Nursing Diagnoses Accepted for Use and Research (2015–2017)
 Activity Intolerance [specify level]
 Activity Intolerance, risk for
 Activity Planning, ineffective
 Activity Planning, risk for ineffective
 Adverse Reaction to Iodinated Contrast Media, risk for
 Airway Clearance, ineffective
 Allergy Response, risk for
 Anxiety [specify level]
 Aspiration, risk for
 Attachment, risk for impaired
 Autonomic Dysreflexia
 Autonomic Dysreflexia, risk for
 Behavior, disorganized infant
 Behavior, risk for disorganized infant
 Behavior, readiness for enhanced organized infant
 Bleeding, risk for
 Blood Glucose Level, risk for unstable
 Body Image, disturbed
 Body Temperature, risk for imbalanced
 Breast Milk, insufficient
 Breastfeeding, ineffective
 Breastfeeding, interrupted
 Breastfeeding, readiness for enhanced
 Breathing Pattern, ineffective
 Cardiac Output, decreased
 Caregiver Role Strain
 Caregiver Role Strain, risk for
 Cardiac Output, risk for decreased
 Cardiovascular Function, risk for impaired
 Childbearing Process, ineffective
 Childbearing Process, readiness for enhanced
 Childbearing Process, risk for ineffective
 Chronic Pain Syndrome
 Comfort, impaired
 Comfort, readiness for enhanced
 Communication, impaired verbal
 Communication, readiness for enhanced
 Confusion, acute
 Confusion, risk for acute
 Confusion, chronic
 Constipation
 Constipation, perceived
 Constipation, risk for
 Contamination
 Contamination, risk for
 Coping, compromised family
 Coping, defensive
 Coping, disabled family
 Coping, ineffective
 Coping, ineffective community
 Coping, readiness for enhanced
 Coping, readiness for enhanced community
 Coping, readiness for enhanced family
 Corneal Injury, risk for
 Death Anxiety
 Decision-Making, readiness for enhanced
 Decisional Conflict
 Delayed Surgical Recovery, risk for
 Denial, ineffective
 Dentition, impaired
 Development, risk for delayed
 Diarrhea
 Disuse Syndrome, risk for
 Diversional Activity, deficient
 Dry Eye, risk for
 Electrolyte Imbalance, risk for
 Emancipated Decision-Making, impaired
 Emancipated Decision-Making, readiness for
enhanced
 Emancipated Decision-Making, risk for impaired
 Emotional Control, labile
 Falls, risk for
 Family Processes, dysfunctional
 Family Processes, interrupted
 Family Processes, readiness for enhanced
 Fatigue
 Fear [specify focus]
 Feeding Pattern, ineffective infant
 Fluid Balance, readiness for enhanced
 Fluid Volume, deficient
 Fluid Volume, excess
 Fluid Volume, risk for deficient
 Fluid Volume, risk for imbalanced
 Frail Elderly Syndrome
 Frail Elderly Syndrome, risk for
 Functional Constipation, chronic
 Functional Constipation, chronic, risk for
 Gas Exchange, impaired
 Gastrointestinal Motility, dysfunctional
 Gastrointestinal Motility, risk for dysfunctional
 Gastrointestinal Perfusion, risk for ineffective
 Grieving
 Grieving, complicated
 Grieving, risk for complicated
 Growth, risk for disproportionate
 Health, deficient community
 Health Behavior, risk-prone
 Health Maintenance, ineffective
 Health Management, ineffective
 Health Management, ineffective family
 Health Management, readiness for enhanced
 Home Maintenance, impaired
 Hope, readiness for enhanced
 Hopelessness
 Human Dignity, risk for compromised
 Hyperthermia
 Hypothermia
 Hypothermia, risk for
 Impaired Oral Mucous Membrane, risk for
 Impaired Tissue Integrity, risk for
 Impulse Control, ineffective
 Incontinence, bowel
 Incontinence, functional urinary
 Incontinence, overflow urinary
 Incontinence, reflex urinary
 Incontinence, stress urinary
 Incontinence, urge urinary
 Incontinence, risk for urge urinary
 Infection, risk for
 Injury, risk for
