NANDA Nursing Diagnoses: Your Complete Guide
Welcome, fellow nurses! Let's dive into everything you need to know about NANDA-I Nursing Diagnoses for 2024-2026: their history, definition, types, domains, and how to apply them with practical examples and helpful resources.
What are NANDA Diagnoses?
NANDA nursing diagnoses are essential clinical tools that describe human responses to actual or potential health problems. As nurses, we use them to enhance communication among healthcare professionals and provide high-quality, standardized care. They form a common language that helps us articulate the unique contributions of nursing to patient well-being.
“A nursing diagnosis is a clinical judgment concerning a human response to health conditions/life processes, or vulnerability for that response, by an individual, family, group, or community.” – NANDA-I
The Story of NANDA International
The journey of NANDA began in the 1970s when a group of forward-thinking nurses in the United States recognized a critical need: to standardize the language of nursing diagnoses. This wasn't just about words; it was about elevating our practice, improving patient care, and ensuring clear communication. This pioneering effort led to the founding of NANDA International, which has since become a globally recognized authority in nursing.
- 1973: NANDA was established to address the need for a standardized nursing language. This was a pivotal moment for our profession!
- 1982: The first official list of nursing diagnoses was published, providing a foundational framework.
- 2002: The organization's name changed to NANDA International, reflecting its worldwide impact and reach.
- Present Day: We now have over 277 diagnoses classified in the Taxonomy II, used by nurses like us around the globe to guide patient care.
The Evolution of NANDA International
NANDA International, since its formal establishment in the 1980s, has been dedicated to systematizing and standardizing nursing diagnoses. It provides a clear framework that empowers us, as nurses, to accurately identify patient responses, develop effective care plans, and enhance communication within the healthcare team. NANDA-I undertakes periodic reviews to reflect evolving patient care needs, ensuring the diagnoses remain relevant and clinically applicable.
Recent Updates in Diagnoses (2024-2026)
The latest updates to NANDA diagnoses for 2024-2026 demonstrate a commitment to addressing contemporary health issues. This dynamic approach ensures that nursing nomenclature stays aligned with advancements in medicine, societal changes, and emerging public health challenges.
Newly Added Diagnoses
As our understanding of patient needs grows, so does our diagnostic toolkit. Some recent additions include:
- Risk for Ineffective Home Maintenance: This addresses concerns about a patient's ability to maintain a safe and healthy living environment.
- Risk for Frail Elderly Syndrome: A crucial diagnosis focusing on the complex vulnerabilities of our older adult population.
- Deficient Knowledge in Treatment Management: This highlights the need for patient education to prevent complications and promote self-care.
Revised and Retired Diagnoses
With each review cycle, NANDA-I also refines or retires diagnoses that are no longer as relevant or have been integrated into broader categories. For instance, diagnoses like "Disturbed Body Image" (formerly "Alteration in body perception") have been updated to better align with patient-centered care trends. This ensures our nursing approach remains agile and responsive to current health demands.
These updates often involve revising descriptions and enhancing the precision of the language used, which is vital for correct interpretation and application in our daily practice. NANDA-I also strives to incorporate diagnoses that reflect global health trends, considering the cultural and social diversity of the patients we serve.
Integrating NANDA-I with NIC and NOC
The real power of NANDA-I diagnoses comes alive when we integrate them with the Nursing Interventions Classification (NIC) and Nursing Outcomes Classification (NOC). This synergy provides a robust framework for our nursing practice, allowing for a structured and comprehensive approach to patient care.
Nursing Interventions Classification (NIC)
NIC provides a standardized system for classifying the actions we, as nurses, implement in response to NANDA-I diagnoses. By using a common, systematic language, NIC helps ensure that the care we provide is consistent, effective, and evidence-based.
Examples of Common Interventions:
Our interventions are tailored to specific diagnoses. Some examples include:
- Self-Care Education: Empowering patients to manage their health, especially for chronic conditions.
- Pain Management: Utilizing pharmacological and non-pharmacological strategies to alleviate acute and chronic pain.
- Infection Prevention: Implementing actions like hygiene protocols and wound care to minimize infection risks.
- Emotional Support: Providing psychological support, particularly in situations of grief or terminal illness.
- Nutrition Promotion: Planning diets and monitoring the patient's nutritional status.
Nursing Outcomes Classification (NOC)
NOC allows us to measure the success of the interventions we implement based on NANDA-I diagnoses. Through a structured approach, NOC provides clear expectations regarding patient progress and helps us evaluate the effectiveness of our care.
Measuring Success and Outcomes:
We evaluate outcomes using indicators that help us assess the impact of our interventions. Some of these indicators include:
- Overall Health Status: Assessing how the patient's health has improved through specific interventions.
- Patient Satisfaction: Measuring the patient's perception of the quality of care received and their involvement in their own care.
- Treatment Adherence: Evaluating the patient's adherence to treatment recommendations and self-care practices.
- Symptom Reduction: Assessing the decrease in symptoms and signs that the patient presented at the beginning of treatment.
By integrating NANDA-I, NIC, and NOC, we gain a complete and clear picture of our patient's needs. This enables us to deliver more effective, person-centered care focused on their well-being.
