Cardiovascular reflex responses to temporal reduction in arterial pressure during dexmedetomidine

response的名词解释Introduction:Response is a versatile term that holds significance in various fields and contexts. It represents reactions, replies, or outcomes in response to a stimulus or situation. In this article, we will delve into the multifaceted meaning and applications of the term "response."1. Biological Response:In the realm of biology, response refers to the reaction of an organism to external stimuli. Living beings, from single-celled organisms to complex organisms like humans, have evolved intricate mechanisms to respond to their environments. These responses can be immediate, such as a reflex action, or delayed, such as a change in behavior or physiological processes. Understanding biological responses is crucial for comprehending how organisms adapt and survive.2. Psychological Response:In psychology, response refers to the reactions, both conscious and subconscious, of an individual to various stimuli or events. These responses can be emotional, cognitive,or behavioral in nature. Psychological responses can be influenced by factors such as past experiences, cultural background, and individual differences. Studying human responses helps psychologists gain insights into mental processes and behavior patterns.3. Emotional Response:Emotional response relates to the feelings or emotions elicited in individuals due to specific stimuli or situations. It encompasses a wide range of emotions, including joy, fear, anger, sadness, and surprise. Emotional responses are subjective and highly personal, varying from person to person. Understanding emotional responses plays a crucial role in fields like marketing, where emotional appeals are used to influence consumer behavior.4. Physiological Response:Physiological response pertains to the changes that occur within the body in reaction to different stimuli. These responses involve various bodily systems, such as the nervous system, endocrine system, and cardiovascular system. For example, when faced with a stressful situation, the body releases stress hormones, increases heart rate, and prepares for a fight-or-flight response. Studying physiological responses helps in comprehending the body's adaptation and functioning.5. Environmental Response:Environmental response refers to the reactions or adaptations of ecosystems or ecosystems' components to changes in their surroundings. Ecosystems exhibit response mechanisms to factors like climate change, natural disturbances, and human activities. These responses can include shifts in species composition, migration patterns, or changes in ecological processes. Understanding environmental responses is crucial for sustainable management and conservation of ecosystems.6. Communication Response:Communication response refers to the reply or feedback given in reply to a message or a stimulus. Effective communication involves not just conveying a message but also analyzing and interpreting the responses received. Communication responses can be verbal, non-verbal, or written, and they play a vital role in maintaining effective interpersonal relationships and facilitating understanding between individuals and groups.7. Emergency Response:Emergency response relates to the actions taken in response to crises or emergencies. It involves coordinated efforts by various stakeholders, including emergency services, organizations, and communities, to mitigate the impact of an adverse event. Emergency response plans encompass preparedness, response, and recovery phases, aiming to save lives, alleviate suffering, and restore normalcy after a disaster.Conclusion:The term "response" encompasses a wide range of meanings and applications across various fields. Whether it is the biological reactions of organisms, psychological reactions of individuals, or environmental adaptations of ecosystems, responses are fundamental to understanding how the world functions. By studying and analyzing responses, we can unravel the complexities of human behavior, biological processes, and ecosystem dynamics.。

抑郁症患者皮肤电反应与焦虑抑郁严重程度的分析张建;岳莹莹;袁勇贵【摘要】目的探讨抑郁症患者交感神经皮肤反应(SSR)的特点及其与焦虑抑郁严重程度的相关性.方法对32例首发抑郁症、19例复发抑郁症和27例正常对照组分别检测SSR潜伏期和波幅.结果首发抑郁症和复发性抑郁症患者的双侧上下肢SSR波潜伏期和波幅与正常组相比,差异均无统计学意义(P＞0.05),但复发性抑郁症的左上肢SSR波潜伏期显著长于首发稀有症(P=0.034)；抑郁症的双侧上下肢SSR 波潜伏期和波幅与HAMD、HAMA的评分,其差异均无统计学意义(P＞0.05).结论SSR可能并不能敏感地反映抑郁症的自主神经功能损害症状,因而其临床应用价值也尚不能肯定.【期刊名称】《四川精神卫生》【年(卷),期】2013(026)001【总页数】4页(P6-9)【关键词】抑郁症;交感神经皮肤反应;自主神经【作者】张建;岳莹莹;袁勇贵【作者单位】东南大学附属中大医院心理精神科【正文语种】中文【中图分类】R749.4抑郁症患者有较多自主神经功能紊乱的临床表现，目前对此尚缺乏客观检查手段。

交感神经皮肤反应(sympathetic skin reflex，SSR)是一种与汗腺活动有关，并反映交感神经节后纤维的表皮电位，临床上用于检测植物神经功能，是一种较为客观的神经电生理指标［1］。

为此，本文对首发和复发抑郁症患者的SSR 进行研究，试图寻找抑郁症患者自主神经病变的电生理学检查方法。

现报道于后。

1 对象和方法1.1 对象为东南大学附属中大医院2010 年8月～2012 年7 月心理精神科住院51 例抑郁症患者。

入组标准:①符合CCMD-3 中国精神障碍分类与诊断标准(第三版)抑郁症诊断标准［2］;②年龄18～65 岁，性别不限;③汉密尔顿抑郁量表(HAMD)评分≥18 分，汉密尔顿焦虑量表(HAMA)评分≥14 分;④入院前2 周未服用过抗抑郁药及其它抗精神病药物;⑤患者均知情同意。

C A RD I O C AREirculationExecutive CommitteePeter B. Raven, PhD Director James L. Caffrey, PhD Associate DirectorDan Dimitrijevich, PhD Division of Cell & Tissue Engineering H. Fred Downey, PhD Division of Cardiac Hemodynamics A. H. O-Yurvati, DO Clinical Research &EducationMichael L. Smith, PhDCenter for Sleep ResearchAdvisory BoardJim EagleTrammell Crow Fort Worth, T exas Joan HenryGlaxo Wellcome Fort Worth, T exas Bob Lanier, MD Fort Worth, T exas Jere Mitchell, MD UT Southwestern Medical Center Dallas, Texas John MorrisJASAO Corporation Abilene, Texas A.H. O-Yurvati, DO Cardiovascular &Thoracic Surgery Fort Worth, T exasEditorial StaffSondra England EditorCARDIO CARE is a publi-cation of the Cardiovas-cular Research Institute at the University of North Texas Health Science Center at Fort rmation contained in this publication is educa-tional only and is not intended to replace proper medical evalua-tion. If you have specific medical questions con-cerning your personal health, please contact your family physician.CARDIOVASCULAR RESEARCH INSTITUTE • UNT HEALTH SCIENCE CENTER AT FORT WORTH • VOLUME 1, NUMBER 3 • SEPTEMBER 2000irculation CCThe Heart...the beginning of circulationdelivered and the waste collected, the blood continues through the capillaries, which come together to form venules, which increase in size to form veins, which carry the deoxygen-ated blood back to the heart. Arriving back at the heart, blood cells pass through the lungs in much the same way as they travel through the body, except that in the lungs, carbon dioxide is exchanged for oxygen and the cycle begins again.As adults, we