Nursing Diagnoses 2015-17 E-Book
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- Herausgeber: John Wiley & Sons
- Kategorie: Fachliteratur
- Sprache: Englisch
Nursing Diagnoses: Definitions and Classification is the definitive guide to nursing diagnoses, as reviewed and approved by NANDA-I. The 2015-2017 edition of the classic and internationally recognised text has been rigorously updated and revised, and now provides more linguistically congruent diagnoses as a result of the Diagnostic Development Committee's attentiveness to understanding the translation of the diagnostic label, definition, defining characteristics, related factors, and risk factors. Each of the 235 diagnoses presented are supported by definitions as well as defining characteristics and related factors, or risk factors. Each new and revised diagnosis is based on the latest global evidence, and approved by expert nurse diagnosticians, researchers, and educators.New to this edition:* 26 brand new nursing diagnoses and 13 revised diagnoses* Updates, changes, and revision to the vast majority of the nursing diagnosis definitions, in particular the Health Promotion and Risk Diagnoses* A standardization of diagnostic indicator terms (defining characteristics, related factors, and risk factors) to further aid clarity for readers and clinicians* All introductory chapters are written at an undergraduate nursing level, and provide critical information needed for nurses to understand assessment, its link to diagnosis, and the purpose and use of taxonomic structure for the nurse at the bedside* A new chapter, focusing on Frequently Asked Questions, representing the most common questions received through the NANDA-I website, and at global conferences* Five nursing diagnoses have been re-slotted within the NANDA-I taxonomy, following a review of the current taxonomic structure* Coding of all diagnostic indicator terms is now available for those using electronic versions of the terminology* Companion website featuring references from the book, video presentations, teaching tips, and links to taxonomy history and diagnosis submission/review process description www.wiley.com/go/nursingdiagnoses
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Veröffentlichungsjahr: 2014
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Table of Contents
Cover
Title page
NANDA International, Inc. Guidelines for Copyright Permission
Translations Terms and Conditions
Preface
Introduction
How to Use This Book
About the Companion Website
Part 1: Changes to the NANDA International Terminology
Introduction
What’s New in the 2015–2017 Edition of
Diagnoses and Classification
?
Acknowledgments
Changes to Health Promotion and Risk Diagnoses
New Nursing Diagnoses, 2015–2017
Revised Nursing Diagnoses, 2015–2017
Changes to Slotting of Current Diagnoses within the NANDA-I Taxonomy II, 2015–2017
Revisions to Nursing Diagnosis Labels within the NANDA-I Taxonomy II, 2015–2017
Nursing Diagnoses Removed from the NANDA-I Taxonomy II, 2015–2017
Standardization of Diagnostic Indicator Terms
Other Changes Made in the 2015–2017 Edition
Part 2: Nursing Diagnosis
Chapter 1: Nursing Diagnosis Basics
How Does a Nurse (or Nursing Student) Diagnose?
Understanding Nursing Concepts
Assessment
Nursing Diagnosis
Planning/Intervention
Evaluation
Use of Nursing Diagnosis
Brief Chapter Summary
Questions Commonly Asked by New Learners About Nursing Diagnosis
References
Chapter 2: From Assessment to Diagnosis
What Happens during Nursing Assessment?
Why Do Nurses Assess?
The Screening Assessment
Assessment Framework
Data Analysis
Subjective versus Objective Data
Clustering of Information/Seeing a Pattern
Identifying Potential Nursing Diagnoses (Diagnostic Hypotheses)
In-Depth Assessment
Confirming/Refuting Potential Nursing Diagnoses
Eliminating Possible Diagnoses
Potential New Diagnoses
Differentiating between Similar Diagnoses
Making a Diagnosis/Prioritizing
Summary
References
Chapter 3: An Introduction to the NANDA-I Taxonomy
Taxonomy: Visualizing a Taxonomic Structure
Classification in Nursing
Using the NANDA-I Taxonomy
Structuring Nursing Curricula
Identifying a Nursing Diagnosis Outside Your Area of Expertise
The NANDA-I Nursing Diagnosis Taxonomy: A Short History
References
Chapter 4: NANDA-I Taxonomy II: Specifications and Definitions
Structure of Taxonomy II
A Multiaxial System for Constructing Diagnostic Concepts
Definitions of the Axes
Developing and Submitting a Nursing Diagnosis
Further Development
References
Other Recommended Reading
Chapter 5: Frequently Asked Questions
Basic Questions about Standardized Nursing Languages
Basic Questions about NANDA-I
Basic Questions about Nursing Diagnoses
Questions about Defining Characteristics
Questions about Related Factors
Questions about Risk Factors
Differentiating between Similar Nursing Diagnoses
Questions Regarding the Development of a Treatment Plan
Questions about Teaching/Learning Nursing Diagnoses
Questions about Using NANDA-I in Electronic Health Records
Questions about Diagnosis Development and Review
Questions about the
NANDA-I Definitions and Classification
Text
References
Part 3: The NANDA International Nursing Diagnoses
International Considerations on the Use of the
NANDA-I Nursing Diagnoses
Domain 1: Health Promotion
Deficient diversional activity
Sedentary lifestyle
Frail elderly syndrome
Risk for frail elderly syndrome
Deficient community health
Risk-prone health behavior
Ineffective health maintenance
Ineffective health management
Readiness for enhanced health management
Ineffective family health management
Non compliance
Ineffective protection
Domain 2: Nutrition
Insufficient breast milk
Ineffective breastfeedinig
Interrupted breastfeeding
Readiness for enhanced breastfeeding
Ineffective infant feeding pattern
Imbalanced nutrition: less than body requirements
Readiness for enhanced nutrition
Obesity
Overweight
Risk for overweight
Impaired swallowing
Risk for unstable blood glucose level
Neonatal jaundice
Risk for neonatal jaundice
Risk for impaired liver function
Risk for electrolyteim balance
Readiness for enhanced fluid balance
Deficient fluid volume
Risk for deficient fluid volume
Excess fluid volume
Risk for imbalanced fluid volume
Domain 3: Elimination and Exchange
Impaired urinary elimination
Readiness for enhanced urinary elimination
Functional urinary incontinence
Overflow urinary incontinence