 Insomnia
 Intracranial Adaptive Capacity, decreased
 Jaundice, neonatal
 Jaundice, risk for neonatal
 Knowledge, deficient [specify learning need]
 Knowledge [specify], readiness for enhanced
 Labor Pain
 Latex Allergy Response,
 Latex Allergy Response, risk for
 Lifestyle, sedentary
 Liver Function, risk for impairment
 Loneliness, risk for
 Maternal/Fetal Dyad, risk for disturbed
 Memory, impaired
 Mobility, impaired bed
 Mobility, impaired physical
 Mobility, impaired wheelchair
 Mood Regulation, impaired
 Moral Distress
 Nausea
 Noncompliance [ineffective Adherence] [specify]
 Nutrition: less than body requirements, imbalanced
 Nutrition, readiness for enhanced
 Obesity
 Oral Mucous Membrane, impaired
 Overweight
 Overweight, risk for
 Pain, acute
 Pain, chronic
 Parenting, impaired
 Parenting, readiness for enhanced
 Parenting, risk for impaired
 Perioperative Hypothermia, risk for
 Perioperative Positioning Injury, risk for
 Peripheral Neurovascular Dysfunction, risk for
 Personal Identity, disturbed
 Personal Identity, risk for disturbed
 Physical Mobility, impaired
 Poisoning, risk for
 Post-Trauma Syndrome [specify stage]
 Post-Trauma Syndrome, risk for
 Power, readiness for enhanced
 Powerlessness [specify level]
 Powerlessness, risk for
 Pressure Ulcer, risk for
 Protection, ineffective
 Rape-Trauma Syndrome
 Relationship, ineffective
 Relationship, readiness for enhanced
 Relationship, risk for ineffective
 Religiosity, impaired
 Religiosity, readiness for enhanced
 Religiosity, risk for impaired
 Relocation Stress Syndrome
 Relocation Stress Syndrome, risk for
 Renal Perfusion, risk for ineffective
 Resilience, impaired
 Resilience, readiness for enhanced
 Resilience, risk for impaired
 Role Conflict, parental
 Role Performance, ineffective
 Self-Care, readiness for enhanced
 Self-Care Deficit, bathing
 Self-Care Deficit, dressing
 Self-Care Deficit, feeding
 Self-Care Deficit, toileting
 Self-Concept, readiness for enhanced
 Self-Esteem, chronic low
 Self-Esteem, risk for chronic low
 Self-Esteem, risk for situational low
 Self-Esteem, situational low
 Self-Mutilation
 Self-Mutilation, risk for
 Self-Neglect
 Sexual Dysfunction
 Sexuality Pattern, ineffective
 Shock, risk for
 Sitting, impaired
 Skin Integrity, impaired
 Skin Integrity, risk for impaired
 Sleep Deprivation
 Sleep Pattern, disturbed
 Sleep, readiness for enhanced
 Social Interaction, impaired
 Social Isolation
 Sorrow, chronic
 Spiritual Distress
 Spiritual Distress, risk for
 Spiritual Well-Being, readiness for enhanced
 Standing, impaired
 Stress Overload
 Sudden Infant Death Syndrome, risk for
 Suffocation, risk for
 Suicide, risk for
 Surgical Recovery, delayed
 Swallowing, impaired
 Thermal Injury, risk for
 Thermoregulation, ineffective
 Tissue Integrity, impaired
 Tissue Perfusion, ineffective peripheral
 Tissue Perfusion, risk for decreased cardiac
 Tissue Perfusion, risk for ineffective cerebral
 Tissue Perfusion, risk for ineffective peripheral
 Transfer Ability, impaired
 Trauma, risk for
 Unilateral Neglect
 Urinary Elimination, impaired
 Urinary Elimination, readiness for enhanced
 Urinary Retention [acute/chronic]
 Urinary Tract Injury, risk for
 Vascular Trauma, risk for
 Ventilation, impaired spontaneous
 Ventilatory Weaning Response, dysfunctional
 Violence, [actual/] risk for other-directed
 Violence, [actual/] risk for self-directed
 Walking, impaired
 Wandering [specify sporadic or continuous]
 Knock-wash hands-introduce self-provide privacy-raise
the bed
ID patient (2 identifiers: name and DOB) Allergies
MSE: LOC, Ox3, speech (quality, quantity, congruence)
VS—Pain (when, where, how long, what helps?)
