N

Narcissistic Personality Disorder

Decisional Conflict r/t lack of realistic problem-solving skills

Defensive Coping r/t grandiose sense of self

Interrupted Family Processes r/t taking advantage of others to achieve own goals

Disturbed personal Identity r/t psychological impairment

Ineffective Relationship r/t lack of mutual support/respect between partners

Impaired individual Resilience r/t psychological disorders

Impaired Social Interaction r/t self-concept disturbance

Risk-prone Health behavior r/t low self-efficacy

Risk for Loneliness r/t inability to interact appropriately with others

Risk for Self-Mutilation: Risk factor: inadequate coping

Narcolepsy

Anxiety r/t fear of lack of control over falling asleep

Disturbed Sleep Pattern r/t uncontrollable desire to sleep

Risk for Trauma: Risk factor: falling asleep during potentially dangerous activity

Readiness for enhanced Sleep: expression of willingness to enhance sleep

Narcotic Use

Risk for Constipation: Risk factor: effects of opioids on peristalsis

See Substance Abuse (if relevant)

Nasogastric Suction

Impaired Oral Mucous Membrane r/t presence of nasogastric tube

Risk for imbalanced Fluid Volume: Risk factor: loss of gastrointestinal fluids without adequate replacement

Risk for dysfunctional Gastrointestinal Motility: Risk factor: blockage in the intestines

Nausea

Nausea: biophysical, situational, treatment-related (See Nausea, Section III)

Near-Drowning

Ineffective Airway Clearance r/t aspiration, impaired gas exchange

Aspiration r/t aspiration of fluid into the lungs

Fear: parental r/t possible death of child, possible permanent and debilitating sequelae

Impaired Gas Exchange r/t laryngospasm, holding breath, aspiration

Grieving r/t potential death of child, unknown sequelae, guilt about accident

Ineffective Health Maintenance r/t parental deficient knowledge regarding safety measures appropriate for age

Hypothermia r/t central nervous system injury, prolonged submersion in cold water

Risk for delayed Development/disproportionate Growth: Risk factors: hypoxemia, cerebral anoxia

Risk for complicated Grieving: Risk factors: potential death of child, unknown sequelae, guilt about accident

Risk for Infection: Risk factors: aspiration, invasive monitoring

Risk for ineffective Cerebral tissue perfusion: Risk factor: hypoxia

Readiness for enhanced Spiritual Well-Being: struggle with survival of life-threatening situation

See Child with Chronic Condition; Hospitalized Child; Safety, Childhood; Terminally Ill Child/Death of Child, Parent

Nearsightedness

Readiness for enhanced Self-Health Management: early diagnosis and appropriate referral for eyeglasses or contact lenses when nearsightedness is suspected; signs that may indicate a vision problem, including sitting close to television, holding books very close when reading, or having difficulty reading the blackboard in school or signs on a wall

Nearsightedness; Corneal Surgery

See LASIK Eye Surgery (Laser-Assisted in Situ Keratomileusis)

Neck Vein Distention

Decreased Cardiac Output r/t decreased contractility of heart resulting in increased preload

Excess Fluid Volume r/t excess fluid intake, compromised regulatory mechanisms

See CHF (Congestive Heart Failure)

Necrosis, Renal Tubular; ATN (Acute Tubular Necrosis); Necrosis, Acute Tubular

See Renal Failure

Necrotizing Enterocolitis (NEC)

Ineffective Breathing Pattern r/t abdominal distention, hypoxia

Diarrhea r/t infection

Disturbed Energy Field r/t illness

Deficient Fluid Volume r/t vomiting, gastrointestinal bleeding

Neonatal Jaundice r/t feeding pattern not well-established

Imbalanced Nutrition: less than body requirements r/t decreased ability to absorb nutrients, decreased perfusion to gastrointestinal tract

Risk for Infection: Risk factors: bacterial invasion of gastrointestinal tract, invasive procedures

Risk for dysfunctional Gastrointestinal Motility: Risk factor: infection

Risk for ineffective Gastrointestinal Perfusion: Risk factors: shunting of blood away from mesenteric circulation and toward vital organs as a result of perinatal stress, hypoxia

See Hospitalized Child; Premature Infant (Child)

Necrotizing Fasciitis (Flesh-Eating Bacteria)

