✅ Overview of the Classification Structure
- Domain: Major categories of nursing knowledge (13 total)
- Class: Subcategories within each domain (48 total)
- NANDA Nursing Diagnoses: Specific nursing diagnoses listed under each class (277 total)
🗂 Domain Summary (2024–2026)
According to the NANDA-I Classification (2024–2026), there are 13 domains that serve as the highest-level categories for organizing nursing diagnoses. Each domain includes multiple classes and individual diagnoses that reflect specific patient care concerns.
ChatGPT - Nursing Case Study - Clinical Placement
An educational tool for nursing students and future nurses to practice the nursing process during clinical placements. Enter a nursing diagnosis to receive examples of goals, plans, interventions, and evaluations. © GANOHAMA ⚠️ For training use only
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🧠 1. Health Promotion
Motivation and behaviors aimed at maintaining or improving health
🧑⚕️ 2. Nutrition
Intake, absorption, and metabolism of nutrients
💧 3. Elimination and Exchange
Excretion and the exchange of substances between organs
🦴 4. Activity/Rest
Energy use, rest, sleep, and physical movement
🫀 5. Perception/Cognition
Sensory function, perception, cognition, insight, and consciousness
🧍 6. Self-Perception
Self-concept, self-esteem, and self-efficacy
🧑🤝🧑 7. Role Relationship
Relationships and role performance within individuals and groups
❤️ 8. Sexuality
Sexual identity, function, and reproduction
🌪 9. Coping/Stress Tolerance
Stress response and coping abilities
🧭 10. Life Principles
Beliefs, values, ethics, and spirituality
🛡 11. Safety/Protection
Infection control, injury prevention, environmental hazards, and defense mechanisms
🌿 12. Comfort
Physical, psychological, and social comfort
📈 13. Growth/Development
Physical growth and cognitive development processes
🗂 NANDA Nursing Diagnoses by Domain (2024–2026)
Definition: Awareness of well-being and normal function, and strategies to maintain or improve that well-being
📘 Class 1: Health Awareness
- Decreased diversional activity engagement
Reduced participation in leisure activities - Risk for decreased diversional activity engagement
Risk of reduced participation in leisure activities - Excessive sedentary behaviors
Engaging in overly sedentary lifestyle habits - Risk for excessive sedentary behaviors
Risk of adopting excessively sedentary behaviors - Imbalanced energy field
Disruption or disharmony in the energy field
🏥 Class 2: Health Management
- Ineffective health self-management
Inefficient personal management of health - Risk for ineffective health self-management
Risk of poor personal health management - Readiness for enhanced health self-management
Readiness to improve personal health management - Ineffective family health management
Ineffective coordination of health practices within the family - Risk for ineffective family health management
Risk of poor family health coordination - Ineffective community health management
Poor management of health at the community level - Risk for ineffective community health management
Risk of ineffective community-level health management - Risk for ineffective blood glucose pattern self-management
Risk of failing to manage blood glucose patterns - Ineffective dry eye self-management
Poor management of dry eye symptoms - Ineffective dry mouth self-management
Ineffective management of dry mouth - Risk for ineffective dry mouth self-management
Risk of poor management of dry mouth - Ineffective fatigue self-management
Inability to manage fatigue effectively - Ineffective lymphedema self-management
Poor management of lymphedema - Risk for ineffective lymphedema self-management
Risk of failing to manage lymphedema - Ineffective nausea self-management
Poor control of nausea symptoms - Ineffective pain self-management
Ineffective strategies for managing pain - Readiness for enhanced weight self-management
Willingness and ability to improve weight control behaviors - Ineffective overweight self-management
Poor management of being overweight - Risk for ineffective overweight self-management
Risk of inadequate overweight management - Ineffective underweight self-management
Poor handling of being underweight - Risk for ineffective underweight self-management
Risk of failing to manage underweight status - Ineffective health maintenance behaviors
Failure to perform behaviors that maintain health - Risk for ineffective health maintenance behaviors
Risk of poor health maintenance practices - Ineffective home maintenance behaviors
Difficulty maintaining a safe and functional home environment - Risk for ineffective home maintenance behaviors
Risk of home environment deterioration - Readiness for enhanced home maintenance behaviors
Preparedness to improve home care activities - Readiness for enhanced exercise engagement
Readiness to increase physical activity - Inadequate health literacy
Limited ability to obtain, process, and understand basic health information - Risk for inadequate health literacy
Risk of insufficient understanding of health information - Readiness for enhanced health literacy
Willingness and ability to improve health-related knowledge - Readiness for enhanced healthy aging
Preparedness to promote optimal aging and wellness - Elder frailty syndrome
Condition of reduced strength and physiological function in older adults - Risk for elder frailty syndrome
Risk of developing frailty in older adults
🗂 Domain 2: Nutrition
Definition: Processes related to the intake, digestion, absorption, metabolism, and balance of nutrients and fluids.
