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

Class 2: Health management

DOMAIN 1: Promoción de la salud

Class 2: Gestión de la salud

DOMAIN 2: Nutrition

Class 1: Ingestion

Class 4: Metabolism

Class 5: Hydration

DOMAIN 2: Nutrición

Class 1: Ingestión

Class 4: Metabolismo

Class 5: Hidratación

DOMAIN 3: Elimination and exange

Class 1: Urinary function

Class 2: Gastrointestinal function

Class 4: Respiratory function

DOMAIN 3: Eliminación e intercambio

Class 1: Función urinaria

Class 2: Función gastrointestinal

DOMAIN 4: Activity - rest

Class 1: Sleep - rest

Class 2: Activity - exercise

Class 3: Energy balance

Class 4: Cardiovascular - pulmonary responses

Class 5: Self-care

DOMAIN 4: Actividad/reposo

Class 1: Sueño/reposo

Class 2: Actividad/ejercicio

Class 3: Equilibrio de la energía

Class 4: Respuestas cardiovasculares/pulmonares

Class 5: Autocuidado

DOMAIN 5: Perception - cognition

Class 4: Cognition

Class 5: Communication

DOMAIN 5: Percepción/cognición

Class 1: Atención

Class 3: Sensation / perception

Class 4: Cognición

Class 5: Comunicación

DOMAIN 6: Self-perception

Class 1: Self-concept

Class 2: Self-esteem

Class 3: Body image

DOMAIN 6: Autopercepción

Class 1: Autoconcepto

Class 2: Autoestima

Class 3: Imagen corporal

DOMAIN 7: Role relationship

Class 1: Caregiving roles

Class 2: Family relationships

Class 3: Role performance

DOMAIN 7: Rol/relaciones

Class 1: Roles de cuidador(a)

Class 2: Relaciones familiares

Class 3: Desempeño del rol

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

Class 2: Coping responses

Class 3: Neurobehavioral responses

DOMAIN 9: Afrontamiento/tolerancia al estrés

Class 1: Respuestas postraumáticas

Class 2: Respuestas de afrontamiento

Class 3: Estrés neurocomportamental

DOMAIN 10: Life principles

Class 3: Value - belief - action congruence

DOMAIN 10: Principios vitales

Class 2: Creencias

Class 3: Congruencia entre valores/creencias/acciones

DOMAIN 11: Safety - protection

Class 1: Infection

Class 2: Physical injury

Class 3: Violence

Class 4: Environmental hazards

Class 5: Defensive processes

Class 6: Thermoregulation

DOMAIN 11: Health promotion

Class 2: Health management

DOMAIN 11: Seguridad/protección

Class 1: Infección

Class 2: Lesión física

Class 3: Violencia

Class 4: Peligros del entorno

Class 5: Procesos defensivos

Class 6: Termorregulación

DOMAIN 12: Comfort

Class 1: Physical comfort

Class 3: Social comfort

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

DOMAIN 13: Growth - development

Class 1: Growth

Class 2: Development

 

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
  • Implement daily physiotherapy exercises.
  • Administer analgesics as prescribed.
  • Monitor pain level before and after mobilization.
  • Assist with ambulation and transfers.
  • Patient will demonstrate improved ability to walk with support.
  • Patient will report a decrease in pain level.
  • Patient will achieve independent transfers by discharge.
Risk for Infection
  • Inspect surgical wound daily for signs of infection.
  • Educate patient on proper hygiene and post-surgical wound care.
  • Monitor blood glucose levels regularly.
  • Administer prophylactic antibiotics if ordered.
  • Surgical wound will heal without signs of infection.
  • Patient will maintain blood glucose levels within normal ranges.
  • Patient will verbalize understanding of infection prevention measures.
Anxiety
  • Establish therapeutic communication to address patient's concerns.
  • Provide clear information about the recovery process and expected timelines.
  • Offer guided relaxation techniques or diversional activities.
  • Encourage verbalization of fears and feelings.
  • Patient will report a reduction in anxiety levels.
  • Patient will demonstrate effective coping mechanisms.
  • Patient will express increased confidence in their recovery.

 

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!

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