NANDA-I 2024-2026 edition · Reviewed November 2, 2026 by the editorial team
Diagnosis at a glance
| Code | 00336 |
|---|---|
| Label | Risk for physical injury |
| Before (2021-2023) | Former code 00035 |
| Spanish label | Riesgo de lesión física |
| Domain | 11. Safety / protection |
| Class | 2. Physical injury |
| Type | Risk |
| Status | Current |
What changed in 2024-2026
NANDA-I 2021-2023 used "Risk for injury," code 00035. In 2024-2026 it was revised and is now called "Risk for physical injury," code 00336, in the same Domain 11, Class 2. If you are looking for the old Risk for injury, this is the corresponding diagnosis in the current edition.
What it means
The patient is exposed to bodily harm, such as bumps, wounds, burns or tongue bites, because their condition or environment keeps them from protecting themselves. Use it when the risk is general and does not fit a more specific diagnosis, such as falls.
Explanation written by our team. The official definition is in the NANDA-I 2024-2026 book.
When to use it
Clinical situations where it commonly shows up. The diagnosis is confirmed by your assessment, not by the medical diagnosis.
- A patient who has had seizures in the past few hours or is at risk of having more.
- Stroke with one-sided weakness, impaired balance or lack of awareness of the affected side.
- Agitation, delirium or withdrawal syndrome.
- Recovery from sedation or anesthesia.
- People with vision or cognitive impairment in unfamiliar surroundings.
What to assess
- Level of consciousness with the Glasgow Coma Scale and orientation to time, place and person.
- Seizure history: type, frequency, duration, last seizure and whether there is a warning (aura).
- Adherence to antiseizure medication or other treatment that prevents symptoms.
- Strength, sensation and balance in all four extremities.
- Environment: bed height, side rails, nearby objects, lighting, call light.
- Point-of-care blood glucose if there is altered consciousness or unusual behavior.
- What the patient and family know about what to do during a seizure.
Risk factors
What makes the problem more likely, and what nursing can monitor or modify.
- Unadapted environment: low side rails, hard or sharp objects within reach, bed in high position.
- Insufficient supervision of patients with altered consciousness or behavior.
- Insufficient knowledge of precautions by the patient or family.
- Inadequate adherence to treatment that prevents seizures or symptoms.
- Sleep deprivation or alcohol use.
- Poor lighting or call light out of reach.
- Inappropriate footwear or wet floors.
- Agitation or disorientation without verbal de-escalation and environmental measures.
At-risk populations
- People with epilepsy or recent seizures.
- Older adults with cognitive or sensory impairment.
- Patients with altered level of consciousness or agitation.
- People who have just had a stroke.
- Hospitalized young children without continuous supervision.
Associated conditions
- Epilepsy and seizures from other causes.
- Stroke with hemiparesis or one-sided neglect.
- Delirium, dementia and alcohol withdrawal.
- Sedation, anesthesia or medications that alter consciousness.
- Hypoglycemia.
- Significant vision or hearing loss.
Risk factors are what nursing can change: the environment, supervision, what the family knows, treatment adherence. Epilepsy, stroke or delirium are associated conditions. If your program requires it, write them as "in a patient with...".
How to write it (PES)
Risk for physical injury related to inadequate adherence to antiseizure medication, sleep deprivation and unadapted environment, in a patient with epilepsy (associated condition).
This is a risk diagnosis, so there is no "as evidenced by." If the main risk is falling, use the falls diagnosis; risk for physical injury is reserved for broader or mixed risks.
Example written by our team for a fictional patient. Adapt it to your own patient's data. Build your statement with the PES generator.
Goals / expected outcomes
Written in measurable terms: what, how much and by when.
- Patient remains free of bumps, wounds and tongue bites during the hospital stay.
- The environment meets the agreed safety measures at every shift check.
- Takes prescribed medication on schedule throughout the stay.
- Before discharge, the patient or family explains and demonstrates what to do during a seizure.
- Identifies at least two factors that raise their own risk (lack of sleep, alcohol, missed doses) and how to avoid them.
Nursing interventions and rationales
| Intervention | Rationale |
|---|---|
| Keep the bed in the lowest position with brakes locked, and side rails up and padded if there is a seizure risk. | It reduces the height of a possible fall and impact against hard surfaces. |
| Remove hard or sharp objects nearby and keep suction and oxygen at the bedside. | During a seizure the patient cannot control their movements and may need airway clearance afterward. |
| During a seizure: stay with the patient, protect their head, do not restrain them, put nothing in their mouth and note the start time. | Restraining them or forcing the mouth open causes injuries; timing the seizure helps identify a prolonged one. |
| Once the jerking phase ends, turn the patient on their side and monitor breathing, SpO2 and level of consciousness. | The side-lying position helps secretions drain and protects the airway. |
| Notify the provider immediately if the seizure lasts more than 5 minutes or recurs without regaining consciousness in between. | This is an emergency that requires immediate medical treatment. |
| Give prescribed antiseizure medication exactly on time. | Late or missed doses are a common cause of new seizures. |
| Promote nighttime rest: reduce noise and light and cluster care. | Sleep deprivation lowers the seizure threshold. |
| Teach the family what to do and what not to do during a seizure, with hands-on practice in the room. | They will be the ones responding at home. |
NOC outcomes and NIC interventions
Outcomes (NOC) and interventions (NIC) that published sources link to this diagnosis. Pick the ones that fit your patient.
