Nursing diagnoses are a critical component of patient care, providing a standardized language for nurses to identify, communicate, and address patient needs. NANDA International (NANDA-I) plays a pivotal role in this framework by establishing and refining a globally recognized classification system for nursing diagnoses. Understanding NANDA approved nursing diagnoses is essential for nursing students and practicing nurses alike to deliver effective and patient-centered care.
The NANDA-I system categorizes diagnoses into domains, offering a structured approach to assessment and care planning. These domains are broad areas of human functioning that provide a framework for organizing assessment data and selecting appropriate nursing diagnoses. This system helps nurses to think holistically about their patients, considering various aspects of their health and well-being.
Here’s a look into some key NANDA-I domains and examples of commonly used nursing diagnoses within each:
Health Promotion Domain
This domain focuses on diagnoses related to the patient’s awareness of well-being and strategies to maintain or enhance it. It emphasizes the proactive role of nursing in promoting health rather than just treating illness.
- Health Awareness: This class includes diagnoses such as “Sedentary Lifestyle,” which is relevant in today’s increasingly inactive society and its impact on health.
- Health Management: Diagnoses here address the ability to identify, manage, seek out, and integrate activities for maintaining health and wellness. “Ineffective Health Maintenance” and “Frail Elderly Syndrome” are examples highlighting challenges in managing health, especially in vulnerable populations.
Nutrition Domain
This domain centers on activities related to taking in and utilizing nutrients. Adequate nutrition is fundamental for healing, growth, and overall health.
- Ingestion: This class focuses on the process of taking food and fluids into the body. Diagnoses like “Imbalanced Nutrition: Less Than Body Requirements” are common in various patient populations. “Impaired Swallowing” is crucial for patient safety, while “Readiness for Enhanced Nutrition” shows a positive focus on improving nutritional status.
- Metabolism: This class addresses the chemical processes in the body that convert food into energy and sustain life. “Risk for Unstable Blood Glucose Level” is a vital diagnosis, particularly for patients with diabetes or metabolic disorders.
- Hydration: Dealing with the intake and absorption of fluids and electrolytes, this class includes diagnoses like “Deficient Fluid Volume” and “Excess Fluid Volume,” both indicating imbalances that can have severe health consequences. “Risk for Electrolyte Imbalance” and “Risk for Imbalanced Fluid Volume” are also important for preventative care.
Elimination and Exchange Domain
This domain covers the secretory and excretory functions of the body, including bowel, urinary, and respiratory systems. Effective elimination is vital for maintaining homeostasis and removing waste products.
- Urinary Function: This class includes various forms of urinary dysfunction. Diagnoses range from “Impaired Urinary Elimination” to specific types of incontinence like “Stress Urinary Incontinence,” “Urge Urinary Incontinence,” “Overflow Urinary Incontinence,” “Reflex Urinary Incontinence,” and “Functional Urinary Incontinence,” as well as “Urinary Retention.” These diagnoses are crucial in addressing a wide range of urinary issues affecting patients.
- Gastrointestinal Function: This class focuses on bowel elimination. Common diagnoses include “Constipation,” “Risk for Constipation,” “Diarrhea,” and “Bowel Incontinence,” addressing frequent gastrointestinal problems encountered in healthcare.
- Respiratory Function: This class is vital for oxygenation. “Impaired Gas Exchange” is a critical diagnosis, especially in patients with respiratory illnesses or those undergoing anesthesia.
Activity/Rest Domain
This domain addresses activities of daily living, exercise, sleep, and rest. Balancing activity and rest is essential for physical and mental restoration.
- Sleep/Rest: This class includes sleep patterns and rest. “Insomnia” and “Disturbed Sleep Pattern” are common diagnoses reflecting sleep disorders affecting patient well-being and recovery.
- Activity/Exercise: This class involves moving, ambulating, and performing physical activities. It includes a range of mobility-related diagnoses such as “Impaired Physical Mobility,” “Impaired Bed Mobility,” “Impaired Wheelchair Mobility,” “Impaired Transfer Ability,” “Impaired Walking,” “Impaired Sitting,” and “Impaired Standing.” “Risk for Disuse Syndrome” is also pertinent for patients with limited mobility.
- Energy Balance: This class concerns the equilibrium between energy intake and expenditure. “Fatigue” and “Wandering” are diagnoses that can significantly impact a patient’s quality of life and safety.
- Cardiovascular/Pulmonary Responses: This class focuses on the body’s responses to activity, particularly the cardiac and respiratory systems. Diagnoses like “Activity Intolerance,” “Ineffective Breathing Pattern,” “Decreased Cardiac Output,” and “Ineffective Peripheral Tissue Perfusion” are critical in managing patients with cardiovascular and respiratory conditions.
- Self-Care: This class addresses the ability to perform personal care activities. It includes various self-care deficits like “Bathing Self-Care Deficit,” “Dressing Self-Care Deficit,” “Feeding Self-Care Deficit,” and “Toileting Self-Care Deficit,” highlighting areas where patients may need assistance.
Perception/Cognition Domain
This domain focuses on sensory and cognitive processes. These processes are fundamental to how individuals perceive, understand, and interact with the world.
- Attention: This class pertains to the ability to focus awareness. “Unilateral Neglect” is a diagnosis often seen after neurological events like strokes, impacting a patient’s awareness of one side of their body or environment.
- Cognition: This class includes thought processes and knowledge. Diagnoses here range from “Acute Confusion” and “Chronic Confusion,” indicating altered states of awareness and thinking, to “Deficient Knowledge” and “Readiness for Enhanced Knowledge,” addressing learning needs and opportunities. “Impaired Memory” is also a significant cognitive diagnosis impacting daily functioning.
