIC	ACTIVITIES
[00032] Ineffective breathing pattern	[0403] Respiratory Status: Ventilation	[3140] Airway management [3350] Respiratory Monitoring [3320] Oxygen therapy	-Position the patient to maximize ventilation potential. -Perform chest physiotherapy, if indicated. -Remove secretions by encouraging coughing or by suction. -Teach the patient to use the prescribed inhalers, if applicable. Use fun techniques to stimulate deep breathing in children (make soap bubbles; blow a whistle, harmonica, balloons; have a contest blowing ping-pong balls, feathers, etc.). -Monitor respiratory status and oxygenation, as appropriate. -Monitor the frequency, rhythm, depth and effort of the breaths. -Evaluate chest movement, observing symmetry, use of accessory muscles and intercostal and supraclavicular muscle retractions. -Observe if noisy breathing occurs, such as stridor or snoring. -Administer supplemental oxygen as ordered. -Monitor the flow of liters of oxygen.
[00033] Impaired spontaneous ventilation	[0403] Respiratory Status: Ventilation	[3390] Ventilation Aid [3350] Respiratory Monitoring [6650] Surveillance	-Monitor respiratory status and oxygenation, as appropriate. -Administer supplemental oxygen as ordered.
[00085] Impairment of physical mobility	[0200] Ambulate [0201] Ambular: wheelchair [0208] Mobility [1308] Adaptation to physical disability [0202] Balance [0206] Joint movement [0210] Perform Transfer [3110] Self-monitoring: osteoporosis [2102] Pain Level	[221] Exercise therapy: ambulation [1805] Help with self-care: aivd [1806] Help with self-care: transfer [200] Promotion of exercise [222] Exercise Therapy: Balance [6490] Fall Prevention	-Teach the patient to get into the correct position during the transfer process. -Assist the patient with the initial ambulation, if necessary. -Instruct the patient/caregiver about safe transfer and ambulation techniques. -Observe the patient’s need for adapted devices for personal hygiene, dressing, personal grooming, grooming and eating. -Help the patient to accept dependency needs. -Control gait, balance and fatigue when walking.
[00093] Fatigue	[0003] Rest [1209] Motivation [0005] Activity Tolerance [2004] Physical Form	[200] Promotion of exercise [221] Exercise therapy: ambulation [226] Exercise Therapy: Muscle Control [222] Exercise Therapy: Balance [224] Exercise Therapy: Joint Mobility [6040] Relaxation therapy	-Assist the patient with the initial ambulation, if necessary. -Instruct the patient/caregiver about safe transfer and ambulation techniques. -Control gait, balance and fatigue when walking. -Determine the limitations of joint movement and its effect on function. -Protect the patient from trauma during exercise. -Create a quiet environment, without interruptions, with soft lights and a comfortable temperature, when possible.
[00102] Food self-care deficit	[0303] Self-care: eating [1308] Adaptation to physical disability	[1803] Help with self-care: feeding [1100] Nutrition Management	-Provide social interaction, as appropriate. -Provide devices adapted to facilitate self-feeding (long handles, handles with a large circumference, or small straps on utensils), if necessary. -Place the patient in a comfortable position. -Instruct the patient on nutritional needs (i.e., discuss dietary guidelines and food pyramids).
[00108] Self-care deficit in the bathroom	[0301] Self-care: bath [0305] Self-care: hygiene [0208] Mobility [1308] Adaptation to physical disability	[1801] Help with self-care: bathing/hygiene	-Provide a therapeutic environment that guarantees a warm, relaxing, private and personalized experience. -Facilitate the maintenance of the patient’s routines at bedtime, signs of sleep onset and familiar objects (for children their favorite blanket or toy, rocking, pacifier or story; for adults read a book or have a pillow from home), as appropriate.
[00109] Self-care deficit in clothing	[0302] Self-care: dressing	[1630] Dress [1802] Help with self-care: dressing/grooming	-Be available to help with dressing, if needed. -Make it easier for the patient to comb their hair, if that is the case. -Encourage the patient to shave himself, as appropriate. -Maintain privacy when the patient is dressed.
[00110] Self-care deficit in the use of the toilet	[0310] Self-care: toilet use [0202] Balance [0208] Mobility	[1804] Help with self-care: urination/defecation [5606] Teaching: individual [1800] Help with self-care	-Provide privacy during elimination. -Facilitate hygiene after urinating / defecating after finishing elimination. -Provide assistive devices (external catheter or urinal), as appropriate.
