NANDA, NIC, and NOC Elements – Care Example

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"NANDA, NIC, and NOC Elements" is an engrossing example of a paper on care. Nursing diagnosis comprises making a clinical judgment about a person, a family, or community reactions to potential or actual life processes, or health problems (Brunner, 2010). Any nursing diagnosis helps nurses to come up with the best nursing intervention and achieve results that the nurse on a particular patient’ s case is accountable for. This paper uses a case study of a 4-year old boy suffering from Acute Lymphoblastic Leukemia (ALL). He was admitted a week after chemotherapy. He had a fever of 102.5F.   His WBC count was 0.3; the total neutrophil count was zero.

The new central line was administered ten days ago. The boy complained of nausea and vomiting. He cried and hid behind his mother whenever the nursing staff approached by. Nursing diagnoses are usually chosen by employing objective and subjective data (Brunner, 2010). The symptoms shown by the boy are examples of infection risk as related to immunosuppression, usually a result of chemotherapy; chronic disease such as ALL; inadequate primary defence, as well as developmental level.

Preliminary observation shows that the boy is at risk of pathogenic invasion. Nursing interventions classification (NIC) and nursing outcomes classification (NOC) come in handy when it comes to effectively treating various conditions (Brunner, 2010). For effective treatment, a label is created. A label simply means the symptoms a patient exhibits. They are useful in formulating the best nursing care for such patients. In the boy’ s case, the label is defined as increased risk of pathogenic infection. This could have been accelerated by inadequate knowledge to avoid pathogenic exposure; insufficient secondary defences, lack of enough defences such as evidenced by broken skin above the central line; and immunosuppressant caused by chemotherapy.

Given these factors, it is not necessary to define characteristics for this diagnosis as it falls under “ Risk for” type of diagnosis. NANDA, NIC, and NOC Elements NANDA is a general term used to denote nursing diagnosis. In the case of the 4-year old boy, nausea seems to result from chemotherapy. The major symptom is vomiting. Some patients complain of a tummy ache and have an aversion for food. This is another pertinent diagnosis for ALL.

NOC or nursing outcome classification, as well as nursing indicators, allow measurements of a patient, family or the community results at any point from the most positive to the most negative at various points in time (Johnson et al. , 2006). NOC outcomes allow for a quantitative measure of a patient’ s progress. This makes it easy for providers of health care to understand and use. A neural name characterizes a patient’ s status and behaviour. For instance, the symptoms shown by the boy are usually associated with ALL (Johnson et al. , 2006).   List of indicators describes status or behaviours of a client.   A 5-point scale is used to rate the status of a patient for every indicator listed above.

When employing NOC results, the nurse must make use of labels and clear definitions (Cimino, 1998). However, the outcomes are usually individualized by using suitable indicators where appropriate. The link between NANDA and NOC is that every nursing diagnosis is trailed by suggested results to measure if the chosen interventions can solve the problem identified (Johnson et al. , 2006). Every outcome can specific to the patient or their family.

This is possible due to the use of suitable indicators as well as an incorporation of other indicators. Examples of NOC include infection severity, immune status, infection control (based on available knowledge), wound healing with regards to the location of the wound, and tissue integrity. Immune status refers to acquired or natural resistance to antigens (both internal and external). Activities and interventions are chosen to meet the specific needs of a patient. Specific information about a client further helps in coming up with solutions that will address their problems (Johnson et al. , 2006).

Some activities and interventions are general while others are specific. Some NIC examples associated with “ Risk for Infection” include skin surveillance, infection protection, nutrition management, wound care and surveillance (Johnson et al. , 2006). Data, Information, Knowledge, and Wisdom Based on the symptoms and signs exhibited by the boy used for this case study, protection of infection would entail detecting infection early enough, prevention, and reducing risks of infection.   Individualized activities, in this case, would include: Monitoring localized, systematic and extent of infection; this is done by use of central line check after 4 hours. Monitoring WBC count as well as differential outcomes Following neutropenic safety measures Providing a private room Controlling the number of visitors, (the boy was afraid of strangers) (Johnson et al. , 2006). Usually, all subjective and data are collected from the patient.

These come in the form of symptoms and behaviours they exhibit. The information gathered, helps the nurse on a particular case to come up with a label (Cimino, 1998). They then use current research and nursing diagnosis to come up with better interventions and disease control.

A particular health worker can formulate information such as age, institution as well as any other specific information. More information can also be collected from the patient. To protect the patient, the following activities come in handy: Screen visitors for contagious and communicable diseases Inspect mucous and skin membranes for redness, drainage, or extreme warmth. Ensure the proper state of the surgical incision Obtain cultures where they are needed Encourage nutritional intake such as 1500kcal every day Promote the intake of fluid Ensure the patient has adequate rest Ensure patient takes prescribed anti-infective. In case they feel something should be added, each nurse will rely on their experience, available information, wisdom and skills in addressing them (Cimino, 1998).

As a future nurse leader, classification and information technology systems such as electronic health records will be useful sources of information about a patient’ s history of sickness, their family backgrounds and whether they have had a genetic condition before. This will make treatment easier and a patient’ s progress easy to follow up and monitor (Cimino, 1998). Every nurse will find the use of evidence-based practice such in the case study mentioned quite instrumental in dealing with various health conditions.


Brunner, L. S. (2010). Brunner & Suddarth's textbook of medical-surgical nursing (Vol. 1). S. C. C. Smeltzer, B. G. Bare, J. L. Hinkle, & K. H. Cheever (Eds.). Lippincott Williams & Wilkins.

Johnson, M., Bulechek, G. M., Dochterman, J. M., Maas, M. L., Moorhead, S., Butcher, H., & North American Nursing Diagnosis Association. (2006). NANDA, NOC, and NIC linkages: Nursing diagnoses, outcomes, & interventions. Mosby.

Cimino, J. J. (1998). Desiderata for controlled medical vocabularies in the twenty-first century. Methods of information in medicine, 37(4-5), 394.

Cimino, J. J. (2000). From Data to Knowledge through Concept-oriented Terminologi Experience with the Medical Entities Dictionary. Journal of the American Medical Informatics Association, 7(3), 288-297.

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