Nursing diagnoses are a critical component of patient care, providing a standardized language for nurses to identify, communicate, and address patient needs. Among the various classification systems available, the NANDA-I (North American Nursing Diagnosis Association International) system stands out as a globally recognized and continuously evolving framework. Understanding and utilizing NANDA-I nursing diagnoses is fundamental for nursing students and practicing healthcare professionals alike to deliver effective and patient-centered care. This guide offers a comprehensive overview of commonly used NANDA-I diagnoses, categorized by domain, to enhance your understanding and application in clinical practice.
Domains and Classes of NANDA-I Diagnoses
The NANDA-I system organizes nursing diagnoses into a hierarchical structure, starting with broad domains and further refining them into more specific classes. This categorization helps nurses to systematically assess patients and select the most appropriate diagnoses. The following table, adapted from Open RN resources, provides a sample of NANDA-I diagnoses structured by these domains and classes. This framework is invaluable for organizing assessment data and formulating accurate nursing diagnoses.
| Domain | Class & Nursing Diagnosis |
|---|---|
| Health Promotion | Health Awareness – Sedentary lifestyle Health Management – Frail elderly syndrome – Ineffective health maintenance |
| Nutrition | Ingestion – Imbalanced nutrition: less than body requirements – Readiness for enhanced nutrition – Impaired swallowing Metabolism – Risk for unstable blood glucose level Hydration – Risk for electrolyte imbalance – Deficient fluid volume – Excess fluid volume – Risk for imbalanced fluid volume |
| Elimination and Exchange | Urinary function – Impaired urinary elimination – Functional urinary incontinence – Overflow urinary incontinence – Reflex urinary incontinence – Stress urinary incontinence – Urge urinary incontinence – Urinary retention Gastrointestinal function – Constipation – Risk for constipation – Diarrhea – Bowel incontinence Respiratory function – Impaired gas exchange |
| Activity/Rest | Sleep/Rest – Insomnia – Disturbed sleep pattern Activity/Rest – Risk for disuse syndrome – Impaired bed mobility – Impaired physical mobility – Impaired wheelchair mobility – Impaired sitting – Impaired standing – Impaired transfer ability – Impaired walking Energy balance – Fatigue – Wandering Cardiovascular/Pulmonary responses – Activity intolerance – Ineffective breathing pattern – Decreased cardiac output – Ineffective peripheral tissue perfusion Self-care – Bathing self-care deficit – Dressing self-care deficit – Feeding self-care deficit – Toileting self-care deficit |
| Perception/Cognition | Attention – Unilateral neglect Cognition – Acute confusion – Chronic confusion – Deficient knowledge – Readiness for enhanced knowledge – Impaired memory Communication – Readiness for enhanced communication – Impaired verbal communication |
| Self-Perception | Self-concept – Hopelessness – Readiness for enhanced self-concept Self-esteemd – Chronic low self-esteem Body image – Disturbed body image |
| Role Relationship | Caregiving roles – Caregiver role strain – Risk for caregiver role strain Family relationships – Dysfunctional family processes Role performance – Impaired social interaction |
| Sexuality | Sexual function – Sexual dysfunction |
| Coping/Stress Tolerance | Post-trauma responses – Risk for relocation stress syndrome Coping responses – Anxiety – Ineffective coping – Death anxiety – Fear – Grieving – Complicated grieving – Powerlessness Neurobehavioral stress – Risk for autonomic dysreflexia |
| Life Principles | – Readiness for enhanced spiritual well-being – Decisional conflict – Spiritual distress |
| Safety/Protection | Infection – Risk for infection Physical injury – Ineffective airway clearance – Risk for aspiration – Risk for bleeding – Risk for falls – Risk for injury – Impaired dentition – Risk for pressure ulcer – Impaired skin integrity – Impaired tissue integrity Violence – Risk for suicide Environmental hazards – Risk for poisoning Defensive processes – Risk for allergy response Thermoregulation – Hyperthermia – Hypothermia |
| Comfort | Physical comfort – Impaired comfort – Nausea – Acute pain – Chronic pain Social comfort – Risk for loneliness |
| Growth/Development | – Risk for delayed development |
Exploring Key Domains and Classes
Let’s delve deeper into some of the domains and classes within the NANDA-I framework to understand their relevance in patient care.