The NANDA-I Taxonomy II
The NANDA-I Taxonomy II is structured into three key levels: Domains, Classes, and Nursing Diagnoses. This organization helps us navigate and apply diagnoses systematically.
1. Domains
A domain is a sphere of activity, study, or interest. The taxonomy features 13 NANDA-I Domains. Each Domain is further structured or subdivided into various Classes.
2. Classes
A class is a subdivision of a larger group; a division of people or things by quality, rank, or degree. The taxonomy includes 48 Classes. These Classes group related Nursing Diagnoses.
3. Nursing Diagnosis
A nursing diagnosis is a clinical judgment concerning a human response to health conditions/life processes, or a vulnerability for that response, by an individual, family, group, or community. A nursing diagnosis provides the basis for selecting nursing interventions to achieve outcomes for which the nurse has accountability (approved at the 9th NANDA conference, 1990).
NANDA-I Domains and Diagnostic Classes
NANDA-I diagnoses are thoughtfully organized into 13 domains, each further divided into specific classes. These categories help us, as healthcare professionals, to identify and classify human responses in a structured and meaningful way.
Domain | Classes |
---|---|
1. Health Promotion |
Health Awareness, Health Management |
2. Nutrition |
Ingestion, Digestion, Absorption, Metabolism, Hydration |
3. Elimination/Exchange |
Urinary Function, Gastrointestinal Function, Integumentary Function, Respiratory Function |
4. Activity/Rest |
Sleep/Rest, Activity/Exercise, Energy Balance, Cardiovascular/Pulmonary Responses, Self-Care |
5. Perception/Cognition |
Attention, Orientation, Sensation/Perception, Cognition, Communication |
6. Self-Perception |
Self-Concept, Self-Esteem, Body Image |
7. Role/Relationships |
Caregiving Roles, Family Relationships, Role Performance |
8. Sexuality |
Sexual Identity, Sexual Function, Reproduction |
9. Coping/Stress Tolerance |
Post-Trauma Responses, Coping Responses, Neurobehavioral Stress |
10. Life Principles |
Values, Beliefs, Value/Belief/Action Congruence |
11. Safety/Protection |
Infection, Physical Injury, Violence, Environmental Hazards, Defensive Processes, Thermoregulation |
12. Comfort |
Physical Comfort, Environmental Comfort, Social Comfort, Psychological Comfort |
13. Growth/Development |
Growth, Development |
Examples of Diagnoses by Domain
Here are a few examples to illustrate how diagnoses fit within these key domains:
- Domain 1: Health PromotionDiagnosis: Readiness for Enhanced Health Management.
- Domain 2: NutritionDiagnosis: Imbalanced Nutrition: More Than Body Requirements related to poor dietary habits.
- Domain 4: Activity/RestDiagnosis: Disturbed Sleep Pattern related to stress.
- Domain 11: Safety/ProtectionDiagnosis: Risk for Infection related to recent surgery.
The 5 Types of NANDA-I Nursing Diagnoses
NANDA-I diagnoses are categorized into five main types, each focusing on a different aspect of human responses to health issues. Let's explore each type with practical examples to help us understand their application in our nursing practice.
Example: Chronic Pain Syndrome (00255), which includes or implies other Nursing Diagnoses such as: Disturbed Sleep Pattern (00198), Social Isolation (00053), Fatigue (00093), or Impaired Physical Mobility (00085).
-
Problem-Focused Diagnosis (Actual Diagnosis)
This describes a patient's current health problem, always validated by observable signs and symptoms. This type of diagnosis helps us identify issues requiring immediate nursing intervention.
Example: "Impaired Physical Mobility related to chronic pain, evidenced by difficulty walking." -
Risk Diagnosis
This refers to conditions where risk factors are present, and nursing intervention is required before an actual problem develops. It's about proactive care.
Example: "Risk for Infection related to recent surgery." -
Health Promotion Diagnosis
This focuses on enhancing the overall well-being of a patient or community by promoting healthy habits and conditions. It's about motivation and desire to increase well-being.
Example: "Readiness for Enhanced Health Management evidenced by changes in dietary habits." -
Wellness Diagnosis
This describes situations where an individual is in a good state of health but wishes to achieve an even higher level of wellness. It’s a clinical judgment about a transition from a specific level of wellness to a higher level of wellness.
Example: "Readiness for Enhanced Sleep Pattern related to a desire to optimize rest." -
Syndrome Diagnosis
This describes specific, complex situations that are always composed of several interrelated nursing diagnoses that need to be addressed collectively.
Example: "Post-Trauma Syndrome related to traumatic events, evidenced by anxiety episodes and avoidance."
