Categories of Nursing Diagnosis
Key Points
- NANDA-I diagnosis categories support safer, clearer clinical judgment.
- Core categories are problem-focused, risk, health promotion, and syndrome.
- Category selection guides care-plan priority and intervention type.
- NANDA-I coding structure supports expansion without recoding legacy entries.
Pathophysiology
Patient conditions evolve across actual problems, potential risks, and readiness for improvement. Categorizing diagnosis statements helps nurses match interventions to current status and avoid over- or under-treatment.
Classification also improves communication in electronic records by using standardized terminology and coding conventions.
Classification
- Problem-focused diagnosis: Describes an existing patient response requiring active intervention.
- Risk diagnosis: Describes vulnerability to a problem that has not yet occurred.
- Health promotion diagnosis: Describes readiness to improve health behaviors or well-being.
- Syndrome diagnosis: Clusters related diagnoses that tend to occur together.
Nursing Assessment
NCLEX Focus
First decide: “Is this actual, potential, readiness-based, or syndrome-patterned?” Then write the diagnosis.
- Validate whether patient cues represent current signs/symptoms or only risk factors.
- Check for readiness and motivation cues before selecting health-promotion diagnoses.
- Identify clustered patterns when multiple related responses occur together.
- Use standardized language and confirm diagnosis specificity before finalizing.
- Reclassify diagnosis category if patient status changes over time.
Nursing Interventions
- Match interventions to category: treatment for actual problems, prevention for risk, coaching for promotion.
- Prioritize high-risk or safety-critical diagnoses first.
- Document category rationale to strengthen handoffs and continuity.
- Refine diagnosis wording as new assessment data become available.
- Re-evaluate outcomes and shift category focus when progression or recovery occurs.
Category Mismatch Risk
Using the wrong category can delay appropriate actions, such as missing prevention in a high-risk patient.
Pharmacology
Medication actions can support any category, but indication and monitoring plans differ by whether care is corrective, preventive, or promotive.
Clinical Judgment Application
Clinical Scenario
A post-op patient shows no current aspiration but has altered sensation and sedation risk factors.
Recognize Cues: Risk factors present, no active aspiration signs. Analyze Cues: Current status fits a risk category, not problem-focused. Prioritize Hypotheses: Prevention must occur before deterioration. Generate Solutions: Apply aspiration-prevention interventions and close monitoring. Take Action: Implement risk-focused care and reassess frequently. Evaluate Outcomes: No aspiration event and risk indicators improve.
Related Concepts
- nursing-diagnosis-vs-medical-diagnosis - Distinguishes category selection from disease labeling.
- ppmp-clinical-decision-making-framework - Connects category logic to Predict-Prevent-Manage-Promote planning.
- nursing-assessment-type-selection - Assessment type influences diagnosis category certainty.
Self-Check
- What cue pattern differentiates risk from problem-focused diagnosis?
- When is a health-promotion diagnosis more appropriate than a risk diagnosis?
- How does category choice influence intervention priority?