Reflex urinary incontinence
Stress urinary incontinence
Urge urinary incontinence
Risk for urge urinary incontinence
Urinary retention
Constipation
Risk for constipation
Chronic functional constipation
Risk for chronic functional constipation
Risk Factors
Perceived constipation
Diarrhea
Dysfunctional gastrointestinal motility
Risk for dysfunctional gastrointestinal motility
Bowel incontinence
Impaired gas exchange
Domain 4: Activity/Rest
Insomnia
Sleepdeprivation
Readiness for enhanced sleep
Disturbed sleep pattern
Risk for disuse syndrome
Impaired bed mobility
Impaired physical mobility
Impaired wheelchair mobility
Impaired sitting
Impaired standing
Impaired transfer ability
Impaired walking
Fatigue
Wandering
Activityin tolerance
Risk for activityin tolerance
Ineffective breathing pattern
Decreased cardiac output
Risk for decreased cardiac output
Risk for impaired cardiovascular function
Risk for ineffective gastrointestinal perfusion
Risk for ineffective renal perfusion
Impaired spontaneous ventilation
Risk for decreased cardiac tissue perfusion
Risk for ineffective cerebral tissue perfusion
Ineffective peripheral tissue perfusion
Risk for ineffective peripheral tissue perfusion
Dysfunctional ventilatory weaning response
Impaired home maintenance
Bathing self-caredeficit
Dressing self-caredeficit
Feeding self-caredeficit
Toileting self-caredeficit
Readiness for enhanced self-care
Self-neglect
Domain 5: Perception/Cognition
Unilateral neglect
Acute confusion
Risk for acute confusion
Chronic confusion
Labile emotional control
Ineffective impulse control
Deficient knowledge
Readiness for enhanced knowledge
Impaired memory
Readiness for enhanced communication
Impaired verbal communication
Domain 6: Self-Perception
Readiness for enhanced hope
Hope lessness
Risk for compromised human dignity
Disturbed personal identity
Risk for disturbed personal identity
Readiness for enhanced self-concept
Chronic low self-esteem
Risk for chronic low self-esteem
Situational low self-esteem
Risk for situational low self-esteem
Disturbed body image
Domain 7: Role Relationships
Caregiver role strain
Risk for caregiver role strain
Impaired parenting
Readiness for enhanced parenting
Risk for impaired parenting
Risk for impaired attachment
Dysfunctional family processes
Interrupted family processes
Readiness for enhanced family processes
Ineffective relationship
Readiness for enhanced relationship
Risk for ineffective relationship
Parental role conflict
Ineffective role performance
Impaired social interaction
Domain 8: Sexuality
Sexual dysfunction
Ineffective sexuality pattern
Ineffective childbearing process
Readiness for enhanced childbearing process
Risk for ineffective childbearing process
Risk for disturbed maternal–fetal dyad
Domain 9: Coping/Stress Tolerance
Post-trauma syndrome
Risk for post-trauma syndrome
Rape-trauma syndrome
Relocation stress syndrome
Risk for relocation stress syndrome
Ineffective activity planning
Risk for ineffective activity planning
Anxiety
Defensive coping
Ineffective coping
Readiness for enhanced coping
Ineffective community coping
Readiness for enhanced community coping
Compromised family coping
Disabled family coping
Readiness for enhanced family coping
Death anxiety
Ineffective denial
Fear
Grieving
Complicated grieving
Risk for complicated grieving
Impaired mood regulation
Readiness for enhanced power
Powerlessness
Risk for powerlessness
Impaired resilience
Readiness for enhanced resilience
Risk for impaired resilience
Chronic sorrow
Stress overload
Decreased intracranial adaptive capacity
Autonomic dysreflexia
Risk for autonomic dysreflexia
Disorganized infant behavior
Readiness for enhanced organized infant behavior
Risk for disorganized infant behavior
Domain 10: Life Principles
Readiness for enhanced spiritual well-being
Readiness for enhanced decision-making
Decisional conflict
Impaired emancipated decision-making
Readiness for enhanced emancipated decision-making
Moral distress
Impaired religiosity
Readiness for enhanced religiosity
Risk for impaired religiosity
Spiritual distress
Risk for spiritual distress
Domain 11: Safety/Protection
Risk for infection
Ineffective airway clearance
Risk for aspiration
Risk for bleeding
Risk for dry eye
Risk for falls
Risk for injury
Risk for corneal injury
Risk for perioperative positioning injury
Risk for thermal injury
Risk for urinary tract injury
Impaired dentition
Impaired oral mucous membrane
Risk for peripheral neurovascular dysfunction
Risk for pressure ulcer
Risk for shock
Impaired skin integrity
Risk for impaired skin integrity
Risk for sudden infant death syndrome
Risk for suffocation
Delayed surgical recovery
Risk for delayed surgical recovery
Impaired tissue integrity
Risk for impaired tissue integrity
Risk for trauma
Risk for vascular trauma
Risk for other-directed violence
Risk for self-directed violence
Self-mutilation
Risk for self-mutilation
Risk for suicide
Contamination
Risk for contamination
Risk for poisoning
Risk for adverse reaction to iodinated contrast media
Risk for allergy response
Latex allergy response
Risk for latex allergy response
Risk for imbalanced body temperature
Hyperthermia
Hypothermia
Risk for hypothermia
Risk for perioperative hypothermia
Ineffective thermoregulation
Domain 12: Comfort
Impaired comfort
Readiness for enhanced comfort
Nausea
Acute pain
Chronic pain
Labor pain
Chronic pain syndrome
Risk for loneliness
Social isolation
Domain 13: Growth/Development
Risk for disproportionate growth
Risk for delayed development
Nursing Diagnoses Accepted for Development and Clinical Validation 2015–2017
Disturbed energy field (formerly held the code 00050) –
Removed from the taxonomy, categorized as LOE 1.2
2013 (1994, 2004)
Part 4: NANDA International, Inc. 2015–2017
NANDA International Position Statements
NANDA INTERNATIONAL Position Statement #1 The Use of Taxonomy II as an Assessment Framework
NANDA INTERNATIONAL Position Statement #2 The Structure of the Nursing Diagnosis Statement When Included in a Care Plan
NANDA International Processes and Procedures for Diagnosis Submission and Review
NANDA-I Diagnosis Submission: Level of Evidence Criteria
Glossary of Terms
Nursing Diagnosis
Diagnostic Axes
Components of a Nursing Diagnosis
Definitions for Classification of Nursing Diagnoses
References
An Invitation to Join NANDA International
NANDA International: A Member-Driven Organization
Why Join NANDA-I?
