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EARNING
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UTCOME
1
Differentiate nursing diagnoses according to status.
Concepts for Lecture
1. There are five types of nursing diagnoses: actual, risk, wellness,
2. An actual diagnosis is a client problem that is present at the time of
3. A risk diagnosis is a clinical judgment that a problem does not exist;
4. A wellness diagnosis “describes human responses to levels of well-
5. A possible diagnosis is one in which evidence about a health prob-
L
EARNING
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2
Identify the components of a nursing diagnosis.
Concepts for Lecture
2. The problem statement, or diagnostic label, describes the client’s
health problem or response for which nursing therapy is given. It
3. The etiology (related factors and risk factors) component of a nurs-
ing diagnosis identifies one or more probable causes of the health
4.
Defining characteristics are the cluster of signs and symptoms that
indicate the presence of a particular diagnostic label. For actual nursing
C
HAPTER
12
DIAGNOSING
S
UGGESTIONS FOR
C
LASSROOM
A
CTIVITIES
• Provide the students with a list of nursing diag-
noses. Ask the students to classify these accord-
ing to type of nursing diagnosis.
•
Provide the students with one or more case
studies. Have the students decide whether
there is no problem, a potential problem, a
Discuss rationales for the classifications.
S
UGGESTIONS FOR
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LINICAL
A
CTIVITIES
S
UGGESTIONS FOR
C
LINICAL
A
CTIVITIES
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UGGESTIONS FOR
C
LASSROOM
A
CTIVITIES
•
Using a nursing diagnosis handbook, develop
a list of diagnostic labels, etiologies, and
defining characteristics. Divide the students
into groups. Have the students classify the
items in the list into the appropriate compo-
CHAPTER 12 / Diagnosing 57
L
EARNING
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UTCOME
3
Compare nursing diagnoses, medical diagnoses, and collaborative problems.
Concepts for Lecture
1. Differences among nursing diagnoses, medical diagnoses, and
2. Nursing diagnoses describe human responses to disease processes or
health problems. They consist of one–, two-, or three-part statements
3.
Medical diagnoses describe disease and pathology, do not consider
human responses, usually consist of a few words, and are oriented to
4.
Collaborative problems involve human responses, mainly physiological
complications of disease, tests, or treatments. They consist of two-part
statements of situation/pathophysiology and the potential complication.
L
EARNING
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UTCOME
4
Identify the basic steps in the diagnostic process.
Concepts for Lecture
1. The diagnostic process includes analyzing data; identifying health
problems, risks, and strengths; and formulating diagnostic state-
ments. To analyze data, the nurse must compare data against stand-
ards (identify significant cues), cluster the cues (generate tentative
hypotheses), and identify gaps and inconsistencies.
S
UGGESTIONS FOR
C
LASSROOM
A
CTIVITIES
• Using case studies, have the students identify
nursing diagnoses, medical diagnoses, and
related collaborative problems.
•
Ask the students to review the nurse practice
act of the state to determine what statements
are made about nursing diagnoses and nursing
•
Ask the students to identify the collaborative
use of critical thinking skills and the decision-
making process in this phase of the nursing
process.
•
Using another case study, divide the students
into small groups. Have each group use the
steps in the diagnostic process to derive nurs-
ing diagnoses and collaborative problems.
Compare and contrast results.
S
UGGESTIONS FOR
C
LINICAL
A
CTIVITIES
•
Demonstrate how to use a nursing diagnosis
manual or handbook to develop nursing diagno-
ses from a student’s client data. Emphasize how
the nursing diagnoses are individualized for the
58 CHAPTER 12 / Diagnosing
cies must be clarified before valid patterns can be established. The
nurse and the client then identify problems that support tentative
L
EARNING
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UTCOME
5
Describe various formats for writing nursing diagnoses.
Concepts for Lecture
1. Most nursing diagnoses are written as two-part or three-part statements,
but there are variations. The basic two-part statement includes problem
(P), a statement of the client’s response (NANDA label), and etiology
2.
There are five variations of the basic formats:
• Writing unknown etiology when the defining characteristics are
present but the nurse does not know the cause or contributing
factors
• Using the phrase complex factors when there are too many
S
UGGESTIONS FOR
C
LASSROOM
A
CTIVITIES
• Using a client database, demonstrate how to
develop two-part and three-part nursing diagnos-
tic statements. Give the students another data-
base and have them develop these types of
diagnostic statements.
•
Provide examples of when the variations of
the basic formats are necessary.
CHAPTER 12 / Diagnosing 59
L
EARNING
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UTCOME
6
List guidelines for writing a nursing diagnosis statement.
Concepts for Lecture
1. Guidelines for writing nursing diagnosis statements include:
• Write the statement in terms of a problem instead of a need.
• Word the statement so that it is legally advisable.
2.
To improve diagnostic reasoning and avoid diagnostic reasoning errors,
the nurse should: verify diagnoses by talking with the client and family,
L
EARNING
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UTCOME
7
Describe the evolution of the nursing diagnosis movement, including work
currently in progress.
Concepts for Lecture
1. The first taxonomy—a classification system or set of categories ar-
ranged based on a single principle or set of principles—was alpha-
betical. In 1982, NANDA accepted the “nine patterns of unitary
man” as an organizing principle. In 1984, NANDA renamed the
S
UGGESTIONS FOR
C
LASSROOM
A
CTIVITIES
• Review common problems that past students
have had with writing nursing diagnoses.
•
Provide the students with a list of properly
written and improperly written nursing diag-
noses. Have the students identify each type
and correct the improperly written diagnoses.