Complete List of NANDA-I Nursing Diagnoses 2024-2026
DOMAIN 1: Health promotion
Class 1: Health awareness
- (00097) – Decreased diversional activity engagement
- (00448) – Risk for decreased diversional activity engagement
- (00355) – Excessive sedentary behaviors
- (00394) – Risk for excessive sedentary behaviors
- (00273) – Imbalanced energy field
- (00084) – Health-promoting behaviors (specify)
Class 2: Health management
- (00276) – Ineffective health self-management
- (00369) – Risk for ineffective health self-management
- (00293) – Readiness for enhanced health self-management
- (00080) – Ineffective family health management
- (00410) – Risk for ineffective family health management
- (00356) – Ineffective community health management
- (00413) – Risk for ineffective community health management
- (00489) – Risk for ineffective blood glucose pattern self-management
- (00277) – Ineffective dry eye self-management
- (00352) – Ineffective dry mouth self-management
- (00412) – Risk for ineffective dry mouth self-management
- (00397) – Ineffective fatigue self-management
- (00278) – Ineffective lymphedema self-management
- (00281) – Risk for ineffective lymphedema self-management
- (00384) – Ineffective nausea self-management
- (00418) – Ineffective pain self-management
- (00447) – Readiness for enhanced weight self-management
- (00398) – Ineffective overweight self-management
- (00487) – Risk for ineffective overweight self-management
- (00485) – Ineffective underweight self-management
- (00486) – Risk for ineffective underweight self-management
- (00292) – Ineffective health maintenance behaviors
- (00395) – Risk for ineffective health maintenance behaviors
- (00300) – Ineffective home maintenance behaviors
- (00308) – Risk for ineffective home maintenance behaviors
- (00309) – Readiness for enhanced home maintenance behaviors
- (00307) – Readiness for enhanced exercise engagement
- (00339) – Inadequate health literacy
- (00411) – Risk for inadequate health literacy
- (00262) – Readiness for enhanced health literacy
- (00340) – Readiness for enhanced healthy aging
- (00353) – Elder frailty syndrome
- (00357) – Risk for elder frailty syndrome
- (00078) – Ineffective therapeutic regimen management
- (00079) – Non-compliance with treatment (specify)
- (00081) – Ineffective community therapeutic regimen management
- (00082) – Effective therapeutic regimen management
- (00099) – Ineffective health maintenance
- (00186) – Willingness to improve immunization status
DOMAIN 1: Promoción de la salud
Class 2: Gestión de la salud
- (00043) – Ineffective protection
- (00188) – Risk-prone behavior tendency
- (00215) – Community ineffective health
- (00231) – Risk for frailty syndrome in the elderly
- (00257) – Elderly frailty syndrome
- (00294) – Ineffective family health management
DOMAIN 2: Nutrition
Class 1: Ingestion
- (00343) – Inadequate nutritional intake
- (00409) – Risk for inadequate nutritional intake
- (00419) – Readiness for enhanced nutritional intake
- (00359) – Inadequate protein energy nutritional intake
- (00360) – Risk for inadequate protein energy nutritional intake
- (00371) – Ineffective chestfeeding
- (00406) – Risk for ineffective chestfeeding
- (00347) – Disrupted exclusive chestfeeding
- (00382) – Risk for disrupted exclusive chestfeeding
- (00479) – Readiness for enhanced chestfeeding
- (00333) – Inadequate human milk production
- (00334) – Risk for inadequate human milk production
- (00271) – Ineffective infant feeding dynamics
- (00270) – Ineffective child eating dynamics
- (00269) – Ineffective adolescent eating dynamics
- (00103) – Impaired swallowing
- (00001) – Nutritional imbalance due to excess
- (00003) – Risk of imbalanced nutrition: more than body requirements
Class 4: Metabolism
Class 5: Hydration
- (00491) – Risk for impaired water-electrolyte balance
- (00492) – Risk for impaired fluid volume balance
- (00026) – Excessive fluid volume
- (00370) – Risk for excessive fluid volume
- (00421) – Inadequate fluid volume
- (00420) – Risk for inadequate fluid volume
- (00160) – Readiness for Enhanced Fluid Volume Balance
DOMAIN 2: Nutrición
Class 1: Ingestión
- (00002) – Nutritional Imbalance: Less than Body Requirements
- (00104) – Ineffective breastfeeding
- (00105) – Interrupted breastfeeding
- (00106) – Effective breastfeeding
- (00163) – Readiness for Enhanced Nutrition
- (00216) – Insufficient breast milk production
- (00232) – Obesity
- (00233) – Overweight
- (00234) – Risk of overweight
- (00107) – Ineffective feeding pattern of the infant
Class 4: Metabolismo
- (00178) – Risk for impaired liver function
- (00179) – Risk for unstable blood glucose levels
- (00296) – Risk of metabolic syndrome
Class 5: Hidratación
- (00025) – Risk for fluid volume imbalance
- (00027) – Fluid volume deficit
- (00028) – Risk for fluid volume deficit
- (00195) – Risk for electrolyte imbalance
DOMAIN 3: Elimination and exange
Class 1: Urinary function
- (00016) – Impaired urinary elimination