[00238] Impaired standing	[0202] Balance [0212] Coordinated Movement [0211] Skeletal function [2102] Pain Level	[5612] Teaching: prescribed exercise [140] Encouraging Body Mechanics [226] Exercise Therapy: Muscle Control [222] Exercise Therapy: Balance [224] Exercise Therapy: Joint Mobility [1806] Help with self-care: transfer	-Assist the patient with the initial ambulation, if necessary. -Instruct the patient/caregiver about safe transfer and ambulation techniques. -Control gait, balance and fatigue when walking. -Determine the limitations of joint movement and its effect on function. -Protect the patient from trauma during exercise.
[00303] Risk of adult falls	[1902] Risk Control [1912] Falls [1910] Safe Home Environment	[6490] Fall Prevention	-Identify cognitive or physical deficits of the patient that may increase the possibility of falls in a given environment. -Control gait, balance and fatigue when walking.
[00306] Risk of child falls	[1902] Risk Control [1912] Falls [1910] Safe Home Environment	[6490] Fall Prevention	-Identify cognitive or physical deficits of the patient that may increase the possibility of falls in a given environment. -Control gait, balance and fatigue when walking.
Pattern 5: Sleep—Rest
NANDA	NOC	NIC	ACTIVITIES
[00095] Insomnia	[2002] Personal Wellness [2000] Quality of life	[5330] Mood Control [1850] Improve sleep [2300] Medication Administration	-Assess mood (signs, symptoms, personal history) initially and regularly as treatment progresses. -Determine the patient’s sleep/wake pattern. -Include the patient’s regular sleep/wake cycle in care planning. -Explain the importance of adequate sleep during pregnancy, illness, situations of psychosocial stress, etc. -Follow the five rules of proper medication administration.
[00198] Sleep pattern disorder	[0004] Dream	[1850] Improve sleep	-Determine the patient’s sleep/wake pattern. -Include the patient’s regular sleep/wake cycle in care planning.
Pattern 6: Cognitive—Perceptual
NANDA	NOC	NIC	ACTIVITIES
[00126] Poor knowledge	[0907] Preparation of information	[5510] Health education	-Determine the personal context and sociocultural history of personal, family or community health behavior. -Determine the current health knowledge and lifestyle behaviors of the individuals, family or target group. -Help individuals, families and communities to clarify health beliefs and values.
[00132] Acute pain	[1605] Pain control [2102] Pain Level	[2210] Administration of analgesics [5820] Decreased anxiety [840] Position Change	-Check the medical orders regarding the medication, dose and frequency of the prescribed analgesic. -Check the patient’s previous response to analgesics (e.g., whether the non-opioid medication is as effective as the opiate). -Check previous doses and routes of administration of analgesics to avoid undertreatment or overtreatment. -Listen carefully. -Reinforce the behavior, as appropriate. -Create an environment that facilitates trust. -Place in the specified therapeutic position.
[00133] Chronic pain	[1605] Pain control [2102] Pain Level	[2210] Administration of analgesics [5820] Decreased anxiety [840] Position Change	-Check the medical orders regarding the medication, dose and frequency of the prescribed analgesic. -Check the patient’s previous response to analgesics (e.g., whether the non-opioid medication is as effective as the opiate). -Check previous doses and routes of administration of analgesics to avoid undertreatment or overtreatment. -Listen carefully. -Reinforce the behavior, as appropriate. -Create an environment that facilitates trust. -Place in the specified therapeutic position
[00214] Discomfort	[2008] State of Comfort	[6482] Environment Management: Comfort [5880] Relaxation Technique	-Determine patient and family goals for environmental manipulation and optimal comfort. -Prepare the transition of the patient and family by giving them a warm welcome to the new environment. -Create a quiet environment, without interruptions, with soft lights and a comfortable temperature, when possible.
Pattern 7: Self-perception—Self -concept
NANDA	NOC	NIC	ACTIVITIES
[00124] Hopelessness	[1300] Acceptance: Health Status [1206] Desire to live [1204] Emotional Balance [1209] Motivation	[5330] Mood Control [5270] Emotional support [5230] Improve coping	-Assess mood (signs, symptoms, personal history) initially and regularly as treatment progresses. -Comment the emotional experience with the patient. -Explore with the patient what has triggered the emotions. -Make empathic or supportive affirmations. -Help the patient to solve problems constructively. -Assess the patient’s understanding of the disease process.