- Communication: This class focuses on sending and receiving information. “Impaired Verbal Communication” is a common diagnosis, especially in patients with language barriers, neurological conditions, or communication difficulties. “Readiness for Enhanced Communication” reflects a positive approach to improving communication skills.
Self-Perception Domain
This domain relates to awareness of self, including body image, self-esteem, and identity. A positive self-perception is crucial for mental health and overall well-being.
- Self-Concept: This class includes how individuals perceive themselves. “Hopelessness” and “Chronic Low Self-Esteem” are diagnoses reflecting negative self-perceptions and emotional distress. “Readiness for Enhanced Self-Concept” indicates a potential for positive self-regard development.
- Body Image: This class addresses the mental image of one’s own body. “Disturbed Body Image” is relevant in patients with body image concerns due to illness, surgery, or other factors.
Role Relationship Domain
This domain focuses on the connections and associations between people and the roles individuals assume. Healthy role relationships are vital for social support and well-being.
- Caregiving Roles: This class addresses the roles of giving care to others. “Caregiver Role Strain” and “Risk for Caregiver Role Strain” are important diagnoses recognizing the challenges and burdens faced by caregivers.
- Family Relationships: This class focuses on the relationships within a family unit. “Dysfunctional Family Processes” indicates unhealthy patterns of family interaction.
- Role Performance: This class relates to how individuals fulfill their social roles. “Impaired Social Interaction” is a diagnosis addressing difficulties in social engagement and relationships.
Sexuality Domain
This domain addresses sexual identity, sexual function, and reproduction. Sexual health is an integral part of overall health.
- Sexual Function: This class focuses on sexual activity and reproductive function. “Sexual Dysfunction” is a diagnosis addressing problems with sexual function or satisfaction.
Coping/Stress Tolerance Domain
This domain addresses the ability to manage psychological stress and cope with life events. Effective coping mechanisms are crucial for mental and emotional resilience.
- Post-Trauma Responses: This class addresses reactions following traumatic events. “Risk for Relocation Stress Syndrome” is a diagnosis relevant for patients moving to new environments, especially healthcare facilities.
- Coping Responses: This class includes behavioral responses to stress. Diagnoses range from “Anxiety,” “Fear,” and “Death Anxiety,” reflecting emotional responses to stress and threats, to “Ineffective Coping,” “Grieving,” and “Complicated Grieving,” addressing maladaptive coping mechanisms and grief processes. “Powerlessness” is also a diagnosis reflecting a perceived lack of control over situations.
- Neurobehavioral Stress: This class focuses on neurological and behavioral responses to stress. “Risk for Autonomic Dysreflexia” is a critical diagnosis in patients with spinal cord injuries, indicating a potentially life-threatening response to stimuli.
Life Principles Domain
This domain addresses values, beliefs, and spirituality that guide decisions and meaning in life. Spiritual well-being is an important aspect of holistic care.
- This domain includes diagnoses like “Readiness for Enhanced Spiritual Well-being,” “Decisional Conflict,” and “Spiritual Distress,” addressing spiritual needs, values conflicts, and spiritual distress.
Safety/Protection Domain
This domain addresses freedom from danger, physical injury, and immune system protection. Ensuring safety is a primary nursing responsibility.
- Infection: “Risk for Infection” is a fundamental diagnosis, particularly in healthcare settings, addressing the vulnerability to pathogens.
- Physical Injury: This class includes risks and actual physical harm. Diagnoses range from “Risk for Falls,” “Risk for Injury,” “Risk for Bleeding,” “Risk for Aspiration,” “Risk for Pressure Ulcer,” and “Risk for Suicide,” all highlighting critical safety concerns, to “Ineffective Airway Clearance,” “Impaired Skin Integrity,” “Impaired Tissue Integrity,” and “Impaired Dentition,” addressing actual physical injuries and impairments.
- Violence: “Risk for Suicide” (also listed under Physical Injury) is a critical safety diagnosis related to self-directed violence.
- Environmental Hazards: “Risk for Poisoning” addresses potential harm from environmental toxins.
- Defensive Processes: “Risk for Allergy Response” addresses potential adverse reactions to allergens.
- Thermoregulation: This class focuses on maintaining body temperature. “Hyperthermia” and “Hypothermia” are diagnoses indicating deviations from normal body temperature, which can be life-threatening.
Comfort Domain
This domain addresses the sense of mental, physical, and social well-being or ease. Promoting comfort is a crucial aspect of patient-centered care.
- Physical Comfort: This class includes physical ease and freedom from pain. Diagnoses range from “Acute Pain” and “Chronic Pain,” addressing pain management needs, to “Nausea” and “Impaired Comfort,” covering other aspects of physical discomfort.
- Social Comfort: “Risk for Loneliness” addresses the potential for social isolation and lack of social support.
Growth/Development Domain
This domain addresses age-appropriate increases in physical dimensions, maturation, and social and cognitive advancements. Monitoring growth and development is particularly important in pediatric nursing but relevant across the lifespan.
- This domain includes “Risk for Delayed Development,” highlighting potential issues in achieving developmental milestones.
Understanding these Nanda Approved Nursing Diagnosis domains and their associated diagnoses is fundamental for providing comprehensive and individualized patient care. By using this standardized language, nurses can effectively communicate patient needs, plan appropriate interventions, and evaluate outcomes, ultimately enhancing the quality of healthcare. Further exploration of each diagnosis within these domains will provide a deeper understanding and enable nurses to apply this knowledge effectively in their practice.