- (00322) – Risk for urinary retention
- (00297) – Disability-associated urinary incontinence
- (00310) – Mixed urinary incontinence
- (00017) – Stress urinary incontinence
- (00019) – Urge urinary incontinence
- (00022) – Risk for urge urinary incontinence
Class 2: Gastrointestinal function
- (00423) – Impaired gastrointestinal motility
- (00422) – Risk for impaired gastrointestinal motility
- (00344) – Impaired intestinal elimination
- (00346) – Risk for impaired intestinal elimination
- (00235) – Chronic functional constipation
- (00236) – Risk for chronic functional constipation
- (00424) – Impaired fecal continence
- (00345) – Risk for impaired fecal continence
- (00014) – Fecal incontinence
Class 4: Respiratory function
DOMAIN 3: Eliminación e intercambio
Class 1: Función urinaria
- (00023) – Urinary retention
- (00166) – Readiness for enhanced urinary elimination
- (00176) – Overflow urinary incontinence
- (00203) – Ineffective renal perfusion risk
- (00018) – Reflex urinary incontinence
- (00020) – Functional urinary incontinence
- (00021) – Total urinary incontinence
Class 2: Función gastrointestinal
- (00011) – Constipation
- (00012) – Subjective constipation
- (00013) – Diarrhea
- (00015) – Risk for constipation
- (00196) – Dysfunctional gastrointestinal motility
- (00197) – Risk for dysfunctional gastrointestinal motility
- (00319) – Bowel incontinence
- (00202) – Ineffective gastrointestinal perfusion risk
DOMAIN 4: Activity - rest
Class 1: Sleep - rest
- (00337) – Ineffective sleep pattern
- (00407) – Risk for ineffective sleep pattern
- (00417) – Readiness for enhanced sleep pattern
- (00323) – Ineffective sleep hygiene behaviors
- (00408) – Risk for ineffective sleep hygiene behaviors
Class 2: Activity - exercise
- (00085) – Impaired physical mobility
- (00324) – Risk for impaired physical mobility
- (00091) – Impaired bed mobility
- (00089) – Impaired wheelchair mobility
- (00363) – Impaired sitting ability
- (00364) – Impaired standing ability
- (00367) – Impaired transferring ability
- (00365) – Impaired walking ability
Class 3: Energy balance
- (00298) – Decreased activity tolerance
- (00299) – Risk for decreased activity tolerance
- (00477) – Excessive fatigue burden
- (00465) – Impaired surgical recovery
- (00464) – Risk for impaired surgical recovery
Class 4: Cardiovascular - pulmonary responses
- (00311) – Risk for impaired cardiovascular function
- (00362) – Risk for imbalanced blood pressure
- (00240) – Risk for decreased cardiac output
- (00201) – Risk for ineffective cerebral tissue perfusion
- (00204) – Ineffective peripheral tissue perfusion
- (00228) – Risk for ineffective peripheral tissue perfusion
- (00032) – Ineffective breathing pattern
- (00033) – Impaired spontaneous ventilation
- (00431) – Impaired child ventilatory weaning response
- (00430) – Impaired adult ventilatory weaning response
Class 5: Self-care
- (00331) – Decreased self-care ability syndrome
- (00332) – Risk for decreased self-care ability syndrome
- (00442) – Readiness for enhanced self-care abilities
- (00326) – Decreased bathing abilities
- (00327) – Decreased dressing abilities
- (00328) – Decreased feeding abilities
- (00330) – Decreased grooming abilities
- (00329) – Decreased toileting abilities
- (00375) – Ineffective oral hygiene behaviors
- (00414) – Risk for ineffective oral hygiene behaviors
DOMAIN 4: Actividad/reposo
Class 1: Sueño/reposo
- (00095) – Sleep Pattern Disturbance
- (00096) – Sleep deprivation
- (00165) – Readiness for Enhanced Sleep
- (00198) – Sleep Pattern Disturbance
Class 2: Actividad/ejercicio
- (00040) – Risk for disuse syndrome
- (00088) – Impaired physical mobility
- (00090) – Impaired transferability
- (00237) – Impaired Sitting Balance
- (00238) – Impaired Standing Balance
- (00092) – Activity intolerance
- (00094) – Risk for activity intolerance
Class 3: Equilibrio de la energía
Class 4: Respuestas cardiovasculares/pulmonares
- (00029) – Decreased cardiac output
- (00034) – Dysfunctional weaning response from the ventilator
- (00200) – Risk of decreased cardiac tissue perfusion
- (00267) – Risk of unstable blood pressure
- (00318) – Dysfunctional ventilatory weaning in adults
- (00024) – Ineffective tissue perfusion
Class 5: Autocuidado
- (00102) – Self-Care Deficit: Feeding
- (00108) – Self-Care Deficit: Bathing/Hygiene
- (00109) – Self-care deficit: dressing/grooming
- (00110) – Self-Care Deficit: Toileting
- (00182) – Readiness for Enhanced Self-Care
- (00193) – Self-Care Deficit
DOMAIN 5: Perception - cognition
Class 4: Cognition
- (00128) – Acute confusion
- (00173) – Risk for acute confusion
- (00129) – Chronic confusion
- (00222) – Ineffective impulse control
- (00493) – Disrupted thought processes
- (00435) – Inadequate health knowledge
- (00499) – Readiness for enhanced health knowledge
- (00131) – Impaired memory
- (00429) – Impaired decision-making
- (00184) – Readiness for enhanced decision-making
- (00242) – Impaired emancipated decision-making
