Nursing diagnoses are a critical component of patient care, providing a standardized approach to identifying patient problems and facilitating effective care planning. NANDA International (NANDA-I) is the leading organization in developing and standardizing nursing diagnoses terminology. Understanding and utilizing NANDA-I nursing diagnoses is essential for nurses and healthcare professionals to deliver patient-centered and evidence-based care. This guide will explore various Nursing Diagnosis Nanda Examples, categorized by domain, to provide a clearer understanding of their application in practice.
The NANDA-I system organizes nursing diagnoses into a multi-axial system, with Domains representing broad areas of human functioning. Using these domains can help nurses to systematically assess patients and categorize their needs. This structured approach ensures a comprehensive evaluation and helps in selecting the most appropriate nursing diagnoses. Gordon’s Functional Health Patterns are often used in conjunction with NANDA-I domains to further organize assessment data and streamline the diagnostic process.
Let’s delve into specific examples of nursing diagnoses within each NANDA-I Domain, drawing from established resources to illustrate their scope and application.
NANDA-I Nursing Diagnosis Examples by Domain
To better understand the breadth of nursing diagnoses, we can explore examples within each NANDA-I Domain. This categorization provides a structured way to learn and apply these diagnoses in various clinical settings.
Domain 1: Health Promotion
This domain focuses on diagnoses related to an individual’s or community’s awareness of health and well-being, and actions to maintain or enhance wellness.
- Health Awareness:
- Sedentary Lifestyle: This diagnosis is applicable when an individual reports or demonstrates a lack of physical activity as part of their daily routine. For example, a patient who spends most of their day sitting and reports minimal exercise might be diagnosed with Sedentary Lifestyle.
- Health Management:
- Frail Elderly Syndrome: This diagnosis is used for older adults experiencing a combination of factors such as weakness, fatigue, weight loss, and decreased physical activity, making them vulnerable to adverse health outcomes.
- Ineffective Health Maintenance: This diagnosis applies when an individual is unable to identify, manage, or seek help to maintain health. An example could be a patient with diabetes who consistently fails to monitor blood glucose levels or adhere to dietary recommendations.
Domain 2: Nutrition
This domain encompasses activities related to the consumption, digestion, absorption, metabolism, and cellular utilization of nutrients.
- Ingestion:
- Imbalanced Nutrition: Less Than Body Requirements: This diagnosis is used when nutrient intake is insufficient to meet metabolic needs. This could be seen in a patient with anorexia nervosa or a patient recovering from surgery with poor appetite.
- Readiness for Enhanced Nutrition: This positive diagnosis is applicable when an individual is motivated and able to improve their nutritional intake for optimal health.
- Impaired Swallowing: This diagnosis is relevant when an individual has difficulty in safely swallowing liquids or solids, potentially due to neurological conditions or structural issues.
- Metabolism:
- Risk for Unstable Blood Glucose Level: This diagnosis is used when an individual is at risk for fluctuations in blood glucose levels, such as patients with diabetes mellitus or those experiencing stress or illness.
- Hydration:
- Risk for Electrolyte Imbalance: This diagnosis is applicable when an individual is at risk for alterations in electrolyte levels, often seen in patients with kidney disease, dehydration, or excessive fluid loss.
- Deficient Fluid Volume: This diagnosis is used when the body experiences decreased intravascular, interstitial, and/or intracellular fluid. This can be seen in patients with dehydration due to vomiting, diarrhea, or inadequate fluid intake.
- Excess Fluid Volume: This diagnosis applies when the body retains excessive fluid, often seen in patients with heart failure or kidney disease.
- Risk for Imbalanced Fluid Volume: This diagnosis is used when an individual is at risk for either deficient or excess fluid volume, depending on their condition and circumstances.
Domain 3: Elimination and Exchange
This domain focuses on the secretion and excretion of waste products from the body.
- Urinary Function:
- Impaired Urinary Elimination: This broad diagnosis is used when there is dysfunction in urine elimination.
- Functional Urinary Incontinence: This diagnosis is applicable when an individual experiences urine loss due to environmental barriers or physical limitations preventing access to a toilet in time.
- Overflow Urinary Incontinence: This diagnosis is used when involuntary urine loss occurs associated with overdistention of the bladder.
- Reflex Urinary Incontinence: This diagnosis applies when involuntary urine loss occurs at somewhat predictable intervals when a specific bladder volume is reached.
- Stress Urinary Incontinence: This diagnosis is used when involuntary urine loss occurs with increased abdominal pressure, such as coughing, sneezing, or laughing.