have about 100,000miles of blood vessels in our bodies! This 100,000 miles of vessels are generally made up of arteries, arterioles, capillaries, venules and veins.Arteries, Capillaries, and VeinsArteries, pressure vessels, are strong enough to withstand the force of the contrac-tion and expansion of the left ventricle. To accomplish this, arteries have a middle layer that is muscular æexpanding and contractingto accommodate the flow of blood circulation.Capillaries are very thin. So thin that red blood cells flow through single file. Blood needs the thin walls to allow the exchange ofoxygen and carbon dioxide. Once this ex-change is made, the blood continues through the capillaries into the veins.Veins are quite similar to arteries, except that theyq transport blood at a lower pressure, and qrather than transporting oxygen richblood, veins transport blood filled with waste (carbon dioxide)irculation of blood through the body begins when the left ventricle of theheart contracts, pumping blood into the aorta through the aortic valve. The aorta, the main artery of the body, leaves the heart as one artery and quickly branches into smaller arteries which continue to branch into even smaller arteries as the blood travels. The smallest of the arteries are called arterioles.Arterioles connect to capillaries. It is within the capillaries where oxygen is ex-changed for waste (normally in the form of carbon dioxide). Once the oxygen has been2 C ARDIO C AREArteriolesCapillariesStructure of the Circulatory SystemHow Blood MovesJust as there are two sides of the heart,there are two “parts” to the circulatory system: arterial, which carries blood rich with oxygen away from the heart and venous,which carries blood with carbon dioxide (waste) back to the heart. To deliver the oxygenated (arterial) blood to our tissues,pressure from the left ventricle keeps it moving through the arteries. However, on the venous side æthe “return” side, circulation depends on the contraction of skeletal muscles to squeeze the veins, thereby pushing the deoxygenated blood forward to complete the cycle. Just as there are one-way valves in the heart to control the flow of blood, there are venous valves in veins that keep blood constantly moving toward the heart.How does blockage occur?Arteries and veins become restricted due to cholesterol deposits. Low-density lipoprotein (LDL), referred to as “bad” cholesterol, binds with oxygen molecules and deposits as soft layers of oxidized cholesterol on the walls of arteries and veins. As the cholesterol collects,it eventually hardens into plaque. The im-mune system sees plaque as an injury and releases macrophages, a form of white blood cells. Macrophages try to remove the plaque,but in the process also become attached causing a further inflammation. In response to this increased threat, the immune system sends out additional white blood cells and causes the liver to produce blood clotting factors. Eventually, the vein or artery becomes calcified and loses elasticity (known as arthrosclerosis) and the flow of blood becomes restricted.C ARDIO C ARE 3Circulation continued from page 1cornea. Currently, Dr. Dimitrijevich is working on construction of a human vascular tissue equivalent – an artery.A human vascular tissue equivalent is composed of a matrix containing collagen that is densely populated with vascular smooth muscle cells. This tissue will be lined with human artery cells on one side and a collagen gel containing a sparse population of human dermal fibroblasts on the other side. In some cases, it would be possible for the human artery to be constructed using the patient’s own cells.The application for this technology would include every one of the bypass surgeries performed every year, plus many other uses invessel replacement therapy.How Blood MovesC ARDIOVASCULAR R ESEARCH I NSTITUTE3500 Camp Bowie Boulevard Fort Worth, Texas 76107-2699An EEO/Affirmative Action InstitutionGlossary of Terms used in this issue:in vitro: in an artificial environment, such as a laboratory setting.matrix: a scaffolding substance used to support a growing biological structure.collagen: the major structural protein of connective tissues in mammals.vascular smooth muscle cells: cells capable of contraction and expansion that make up blood vessel walls.dermal fibroblasts: those cells which can develop into skin.cholesterol: the most abundant steroid in human tissue and also found in fat rich foods.CRI FacultyJames L. Caffrey , Ph.D.Associate Director of the CRI Division of Cardiac Endocrinology S. Dan Dimitrijevich, Ph.D.Division of Cell & Tissue Engineering H. Fred Downey , Ph.D.Division of Cardiac Hemodynamics Stephen Grant, Ph.D.Division of Molecular and Vascular GeneticsRobert T. Mallet, Ph.D.Division of Cardiac Metabolism Michael L. Smith, Ph.D.Center for Sleep ResearchAssociate FacultyNeeraj Agarwal, Ph.D.Mark Baker, D.O.,Barbara A. Barron, Ph.D.Joan F . Carroll, Ph.D.Glenn Dillion, Ph.D.Richard Easom, Ph.D.Michael J. Forster, Ph.D.Robert W. Gracy , Ph.D.Patricia A. Gwirtz, Ph.D.Robert L. Kaman, Ph.D.Andras Lacko, Ph.D.Robert R. Luedtke, Ph.D.Muriel Marshall, D.O., Ph.D.Michael Martin, Ph.D.Walter McConathy , Ph.D.William McIntosh, D.O.,A. H. O-Yurvati, D.O.Frederick A. Schaller, D.O.Xiangrong Shi, Ph.D.Craig W . Spellman, D.O., Ph.D.Scott Stoll, D.O., Ph.D.Donald E. Watenpaugh, Ph.D.Martin Weiss, D.O.Thomas Yorio, Ph.D.U NIVERSITY of N ORTH T EXAS H EALTH S CIENCE C ENTER at Fort Worth5Education, Research, Patient Care andServiceC A RD I O C ARE。

新版216个护理诊断NANDA护理诊断2012~2014（共216项）领域1：健康促进（Health Promotion）类别1：健康意识（Health Awareness）1.娱乐活动缺乏（Deficient Diversional Activity）（00097）2.静态的生活方式（Sedentary Lifestyle）（00168）类别2：健康管理（Health Management）1.缺乏公共卫生（Deficient Community Health）（00215）2.有危险倾向的健康行为（Risk-Prone Health Behavior）（00188）3.健康维持无效（Ineffective Health Maintenance）（00099）4.有增强免疫状态的愿望（Readiness for EnhancedImmunization Status）（00186）5.防护无效（Ineffective Protection）（00043）6.自我健康维持无效（Ineffective Self-Health Management）（00078）7.有增强自我健康管理的愿望（Readiness for EnhancedSelf-Health Management）（00162）家庭执行治疗方案无效（Ineffective Family Therapeutic Regimen Management）（00080）领域2：营养（Nutrition）类别1：摄入（Ingestion）1.母乳不足（Insufficient Breast Milk）（00216）2.婴儿喂养无效（Ineffective Infant Feeding Pattern）（00107）3.营养失调：低于机体需要量（Imbalanced Nutrition：Less ThanBody Requirement（00002）营养失调：高于机体需要量(Imbalanced Nutrition：More Than Body Requirements（00001）有增强营养的愿望（Readiness for Enhanced Nutrition）（00163）4.有营养失调的危险：高于机体需要量（Risk for ImbalancedNutrition：More Than Body Requirements）（00003）5.