Sensory: numbness, tingling, burning
Location/duration
Eyes (lids, pupils, EOM, sclera) Nose (inspect) Ears
(inspect) Skin intact?
Mouth (tongue, teeth, mucous membrane color &
moisture)
Throat/neck: swallowing; lymph node chains
Anterior thorax: shape heart sounds (S1 & S2, apical
heart rate, apical impulse), lung sounds (6 on front, 2
each side), breathing pattern, accessory muscle use
Wounds, lesions, drains, tubes? SOB, cough, mucous
production, treatments
Abdomen: ( look, listen, feel) Shape, symmetry,
pulsations, BS x 4 quads, light palpation
Wounds, lesions, drains, tubes? Nausea, vomiting,
constipation, diarrhea, treatments
Posterior thorax: excursion, symmetry Lung sounds (8
on back)
Wounds, lesions, drains, tubes, pressure points
(scapula, spinal processes, sacrum)
Upper ext: pulses, edema, turgor, cap refill, pressure
points, grips and pushes
Wounds, lesions, drains, tubes?
Genitals: femoral pulses Urinating? Last BM? Pain,
penile/vaginal drainage, I/O
Wounds, lesions, drains, tubes?
Lower extremities: pulses (popliteal, post tib, dorsalis
pedis), edema (how deep & how high) feet: cap refill,
push, flex, homan’s sign
Wounds, lesions, drains, tubes, treatments?
Is there anything I can do for you before leaving? Is
there anything I can bring you when I return?
SEE the SCENE: Check every tube, every attachment.
O2, IV, drains. Bed down, rails up. Call bell. Personal
belongings. Phone. TV. State when returning.
6. Young Adulthood: 18 to 35
Ego Development Outcome: Intimacy and
Solidarity vs. Isolation
Basic Strengths: Affiliation and Love
In the initial stage of being an adult we seek one or
more companions and love. As we try to find mutually personal, social and consultative, and public. Rules
satisfying relationships, primarily through marriage
and friends, we generally also begin to start a family, culture. Territoriality refers to feelings or an attitude
though this age has been pushed back for many
couples who today don't start their families until their own territorial behavior. Feelings of territoriality or
late thirties. If negotiating this stage is successful, we violation of the client’s personal and intimate space
can experience intimacy on a deep level.
If we're not successful, isolation and distance from
others may occur. And when we don't find it easy to
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
Our significant relationships are with marital partners
and friends.
7. Middle Adulthood: 35 to 55 or 65
Ego Development Outcome: Generativity vs. Self
absorption or Stagnation
Basic Strengths: Production and Care
Now work is most crucial. Erikson observed that
middle-age is when we tend to be occupied with
creative and meaningful work and with issues
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.
The significant task is to perpetuate culture and
transmit values of the culture through the family
(taming the kids) and working to establish a stable
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
betterment of society, which Erikson calls generativity,
so when we're in this stage we often fear inactivity
and meaninglessness.