[00125] Impotence	[1702] Health beliefs: perception of control [1308] Adaptation to physical disability [1614] Personal autonomy	[5395] Improved self-confidence [5270] Emotional support	-Comment the emotional experience with the patient. -Explore with the patient what has triggered the emotions. -Make empathic or supportive affirmations. -Provide information about the desired behavior. -Help the individual commit to a plan of action to change behavior.
[00146] Anxiety	[1211] Anxiety Level [1402] Self-control of anxiety [0905] Concentration	[5820] Decreased anxiety [5230] Improve coping [6040] Relaxation therapy	-Listen carefully. -Reinforce the behavior, as appropriate. -Create an environment that facilitates trust. -Encourage the manifestation of feelings, perceptions and fears. -Identify changes in the level of anxiety. -Establish recreational activities aimed at reducing tensions. -Help the patient to identify situations that precipitate anxiety.
[00148] Fear	[1404] Fear Self Control [1210] Fear Level	[5820] Decreased anxiety [5230] Improve coping [5270] Emotional support	-Listen carefully. -Reinforce the behavior, as appropriate. -Create an environment that facilitates trust. -Encourage the manifestation of feelings, perceptions and fears.
[00153] Risk of situational low self-esteem	[1205] Self-esteem [1215] Self-awareness [1300] Acceptance: Health Status [1308] Adaptation to physical disability [1302] Coping with problems [1614] Personal autonomy	[5400] Enhancement of self-esteem [5270] Emotional support [6400] Support in protection against abuse [5240] Advice	-Determine the patient’s confidence in their own criteria. -Encourage the patient to identify their strengths. Help the patient find self- acceptance. -Determine if the child/dependent adult is viewed differently by an adult based on sex, appearance, or behavior. -Identify crisis situations that may trigger abuse, such as poverty, unemployment, divorce or death of a loved one.
Pattern 8: Role—Relationships
NANDA	NOC	NIC	ACTIVITIES
[00051] Impaired verbal communication	[0902] Communication [0907] Preparation of information	[4920] Listen Active [4974] Improve communication: hearing impairment [4976] Improve communication: speech deficit	-Show interest in the patient. -Ask questions or statements that encourage expressing thoughts, feelings and concerns. -Carry out or organize routine hearing evaluations and screenings. -Monitor the speed, pressure, rhythm, amount, volume and diction of speech. -Monitor the cognitive, anatomical, and physiological processes associated with speech capabilities (e.g., memory, hearing, and language). -Instruct the patient or family about the cognitive, anatomical and physiological processes involved in speech abilities.
[00062] Risk of caregiver role fatigue	[2205] Primary Caregiver Performance: Direct Care [2206] Primary caregiver performance: indirect care	[7040] Primary Caregiver Support	-Determine the level of knowledge of the caregiver. -Determine the caregiver’s acceptance of their role. -Encourage the caregiver to participate in support groups. -Teach the caregiver health care maintenance strategies to promote their own physical and mental health.
Pattern 9: Sexuality and Reproduction
NANDA	NOC	NIC	ACTIVITIES
[00227] Risk of ineffective maternity process	[1908] Risk Detection [2013] Balance in lifestyle	[5440] Increase Support Systems
Pattern 10: Adaptation—Stress Tolerance
NANDA	NOC	NIC	ACTIVITIES
[00177] Overload stress	[1212] Stress Level [1308] Adaptation to physical disability	[8340] Foster resilience [5230] Improve coping [5270] Emotional support	-Promote family support. -Facilitate family communication. -Help the patient develop an objective assessment of the event. -Make empathic or supportive affirmations. -Hug or touch the patient to provide support.
Pattern 11: Values—Beliefs
NANDA	NOC	NIC	ACTIVITIES
[00066] Spiritual suffering	[1300] Acceptance: Health Status [1302] Coping with problems [1215] Self-awareness	[5426] Facilitate spiritual growth [5270] Emotional support [5250] Support in decision making [5240] Advice	-Show assistance and comfort by spending time with the patient, with the patient’s family and with those close to them. -Encourage conversation that helps the patient organize spiritual interests. -Model healthy relationship and reasoning skills. -Make empathic or supportive affirmations. -Hug or touch the patient to provide support.