What Is the NANDA Nursing Diagnosis List?
If you’re a nursing student learning about NANDA nursing diagnoses for the first time, you might be wondering what their purpose is. The NANDA nursing diagnosis list helps nurses create patient-centered care plans by providing standardized diagnoses organized by specialty. These essential pieces of the nursing process guide care and bring your attention to the specific problems that patients are facing.
NANDA nursing diagnoses fall into the second step of the nursing process. During nursing school, you learn this process to help standardize the flow of care. Once you’re a practicing nurse, these steps will become second nature, and you likely won’t even notice that you’re following them.
For review, here are the five essential steps of the nursing process:
- Assessment
- Diagnosis
- Planning
- Implementation
- Evaluation
So, what does this mean for you? In this article, we’ll explore what nursing diagnoses are, list NANDA nursing diagnosis examples, and answer common questions to help you formulate care plans with confidence.
What Is a NANDA Nursing Diagnosis?
NANDA, formally known as NANDA International, is the organization that creates and continuously updates official lists of nursing diagnoses for nurses across the globe. Nursing diagnoses identify patient problems and risks and guide nursing interventions to help patients experience the best outcomes.
Nursing diagnoses are separate from medical diagnoses, which help guide treatment by identifying diseases and conditions based on symptoms and testing. Medical diagnoses focus on illness and disease, while nursing diagnoses focus on the patient.
The NANDA nursing diagnosis list is a database of nursing diagnoses that can be used as part of the nursing process. Updated every few years, NANDA nursing diagnoses fall into one of these categories:
- Problem-focused nursing diagnosis: Made up of patient issues observed in the assessment phase based on patient reports and physical signs. Problem diagnoses include three parts: the diagnosis, related factors, and defining characteristics.
- Risk nursing diagnosis: Focuses on issues that a patient is vulnerable to, or potential problem diagnoses that nursing care can help avoid.
- Health promotion nursing diagnosis: Focuses on a patient’s motivation to optimize their health and well-being. These can exist for the individual patient, family, or community.
- Syndromes: Includes a cluster of nursing diagnoses that happen simultaneously, and can be treated with similar nursing interventions.
To further organize the NANDA nursing diagnosis list, NANDA developed a more detailed classification system, which divides diagnoses into levels of domain and class. View the NANDA Taxonomy II chart and common examples below:
| Domain | Classes | Common Examples |
|---|---|---|
| Health promotion | Class 1: Health awarenessClass 2: Health management | Ineffective health maintenance, sedentary lifestyle |
| Nutrition | Class 1: IngestionClass 2: Digestion
Class 3: Absorption Class 4: Metabolism Class 5: Hydration |
Imbalanced nutrition: less than body requirements, impaired swallowing, risk for unstable blood glucose levels, deficient fluid volume |
| Elimination/exchange | Class 1: Urinary functionClass 2: Gastrointestinal function
Class 3: Integumentary function Class 4: Respiratory function |
Impaired urinary elimination, urge urinary incontinence, constipation, diarrhea, bowel incontinence, impaired gas exchange |
| Activity/rest | Class 1: Sleep/restClass 2: Activity/Exercise
Class 3: Energy balance Class 4: Cardiovascular/pulmonary responses Class 5: Self-care |
Insomnia, impaired bed mobility, impaired walking, fatigue, activity intolerance, decreased cardiac output, bathing self-care deficit |
| Perception/cognition | Class 1: AttentionClass 2: Orientation
Class 3: Sensation/perception Class 4: Cognition Class 5: Communication |
Acute confusion, impaired memory, impaired verbal communication |
| Self-perception | Class 1: Self-conceptClass 2: Self-esteem
Class 3: Body image |
Hopelessness, chronic low self-esteem, disturbed body image |
| Role relationship | Class 1: Caregiving rolesClass 2: Family relationships
Class 3: Role performance |
Caregiver role strain, dysfunctional family processes, impaired social interaction |
| Sexuality | Class 1: Sexual identityClass 2: Sexual function
Class 3: Reproduction |
Sexual dysfunction |
| Coping/stress tolerance | Class 1: Post-trauma responseClass 2: Coping responses
Class 3: Neuro-behavioral stress |
Risk for relocation stress syndrome, ineffective coping, fear, powerlessness, risk for autonomic dysreflexia |
| Life principles | Class 1: ValuesClass 2: Beliefs
Class 3: Value/belief/action congruence |
Readiness for enhanced spiritual well-being, decisional conflict, spiritual distress |
| Safety/protection | Class 1: InfectionClass 2: Physical injury
Class 3: Violence Class 4: Environmental hazards Class 5: Defensive processes Class 6: Thermo-regulation |
Risk for infection, ineffective airway clearance, risk for falls, risk for pressure ulcer, impaired skin integrity, hypothermia |
| Comfort | Class 1: Physical comfortClass 2: Environmental comfort
Class 3: Social comfort |
Impaired comfort, chronic pain, risk for loneliness |
| Growth/development | Class 1: GrowthClass 2: Development | Risk for delayed development |
Once you’ve selected diagnoses based on your nursing assessment, NANDA provides nursing interventions that may be appropriate. Then, you’ll use your own critical thinking and nursing judgment to create a care plan for each patient, implement it, and evaluate outcomes.
NANDA Nursing Diagnosis Examples
The NANDA diagnosis list is updated every few years through NANDA’s membership publication and textbook. Your nursing school will likely require you to purchase one of these resources to refer back to.
