Nursing Diagnosis: NANDA List, Types, and Examples

Definition: A nursing diagnosis is a clinical judgment about a human response, not a disease, and not a raw observation.
Scope: If nurses can't intervene autonomously to address it, it isn't a nursing diagnosis.
Structure: The current taxonomy holds 277 diagnoses across 13 domains and 48 classes.
13th edition changes: 56 new, 46 retired, 123 revised, and 98 relabeled diagnoses.
Practical rule: Document the labels your program or charting system uses, and map older labels to current ones with the table.

Is your patient experiencing excessive anxiety or excessive fear? What’s the difference?

Check the NANDA-I definitions. Hint: one is about a perceived threat, while the other is about an imminent one.

Writing a nursing diagnosis—or selecting it from a list in the electronic health record—is part of the nursing process and part of a nurse’s day-to-day responsibilities.

And who defines the nursing diagnoses in the first place?

NANDA-I.

So whether you’re a nursing student still learning the list or an experienced nurse trying to understand the latest updates, this guide covers NANDA’s official nursing diagnoses, the diagnostic axes, and what changed in the 13th edition.

What does NANDA stand for?

NANDA originally stood for the North American Nursing Diagnosis Association. The organization renamed itself NANDA International, Inc. in 2002 to reflect its membership beyond North America, and now uses NANDA-I as a name rather than an abbreviation. So the "full form" you'll still find in older textbooks is the historical name, not the current one.

NANDA-I provides a framework for nurses to identify and name patient responses using standardized nursing language. A shared language allows nurses to communicate effectively with other healthcare professionals about patients and follow the same method for identifying nursing diagnoses.

What is a nursing diagnosis?

According to NANDA-I, a nursing diagnosis is:

“...a clinical judgment concerning a human response to health conditions/life processes, or a susceptibility to that response, that is recognized in an individual, family, or community. A nursing diagnosis provides the basis for selection of nursing interventions to achieve outcomes for which the nurse has accountability.”

That definition was last amended in 2023. If your course materials say "vulnerability" rather than "susceptibility," or list "group" as a possible subject, they're quoting the earlier version; groups are now folded into the community category.

A diagnosis is not the same as an observation. "Peripheral edema" and "agitation" are things you noted; a diagnosis is what your clinical reasoning made of them.

Making an accurate diagnosis matters for 3 reasons:

A nursing diagnosis documents clinical judgment that no other discipline on the team is making, which is what gives nursing a distinct voice in the record.
The diagnosis determines what comes next, because the outcomes you set and the interventions you choose follow directly from the label and its related or risk factors.
Nurses are held legally accountable for their professional responsibilities and contributions to patient diagnoses.

Nursing diagnosis vs. medical diagnosis

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 assistants (PAs), and advanced practice registered nurses (APRNs) are responsible for making medical diagnoses, whereas registered nurses are responsible for nursing diagnoses.

Two patients with the same medical diagnosis—such as pneumonia, diabetes, or hypertension—can have different nursing diagnoses.

For example, a patient with a medical diagnosis of chronic obstructive pulmonary disease (COPD) may carry a nursing diagnosis such as impaired resilience or excessive anxiety—responses commonly observed among patients with this disease.

The 13th edition sharpened this boundary: if nurses can't autonomously intervene to help the patient, it isn't a nursing diagnosis.

4 types of nursing diagnosis

The type you write depends on what your assessment found: a problem the patient already has, a susceptibility to one they don't, a readiness to improve, or a cluster of diagnoses that travel together. Each type also determines which components the diagnosis carries and how you write the statement.

1. Problem-focused nursing diagnosis

A problem-focused nursing diagnosis relates to an undesirable human response to a health condition or life process, recognized in an individual, family, or community. To diagnose one, you need both defining characteristics that cluster in patterns of related cues and related factors. This is the "actual" nursing diagnosis type.

2. Health-promotion nursing diagnosis

A health-promotion nursing diagnosis concerns the motivation and desire to increase well-being and reach human health potential. This motivation may exist in an individual, family, or community, and applies to any health state. Nurses can make this type of diagnosis when patients express a desire to enhance their health.

Where a patient can't express their own readiness, the nurse may determine that a condition for health promotion exists and act on their behalf.

3. Risk nursing diagnosis

A risk nursing diagnosis refers to the susceptibility of an individual, family, or community to developing an undesirable human response to a health condition or life process in the future. Risk factors contributing to that susceptibility must be present for nurses to make this type of diagnosis. Every risk label in the classification begins with "risk for."

4. Syndrome

A syndrome relates to a specific cluster of nursing diagnoses that occur together and can be treated simultaneously through similar grouped nursing interventions. Nurses can make this type of diagnosis when 2 or more nursing diagnoses are present as defining characteristics.

Elder frailty syndrome is one example. Its defining characteristics include the nursing diagnoses of decreased activity tolerance and inadequate social connectedness, and fear of falling appears among its related factors.