🍽️ Class 1: Ingestion
- Inadequate nutritional intake
Insufficient intake of essential nutrients - Risk for inadequate nutritional intake
Risk of not consuming enough nutrients - Readiness for enhanced nutritional intake
Willingness and ability to improve nutrient intake - Inadequate protein energy nutritional intake
Lack of sufficient protein and energy intake - Risk for inadequate protein energy nutritional intake
Risk of insufficient intake of protein and energy - Ineffective chestfeeding
Difficulty or inefficiency in breastfeeding - Risk for ineffective chestfeeding
Risk of complications in breastfeeding - Disrupted exclusive chestfeeding
Interruption or cessation of exclusive breastfeeding - Risk for disrupted exclusive chestfeeding
Risk of early discontinuation of exclusive breastfeeding - Readiness for enhanced chestfeeding
Willingness and ability to improve breastfeeding practices - Inadequate human milk production
Insufficient production of human milk - Risk for inadequate human milk production
Risk of low milk supply - Ineffective infant feeding dynamics
Poor coordination and effectiveness during infant feeding - Ineffective child eating dynamics
Disruption in mealtime behaviors or patterns in children - Ineffective adolescent eating dynamics
Ineffective or disordered eating patterns in adolescents - Impaired swallowing
Difficulty or dysfunction in swallowing (dysphagia)
🔬 Class 2: Digestion
(Includes diagnoses related to digestive function disorders)
🧪 Class 3: Absorption
(Includes diagnoses related to nutrient absorption disorders)
🔥 Class 4: Metabolism
- Neonatal hyperbilirubinemia
Elevated bilirubin levels in newborns - Risk for neonatal hyperbilirubinemia
Risk of developing high bilirubin levels in newborns
💧 Class 5: Hydration
- Risk for impaired water-electrolyte balance
Risk of imbalance in fluid and electrolyte levels - Risk for impaired fluid volume balance
Risk of disrupted fluid volume homeostasis - Excessive fluid volume
Fluid overload within the body - Risk for excessive fluid volume
Risk of developing fluid overload - Inadequate fluid volume
Insufficient body fluid levels - Risk for inadequate fluid volume
Risk of dehydration or fluid deficiency
🗂 Domain 3: Elimination and Exchange
Definition: Processes related to the removal of body wastes and the exchange of gases and fluids across body systems.
🚽 Class 1: Urinary Function
- Impaired urinary elimination
Dysfunctional or abnormal urine elimination - Risk for urinary retention
Risk of inability to completely empty the bladder - Disability-associated urinary incontinence
Involuntary urine leakage associated with physical or cognitive impairments - Mixed urinary incontinence
Combination of stress and urge urinary incontinence - Stress urinary incontinence
Involuntary leakage of urine during physical activity or exertion - Urge urinary incontinence
Sudden, strong urge to urinate followed by involuntary leakage - Risk for urge urinary incontinence
Risk of developing symptoms of urge incontinence
🍽️ Class 2: Gastrointestinal Function
- Impaired gastrointestinal motility
Altered peristalsis or movement in the digestive tract - Risk for impaired gastrointestinal motility
Risk of abnormal or slowed GI motility - Impaired intestinal elimination
Difficulty or disruption in regular bowel movements - Risk for impaired intestinal elimination
Risk of problems with fecal elimination - Chronic functional constipation
Ongoing constipation not caused by structural or biochemical abnormalities - Risk for chronic functional constipation
Risk of developing persistent functional constipation - Impaired fecal continence
Inability to control bowel movements - Risk for impaired fecal continence
Risk of losing control over bowel function
🧴 Class 3: Integumentary Function
(Includes related diagnoses related to skin and mucous membrane integrity – content to be added)
🧴 Class 4: Respiratory Function
- Impaired gas exchange
Decreased or ineffective exchange of oxygen and carbon dioxide at the alveolar-capillary membrane
🗂 Domain 4: Activity / Rest
Definition: Patterns of energy use, rest, and sleep that support optimal functioning.
