2. Types of Nursing Diagnosis
There are 4 types of nursing diagnosis
according to NANDA-I. They are:
• Problem-focused (Actual)
• Risk (Potential)
• Health promotion– Wellness
• Syndrome
3. Problem-focused (Actual)
• A problem-focused nursing diagnosis is
a “clinical judgment concerning an
undesirable human response to health
condition/life processes that exist in an
individual, family, group, or community.
4. Cont..,
• A patient problem present during a nursing
assessment is known as a problem-focused
diagnosis.
• Generally, the problem is seen throughout
several shifts or a patient’s entire
hospitalization. However, it may be
resolved during a shift depending on the
nursing and medical care.
5. • A problem-focused nursing diagnosis
contains all three components of the PES
format:
• Problem (P) – statement of the patient
response (nursing diagnosis).
• Etiology (E) – related factors contributing to
the nursing diagnosis.
• Signs and Symptoms (S) – defining
characteristics manifested by that patient.
6. Example.
• The components of a problem focused
nursing diagnosis statement would be:
• (P) Fluid Volume Excess
• (E) Related to compromised regulatory
mechanisms secondary to Renal failure
(acute or chronic)
• (S) As manifested by bilateral 2+ pitting
edema of the ankles and feet, increased
weight of 10 pounds, and the patient
reports, “My ankles are so swollen.”
7. • A correctly written problem focused
nursing diagnosis statement would look
like this:
• Fluid Volume Excess related to
compromised regulatory mechanisms
secondary to Renal failure (acute or
chronic) as manifested by bilateral 2+
pitting edema of the ankles and feet, an
increase weight of 10 pounds, and the
patient reports, “My ankles are so
swollen.”
8. • Anxiety related to unpredictable nature of
asthmatic episodes as evident by
statements of “I’m afraid I won’t be able to
breathe”
9. Risk Nursing Diagnosis
• A risk nursing diagnosis should be
supported by evidence of the patient’s
vulnerability for developing a problem.
Different experts recommend different
phrasing. NANDA-I 2018-2020
recommends using the phrase “as
evidenced by” to refer to the risk factors
for developing that problem.
10. A risk nursing diagnosis applies when risk
factors require intervention from the nurse
and healthcare team prior to a real
problem developing.
11. • A risk diagnosis consists of the following:
• Problem (P) – statement of the patient
response (nursing diagnosis)
• Signs and Symptoms (S) – risk factors
indicating the vulnerability for developing
the problem
12. Example.
• The components of a risk diagnosis
statement would be:
• Problem (P) – Risk for Falls
• Signs and Symptoms (S) – Dizziness
and decreased lower extremity strength
13. • A correctly written risk nursing diagnosis
statement would look like this:
• Risk for Falls as evidenced by dizziness
and decreased lower extremity strength.
• Risk for Impaired Skin Integrity related to
immobility secondary to fractured hip
14. Health-Promotion Nursing
Diagnosis
• A health-promotion nursing diagnosis
statement contains the problem (P) and
the defining characteristics (S). The
defining characteristics component of a
health-promotion nursing diagnosis
statement should begin with the phrase
“expresses desire to enhance’’.
15. • The goal of a health promotion nursing
diagnosis is to improve the overall well-
being of an individual, family or
community.
• Problem (P) – statement of the patient
response (nursing diagnosis)
• Signs and Symptoms (S) – the patient’s
expressed desire
16. Example.
• The components of a health promotion
nursing diagnosis would be:
• (P) Readiness for Enhanced Health
Management
• (S) Expressed desire to “learn more about
my health so I can take better care of
myself.”
17. • A correctly written health promotion
nursing diagnosis statement would look
like this:
• Enhanced Readiness for Health Promotion
as manifested by expressed desire to
“learn more about my health so I can take
better care of myself.”
18. Syndrome
• A syndrome is a cluster of nursing
diagnoses that occur together and are best
addressed together and through similar
interventions.” To make a syndrome
diagnosis, two or more nursing diagnoses
must be used as defining characteristics (S)
that create a syndrome. Related factors
may be used if they add clarity to the
definition, but are not required.
19. • A syndrome statement consists of these
items:
• Problem (P) – the syndrome
• Signs and Symptoms (S) – the defining
characteristics are two or more similar
nursing diagnoses
20. • A syndrome diagnosis refers to a cluster
of nursing diagnoses that occur in a
pattern or can all be addressed through
the same or similar nursing interventions.
Examples of this diagnosis include:
• Decreased cardiac output
• Decreased cardiac tissue perfusion
• Ineffective cerebral tissue perfusion
• Ineffective peripheral tissue perfusion
21. • Possible nursing diagnosis is not a type of
diagnosis as are actual, risk, and
syndrome.
• Possible nursing diagnoses are a
diagnostician’s option to indicate that
some data are present to confirm a
diagnosis but are insufficient at this time.