Common nursing diagnoses

Some diagnoses are used more frequently than others. Therefore, nurses can start out by becoming familiar with the most common nursing diagnoses:

Acute pain
Chronic pain
Excessive anxiety
Decreased activity tolerance
Acute confusion
Risk for infection
Impaired gas exchange
Ineffective airway clearance
Ineffective breathing pattern
Impaired skin integrity
Impaired physical mobility
Risk for adult falls

Some of these were renamed in recent editions, so they may not match what you learned. The full list of changes appears below the domains.

NANDA nursing diagnosis list by domain

The current NANDA-approved classification contains 277 nursing diagnoses across 13 domains and 48 classes.

Note: The lists below are a representative selection by domain and class rather than the complete taxonomy—enough to show the structure and locate the diagnosis you're looking for.

Domain 1. Health promotion

Class	Example diagnoses
Health awareness	Excessive sedentary behaviors; decreased diversional activity engagement
Health management	Ineffective health self-management; ineffective health maintenance behaviors; elder frailty syndrome; inadequate health literacy

Domain 2. Nutrition

Class	Example diagnoses
Ingestion	Inadequate nutritional intake; readiness for enhanced nutritional intake; impaired swallowing
Metabolism	Neonatal hyperbilirubinemia
Hydration	Excessive fluid volume; inadequate fluid volume; risk for impaired water-electrolyte balance

Domain 3. Elimination and exchange

Class	Example diagnoses
Urinary function	Impaired urinary elimination; stress urinary incontinence; urge urinary incontinence; risk for urinary retention
Gastrointestinal function	Impaired intestinal elimination; chronic functional constipation; impaired fecal continence
Respiratory function	Impaired gas exchange

The integumentary function class currently contains no diagnoses.

Domain 4. Activity and rest

Class	Example diagnoses
Sleep/rest	Ineffective sleep pattern; ineffective sleep hygiene behaviors
Activity/exercise	Impaired physical mobility; impaired bed mobility; impaired walking ability; impaired transferring ability
Energy balance	Decreased activity tolerance; excessive fatigue burden; impaired surgical recovery
Cardiovascular/pulmonary responses	Ineffective breathing pattern; risk for decreased cardiac output; ineffective peripheral tissue perfusion
Self-care	Decreased self-care ability syndrome; decreased bathing abilities; decreased feeding abilities

Domain 5. Perception and cognition

Class	Example diagnoses
Cognition	Acute confusion; chronic confusion; inadequate health knowledge; impaired memory; impaired decision-making
Communication	Impaired verbal communication; readiness for enhanced verbal communication

Domain 6. Self-perception

Class	Example diagnoses
Self-concept	Disrupted personal identity; risk for impaired human dignity
Self-esteem	Chronic inadequate self-esteem; situational inadequate self-esteem; inadequate health self-efficacy
Body image	Disrupted body image

Domain 7. Role relationship

Class	Example diagnoses
Caregiving roles	Impaired parenting behaviors; excessive parental role conflict
Family relationships	Impaired family processes; disrupted family interaction patterns
Role performance	Impaired social interaction; ineffective role performance

Domain 8. Sexuality

Class	Example diagnoses
Sexual function	Impaired sexual function
Reproduction	Risk for impaired maternal-fetal dyad

The sexual identity class currently contains no diagnoses.

Domain 9. Coping and stress tolerance

Class	Example diagnoses
Post-trauma responses	Post-trauma syndrome; risk for disrupted immigration transition
Coping responses	Maladaptive coping; excessive anxiety; excessive fear; maladaptive grieving; impaired resilience; excessive caregiving burden
Neurobehavioral responses	Risk for autonomic dysreflexia; ineffective emotion regulation; impaired mood regulation

Domain 10. Life principles

Class	Example diagnoses
Value/belief/action congruence	Moral distress; impaired spiritual well-being; readiness for enhanced spiritual well-being; impaired religiosity

The values and beliefs classes currently contain no diagnoses.

Domain 11. Safety and protection

Class	Example diagnoses
Infection	Risk for infection; risk for surgical wound infection; impaired immune response
Physical injury	Risk for adult falls; risk for aspiration; ineffective airway clearance; impaired skin integrity; adult pressure injury; risk for excessive bleeding
Violence	Risk for other-directed violence; risk for suicidal self-injurious behavior
Environmental hazards	Contamination; risk for accidental poisoning; risk for occupational illness
Defensive processes	Risk for allergic reaction; risk for latex allergy reaction
Thermoregulation	Hyperthermia; decreased body temperature; ineffective thermoregulation

Domain 12. Comfort

Class	Example diagnoses
Physical comfort	Acute pain; chronic pain; labor pain; impaired physical comfort
Social comfort	Inadequate social connectedness; risk for excessive loneliness
Psychological comfort	Impaired psychological comfort; readiness for enhanced psychological comfort

Psychological comfort is new in this edition; it was added as class 4 to hold 2 comfort nursing diagnoses that didn't fit the existing 3 classes in this domain. Environmental comfort currently contains no diagnoses.

Domain 13. Growth and development

Class	Example diagnoses
Growth	Delayed child growth; risk for delayed child growth
Development	Delayed child development; impaired infant neurodevelopmental organization; ineffective infant suck-swallow response

‍

Several classes currently contain no diagnoses at all. NANDA-I treats this as an unresolved problem rather than a feature. Taxonomy II has been in use since 2002, and the editors note that it's hard to imagine what diagnoses would ever fill some of these classes, which makes those classes questionable as a representation of the discipline. A structural review of the taxonomy is planned for the next cycle, so some empty classes may not survive it.