Who Is Using the NANDA International Taxonomy?
Index
End User License Agreement
List of Tables
Chapter 01
Table I.1 New NANDA-I Nursing Diagnoses, 2015–2017
Table I.2 Revised NANDA-I Nursing Diagnoses, 2015–2017
Table I.3 Slotting Changes to NANDA-I Nursing Diagnoses, 2015–2017
Table I.4 Revisions to Nursing Diagnosis Labels of NANDA-I Nursing Diagnoses, 2015–2017
Table I.5 Nursing Diagnoses Removed from the NANDA-I Taxonomy II, 2015–2017
Chapter 02
Table 1.1 Parts of a Nursing Diagnosis Label
Table 1.2 Key Terms at a Glance
Chapter 03
Table 2.1 The Case of Caroline: A Comparison of Identified Defining Characteristics and Related Factors
Table 2.2 The Case of Caroline: A Comparison of Domains and Classes of Potential Diagnoses
Chapter 04
Table 3.1 Domains, Classes, and Nursing Diagnoses in the NANDA-I Taxonomy II
Table 3.2 Proposed Taxonomy III Domains, Classes, and Nursing Diagnoses
Chapter 05
Table 4.1 Foci of the NANDA-I Nursing Diagnoses
Table 4.2 Definitions of Judgment Terms for Axis 3, NANDA-I Taxonomy II, adapted from the Oxford Dictionary On-Line (2013).
Table 4.3 Locations in Axis 4, NANDA-I Taxonomy II
List of Illustrations
Chapter 02
Figure 1.1 Example of a Collaborative Healthcare Team
Figure 1.2 The Modified Nursing Process
Chapter 03
Figure 2.1 Steps in Moving from Assessment to Diagnosis
Figure 2.2 Converting Data to Information: The Case of Caroline, a 14-year-old Female Seen in Ambulatory Clinic
Figure 2.3 The Modified Nursing Process
Figure 2.4 In-Depth Assessment: The Case of Caroline, a 14-year-old Female Seen in Ambulatory Clinic
Figure 2.5 SEA TOW: A Thinking Tool for Diagnostic Decision-Making
Chapter 04
Figure 3.1 Domains and Classes of Classified Groceries, Inc.
Figure 3.2 Classes and Concepts of Classified Groceries, Inc.
Figure 3.3 NANDA-I Taxonomy II Domains and Classes
Figure 3.4 NANDA-I Domain 1,
Health Promotion
, with Classes and Nursing Diagnoses
Figure 3.5 NANDA-I Taxonomy II Activity/Rest Domain
Figure 3.6 Use of the NANDA-I Taxonomy II and Terminology to Identify and Validate a Nursing Diagnosis Outside the Nurse’s Area of Expertise
Figure 3.7 Diagnosing Mrs. Lendo
Figure 3.8 Seven Domains of the Proposed Taxonomy III
Figure 3.9 Proposed Taxonomy III Domains and Classes (von Krogh, 2011)
Chapter 05
Figure 4.1 The ISO Reference Terminology Model for a Nursing Diagnosis
Figure 4.2 The NANDA-I Model of a Nursing Diagnosis
Figure 4.3 A NANDA-I Nursing Diagnosis Model: (Individual) Impaired Standing
Figure 4.4 A NANDA-I Nursing Diagnosis Model: Risk for Disorganized Infant Behavior
Figure 4.5 A NANDA-I Nursing Diagnosis Model: Readiness for Enhanced Family Coping
Chapter 06
Figure 5.1 The SNAPPS diagnostic aid
Figure 5.2 Tripartite Model of Nursing Practice (Kamitsuru, 2008 )
Guide
Cover
Table of Contents
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NANDA International, Inc.
NURSING DIAGNOSES:Definitions & Classification 2015–2017
Tenth Edition
Edited by
T. Heather Herdman, PhD, RN, FNI
and
Shigemi Kamitsuru, PhD, RN, FNI
This edition first published 2014© 2014, 2012, 2009, 2007, 2005, 2003, 2001, 1998, 1996, 1994 by NANDA International, Inc.
Registered officeJohn Wiley & Sons, Ltd., The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK
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Cover image: iStockphoto / © alvarez
Correct citation of this text (APA Format, based on the 6th Edition):
Herdman, T.H. & Kamitsuru, S. (Eds.). (2014). NANDA International Nursing Diagnoses: Definitions & Classification, 2015–2017. Oxford: Wiley Blackwell.