吞咽能力受损（Impaired Swallowing）（00103）类别2：消化（Digestion）类别3：吸收（Absorption）类别4：代谢（Metabolism）1.有血糖不稳定的危险（Risk for Unstable Blood Glucose Level）（00179）2.新生儿黄疸（Neonatal Jaundice）（00194）3.有新生儿黄疸的危险（Risk for Neonatal Jaundice）（00230）4.有肝功能受损的危险（Risk for Impaired Liver Function）（00178）类别5：水化1.有电解质失衡的危险（Risk for Electrolyte Imbalance）（00195）2.有维持体液平衡的愿望（Readiness for Enhanced FluidBalance）（00160）3.体液不足（Deficient Fluid Volume）（00027）4.体液过多（Excess Fluid Volume）（00026）5.有体液不足的危险（Risk for Deficient Fluid Volume）（00028）6.有体液失衡的危险（Risk for Imbalanced Fluid Volume）（00025）领域3：排泄（Elimination and Exchange）类别1：排尿功能（Urinary Function）1.功能性尿失禁（Functional Urinary Incontinence）（00020）2.充溢性尿失禁（Overflow Urinary Incontinence）（00176）3.反射性尿失禁（Reflex Urinary Incontinence）（00018）4.压力性尿失禁（Stress Urinary Incontinence）（00017）5.急迫性尿失禁（Urge Urinary Incontinence）（00019）6.有急迫性尿失禁的危险（Risk for Urge Urinary Incontinence）（00022）7.排尿形态改变（Impaired Urinary Elimination）（00016）8.有排尿形态恢复正常的愿望（Readiness for Enhanced UrinaryElimination）（00166）9.尿潴留（Urinary Retention）（00023）类别2：胃肠功能（Gastrointestinal Function）1.便秘（Constipation）（00011）2.感知性便秘（Perceived Constipation）（00012）3.有便秘的危险（Risk for Constipation）（00015）4.腹泻（Diarrhea）（00013）5.胃肠动力紊乱（Dysfunctional Gastrointestinal Motility）（00196）6.有胃肠动力紊乱的危险（Risk for DysfunctionalGastrointestinal Motility）（00197）7.排便失禁（Bowel Incontinence）（00014）类别3：皮肤功能（Integumentary Function）类别4：呼吸功能（Respiratory Function）1.气体交换受损（Impaired Gas Exchange）（00030）领域4：活动∕休息（Activit y∕Rest）类别1：睡眠/休息（Sleep/Rest）1.失眠（Insomnia）（00095）2.睡眠剥夺（Sleep Deprivation）（00096）3.有睡眠形态增进的愿望（Readiness for Enhanced Sleep）（00165）4.睡眠形态紊乱（Disturbed Sleep Pattern）（00198）类别2：活动/运动（Activity/Exercise）1.有废用综合征的危险（Risk for Disuse Syndrome）（00040）2.床上活动障碍（Impaired Bed Mobility）（00091）3.躯体移动障碍（Impaired Physical Mobility）（00085）4.借助轮椅活动障碍（Impaired Wheelchair Mobility）（00089）5.移位能力障碍（Impaired Transfer Ability）（00090）6.行走障碍（Impaired Walking）（00088）类别3：能量平衡（Energy Balance）1.能量场紊乱（Disturbed Energy Field）（00050）2.疲乏（Fatigue）（00093）3.漫游（Wandering）（00154）类别4：心血管/肺部反应（Cardiovascular/Pulmonary Responses）1.活动无耐力（Activity Intolerance）（00092）2.有活动无耐力的危险（Risk for Activity Intolerance）（00094）3.低效性呼吸形态（Ineffective Breathing Pattern）（00032）4.心输出量减少（Decreased Cardiac Output）（00029）5.有胃肠灌注不足的危险（Risk for Ineffective GastrointestinalPerfusion）（00202）6.有肾脏灌注不足的危险（Risk for Ineffective Renal Perfusion）（00203）7.不能维持自主呼吸（Impaired Spontaneous Ventilation）（00033）8.周围组织灌注不足（Ineffective Peripheral Tissue Perfusion）（00204）9.有心脏组织灌注不足的危险（Risk for Decreased CardiacTissue Perfusion）（00200）有脑组织灌注不足的危险（Risk for Ineffective Cerebral Tissue Perfusion）（00201）有周围组织灌注不足的危险（Risk for IneffectivePeripheral Tissue Perfusion）（00228）呼吸机依赖（Dysfunctional Ventilatory Weaning Response）（00034）类别5：自我照顾（Self-Care）1.持家能力障碍（Impaired Home Maintenance）（00098）2.有增强自理的愿望（Readiness for Enhanced Self-Care）（00182）3.沐浴自理缺陷（Bathing Self-Care Deficit）（00108）4.穿衣自理缺陷（Dressing Self-Care Deficit）（00109）5.进食自理缺陷（Feeding Self-Care Deficit）（00102）6.如厕自理缺陷（Toileting Self-Care Deficit）（00110）7.忽视自我健康管理（Self-Neglect）（00193）领域5：知觉∕认知（Perception∕Cognition）类别1：注意力（Attention）1.忽视单侧身体（Unilateral Neglect）（00123）类别2：定向力（Orientation）1.环境解析障碍综合征（Impaired Environmental InterpretationSyndrome）（00127）类别3：感觉/知觉（Sensation/Perception）类别4：认知（Cognition）1.急性意识障碍（Acute Confusion）（00128）2.慢性意识障碍（Chronic Confusion）（00129）3.有急性意识障碍的危险（Risk for Acute Confusion）（00173）4.自我控制无效（Ineffective Impulse Control）（00222）5.知识缺乏（Deficient Knowledge）（00126）6.有增加知识的愿望（Readiness for Enhanced Knowledge）（00161）7.记忆受损（Impaired Memory）（00131）类别5：沟通（Communication）1.有加强沟通的愿望（Readiness for Enhanced Communication）（00157）2.语言沟通障碍（Impaired Verbal Communication）（00051）领域6：自我知觉（Self-Perception）类别1：自我概念（Self-Concept）1.绝望（Hopelessness）（00124）2.有危及个人尊严的危险（Risk for Compromised HumanDignity）（00174）3.有孤独的危险（Risk for Loneliness）（00054）4.自我认同紊乱（Disturbed Personal Identity）（00121）5.有自我认同紊乱的危险（Risk for Disturbed Personal Identity）（00225）6.有增强自我概念的愿望（Readiness for EnhancedSelf-Concept）（00167）类别2：自尊Self-Esteem1.慢性低自尊（Chronic Low Self-Esteem）（00119）2.情境性低自尊（Situational Low Self-Esteem）（00120）3.有慢性低自尊的危险（Risk for Chronic Low Self-Esteem）（00224）4.有情境性低自尊的危险（Risk for Situational Low Self-Esteem）（00153）类别3：自我形象（Body Image）1.自我形象紊乱（Disturbed Body Image）（00118）领域7：角色关系（Role Relationships）类别1：照顾者角色（Caregiving Roles）1.母乳喂养无效（Ineffective Breastfeeding）（00104）2.母乳喂养中断（Interrupted Breastfeeding）（00105）3.有增强母乳喂养的愿望（Readiness for EnhancedBreastfeeding）（00106）4.照顾者角色紧张（Caregiver Role Strain）（00061）5.有照顾者角色紧张的危险（Risk for Caregiver Role Strain）（00062）6.抚养障碍（Impaired Parenting）（00056）7.有增进抚养能力的愿望（Readiness for Enhanced Parenting）（00164）8.有抚养障碍的危险（Risk for Impaired Parenting）（00057）类别2：家庭关系（Family Relationships）1.有依附关系障碍的危险（Risk for Impaired Attachment）（00058）2.家庭运作紊乱（Dysfunctional Family Processes）（00063）3.家庭运作中断（Interrupted Family Processes）（00060）4.有家庭运作稳定的愿望（Readiness for Enhanced FamilyProcesses）（00159）类别3：角色表现（Role Performance）1.无效的关系（Ineffective Relationship）（00223）2.有增进关系的愿望（Readiness for Enhanced Relationship）（00207）3.有关系无效的危险（Risk for Ineffective Relationship）（00229）4.父母角色冲突（Parental Role Conflict）（00064）5.角色紊乱（Ineffective Role Performance）（00055）6.社交障碍（Impaired Social Interaction）（00052）领域8：性学（Sexuality）类别1：性别认同（Sexual Identity）类别2：性功能（Sexual Function）1.性功能障碍（Sexual Dysfunction）（00059）2.性生活形态改变（Ineffective Sexuality Pattern）（00065）类别3：生殖（Reproduction）1.分娩过程无效（Ineffective Childbearing Process）（00221）2.有增进分娩过程的愿望（Readiness for Enhanced ChildbearingProcess）（00208）有分娩过程无效的危险（Risk for Ineffective Childbearing Process）（00227）有母体-胎儿受干扰的危险（Risk for Disturbed Maternal-Fetal Dyad）（00209）领域9：调适∕压力耐受（Coping∕Stress Tolerance）类别1：创伤后反应（Post-Trauma Responses）1.创伤后综合征（Post-Trauma Syndrome）（00141）2.有创伤后综合征的危险（Risk for Post-Trauma Syndrome）（00145）3.强暴创伤综合征（Rape-Trauma Syndrome）（00142）4.迁移应激综合征（Relocation Stress Syndrome）（00114）5.有迁移应激综合征的危险（Risk for Relocation StressSyndrome）（00149）类别2：应对反应（Coping Responses）1.活动计划无效（Ineffective Activity Planning）（00199）2.有活动计划无效的危险（Risk for Ineffective Activity Planning）（00226）3.焦虑（Anxiety）（00146）4.防御性应对（Defensive Coping）（00071）5.应对无效（Ineffective Coping）（00069）6.有增强应对的愿望（Readiness for Enhanced Coping）（00158）7.社区应对无效（Ineffective Community Coping）（00077）8.社区有增强应对的愿望（Readiness for Enhanced CommunityCoping）（00076）9.家庭妥协性应对（Compromised Family Coping）（00074）10.家庭应对缺陷（Disabled Family Coping）（00073）11.家庭有增强应对的愿望（Readiness for Enhanced FamilyCoping）（00075）12.死亡焦虑（Death Anxiety）（00147）13.无效性否认（Ineffective Denial）（00072）14.人生存功能衰退（Adult Failure to Thrive）（00101）15.恐惧（Fear）（00148）16.悲痛（Grieving）（00136）17.复杂性哀伤（Complicated Grieving）（00135）18.有复杂性哀伤的危险（Risk for Complicated Grieving）（00172）19.有增强能力的愿望（Readiness for Enhanced Power）（00187）20.