This document discusses nursing diagnosis, which is the second phase of the nursing process where nurses use critical thinking to interpret assessment data and identify client strengths and problems in order to formulate nursing diagnoses. It provides details on the history and development of nursing diagnosis through organizations like NANDA International, and outlines the 13 domains and associated classes that make up NANDA's standardized nursing diagnosis terminology.

3. Nursing Diagnosing is the
second phase of the nursing
process.

4.  In this phase, nurses use critical
thinking skills to interpret
assessment data and identify
client strengths and problems.

5.  This phase are directed toward
formulating the nursing
diagnoses.

6.  The care planning activities
following this phase are based on
the nursing diagnosis.

7.  The identification and development of
nursing diagnoses began formally in
1973, when two faculty members of
Saint Louis University, Kristine
Gebbie and Mary Ann Lavin, perceived
a need to identify nurses’ roles in an
ambulatory care setting.

8.  The first national conference to
identify nursing diagnoses was
sponsored by the Saint Louis
University School of Nursing
and Allied Health Professions in
1973.

9.  International recognition came with
the First Canadian Conference in
Toronto in 1977 and the International
Nursing Conference in May 1987 in
Calgary, Alberta, Canada.

10.  In 1982, the conference group
accepted the name North American
Nursing Diagnosis Association
(NANDA), recognizing the
participation and contributions of
nurses in the United States and
Canada.

11. In 2002, the organization
changed its name to NANDA
International to further reflect
the worldwide interest in
nursing diagnosis.

12.  The purpose of NANDA
International is to define, refine,
and promote a taxonomy of nursing
diagnostic terminology of general
use to professional nurses.
N
A
N
D
A

13. A taxonomy is a classification
system or set of categories
arranged based on a single
principle or set of principles.

14.  The members of NANDA include
staff nurses, clinical specialists,
faculty, directors of nursing,
deans, theorists, and
researchers.

16.  To use the concept of nursing
diagnoses effectively in generating
and completing a nursing care plan,
the nurse must be familiar with the
definitions of terms used and the
components of nursing diagnoses.

17.  The term diagnosing refers to the
reasoning process, whereas the
term diagnosis is a statement or
conclusion regarding the nature
of a phenomenon.

18.  The standardized NANDA names for the
diagnoses are called Diagnostic labels;

21. The official NANDA definition of 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”.

23. Domain 1: Health Promotion
Domain 2: Nutrition
Domain 3: Elimination and
Exchange

24. Con--
Domain 4: Activity/Rest
Domain 5:
Perception/Cognition
Domain 6: Self-Perception

25.  Con---
 Domain 7: Role Relationships
 Domain 8: Sexuality
 Domain 9: Coping/Stress Tolerance
 Domain 10: Life Principles

26. Con---
 Domain 11: Safety/Protection
 Domain 12: Comfort
 Domain 13: Growth/Development

27. DOMAIN 1: HEALTH
PROMOTION
CLASS 1. HEALTH
AWARENESS
CLASS 2. HEALTH
MANAGEMENT

28. Class 1. Health awareness
Class 2. Health management
 Deficient community
 Risk-prone health behavior
 Ineffective health maintenance

29. Con------
 Ineffective health management
 Ineffective family health
management
 Ineffective protection

30. DOMAIN 2: NUTRITION
CLASS 1. INGESTION
CLASS 2. DIGESTION
CLASS 3. ABSORPTION
CLASS 4. METABOLISM
CLASS 5. HYDRATION

31. CLASS 1. INGESTION
 Insufficient breast milk
 Ineffective breastfeeding
 Interrupted breastfeeding
 Readiness for enhanced
breastfeeding

32. Con-------
 Ineffective infant feeding pattern
 Imbalanced nutrition: less than
body requirements
 Readiness for enhanced nutrition

33. Con---
 Obesity
 Overweight
 Risk for overweight
 Impaired swallowing

34.  Class 2. Digestion
 Class 3. Absorption
 Class 4. Metabolism
 Risk for unstable blood glucose
level
 Neonatal jaundice
 Risk for neonatal jaundice
 Risk for impaired liver function

35. Class 5. Hydration
 Risk for electrolyte imbalance
 Readiness for enhanced fluid
balance
 Deficient fluid volume

36. Con--
 Risk for deficient fluid volume
 Excess fluid volume
 Risk for imbalanced fluid volume

37. CLASS 1. URINARY FUNCTION
CLASS 2. GASTROINTESTINAL
FUNCTION
CLASS 3. INTEGUMENTARY
FUNCTION
CLASS 4. RESPIRATORY
FUNCTION

38. Class 1. Urinary function
 Impaired urinary elimination
 Readiness for enhanced urinary
elimination
 Functional urinary incontinence
 Overflow urinary incontinence

39. Con---
 Reflex urinary incontinence
 Stress urinary incontinence
 Urge urinary incontinence
 Risk for urge urinary
incontinence
 Urinary retention

