Nursing Diagnoses Accepted for Use and Research (2015–2017)

 Activity Intolerance [specify level]  Fluid Volume, risk for imbalanced  Pressure Ulcer, risk for
 Activity Intolerance, risk for  Frail Elderly Syndrome  Protection, ineffective
 Activity Planning, ineffective  Frail Elderly Syndrome, risk for  Rape-Trauma Syndrome
 Activity Planning, risk for ineffective  Functional Constipation, chronic  Relationship, ineffective
 Adverse Reaction to Iodinated Contrast Media, risk for  Functional Constipation, chronic, risk for  Relationship, readiness for enhanced
 Airway Clearance, ineffective  Gas Exchange, impaired  Relationship, risk for ineffective
 Allergy Response, risk for  Gastrointestinal Motility, dysfunctional  Religiosity, impaired
 Anxiety [specify level]  Gastrointestinal Motility, risk for dysfunctional  Religiosity, readiness for enhanced
 Aspiration, risk for  Gastrointestinal Perfusion, risk for ineffective  Religiosity, risk for impaired
 Attachment, risk for impaired  Grieving  Relocation Stress Syndrome
 Autonomic Dysreflexia  Grieving, complicated  Relocation Stress Syndrome, risk for
 Autonomic Dysreflexia, risk for  Grieving, risk for complicated  Renal Perfusion, risk for ineffective
 Behavior, disorganized infant  Growth, risk for disproportionate  Resilience, impaired
 Behavior, risk for disorganized infant  Health, deficient community  Resilience, readiness for enhanced
 Behavior, readiness for enhanced organized infant  Health Behavior, risk-prone  Resilience, risk for impaired
 Bleeding, risk for  Health Maintenance, ineffective  Role Conflict, parental
 Blood Glucose Level, risk for unstable  Health Management, ineffective  Role Performance, ineffective
 Body Image, disturbed  Health Management, ineffective family  Self-Care, readiness for enhanced
 Body Temperature, risk for imbalanced  Health Management, readiness for enhanced  Self-Care Deficit, bathing
 Breast Milk, insufficient  Home Maintenance, impaired  Self-Care Deficit, dressing
 Breastfeeding, ineffective  Hope, readiness for enhanced  Self-Care Deficit, feeding
 Breastfeeding, interrupted  Hopelessness  Self-Care Deficit, toileting
 Breastfeeding, readiness for enhanced  Human Dignity, risk for compromised  Self-Concept, readiness for enhanced
 Breathing Pattern, ineffective  Hyperthermia  Self-Esteem, chronic low
 Cardiac Output, decreased  Hypothermia  Self-Esteem, risk for chronic low
 Caregiver Role Strain  Hypothermia, risk for  Self-Esteem, risk for situational low
 Caregiver Role Strain, risk for  Impaired Oral Mucous Membrane, risk for  Self-Esteem, situational low
 Cardiac Output, risk for decreased  Impaired Tissue Integrity, risk for  Self-Mutilation
 Cardiovascular Function, risk for impaired  Impulse Control, ineffective  Self-Mutilation, risk for
 Childbearing Process, ineffective  Incontinence, bowel  Self-Neglect
 Childbearing Process, readiness for enhanced  Incontinence, functional urinary  Sexual Dysfunction
 Childbearing Process, risk for ineffective  Incontinence, overflow urinary  Sexuality Pattern, ineffective
 Chronic Pain Syndrome  Incontinence, reflex urinary  Shock, risk for
 Comfort, impaired  Incontinence, stress urinary  Sitting, impaired
 Comfort, readiness for enhanced  Incontinence, urge urinary  Skin Integrity, impaired
 Communication, impaired verbal  Incontinence, risk for urge urinary  Skin Integrity, risk for impaired
 Communication, readiness for enhanced  Infection, risk for  Sleep Deprivation
 Confusion, acute  Injury, risk for  Sleep Pattern, disturbed
 Confusion, risk for acute  Insomnia  Sleep, readiness for enhanced
 Confusion, chronic  Intracranial Adaptive Capacity, decreased  Social Interaction, impaired
 Constipation  Jaundice, neonatal  Social Isolation
 Constipation, perceived  Jaundice, risk for neonatal  Sorrow, chronic
 Constipation, risk for  Knowledge, deficient [specify learning need]  Spiritual Distress
 Contamination  Knowledge [specify], readiness for enhanced  Spiritual Distress, risk for
 Contamination, risk for  Labor Pain  Spiritual Well-Being, readiness for enhanced
