NANDA International Nursing Diagnosis List (20182020)

Introduction

The NANDA International (NANDAI) classification provides a standardized language for nursing diagnosis. The 20182020 edition introduced several new diagnoses, merged some older ones, and refined definitions to reflect current evidencebased practice. This page summarizes the major categories, highlights the most frequently used diagnoses, and explains how the list is organized.

How the List Is Structured

NANDAI diagnoses are grouped into 13 domains, each representing a broad area of patient response to healthrelated conditions. Within each domain are classes that further narrow the focus, and finally individual diagnoses that describe specific problems. The 20182020 edition contains 244 distinct diagnoses.

Key changes from previous editions include:

• 13 new diagnoses added (e.g., Risk for infectionrelated aggression, Impaired social interaction).
• Four diagnoses eliminated or merged for redundancy.
• Updated definitions for 27 diagnoses to improve clinical clarity.
• Recategorization of several diagnoses to more appropriate domains.

Domains and Representative Diagnoses (20182020)

Frequently Cited Diagnoses (20182020)

While the full list includes many specialized diagnoses, a core set appears consistently in clinical documentation, research, and education.

1. Pain

Definition: An unpleasant sensory and emotional experience associated with actual or potential tissue damage.

Subdiagnoses (e.g., acute, chronic, postoperative) enable precise care planning.

2. Risk for Falls

Identifies patients who have an increased probability of falling due to intrinsic (e.g., muscle weakness) or extrinsic (e.g., environmental hazards) factors.

3. Ineffective Airway Clearance

Occurs when a patient is unable to clear secretions orobstructive material from the respiratory tract.

4. Impaired Skin Integrity

Describes any alteration in epidermal or dermal layer continuity, ranging from pressure ulcers to surgical wounds.

5. Anxiety

A vague feeling of apprehension resulting from a perceived threat that interferes with normal function.

6. Risk for Infection

Encompasses factors that increase susceptibility to bacterial, viral, or fungal invasion.

7. Impaired Mobility

Shows limitation in independent, purposeful physical movement.

8. Deficient Knowledge

Insufficient information needed to understand or comply with care instructions.

9. Disturbed Body Image

Discrepancy between perceived self and actual physical appearance, common after surgery or illness.

10. Powerlessness

Feelings of lack of control over ones circumstances, frequently noted in chronic disease.

New Diagnoses Introduced in 20182020

The following diagnoses were added to reflect emerging health trends and research:

• Risk for infectionrelated aggression anticipates aggressive behavior triggered by infection, especially in elderly or cognitively impaired patients.
• Impaired social interaction describes difficulty establishing or maintaining relationships, distinct from broader psychosocial diagnoses.
• Risk for compromised family coping recognizes families under stress from chronic illness or endoflife situations.
• Readiness for enhanced selfcare management a positive diagnosis indicating a patients motivation to improve selfmanagement skills.
• Risk for impaired skin integrity: devicerelated highlights potential skin damage from medical devices such as catheters or tubing.

Using the Diagnosis List in Practice

Effective use of the NANDAI list involves three steps:

1. Assessment: Collect comprehensive data (subjective & objective) using validated tools.
2. Analysis: Match assessment findings with diagnosis definitions and criteria. Consider risk versus actual problems.
3. Planning & Intervention: Select outcomes and interventions from related taxonomies (e.g., NIC, NOC) that align with the chosen diagnosis.

Documentation should include the exact label, defining characteristics, related factors, and any risk indicators. Aligning with the latest edition ensures consistency across institutions and facilitates research comparability.

Resources for Further Study

• NANDA International Official Website full diagnostic criteria, updates, and certification information.
• Herdman, T.H., & Kamitsuru, S. (2018). NANDAI Diagnoses: Definitions & Classification, 20182020. Elsevier.
• American Nurses Association. (2020). Documentation Standards: A Guide for Nurses.
• Online modules on Coursera and edX covering NANDAI application.