NOC outcomes
- 1828Knowledge: Fall Prevention
- 1909Fall Prevention Behavior
NIC interventions
- 5620Teaching: Psychomotor Skill
- 6486Environmental Management: Safety
- 6490Fall Prevention
Linkages drawn from care plans published by health services, universities and nursing journals. Labels may vary depending on the NIC and NOC edition your facility uses.
Case study: Seizures after stopping medication
Patient. 26-year-old man with epilepsy since adolescence. He is admitted after two tonic-clonic seizures in 12 hours; he stopped his medication a week ago and has slept very little the past two nights.
Assessment
- GCS 15 on admission, oriented, drowsy.
- Bite on the side of the tongue from the last seizure, no other injuries.
- Previous seizures lasted about 2 minutes, no aura, slow recovery.
- Bed in high position, unpadded side rails and a bedside table with a glass cup next to the head of the bed.
- Reports sleeping 4 hours a night for the past two days and drinking alcohol over the weekend.
- His mother says she tried to put a spoon in his mouth during the last seizure.
Nursing diagnosis
Risk for physical injury related to inadequate adherence to antiseizure medication, sleep deprivation, unadapted environment and family's insufficient knowledge of seizure management, in a patient with epilepsy (associated condition).
Goal
Remains free of new injuries during the hospital stay and, before discharge, his mother explains and demonstrates what to do during a seizure.
Interventions
- Lower the bed, lock the brakes, pad the side rails and remove hard and glass objects.
- Keep suction and oxygen ready at the bedside.
- Give the prescribed antiseizure medication exactly on time.
- Organize care so he gets at least 7 hours of uninterrupted sleep.
- Teach his mother to protect his head, not restrain him, put nothing in his mouth, turn him on his side and time the seizure.
- Talk with the patient about why he stopped his medication and how alcohol affects seizures.
Evaluation
At 72 hours he has had no new seizures or injuries and takes his medication on schedule. His mother explains and demonstrates seizure management. The diagnosis stays active until discharge and a written plan for home is provided.
How it differs from similar diagnoses
- Risk for adult falls (00303): Risk for adult falls is more specific. If the main danger is falling, use it; if the risk is broader (seizures, agitation, bumps, wounds), use 00336.
- Risk for aspiration (00039): Risk for aspiration focuses on secretions or food entering the airway, which can also happen during and after a seizure.
- Risk for corneal injury (00245): Risk for corneal injury is an eye-specific risk, common in sedated patients or those with incomplete eyelid closure.
- Risk for perioperative positioning injury (00087): Risk for perioperative positioning injury applies only to positioning during surgery.
Common mistakes
- Still writing "Risk for injury (00035)" in a care plan based on the 2024-2026 edition.
- Using it when a more specific diagnosis describes the risk better, such as falls or pressure injury.
- Writing only "related to epilepsy" with no factors nursing can change.
- Listing putting something in the mouth during a seizure as an intervention: it causes injuries and does not prevent tongue bites.
- Using physical restraints as a routine measure: they increase agitation and injuries.
Used in these conditions
Other diagnoses in the Physical injury class
Domain 11, Safety / protection. See every diagnosis in this domain.
Frequently asked questions
What is the NANDA code for risk for physical injury?
00336, in Domain 11 (Safety/protection), Class 2 (Physical injury). It is the 2024-2026 revised version of the old Risk for injury (00035).
What happened to the Risk for injury (00035) diagnosis?
It was revised in the 2024-2026 edition and, in practice, replaced by Risk for physical injury (00336). If your program still uses the previous edition, you will see it as 00035.
What nursing diagnosis do I use for a patient with seizures?
Risk for physical injury to prevent bumps and wounds, and often risk for aspiration as well, because of the loss of airway protection.
When do I use risk for falls instead of risk for physical injury?
When the main danger is falling: weakness when walking, dizziness, history of falls. If the risk is broader, use 00336.
Does risk for physical injury have an "as evidenced by" part?
No. It is a risk diagnosis and only includes risk factors.
Study material: the explanation, characteristics, factors, examples and case study on this page were written by our editorial team. The official text for Risk for physical injury (00336) is in NANDA International Nursing Diagnoses: Definitions and Classification 2024-2026. This page does not replace clinical judgment or your facility's protocols.
Classification sources: NANDA-I 2024-2026, Thieme supplement · Elsevier summary of changes · Spanish edition table of contents · NOC/NIC: source 1. Reviewed November 2, 2026.