 Coping, compromised family  Latex Allergy Response,  Standing, impaired
 Coping, defensive  Latex Allergy Response, risk for  Stress Overload
 Coping, disabled family  Lifestyle, sedentary  Sudden Infant Death Syndrome, risk for
 Coping, ineffective  Liver Function, risk for impairment  Suffocation, risk for
 Coping, ineffective community  Loneliness, risk for  Suicide, risk for
 Coping, readiness for enhanced  Maternal/Fetal Dyad, risk for disturbed  Surgical Recovery, delayed
 Coping, readiness for enhanced community  Memory, impaired  Swallowing, impaired
 Coping, readiness for enhanced family  Mobility, impaired bed  Thermal Injury, risk for
 Corneal Injury, risk for  Mobility, impaired physical  Thermoregulation, ineffective
 Death Anxiety  Mobility, impaired wheelchair  Tissue Integrity, impaired
 Decision-Making, readiness for enhanced  Mood Regulation, impaired  Tissue Perfusion, ineffective peripheral
 Decisional Conflict  Moral Distress  Tissue Perfusion, risk for decreased cardiac
 Delayed Surgical Recovery, risk for  Nausea  Tissue Perfusion, risk for ineffective cerebral
 Denial, ineffective  Noncompliance [ineffective Adherence] [specify]  Tissue Perfusion, risk for ineffective peripheral
 Dentition, impaired  Nutrition: less than body requirements, imbalanced  Transfer Ability, impaired
 Development, risk for delayed  Nutrition, readiness for enhanced  Trauma, risk for
 Diarrhea  Obesity  Unilateral Neglect
 Disuse Syndrome, risk for  Oral Mucous Membrane, impaired  Urinary Elimination, impaired
 Diversional Activity, deficient  Overweight  Urinary Elimination, readiness for enhanced
 Dry Eye, risk for  Overweight, risk for  Urinary Retention [acute/chronic]
 Electrolyte Imbalance, risk for  Pain, acute  Urinary Tract Injury, risk for
 Emancipated Decision-Making, impaired  Pain, chronic  Vascular Trauma, risk for
 Emancipated Decision-Making, readiness for  Parenting, impaired  Ventilation, impaired spontaneous
enhanced  Parenting, readiness for enhanced  Ventilatory Weaning Response, dysfunctional
 Emancipated Decision-Making, risk for impaired  Parenting, risk for impaired  Violence, [actual/] risk for other-directed
 Emotional Control, labile  Perioperative Hypothermia, risk for  Violence, [actual/] risk for self-directed
 Falls, risk for  Perioperative Positioning Injury, risk for  Walking, impaired
 Family Processes, dysfunctional  Peripheral Neurovascular Dysfunction, risk for  Wandering [specify sporadic or continuous]
 Family Processes, interrupted  Personal Identity, disturbed
 Family Processes, readiness for enhanced  Personal Identity, risk for disturbed
 Fatigue  Physical Mobility, impaired
 Fear [specify focus]  Poisoning, risk for
 Feeding Pattern, ineffective infant  Post-Trauma Syndrome [specify stage]
 Fluid Balance, readiness for enhanced  Post-Trauma Syndrome, risk for
 Fluid Volume, deficient  Power, readiness for enhanced
 Fluid Volume, excess  Powerlessness [specify level]
 Fluid Volume, risk for deficient  Powerlessness, risk for
 Knock-wash hands-introduce self-provide privacy-raise As our children leave home, or our relationships or Biological variations, especially genetic variations,
the bed goals change, we may be faced with major life exist between individuals in different racial groups. It
ID patient (2 identifiers: name and DOB) Allergies changes — the mid-life crisis — and struggle with is a well-known fact that people differ culturally. Less
MSE: LOC, Ox3, speech (quality, quantity, congruence) finding new meanings and purposes. If we don't get recognized and understood are the biological
VS—Pain (when, where, how long, what helps?) through this stage successfully, we can become self- differences that exist among people in various racial
Sensory: numbness, tingling, burning absorbed and stagnate. groups. Although there is as much diversity within
Location/duration Significant relationships are within the workplace,
cultural and racial groups as there is across and
the community and the family.