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Preface
The 2015–2017 edition of the classic NANDA International, Inc. text, Nursing Diagnoses: Definitions & Classification, provides more clinically applicable diagnoses as a result of the Diagnostic Development Committee’s attentiveness to the potential translations of the diagnostic label, definition, defining characteristics, related factors, and risk factors. In the past, a number of nurses asked about the applicability of our work in their own countries and jurisdiction. Changes within the 2015–2017 edition have been implemented to incorporate the diversity and practice differences across the world. The latest edition is not only considered a language, but, truthfully, it is a body of nursing knowledge. These new and revised diagnoses are based on the state of evidence around the world, and they are submitted by nurses, reviewed and revised by nurses, and approved by expert nurse diagnosticians, researchers, and educators. The latest edition enhances the cultural applicability with 26 new nursing diagnoses and 14 revised diagnoses. Additionally, the text includes changes to the official NANDA-I nursing diagnosis category definitions (problem-focused, risk, health promotion), and the overall nursing diagnosis definition.
NANDA International, Inc. (NANDA-I) is a not-for-profit membership organization. This means that with the exception of our business management and administration functions, all of our work is accomplished by volunteers. Some of the world’s most talented nurse scientists and scholars are or have been NANDA-I volunteers. Contrary to most business entities, there is not an office somewhere with nurse researchers working on nursing diagnoses. The volunteers are people like you and me who give their time and expertise to NANDA-I, because of their strongly held beliefs about the importance of patient care and the contributions that nursing and nurses can and do make to society.
With the publication of each new edition of our work, more translations are added. I am delighted that the work is published in numerous languages for this international membership organization. Our relationship with our publishing partner, Wiley Blackwell, has evolved over the past five years. One of the arrangements is to ensure that each and every translation is accurate and exact. Together with our publishers, we now have a robust quality assurance mechanism in place to ensure the accuracy of each translation. The source document for each translation is always this, the American English version. We are deeply committed to ensuring the integrity of our work worldwide and invite you to support us in this quest in order to improve patient safety and the consistency of high-quality evidence-based care. As a not-for-profit organization, we obviously need an income to run the organization, facilitate meetings of our committees and Board of Directors, sponsor our website and knowledge base, and support educational offerings and conferences throughout the world, and this comes from the licenses we sell for the publishing and use of our work in electronic form. For the first time this year, we will be offering an electronic application of the NANDA-I terminology, complete with an assessment feature and decision support for some of the most commonly used diagnoses. This type of work, too, requires funding for development and testing.
As an international organization, we truly value cultural diversity and practice differences. However, as the provider of the world’s most successful standardized nursing diagnostic language and knowledge, we have a duty to provide you with exactly that: standardized nursing diagnostic knowledge. We do not support changing diagnoses at the request of translators or clinical specialists in just one edition in a particular language, when diagnosis lacks applicability in that particular culture. This is because we are deeply committed to realizing the clinical benefits of nursing diagnostic knowledge content for diverse cultures and specialties. We do not believe that we should be supporting the censorship of clinical information in this text. As a registered nurse you are accountable for appropriate diagnosis, and the use of appropriate terms, within your practice. Clearly, it would be inappropriate for all of us to use each and every one of the diagnoses in this edition, because none of us could claim competence in every sphere of nursing practice simultaneously. Clinically safe nurses are reflective practitioners; a central component to safe practice is to thoroughly understand one’s own clinical competence. It is highly likely that there are numerous diagnoses in this edition that you will never use in your own practice; others you may use daily. This also links to the issue of cultural applicability because if, when studying this edition, you find a diagnosis that is not applicable to your practice or culture, it is within your gift simply not to use it. However, based on my own varied clinical experiences as a registered nurse, I would implore you to not ignore completely those diagnoses that might at first seem culturally awkward. We live in a transcultural and highly mobile society, and exploring those diagnoses that might initially seem unusual can challenge your thinking and open up new possibilities and understanding. This is all part of being a reflective and life-long learning practitioner.
Each diagnosis has been the product of one or more of our NANDA-I volunteers or NANDA-I users, and most have a defined evidence base. Each and every new and revised diagnosis will have been refined and debated by our DDC members before finally being submitted to NANDA-I members for a vote of approval. Only if our members vote positively for the inclusion of a new or refined diagnosis does the work “make it” into the published edition. However, if you feel that a particular diagnosis is incorrect and requires revision, we welcome your views. You should contact the chair of the DDC through our website. Please provide as much evidence as possible to support your views. By working in this way, rather than changing just one translation or edition, we can ensure that our nursing diagnostic knowledge continues to have integrity and consistency, and that all benefit from the wisdom and work of individual scholars. We welcome you to submit new diagnoses, as well as revisions to current diagnoses, by using the submission guidelines found on our website.
One of the key membership developments in the past few years has been educational content published by Artmed/Panamericana Editora Ltda. (Porto Alegre, Brazil), which compiles educational modules, published in Portuguese, known as PRONANDA. A similar offering will soon be provided in Spanish. Other developments are the NANDA-I database for researchers and others needing to design electronic content. The Educational and Research Committee is preparing new educational materials to help with the educational process. The aim of this new edition of our book is to support those learning to diagnose, and to enable decision-makers to have access to information about diagnoses that describe the problems, risks, and health promotion needs of persons, families, groups, and communities. I personally was very interested in membership of NANDA-I because the body of nursing knowledge content is essential in the design of clinical decision support logic for electronic health record systems and for data analysis.