无能为力（Powerlessness）（00125）21.有无能为力的危险（Risk for Powerlessness）（00152）22.个人复原能力受损（Impaired Individual Resilience）（00210）23.有增强复原能力的愿望（Readiness for Enhanced Resilience）（00212）24.有危及复原的危险（Risk for Compromised Resilience）（00211）25.长期悲伤（Chronic Sorrow）（00137）26.超负荷压力（Stress Overload）（00177）类别3：神经行为压力（Neurobehavioral Stress）1.自主性反射障碍（Autonomic Dysreflexia）（00009）2.有自主反射障碍的危险（Risk for Autonomic Dysreflexia）（00010）3.婴儿行为紊乱（Disorganized Infant Behavior）（00116）4.婴儿有行为能力增强的潜力（Readiness for EnhancedOrganized Infant Behavior）（00117）5.有婴儿行为紊乱的危险（Risk for Disorganized InfantBehavior）（00115）6.颅内调试能力下降（Decreased Intracranial AdaptiveCapacity）（00049）领域10：生命原则（Life Principles）类别1：价值观（Values）1.有增进希望的愿望（Readiness for Enhanced Hope）（00185）类别2：信念（Beliefs）1.有促进精神健康增强的愿望（Readiness for Enhanced SpiritualWell-Being）（00068）类别3：价值/信念/行动一致（Value/Belief/Action Congruence）1.有增强决策的愿望（Readiness for EnhancedDecision-Making）（00184）2.决策冲突（Decisional Conflict）（00083）3.道德困扰（Moral Distress）（00175）4.不合作（Noncompliance）（00079）5.虔信受损（Impaired Religiosity）（00169）6.有增进虔信的愿望（Readiness for Enhanced Religiosity）（00171）7.有虔信受损的危险（Risk for Impaired Religiosity）（00170）8.精神困扰（Spiritual Distress）（00066）9.有精神困扰的危险（Risk for Spiritual Distress）（00067）领域11：安全∕保护（Safety∕Protection）类别1：感染（Infection）1.有感染的危险（Risk for Infection）（00004）类别2：身体伤害（Physical Injury）1.清理呼吸道无效（Ineffective Airway Clearance）（00031）2.有误吸的危险（Risk for Aspiration）（00039）3.有出血的危险（Risk for Bleeding）（00206）4.牙齿受损（Impaired Dentition）（00048）5.有干眼症的危险（Risk for Dry Eye）（00219）6.有跌倒的危险（Risk for Falls）（00155）7.有受伤的危险（Risk for Injury）（00035）8.口腔黏膜受损（Impaired Oral Mucous Membrane）（00045）9.有围手术期体位性损伤的危险（Risk for PerioperativePositioning Injury）（00087）10.有周围神经血管功能障碍的危险（Risk for PeripheralNeurovascular Dysfunction）（00086）有休克的危险（Risk for Shock）（00205）11.皮肤完整性受损（Impaired Skin Integrity）（00046）12.有皮肤完整性受损的危险（Risk for Impaired Skin Integrity）（00047）13.有婴儿猝死综合征的危险（Risk for Sudden Infant DeathSyndrome）（00156）14.有窒息的危险（Risk for Suffocation）（00036）15.术后恢复延迟（Delayed Surgical Recovery）（00100）16.有烫伤的危险（Risk for Thermal Injury）（00220）17.组织完整性受损（Impaired Tissue Integrity）（00044）18.有外伤的危险（Risk for Trauma）（00038）19.有血管受损的危险（Risk for Vascular Trauma）（00213）类别3：暴力（Violence）1.有虐待他人的危险（Risk for Other-Directed Violence）（00138）2.有自虐的危险（Risk for Self-Directed Violence）（00140）3.自残（Self-Mutilation）（00151）4.有自残的危险（Risk for Self-Mutilation）（00139）5.有自杀的危险（Risk for Suicide）（00150）类别4：环境危害（Environmental Hazards）1.污染（Contamination）（00181）2.有污染的危险（Risk for Contamination）（00180）3.有中毒的危险（Risk for Poisoning）（00037）类别5：防御过程（Defensive Processes）1.有碘造影剂不良反应的危险（Risk for Adverse Reaction toIodinated Contrast Media）（000218）2.乳胶过敏反应（Latex Allergy Response）（00041）3.有过敏反应的危险（Risk for Allergy Response）（00217）4.有乳胶过敏反应的危险（Risk for Latex Allergy Response）（00042）类别6：体温调节（Thermoregulation）1.有体温平衡失调的危险（Risk for Imbalanced BodyTemperature）（00005）2.体温过高（Hyperthermia）（00007）3.体温过低（Hypothermia）（00006）4.体温调节无效（Ineffective Thermoregulation）（00008）领域12：舒适（Comfort）类别1：身体舒适（Physical Comfort）类别2：环境舒适（Environmental Comfort）类别3：社交舒适（Social Comfort）1.舒适的改变（Impaired Comfort）（00214）2.有增加舒适的愿望（Readiness for Enhanced Comfort）（00183）3.恶心（Nausea）（00134）4.急性疼痛（Acute Pain）（00132）5.慢性疼痛（Chronic Pain）（00133）6. 社交隔离（Social Isolation）（00053）领域13：生长∕发育（Growth∕Development）类别1：生长（Growth）1.有生长不成比例的危险（Risk for Disproportionate Growth）（00113）类别2：发育（Development）1.生长发育迟缓（Delayed Growth and Development）（00111）2. 有发育迟缓的危险（Risk for Delayed Development）（00112）一、新增诊断（16项）：领域1：健康促进（Health Promotion）类别2：健康管理（Health Management）缺乏公共卫生（Deficient Community Health）（00215）领域2：营养（Nutrition）类别1：摄入（Ingestion）母乳不足（Insufficient Breast Milk）（00216）类别4：代谢（Metabolism）有新生儿黄疸的危险（Risk for Neonatal Jaundice）（00230）领域4：活动∕休息（Activit y∕Rest）类别4：心血管/肺部反应（Cardiovascular/Pulmonary Responses）有周围组织灌注不足的危险（Risk for Ineffective Peripheral Tissue Perfusion）（00228）领域5：知觉∕认知（Perception∕Cognition）类别3：感觉/知觉（Sensation/Perception）类别4：认知（Cognition）自我控制无效（Ineffective Impulse Control）（00222）领域6：自我知觉（Self-Perception）类别1：自我概念（Self-Concept）有自我认同紊乱的危险（Risk for Disturbed Personal Identity）（00225）类别2：自尊Self-Esteem有慢性低自尊的危险（Risk for Chronic Low Self-Esteem）（00224）领域7：角色关系（Role Relationships）类别3：角色表现（Role Performance）无效的关系（Ineffective Relationship）（00223）有关系无效的危险（Risk for Ineffective Relationship）（00229）领域8：性学（Sexuality）类别3：生殖（Reproduction）分娩过程无效（Ineffective Childbearing Process）（00221）有分娩过程无效的危险（Risk for Ineffective Childbearing Process）（00227）领域9：调适∕压力耐受（Coping∕Stress Tolerance）类别2：应对反应（Coping Responses）有活动计划无效的危险（Risk for Ineffective Activity Planning）（00226）领域11：安全∕保护（Safety∕Protection）类别2：身体伤害（Physical Injury）有干眼症的危险（Risk for Dry Eye）（00219）有烫伤的危险（Risk for Thermal Injury）（00220）类别5：防御过程（Defensive Processes）有碘造影剂不良反应的危险（Risk for Adverse Reaction to Iodinated Contrast Media）（000218）有过敏反应的危险（Risk for Allergy Response）（00217）二、修改诊断（11项）：1.有增强母乳喂养的愿望（Readiness for EnhancedBreastfeeding）（00106）2.低效性呼吸形态（Ineffective Breathing Pattern）（00032）3.舒适的改变（Impaired Comfort）（00214）4.有感染的危险（Risk for Infection）（00004）5.新生儿黄疸（Neonatal Jaundice）（00194）6.恶心（Nausea）（00134）7.无能为力（Powerlessness）（00125）8.有无能为力的危险（Risk for Powerlessness）（00152）9.有增强自我健康管理的愿望（Readiness for EnhancedSelf-Health Management）（00162）有皮肤完整性受损的危险（Risk for Impaired Skin Integrity）（00047）10.周围组织灌注不足（Ineffective Peripheral Tissue Perfusion）（00204）三、退出诊断（1项）：领域5：知觉∕认知（Perception∕Cognition）类别5：沟通（Communication）感觉知觉紊乱（特定的：视觉、听觉、方位感、味觉、触觉、嗅觉）（Disturbed Sensory Perception）（00122）。

新版216个护理诊断NANDA护理诊断NANDA-I护理诊断2012~2014（共216页）1. 领域1：健康促进（Health Promotion）2. 类别1：健康意识（Health Awareness）3. 娱乐活动缺乏（Deficient Diversional Activity）（00097）4. 静态的生活方式（Sedentary Lifestyle）（00168）5. 类别2：健康管理（Health Management）6. 缺乏公共卫生（Deficient Community Health）（00215）7. 有危险倾向的健康行为（Risk-Prone Health Behavior）（00188）8. 健康维持无效（Ineffective Health Maintenance）（00099）9. 有增强免疫状态的愿望（Readiness for Enhanced Immunization Status）（00186）10. 防护无效（Ineffective Protection）（00043）11. 自我健康维持无效（Ineffective Self-Health Management）（00078）12. 有增强自我健康管理的愿望（Readiness for Enhanced Self-HealthManagement）（00162）家庭执行治疗方案无效（Ineffective FamilyTherapeutic Regimen Management）（00080）13. 领域2：营养（Nutrition）14. 类别1：摄入（Ingestion）15. 母乳不足（Insufficient Breast Milk）（00216）16. 婴儿喂养无效（Ineffective Infant Feeding Pattern）（00107）17. 营养失调：低于机体需要量（Imbalanced Nutrition：Less Than BodyRequirements）（00002）营养失调：高于机体需要量(Imbalanced Nutrition：More Than Body Requirements）（00001）有增强营养的愿望（Readiness for Enhanced Nutrition）（00163）18. 有营养失调的危险：高于机体需要量（Risk for Imbalanced Nutrition：MoreThan Body Requirements）（00003）19. 吞咽能力受损（Impaired Swallowing）（00103）20. 类别2：消化（Digestion）21. 类别3：吸收（Absorption）22. 类别4：代谢（Metabolism）23. 