- (00244) – Risk for impaired emancipated decision-making
- (00243) – Readiness for enhanced emancipated decision-making
Class 5: Communication
- (00051) – Impaired verbal communication
- (00434) – Risk for impaired verbal communication
- (00368) – Readiness for enhanced verbal communication
DOMAIN 5: Percepción/cognición
Class 1: Atención
Class 3: Sensation / perception
Class 4: Cognición
- (00126) – Deficient Knowledge (specify)
- (00161) – Readiness for enhanced knowledge (specify)
- (00251) – Emotional instability
- (00279) – Impaired Thought Processes
- (00049) – Decreased intracranial adaptive capacity
- (00127) – Syndrome of impairment in environmental interpretation
- (00130) – Disorder of Thought Processes
Class 5: Comunicación
DOMAIN 6: Self-perception
Class 1: Self-concept
- (00167) – Readiness for enhanced self-concept
- (00494) – Disrupted personal identity
- (00495) – Disrupted family identity syndrome
- (00496) – Risk for disrupted family identity syndrome
- (00488) – Risk for impaired human dignity
- (00341) – Readiness for enhanced transgender social identity
Class 2: Self-esteem
- (00483) – Chronic inadequate self-esteem
- (00480) – Risk for chronic inadequate self-esteem
- (00481) – Situational inadequate self-esteem
- (00482) – Risk for situational inadequate self-esteem
- (00338) – Inadequate health self-efficacy
Class 3: Body image
DOMAIN 6: Autopercepción
Class 1: Autoconcepto
- (00121) – Personal Identity Disturbance
- (00124) – Hopelessness
- (00174) – Risk for compromised human dignity
- (00225) – Risk for impaired identity
Class 2: Autoestima
- (00119) – Chronic Low Self-Esteem
- (00120) – Situational low self-esteem
- (00153) – Risk for situational low self-esteem
- (00224) – Risk for chronic low self-esteem
Class 3: Imagen corporal
DOMAIN 7: Role relationship
Class 1: Caregiving roles
- (00436) – Impaired parenting behaviors
- (00437) – Risk for impaired parenting behaviors
- (00438) – Readiness for enhanced parenting behaviors
- (00387) – Excessive parental role conflict
Class 2: Family relationships
- (00389) – Disrupted family interaction patterns
- (00440) – Risk for disrupted family interaction patterns
- (00388) – Impaired family processes
- (00159) – Readiness for enhanced family processes
- (00439) – Risk for disrupted attachment behaviors
Class 3: Role performance
- (00055) – Ineffective role performance
- (00449) – Ineffective intimate partner relationship
- (00445) – Risk for ineffective intimate partner relationship
- (00446) – Readiness for enhanced intimate partner relationship
- (00052) – Impaired social interaction
- (00221) – Ineffective childbearing process
- (00227) – Risk for ineffective childbearing process
- (00208) – Readiness for enhanced childbearing process
DOMAIN 7: Rol/relaciones
Class 1: Roles de cuidador(a)
- (00056) – Parental role disorder
- (00057) – Risk for impaired parenting
- (00061) – Fatigue in caregiver role performance
- (00062) – Risk of caregiver role strain
- (00164) – Readiness for Enhanced Parenting Role
Class 2: Relaciones familiares
- (00058) – Risk for impaired attachment between parents and infant/child
- (00060) – Disruption of family processes
- (00063) – Dysfunctional family processes: alcoholism
- (00283) – Family Identity Deprivation Syndrome
- (00284) – Risk of family identity disintegration syndrome
Class 3: Desempeño del rol
- (00064) – Parental Role Conflict
- (00207) – Readiness for Enhanced Relationships
- (00223) – Ineffective Relationships
- (00229) – Ineffective relationship risk
DOMAIN 8: Sexuality
Class 2: Sexual function
Class 3: Reproduction
DOMAIN 8: Sexualidad
Class 2: Función sexual
Class 3: Reproducción
DOMAIN 9: Coping - Stress tolerance
Class 1: Post-trauma responses
- (00141) – Post-trauma syndrome
- (00145) – Risk for post-trauma syndrome
- (00484) – Risk for disrupted immigration transition
Class 2: Coping responses
- (00405) – Maladaptive coping
- (00158) – Readiness for enhanced coping
- (00373) – Maladaptive family coping
- (00075) – Readiness for enhanced family coping
- (00456) – Maladaptive community coping
- (00076) – Readiness for enhanced community coping
- (00366) – Excessive caregiving burden
- (00401) – Risk for excessive caregiving burden
- (00301) – Maladaptive grieving
- (00302) – Risk for maladaptive grieving
- (00285) – Readiness for enhanced grieving
- (00210) – Impaired resilience
- (00211) – Risk for impaired resilience
- (00212) – Readiness for enhanced resilience
- (00185) – Readiness for enhanced hope
- (00325) – Inadequate self-compassion
- (00400) – Excessive anxiety
- (00399) – Excessive death anxiety
- (00390) – Excessive fear
- (00070) – Impaired adaptation
Class 3: Neurobehavioral responses
- (00010) – Risk for autonomic dysreflexia
- (00372) – Ineffective emotion regulation
- (00241) – Impaired mood regulation
- (00258) – Acute substance withdrawal syndrome
- (00259) – Risk for acute substance withdrawal syndrome
DOMAIN 9: Afrontamiento/tolerancia al estrés
Class 1: Respuestas postraumáticas