40. Class 2. Gastrointestinal
function
 Constipation
 Risk for constipation
 Chronic functional constipation
 Risk for chronic functional
constipation

41.  Perceived constipation
 Diarrhea
 Dysfunctional gastrointestinal
motility
 Risk for dysfunctional
gastrointestinal motility
 Bowel incontinence

42. Class 3. Integumentary function
Class 4. Respiratory function
 Impaired gas exchange

43. DOMAIN 4: ACTIVITY/REST
CLASS 1. SLEEP/REST
CLASS 2. ACTIVITY/EXERCISE
CLASS 3. ENERGY BALANCE
CLASS 4.
CARDIOVASCULAR/PULMONA
RY RESPONSES
CLASS 5. SELF-CARE

44. Class 1. Sleep/rest
 Insomnia
 Sleep deprivation
 Readiness for enhanced
sleep
 Disturbed sleep pattern

45. Class 2. Activity/exercise
 Risk for disuse syndrome
 Impaired bed mobility
 Impaired physical mobility
 Impaired wheelchair mobility

46. Con---
Impaired sitting
Impaired standing
Impaired transfer ability
Impaired walking

47. Class 3. Energy balance
 Fatigue
 Wandering

48. Class 4. Cardiovascular/pulmonary
responses
 Activity intolerance
 Risk for activity intolerance
 Ineffective breathing pattern
 Decreased cardiac output

49. Con--
 Risk for decreased cardiac output
 Risk for impaired cardiovascular
function
 Risk for ineffective
gastrointestinal perfusion

50.  Risk for ineffective renal
perfusion
 Impaired spontaneous
ventilation
 Risk for decreased
cardiac tissue perfusion

51. Risk for ineffective
cerebral tissue perfusion
Ineffective peripheral
tissue perfusion

52. Con--
Risk for ineffective peripheral
tissue perfusion
Dysfunctional ventilatory
weaning response

53. Class 5. Self-care
 Impaired home maintenance
 Bathing self-care deficit
 Dressing self-care deficit
 Feeding self-care deficit

54. Toileting self-care deficit
Readiness for enhanced self-
care
Self-neglect

55. CLASS 1. ATTENTION
CLASS 2. ORIENTATION
CLASS 3.
SENSATION/PERCEPTION
CLASS 4. COGNITION
CLASS 5. COMMUNICATION

56.  Class 1. Attention
 Unilateral neglect
 Class 2. Orientation
 Class 3. Sensation/perception

57. Class 4. Cognition
 Acute confusion
 Risk for acute confusion
 Chronic confusion
 Labile emotional control
 Ineffective impulse control

58. Con--
 Deficient knowledge
 Readiness for enhanced
knowledge
 Impaired memory

59. Class 5. Communication
 Readiness for enhanced
communication
 Impaired verbal communication

60. DOMAIN 6: SELF-
PERCEPTION
CLASS 1. SELF-CONCEPT
CLASS 2. SELF-ESTEEM
CLASS 3. BODY IMAGE

61.  Class 1. Self-concept
 Readiness for enhanced hope
 Hopelessness
 Risk for compromised human
dignity

62. Con--
 Disturbed personal identity
 Risk for disturbed personal identity
 Readiness for enhanced self-
concept

63. Class 2. Self-esteem
 Chronic low self-esteem
 Risk for chronic low self-
esteem
 Situational low self-esteem
 Risk for situational low self-
esteem

64. Class 3. Body image
 Disturbed body image

65. DOMAIN 7: ROLE
RELATIONSHIPS
CLASS 1. CAREGIVING
ROLES
CLASS 2. FAMILY
RELATIONSHIPS
CLASS 3. ROLE
PERFORMANCE

66. Class 1. Caregiving roles
 Caregiver role strain
 Risk for caregiver role strain
 Impaired parenting
 Readiness for enhanced
parenting
 Risk for impaired parenting

67. DOMAIN 8: SEXUALITY
CLASS 1. SEXUAL IDENTITY
CLASS 2. SEXUAL FUNCTION
CLASS 3. REPRODUCTION

68. Class 2. Family
relationships
 Risk for impaired attachment
 Dysfunctional family
processes
 Interrupted family processes
 Readiness for enhanced family
processes

69. Class 3. Role performance
 Ineffective relationship
 Readiness for enhanced
relationship
 Risk for ineffective
relationship

70. Con--
 Parental role conflict
 Ineffective role performance
 Impaired social interaction

71. DOMAIN 8: SEXUALITY
CLASS 1. SEXUAL
IDENTITY
CLASS 2. SEXUAL
FUNCTION
SEXUAL DYSFUNCTION
INEFFECTIVE SEXUALITY
PATTERN

72.  Class 1. Sexual identity
 Class 2. Sexual function
 Sexual dysfunction
 Ineffective sexuality pattern

73. Class 3. Reproduction
 Ineffective childbearing process
 Readiness for enhanced
childbearing process
 Risk for ineffective childbearing
process
 Risk for disturbed maternal–fetal
dyad

