201项护理诊断一览表.docx

1、201项护理诊断一览表附录2 201项护理诊断一览表(20092011) 领域1:健康促进(Health Promotion) 健康维护能力低下(Ineffective Health Maintenance) 自我健康管理无效(Ineffective Self Health Management) 持家能力障碍(Impaired Home Maintenance) 有免疫状态改善的趋势(Readiness for Enhanced Immunization Status) 忽视自我健康管理(Self Neglect) 有营养改善的趋势(Readiness for Enhanced Nutrit

2、ion) 家庭执行治疗方案无效(Ineffective Family Therapeutic Regimen Management) 有自我健康管理改善的趋势(Readiness for Enhanced Self Health Management) 领域2:营养(Nutrition) 无效性婴儿喂养型态(Ineffective Infant Feeding Pattern) 营养失调:低于机体需要量(Imbalanced Nutrition: Less Than Body Requirements) 营养失调:高于机体需要量(Imbalanced Nutrition: More Than

3、Body Requirements) 有营养失调的危险:高于机体需要量(Risk for Imbalanced Nutrition: More Than Body Requirements)吞咽障碍(Impaired Swallowing) 有血糖不稳定的危险(Risk for Unstable Glucose Level) 新生儿黄疸(Neonatal Jaundice) 有肝功能受损的危险(Risk for Impaired Liver Function) 有电解质失衡的危险(Risk for Electrolyte Imbalance) 有体液平衡改善的趋势(Readiness for

4、Enhanced Fluid Balance) 体液不足(Deficient Fluid V olume) 体液过多(Excess Fluid V olume) 有体液不足的危险(Risk for Deficient Fluid V olume) 有体液失衡的危险(Risk for Imbalanced Fluid V olume) 领域3:排泄(Elimination and Exchange) 排尿障碍(Impaired Urinary Elimination) 功能性尿失禁(Functional Urinary Incontinence) 溢出性尿失禁(Overflow Urinary

5、Incontinence) 反射性尿失禁(Reflex Urinary Incontinence) 压力性尿失禁(Stress Urinary Incontinence) 急迫性尿失禁(Urge Urinary Incontinence) 有急迫性尿失禁的危险(Risk for Urge Urinary Incontinence) 尿潴留(Urinary Retention) 有排尿功能改善的趋势(Readiness for Enhanced Urinary Elimination) 排便失禁(Bowel Incontinence) 便秘(Constipation) 感知性便秘(Perceiv

6、ed Constipation) 有便秘的危险(Risk for Constipation)腹泻(Diarrhea) 胃肠动力失调(Dysfunctional Gastrointestinal Motility) 有胃肠动力失调的危险(Risk for Dysfunctional Gastrointestinal Motility) 气体交换障碍(Impaired Gas Exchange) 领域4:活动/休息(Activity/Rest) 失眠(Insomnia) 睡眠型态紊乱(Disturbed Sleep Pattern) 睡眠剥夺(Sleep Deprivation) 有睡眠改善的趋势

7、(Readiness for Enhanced Sleep) 有废用综合征的危险(Risk for Disuse Syndrome) 缺乏娱乐活动(Deficient Diversional Activity) 久坐的生活方式(Sedentary Lifestyle) 床上活动障碍(Impaired Bed Mobility) 躯体活动障碍(Impaired Physical Mobility) 借助轮椅活动障碍(Impaired wheelchair Mobility) 移动能力障碍(Impaired Transfer Ability) 行走障碍(Impaired Walking) 术后康复

8、迟缓(Delayed Surgical Recovery) 能量场紊乱(Disturbed Energy Field) 疲乏(Fatigue) 活动无耐力(Activity Intolerance) 有活动无耐力的危险(Risk for Activity Intolerance) 有出血的危险(Risk for Bleeding) 低效性呼吸型态(Ineffective Breathing Pattern) 心输出量减少(Decreased Cardiac Output) 外周组织灌注无效(Ineffective Peripheral Tissue Perfusion) 有心脏组织灌注不足的危

9、险(Risk for Decreased Cardiac Tissue Perfusion) 有脑组织灌注无效的危险(Risk for Ineffective Cerebral Tissue Perfusion) 有胃肠道灌注无效的危险(Risk for Ineffective Gastrointestinal Tissue Perfusion)有肾脏灌注无效的危险(Risk for Ineffective Renal Perfusion) 有休克的危险(Risk for Shock) 自主呼吸障碍(Impaired Spontaneous Ventilation) 呼吸机依赖(Dysfunc