😴 Class 1: Sleep/Rest
- Sleep deprivation
Prolonged lack of adequate sleep - Disturbed sleep pattern
Disruption in the quality or quantity of sleep - Readiness for enhanced sleep
Willingness and ability to improve sleep quality and patterns
🏃 Class 2: Activity/Exercise
- Impaired spontaneous ventilation
Inability to breathe adequately without mechanical support - Ineffective breathing pattern
Abnormal respiratory rate, rhythm, depth, or effort - Impaired physical mobility
Limitation in independent, purposeful physical movement - Bed mobility impairment
Difficulty in moving within the bed (e.g., turning, repositioning) - Wheelchair mobility impairment
Inability to move independently using a wheelchair - Walking impairment
Difficulty in walking independently or safely - Risk for disuse syndrome
Risk of physiological deterioration due to inactivity - Activity intolerance
Insufficient energy to endure or perform physical activity - Risk for activity intolerance
Risk of experiencing insufficient energy for activity - Impaired cardiovascular-pulmonary response to activity
Ineffective heart and lung response during physical exertion - Ineffective community physical activity control
Inability to regulate or manage physical activity within the community - Impaired sitting
Difficulty in maintaining a seated position - Risk for frailty syndrome
Risk of physical weakness and reduced physiological reserve - Risk for musculoskeletal impairment
Risk of damage or dysfunction in bones, muscles, or joints - Sedentary lifestyle
Habitual lack of physical activity - Risk-prone health behavior
Behavior that increases risk for adverse health outcomes
⚡ Class 3: Energy Balance
- Fatigue
An overwhelming sustained sense of exhaustion - Readiness for enhanced self-management of fatigue
Willingness and ability to improve energy conservation strategies - Wandering
Aimless or purposeful locomotion, often with safety concerns (commonly seen in cognitive disorders)
❤️🩹 Class 4: Cardiovascular/Pulmonary Responses
Note: Most major diagnoses in this class have been integrated into Class 2 (e.g., Impaired cardiovascular-pulmonary response to activity).
🧼 Class 5: Self-Care
- Self-care deficit: bathing
Inability to bathe oneself independently - Self-care deficit: dressing
Inability to dress oneself without assistance - Self-care deficit: feeding
Inability to feed oneself effectively - Self-care deficit: toileting
Inability to use the toilet independently - Self-care deficit syndrome
A cluster of self-care deficits in multiple areas - Readiness for enhanced self-care
Willingness and ability to improve independence in self-care - Ineffective self-care maintenance
Inability to perform routine health-promoting behaviors
🗂 Domain 5: Perception / Cognition
Definition: The human processes of perceiving, attending, processing, interpreting, and communicating information.