74. DOMAIN 9: COPING/STRESS
TOLERANCE
CLASS 1. POST-TRAUMA
RESPONSES POST-TRAUMA
SYNDROME
CLASS 2. COPING RESPONSES
CLASS 3. NEUROBEHAVIORAL
STRESS

75.  Class 1. Post-trauma responses
Post-trauma syndrome
 Risk for post-trauma syndrome
 Rape-trauma syndrome
 Relocation stress syndrome
 Risk for relocation stress syndrome

76. Class 2. Coping responses
 Ineffective activity planning
 Risk for ineffective activity
planning
 Anxiety
 Defensive coping

77. Con--
 Ineffective coping
 Readiness for enhanced
coping
 Ineffective community coping
 Readiness for enhanced
community coping

78.  Compromised family coping
 Disabled family coping
 Readiness for enhanced family
coping
 Death anxiety

79. Con---
 Ineffective denial
 Fear
 Grieving
 Complicated grieving
 Risk for complicated grieving

80.  Impaired mood regulation
 Readiness for enhanced power
 Powerlessness
 Risk for powerlessness

81. Con--
 Impaired resilience
 Readiness for enhanced
resilience
 Risk for impaired resilience
 Chronic sorrow
 Stress overload

82. Class 3. Neurobehavioral
stress
 Decreased intracranial adaptive
capacity
 Autonomic dysreflexia
 Risk for autonomic dysreflexia

83. Con--
 Disorganized infant behavior
 Readiness for enhanced
organized infant behavior
 Risk for disorganized infant
behavior

84. DOMAIN 10: LIFE PRINCIPLES
CLASS 1. VALUES
CLASS 2. BELIEFS
CLASS 3.
VALUE/BELIEF/ACTION
CONGRUENCE

85. Class 1. Values
Class 2. Beliefs
 Readiness for enhanced
spiritual well-being

86. Class 3. Value/belief/action
congruence
 Readiness for enhanced
decision-making
 Decisional conflict
 Impaired emancipated
decision-making

87. Con--
 Readiness for enhanced
emancipated
 Decision-making
 Risk for impaired emancipated
decision-making
 Moral distress
 Impaired religiosity

88.  Readiness for enhanced
religiosity
 Risk for impaired religiosity
 Spiritual distress
 Risk for spiritual distress

89. 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

90.  Class 1. Infection
 Risk for infection
 Class 2. Physical injury
 Ineffective airway clearance
 Risk for aspiration
 Risk for bleeding
 Risk for dry eye

91. Risk for falls
Risk for injury
Risk for corneal injury
Risk for perioperative
positioning injury

92. Con--
 Risk for thermal injury
 Risk for urinary tract injury
 Impaired dentition
 Impaired oral mucous membrane

93.  Risk for impaired oral mucous
membrane
 Risk for peripheral
neurovascular dysfunction
 Risk for pressure ulcer

94. Con--
 Risk for shock
 Impaired skin integrity
 Risk for impaired skin integrity
 Risk for sudden infant death
syndrome
 Risk for suffocation Delayed
surgical recovery

95.  Risk for delayed surgical recovery
 Impaired tissue integrity
 Risk for impaired tissue integrity
 Risk for trauma
 Risk for vascular trauma

96. Class 3. Violence
 Risk for other-directed violence
 Risk for self-directed violence
 Self-mutilation
 Risk for self-mutilation
 Risk for suicide

97. Class 4. Environmental
hazards
 Contamination
 Risk for contamination
 Risk for poisoning

98. Class 5. Defensive
processes
 Risk for adverse reaction to
iodinated contrast media
 Risk for allergy response
 Latex allergy response
 Risk for latex allergy response

99. Class 6. Thermoregulation
 Risk for imbalanced body
temperature
 Hyperthermia
 Hypothermia
 Risk for hypothermia
 Risk for perioperative hypothermia
 Ineffective thermoregulation

100. DOMAIN 12: COMFORT
CLASS 1. PHYSICAL COMFORT
CLASS 2. ENVIRONMENTAL
COMFORT
CLASS 3. SOCIAL COMFORT

101. Class 1. Physical comfort
•Impaired comfort
•Readiness for enhanced comfort
•Nausea
•Acute pain
•Chronic pain
•Labor pain
•Chronic pain syndrome

102. Class 2. Environmental
comfort
 Impaired comfort
 Readiness for enhanced comfort

103. Class 3. Social comfort
 Impaired comfort
 Readiness for enhanced comfort
 Risk for loneliness
 Social isolation

104. DOMAIN 13:
GROWTH/DEVELOPMENT
CLASS 1. GROWTH
CLASS 2. DEVELOPMENT

105. Class 1. Growth
 Risk for disproportionate growth
Class 2. Development
 Risk for delayed development