- (00114) – Relocation Stress Syndrome
- (00142) – Rape Trauma Syndrome
- (00149) – Risk for transfer stress syndrome
- (00260) – Risk of complicated migratory transition
- (00143) – Trauma syndrome of rape: compounded reaction
- (00144) – Silent reaction to rape trauma syndrome
Class 2: Respuestas de afrontamiento
- (00069) – Ineffective coping
- (00071) – Defensive Coping
- (00072) – Ineffective denial
- (00073) – Disabling family coping
- (00074) – Compromised Family Coping
- (00077) – Ineffective community coping
- (00125) – Impotence
- (00137) – Chronic sorrow
- (00146) – Anxiety
- (00147) – Anxiety related to death
- (00148) – Fear
- (00152) – Risk for Impotence
- (00177) – Overload Stress
- (00187) – Readiness for Enhanced Power
- (00199) – Ineffective Activity Planning
- (00226) – Ineffective activity planning risk
- (00135) – Dysfunctional grieving
- (00136) – Anticipatory grieving
- (00150) – Risk of suicide
- (00172) – Risk for dysfunctional grieving
Class 3: Estrés neurocomportamental
- (00009) – Autonomic dysreflexia
- (00115) – Risk for disorganized infant behavior
- (00116) – Disorganized Infant Behavior
- (00117) – Readiness for Enhanced Infant Behavior Organization
- (00264) – Neonatal Abstinence Syndrome
DOMAIN 10: Life principles
Class 3: Value - belief - action congruence
- (00175) – Moral distress
- (00454) – Impaired spiritual well-being
- (00460) – Risk for impaired spiritual well-being
- (00168) – Readiness for enhanced spiritual well-being
- (00169) – Impaired religiosity
- (00170) – Risk for impaired religiosity
- (00171) – Readiness for enhanced religiosity
DOMAIN 10: Principios vitales
Class 2: Creencias
Class 3: Congruencia entre valores/creencias/acciones
- (00066) – Spiritual Distress
- (00067) – Risk for spiritual distress
- (00083) – Decision-making conflict (specify)
DOMAIN 11: Safety - protection
Class 1: Infection
- (00361) – Impaired immune response
- (00004) – Risk for infection
- (00500) – Risk for surgical wound infection
Class 2: Physical injury
- (00336) – Risk for physical injury
- (00350) – Risk for burn injury
- (00351) – Risk for cold injury
- (00245) – Risk for corneal injury
- (00219) – Risk for dry eye
- (00087) – Risk for perioperative positioning injury
- (00287) – Neonatal pressure injury
- (00288) – Risk for neonatal pressure injury
- (00313) – Child pressure injury
- (00286) – Risk for child pressure injury
- (00312) – Adult pressure injury
- (00304) – Risk for adult pressure injury
- (00250) – Risk for urinary tract injury
- (00044) – Impaired tissue integrity
- (00248) – Risk for impaired tissue integrity
- (00046) – Impaired skin integrity
- (00047) – Risk for impaired skin integrity
- (00461) – Impaired nipple-areolar complex integrity
- (00462) – Risk for impaired nipple-areolar complex integrity
- (00045) – Impaired oral mucous membrane integrity
- (00247) – Risk for impaired oral mucous membrane integrity
- (00306) – Risk for child falls
- (00303) – Risk for adult falls
- (00039) – Risk for aspiration
- (00031) – Ineffective airway clearance
- (00463) – Risk for accidental suffocation
- (00374) – Risk for excessive bleeding
- (00205) – Risk for shock
- (00291) – Risk for thrombosis
- (00425) – Risk for impaired peripheral neurovascular function
- (00156) – Risk for sudden infant death
- (00290) – Risk for elopement attempt
- (00005) – Risk for Imbalanced Body Temperature
- (00041) – Latex allergy response
Class 3: Violence
- (00138) – Risk for other-directed violence
- (00272) – Risk for female genital mutilation
- (00466) – Risk for suicidal self-injurious behavior
- (00467) – Non-suicidal self-injurious behavior
- (00468) – Risk for non-suicidal self-injurious behavior
Class 4: Environmental hazards
- (00181) – Contamination
- (00180) – Risk for contamination
- (00469) – Risk for accidental poisoning
- (00404) – Risk for occupational illness
- (00402) – Risk for occupational physical injury
Class 5: Defensive processes
Class 6: Thermoregulation
- (00008) – Ineffective thermoregulation
- (00274) – Risk for ineffective thermoregulation
- (00474) – Decreased neonatal body temperature
- (00476) – Risk for decreased neonatal body temperature
- (00472) – Decreased body temperature
- (00473) – Risk for decreased body temperature
- (00490) – Risk for decreased perioperative body temperature
- (00007) – Hyperthermia
- (00471) – Risk for hyperthermia
DOMAIN 11: Health promotion
Class 2: Health management
DOMAIN 11: Seguridad/protección
Class 1: Infección
Class 2: Lesión física
- (00035) – Risk for injury
- (00036) – Risk for Aspiration
- (00038) – Risk for injury
- (00048) – Deterioration of dentition
- (00086) – Risk for peripheral neurovascular dysfunction
- (00100) – Delayed surgical recovery
- (00206) – Risk for bleeding
- (00213) – Risk of vascular injury
- (00220) – Risk for thermal injury
- (00246) – Risk for delayed surgical recovery
- (00261) – Risk for dry mouth
- (00320) – Nipple-areolar complex injury
- (00321) – Risk for injury of the nipple-areolar complex