🎯 Class 1: Attention
- Impaired attention
Difficulty focusing or maintaining attention - Risk for impaired attention
Risk of decreased ability to focus or attend to stimuli
🧭 Class 2: Orientation
- Acute confusion
Sudden onset of altered mental status and disorientation - Chronic confusion
Long-term, progressive cognitive disorientation - Risk for acute confusion
Risk of developing sudden confusion or disorientation
👁👂 Class 3: Sensation / Perception
- Impaired environmental interpretation syndrome
Inability to correctly interpret surroundings or environmental cues - Impaired verbal communication
Difficulty expressing oneself using spoken language - Impaired visual sensory perception
Distorted or decreased ability to perceive visual stimuli - Impaired auditory sensory perception
Altered ability to perceive sounds - Impaired tactile sensory perception
Decreased ability to perceive touch or pressure - Impaired gustatory sensory perception
Impaired sense of taste - Impaired olfactory sensory perception
Impaired sense of smell - Unilateral neglect
Inattention to one side of the body or environment, usually after stroke - Risk for unilateral neglect
Risk of ignoring stimuli on one side due to neurological deficit
🧠 Class 4: Cognition
- Impaired memory
Inability to remember information or events - Risk for impaired memory
Risk of developing memory loss or deficits - Impaired executive function
Difficulty with planning, decision-making, or problem-solving
🗣 Class 5: Communication
- Readiness for enhanced communication
Willingness and ability to improve interpersonal communication - Impaired communication
General difficulties in expressing or receiving messages - Risk for impaired communication
Risk of developing communication difficulties - Nonverbal communication impairment
Disruption in sending or interpreting nonverbal cues such as facial expressions, gestures, or body language
Catheter Management Scenarios: Central Venous Catheter (CVC), Peripherally Inserted Central Catheter (PICC), and Implanted Port
Contents🔹 1. Understanding Central Venous Catheters (CVC), PICC Lines, and Chemoports 💡 Central venous catheters, peripherally inserted central catheters (PICC), and chemoports are used based on the patient's clinical cond
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🗂 Domain 6: Self-Perception
Definition: The individual's awareness about themselves, including body image, self-esteem, and personal identity.
🧍 Class 1: Self-Concept
- Disturbed body image
Negative perception of one’s physical appearance or body function - Readiness for enhanced self-concept
Willingness and ability to strengthen personal identity and self-view - Chronic low self-esteem
Ongoing feelings of worthlessness or inadequacy - Situational low self-esteem
Temporary decrease in self-worth due to specific life events or stressors - Risk for situational low self-esteem
Risk of reduced self-worth triggered by situational factors - Readiness for enhanced self-esteem
Openness and motivation to improve self-respect and confidence
💬 Class 2: Self-Esteem
Note: Related nursing diagnoses are included under Class 1 (Self-Concept).
💪 Class 3: Self-Control
- Impaired individual resilience
Reduced ability to adapt and recover from stress or adversity - Readiness for enhanced resilience
Motivation and capacity to strengthen personal coping ability - Hopelessness
A subjective state in which a person sees limited or no options for positive change
Respiratory care nursing
👀 Oxygen Therapy – Proper oxygen usage and application to patients
(Nasal Cannula, Simple Oxygen Mask, and Partial Rebreather Mask)
Applying a Partial Rebreathing Mask for Oxygen Therapy
👀 Tracheostomy Care – Managing tracheostomy and preventing infections👀 Suctioning – Procedures for secretion removal and safe execution👀 Oxygen Therapy – Proper oxygen usage and application to patients (Nasal Cannula, Simple Oxygen Mask, and
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🗂 Domain 7: Role Relationships
Definition: Patterns of social positioning, responsibility, and interpersonal interactions within family and community roles.
👩👧 Class 1: Caregiving Role
- Compromised family caregiving
Family caregiver’s capacity to provide care is reduced or limited - Readiness for enhanced family caregiving
Willingness and ability to improve family caregiving skills - Ineffective family caregiving
Inability to provide appropriate care to a family member - Risk for ineffective family caregiving
Risk of being unable to meet the caregiving needs of a family member - Impaired parenting
Difficulty in performing parental responsibilities effectively - Risk for impaired parenting
Risk of disruption in fulfilling the parenting role - Readiness for enhanced parenting
Openness and motivation to improve parenting abilities
🎭 Class 2: Role Performance
- Ineffective role performance
Difficulty fulfilling expected societal or personal roles - Readiness for enhanced role performance
Willingness and ability to improve role functioning and responsibility
🏠 Class 3: Family Relationships
- Dysfunctional family processes
Ongoing conflict or lack of support in family dynamics - Interrupted family processes
Sudden disruption in family interactions and routines - Readiness for enhanced family processes
Motivation and capacity to strengthen family communication and support
Dialysis nursing
Continuous Ambulatory Peritoneal Dialysis (CAPD) Patient Care :Comprehensive Simulation Scenario for Nurse Training
👀 Peritoneal Dialysis Care – Preparation before dialysis, monitoring during dialysis, post-dialysis care, and infection prevention.👀 Hemodialysis Care – Checking vascular conditions before dialysis, monitoring vital signs during dialysis, post-di
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🗂 Domain 8: Sexuality
Definition: Patterns of sexual identity, function, and reproduction, and how they relate to overall health and well-being.
