One of the steps of the nursing process is making a diagnosis.
As a registered nurse (RN), making diagnoses is part of your job responsibilities. However, understanding a nursing diagnosis and writing your own may seem daunting. Thankfully, NANDA can help.
NANDA International, Inc. offers guidelines to help nurses make standardized nursing diagnoses, ensuring clear and effective communication and quality patient care.
What is a nursing diagnosis?
According to NANDA, a nursing diagnosis is “a clinical judgment concerning a human response to health conditions/life processes, or a vulnerability for that response, by an individual, family, group or community. A nursing diagnosis provides the basis for selecting nursing interventions to achieve outcomes for which the nurse has accountability.”
A nursing diagnosis is an essential step of the nursing process and is crucial to ensure quality of care for the following reasons:
- An accurate nursing assessment and diagnosis contribute to a holistic understanding of a patient’s health and an effective treatment plan.
- A nursing diagnosis provides a framework for identifying and documenting nurses’ clinical judgments. They offer a perspective that is different from those of other healthcare professionals.
- Nurses are held legally accountable for their professional responsibilities and contributions to patient diagnoses.
In short, the nursing diagnosis contributes valuable insights regarding patients’ health and care plans. They also help validate nurses as essential players in interdisciplinary healthcare teams.
Common nursing diagnoses
Some diagnoses are used more frequently than others. Therefore, nurses can start out by becoming familiarized with the most common nursing diagnoses:
- Chronic pain
- Impaired gas exchange
- Acute pain
- Risk for infection
- Ineffective airway clearance
- Activity intolerance
- Acute confusion
- Anxiety
- Chronic pain
- Impaired skin integrity
- Risk for decreased cardiac output
- Diarrhea
- Ineffective breathing pattern
Nursing vs medical diagnoses: What’s the difference?
A medical diagnosis focuses on diseases or other medical problems; a nursing diagnosis deals with the human response to health conditions and life processes.
Physicians, physician’s assistants (PAs), and advanced nurse practitioners (ANPs) are responsible for making medical diagnoses, whereas registered nurses are responsible for nursing diagnoses. They also educate patients on these diagnoses.
However, the healthcare provider’s credentials are not the only distinction.
A medical diagnosis focuses on diseases or other medical problems; a nursing diagnosis deals with the human response to health conditions and life processes.
The nursing diagnosis contemplates the following factors related to patients:
- Level of pain
- Presence of mental health conditions as a result of physical illness
- Attitudes
- Challenges, such as social determinants of health (housing, work conditions, etc.)
- Resources
Therefore, two patients with the same medical diagnosis—such as pneumonia, diabetes, or hypertension—can have different nursing diagnoses.
For example, the nursing diagnosis of a patient with chronic obstructive pulmonary disease (COPD) may address the patient’s feelings of depression, hopelessness, and pessimism—commonly observed behaviors among patients with this disease.
NANDA nursing diagnosis list
NANDA, or the North American Nursing Diagnosis Association, is an organization that develops, refines, and promotes terminology that accurately reflects nurses’ clinical judgments. NANDA provides a framework for nurses to diagnose patients’ signs and symptoms using standardized nursing language (SNL).
A shared language allows nurses to communicate effectively with other healthcare professionals about patients and follow the same method for identifying nursing diagnoses.
The following table includes NANDA nursing diagnosis examples by domain, encompassing environmental, physical, psychosocial, and spiritual areas:
What are the components of the NANDA format in nursing?
According to NANDA recommendations, a nursing diagnosis is a statement that includes both the diagnosis itself and related factors seen through defining characteristics.
Nurses should also try to link the defining characteristics, associated factors, and risk factors discovered during the patient’s assessment.
A nursing diagnosis should include the following components.
Diagnosis label
This is the name for a diagnosis and reflects the diagnostic focus and the nursing judgment. It is a term or phrase representing a pattern of related signs and symptoms.
The diagnosis label could be any from the previous table, such as risk for unstable blood glucose level or acute pain.
Definition
This clear description helps set the diagnosis apart from other diagnoses.