- (00155) – Risk for falls
Class 3: Violencia
- (00139) – Risk for self-mutilation
- (00140) – Risk for self-directed violence
- (00151) – Self-mutilation
- (00289) – Risk for suicide behavior
Class 4: Peligros del entorno
- (00037) – Risk of poisoning
- (00265) – Risk of occupational injury
- (00098) – Deterioration of home maintenance
Class 5: Procesos defensivos
Class 6: Termorregulación
- (00006) – Hypothermia
- (00253) – Risk for hypothermia
- (00254) – Risk for perioperative hypothermia
- (00280) – Neonatal Hypothermia
- (00282) – Risk for Neonatal Hypothermia
DOMAIN 12: Comfort
Class 1: Physical comfort
- (00380) – Impaired physical comfort
- (00378) – Readiness for enhanced physical comfort
- (00342) – Impaired end-of-life comfort syndrome
- (00132) – Acute pain
- (00255) – Chronic pain syndrome
- (00133) – Chronic pain
- (00256) – Labor pain
Class 3: Social comfort
- (00376) – Readiness for enhanced social comfort
- (00383) – Inadequate social connectedness
- (00358) – Inadequate social support network
- (00475) – Excessive loneliness
- (00335) – Risk for excessive loneliness
Class 4: Psychological comfort
DOMAIN 12: Confort
Class 1: Confort físico
Class 3: Confort social
DOMAIN 13: Growth - development
Class 1: Growth
Class 2: Development
- (00314) – Delayed child development
- (00305) – Risk for delayed child development
- (00315) – Delayed infant motor development
- (00316) – Risk for delayed infant motor development
- (00451) – Impaired infant neurodevelopmental organization
- (00452) – Risk for impaired infant neurodevelopmental organization
- (00453) – Readiness for enhanced infant neurodevelopmental organization
- (00295) – Ineffective infant suck-swallow response
DOMAIN 13: Growth - development
Class 1: Growth
Class 2: Development
- (00101) – Inability of the adult to maintain their development
- (00112) – Risk of developmental delay
The PES Format for NANDA-I Diagnoses
As nurses, we often use the PES format to structure our nursing diagnoses. It's a simple yet powerful tool that helps ensure clarity and precision. PES stands for Problem (P), Etiology (E), and Signs and Symptoms (S).
How Does the PES Format Work?
The PES format helps us clearly articulate a nursing diagnosis:
- Problem (P): This is the NANDA-I diagnostic label. It identifies the observed or anticipated human response.
- Etiology (E): This describes the cause or contributing factors related to the problem. It answers the question, "What's causing or contributing to this problem?" We often use "related to" (r/t) here.
- Signs and Symptoms (S): These are the defining characteristics – the observable evidence and patient statements that validate the diagnosis. We often use "as evidenced by" (a/e/b) or "as manifested by" (a/m/b).
Complete Example of the PES Format
Diagnosis: Impaired Physical Mobility
PES Format:
- P (Problem): Impaired Physical Mobility
- E (Etiology): Related to hip fracture
- S (Signs/Symptoms): Evidenced by difficulty walking and pain upon movement
Common Mistakes When Using the PES Format
To ensure our diagnoses are accurate and useful, let's be mindful of these common pitfalls:
- Lack of Specificity: Avoid overly general problem statements, like just "Discomfort." Be precise.
- Incorrect Etiology: Don't relate the problem to a medical diagnosis. Instead, focus on the nursing-related cause (e.g., "related to surgical incision" rather than "related to appendectomy").
- Omitting Evidence: Always include the signs and symptoms that validate your chosen diagnosis. This is crucial for demonstrating your clinical judgment.
Practical Example: Applying NANDA-I Diagnoses
Let's walk through a practical example to see how we can identify and structure a nursing diagnosis using NANDA-I domains, diagnosis types, and the PES format. This case focuses on a patient experiencing issues with mobility and pain.
Case Description
A 65-year-old male patient was admitted following a fall at home, resulting in a hip fracture. He reports significant pain, has difficulty mobilizing, and has a history of poorly controlled type 2 diabetes. He expresses concern about his ability to regain independence after surgery.
Relevant Data Points:
- Domain 4 (Activity/Rest): Interrupted mobility pattern.
- Domain 11 (Safety/Protection): Risk for post-surgical infection.
- Domain 9 (Coping/Stress Tolerance): Anxiety related to recovery.
Identified Diagnoses
Based on our assessment, we can identify the following nursing diagnoses:
- Diagnosis 1: Impaired Physical Mobility
- P (Problem): Impaired Physical Mobility
- E (Etiology): Related to hip fracture and pain
- S (Signs/Symptoms): Evidenced by difficulty walking and verbalization of pain upon movement
- Diagnosis 2: Risk for Infection
- P (Problem): Risk for Infection
- E (Etiology): Related to recent surgery and history of type 2 diabetes
- S (Signs/Symptoms): (Not applicable for risk diagnoses, as the problem has not yet occurred; risk factors are the evidence.)