🏳️🌈 Class 1: Sexual Identity
- Ineffective sexual orientation process
Difficulty in accepting or understanding one’s sexual orientation - Readiness for enhanced sexual orientation process
Openness and willingness to explore or strengthen understanding of one’s sexual identity
💑 Class 2: Self-Concept (related to sexual health)
- Sexual dysfunction
Persistent problems with sexual desire, response, or satisfaction - Ineffective sexuality pattern
Unsatisfying or dysfunctional sexual behavior or relationships - Readiness for enhanced sexuality
Motivation and ability to improve sexual health and intimacy
Transfusion nursing
Scenario 1. Crossmatch Completed, but Blood Bank Sent Mismatched Blood → Nurse Identifies Error During Dual Verification and H
No.Error Case (Pre-Transfusion Testing Phase)1Mismatch between the patient's actual blood type and medical records2Unexpected antibody detected during antibody screening test3Transfusion ordered without performing pre-transfusion testing4ABO and Rh test re
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🗂 Domain 9: Coping / Stress Tolerance
Definition: The capacity to manage internal or external stressors and the effectiveness of coping strategies in maintaining emotional and psychological balance.
🧠 Class 1: Coping Responses
- Defensive coping
Use of ineffective defense mechanisms that hinder problem resolution - Ineffective coping
Inability to manage stressors effectively or adapt to change - Compromised coping
Gradual deterioration of previously effective coping abilities - Readiness for enhanced coping
Willingness and ability to strengthen personal coping skills - Ineffective denial
Use of denial that prevents necessary health actions or adaptation - Ineffective impulse control
Difficulty controlling impulses or delaying gratification
⚠️ Class 2: Suicide Urgency
- Risk for suicide
Risk of self-inflicted, life-threatening harm with the intent to end one’s life
🧳 Class 3: Stress Detection
- Post-trauma syndrome
Ongoing response to a traumatic experience, including anxiety, hypervigilance, and avoidance - Risk for post-trauma syndrome
Risk of developing maladaptive responses following trauma - Relocation stress syndrome
Physical or emotional disturbance due to moving to a new environment - Risk for relocation stress syndrome
Risk of experiencing adverse effects during or after a relocation
🗂 Domain 10: Life Principles
Definition: Patterns of beliefs, values, and spiritual practices that influence decision-making, meaning in life, and health behaviors.
⚖️ Class 1: Values
- Decisional conflict
Uncertainty about which course of action to take when choices involve risk, loss, or challenge to personal values - Readiness for enhanced decision-making
Willingness and ability to improve decision-making skills based on personal beliefs and values
🙏 Class 2: Self-Concept (Spirituality and Belief Systems)
- Impaired religiosity
Difficulty adhering to or integrating religious beliefs or practices - Risk for impaired religiosity
Risk of disruption in religious or spiritual practices - Readiness for enhanced religiosity
Openness to strengthen or deepen religious faith and involvement - Spiritual distress
Disruption in the life principle that integrates a person’s inner resources, meaning, and purpose - Risk for spiritual distress
Risk of experiencing disconnection from spiritual sources of strength - Readiness for enhanced spiritual well-being
Willingness and capacity to improve spiritual health and sense of inner peace
History Taking and Initial Care
Femoral Fracture Case History and Initial Assessment
History Taking and Initial Care👀 Pyelonephritis – Check for fever and urination pain and monitor body temperature rise👀 FEMORAL FRACTURE – Check accident progress and pain area, check blood pressure and pain score👀 Pulmonic embolism – Check
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🗂 Domain 11: Safety / Protection
Definition: Patterns of safeguarding oneself or others from injury, infection, violence, or environmental threats.