Decreased Cardiac Output r/t tachycardia and hypotension

Fear r/t possible fatal outcome of disease

Grieving r/t poor prognosis associated with disease

Hyperthermia r/t presence of infection

Acute Pain r/t toxins interfering with blood flow

Ineffective peripheral Tissue Perfusion r/t thrombosis of the subcutaneous blood vessels, leading to necrosis of nerve fibers

Ineffective Protection r/t cellulites resistant to treatment

Risk for Shock: Risk factors: infection; sepsis

See Renal Failure; Septicemia; Shock, Septic

Negative Feelings About Self

Self-Neglect r/t negative feelings

Chronic low Self-esteem r/t long-standing negative self-evaluation

Situational low Self-esteem r/t inappropriate learned negative feelings about self

Readiness for enhanced Self-Concept: expresses willingness to enhance self-concept

Neglect, Unilateral

Unilateral Neglect (See Unilateral Neglect, Section III)

Neglectful Care of Family Member

Caregiver Role Strain r/t care demands of family member, lack of social or financial support

Disabled family Coping r/t highly ambivalent family relationships, lack of respite care

Interrupted Family Processes r/t situational transition or crisis

Deficient Knowledge r/t care needs

Impaired individual Resilience r/t vulnerability from neglect

Risk for compromised Human Dignity: Risk factor: inadequate participation in decision-making

Neonatal Jaundice

Neonatal Jaundice (See Neonatal Jaundice, Section III)

Neonate

Readiness for enhanced Childbearing Process: appropriate care of newborn

See Newborn, Normal; Newborn, Postmature; Newborn, Small for Gestational Age (SGA)

Neoplasm

Fear r/t possible malignancy

See Cancer

Nephrectomy

Anxiety r/t surgical recovery, prognosis

Ineffective Breathing Pattern r/t location of surgical incision

Constipation r/t lack of return of peristalsis

Acute Pain r/t incisional discomfort

Spiritual Distress r/t chronic illness

Impaired Urinary Elimination r/t loss of kidney

Risk for Bleeding: Risk factor: surgery

Risk for Electrolyte Imbalance: Risk factor: renal dysfunction

Risk for imbalanced Fluid Volume: Risk factors: vascular losses, decreased intake

Risk for Infection: Risk factors: invasive procedure, lack of deep breathing because of location of surgical incision

Risk for ineffective Renal Perfusion: Risk factor: renal disease

Nephrostomy, Percutaneous

Acute Pain r/t invasive procedure

Impaired Urinary Elimination r/t nephrostomy tube

Risk for Infection: Risk factor: invasive procedure

Nephrotic Syndrome

Activity Intolerance r/t generalized edema

Disturbed Body Image r/t edematous appearance and side effects of steroid therapy

Excess Fluid Volume r/t edema resulting from oncotic fluid shift caused by serum protein loss and renal retention of salt and water

Imbalanced Nutrition: less than body requirements r/t anorexia, protein loss

Imbalanced Nutrition: more than body requirements r/t increased appetite attributable to steroid therapy

Social Isolation r/t edematous appearance

Risk for Infection: Risk factor: altered immune mechanisms caused by disease and effects of steroids

Risk for ineffective Renal Perfusion: Risk factor: renal disease

Risk for impaired Skin Integrity: Risk factor: edema

See Child with Chronic Condition; Hospitalized Child

Nerve Entrapment

See Carpal Tunnel Syndrome

Neural Tube Defects (Meningocele, Myelomeningocele, Spina Bifida, Anencephaly)

Constipation r/t immobility or less than adequate mobility

Grieving r/t loss of perfect child, birth of child with congenital defect

Delayed Growth and Development r/t physical impairments, possible cognitive impairment

Reflex urinary Incontinence r/t neurogenic impairment

Total urinary Incontinence r/t neurogenic impairment

Urge urinary Incontinence r/t neurogenic impairment

Impaired Mobility r/t neuromuscular impairment

Chronic low Self-Esteem r/t perceived differences, decreased ability to participate in physical and social activities at school

Impaired Skin Integrity r/t incontinence

Risk for Latex Allergy Response: Risk factor: multiple exposures to latex products

Risk for imbalanced Nutrition: more than body requirements: Risk factors: diminished, limited, or impaired physical activity

Risk for Powerlessness: Risk factor: debilitating disease

Risk for impaired Skin Integrity: lower extremities: Risk factor: decreased sensory perception

Readiness for enhanced family Coping: effective adaptive response by family members