Here’s a short list of common NANDA nursing diagnoses and their definitions:
- Acute pain: An unpleasant emotional or sensory experience associated with damage to tissue. This may be evidenced by guarding behavior, restlessness, self-reporting, and diaphoresis (sweating).
- Impaired gas exchange: Imbalance in the patient’s ability to meet their oxygen demands. This may be evidenced by cyanosis (bluish coloring), abnormal breathing pattern, cough, and abnormal arterial blood gas labs.
- Risk for aspiration: The patient is at risk for choking or being unable to clear their airway of food or saliva. This can be evidenced by low oxygen saturation, cough, and being unable to clear secretions.
- Impaired skin integrity: The patient’s skin is wounded, broken, at risk for pressure sores, or malnourished. This may be evidenced by visible damage to the skin tissue, hot or tender skin surface, swelling, and bruising.
- Disturbed body image: The patient’s self-perception or their own image is negative or painful. This may be evidenced by intentionally hiding their body or specific body parts, refusing to look at themselves, or withdrawing socially.
Each NANDA nursing diagnosis should form a complete sentence that includes your evidence and related factors. For example, a NANDA nursing diagnosis list for mental health could include:
- Disturbed thought processes related to acute anxiety and intrusive thoughts, as evidenced by racing thoughts, difficulty concentrating, and verbalizing feelings of panic. Interventions may include administering as-needed medications or teaching the patient self-soothing techniques.
- Risk for self-harm related to depressive symptoms and history of suicidal ideation, as evidenced by expressing feelings of hopelessness, self-isolation, and previous suicide attempts. Interventions may include 1-on-1 staff supervision and removing any sharp objects from the patient’s room.
- Ineffective coping related to recent loss of employment, as evidenced by increased irritability, social withdrawal, and decreased self-care activities. Interventions may include providing employment resources and asking if the patient would like to talk about how they are feeling.
History and Development of the NANDA Nursing Diagnosis List
The nursing process, along with the first list of nursing diagnoses, was first developed in the 1960s as a framework to guide nurses in patient care. The first list of nursing diagnoses by NANDA was published in the ‘70s, and in 1982, the North American Nursing Diagnosis Association was formally created.
In 2002, NANDA released its Taxonomy II, which further organizes nursing diagnoses, and in response to the growing global nursing workforce, the association was formally renamed NANDA International (NANDA-I). A few years later, in 2006, a nursing educator named Christine Tanner developed an additional framework called the Clinical Judgement Model (TCJM). This included additional guidance on critical thinking and judgment amidst more complex care needs.
NANDA’s evolution, as well as the continuous development of its diagnosis list, reveals how the nursing profession has evolved over time. Articulating nursing-focused patient problems not only helps to standardize care processes but also shows that nursing is a distinct and autonomous profession, separate from medicine.
NANDA Diagnosis List: FAQs
How do I decide on the right NANDA diagnosis?
Start by analyzing the data collected during your patient assessment, including both subjective symptoms (what the patient tells you) and objective signs (what you observe or measure). From there, consider the patient’s most urgent needs — Airway, Breathing, and Circulation should always come first. You might also consider other frameworks, such as Maslow’s Hierarchy, and Henderson’s 14 basic needs.
Once you’ve identified your top concerns, compare them with the defining characteristics and related factors listed in the NANDA-I taxonomy. This will help you select the most accurate and relevant nursing diagnosis that reflects how the patient is responding to their condition, not just the condition itself.
What is the NANDA format in nursing?
The NANDA format is a way to write nursing diagnoses so that they’re standardized and reflect the reasoning behind them. NANDA diagnoses typically follow the PES format:
- Problem: A diagnosis from the list of NANDA nursing diagnosis list
- Etiology: Origin of the problem, which is not a medical diagnosis
- Symptoms: Assessment data that contributes to the diagnosis
How do I write a NANDA care plan?
To write a nursing care plan, follow the ADPIE steps and use a diagnosis from the NANDA list for nursing diagnosis. Learn more about writing nursing care plans.
Do nurses use NANDA?
Most nurses are introduced to the NANDA nursing diagnosis list in nursing school. During this time, their purpose is to help you understand the nursing process and familiarize yourself with common patient problems, their symptoms, and interventions.
If you asked the average working nurse whether they use NANDA diagnoses today, they might say no. That’s because the nursing process becomes second nature as you transition from being a student to a working nurse. Many Electronic Health Records (EHRs), such as Epic, include nursing diagnoses in their nursing order plans, along with associated interventions.
What’s the difference between a NANDA nursing diagnosis and a medical diagnosis?
Medical diagnoses identify diseases or medical conditions, and they’re used to create a medical treatment plan. For example, a patient diagnosed with asthma may be prescribed a nebulizer by their medical provider.
Nursing diagnoses, on the other hand, focus on the patient’s response to health conditions or life processes and are linked to interventions within the nursing scope of practice. The same patient with asthma may be given a nursing diagnosis of impaired gas exchange or anxiety, and potential interventions may be positioning and using supplemental oxygen.
See more examples of medical diagnoses and a list of NANDA nursing diagnoses for each in the chart below:
| Medical Diagnosis | Potential Nursing Diagnosis |
|---|---|
| Heart Failure | Decreased cardiac outputExcess fluid volume
Risk for impaired skin integrity |
| Stroke | Impaired physical mobilityRisk for aspiration
Disturbed body image |
| Chronic kidney disease | Risk for electrolyte imbalanceFatigue
Imbalanced nutrition: less than body requirements |
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