有血糖不稳定的危险（Risk for Unstable Blood Glucose Level）（00179）24. 新生儿黄疸（Neonatal Jaundice）（00194）25. 有新生儿黄疸的危险（Risk for Neonatal Jaundice）（00230）26. 有肝功能受损的危险（Risk for Impaired Liver Function）（00178）27. 类别5：水化28. 有电解质失衡的危险（Risk for Electrolyte Imbalance）（00195）29. 有维持体液平衡的愿望（Readiness for Enhanced Fluid Balance）（00160）30. 体液不足（Deficient Fluid Volume）（00027）31. 体液过多（Excess Fluid Volume）（00026）32. 有体液不足的危险（Risk for Deficient Fluid Volume）（00028）33. 有体液失衡的危险（Risk for Imbalanced Fluid Volume）（00025）34. 领域3：排泄（Elimination and Exchange）35. 类别1：排尿功能（Urinary Function）36. 功能性尿失禁（Functional Urinary Incontinence）（00020）37. 充溢性尿失禁（Overflow Urinary Incontinence）（00176）38. 反射性尿失禁（Reflex Urinary Incontinence）（00018）39. 压力性尿失禁（Stress Urinary Incontinence）（00017）40. 急迫性尿失禁（Urge Urinary Incontinence）（00019）41. 有急迫性尿失禁的危险（Risk for Urge Urinary Incontinence）（00022）42. 排尿形态改变（Impaired Urinary Elimination）（00016）43. 有排尿形态恢复正常的愿望（Readiness for Enhanced Urinary Elimination）（00166）尿潴留（Urinary Retention）（00023）44. 类别2：胃肠功能（Gastrointestinal Function）45. 便秘（Constipation）（00011）46. 感知性便秘（Perceived Constipation）（00012）47. 有便秘的危险（Risk for Constipation）（00015）48. 腹泻（Diarrhea）（00013）49. 胃肠动力紊乱（Dysfunctional Gastrointestinal Motility）（00196）50. 有胃肠动力紊乱的危险（Risk for Dysfunctional Gastrointestinal Motility）（00197）排便失禁（Bowel Incontinence）（00014）51. 类别3：皮肤功能（Integumentary Function）52. 类别4：呼吸功能（Respiratory Function）53. 气体交换受损（Impaired Gas Exchange）（00030）54. 领域4：活动∕休息（Activit y∕Rest）55. 类别1：睡眠/休息（Sleep/Rest）56. 失眠（Insomnia）（00095）57. 睡眠剥夺（Sleep Deprivation）（00096）58. 有睡眠形态增进的愿望（Readiness for Enhanced Sleep）（00165）59. 睡眠形态紊乱（Disturbed Sleep Pattern）（00198）60. 类别2：活动/运动（Activity/Exercise）61. 有废用综合征的危险（Risk for Disuse Syndrome）（00040）62. 床上活动障碍（Impaired Bed Mobility）（00091）63. 躯体移动障碍（Impaired Physical Mobility）（00085）64. 借助轮椅活动障碍（Impaired Wheelchair Mobility）（00089）65. 移位能力障碍（Impaired Transfer Ability）（00090）66. 行走障碍（Impaired Walking）（00088）67. 类别3：能量平衡（Energy Balance）68. 能量场紊乱（Disturbed Energy Field）（00050）69. 疲乏（Fatigue）（00093）70. 漫游（Wandering）（00154）71. 类别4：心血管/肺部反应（Cardiovascular/Pulmonary Responses）72. 活动无耐力（Activity Intolerance）（00092）73. 有活动无耐力的危险（Risk for Activity Intolerance）（00094）74. 低效性呼吸形态（Ineffective Breathing Pattern）（00032）75. 心输出量减少（Decreased Cardiac Output）（00029）76. 有胃肠灌注不足的危险（Risk for Ineffective Gastrointestinal Perfusion）（00202）77. 有肾脏灌注不足的危险（Risk for Ineffective Renal Perfusion）（00203）78. 不能维持自主呼吸（Impaired Spontaneous Ventilation）（00033）79. 周围组织灌注不足（Ineffective Peripheral Tissue Perfusion）（00204）80. 有心脏组织灌注不足的危险（Risk for Decreased Cardiac Tissue Perfusion）（00200）有脑组织灌注不足的危险（Risk for Ineffective Cerebral Tissue Perfusion）（00201）有周围组织灌注不足的危险（Risk for IneffectivePeripheral Tissue Perfusion）（00228）呼吸机依赖（Dysfunctional Ventilatory Weaning Response）（00034）类别5：自我照顾（Self-Care）81. 持家能力障碍（Impaired Home Maintenance）（00098）82. 有增强自理的愿望（Readiness for Enhanced Self-Care）（00182）83. 沐浴自理缺陷（Bathing Self-Care Deficit）（00108）84. 穿衣自理缺陷（Dressing Self-Care Deficit）（00109）85. 进食自理缺陷（Feeding Self-Care Deficit）（00102）86. 如厕自理缺陷（Toileting Self-Care Deficit）（00110）87. 忽视自我健康管理（Self-Neglect）（00193）88. 领域5：知觉∕认知（Perception∕Cognition）89. 类别1：注意力（Attention）90. 忽视单侧身体（Unilateral Neglect）（00123）91. 类别2：定向力（Orientation）92. 环境解析障碍综合征（Impaired Environmental Interpretation Syndrome）（00127）类别3：感觉/知觉（Sensation/Perception）93. 类别4：认知（Cognition）94. 急性意识障碍（Acute Confusion）（00128）95. 慢性意识障碍（Chronic Confusion）（00129）96. 有急性意识障碍的危险（Risk for Acute Confusion）（00173）97. 自我控制无效（Ineffective Impulse Control）（00222）98. 知识缺乏（Deficient Knowledge）（00126）99. 有增加知识的愿望（Readiness for Enhanced Knowledge）（00161）100. 记忆受损（Impaired Memory）（00131）101. 类别5：沟通（Communication）102. 有加强沟通的愿望（Readiness for Enhanced Communication）（00157）103. 语言沟通障碍（Impaired Verbal Communication）（00051）104. 领域6：自我知觉（Self-Perception）105. 类别1：自我概念（Self-Concept）106. 绝望（Hopelessness）（00124）107. 有危及个人尊严的危险（Risk for Compromised Human Dignity）（00174）108. 有孤独的危险（Risk for Loneliness）（00054）109. 自我认同紊乱（Disturbed Personal Identity）（00121）110. 有自我认同紊乱的危险（Risk for Disturbed Personal Identity）（00225）111. 有增强自我概念的愿望（Readiness for Enhanced Self-Concept）（00167）类别2：自尊Self-Esteem112. 慢性低自尊（Chronic Low Self-Esteem）（00119）113. 情境性低自尊（Situational Low Self-Esteem）（00120）114. 有慢性低自尊的危险（Risk for Chronic Low Self-Esteem）（00224）115. 有情境性低自尊的危险（Risk for Situational Low Self-Esteem）（00153）类别3：自我形象（Body Image）116. 自我形象紊乱（Disturbed Body Image）（00118）117. 领域7：角色关系（Role Relationships）118. 类别1：照顾者角色（Caregiving Roles）119. 母乳喂养无效（Ineffective Breastfeeding）（00104）120. 母乳喂养中断（Interrupted Breastfeeding）（00105）121. 有增强母乳喂养的愿望（Readiness for Enhanced Breastfeeding）（00106）122. 照顾者角色紧张（Caregiver Role Strain）（00061）123. 有照顾者角色紧张的危险（Risk for Caregiver Role Strain）（00062）124. 抚养障碍（Impaired Parenting）（00056）125. 有增进抚养能力的愿望（Readiness for Enhanced Parenting）（00164）126. 有抚养障碍的危险（Risk for Impaired Parenting）（00057）127. 类别2：家庭关系（Family Relationships）128. 有依附关系障碍的危险（Risk for Impaired Attachment）（00058）129. 家庭运作紊乱（Dysfunctional Family Processes）（00063）130. 家庭运作中断（Interrupted Family Processes）（00060）131. 有家庭运作稳定的愿望（Readiness for Enhanced Family Processes）（00159）类别3：角色表现（Role Performance）132. 无效的关系（Ineffective Relationship）（00223）133. 有增进关系的愿望（Readiness for Enhanced Relationship）（00207）134. 有关系无效的危险（Risk for Ineffective Relationship）（00229）135. 父母角色冲突（Parental Role Conflict）（00064）136. 角色紊乱（Ineffective Role Performance）（00055）137. 社交障碍（Impaired Social Interaction）（00052）138. 领域8：性学（Sexuality）139. 类别1：性别认同（Sexual Identity）140. 类别2：性功能（Sexual Function）141. 性功能障碍（Sexual Dysfunction）（00059）142. 性生活形态改变（Ineffective Sexuality Pattern）（00065）143. 类别3：生殖（Reproduction）144. 分娩过程无效（Ineffective Childbearing Process）（00221）145. 有增进分娩过程的愿望（Readiness for Enhanced Childbearing Process）（00208）有分娩过程无效的危险（Risk for Ineffective Childbearing Process）（00227）有母体-胎儿受干扰的危险（Risk for Disturbed Maternal-FetalDyad）（00209）146. 领域9：调适∕压力耐受（Coping∕Stress Tolerance）147. 类别1：创伤后反应（Post-Trauma Responses）148. 创伤后综合征（Post-Trauma Syndrome）（00141）149. 有创伤后综合征的危险（Risk for Post-Trauma Syndrome）（00145）150. 强暴创伤综合征（Rape-Trauma Syndrome）（00142）151. 迁移应激综合征（Relocation Stress Syndrome）（00114）152. 有迁移应激综合征的危险（Risk for Relocation Stress Syndrome）（00149）类别2：应对反应（Coping Responses）153. 活动计划无效（Ineffective Activity Planning）（00199）154. 有活动计划无效的危险（Risk for Ineffective Activity Planning）（00226）155. 焦虑（Anxiety）（00146）156. 防御性应对（Defensive Coping）（00071）157. 应对无效（Ineffective Coping）（00069）158. 有增强应对的愿望（Readiness for Enhanced Coping）（00158）159. 社区应对无效（Ineffective Community Coping）（00077）160. 社区有增强应对的愿望（Readiness for Enhanced Community Coping）（00076）161. 家庭妥协性应对（Compromised Family Coping）（00074）162. 家庭应对缺陷（Disabled Family Coping）（00073）163. 