- Diagnosis 3: Anxiety
- P (Problem): Anxiety
- E (Etiology): Related to concern about recovery and potential loss of independence
- S (Signs/Symptoms): Evidenced by patient's statements of worry and observed nervousness
Care Plan Outline
Based on these diagnoses, our nursing care plan would aim to address each issue:
Diagnosis | Interventions (NIC examples) | Expected Outcomes (NOC examples) |
---|---|---|
Impaired Physical Mobility |
|
|
Risk for Infection |
|
|
Anxiety |
|
|
More Examples of NANDA-I Nursing Diagnoses
NANDA-I nursing diagnoses cover a wide array of patient responses, allowing us, as nurses, to address diverse health aspects. Here are some more concrete examples applicable in our clinical practice.
Nursing Diagnoses by Medical Condition
While nursing diagnoses focus on human responses rather than medical diseases, understanding common responses associated with certain conditions helps us anticipate needs and plan care more effectively. For example:
- Diabetes Mellitus: "Risk for Unstable Blood Glucose Level" or "Deficient Knowledge related to diabetes management."
- Chronic Obstructive Pulmonary Disease (COPD): "Ineffective Airway Clearance" or "Activity Intolerance."
- Heart Failure: "Excess Fluid Volume related to compromised regulatory mechanisms" or "Decreased Cardiac Output."
Risk for Infection and Other Risks
Identifying and addressing risks is a cornerstone of proactive nursing. "Risk for Infection" is crucial for vulnerable patients, prompting interventions to mitigate those risks. Other common risk diagnoses include:
Risk Factors for Falls
"Risk for Falls" is fundamental, especially for elderly patients or those with mobility-affecting conditions. Specific diagnoses might be:
- "Risk for Falls related to muscle weakness and impaired mobility."
- "Risk for Falls secondary to balance disturbances."
Risk for Pressure Injury
Patients with limited mobility are at high risk for developing pressure injuries. Examples include:
- "Risk for Impaired Skin Integrity related to prolonged immobility."
- "Risk for Pressure Ulcer in bedridden patients."
Common Problems: Acute and Chronic Pain
Pain, whether acute or chronic, is a common response affecting many patients. Diagnoses related to pain are essential for its effective management.
- "Acute Pain related to tissue trauma."
- "Chronic Pain related to arthritis."
Wellness and Health Promotion Diagnoses
Promoting health is a vital part of our nursing care. Diagnoses in this category allow us to foster healthy habits and overall well-being.
- "Readiness for Enhanced Nutrition."
- "Readiness for Enhanced Mental Well-being."
Frequently Asked Questions (FAQs) about NANDA-I Diagnoses
Here, we address some of the most common questions about NANDA-I diagnoses, their use, application, and benefits in our nursing practice.
1. What are NANDA-I diagnoses?
NANDA-I diagnoses are clinical tools that describe human responses to actual or potential health problems or life processes. They are used globally to standardize nursing language and improve care.
2. What is the main purpose of NANDA-I diagnoses?
The primary goal is to provide a standardized language that facilitates communication among healthcare professionals, enhances the quality of care, and promotes evidence-based nursing interventions.
3. How many NANDA-I diagnoses currently exist?
Currently, NANDA International recognizes 277 diagnoses, organized within Taxonomy II, which includes 13 domains and 48 classes.
4. What's the difference between a nursing diagnosis and a medical diagnosis?
A nursing diagnosis identifies human responses to health problems (e.g., "Impaired Physical Mobility"). In contrast, a medical diagnosis focuses on the disease or pathology itself (e.g., "Hip Fracture"). Nursing diagnoses address how the patient is responding to their condition, which is where our unique nursing interventions come into play.
5. How can I learn to use NANDA-I diagnoses effectively?
Learning comes through official NANDA-I guides, specific training programs, and, most importantly, practice in assessing patients. Familiarizing yourself with the PES format and practical examples is also very helpful. Consistent application in your clinical setting will build your proficiency.
6. Are NANDA-I diagnoses applicable in all countries?
Yes, NANDA-I diagnoses have an international scope and are translated into multiple languages. While some institutions might adapt them to local needs, the core language and structure are designed for global use in nursing.
7. What tools complement NANDA-I diagnoses?
NANDA-I diagnoses are often used in conjunction with systems like NIC (Nursing Interventions Classification) and NOC (Nursing Outcomes Classification). Together, these frameworks help us plan, implement, and evaluate nursing care comprehensively.
About This Guide
NANDA-I diagnoses are an indispensable tool in modern nursing practice. They provide us with a standardized language that enhances the quality of care we deliver, fosters clear communication among healthcare professionals, and promotes an evidence-based approach to nursing.
With this guide, we hope you have a solid understanding of the key concepts, from NANDA-I domains and types of diagnoses to the practical application of the PES format. As dedicated nurses, continually refining our diagnostic skills helps us provide the best possible care to our patients. Keep exploring, keep learning, and keep making a difference!