Nursing Diagnosis vs. other types of Diagnoses

In the continuum of care, there exist other diagnoses other than nursing diagnoses. Understanding the difference between these types of diagnosis is vital so that you don't confuse one for the other. A nursing diagnosis is an evidence-based mechanism nurses use to communicate their professional judgments of patients' problems and issues to fellow nursing professionals, healthcare practitioners, the public, patients, and other healthcare stakeholders. Nurses use it as a label to assign meaning to the patient data collected during the assessment phase. Let's look at medical and collaborative diagnoses to make things clear. Unlike a nursing diagnosis, a medical diagnosis is made by a doctor or an advanced healthcare practitioner. The main focus of such a diagnosis is on the patient's medical condition, pathological state, and disease. A medical diagnosis can be informed by a nursing diagnosis, not the other way. A medical diagnosis remains part of a patient's medical history and cannot be altered. Medical diagnoses include jaundice, Type II diabetes mellitus, congestive heart failure, heart attack, diabetes insipidus, meningitis, scoliosis, and stroke. A third type of diagnosis is collaborative diagnosis, which combines nursing and medical interventions. It is based on working together as part of an interprofessional healthcare team. The nurses can focus on the health problems, whereas the medical practitioners prescribe drugs and order more diagnostic tests to exhaustively address the patient's healthcare needs. A good example is respiratory failure or inefficiency, where doctors and nurses collaborate through different interventions to stabilize the patient's condition. Related: SOAP notes writing guide for nursing students

Classification of Nursing Diagnosis

Nursing diagnosis has evolved through the years. To track nursing diagnoses, there is a need to follow specific conventions. The NANDA-I has a list, arrangement, and classification of the nursing diagnosis in a register referred to as the Taxonomy II, which has been used for over two decades. Taxonomy Ii has three levels:

13 domains
47 classes
267 nursing diagnoses

Let's have an overview of each because they are instrumental in formulating a diagnosis when writing a nursing care plan for the patient. Taxonomy II is approved in collaboration with the National Library of Medicine (NMLM), considering the healthcare terminology codes. It is also based on the Functional Health Patterns assessment framework Dr. Mary Joy Gordon developed. It also complies with the Internal Standards Organization (ISO) terminology model for a nursing diagnosis. The terminology is also registered with the Health Level Seven International (HL7), an international healthcare informatics standard that helps identify nursing diagnoses in specific electronic messages among different clinical information systems. There are currently 13 domains and 47 classes: Domain 1 - Health Promotion

Class 1: Health Awareness
Class 2: Health Management

Domain 2 - Nutrition

Class 1: Ingestion
Class 2: Digestion
Class 3: Absorption
Class 4: Metabolism
Class 5: Hydration

Domain 3 - Elimination/Exchange

Class 1: Urinary Function
Class 2: Gastrointestinal Function
Class 3: Integumentary Function
Class 4: Respiratory Function

Domain 4 - Activity/Rest

Class 1: Sleep/Rest
Class 2: Activity/Exercise
Class 3: Energy Balance
Class 4: Cardiovascular-Pulmonary Responses
Class 5: Self-Care

Domain 5 - Perception/Cognition

Class 1: Attention
Class 2: Orientation
Class 3: Sensation/Perception
Class 4: Cognition
Class 5: Communication

Domain 6 - Self-Perception

Class 1: Self-concept
Class 2: Self-esteem
Class 3: Body image

Domain 7 - Role Relationship

Class 1: Caregiving Roles
Class 2: Family Relationships
Class 3: Role Performance

Domain 8 - Sexuality

Class 1: Sexual Identity
Class 2: Sexual Function
Class 3: Reproduction

Domain 9 - Coping/Stress Tolerance

Class 1: Post-trauma Responses
Class 2: Coping Response
Class 3: Neuro-Behavioral Stress

Domain 10 - Life Principles

Class 1: Values
Class 2: Beliefs
Class 3: Value/Belief Action Congruence

Domain 11 - Safety/Protection

Class 1: Infection
Class 2: Physical Injury
Class 3: Violence
Class 4: Environmental Hazards
Class 5: Defensive Processes
Class 6: Thermoregulation

Domain 12 - Comfort

Class 1: Physical Comfort
Class 2: Environmental Comfort
Class 3: Social Comfort

Domain 13 - Growth/Development

Class 1: Growth
Class 2: Development

Here is a list of potential nursing diagnoses examples that you can consider as you formulate a nursing care plan:

Risk for injury
Risk for electrolyte imbalance
Fatigue
Shortness of breath (apnea)
Deficient knowledge
Decreased cardiac output
Risk for surgical site infection
Deficient fluid volume
Acute pain
Ineffective coping
Ineffective breathing programs
Ineffective thermoregulation
Risk for inefficient childbearing process
Impaired physical mobility
Ineffective airway clearance
Impaired comfort
Disturbed body image
Risk for vascular trauma
Risk for neonatal hypothermia
Risk for obesity
Risk for kidney failure
Risk for kidney stones
Risk for depression

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Nursing Diagnosis vs. other types of Diagnoses