- Urge Urinary Incontinence: This diagnosis applies when involuntary urine loss occurs with a sudden, strong desire to void.
- Urinary Retention: This diagnosis is used when an individual experiences incomplete emptying of the bladder.
- Gastrointestinal Function:
- Constipation: This diagnosis is used when an individual experiences infrequent or difficult bowel movements.
- Risk for Constipation: This diagnosis is applicable when an individual is at risk for developing constipation due to factors such as immobility, medication side effects, or inadequate fiber intake.
- Diarrhea: This diagnosis is used when an individual experiences frequent, loose, watery stools.
- Bowel Incontinence: This diagnosis applies when there is a change in normal bowel elimination resulting in involuntary passage of stool.
- Respiratory Function:
- Impaired Gas Exchange: This diagnosis is used when an individual experiences excess or deficit in oxygenation and/or carbon dioxide elimination at the alveolar-capillary membrane. This can be seen in patients with pneumonia or chronic obstructive pulmonary disease (COPD).
Domain 4: Activity/Rest
This domain addresses activities of daily living, including sleep, rest, activity, exercise, energy balance, and cardiovascular and respiratory responses.
- Sleep/Rest:
- Insomnia: This diagnosis is used when an individual experiences a disruption in sleep quantity and quality that impairs functioning.
- Disturbed Sleep Pattern: This diagnosis is applicable when an individual experiences time-limited disruptions in sleep patterns.
- Activity/Exercise:
- Risk for Disuse Syndrome: This diagnosis is used when an individual is at risk for deterioration of body systems as a result of prescribed or unavoidable musculoskeletal inactivity.
- Impaired Bed Mobility: This diagnosis is used when an individual experiences limitation in independent movement from one position to another in bed.
- Impaired Physical Mobility: This diagnosis is used when an individual experiences limitation in independent, purposeful physical movement of the body or one or more extremities.
- Impaired Wheelchair Mobility: This diagnosis is used when an individual experiences limitation in independent operation of a manual or powered wheelchair within environments.
- Impaired Sitting: This diagnosis is used when an individual experiences limitation in ability to sit.
- Impaired Standing: This diagnosis is used when an individual experiences limitation in ability to stand.
- Impaired Transfer Ability: This diagnosis is used when an individual experiences limitation in independent movement between two nearby surfaces.
- Impaired Walking: This diagnosis is used when an individual experiences limitation in independent and safe ambulation in the environment.
- Energy Balance:
- Fatigue: This diagnosis is used when an individual experiences an overwhelming sustained sense of exhaustion and decreased capacity for physical and mental work at usual level.
- Wandering: This diagnosis is used when an individual with dementia or cognitive impairment is prone to episodes of aimless or repetitive locomotion that exposes the person to harm.
- Cardiovascular/Pulmonary Responses:
- Activity Intolerance: This diagnosis is used when an individual has insufficient physiological or psychological energy to endure or complete required or desired daily activities.
- Ineffective Breathing Pattern: This diagnosis is used when inspiration and/or expiration does not provide adequate ventilation.
- Decreased Cardiac Output: This diagnosis is used when the heart is unable to pump adequate blood to meet the metabolic demands of the body.
- Ineffective Peripheral Tissue Perfusion: This diagnosis is used when there is a decrease in blood circulation to the periphery that may compromise health.
- Self-Care:
- Bathing Self-Care Deficit: This diagnosis is used when an individual experiences impaired ability to perform or complete bathing/hygiene activities for oneself.
- Dressing Self-Care Deficit: This diagnosis is used when an individual experiences impaired ability to perform or complete dressing and grooming activities for oneself.
- Feeding Self-Care Deficit: This diagnosis is used when an individual experiences impaired ability to perform or complete feeding activities for oneself.
- Toileting Self-Care Deficit: This diagnosis is used when an individual experiences impaired ability to perform or complete toileting activities for oneself.
Domain 5: Perception/Cognition
This domain focuses on the sensory, perceptual, and cognitive processes.
- Attention:
- Unilateral Neglect: This diagnosis is used when an individual is inattentive to and unaware of stimuli on one side of the body, often seen after a stroke.
- Cognition:
- Acute Confusion: This diagnosis is used when an individual experiences abrupt onset of a cluster of global transient changes and disturbances in attention, cognition, psychomotor activity, level of consciousness, and/or sleep-wake cycle.
- Chronic Confusion: This diagnosis is used when an individual experiences an irreversible, long-standing, and/or progressive deterioration of intellect and personality characterized by decreased ability to interpret environmental stimuli; decreased capacity for intellectual thought processes; and disturbances of memory, orientation, and behavior.
