Nursing Diagnosis Guide

In 1982, NANDA-I, then known as the North American Nursing Diagnosis Association (NANDA), created official nursing diagnosis classifications to help document the many clinical decisions nurses make on behalf of their patients.

Creating and implementing a nursing diagnosis improves communication and patient care outcomes. Nursing diagnoses and processes help ensure and promote evidence-based, safe practices.

Learn about nursing diagnosis, its importance, and how to write one.

NANDA-I defines the nursing diagnosis as communicating “the professional judgments that nurses make every day to our patients, colleagues, members of other disciplines and the public.”

A nursing diagnosis generally has three components:

Risk-related nursing diagnoses are used when patients are at risk for developing certain conditions. In this case, nurses use “risk for” and “as evidenced by” statements.

The nursing diagnosis involves nurses’ clinical decisions and expands the nursing process, which includes five core steps.

A nurse initiates a nurse’s diagnosis. The nursing diagnosis focuses on the patient’s needs and outcomes holistically.

A nursing diagnosis aims to incorporate every part of the nursing practice and clinical judgment into accurate documentation.

A doctor’s diagnosis focuses on assessing the patient’s signs and symptoms, identifying the condition, and constructing a medical diagnosis. In many states, advanced practice registered nurses (APRNs) have full practice authority, so they can diagnose patients independently of a physician.

NANDA-I divides nursing diagnosis into four main categories.

A problem-focused nursing diagnosis is related to a patient’s problem. It can be used throughout the patient’s hospitalization or resolved by the shift’s end.

Example: Anxiety related to situational crises and stress (related factors) as evidenced by restlessness, insomnia, anguish, and anorexia (defining characteristics)

A risk nursing diagnosis identifies when the patient is at risk for developing a problem. NANDA-I describes it as a vulnerability the patient has encountered.

Example: Risk for infection as evidenced by inadequate vaccination and immunosuppression (risk factors)

A health promotion diagnosis identifies how to improve a patient’s health. A health promotion diagnosis includes the patient and their family/community members.

Example: Readiness for enhanced self-care as evidenced by expressed desire to enhance self-care

A syndrome nursing diagnosis identifies a cluster of diagnoses for a patient. These nursing diagnoses are best described together. The patient may be experiencing several health problems forming a pattern.

Example: Chronic pain syndrome

NANDA-I created Taxonomy II after collaborating with the National Library of Medicine. Taxonomy, defined as “a system of naming, describing, and classifying related things,” was created to standardize care. There are three levels: nursing diagnosis, domains, and classes.

The NANDA-I Taxonomy II currently has over 200 nursing diagnoses, 47 classes, and 13 domains of nursing practice. The domains are:

Each domain is associated with specific classes.

Nurses and nursing students must become members of NANDA-I or purchase the NANDA-I Taxonomy II book to obtain the complete list of nursing diagnoses.