As our children leave home, or our relationships or Biological variations, especially genetic variations,
goals change, we may be faced with major life exist between individuals in different racial groups. It
changes — the mid-life crisis — and struggle with is a well-known fact that people differ culturally. Less
finding new meanings and purposes. If we don't get recognized and understood are the biological
through this stage successfully, we can become self- differences that exist among people in various racial
absorbed and stagnate. groups. Although there is as much diversity within
Significant relationships are within the workplace,
cultural and racial groups as there is across and
the community and the family.
among cultural and racial groups, knowledge of
general baseline data relative to the specific cultural
8. Late Adulthood: 55 or 65 to Death
Ego Development Outcome: Integrity vs. Despair group is an excellent starting point to provide
Basic Strengths: Wisdom culturally appropriate care. There is some evidence
Erikson felt that much of life is preparing for the suggesting that different races metabolize drugs in
middle adulthood stage and the last stage is different ways and at different rates (Echizen, Horari,
recovering from it. Perhaps that is because as older & Ishizaki, 1989). For example, Chinese people are
adults we can often look back on our lives with more sensitive to the cardiovascular effects of
happiness and are content, feeling fulfilled with a Propranolol than are White people. Primaquine is
deep sense that life has meaning and we've made a metabolized by oxidation and is used in the treatment
contribution to life, a feeling Erikson calls integrity. of malaria. Although Primaquine is given to individuals
Our strength comes from a wisdom that the world is who lack the enzymes necessary for glucose
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
red blood cells occurs. Approximately 100 million
of life.
On the other hand, some adults may reach this people in the world are affected by this particular
stage and despair at their experiences and enzyme deficiency and thus are unable to ingest
perceived failures. They may fear death as they Primaquine. Approximately 35% of African Americans
struggle to find a purpose to their lives, wondering have this particular enzyme deficiency.
"Was the trip worth it?" Alternatively, they may feel Antihypertensives are another category of drugs that
they have all the answers (not unlike going back to are metabolized differently depending on race. For
adolescence) and end with a strong dogmatism that example, African Americans tend to need higher
only their view has been correct. doses of beta-adrenergic blocking agents such as
The significant relationship is with all of mankind — Inderal. Chinese men tend to need only about half as
"my-kind.” much Inderal as compared to White American males.
One category of differences between racial groups is
susceptibility to disease. The increased or decreased
incidence may be genetically, environmentally, or
Communication embraces the entire world of
human interaction and behavior. Communication is gene-environmentally induced. American Indians
have a tuberculosis incidence that is 7 to 15 times
the means by which culture is transmitted and
that of non-Indians. African Americans have a
preserved. Both verbal and nonverbal
communication are learned in one’s culture. tuberculosis incidence three times that of White
Americans. Urban American Jews have been the
Communication often presents the most significant
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
result of the increased incidence of tuberculosis
Space refers to the distance between individuals
among ethnic minorities affected with HIV (Centers for
when they interact. All communication occurs in the
Disease Control, 1998). Diabetes is quite rare among
context of space. According to Hall (1966), there are
four distinct zones of interpersonal space: intimate, American Eskimos. Diabetes has a high incidence
within certain American Indian tribes, including the
concerning personal distance vary from culture to Seminole, Pima, and Papago. NIDDM, or Type 2
diabetes, is a major health problem for Native
toward one’s personal area. Each person has their American Indians, occurring as early as the teens or
early twenties. Age-specific death rates for diabetes
appear to be 2.6 higher for Native Americans between
can cause discomfort and may result in a client’s 25 and 54 years of age, compared with the rest of the
refusing treatment or not returning for further care. general population. The incidence of hypertension is
higher in African Americans than Whites. The onset
hypertension is more severe and associated with the
higher mortality in African Americans. It is important to
group. Family structure and organization, religious
values and beliefs, and role assignments may all remember that susceptibility to disease may also be
relate to ethnicity and culture. environmental or a combination of both genetic and
environmental factors.
Time is an important aspect of interpersonal
communication. Cultural groups can be past, present,
or future oriented. Preventive health care requires
some future time orientation because preventive
actions are motivated by a future reward.
person to control nature and to plan and direct factors
in the environment that affect them. Many Americans
believe they control nature to meet their needs and
thus are more likely to seek health care when needed.
is less belief in internal control and more in external
control, there may be a fatalistic view in which
seeking health care is viewed as useless.