I want to commend the work of all NANDA-I volunteers, committee members, chairpersons, and members of the Board of Directors for their time, commitment and enthusiasm, and ongoing support. I want to thank our staff, led by our CEO/Executive Director, Dr. T. Heather Herdman, for its efforts and support. I appreciate the publishing partnership with Wiley-Blackwell as well as our translation and global publishing partners, which support the dissemination of knowledge content and the database developed by NANDA-I.
My special thanks to the members of the Diagnosis Development Committee for their outstanding and timely efforts to review and edit the diagnoses that are the core portion of this book, and especially for the leadership of the DDC by our Chair since 2010, Dr. Shigemi Kamitsuru. This wonderful committee, with representation from North and Latin America, Europe, and Asia, is the true “power house” of the NANDA-I knowledge content, and I am deeply impressed and pleased by the astonishingly comprehensive work of these volunteers over the years.
Finally, when I first learned about and learned to use nursing diagnoses 30 years ago, I never imagined that I would one day be the President of NANDA-I, setting the agenda for this incredible body of nursing knowledge. I welcomed the opportunity to volunteer for NANDA-I, because I found value in supporting the advancement of meaningful and useful knowledge to support nurses and students of nursing. All registered nurses and advanced practice nurses are making clinical decisions within practice, education, administration of critical thinking processes, and informatics clinical decision support system designs. For these reasons, NANDA International, Inc. has had, and continues to have, a role in improving the quality of evidence-based care and the safety of patient care, and remains the core base of knowledge for nursing professionals.
Jane M. Brokel, PhD, RN, FNIPresident, NANDA International, Inc.
Introduction
This book is divided into four parts:
Part 1
provides the introduction to the NANDA International, Inc. (NANDA-I) Taxonomy of Nursing Diagnoses. Taxonomy II organizes the diagnoses into domains and classes. Information is provided on diagnoses that are new to, or were removed from, the taxonomy during the past review cycle.
Part 2
provides chapters on the basics of nursing diagnosis, assessment, and clinical judgment. These chapters are primarily written for students, clinicians, and educators. The accompanying website includes educational materials designed to support students and faculty in understanding and teaching this material. Changes to the chapters were made based on incredibly helpful feedback received from readers around the world, and questions that we receive on a daily basis at NANDA International, Inc.
Part 3
provides the core contents of the
NANDA International Nursing Diagnoses: Definitions & Classification
book: the 235 diagnoses themselves, including definitions, defining characteristics, risk factors, and related factors, as appropriate. The diagnoses are categorized using Taxonomy II, and ordered by Domain first, then Class, and then alphabetically within each class (in the English language) by the focus of each diagnosis. We recommend that all translations maintain this order, (Domain, class, alphabetic order in their own language), to facilitate ease of discussion between inter-language groups.
Part 4
includes information that relates specifically to NANDA International. Information on processes and procedures related to review of NANDA-I diagnoses, the submission process, and level of evidence criteria are provided. A glossary of terms is given. Finally, information specific to the organization and the benefits of membership are outlined.
How to Use This Book
As noted above, the nursing diagnoses are listed by Domain first, then by Class, and then alphabetically within each class (in the English language) by the focus of each diagnosis. For example, Impaired standing is listed under Domain 4 (Activity / Rest), Class 2 (Activity / Exercise):
Domain 4: Activity / Rest
Class 2: Activity / Exercise
Impaired
standing
(00238)
It is our hope that the organization of NANDA-I Nursing Diagnoses: Definitions & Classification, 2015–2017 will make it efficient and effective to use. We welcome your feedback. If you have suggestions, please send them by email to: [email protected].
About the Companion Website
This book is accompanied by a companion website:
www.wiley.com/go/nursingdiagnoses
The website includes:
Videos
References
Weblinks
Part 1Changes to the NANDA International Terminology
Introduction
What’s New in the 2015–2017 Edition of
Diagnoses and Classification
?
Acknowledgments
Changes to Health Promotion and Risk Diagnoses
New Nursing Diagnoses, 2015–2017
Revised Nursing Diagnoses, 2015–2017
Changes to Slotting of Current Diagnoses within the NANDA-I Taxonomy II, 2015–2017
Revisions to Nursing Diagnosis Labels within the NANDA-I Taxonomy II, 2015–2017
Nursing Diagnoses Removed from the NANDA-I Taxonomy II, 2015–2017
Standardization of Diagnostic Indicator Terms
Other Changes Made in the 2015–2017 Edition
Introduction
T. Heather Herdman, RN, PhD, FNI
In this section, introductory information on the new edition of the NANDA International Taxonomy, 2015–2017 is presented. This includes an overview of major changes to this edition: new and revised diagnoses, changes to slotting within the taxonomy, changes to diagnostic labels, and diagnoses that were removed or retired.
Those individuals and groups who submitted new or revised diagnoses for approval are identified. A historical perspective on submitters to the complete NANDA-I terminology, which was developed by Betty Ackley for the previous edition of this book, has been updated to include this information, and is now available on our website, at www.nanda.org.
A description of editorial changes is also provided; readers will note that nearly every diagnosis has some changes as we have worked to increase the standardization of the terms used within our diagnostic indicators (defining characteristics, related factors, risk factors).
I would like to offer a particularly significant note of appreciation to Dr. Susan Gallagher-Lepak, of the University of Wisconsin – Green Bay College of Professional Studies, who worked with me over a period of several months to standardize these terms. Additional thanks go to my co-editor, Dr. Shigemi Kamitsuru, who further reviewed and revised our work, which then came full circle back to us for consensus. This process has been a daunting one, with more than 5,600 individual terms requiring review! However, the standardization of these terms has now enabled the coding of all of the diagnostic indicator terms, facilitating their use as assessment data within electronic health records, leading to the development within those records of critical clinical decision support tools for professional nurses. These codes are now available on the NANDA-I website.