Readiness for enhanced Family Processes: family supports each other

See Child with Chronic Condition; Premature Infant (Child)

Neuralgia

See Trigeminal Neuralgia

Neuritis (Peripheral Neuropathy)

Activity Intolerance r/t pain with movement

Ineffective Health Maintenance r/t deficient knowledge regarding self-care with neuritis

Acute Pain r/t stimulation of affected nerve endings, inflammation of sensory nerves

See Neuropathy, Peripheral

Neurofibromatosis

Disturbed Energy Field r/t disease

Compromised Family coping r/t cost and emotional needs of disease

Impaired Skin Integrity r/t café-au-lait spots

Risk for delayed Development: learning disorders including attention deficit hyperactivity disorder, low intelligent quotient scores, and developmental delay: Risk factor: genetic disorder

Risk for disproportionate Growth: short stature, precocious puberty, delayed maturation, thyroid disorders: Risk factor: genetic disorder

Risk for Injury: Risk factor: possible problems with balance

Risk for decreased Cardiac tissue perfusion: Risk factor: hypertension

Risk for compromised Resilience: Risk factor: presence of chronic disease

Risk for Spiritual Distress: Risk factor: possible severity of disease

Readiness for enhanced Decision-Making: expresses desire to enhance understanding of choices and meaning of choices, genetic counseling

Readiness for enhanced Self-Health Management: seeks cancer screening, education and genetic counseling

See Abdominal Distention; Surgery, Perioperative; Surgery, Post-operative; Surgery, Preoperative

Neurogenic Bladder

Overflow urinary Incontinence r/t detrusor external sphincter dyssynergia

Reflex urinary Incontinence r/t neurological impairment

Urinary Retention r/t interruption in the lateral spinal tracts

Risk for Latex Allergy Response: Risk factors: repeated exposures to latex associated with possible repeated catheterizations

Neurologic Disorders

Ineffective Airway Clearance r/t perceptual or cognitive impairment, decreased energy, fatigue

Acute Confusion r/t dementia, alcohol abuse, drug abuse, delirium

Ineffective Coping r/t disability requiring change in lifestyle

Risk for dry Eye r/t lagophthalmos (lack of spontaneous blink reflex)

Disturbed Energy Field r/t illness

Interrupted Family Processes r/t situational crisis, illness, or disability of family member

Grieving r/t loss of usual body functioning

Impaired Home Maintenance r/t client’s or family member’s disease

Impaired Memory r/t neurological disturbance

Impaired physical Mobility r/t neuromuscular impairment

Imbalanced Nutrition: less than body requirements r/t impaired swallowing, depression, difficulty feeding self

Powerlessness r/t progressive nature of disease

Self-Care deficit: specify r/t neuromuscular dysfunction

Sexual Dysfunction r/t biopsychosocial alteration of sexuality

Social Isolation r/t altered state of wellness

Impaired Swallowing r/t neuromuscular dysfunction

Wandering r/t cognitive impairment

Risk for Disuse Syndrome: Risk factors: physical immobility, neuromuscular dysfunction

Risk for Injury: Risk factors: altered mobility, sensory dysfunction, cognitive impairment

Risk for ineffective Cerebral tissue perfusion: Risk factor: cerebral disease/injury

Risk for impaired Religiosity: Risk factor: life transition

Risk for impaired Skin Integrity: Risk factors: altered sensation, altered mental status, paralysis

See specific condition: Alcohol Withdrawal; Amyotrophic Lateral Sclerosis (ALS); CVA (Cerebrovascular Accident); Delirium; Dementia; Guillain-Barré Syndrome; Head Injury; Huntington’s Disease; Multiple Sclerosis (MS); Myasthenia Gravis; Muscular Dystrophy; Parkinson’s Disease

Neuropathy, Peripheral

Chronic Pain r/t damage to nerves in the peripheral nervous system as a result of medication side effects, vitamin deficiency, or diabetes

Ineffective Thermoregulation r/t decreased ability to regulate body temperature

Risk for Injury: Risk factors: lack of muscle control, decreased sensation

Risk for Thermal Injury r/t nerve damage

See Peripheral Vascular Disease (PVD)

Neurosurgery

See Craniectomy/Craniotomy

Newborn, Normal

Breastfeeding r/t normal oral structure and gestational age greater than 34 weeks