For example, the following is the definition of the diagnostic label “risk of shock”:
The risk of shock is the susceptibility to inadequate blood flow to the body’s tissues, which may lead to life-threatening cellular dysfunction, which may compromise health.
Defining characteristics
These are all the observable signs and symptoms that cluster to indicate a problem-focused or health-promotion nursing diagnosis or a syndrome.
These signs and symptoms include subjective and objective data.
In other words, they may be perceived through any of the senses (sight, touch, smell, etc.) or communicated by the patient or family members.
Examples include the following:
- Posture, gait, and balance alterations
- Abnormal heart, lung, abdominal, or vascular sounds
- Pain
- Temperature
Risk factors
These are only part of risk diagnoses; they increase an individual’s, family’s, group’s, or community’s vulnerability to experiencing an unhealthy event.
They may be environmental, physiological, psychological, genetic, or chemical.
Example risk factors for the nursing diagnosis “risk for infection” include the following:
- Alteration in skin integrity
- Obesity
- Malnutrition
- Smoking
- Inadequate vaccination
- Alteration in peristalsis
- Stasis of body fluid
Related factors
The related factors in a nursing diagnosis refer to the underlying causes or etiology of a patient’s problem or situation.
These factors should not refer to medical diagnoses but to underlying causes that nurses can treat.
For instance, in the nursing diagnosis of “elder frailty syndrome,” a related factor could be the fear of falling.
The planned nursing interventions should aim to modify or remove these related factors.
4 types of nursing diagnoses and how to write them
The type of diagnosis a nurse can make depends on several factors.
- Is the patient experiencing the effects of a medical condition, or are they at risk of developing a disease or other undesirable human response?
- Is the patient experiencing one cluster of related symptoms, or is the condition more complex?
- How involved does the patient want to be in their treatment and care plan?
These factors converge to determine the type of nursing diagnosis registered nurses can make in order to maintain optimal health status.
Neglecting the nursing diagnosis increases the risk of negative outcomes.
1. Problem-focused nursing diagnosis
This type of nursing diagnosis relates to undesirable human responses (a.k.a. problems) to specific conditions or life processes in individuals, families, groups, or communities.
Problem-focused nursing diagnoses require defining characteristics—such as manifestations, signs, and symptoms—that cluster in patterns of related cues and etiological factors that are related to, contribute to, or are antecedent to the diagnostic focus.
Here are example components of a problem-focused nursing diagnosis statement:
- Problem: Excess fluid volume
- Etiology: Related to excessive fluid intake
- Signs and symptoms: Bilateral basilar crackles in the lungs, bilateral 2+ pitting edema of the ankles and feet, increased weight of 10 lb, and the patient reports, “My ankles are so swollen.”
Based on these components, nurses could write the following problem-focused nursing diagnosis statement:
Excess fluid volume associated with excessive fluid intake is indicated by bilateral basilar crackles in the lungs, bilateral 2+ pitting edema of the ankles and feet, an increased weight of 10 lb, and the patient reports, “My ankles are so swollen.”
2. Health-promotion nursing diagnosis
A health-promotion nursing diagnosis concerns the motivation and desire to increase wellbeing and reach human health potential.
This motivation may exist in individuals, families, groups, or communities and applies to any health state. Nurses can make this type of diagnosis when patients express a desire to enhance their health.
The following could be components of a health-promotion nursing diagnosis:
- Problem: Readiness for enhanced health self-management
- Symptoms: The patient expressed the desire to “learn more about my treatment plan so I can take better care of myself.”
The following could be the health-promotion nursing diagnosis for this patient:
An enhanced readiness for health promotion is indicated by the expressed desire to “learn more about my treatment plan so I can take better care of myself.”
3. Risk nursing diagnosis
A risk nursing diagnosis refers to the vulnerability of individuals, families, groups, or communities to develop unwanted human responses to health conditions or life processes.
Risk factors contributing to increased vulnerability must be present for nurses to make this type of diagnosis.
The following are example components of a risk nursing diagnosis statement:
- Problem: Risk for adult falls
- Evidence: Decreased lower extremity strength and fear of falling
These components could be brought together in the following way to write a risk nursing diagnosis statement:
The risk for adult falls is indicated by decreased lower extremity strength and fear of falling.