- Deficient Knowledge: This diagnosis is used when an individual lacks cognitive information related to a specific topic.
- Readiness for Enhanced Knowledge: This positive diagnosis is applicable when an individual is motivated and able to increase knowledge on a specific topic.
- Impaired Memory: This diagnosis is used when an individual experiences the inability to remember or recall bits of information or behavioral skills.
- Communication:
- Readiness for Enhanced Communication: This positive diagnosis is applicable when an individual is motivated and able to improve communication skills.
- Impaired Verbal Communication: This diagnosis is used when an individual experiences decreased, delayed, or absent ability to receive, process, transmit, and/or use symbols in spoken and/or written language.
Domain 6: Self-Perception
This domain focuses on awareness about oneself.
- Self-Concept:
- Hopelessness: This diagnosis is used when an individual experiences subjective state in which an individual sees limited or no alternatives or personal choices available and is unable to mobilize energy on own behalf.
- Readiness for Enhanced Self-Concept: This positive diagnosis is applicable when an individual is motivated and able to improve their self-concept.
- Self-Esteem:
- Chronic Low Self-Esteem: This diagnosis is used when an individual experiences long-standing negative self-evaluation/feelings about self or self-capabilities.
- Body Image:
- Disturbed Body Image: This diagnosis is used when an individual experiences confusion in mental picture of one’s physical self.
Domain 7: Role Relationship
This domain focuses on the connections or associations between persons or groups and the means by which they are connected.
- Caregiving Roles:
- Caregiver Role Strain: This diagnosis is used when a caregiver experiences physical, emotional, social, and/or financial burdens in the process of giving long-term care to family members or others.
- Risk for Caregiver Role Strain: This diagnosis is applicable when a caregiver is at risk for experiencing strain due to the demands of caregiving.
- Family Relationships:
- Dysfunctional Family Processes: This diagnosis is used when family functioning does not achieve optimal physical, psychosocial, and/or spiritual well-being of family members.
- Role Performance:
- Impaired Social Interaction: This diagnosis is used when an individual engages in an insufficient or excessive quantity or ineffective quality of social exchange.
Domain 8: Sexuality
This domain focuses on sexual identity, sexual function, and reproduction.
- Sexual Function:
- Sexual Dysfunction: This diagnosis is used when an individual experiences a change in sexual function that is viewed as unsatisfying, unrewarding, or inadequate.
Domain 9: Coping/Stress Tolerance
This domain focuses on adaptation and stress response patterns.
- Post-Trauma Responses:
- Risk for Relocation Stress Syndrome: This diagnosis is used when an individual is at risk for physiological and/or psychosocial disturbances as a result of transfer from one environment to another.
- Coping Responses:
- Anxiety: This diagnosis is used when an individual experiences vague uneasy feeling of discomfort or dread accompanied by an autonomic response (the source often nonspecific or unknown to the individual); a feeling of apprehension caused by anticipation of danger.
- Ineffective Coping: This diagnosis is used when an individual is unable to form a valid appraisal of the stressors, inadequate choices of practiced responses, and/or inability to use available resources.
- Death Anxiety: This diagnosis is used when an individual experiences apprehension, worry, or fear related to death and dying.
- Fear: This diagnosis is used when an individual experiences response to perceived threat that is consciously recognized as a danger.
- Grieving: This diagnosis is used when an individual experiences a normal complex process that includes emotional, physical, spiritual, social, and intellectual responses and behaviors by which individuals, families, and communities incorporate an actual, anticipated, or perceived loss into their daily lives.
- Complicated Grieving: This diagnosis is used when an individual experiences a disorder that occurs after the death of a significant other (or other losses). The experience of distress accompanying bereavement fails to follow normative expectations and manifests in functional disability.
- Powerlessness: This diagnosis is used when an individual experiences perception that one’s own action will not significantly affect an outcome; a perceived lack of control over a current situation or immediate happening.
- Neurobehavioral Stress:
- Risk for Autonomic Dysreflexia: This diagnosis is used when an individual with a spinal cord injury at or above T6 is at risk for developing autonomic dysreflexia (life-threatening but uncommonly occurring massive reflex sympathetic discharge).
Domain 10: Life Principles
This domain focuses on the values, beliefs, and spirituality that guide choices or decisions.
- Spiritual Well-Being:
- Readiness for Enhanced Spiritual Well-Being: This positive diagnosis is applicable when an individual is motivated and able to increase connectedness with self, others, higher power/God, or life forces.