10、tional Ventilatory Weaning Response) 有自理能力增强的趋势(Readiness for Enhanced Self-Care) 沐浴/卫生自理缺陷(Bathing/Hygiene Self-Care Deficit) 穿着/修饰自理缺陷(Dressing/grooming Self-Care Deficit) 进食自理缺陷(Feeding Self-Care Deficit) 如厕自理缺陷(Toileting Self-Care Deficit) 领域5:感知/认知(Perception/Cognition) 单侧身体忽视(Unilateral Neglec

11、t) 环境认知障碍综合征(Impaired Environmental Interpretation Syndrome) 漫游状态(Wandering) 感知觉紊乱(具体说明:视觉、听觉、方位感、味觉、触觉、嗅觉)(Disturbed Sensory PerceptionSpecify: Visual,Auditory,Kinesthetic,Gustatory,Tactile,Olfactory) 急性意识障碍(Acute Confusion) 慢性意识障碍(Chronic Confusion) 有急性意识障碍的危险(Risk for Acute Confusion) 知识缺乏(Defici

12、ent Knowledge) 有知识增进的趋势(Readiness for Enhanced Knowledge) 记忆功能障碍(Impaired Memory) 有决策能力增强的趋势(Readiness for Enhanced Decision-Making) 活动计划无效(Ineffective Activity Planning) 语言沟通障碍(Impaired Verbal Communication) 有沟通增进的趋势(Readiness for Enhanced Communication) 领域6:自我感知(Self-Perception) 有个人尊严受损的危险(Risk fo

13、r Compromised Human Dignity) 无望感(Hopelessness) 自我认同紊乱(Disturbed Personal Identity) 有孤独的危险(Risk for Loneliness) 有能力增强的趋势(Readiness for Enhanced Power) 无能为力感(Powerlessness) 有无能为力感的危险(Risk for Powerlessness) 有自我概念改善的趋势(Readiness for Enhanced Self-Concept) 情境性低自尊(Situational low Self-Esteem) 长期性低自尊(Chro

14、nic Low Self-Esteem) 有情境性低自尊的危险(Risk for Situational Low Self-Esteem) 体像紊乱(Disturbed Body Image) 领域7:角色关系(Role Relationships) 照顾者角色紧张(Caregiver Role Strain) 有照顾者角色紧张的危险(Risk for Caregiver Role Strain) 养育功能障碍(Impaired Parenting) 有养育功能改善的趋势(Readiness for Enhanced Parenting) 有养育功能障碍的危险(Risk for Impaire

15、d Parenting) 有依附关系受损的危险(Risk for Impaired Parent/Infant/Child Attachment) 家庭运作过程失常(Dysfunctional Family Processes) 家庭运作过程改变(Interrupted Family Processes) 有家庭运作过程改善的趋势(Readiness for Enhanced Family Processes) 母乳喂养有效(Effective Breastfeeding)母乳喂养无效(Ineffective Breastfeeding) 母乳喂养中断(Interrupted Breastfe

16、eding) 父母角色冲突(Parental Role Conflict) 有关系改善的趋势(Readiness for Enhanced Relationship) 无效性角色行为(Ineffective Role Performance) 社会交往障碍(Impaired Social Interaction) 领域8:性(Sexuality) 性功能障碍(Sexual Dysfunction) 性生活型态无效(Ineffective Sexuality Patterns) 有生育进程改善的趋势(Readiness for Enhanced Childbearing Process) 有母体

17、与胎儿双方受干扰的危险(Risk for Disturbed Maternal/Fetal Dyad) 领域9:应对/应激耐受性(Coping/ Stress Tolerance) 创伤后综合征(Post Trauma Syndrome) 有创伤后综合征的危险(Risk for Post Trauma Syndrome) 强暴创伤综合征(Rape-Trauma Syndrome) 迁移应激综合征(Relocation Stress Syndrome) 有迁移应激综合征的危险(Risk for Relocation Stress Syndrome) 焦虑(Anxiety) 对死亡的焦虑(Deat