What’s New in the 2015–2017 Edition of Diagnoses and Classification?
Changes have been made in this edition based on feedback from users, to address the needs of both students and clinicians, as well as to provide additional support to educators. All of the chapters are new for this edition, with the exception of the chapter NANDA-I Taxonomy: Specifications and Definitions, which provides a revision of that found in the previous edition. There are corresponding web-based presentations available for teachers and students that augment the information found within the chapters; icons appear in chapters that have these accompanying support tools.
A new chapter, focusing on Frequently Asked Questions, is included. These questions represent the most common questions we receive through the NANDA-I website, and when we present at conferences around the globe.
Acknowledgments
It goes without saying that the dedication of several individuals to the work of NANDA International, Inc. (NANDA-I) is evident in their donation of time and effort to the improvement of the NANDA-I terminology and taxonomy. This text represents the culmination of the tireless volunteer work of a group of very dedicated, extremely talented individuals who have developed, revised, and studied nursing diagnoses for more than 40 years.
Additionally, we would like to take the opportunity to acknowledge and personally thank the following individuals for their contributions to this particular edition of the NANDA-I text.
Chapter Authors
The Basics of Nursing Diagnosis – Susan Gallagher-Lepak, PhD, RN
Chapter Reviewers
An introduction to the NANDA-I taxonomy – Kay Avant, PhD, RN, FNI, FAAN; Gunn von Krogh, RN, PhD
Reviewer for Standardization of Diagnostic Terms
Susan Gallagher-Lepak, PhD, RN
Please contact us at [email protected] if you have questions on any of the content or if you find errors, so that these may be corrected for future publication and translation.
T. Heather Herdman, PhD, RN, FNI
Shigemi Kamitsuru, PhD, RN, FNI
Editors
NANDA International, Inc.
Changes to Health Promotion and Risk Diagnoses
The overall definitions for nursing diagnoses were changed during this cycle. These changes had impacts on the way in which current risk and health promotion diagnoses should be defined, so you will note changes to every definition of these diagnoses. These changes were presented to the NANDA-I membership, and approved via online voting.
The risk diagnoses were changed to eliminate “risk” from the definition, which has now been replaced by the use of the word “vulnerable.”
The health promotion diagnoses were changed to ensure that the definitions reflected that these diagnoses are appropriate for use at any stage in the health–illness continuum, and that a state of balance or health is not required. Similarly, defining characteristics of these diagnoses needed to change, as in many cases they represented healthy, stable states. All of the defining characteristics now begin with the phrase “Expresses the desire to enhance,” because health promotion requires the willingness of the patient to improve upon his current status, whatever that might be.
New Nursing Diagnoses, 2015–2017
A significant body of work representing new and revised nursing diagnoses was submitted to the NANDA-I Diagnosis Development Committee, with a substantial portion of that work being presented to the NANDA-I membership for consideration in this review cycle. NANDA-I would like to take this opportunity to congratulate those submitters who successfully met the level of evidence criteria with their submissions and/or revisions. Twenty-six new diagnoses were approved by the Diagnosis Development Committee, the NANDA-I Board of Directors, and the NANDA-I membership (Table I.1).
Table I.1New NANDA-I Nursing Diagnoses, 2015–2017
Approved diagnosis (New)
Submitter(s)
Domain 1. Health Promotion
Frail elderly syndrome
Margarita Garrido Abejar; Mª Dolores Serrano Parra; Rosa Mª Fuentes Chacón
Risk for
frail elderly syndrome
Margarita Garrido Abejar; Mª Dolores Serrano Parra; Rosa Mª Fuentes Chacón
Domain 2. Nutrition
Obesity
T. Heather Herdman, PhD, RN, FNI
Overweight
T. Heather Herdman, PhD, RN, FNI
Risk for
overweight
T. Heather Herdman, PhD, RN, FNI
Domain 3. Elimination and Exchange
Chronic
functional constipation
T. Heather Herdman, PhD, RN, FNI
Risk for chronic
functional constipation
T. Heather Herdman, PhD, RN, FNI
Domain 4. Activity / Rest
Impaired
sitting
Christian Heering, EdN, RN
Impaired
standing
Christian Heering, EdN, RN
Risk for decreased
cardiac output
Eduarda Ribeiro dos Santos, PhD, RN; Vera Lúcia Regina Maria, PhD, RN; Mariana Fernandes de Souza, PhD, RN; Maria Gaby Rivero de Gutierrez, PhD, RN; Alba Lúcia Bottura Leite de Barros, PhD, RN
Risk for impaired
cardiovascular function
María Begoña Sánchez Gómez PhD(c), RN; Gonzalo Duarte Clíments PhD(c), RN
Domain 5. Perception / Cognition
Labile
emotional control
Gülendam Hakverdioğlu Yönt, PhD, RN; Esra Akın Korhan, PhD, RN; Leyla Khorshid, PhD, RN
Domain 9. Coping / Stress Tolerance
Impaired
mood regulation
Heidi Bjørge, MnSc, RN
Domain 10. Life Principles
Impaired
emancipated decision-making
Ruth Wittmann-Price, PhD, RN
Readiness for enhanced
emancipated decision-making
Ruth Wittmann-Price, PhD, RN
Risk for impaired
emancipated decision-making
Ruth Wittmann-Price, PhD, RN