- Decisional Conflict: This diagnosis is used when an individual is uncertain about which course of action to take when the choice among options involves risk or loss.
- Spiritual Distress: This diagnosis is used when an individual experiences impaired ability to experience and integrate meaning and purpose in life through connectedness with self, others, art, music, literature, nature, and/or a power greater than oneself.
Domain 11: Safety/Protection
This domain focuses on being free from danger, physical injury, or immune system damage; preservation from loss; and security and safety.
- Infection:
- Risk for Infection: This diagnosis is used when an individual is at increased risk for being invaded by pathogenic organisms.
- Physical Injury:
- Ineffective Airway Clearance: This diagnosis is used when an individual is unable to clear secretions or obstructions from the respiratory tract to maintain a clear airway.
- Risk for Aspiration: This diagnosis is used when an individual is at risk for entry of gastrointestinal secretions, oropharyngeal secretions, solids, or fluids into tracheobronchial passages.
- Risk for Bleeding: This diagnosis is used when an individual is at risk for a decrease in blood volume that may compromise health.
- Risk for Falls: This diagnosis is used when an individual is at increased risk for falls.
- Risk for Injury: This broad diagnosis is used when an individual is at risk of injury as a result of environmental conditions interacting with the individual’s adaptive and defensive resources.
- Impaired Dentition: This diagnosis is used when an individual experiences disruption in tooth development/eruption patterns or structural integrity of individual teeth.
- Risk for Pressure Ulcer: This diagnosis is used when an individual is at risk for skin and/or mucous membrane damage as a result of pressure.
- Impaired Skin Integrity: This diagnosis is used when an individual experiences altered epidermis and/or dermis.
- Impaired Tissue Integrity: This diagnosis is used when an individual experiences damage to mucous membrane, corneal, integumentary, or subcutaneous tissues.
- Violence:
- Risk for Suicide: This diagnosis is used when an individual is at risk for self-inflicted, life-threatening injury.
- Environmental Hazards:
- Risk for Poisoning: This diagnosis is used when an individual is at risk for accidental exposure to or ingestion of dangerous compounds or agents.
- Defensive Processes:
- Risk for Allergy Response: This diagnosis is used when an individual is at risk for overreaction to intrinsic or environmental antigens.
- Thermoregulation:
- Hyperthermia: This diagnosis is used when body temperature is significantly above normal range.
- Hypothermia: This diagnosis is used when body temperature is significantly below normal range.
Domain 12: Comfort
This domain addresses the sense of mental, physical, or social well-being or ease.
- Physical Comfort:
- Impaired Comfort: This broad diagnosis is used when an individual experiences perceived deficiency in ease, relief, and transcendence in physical, psychospiritual, environmental, and/or social dimensions.
- Nausea: This diagnosis is used when an individual experiences a subjective unpleasant wave-like sensation in the back of the throat, epigastrium, or abdomen that may lead to the urge or need to vomit.
- Acute Pain: This diagnosis is used when an individual experiences unpleasant sensory and emotional experience arising from actual or potential tissue damage or described in terms of such damage; sudden or slow onset of any intensity from mild to severe with an anticipated or predictable end and a duration of less than 3 months.
- Chronic Pain: This diagnosis is used when an individual experiences unpleasant sensory and emotional experience arising from actual or potential tissue damage or described in terms of such damage; sudden or slow onset of any intensity from mild to severe, constant or recurring without an anticipated or predictable end and a duration of greater than 3 months.
- Social Comfort:
- Risk for Loneliness: This diagnosis is used when an individual is at risk for experiencing subjective state in which an individual perceives aloneness imposed by others and feels sadness or emptiness and experiences feelings of being abandoned or set aside.
Domain 13: Growth/Development
This domain focuses on age-appropriate increases in physical dimensions, maturation of organ systems, and/or progression through the developmental milestones.
- Development:
- Risk for Delayed Development: This diagnosis is used when an individual is at risk for delay of 25% or more in one or more of the areas of social or self-regulatory behavior, or cognitive, language, gross or fine motor skills.
Conclusion
This overview of nursing diagnosis NANDA examples categorized by domain provides a foundational understanding for healthcare professionals. By utilizing the NANDA-I framework and understanding these examples, nurses can enhance their diagnostic accuracy, develop effective care plans, and ultimately improve patient outcomes. Continued education and practical application of NANDA-I diagnoses are crucial for professional growth and excellence in nursing practice. Remember to always consult the latest NANDA-I resources for the most up-to-date and comprehensive information.