家庭有增强应对的愿望（Readiness for Enhanced Family Coping）（00075）164. 死亡焦虑（Death Anxiety）（00147）165. 无效性否认（Ineffective Denial）（00072）166. 成人生存功能衰退（Adult Failure to Thrive）（00101）167. 恐惧（Fear）（00148）168. 悲痛（Grieving）（00136）169. 复杂性哀伤（Complicated Grieving）（00135）170. 有复杂性哀伤的危险（Risk for Complicated Grieving）（00172）171. 有增强能力的愿望（Readiness for Enhanced Power）（00187）172. 无能为力（Powerlessness）（00125）173. 有无能为力的危险（Risk for Powerlessness）（00152）174. 个人复原能力受损（Impaired Individual Resilience）（00210）175. 有增强复原能力的愿望（Readiness for Enhanced Resilience）（00212）176. 有危及复原的危险（Risk for Compromised Resilience）（00211）177. 长期悲伤（Chronic Sorrow）（00137）178. 超负荷压力（Stress Overload）（00177）179. 类别3：神经行为压力（Neurobehavioral Stress）180. 自主性反射障碍（Autonomic Dysreflexia）（00009）181. 有自主反射障碍的危险（Risk for Autonomic Dysreflexia）（00010）182. 婴儿行为紊乱（Disorganized Infant Behavior）（00116）183. 婴儿有行为能力增强的潜力（Readiness for Enhanced Organized Infant Behavior）（00117）有婴儿行为紊乱的危险（Risk for Disorganized Infant Behavior）（00115）184. 颅内调试能力下降（Decreased Intracranial Adaptive Capacity）（00049）185. 领域10：生命原则（Life Principles）186. 类别1：价值观（Values）187. 有增进希望的愿望（Readiness for Enhanced Hope）（00185）188. 类别2：信念（Beliefs）189. 有促进精神健康增强的愿望（Readiness for Enhanced Spiritual Well-Being）（00068）190. 类别3：价值/信念/行动一致（Value/Belief/Action Congruence）191. 有增强决策的愿望（Readiness for Enhanced Decision-Making）（00184）192. 决策冲突（Decisional Conflict）（00083）193. 道德困扰（Moral Distress）（00175）194. 不合作（Noncompliance）（00079）195. 虔信受损（Impaired Religiosity）（00169）196. 有增进虔信的愿望（Readiness for Enhanced Religiosity）（00171）197. 有虔信受损的危险（Risk for Impaired Religiosity）（00170）198. 精神困扰（Spiritual Distress）（00066）199. 有精神困扰的危险（Risk for Spiritual Distress）（00067）200. 领域11：安全∕保护（Safety∕Protection）201. 类别1：感染（Infection）202. 有感染的危险（Risk for Infection）（00004）203. 类别2：身体伤害（Physical Injury）204. 清理呼吸道无效（Ineffective Airway Clearance）（00031）205. 有误吸的危险（Risk for Aspiration）（00039）206. 有出血的危险（Risk for Bleeding）（00206）207. 牙齿受损（Impaired Dentition）（00048）208. 有干眼症的危险（Risk for Dry Eye）（00219）209. 有跌倒的危险（Risk for Falls）（00155）210. 有受伤的危险（Risk for Injury）（00035）211. 口腔黏膜受损（Impaired Oral Mucous Membrane）（00045）212. 有围手术期体位性损伤的危险（Risk for Perioperative Positioning Injury）（00087）213. 有周围神经血管功能障碍的危险（Risk for Peripheral Neurovascular Dysfunction）（00086）有休克的危险（Risk for Shock）（00205）214. 皮肤完整性受损（Impaired Skin Integrity）（00046）215. 有皮肤完整性受损的危险（Risk for Impaired Skin Integrity）（00047）216. 有婴儿猝死综合征的危险（Risk for Sudden Infant Death Syndrome）（00156）217. 有窒息的危险（Risk for Suffocation）（00036）218. 术后恢复延迟（Delayed Surgical Recovery）（00100）219. 有烫伤的危险（Risk for Thermal Injury）（00220）220. 组织完整性受损（Impaired Tissue Integrity）（00044）221. 有外伤的危险（Risk for Trauma）（00038）222. 有血管受损的危险（Risk for Vascular Trauma）（00213）223. 类别3：暴力（Violence）224. 有虐待他人的危险（Risk for Other-Directed Violence）（00138）225. 有自虐的危险（Risk for Self-Directed Violence）（00140）226. 自残（Self-Mutilation）（00151）227. 有自残的危险（Risk for Self-Mutilation）（00139）228. 有自杀的危险（Risk for Suicide）（00150）229. 类别4：环境危害（Environmental Hazards）230. 污染（Contamination）（00181）231. 有污染的危险（Risk for Contamination）（00180）232. 有中毒的危险（Risk for Poisoning）（00037）233. 类别5：防御过程（Defensive Processes）234. 有碘造影剂不良反应的危险（Risk for Adverse Reaction to Iodinated Contrast Media）（000218）乳胶过敏反应（Latex Allergy Response）（00041）235. 有过敏反应的危险（Risk for Allergy Response）（00217）236. 有乳胶过敏反应的危险（Risk for Latex Allergy Response）（00042）237. 类别6：体温调节（Thermoregulation）238. 有体温平衡失调的危险（Risk for Imbalanced Body Temperature）（00005）239. 体温过高（Hyperthermia）（00007）240. 体温过低（Hypothermia）（00006）241. 体温调节无效（Ineffective Thermoregulation）（00008）242. 领域12：舒适（Comfort）243. 类别1：身体舒适（Physical Comfort）244. 类别2：环境舒适（Environmental Comfort）245. 类别3：社交舒适（Social Comfort）246. 舒适的改变（Impaired Comfort）（00214）247. 有增加舒适的愿望（Readiness for Enhanced Comfort）（00183）248. 恶心（Nausea）（00134）249. 急性疼痛（Acute Pain）（00132）250. 慢性疼痛（Chronic Pain）（00133）251. 社交隔离（Social Isolation）（00053）252. 领域13：生长∕发育（Growth∕Development）253. 类别1：生长（Growth）254. 有生长不成比例的危险（Risk for Disproportionate Growth）（00113）255. 类别2：发育（Development）256. 生长发育迟缓（Delayed Growth and Development）（00111）257. 有发育迟缓的危险（Risk for Delayed Development）（00112）258. 一、新增诊断（16项）：259. 领域1：健康促进（Health Promotion）260. 类别2：健康管理（Health Management）261. 缺乏公共卫生（Deficient Community Health）（00215）262. 领域2：营养（Nutrition）263. 类别1：摄入（Ingestion）264. 母乳不足（Insufficient Breast Milk）（00216）265. 类别4：代谢（Metabolism）266. 有新生儿黄疸的危险（Risk for Neonatal Jaundice）（00230）267. 领域4：活动∕休息（Activit y∕Rest）268. 类别4：心血管/肺部反应（Cardiovascular/Pulmonary Responses）269. 有周围组织灌注不足的危险（Risk for Ineffective Peripheral Tissue Perfusion）（00228）领域5：知觉∕认知（Perception∕Cognition）270. 类别3：感觉/知觉（Sensation/Perception）271. 类别4：认知（Cognition）272. 自我控制无效（Ineffective Impulse Control）（00222）273. 领域6：自我知觉（Self-Perception）274. 类别1：自我概念（Self-Concept）275. 有自我认同紊乱的危险（Risk for Disturbed Personal Identity）（00225）类别2：自尊Self-Esteem276. 有慢性低自尊的危险（Risk for Chronic Low Self-Esteem）（00224）277. 领域7：角色关系（Role Relationships）278. 类别3：角色表现（Role Performance）279. 无效的关系（Ineffective Relationship）（00223）280. 有关系无效的危险（Risk for Ineffective Relationship）（00229）281. 领域8：性学（Sexuality）282. 类别3：生殖（Reproduction）283. 分娩过程无效（Ineffective Childbearing Process）（00221）284. 有分娩过程无效的危险（Risk for Ineffective Childbearing Process）（00227）285. 领域9：调适∕压力耐受（Coping∕Stress Tolerance）286. 类别2：应对反应（Coping Responses）287. 有活动计划无效的危险（Risk for Ineffective Activity Planning）（00226）288. 领域11：安全∕保护（Safety∕Protection）289. 类别2：身体伤害（Physical Injury）290. 有干眼症的危险（Risk for Dry Eye）（00219）291. 有烫伤的危险（Risk for Thermal Injury）（00220）292. 类别5：防御过程（Defensive Processes）293. 有碘造影剂不良反应的危险（Risk for Adverse Reaction to Iodinated Contrast Media）（000218）有过敏反应的危险（Risk for Allergy Response）（00217）294. 二、修改诊断（11项）：295. 有增强母乳喂养的愿望（Readiness for Enhanced Breastfeeding）（00106）296. 低效性呼吸形态（Ineffective Breathing Pattern）（00032）297. 舒适的改变（Impaired Comfort）（00214）298. 有感染的危险（Risk for Infection）（00004）299. 新生儿黄疸（Neonatal Jaundice）（00194）300. 恶心（Nausea）（00134）301. 无能为力（Powerlessness）（00125）302. 有无能为力的危险（Risk for Powerlessness）（00152）303. 有增强自我健康管理的愿望（Readiness for Enhanced Self-Health Management）（00162）有皮肤完整性受损的危险（Risk for Impaired Skin Integrity）（00047）304. 周围组织灌注不足（Ineffective Peripheral Tissue Perfusion）（00204）305. 三、退出诊断（1项）：306. 领域5：知觉∕认知（Perception∕Cognition）307. 类别5：沟通（Communication）308.感觉知觉紊乱（特定的：视觉、听觉、方位感、味觉、触觉、嗅觉）（Disturbed Sensory Perception）（00122）。