Eyes (lids, pupils, EOM, sclera) Nose (inspect) Ears among cultural and racial groups, knowledge of
(inspect) Skin intact? general baseline data relative to the specific cultural
8. Late Adulthood: 55 or 65 to Death
Mouth (tongue, teeth, mucous membrane color & Ego Development Outcome: Integrity vs. Despair group is an excellent starting point to provide
moisture) Basic Strengths: Wisdom culturally appropriate care. There is some evidence
Throat/neck: swallowing; lymph node chains Erikson felt that much of life is preparing for the suggesting that different races metabolize drugs in
Anterior thorax: shape heart sounds (S1 & S2, apical middle adulthood stage and the last stage is different ways and at different rates (Echizen, Horari,
heart rate, apical impulse), lung sounds (6 on front, 2 recovering from it. Perhaps that is because as older & Ishizaki, 1989). For example, Chinese people are
each side), breathing pattern, accessory muscle use adults we can often look back on our lives with more sensitive to the cardiovascular effects of
Wounds, lesions, drains, tubes? SOB, cough, mucous happiness and are content, feeling fulfilled with a Propranolol than are White people. Primaquine is
production, treatments deep sense that life has meaning and we've made a metabolized by oxidation and is used in the treatment
Abdomen: ( look, listen, feel) Shape, symmetry, contribution to life, a feeling Erikson calls integrity. of malaria. Although Primaquine is given to individuals
pulsations, BS x 4 quads, light palpation Our strength comes from a wisdom that the world is who lack the enzymes necessary for glucose
Wounds, lesions, drains, tubes? Nausea, vomiting, very large and we now have a detached concern for
metabolism or the red blood cells, hemolysis of the
the whole of life, accepting death as the completion
constipation, diarrhea, treatments red blood cells occurs. Approximately 100 million
of life.
Posterior thorax: excursion, symmetry Lung sounds (8 On the other hand, some adults may reach this people in the world are affected by this particular
on back) stage and despair at their experiences and enzyme deficiency and thus are unable to ingest
Wounds, lesions, drains, tubes, pressure points perceived failures. They may fear death as they Primaquine. Approximately 35% of African Americans
(scapula, spinal processes, sacrum) struggle to find a purpose to their lives, wondering have this particular enzyme deficiency.
Upper ext: pulses, edema, turgor, cap refill, pressure "Was the trip worth it?" Alternatively, they may feel Antihypertensives are another category of drugs that
points, grips and pushes they have all the answers (not unlike going back to are metabolized differently depending on race. For
Wounds, lesions, drains, tubes? adolescence) and end with a strong dogmatism that example, African Americans tend to need higher
Genitals: femoral pulses Urinating? Last BM? Pain, only their view has been correct. doses of beta-adrenergic blocking agents such as
penile/vaginal drainage, I/O The significant relationship is with all of mankind — Inderal. Chinese men tend to need only about half as
Wounds, lesions, drains, tubes? "my-kind.” much Inderal as compared to White American males.