What changed in NANDA’s 13th edition

The 13th edition made substantial changes: 56 new diagnoses, 46 retired, 123 revised, and 98 label changes.

If you learned nursing diagnoses before 2024, a meaningful share of what you memorized has been renamed or removed.

Retirements followed 5 rationales:

Research showed the old term was outdated or had been replaced in the nursing literature.
The diagnosis had no related factors or risk factors that nurses could modify through independent intervention.
The label needed a judgment term, so it was retired and rebuilt as a new diagnosis carrying one.
The label's content was absorbed into the diagnostic indicators of another diagnosis.
The concept didn't meet the definition of a nursing diagnosis at all.

Here are the retired labels most likely to appear in older study materials, including a few, such as activity intolerance and risk for falls, that were renamed in previous editions but still show up in many textbooks:

Older label	Current label
Anxiety/death anxiety/fear	Excessive anxiety/excessive death anxiety/excessive fear
Activity intolerance	Decreased activity tolerance
Fatigue	Excessive fatigue burden
Insomnia/disturbed sleep pattern/sleep deprivation	Ineffective sleep pattern
Deficient knowledge	Inadequate health knowledge
Imbalanced nutrition: less than body requirements	Inadequate nutritional intake
Excess/deficient fluid volume	Excessive/inadequate fluid volume
Bathing self-care deficit (and dressing, feeding, toileting)	Decreased bathing abilities (and dressing, feeding, toileting)
Caregiver role strain	Excessive caregiving burden
Ineffective coping	Maladaptive coping
Social isolation	Inadequate social connectedness
Chronic low self-esteem	Chronic inadequate self-esteem
Risk for falls	Risk for adult falls/risk for child falls
Risk for bleeding	Risk for excessive bleeding
Impaired comfort	Impaired physical comfort/impaired psychological comfort
Hopelessness/powerlessness	Impaired resilience; chronic inadequate self-esteem
Nausea/diarrhea/constipation	Reclassified as symptoms (nursing diagnoses are now ineffective nausea self-management, impaired intestinal elimination, impaired fecal continence; chronic functional constipation remains a separate diagnosis)

‍

Additional diagnoses were retired entirely, with no direct replacement: risk for disuse syndrome, unilateral neglect, impaired dentition, and decreased cardiac output (though risk for decreased cardiac output was retained).

If you're in a nursing program, follow the edition your course materials use—an instructor grading against the assigned textbook will mark a label that isn't in it. Working nurses usually don't get the choice: most electronic health records offer a fixed list of diagnoses to select from, and that list reflects whatever taxonomy the vendor last loaded, which often trails the current NANDA edition. Document the label your system offers, and use the list here to know what that term is called now.

What are NANDA's diagnostic axes?

NANDA's axes are the dimensions of the human response that are considered in the diagnostic process. They were revised for the 13th edition to clarify terms and align with the International Organization for Standardization (ISO) 18104 model.

Bedside nurses do not need to use NANDA's diagnostic axes when caring for patients—NANDA-I is explicit that the axis values aren't meant for memorization. They exist for informaticists building electronic health record structures, apps, and clinical decision support tools.

That said, these axes can support clinical decision-making, especially when nurses are faced with patient responses they don't frequently see in practice.

Axis	What it captures	Terms
1. Diagnostic focus	The human response at the center of the diagnosis	Primary focus, such as behavior, development, respiratory function; secondary focus, such as parenting, pain management, violence
2. Subject of care	The person or persons the diagnosis is for	Individual, family, community. Informal caregivers count as individuals; groups count as communities
3. Judgment	The descriptor that specifies the meaning of the diagnostic focus	Delayed, excessive, ineffective, impaired, decreased, disrupted, and maladaptive, among others
4. Anatomical site	Body systems and their related functions	Cardiopulmonary, cerebrovascular, gastrointestinal, genitourinary, integumentary, lymphatic, musculoskeletal, peripheral vascular, sensory nervous systems
5. Age	Age of the subject of care	No fixed terms (upper and lower limits in days or years)
6. Clinical course	Onset or duration of the diagnostic focus	Acute (under 3 months), chronic (3 months or more), intermittent
7. Status	The type of diagnosis	Problem-focused, potential to improve ("readiness for"), potential to deteriorate ("risk for")
8. Situational constraint	Settings or situational periods	Occupational setting, perioperative period, end-of-life

‍

Two changes worth noting if you're working from older materials: Axis 6 was previously called Time, and Axis 5 no longer has named age categories.

How nurses apply the diagnostic axes

Nurses typically cover at least some of these axes in their diagnoses, whether implicitly or explicitly. In maladaptive community coping, the subject and judgment are both stated in the label. In decreased activity tolerance, the subject is implied to be an individual patient—that's the default whenever the subject isn't named.

Include the other axes when they clarify the diagnosis you're documenting in your nursing notes.