Levophed™Norepinephrine BitartrateInjection, USP R x only DESCRIPTIONNorepinephrine (sometimes referred to as l-arterenol/Levarterenol or l-norepinephrine) is a sympathomimetic amine which differs from epinephrine by the absence of a methyl group on the nitrogen atom.Norepinephrine Bitartrate is (-)-α-(aminomethyl)-3,4-dihydroxybenzyl alcohol tartrate (1:1) (salt) monohydrate and has the following structural formula:LEVOPHED is supplied in sterile aqueous solution in the form of the bitartrate salt to be administered by intravenous infusion following dilution. Norepinephrine is sparingly soluble in water, very slightly soluble in alcohol and ether, and readily soluble in acids. Each mL contains the equivalent of 1 mg base of norepinephrine, sodium chloride for isotonicity, and not more than 2 mg of sodium metabisulfite as an antioxidant. It has a pH of 3 to 4.5. The air in the ampuls has been displaced by nitrogen gas.CLINICAL PHARMACOLOGYLEVOPHED functions as a peripheral vasoconstrictor (alpha-adrenergic action) and as an inotropic stimulator of the heart and dilator of coronary arteries (beta-adrenergic action).INDICATIONS AND USAGEFor blood pressure control in certain acute hypotensive states (e.g., pheochromocytomectomy, sympathectomy, poliomyelitis, spinal anesthesia, myocardial infarction, septicemia, blood transfusion, and drug reactions).As an adjunct in the treatment of cardiac arrest and profound hypotension. CONTRAINDICATIONSLEVOPHED should not be given to patients who are hypotensive from blood volume deficits except as an emergency measure to maintain coronary and cerebral artery perfusion until blood volume replacement therapy can be completed. If LEVOPHED is continuously administered to maintain blood pressure in the absence of blood volume replacement, the following may occur: severe peripheral and visceral vasoconstriction, decreased renal perfusion and urine output, poor systemic blood flow despite “normal” blood pressure, tissue hypoxia, and lactate acidosis.LEVOPHED should also not be given to patients with mesenteric or peripheral vascular thrombosis (because of the risk of increasing ischemia and extending the area of infarction) unless, in the opinion of the attending physician, the administration of LEVOPHED is necessary as a life-saving procedure.Cyclopropane and halothane anesthetics increase cardiac autonomic irritability and therefore seem to sensitize the myocardium to the action of intravenously administered epinephrine or norepinephrine.Hence, the use of LEVOPHED during cyclopropane and halothane anesthesia is generally considered contraindicated because of the risk of producing ventricular tachycardia or fibrillation.The same type of cardiac arrhythmias may result from the use of LEVOPHED in patients with profound hypoxia or hypercarbia.WARNINGSLEVOPHED should be used with extreme caution in patients receiving monoamine oxidase inhibitors (MAOI) or antidepressants of the triptyline or imipramine types, because severe, prolonged hypertension may result.LEVOPHED Bitartrate Injection contains sodium metabisulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. The overall prevalence of sulfite sensitivity in the general population is unknown. Sulfite sensitivity is seen more frequently in asthmatic than in nonasthmatic people. PRECAUTIONSGeneralAvoid Hypertension: Because of the potency of LEVOPHED and because of varying response to pressor substances, the possibility always exists that dangerously high blood pressure may be produced with overdoses of this pressor agent. It is desirable, therefore, to record the blood pressure every two minutes from the time administration is started until the desired blood pressure is obtained, then every five minutes if administration is to be continued.The rate of flow must be watched constantly, and the patient should never be left unattended while receiving LEVOPHED. Headache may be a symptom of hypertension due to overdosage.Site of Infusion: Whenever possible, infusions of LEVOPHED should be given into a large vein, particularly an antecubital vein because, when administered into this vein, the risk of necrosis of the overlying skin from prolonged vasoconstriction is apparently very slight. Some authors have indicated that the femoral vein is also an acceptable route of administration. A catheter tie-in technique should be avoided, if possible, since the obstruction to blood flow around the tubing may cause stasis and increased local concentration of the drug. Occlusive vascular diseases (for example, atherosclerosis, arteriosclerosis, diabetic endarteritis, Buerger’s disease) are more likely to occur in the lower than in the upper extremity. Therefore, one should avoid the veins of the leg in elderly patients or in those suffering from such disorders. Gangrene has been reported in a lower extremity when infusions of LEVOPHED were given in an ankle vein.Extravasation: The infusion site should be checked frequently for free flow. Care should be taken to avoid extravasation of LEVOPHED into the tissues, as local necrosis might ensue due to the vasoconstrictive action of the drug. Blanching along the course of the infused vein, sometimes without obvious extravasation, has been attributed to vasa vasorum constriction with increased permeability of the vein wall, permitting some leakage.This also may progress on rare occasions to superficial slough, particularly during infusion into leg veins in elderly patients or in those suffering from obliterative vascular disease. Hence, if blanching occurs, consideration should be given to the advisability of changing the infusion site at intervals to allow the effects of local vasoconstriction to subside.therefore seem to sensitize the myocardium to the action of intravenously administered epinephrine or norepinephrine. Hence, the use of LEVOPHED during cyclopropane and halothane anesthesia is generally considered contraindicated because of the risk of producing ventricular tachycardia or fibrillation. The same type of cardiac arrhythmias may result from the use of LEVOPHED in patients with profound hypoxia or hypercarbia.LEVOPHED should be used with extreme caution in patients receiving monoamine oxidase inhibitors (MAOI) or antidepressants of the triptyline or imipramine types, because severe, prolonged hypertension may result.Carcinogenesis, Mutagenesis, Impairment of Fertility: Studies have not been performed.Pregnancy Category C: Animal reproduction studies have not been conducted with LEVOPHED. It is also not known whether LEVOPHED can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. LEVOPHED should be given to a pregnant woman only if clearly needed.Nursing Mothers: It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when LEVOPHED is administered to a nursing woman.Pediatric Use: Safety and effectiveness in pediatric patients has not been established.Geriatric Use: