Nursing diagnosis involves making a clinical judgment about a patient's health issues and developing a care plan accordingly. It has three main parts - the problem, likely cause, and defining characteristics. Common types of nursing diagnoses include actual, risk, and wellness diagnoses. Accurate nursing diagnoses are important for effective patient care, developing nursing autonomy, and ensuring accountability. However, errors can occur if the nurse lacks knowledge, misinterprets data, or chooses the wrong diagnostic label. To improve, nurses should seek guidance when unsure and state diagnoses specifically to guide interventions.

1. NURSINGDIAGNOSIS
By:-
DeveshwarP.D.

2. NURSINGDIAGNOSIS
Definition: North American Nursing
Diagnosis Association (NANDA, 1992)
definesnursingdiagnosisasfollowing:-
Aclinicaljudgementaboutindividual,family
or community responses to actualand
potentialhealth/ life processes.Nursing
diagnosisprovidesthebasisforselectionof
nursing interventionsto achieveoutcomes
forwhichthenurseisaccountable.
OR
Gordon(1976)definednursingdiagnosisasa
ActualorPotentialhealthproblemswhich
nursesbyvirtueoftheireducationand
experiencesarecapableandlicensedtotreat.
PURPOSESOFNURSINGDIAGNOSIS
 Toanalyzecollecteddata.
 To identify client's normalfunctional

3. levelstatement.
 To identify the client's strength and
weaknesses.
 Toformulateadiagnosticweaknesses.
CHARACTERISTICSOFNURSINGDIAGNOSIS
 Itstatesaclearandconcisehealth
problem
 Itisderivedfrom existingevidences
abouttheclient
 Itispotentiallyamenabletonursing
therapy
 Itisthebasisforplanningandcarrying
outnursingcare
IMPORTANCEOFNURSINGDIAGNOSIS
Rememberingandwritingnursingdiagnosis
taxonomyis nota easyjob.Itis a really
irksome work. But if every nurse
reads/understandstheimportanceofwriting
diagnosis,itissurethateverynursewillstart

4. labelingit.
 Nursingdiagnosistaxonomyprovidesa
common languageforcommunication.It
helpstounderstandinbetterway.
Example:Ifnursingdiagnosisforclientis:
"Activityintolerancer/tprolongedbedrest"
Whereverthenurseisresiding,everyone
willunderstanditbecauseallnursesare
followingonetaxonomyi.e.NANDA.
 Itprovidesameansofcommunicating
toothernurses,healthcareteam.
 Asnursingdiagnosisisframedbynurse
andsheislicensedtotreatitindependently.
It facilitates development of Nurse's
autonomy.
 Ithelpsthenursestobeaccountablefor
theirprofession.
 Makingaccuratenursingdiagnosishelps
toensurethatclientreceivesqualitynursing
care.Thus,itservesasafocusforquality
improvement.

5.  Nursing diagnosis gives direction for
planningnursingintervention.
 Nursing diagnosis taxonomyhelps to
bridge gap between knowledge and
practice•Ultimatleyenhancesthescopeof
nursingpractice,whichisveryimportantfor
developing nurse's professionalrole in
healthcare.

6. DIFFERENCEINMEDICALDIAGNOSISAND
NURSINGDIAGNOSIS

7. TYPESOFNURSINGDIAGNOSIS
a) Actualdiagnosisrepresentsaproblem
whichhasmanydefiningcharacteristics.
Itisajudgementaboutaclient'sresponse
toahealthproblem thatispresentatthe
timeofnursing assessment(Problem +
Etiology+S/S).Itisbasedonthepresence
ofsignsandsymptoms.Examples:
 Imbalanced Nutrition:Lessthanbody
requirements r/t decreased appetite
nausea

8.  DisturbedSleepPatternr/tcough,fever
andpain
 Constipation r/ tlong term use of
laxative
 Ineffective airway clearance r/t to
viscoussecretions
 Acute Pain (Chest) r/ t coughs
secondarytopneumonia
 Activity Intolerance r/ t general
weakness
b) High risk diagnosis describes a
potentialproblem.Itmeansclientisprone
otdevelopaproblemthanotherproblemsif

9. leftin similarcondition.Itis a clinical
judgmentthataproblem doesnotexist,
therefore no S/S are present,butthe
presenceofriskfactorsisindicatesthata
problem isonlyislikelytodevelopunless
nurseinterveneordosomethingaboutit
(Problem +RiskFactors).Nosubjectiveor
objective cuesare presenttherefore the
factorsthatcausetheclienttobemore
vulnerabletotheproblem aretheetiology
ofarisknursingdiagnosis.Examples:
An obese client is undergone for hip
replacement surgery. As patient is
immobile/bed ridden,nurse may follow
nursingdiagnosisframe.