Lower extremities: pulses (popliteal, post tib, dorsalis One category of differences between racial groups is
pedis), edema (how deep & how high) feet: cap refill, susceptibility to disease. The increased or decreased
push, flex, homan’s sign incidence may be genetically, environmentally, or
Communication embraces the entire world of
Wounds, lesions, drains, tubes, treatments?
human interaction and behavior. Communication is gene-environmentally induced. American Indians
Is there anything I can do for you before leaving? Is have a tuberculosis incidence that is 7 to 15 times
the means by which culture is transmitted and
there anything I can bring you when I return? that of non-Indians. African Americans have a
preserved. Both verbal and nonverbal
SEE the SCENE: Check every tube, every attachment. communication are learned in one’s culture. tuberculosis incidence three times that of White
O2, IV, drains. Bed down, rails up. Call bell. Personal Americans. Urban American Jews have been the
Communication often presents the most significant
belongings. Phone. TV. State when returning.
problem in working with clients from diverse cultural most resistant to tuberculosis. Ethnic minorities now
backgrounds. account for more than two thirds of all the reported
cases of tuberculosis in the United States, partly as a
6. Young Adulthood: 18 to 35 result of the increased incidence of tuberculosis
Space refers to the distance between individuals
Ego Development Outcome: Intimacy and among ethnic minorities affected with HIV (Centers for
when they interact. All communication occurs in the
Solidarity vs. Isolation Disease Control, 1998). Diabetes is quite rare among
Basic Strengths: Affiliation and Love context of space. According to Hall (1966), there are
four distinct zones of interpersonal space: intimate, American Eskimos. Diabetes has a high incidence
In the initial stage of being an adult we seek one or
within certain American Indian tribes, including the
more companions and love. As we try to find mutually personal, social and consultative, and public. Rules
satisfying relationships, primarily through marriage concerning personal distance vary from culture to Seminole, Pima, and Papago. NIDDM, or Type 2
and friends, we generally also begin to start a family, culture. Territoriality refers to feelings or an attitude diabetes, is a major health problem for Native
though this age has been pushed back for many toward one’s personal area. Each person has their American Indians, occurring as early as the teens or
couples who today don't start their families until their own territorial behavior. Feelings of territoriality or early twenties. Age-specific death rates for diabetes
late thirties. If negotiating this stage is successful, we violation of the client’s personal and intimate space appear to be 2.6 higher for Native Americans between
can experience intimacy on a deep level. can cause discomfort and may result in a client’s 25 and 54 years of age, compared with the rest of the
If we're not successful, isolation and distance from refusing treatment or not returning for further care. general population. The incidence of hypertension is
others may occur. And when we don't find it easy to higher in African Americans than Whites. The onset
create satisfying relationships, our world can begin to Social organization refers to the manner in which a by age is earlier in African Americans, and the
shrink as, in defense, we can feel superior to others. cultural group organizes itself around the family hypertension is more severe and associated with the
Our significant relationships are with marital partners higher mortality in African Americans. It is important to
group. Family structure and organization, religious
and friends.
values and beliefs, and role assignments may all remember that susceptibility to disease may also be
7. Middle Adulthood: 35 to 55 or 65 relate to ethnicity and culture. environmental or a combination of both genetic and
Ego Development Outcome: Generativity vs. Self environmental factors.
absorption or Stagnation Time is an important aspect of interpersonal
Basic Strengths: Production and Care communication. Cultural groups can be past, present,
Now work is most crucial. Erikson observed that or future oriented. Preventive health care requires
middle-age is when we tend to be occupied with some future time orientation because preventive
creative and meaningful work and with issues actions are motivated by a future reward.
surrounding our family. Also, middle adulthood is
when we can expect to "be in charge," the role we've Environmental control refers to the ability of the
longer envied. person to control nature and to plan and direct factors
The significant task is to perpetuate culture and in the environment that affect them. Many Americans
transmit values of the culture through the family believe they control nature to meet their needs and
(taming the kids) and working to establish a stable thus are more likely to seek health care when needed.
environment. Strength comes through care of others If persons come from a cultural group in which there
and production of something that contributes to the
is less belief in internal control and more in external
betterment of society, which Erikson calls generativity,
control, there may be a fatalistic view in which
so when we're in this stage we often fear inactivity
and meaninglessness. seeking health care is viewed as useless.