Health Promotion Domain
This domain focuses on diagnoses related to an individual’s awareness of well-being and strategies to maintain or enhance it. Diagnoses like Sedentary Lifestyle and Ineffective Health Maintenance highlight areas where nursing interventions can promote healthier behaviors and prevent potential health issues. Addressing these diagnoses is crucial in preventative care and patient education.
Nutrition Domain
The Nutrition domain encompasses diagnoses related to the intake, digestion, absorption, metabolism, and hydration of nutrients. From Imbalanced Nutrition: Less than Body Requirements to Risk for Unstable Blood Glucose Level, these diagnoses are vital in managing patients with nutritional deficits, metabolic disorders, and hydration imbalances. Nurses play a key role in nutritional assessment, planning dietary interventions, and monitoring patient responses.
Elimination and Exchange Domain
This domain addresses diagnoses concerning the secretion and excretion of waste products from the body. It includes both urinary, gastrointestinal, and respiratory functions. Diagnoses range from various types of Urinary Incontinence to Constipation, Diarrhea, and Impaired Gas Exchange. These diagnoses are fundamental in managing patients with elimination disorders and ensuring proper bodily function.
Activity/Rest Domain
The Activity/Rest domain focuses on diagnoses related to activity, exercise, sleep, rest, and energy balance. This broad domain includes diagnoses like Insomnia, Impaired Physical Mobility, Activity Intolerance, and Fatigue. Nurses use these diagnoses to address issues affecting patients’ mobility, rest patterns, and overall energy levels, implementing interventions to promote activity, rest, and energy conservation.
Perception/Cognition Domain
This domain encompasses diagnoses related to sensory and cognitive processes, including attention, orientation, thought, memory, and communication. Diagnoses such as Acute Confusion, Deficient Knowledge, and Impaired Verbal Communication fall under this domain. Addressing these cognitive and perceptual challenges is vital for patient safety, learning, and effective communication within the healthcare setting.
Safety/Protection Domain
The Safety/Protection domain is paramount and includes diagnoses related to risks of injury, infection, violence, and environmental hazards, as well as defensive and thermoregulatory processes. Risk for Infection, Risk for Falls, Impaired Skin Integrity, and Hyperthermia are examples of diagnoses in this domain. Nurses prioritize patient safety and utilize these diagnoses to implement preventive measures and minimize risks across various healthcare settings.
Utilizing NANDA-I in Nursing Practice
The NANDA-I classification serves as a cornerstone for developing individualized nursing care plans. By accurately identifying nursing diagnoses, nurses can then formulate specific patient outcomes and plan appropriate interventions. Frameworks like Gordon’s Functional Health Patterns can be used to organize assessment data by domain, further facilitating the selection of relevant NANDA-I diagnoses. Consulting nursing care planning resources is essential for students and professionals to deepen their understanding and effective application of NANDA-I in practice.
Conclusion
Understanding Nursing Diagnosis Nanda is fundamental for providing standardized, effective, and patient-centered care. This guide, based on open educational resources, provides a starting point for exploring the vast array of NANDA-I diagnoses and their application in various clinical scenarios. By utilizing this framework, nurses can enhance their diagnostic reasoning, improve communication within the healthcare team, and ultimately contribute to better patient outcomes.
Reference
[1] Open Resources for Nursing (Open RN). (n.d.). Appendix A: Sample NANDA-I Diagnoses by Domain. Nursing Fundamentals. https://wtcs.pressbooks.pub/nursingfundamentals/back-matter/appendix-a-sample-nanda-i-diagnoses/
