Weakened ability to defend against foreign microorganisms or the toxic effect of antigenic substances

• Depressive symptoms
• Difficulty managing complex treatment regimen
• Hopelessness
• Inadequate access to vaccines
• Inadequate immunization level within community
• Inadequate self-efficacy
• Ineffective health self-management
• Ineffective overweight self-management
• Ineffective sleep pattern
• Maladaptive stress response
• Malnutrition
• Prolonged immobility
• Sedentary behavior occurring for ≥ 2 hours/day
• Substance misuse
• Tainted dietary source
• Vaccine hesitancy

• Immune system diseases
• Impaired primary defense mechanisms
• Neoplasms
• Pharmaceutical preparations
• Treatment regimen

• Vital signs
• Health maintenance, including high-risk behaviors and health-promoting activities
• Patient's knowledge of present condition, including diagnosis, treatment, prevention of complications, and management of adverse effects
• Coping skills, including physical, psychosocial, and spiritual strengths
• Mobility status
• Comfort level, including symptom management
• Activities of daily living, including rest, sleep, and exercise
• Cardiovascular status, including heart rate, rhythm, heart sounds, blood pressure, peripheral pulses, and electrocardiogram results
• Neurologic status, including sensory perception, decision-making abilities, and thought processes
• Respiratory status, including gas exchange and breathing patterns
• Nutritional status, including food preferences, modifications in diet, and weight changes
• Bowel and bladder elimination patterns
• Protective mechanisms, including immune, hematopoietic, integumentary, and sensorimotor systems
• Laboratory studies, including white blood cell count and differential, erythrocyte sedimentation rate, immunoelectrophoresis, enzyme-linked immunosorbent assay, and cultures of blood, body fluid, sputum, urine, and wound exudate
• Sexuality patterns

• Chilling
• Coughing
• Disorientation
• Dyspnea
• Fatigue
• Fever
• Impaired tissue healing
• Inadequate appetite
• Insomnia
• Leukopenia
• Pruritus
• Recurring infections
• Thrombocytopenia
• Weakness

• Patient won't experience chills, fever, or other signs and symptoms of illness.
• Patient will demonstrate use of protective measures, including conservation of energy, maintenance of balanced diet, and attainment of adequate rest.
• Patient will demonstrate effective coping skills.
• Patient will demonstrate personal cleanliness and will maintain clean environment.
• Patient will maintain safe environment.
• Patient will demonstrate increased strength and resistance.
• Patient's immune system response will improve.

Suggested NOC Outcomes

• Spend as much time as possible with patient to provide comfort and support.
• Promote personal and environmental cleanliness to decrease threat from microorganisms.
• Monitor vital signs. This allows for early detection of complications.
• Institute safety precautions to reduce risk of falls, cuts, or other injuries and subsequent infection, bleeding, and impaired healing.
• Teach protective measures, including the need to conserve energy, obtain adequate rest, and eat a balanced diet. Adequate sleep and nutrition enhance immune function. Energy conservation can help decrease the weakness caused by anemia.
• Provide relief for symptoms (fever, chills, myalgia, weakness). Discomfort interferes with rest, disturbs nutritional intake, and places added stress on patient.
• Teach patient coping strategies, including stress management and relaxation techniques. Relaxation and decreased stress can increase immune function, thereby improving strength and resistance.

Suggested NIC Interventions

• Patient doesn't develop petechiae, epistaxis, melena, hematuria, fever, cough, redness, drainage, pallor, headache, weakness, or dizziness. Vital signs remain within normal limits.
• Patient demonstrates a normal pattern of rest, activity, and sleep.
• Patient consumes an adequate diet.
• Patient reports being able to cope effectively.
• Patient demonstrates personal cleanliness and maintains clean environment.
• Patient uses safety precautions to avoid falls and other injuries.
• Patient demonstrates increased strength and resistance.
• Patient's immune system response improves.

• Patient's understanding of abnormal blood profiles
• Patient's description of measures to prevent or manage complications
• Observations of patient's behavior, including health-promoting and high-risk activities
• Signs and symptoms of decreased immune resistance in body systems assessed (cardiopulmonary, neurologic, gastrointestinal, genitourinary, and integumentary)
• Observations of infection or bleeding
• Interventions to assist with coping strategies and health maintenance and promotion
• Patient's response to interventions
• Evaluations for expected outcomes

• Anakaraonye, A. R., Mann, E. S., Annang Ingram, L., & Henderson, A. K. (2019). Black US college women's strategies of sexual self-protection. Culture, Health & Sexuality, 21(2), 160-174. doi:10.1080/13691058.2018.1459844
• Juanjuan, L., Yanjin, H., & Ling, Z. (2017). Application of protection motivation intervention in risk factors self-management of elderly with cardiovascular disease. Chinese Nursing Research, 31(34), 4388-4391. doi:10.3969/j.issn.1009-6493.2017.34.020
• Konkle-Parker, D., Fouquier, K., Portz, K., Wheeless, L., Arnold, T., Harris, C., & Turan, J. (2018). Women's decision-making about self-protection during sexual activity in the deep south of the USA: A grounded theory study. Culture, Health & Sexuality, 20(1), 84-98. doi:10.1080/13691058.2017.1331468
• Tangcharoensathien, V., Chandrasiri, O., Waleewong, O., & Rajatanavin, N. (2019). Overcoming internal challenges and external threats to noncommunicable disease control. Bulletin of the World Health Organization, 97(2), 74-74A. doi:10.2471/BLT.18.228809