4. Syndrome
A syndrome relates to a specific cluster of nursing diagnoses that occur together and can be treated simultaneously through similar interventions.
Interventions may include providing pain control, alleviating chest pain, or helping increase blood flow.
Nurses can make this type of diagnosis when two or more nursing diagnoses are present as defining characteristics. Although not required, nurses may also use related factors to clarify the definition.
Here are example components of a syndrome nursing diagnosis:
- Problem: Elder frailty syndrome
- Signs and symptoms: The nursing diagnoses of activity intolerance and social isolation
- Additional related factor: Fear of falling
A syndrome diagnosis statement could be written in the following way:
The patient presents elder frailty syndrome related to activity intolerance, social isolation, and fear of falling.
How do I write a NANDA nursing diagnosis for a care plan?
While the information provided so far can help deepen nurses’ understanding and provide clarity, writing a diagnosis may still seem overwhelming.
Aren’t sure where to start?
Here are general steps nurses must follow to write nursing diagnoses:
- First, registered nurses must analyze patients’ subjective and objective data and identify patterns.
- Then, nurses develop hypotheses based on how these patterns correlate with defining characteristics of a nursing diagnosis.
- Nurses must also include the cause—or related factors—of a patient’s problem. If possible, nursing care plans created based on these diagnoses should modify or remove the associated factors that cause the problem identified in the nursing diagnosis.
- As with any part of the nursing process, if a nursing diagnosis was not documented, it didn’t happen. Thankfully, with modern charting technology, most of the nursing diagnoses are now digitally created after you document your assessment, and they are automatically added to the plan of care.
What are NANDA’s diagnostic axes?
NANDA’s axes are the dimensions of the human response that are considered in the diagnostic process. These were updated in 2023 to further clarify terms and to synchronize with the ISO Norm 18104 model for nursing diagnosis.
NANDA recommends using these axes primarily in nursing informatics to have standardized terminology systems within electronic health records and apps and to develop clinical support tools.
Bedside nurses do not need to use NANDA’s diagnostic axes when caring for patients. However, these axes can support clinical decision-making, especially when nurses are faced with patient responses they don’t frequently see in practice.
These are the eight axes NANDA currently recommends considering as part of the diagnostic process.
Axis 1: The diagnostic focus
This axis describes the human response at the center of the nursing diagnosis; it is the root of the diagnostic concept.
The primary focus is the broad conceptual focus of the diagnosis or area of attention. It may include the following:
- Behavior
- Development
- Respiratory function
- Thermoregulatory function
The secondary focus relates to context or symptoms and may include the following:
- Allergy
- Communication
- Decision-making
- Health management
- Lactation
- Parenting
Axis 2: Subject of the diagnosis
The subject of the diagnosis refers to the person or persons the diagnosis is for. The subject may be any of the following:
- Individual: A single human being
- Caregiver: A family member or helper who provides regular care for a child or a sick, elderly, or disabled person
- Family: Two or more people related by blood or choice who have sustained relationships, perceive reciprocal obligations, sense common meaning, and share certain obligations toward others
- Group: Several people with shared characteristics
- Community: A group of people living in the same location under the same governance, such as the same neighborhood or city
Axis 3: Judgment
A nurse’s judgment is represented by a descriptor or modifier that specifies the meaning of the diagnostic focus. The nursing diagnosis is composed primarily of the diagnostic focus and the nurse’s judgment.
Here are examples of descriptors that represent a nurse’s judgment:
- Decreased
- Excessive
- Delayed
- Disrupted
- Inadequate
- Ineffective
- Impaired
- Maladaptive
- Imbalanced
- Unstable
- Prepared
Axis 4: Location
The location of the diagnosis refers to the parts of the body or their related functions: tissues, organs, anatomical sites, or structures. Examples include bladder, auditory, cerebral, etc.
Axis 5: Age
This axis refers to the age of the subject of the diagnosis demarcated by upper and lower age limits, notated in days or years:
- Age lower limit (1 day, 1 year, etc.)
- Age upper limit (28 days, 60 years, etc.)