Domain 11. Safety / Protection
Risk for
corneal injury
Andreza Werli-Alvarenga, PhD, RN; Tânia Couto Machado Chianca, PhD, RN; Flávia Falci Ercole, PhD, RN
Risk for
urinary tract injury
Danielle Cristina Garbuio, MS; Elaine Santos, MS, RN; Emília Campos de Carvalho, PhD, RN; Tânia Couto Machado Chianca, PhD, RN; Anamaria Alves Napoleão, PhD, RN
Risk for
impaired oral mucous membrane
Emilia Campos de Carvalho, PhD, RN; Cristina Mara Zamarioli, RN; Ana Paula Neroni Stina, RN; Vanessa dos Santos Ribeiro, undergraduate student; Sheila Ramalho Coelho Vasconcelos de Morais, MNSc, RN
Risk for
pressure ulcer
T. Heather Herdman, PhD, RN, FNI; Cássia Teixeira dos Santos MSN, RN; Miriam de Abreu Almeida PhD, RN; Amália de Fátima Lucena PhD, RN
Risk for
delayed surgical recovery
Rosimere Ferreira Santana, PhD, RN; Dayana Medeiros do Amaral, BSN; Shimmenes Kamacael Pereira, MSN, RN; Tallita Mello Delphino, MSN, RN; Deborah Marinho da Silva, BSN; Thais da Silva Soares, BSN
Risk for
impaired tissue integrity
Katiucia Martins Barros MS, RN; Daclé Vilma Carvalho, PhD, RN
Risk for
hypothermia
T. Heather Herdman, PhD, RN, FNI
Risk for
perioperative hypothermia
Manuel Schwanda, BSc.,RN; Prof. Marianne Kriegl, Mag.; Maria Müller Staub, PhD, EdN, RN, FEANS
Domain 12. Comfort
Labor pain
Simone Roque Mazoni, PhD, RN; Emilia Campos de Carvalho, PhD, RN
Chronic pain syndrome
T. Heather Herdman, PhD, RN, FNI
Revised Nursing Diagnoses, 2015–2017
Fourteen diagnoses were revised during this cycle; five were approved by the DDC through the expedited review process and nine were revised through the standard review process. Table I.2 shows those diagnoses, highlights the revisions that were made for each of them, and identifies the submitters.
Table I.2Revised NANDA-I Nursing Diagnoses, 2015–2017
Approved diagnosis (Revised)
Revision
Submitter(s)
DC removed
DC added
ReF/RiF removed
ReF/RiF added
Definition revised
Comment
Domain 2. Nutrition
Ineffective
breastfeeding
1
1
1
10
X
Definition reflects change in focus from the attachment/bonding process to that of nutrition
2 defining characteristics reassigned to related factors
T. Heather Herdman, RN, PhD, FNI
Interrupted
breastfeeding
6
1
1
X
Definition reflects change in focus from attachment/bonding process to that of nutrition
1 defining characteristic reassigned to related factor
T. Heather Herdman, RN, PhD, FNI
Readiness for enhanced
breastfeeding
1
2
X
Definition reflects change in focus from attachment/bonding process to that of nutrition
T. Heather Herdman, RN, PhD, FNI
Excess
fluid volume
2
Eneida Rejane Rabelo da Silva ScD, RN; Quenia Camille Soares Martins ScD, RN; Graziella Badin Aliti ScD, RN
Domain 4. Activity / Rest
Impaired
physical mobility
1
Eneida Rejane Rabelo da Silva ScD, RN; Angelita Paganin MSc, RN
Domain 7. Role Relationships
Risk for caregiver role strain
X
Definition revised to be consistent with the problem-focused definition
Domain 10. Life Principles
Spiritual
distress
4
7
11
X
Sílvia Caldeira PhD, RN; Emília Campos de Carvalho PhD, RN; Margarita Vieira PhD, RN
Domain 11. Safety / Protection
Risk for imbalanced
body temperature
10
Diagnosis revised to incorporate neonatal characteristics
T. Heather Herdman, RN, PhD, FNI
Hyperthermia
9
1
3
X
Diagnosis revised to incorporate neonatal characteristics
T. Heather Herdman, RN, PhD, FNI
Hypothermia
24
4
8
X
Diagnosis revised to incorporate neonatal characteristics
T. Heather Herdman, RN, PhD, FNI
Delayed
surgical recovery
6
4
1
8
Rosimere Ferreira Santana, Associate PhD, RN; Shimmenes Kamacael Pereira, MSN, RN; Tallita Mello Delphino, MSN, RN; Dayana Medeiros do Amaral, BSN; Deborah Marinho da Silva, BSN; Thais da Silva Soares, BSN; Marcos Venicius de Oliveira Lopes, PhD, RN
Impaired
tissue integrity
3
10
X
Katiucia Martins Barros MS, RN; Daclé Vilma Carvalho PhD, RN
Domain 12. Comfort
Acute
pain
6
6
1
3
X
T. Heather Herdman, RN, PhD, FNI
Chronic
pain
10
5
2
35
X
T. Heather Herdman, RN, PhD, FNI
DC, defining characteristic; ReF, related factor; RiF, risk factor.
Changes to Slotting of Current Diagnoses within the NANDA-I Taxonomy II, 2015–2017
A review of the current taxonomic structure, and slotting of diagnoses within that structure, led to some changes in the way some diagnoses are now classified within the NANDA-I taxonomy. Five nursing diagnoses were reslotted within the NANDA-I taxonomy; these are noted in Table I.3 with their previous and new places in the taxonomy noted.
Table I.3Slotting Changes to NANDA-I Nursing Diagnoses, 2015–2017
Nursing diagnosis
Previous slotting
New slotting
Domain
Class
Domain
Class
Noncompliance
Life Principles
Value/Belief/Action Congruence
Health Promotion
Health Management
Ineffective
breastfeeding
1
Role Relationship
Caregiving Roles
Nutrition
Ingestion
Interrupted
breastfeeding
1
Role Relationship
Caregiving Roles
Nutrition
Ingestion
Readiness for enhanced
breastfeeding
1
Role Relationship
Caregiving Roles
Nutrition
Ingestion
Readiness for enhanced
hope
Life Principles
Values
Self-Perception
Self-Concept
Risk for
loneliness
Self-Perception
Self-Concept
Comfort
Social Comfort
1 Reslotting due to diagnosis revision, including definition change.
Revisions to Nursing Diagnosis Labels within the NANDA-I Taxonomy II, 2015–2017
Changes were made in five diagnosis labels. These changes, and their rationale, are shown in Table I.4.