18、h Anxiety) 有威胁健康的行为(Risk-Prone Health Behavior) 妥协性家庭应对(Compromised Family Coping) 无能性家庭应对(Disabled Family Coping) 防卫性应对(Defensive Coping) 应对无效(Ineffective Coping) 社区应对无效(Ineffective Community Coping) 有应对增强的趋势(Readiness for Enhanced Coping) 有社区应对增强的趋势(Readiness for Enhanced Community Coping) 有家庭应对增强

19、的趋势(Readiness for Enhanced Family Coping) 无效性否认(Ineffective Denial) 恐惧(Fear) 悲伤(Grieving) 复杂性悲伤(Complicated Grieving) 有复杂性悲伤的危险(Risk for Complicated Grieving) 个人恢复能力障碍(Impaired Individual Resilience) 有恢复能力受损的危险(Risk for Compromised Resilience) 有恢复能力增强的趋势(Readiness for Enhanced Resilience) 持续性悲伤(Chro

20、nic Sorrow) 压力负荷过重(Stress Overload) 自主性反射失调(Autonomic Dysreflexia) 有自主性反射失调的危险(Risk for Autonomic Dysreflexia) 婴儿行为紊乱(Disorganized Infant Behavior) 有婴儿行为紊乱的危险(Risk for Disorganized Infant Behavior) 有婴儿行为调节改善的趋势(Readiness for Enhanced Organized Infant Behavior)颅内调适能力降低(Decreased Intracranial Adaptive

21、 Capacity) 领域10:生活准则(Life Principles) 有希望增强的趋势(Readiness for Enhanced Hope) 有精神安适增进的趋势(Readiness for Enhanced Spiritual Well-being) 抉择冲突(Decisional Conflict) 道德困扰(Moral Distress) 不依从行为(Noncompliance) 宗教信仰减弱(Impaired Religiosity) 有宗教信仰增强的趋势(Readiness for Enhanced Religiosity) 有宗教信仰减弱的危险(Risk for Impa

22、ired Religiosity) 精神困扰(Spiritual Distress) 有精神困扰的危险(Risk for Spiritual Distress) 领域11:安全/防护(Safety/Protection) 有感染的危险(Risk for Infect ion) 清理呼吸道无效(Ineffective Airway Clearance) 有误吸的危险(Risk for Aspiration) 有婴儿猝死综合症的危险(Risk for Sudden Infant Death Syndrome) 牙齿受损(Impaired Dentition) 有跌倒的危险(Risk for Fal

23、ls) 有受伤害的危险(Risk for Injury) 有手术期体位性损伤的危险(Risk for Perioperative-Positioning Injury) 口腔黏膜受损(Impaired Oral Mucous Membrane) 有外周神经血管功能障碍的危险(Risk for Peripheral Neurovascular Dysfunction)防护能力低下(Ineffective Protection) 皮肤完整性受损(Impaired Skin Integrity) 有皮肤完整性受损的危险(Risk for Impaired Skin Integrity) 有窒息的危险

24、(Risk for Suffocation) 组织完整性受损(Impaired Tissue Integrity) 有外伤的危险(Risk for Trauma) 有血管损伤的危险(Risk for Vascular Trauma) 自伤(Self-Mutilation) 有自伤的危险(Risk for Self-Mutilation) 有自杀的危险(Risk for Suicide) 有对他人施行暴力的危险(Risk for Other-Directed Violence) 有对自己施行暴力的危险(Risk for Self-Directed Violence) 受污染(Contaminat

25、ion) 有受污染的危险(Risk for Contamination)有中毒的危险(Risk for Poisoning) 乳胶过敏反应(Latex Allergy Response) 有乳胶过敏反应的危险(Risk for Latex Allergy Response)有体温失调的危险(Risk for Imbalanced Body Temperature)体温过高(Hyperthermia) 体温过低(Hypothermia) 体温调节无效(Ineffective Thermoregulation) 领域12:舒适(Comfort) 有舒适增进的趋势(Readiness for Enhanced Comfort) 舒适度减弱(Impaired Comfort) 恶心(Nausea) 急性疼痛(Acute Pain) 慢性疼痛(Chronic Pain) 社交孤立(Social Isolation) 领域13:生长/发展(Growth/Development) 成人身心功能衰退(Adult Failure to Thrive) 生长发展迟缓(Delayed Growth and Development) 有发展迟缓的危险(Risk for Delayed Development) 有生长比例失调的危险(Risk for Disproportionate Growth)