10. 1)"Risk for impaired skin integrity r/t
surgery.Presentlyclientdoesnothave
pressureulcer,butifremainsbedridden
forlongtime,withoutchangingposition,
heisathigh riskto develop pressure
ulcer.
2)"Highriskforinfectionr/thospitalization
immunosuppressedmedication.
c) Wellness diagnosis is a clinical

11. judgement about an individual family
communityin transition from a specific
levelofwellness to a higherlevelof
wellness"(Carpenito1993)Example:Birth
ofnewborntwins.
Wellnessnursing diagnosis:Potentialfor
growthrelatedtoanunexpectedbirthOf
twins.
d)Syndromediagnosis:Clusterofactual
orhigh risknursing diagnoses thatare
predictedtobepresentbecauseofcertain
event or situation. (Carpenito 1993)
Example:RapeTraumaSyndrome.
STATEMENTOFNURSINGDIAGNOSIS
Nursingdiagnosisgivedirectioninplanning

12. goal oriented nursing care. Nursing
Diagnosticstatementconsistsofthreeparts:
problem,etiologyanddefiningcharacteristics.
I.Problem:Itdescribesclient'sresponsefor
whichnursingcareisgiven.Nursestates
the1,areaclearlyandconciselyinwhich
theproblemoccurs.
Example: Knowledge deficit, Acute,
Chronic,Ineffective,and Decreased etc.
Knowledgedeficitindiet.
II. Etiology: Etiology component of
diagnosisidentifiesoneormorecausesof
health problem. Etiology should give
directioninplanningnursinginterventions.

13. Ithelpsthenurseto giveindividualized
patientcare because two patients may
havesameproblem.
III. Definingcharacteristicsarethesigns
andsymptomsofproblem whichhelpsin
validatingthenursingdiagnosis.Itincludes
subjectiveorobjectivedata.Example:
Fluidvolumedeficitrelatedtodecreasedoral
intakemanifestedbydryskinandmucous

14. membranes.
Riskforimpaired skin integrityrelated to
immobilitymanifestedbyrednessonsacral
region.
NURSINGDIAGNOSIS
New & Approved NANDA Nursing
DiagnosisListfor2012-2014
l.RiskforIneffectiveActivityPlanning
2.RiskforAdverseReactiontoIodinated
ContrastMedia
3.RiskforAllergyResponse
4.InsufficientBreastMilk
5.IneffectiveChildbearingProcess
6.Risk for Ineffective Child Bearing

15. Process
7.RiskforDryEye
8.DeficientCommunityHealth
9.IneffectiveImpulseControl
10.RiskforNeonatalJaundice
11.RiskforDisturbedPersonalIdentity
12.IneffectiveRelationship
13.RiskforIneffectiveRelationship
14.RiskforChronicLowSelf-Esteem
15.RiskforThermalInjury
16.Risk forIneffective PeripheralTissue
Perfusion
SOURCES OF ERROR IN NURSING
DIAGNOSIS
A. Problemincollectingdatasuchas-

16.  Lackofknowledge.
 Lackofskill.
 Inaccuratedata.
 Missingdata.
 Disorganizeddata.
B. Problem in interpretation ofData
suchas-
 Inaccurateinterpretationofcues.
 Failuretoconsiderconflictingcues.
 Useofinvaliddata.
 Givinglessconsiderationtocultural
influenceanddevelopmentstage.

17. C. Problem in labeling Nursing
diagnosissuchas-
 Wrongselectionofdiagnosticlabel.
 Failuretovalidatenursingdiagnosis
withpatient.
 Failuretoseekguidance.
ROLEOFNURSE
 Nurse musthave up to date good
knowledgebaseandclinicalexperience.
 Nurseshould haveknowledgeofnot
onlynursing subjects butalso ofother
subjects: chemistry, biochemistry,
pharmacologyetc.

18.  Itwillhelpherto understandclient's
data.
 Nurseshouldhaveuptodateclinical
knowledge.
NormalvalueofBP,temperature,Blood
count,ESR.
 Alongwiththis,sheshouldknow what
isnormalforaparticularpersonkeepingin
mindage,education,occupation,lifestyle,
cultureandreligionetc.
 Insteadofproceedingwithmisseddata,
nurseshouldinteractwithclientagainand
shouldhavecompleteinformation.
 Nurse should verify the
conflicting/ambiguousdata/cues.Shecan

19. consultherexpertcolleagues,recordsetc.
 In case ofdoubtin labeling nursing
diagnosis,nurseshouldberesourcefuli.e.
consult/useanursingdiagnosishandbook.
ShecankeeplistofNANDAdiagnosisin
herpocketdiary.
 Asnurseisdealingwithhumanlife,she
should never hesitate to take expert
opinion.
 Nurseshouldimprovecriticalthinking
skill.
 Nurse should state/ labeldiagnosis
briefly,specifically.
 Nurseshouldidentifyoneproblem in
eachnursingdiagnosis.

20.  Nursing diagnosismustbebased on
patient'sdatabase.
 Nurseshouldkeepinmindthatproblem
andcauseisnotsamething.Forexample:
Alterationincomfortrelatedtofractureof
righthip.(Wrong)
 Alterationincomfortassociatedwith
paininrighthip.(Right)
 Alwaysstatenursingdiagnosisinaway
thatdirectsnursing
interventions/strategies.
Example:Anxietyrelatedtodiagnostictest.
 Sleeppatterndisturbancerelatedto
hospitalization.