Axis 6: Time
This axis describes the duration of the diagnostic concept (Axis 1). Nurses can describe time with the following terms:
- Acute: Lasting less than three months
- Chronic: Lasting more than three months
- Intermittent: Occurring at intervals, periodic, cyclic
- Continuous: Uninterrupted
Axis 7: Status of the diagnosis
The diagnosis status can also be called the categorization or type of nursing diagnosis:
- Problem-focused
- Potential to improve
- Potential to deteriorate
Axis 8: Situational constraint
This final and most recently added diagnostic axis refers to situational factors such as the occupational setting, perioperative period, or end-of-life condition.
How nurses apply the diagnostic axes
As mentioned, bedside nurses don’t need to address all eight axes as part of their diagnostic process. However, nurses typically do cover at least some of these axes in their diagnoses, whether implicitly or explicitly.
For example, in the diagnosis “compromised family coping,” the nurse explicitly identifies the subject and judgment.
On the contrary, in an “activity intolerance” diagnosis, the subject is implied to be an individual patient. Furthermore, in other cases, an axis may not be relevant and, therefore, not mentioned either implicitly or explicitly.
As mentioned, the nursing diagnosis requires the diagnostic focus and the nurse’s judgment. Occasionally, the diagnostic focus may contain the judgment, such as in a diagnosis of nausea. In this case, the judgment is implicit and, therefore, not explicitly stated in the label.
Nurses may include the other axes when they are relevant to or clarify the nursing diagnosis.
Are there other types of diagnoses in healthcare?
Besides physicians and nurses, other healthcare professionals also make diagnoses. Here are some examples:
- Physical therapists independently diagnose patients within the scope of physiotherapy.
- Speech-language pathologists diagnose speech, language, social communication, cognitive communication, and swallowing disorders.
- Psychologists diagnose mental health disorders.
- Dietitians assist in diagnosing illnesses like eating disorders.
In short, making diagnoses is a responsibility shared by many different healthcare professionals.
Therefore, interprofessional collaboration is essential to better understanding patients’ health conditions and needs.
Diagnosis as part of the nursing process
Diagnosis is just one step of the nursing process.
Regardless of a nurse’s work setting, their role revolves around implementing the five steps of the nursing process:
- Assessment: The first step of the nursing process is collecting and analyzing patient data, including physiological, psychological, sociocultural, lifestyle, economic, and spiritual information. Read more about the complete head-to-toe nursing assessment.
- Diagnosis: The next step of the process is making a diagnosis based on a clinical judgment of the patient’s medical condition. This diagnosis becomes the basis of the nursing care plan.
- Outcomes/planning: Based on the previous steps, nurses set goals for the patient and include them in the treatment plan in order to achieve the desired outcome.
- Implementation: In this step, nurses implement and document nursing interventions according to the care plan. This may include administering medications, educating the patient, monitoring vital signs, etc.
- Evaluation: Throughout the nursing process, nurses evaluate the patient’s status and the impact of the care they provide, which can lead to modifications in the care plan.
To improve nursing diagnoses, it is essential to raise awareness of nurses’ critical roles and responsibilities in the diagnostic process and enhance their knowledge and skills to fulfill those responsibilities effectively.
Other resources for nurses
Want to brush up on your nurse charting skills? You can explore other informative guides, learn about healthcare trends, and find useful tips in Nursa’s per diem nursing blog.
Here are just a few articles you may find interesting:
- How do nursing care models work?
- A close look at the top nursing trends of 2025
- Everything you need to know about nursing implications
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Sources:
- NANDA International, Inc.: What is Nursing Diagnosis - And Why Should I Care?
- NANDA International, Inc.: Glossary of Terms
- National Library of Medicine: Evidence That Nurses Need to Participate in Diagnosis: Lessons From Malpractice Claims
- National Library of Medicine: Use and Significance of Nursing Diagnosis in Hospital Emergencies: A Phenomenological Approach
- Nursing Fundamentals 2e: Appendix A: Sample NANDA-I Diagnoses
- Nursing Fundamentals 2e: 4.4 Diagnosis
- American Nurses Association: The Nursing Process