Table I.4Revisions to Nursing Diagnosis Labels of NANDA-I Nursing Diagnoses, 2015–2017
Previous diagnostic label
New diagnostic label
Rationale
Ineffective
self-health management
Ineffective
health management
There is no need to include the “self” in the diagnostic label, as the focus of the diagnosis is assumed to be the individual unless otherwise stated.
Readiness for enhanced
self-health management
Readiness for enhanced
health management
There is no need to include the “self” in the diagnostic label, as the focus of the diagnosis is assumed to be the individual unless otherwise stated.
Ineffective family
therapeutic regimen management
Ineffective family
health management
Definition is consistent with the individual health management diagnoses, therefore the diagnostic label should reflect the same diagnostic focus.
Impaired individual
resilience
Impaired
resilience
There is no need to include “individual” in the diagnostic label, as the focus of the diagnosis is assumed to be the individual unless otherwise stated.
Risk for compromised
resilience
Risk for impaired
resilience
The problem-focused diagnosis carries the diagnostic label, Impaired resilience, and the definition of the risk diagnosis is consistent with that diagnosis.
Nursing Diagnoses Removed from the NANDA-I Taxonomy II, 2015–2017
Seven nursing diagnoses were removed from the taxonomy, either because they were slotted for removal if they were not updated to bring them to a level of evidence of 2.1, due to a change in the classification of level of evidence supporting the diagnosis, or because new diagnoses replaced them. Table I.5 provides information on each of the diagnoses that were removed from the taxonomy.
Table I.5Nursing Diagnoses Removed from the NANDA-I Taxonomy II, 2015–2017
Retireddiagnostic label
New diagnostic label
Rationale
Disturbed
energy field
(00050)
–
Removed from taxonomy, but reassigned to level of evidence (LOE) 1.2, Theoretical Level, for Development and Validation (LOE 1.2 is not accepted for publication and inclusion in the taxonomy; all literature support currently provided for this diagnosis is regarding intervention rather than for the nursing diagnosis itself)
Adult
failure to thrive
(00101)
Frail elderly syndrome
New diagnosis replaced previous diagnosis
Readiness for enhanced
immunization status
(00186)
–
Diagnosis was indicated for retirement in the 2012–2014 edition. Additionally, this content is currently covered within the diagnosis, Readiness for enhanced health management
Imbalanced
nutrition
: more than body requirements (00001)
Overweight
Obesity
New diagnoses replaced previous diagnosis
Risk for imbalanced
nutrition
: more than body requirements (00003)
Risk for
overweight
New diagnosis replaced previous diagnosis
Impaired
environmental interpretation syndrome
(00127)
–
Diagnosis was indicated for removal in the 2012–2014 edition unless additional work was completed to bring it into compliance with the definition of syndrome diagnoses. This work was not completed.
Delayed
growth and development
(00111)
–
Diagnosis was indicated for removal in the 2012–2014 edition, unless additional work was completed to separate the foci of (1) growth and (2) development into separate diagnostic concepts. This work was not completed.
Standardization of Diagnostic Indicator Terms
For the past two cycles of this book, work has been slowly underway to decrease variation in the terms used for defining characteristics, related factors, and risk factors. This work was undertaken in earnest during this cycle of the book, with several months being dedicated for the review, revision, and standardization of terms being used. This was no easy task, and it involved many hours of review, literature searches, discussion, and consultation with clinical experts in different fields.
The process we used included individual review of assigned domains, followed by a second reviewer independently reviewing the current and newly recommended terms. The two reviewers then met together, either in person or via web-based video conferencing, and reviewed each and every line a third time, together. Once consensus was reached, the third reviewer then took the current terms and recommended terms, and independently reviewed these. Any discrepancies were discussed until consensus was reached. After the entire process was completed for every diagnosis, including new and revised diagnoses, a process of filtering for similar terms was begun. For example, every term with the stem “pulmo-” was searched, to ensure that consistency was maintained. Common phrases were also used to filter, such as verbalizes, reports, states; lack of; insufficient; inadequate; excess, etc. This process continued until the team was unable to find additional terms that had not previously been reviewed.
That said, we know the work is not done, it is not perfect, and there may be disagreements with some of the changes that were made. We can tell you that there are more than 5,600 diagnostic indicators within the terminology, and we believe that we have made a good first effort at standardization of the terms.
The benefits of this are many, but three are perhaps the most notable:
Translations should be improved
. There have been multiple questions over the last two editions that were difficult to answer. Some examples include:
When you say
lack
in English, does that mean
absence of
or
insufficient
? The answer is often “Both!” Although the duality of this word is well accepted in English, the lack of clarity does not support the clinician in any language, and it makes it very difficult to translate into languages in which a different word would be used depending on the intended meaning.
Is there a reason why some defining characteristics are noted in the singular and yet in another diagnosis the same characteristic is noted in the plural (e.g., absence of significant other(s), absence of significant other, absence of significant others)?
There are many terms that are similar, or that are examples of other terms used in the terminology. For example, what is the difference between:
abnormal skin color (e.g., pale, dusky)
,
color changes
,
cyanosis
,
pale
,
skin color changes
,
slight cyanosis
? Are the differences significant? Could these be combined into one term? Some of the translations are almost the same (e.g.,
abnormal skin color, color changes, skin color changes