Ineffective Protection r/t immature immune system

Ineffective Thermoregulation r/t immaturity of neuroendocrine system

Risk for Sudden Infant Death Syndrome: Risk factors: lack of knowledge regarding infant sleeping in prone or side-lying position, prenatal or postnatal infant smoke exposure, infant overheating or overwrapping, loose articles in the sleep environment

Risk for Infection: Risk factor: open umbilical stump

Risk for Injury: Risk factors: immaturity, need for caretaking

Readiness for enhanced Childbearing Process: appropriate care of newborn

Readiness for enhanced organized Infant behavior: demonstrates adaptive response to pain

Readiness for enhanced Parenting: providing emotional and physical needs of infant

Newborn, Postmature

Hypothermia r/t depleted stores of subcutaneous fat

Impaired Skin Integrity r/t cracked and peeling skin as a result of decreased vernix

Risk for ineffective Airway Clearance: Risk factor: meconium aspiration

Risk for unstable blood Glucose level: Risk factor: depleted glycogen stores

Risk for Injury: Risk factor: hypoglycemia caused by depleted glycogen stores

Newborn, Small for Gestational Age (SGA)

Neonatal Jaundice r/t neonate age and difficulty feeding

Imbalanced Nutrition: less than body requirements r/t history of placental insufficiency

Ineffective Thermoregulation r/t decreased brown fat, subcutaneous fat

Risk for Sudden Infant Death Syndrome: Risk factor: low birth weight

Risk for delayed Development: Risk factor: history of placental insufficiency

Risk for disproportionate Growth: Risk factor: history of placental insufficiency

Risk for Injury: Risk factors: hypoglycemia, perinatal asphyxia, meconium aspiration

Nicotine Addiction

Risk-prone Health Behavior r/t smoking

Ineffective Health Maintenance r/t lack of ability to make a judgment about smoking cessation

Powerlessness r/t perceived lack of control over ability to give up nicotine

Readiness for enhanced Decision-Making: expresses desire to enhance understanding and meaning of choices

Readiness for enhanced Self-Health Management: expresses desire to learn measures to stop smoking

NIDDM (Non-Insulin-Dependent Diabetes Mellitus)

Readiness for enhanced Self-Health Management: expresses desire for information on exercise and diet to manage diabetes

See Diabetes Mellitus

Nightmares

Disturbed Energy Field r/t disharmony of body and mind

Post-Trauma Syndrome r/t disaster, war, epidemic, rape, assault, torture, catastrophic illness, or accident

Nipple Soreness

Impaired Comfort r/t physical condition

See Painful Breasts, Sore Nipples

Nocturia

Urge urinary Incontinence r/t decreased bladder capacity, irritation of bladder stretch receptors causing spasm, alcohol, caffeine, increased fluids, increased urine concentration, overdistention of bladder

Impaired Urinary Elimination r/t sensory motor impairment, urinary tract infection

Risk for Powerlessness: Risk factor: inability to control nighttime voiding

Nocturnal Myoclonus

See Restless Leg Syndrome; Stress

Nocturnal Paroxysmal Dyspnea

See PND (Paroxysmal Nocturnal Dyspnea)

Noncompliance

Noncompliance (See Noncompliance, Section III)

Non–Insulin-Dependent Diabetes Mellitus (NIDDM)

See Diabetes Mellitus

Normal Pressure Hydrocephalus (NPH)

Impaired verbal Communication r/t obstruction of flow of cerebrospinal fluid

Acute Confusion r/t dementia caused by obstruction to flow of cerebrospinal fluid

Impaired Memory r/t neurological disturbance

Risk for Falls: Risk factor: unsteady gait as a result of obstruction of cerebrospinal fluid

Risk for ineffective Cerebral tissue perfusion: Risk factor: fluid pressing on the brain

Norwalk Virus

See Viral Gastroenteritis

NSTEMI (non-ST-elevation myocardial infarction)

See MI (Myocardial Infarction)

Nursing

See Breastfeeding, Effective; Breastfeeding, Ineffective; Breastfeeding, Interrupted

Nutrition

Readiness for enhanced Nutrition (See Nutrition, readiness for enhanced, Section III)

Nutrition, Imbalanced

Imbalanced Nutrition: less than body requirements (See Nutrition: less than body requirements, imbalanced, Section III)

Imbalanced Nutrition: more than body requirements (See Nutrition: more than body requirements, imbalanced, Section III)

Risk for imbalanced Nutrition: more than body requirements (See Nutrition: more than body requirements, imbalanced, risk for, Section III)