Domains

Environmental Domain Environmental Domain

Psychosocial Domain Environmental Domain
Physiological Domain Environmental Domain
Health-related Behaviors Domain Environmental Domain
Psychosocial Domain
Psychosocial Domain
Modifier 1 Psychosocial Domain
Individual Psychosocial Domain
Family Psychosocial Domain
Community Psychosocial Domain
Psychosocial Domain
Modifier 2 Psychosocial Domain
Potential Psychosocial Domain
Actual Psychosocial Domain
Health Promotion Psychosocial Domain
Psychosocial Domain
Physiological Domain
Physiological Domain
Physiological Domain
Physiological Domain
Physiological Domain
Physiological Domain
Physiological Domain
Physiological Domain
Physiological Domain
Physiological Domain
Physiological Domain
Physiological Domain
Physiological Domain
Physiological Domain
Physiological Domain
Physiological Domain
Physiological Domain
Physiological Domain
Health-related Behaviors Domain
Health-related Behaviors Domain
Health-related Behaviors Domain
Health-related Behaviors Domain
Health-related Behaviors Domain
 Health-related Behaviors Domain
Health-related Behaviors Domain
Health-related Behaviors Domain

Intervention
Targets
Categories: anatomy/physiology
Teaching, Guidance, and Counseling anger management
Treatments and Procedures behavior modification 
Case Management bladder care 
Surveillance bonding/attachment 
bowel care 
cardiac care 
caretaking/parenting skills 
cast care 
communication
community outreach worker services
continuity of care 
coping skills 
day care/respite
dietary management 
discipline 
dressing change/wound care 
durable medical equipment 
education 
employment
end-of-life care 
environment 
exercises 
family planning care 
feeding procedures 
finances 
gait training
genetics 
growth/development care 
home 
homemaking/housekeeping 
infection precautions 
interaction
interpreter/translator services 
laboratory findings 
legal system 
medical/dental care
medication action/side effects
medication administration
 medication coordination/ordering
medication prescription
medication set-up
mobility/transfers
nursing care
nutritionist care
occupational therapy care
ostomy care
other community resources
paraprofessional/aide care
personal hygiene
physical therapy care
positioning
recreational therapy care
relaxation/breathing techniques
respiratory care
respiratory therapy care 
rest/sleep
safety
screening procedures
sickness/injury care
signs/symptoms-mental/emotional
signs/symptoms-physical
skin care
social work/counseling care
specimen collection
speech and language pathology care
spiritual care
stimulation/nurturance
stress management
substance use cessation
supplies
support group
support system
transportation
wellness
other

Outcomes
1
2
3
4
5
Environmental Domain: Income
Environmental Domain: Sanitation
Environmental Domain: Residence
Environmental Domain: Neighborhood/workplace safety
Psychosocial Domain: Communication with community resources
Psychosocial Domain: Social contact
Psychosocial Domain: Role change
Psychosocial Domain: Interpersonal relationship
Psychosocial Domain: Spirituality
Psychosocial Domain: Grief
Psychosocial Domain: Mental health
Psychosocial Domain: Sexuality
Psychosocial Domain: Caretaking/parenting
Psychosocial Domain: Neglect
Psychosocial Domain: Abuse
Psychosocial Domain: Growth and development
Physiological Domain: Hearing
Physiological Domain: Vision
Physiological Domain: Speech and language
Physiological Domain: Oral health
Physiological Domain: Cognition
Physiological Domain: Pain
Physiological Domain: Consciousness
Physiological Domain: Skin
Physiological Domain: Neuro-musculo-skeletal function
Physiological Domain: Respiration
Physiological Domain: Circulation
Physiological Domain: Digestion-hydration
Physiological Domain: Bowel function
Physiological Domain: Urinary function
Physiological Domain: Reproductive function
Physiological Domain: Pregnancy
Physiological Domain: Postpartum
Physiological Domain: Communicable/infectious condition
Health-related Behaviors Domain: Nutrition
Health-related Behaviors Domain: Sleep and rest patterns
Health-related Behaviors Domain: Physical activity
Health-related Behaviors Domain: Personal care
Health-related Behaviors Domain: Substance use
 Health-related Behaviors Domain: Family planning
Health-related Behaviors Domain: Health care supervision
Health-related Behaviors Domain: Medication regimen

orker services
athology care
Problem Identification
Domain: Subdomain Physiological Domain: Pain
Modifier 1 Individual
Modifier 2 Actual
Clutching of arm. Verbalization of pain with pain scale of
Cluster of Signs/Symptoms 3/10 where 10 is the most severe pain. Hugging of right
arm to the body
Facial grimacing when arm is flexed
Hugging of right arm to the body

Interventions
Category Treatments and procedures

Target Sickness, injury care

Specific Actions Assessed for the characteristics of pain with OLDCARTS
Immobilized joint with a sling
Nonpharmacological pain reducers performed
such as pet therapy, and music therapy.
Encouraged to meet with physician.

Outcomes
Rating Day 1 Day2 Day 3 Day 4 Day 5
Knowledge 1 2 2 3 5
Behavior 1 1 2 2 3
Status 1 3 4 5 5
Problem Identification
Domain: Subdomain Psychosocial Domain: Social contact
Modifier 1 Individual
Modifier 2 Health Promotion
Cluster of Signs/Symptoms No family in neighborhood
Cat "Buddy", is his best friend, according to client

Interventions
Category Teaching, guidance and counseling

Target Support system

Specific Actions Inquired about presence of family, his acquaintances
and his neighbors. Encouraged client to socialize
with them. Asked for help from statistics office
about whereabouts of family and close kin of client.

Outcomes
Rating Day 1 Day2 Day 3 Day 4 Day 5
Knowledge 1 2 2 2 2
Behavior 1 1 2 2 3
Status 1 1 2 2 2
Problem Identification
Health-related Behaviors Domain: Health care
supervision
Domain: Subdomain
Modifier 1 Individual
Modifier 2 Health Promotion
Cluster of Signs/Symptoms Reluctance to see physician, regardless of chronic pain
noted on arm due to fear of expense.

Interventions
Category Teaching, Guidance and Counseling

Target Medical/dental care

Specific Actions Inquired for reasons why client does not seak medical
care. Provided referral to a doctor, and scheduled
an appointment for the next day.

Outcomes
Rating Day 1 Day2 Day 3 Day 4 Day 5
Knowledge 1 2 2 2 2
Behavior 2 2 2 2 2
Status 2 3 3 2 2
Problem Identification
Domain: Subdomain Environmental Domain: Income
Modifier 1 Individual
Modifier 2 Health Promotion
Cluster of Signs/Symptoms Reluctance to see physician, regardless of chronic pain
noted on arm. Lack of knowledge on Medicare.

Interventions
Category Teaching, Guidance and Counseling

Target Finances
Specific Actions Inquired for reasons why client does not seak medical
care. Provided referral to a doctor, and scheduled
an appointment for the next day.

Outcomes
Rating Day 1 Day2 Day 3 Day 4 Day 5
Knowledge 1 2 2 3 3
Behavior 2 2 3 3 3
Status 2 2 2 2 2