Domain 9. Coping-stress tolerance
Class 3. Neurobehavioral stress
Diagnostic Code: 00116
Nanda label: Disorganized infant behavior
Diagnostic focus: Organized behavior
Nursing diagnosis is becoming increasingly important in the field of pediatric nursing as it allows nurses to better understand and assess an individual child's needs. Nursing diagnosis has the potential to improve treatments and reduce errors, due to its focus on the individual child. Disorganized infant behavior is one type of nursing diagnosis given to children who engage in reoccurring patterns of behaviors that fall outside normal developmental expectations. The purpose of this article is to provide an introduction to disorganized infant behavior, discuss theNANDA Nursing Diagnosis Definition, define characteristics, list associated conditions, suggest alternatives, provide usage tips, list NOC outcomes and criteria, list NIC Interventions and activities, and answer some frequently asked questions.
NANDA Nursing Diagnosis Definition
NURSING DIAGNOSIS: Disorganized Infant Behavior related to inadequate parenting, lack of support systems, or environmental disruption as evidenced by irritability; agitation; failure to follow instructions; refusal to participate in activities; disregarding physical boundaries; impaired sleep patterns; and aggression
Defining Characteristics
The defining characteristics of disorganized infant behavior include both subjective and objective components. Subjective components include irritability, agitation, failure to follow instructions, refusal to participate in activities, disregarding physical boundaries, and impaired sleep patterns. Objective components may include fearfulness, crying excessively, difficulty in socializing, poor attention span, poor memory and comprehension, hyperactivity, difficulty in self-regulation, aggressiveness, and impulsivity.
Disorganized infant behavior is typically related to inadequate parenting, lack of support systems, and/or environmental disruption. Inadequate parenting—which can include inconsistent discipline, inadequate supervision, and lack of communication—may lead to a child feeling confused and overwhelmed. Additionally, without adequate support systems, such as family and friends, a child is more likely to feel overwhelmed and frustrated. Lastly, environmental disruptions, such as moving, divorce, or the sudden loss of a loved one can cause extreme distress in infant children.
At Risk Population
There are a few populations that are particularly vulnerable to disorganized infant behavior. These include families with incomes below the poverty line, those who have been exposed to neglect or abuse, foster children, and children who have been adopted. Additionally, premature babies or those born with medical difficulties are at an increased risk for disorganized behavior.
Associated Conditions
The degree to which disorganized infant behavior is classified as a disorder is often dependent on the severity of the symptoms and the associated conditions present. Some of these include hyperactivity, attention deficit disorder (ADD or ADHD), obsessive compulsive disorder (OCD), anxiety disorders, depression, and oppositional defiant disorder (ODD).
Suggested Alternative NANDA Nursing Diagnoses
If the child’s symptoms are indicative of a different condition than disorganized infant behavior, some alternative diagnoses to consider are delayed social and communication development, impaired ability to form relationships, disturbed thought processes, declining verbal communication, and impaired interpersonal communication.
Usage Tips
When using nursing diagnosis to assess a child’s disorganized behavior, it is important to remember to look at the child’s functioning within a broad range of contexts and influences. Additionally, it is beneficial to form partnerships between all members of the child’s family in order to create an environment that will be supportive to the child’s development and well-being. Lastly, it is important to be aware of and address the issues of culture and ethnicity when assessing a child’s behavior.
NOC Outcomes
NOC Outcomes refers to the “Nursing Outcomes Classification.” When assessing or treating disorganized infant behavior there are three primary outcomes to strive for. These include: Acceptance of Responsibilities, Stress Tolerance, and Self-Care Demand. Each of these outcomes focuses on the child’s ability to accept responsibility, tolerate stress, and meet their own self-care needs.
Evaluation Objectives and Criteria
Assessing the effectiveness of interventions and establishing treatment goals for disorganized infant behavior involves evaluating multiple factors. These include the child’s age, experienced events leading up to the disorganized behavior, family routines and expectations, parental reactions to behavior, and any underlying physical or mental health disorders.
NIC Interventions
NIC Interventions refer to the “Nursing Interventions Classification” and is divided into four categories: direct patient care, family support and education, community involvement and education, and staff training and development. When treating disorganized infant behavior, the four most commonly used NIC Interventions are: Assess for Psychosocial Issues, Crisis Intervention, Case Management, and Parent Education.
Nursing Activities
In order to effectively treat disorganized behavior in infants, there are several nursing activities that can be used. Some of these include providing support for parents, engaging in playful interaction with the infant, redirecting or guiding behavior, assertive discipline, and routine planning.
Conclusion
Disorganized infant behavior is a complex nursing diagnosis that requires the use of NANDA nursing diagnosis definition, defining characteristics, related factors, associated conditions, suggested alternative diagnoses, usage tips, NOC Outcomes, evaluation objectives and criteria, and NIC Interventions in order to assess, diagnose, and treat. With an understanding of the various elements involved in disorganized infant behavior, nurses are better equipped to form an accurate and comprehensive assessment.
Frequently Asked Questions
- What is disorganized infant behavior?
Disorganized infant behavior is defined as reoccurring patterns of behaviors that fall outside of normal developmental expectations. It may include irritability, agitation, failure to follow instructions, refusal to participate in activities, disregarding of physical boundaries, impaired sleep patterns, and aggression. - What are the defining characteristics of disorganized infant behavior?
The defining characteristics of disorganized infant behavior include both subjective and objective components. Subjective components include irritability, agitation, failure to follow instructions, refusal to participate in activities, disregarding physical boundaries, and impaired sleep patterns. Objective components may include fearfulness, crying excessively, difficulty in socializing, poor attention span, poor memory and comprehension, hyperactivity, difficulty in self-regulation, aggressiveness, and impulsivity. - Who is at risk for developing disorganized infant behavior?
Populations that are particularly vulnerable to disorganized infant behavior include those with incomes below the poverty line, those who have been exposed to neglect or abuse, foster children, and those who have been adopted. Additionally, premature babies or those born with medical difficulties are at an increased risk for disorganized behavior. - What types of interventions are used to treat disorganized infant behavior?
When treating disorganized infant behavior, the four most commonly used NIC Interventions are: Assess for Psychosocial Issues, Crisis Intervention, Case Management, and Parent Education. Other interventions include providing support for parents, engaging in playful interaction with the infant, redirecting or guiding behavior, assertive discipline, and routine planning. - What are NOC Outcomes?
NOC Outcomes refers to the “Nursing Outcomes Classification.” When assessing or treating disorganized infant behavior there are three primary outcomes to strive for. These include: Acceptance of Responsibilities, Stress Tolerance, and Self-Care Demand.