Clinical studies of LEVOPHED did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.LEVOPHED infusions should not be administered into the veins in the leg in elderly patients (see PRECAUTIONS, General).ADVERSE REACTIONSThe following reactions can occur:Body As A Whole: Ischemic injury due to potent vasoconstrictor action and tissue hypoxia. Cardiovascular System: Bradycardia, probably as a reflex result of a rise in blood pressure, arrhythmias. Nervous System: Anxiety, transient headache.Respiratory System: Respiratory difficulty.Skin and Appendages: Extravasation necrosis at injection site.Prolonged administration of any potent vasopressor may result in plasma volume depletion which should be continuously corrected by appropriate fluid and electrolyte replacement therapy. If plasma volumes are not corrected, hypotension may recur when LEVOPHED is discontinued, or blood pressure may be maintained at the risk of severe peripheral and visceral vasoconstriction (e.g., decreased renal perfusion) with diminution in blood flow and tissue perfusion with subsequent tissue hypoxia and lactic acidosis and possible ischemic injury. Gangrene of extremities has been rarely reported.Overdoses or conventional doses in hypersensitive persons (e.g., hyperthyroid patients) cause severe hypertension with violent headache, photophobia, stabbing retrosternal pain, pallor, intense sweating, and vomiting.OVERDOSAGEOverdosage with LEVOPHED may result in headache, severe hypertension, reflex bradycardia, marked increase in peripheral resistance, and decreased cardiac output. In case of accidental overdosage, as evidenced by excessive blood pressure elevation, discontinue LEVOPHED until the condition of the patient stabilizes.DOSAGE AND ADMINISTRATIONNorepinephrine Bitartrate Injection is a concentrated, potent drug which must be diluted in dextrose containing solutions prior to infusion. An infusion of LEVOPHED should be given into a large vein (see PRECAUTIONS).Restoration of Blood Pressure in Acute Hypotensive StatesBlood volume depletion should always be corrected as fully as possible before any vasopressor is administered. When, as an emergency measure, intraaortic pressures must be maintained to prevent cerebral or coronary artery ischemia, LEVOPHED can be administered before and concurrently with blood volume replacement.Diluent: LEVOPHED should be diluted in 5 percent dextrose injection or 5 percent dextrose and sodium chloride injections. These dextrose containing fluids are protection against significant loss of potency due to oxidation. Administration in saline solution alone is not recommended. Whole blood or plasma, if indicated to increase blood volume, should be administered separately (for example, by use of a Y-tube and individual containers if given simultaneously).Average Dosage: Add a 4 mL ampul (4 mg) of LEVOPHED to 1,000 mL of a 5 percent dextrose containing solution. Each mL of this dilution contains 4 mcg of the base of LEVOPHED. Give this solution by intravenous infusion. Insert a plastic intravenous catheter through a suitable bore needle well advanced centrally into the vein and securely fixed with adhesive tape, avoiding, if possible, a catheter tie-in technique as this promotes stasis. An IV drip chamber or other suitable metering device is essential to permit an accurate estimation of the rate of flow in drops per minute. After observing the response to an initial dose of 2 mL to 3 mL (from 8 mcg to 12 mcg of base) per minute, adjust the rate of flow to establish and maintain a low normal blood pressure (usually 80 mm Hg to 100 mm Hg systolic) sufficient to maintain the circulation to vital organs. In previously hypertensive patients, it is recommended that the blood pressure should be raised no higher than 40 mm Hg below the preexisting systolic pressure. The average maintenance dose ranges from 0.5 mL to 1 mL per minute (from 2 mcg to 4 mcg of base).High Dosage: Great individual variation occurs in the dose required to attain and maintain an adequate blood pressure. In all cases, dosage of LEVOPHED should be titrated according to the response of the patient. Occasionally much larger or even enormous daily doses (as high as 68 mg base or 17 ampuls) may be necessary if the patient remains hypotensive, but occult blood volume depletion should always be suspected and corrected when present. Central venous pressure monitoring is usually helpful in detecting and treating this situation.Fluid Intake: The degree of dilution depends on clinical fluid volume requirements. If large volumes of fluid (dextrose) are needed at a flow rate that would involve an excessive dose of the pressor agent per unit of time, a solution more dilute than 4 mcg per mL should be used. On the other hand, when large volumes of fluid are clinically undesirable, a concentration greater than 4 mcg per mL may be necessary.Duration of Therapy: The infusion should be continued until adequate blood pressure and tissue perfusion are maintained without therapy. Infusions of LEVOPHED should be reduced gradually, avoiding abrupt withdrawal. In some of the reported cases of vascular collapse due to acute myocardial infarction, treatment was required for up to six days.Adjunctive Treatment in Cardiac ArrestInfusions of LEVOPHED are usually administered intravenously during cardiac resuscitation to restore and maintain an adequate blood pressure after an effective heartbeat and ventilation have been established by other means. [LEVOPHED’s powerful beta-adrenergic stimulating action is also thought to increase the strength and effectiveness of systolic contractions once they occur.]Average Dosage: To maintain systemic blood pressure during the management of cardiac arrest, LEVOPHED is used in the same manner as described under Restoration of Blood Pressure in Acute Hypotensive States.Parenteral drug products should be inspected visually for particulate matter and discoloration prior to use, whenever solution and container permit.Do not use the solution if its color is pinkish or darker than slightly yellow or if it contains a precipitate.Avoid contact with iron salts, alkalis, or oxidizing agents.HOW SUPPLIEDLEVOPHED, norepinephrine bitartrate injection, USP, contains the equivalent of 4 mg base of LEVOPHED per each 4 mL ampul (1 mg/mL).Supplied as:Ampuls of 4 mL in boxes of 10, NDC 0409-1443-04Store at 20 to 25°C (68 to 77°F). [See USP Controlled Room Temperature.] Protect from light. Regitine, trademark, CIBA Pharmaceuticals Company.Revised: November, 2009Printed in USA EN-2297Hospira, Inc., Lake Forest, IL 60045, USA。