🦠 Class 1: Infection
- Risk for infection
Risk of being invaded by pathogenic organisms
🩹 Class 2: Injury
- Risk for injury
Risk of physical harm due to internal or external conditions - Risk for adverse reaction to iodinated contrast media
Risk of allergic or harmful response to iodine-based contrast agents - Risk for vascular trauma
Risk of damage to blood vessels, often related to procedures or conditions
⚠️ Class 3: Violence
- Risk for self-directed violence
Risk of intentionally harming oneself - Risk for other-directed violence
Risk of causing physical harm to others
🏚 Class 4: Environmental Hazards
- Risk for falls
Risk of unintentional descent to the ground - Risk for thermal injury
Risk of damage caused by heat, cold, or exposure to extreme temperatures - Risk for aspiration
Risk of inhaling food, fluids, or foreign material into the airway - Risk for suffocation
Risk of airflow obstruction leading to oxygen deprivation - Risk for poisoning
Risk of exposure to harmful substances - Risk for sudden infant death
Risk of unexplained death in a sleeping infant under one year of age (SIDS)
🛡 Class 5: Defensive Processes
- Impaired immune system
Dysfunction or suppression of the body's immune defenses - Risk for abnormal blood clotting
Risk of excessive or insufficient clot formation - Risk for shock
Risk of circulatory failure due to inadequate perfusion - Risk for allergy response
Risk of hypersensitivity reactions to allergens - Risk for anaphylactic reaction
Risk of severe, life-threatening allergic response
🧬 Class 6: Physical Harm
- Impaired skin integrity
Damage to the skin's protective barrier - Risk for impaired skin integrity
Risk of skin damage due to various risk factors - Impaired tissue integrity
Damage to mucous membranes, corneal, integumentary, or subcutaneous tissues - Risk for impaired tissue integrity
Risk of tissue breakdown or injury - Risk for pressure injury
Risk of skin and underlying tissue damage due to prolonged pressure (e.g., pressure ulcers) - Delayed surgical recovery
Slower-than-expected return to normal function after surgery
🗂 Domain 12: Comfort
Definition: The experience of physical, environmental, and social ease or relief from discomfort.
⚕️ Class 1: Physical Comfort
- Acute pain
Sudden or short-term pain that serves as a warning of injury or illness - Chronic pain
Persistent or recurring pain lasting more than three months - Labor pain
Pain associated with the physiological process of childbirth - Chronic pain syndrome
Complex condition with chronic pain that affects multiple aspects of life - Nausea
Unpleasant sensation in the stomach often leading to the urge to vomit - Constipation discomfort
Physical discomfort resulting from difficulty in bowel movements
🛏 Class 2: Environmental Comfort
- Impaired comfort
Perceived lack of ease or relief in the physical or emotional environment - Readiness for enhanced comfort
Willingness and ability to improve one’s state of comfort or well-being
🧑🤝🧑 Class 3: Social Comfort
- Social isolation
Lack of meaningful interpersonal interaction - Risk for social isolation
Risk of experiencing limited or no social contact - Loneliness
Subjective feeling of being alone or separated from others
🗂 Domain 13: Growth / Development
Definition: Patterns of physical, cognitive, and psychosocial development across the lifespan.
🌱 Class 1: Growth
- Delayed growth and development
Slower-than-expected progression in physical or cognitive milestones - Risk for delayed growth and development
Risk of experiencing developmental or physical growth delays - Readiness for enhanced growth
Willingness and capacity to optimize growth potential
🧒 Class 2: Development
- Risk for developmental delay
Risk of lagging behind age-appropriate cognitive, motor, or social skills - Readiness for enhanced child development
Willingness and ability to support or accelerate a child's development
📝 Notes & Highlights (2024–2026 Edition)
- 🆕 New diagnoses: 56 added
- 🔄 Revised diagnoses: 123 updated with improved definitions or structure
- ❌ Removed diagnoses: Several outdated diagnoses have been retired
- 🧩 Diagnosis format:
Each diagnosis follows a structured format:
Problem + Related factors + Defining characteristics
Example:
Ineffective coping related to stress as evidenced by crying spells
