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: Diki Alifta
Rachmad

Nama
NIM

:
131511133006

Mata Kuliah

: EIN 2
: Resume Nrsing
Diagnosis

Judul Tugas
Pertemuan Ke

:3

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mengumpulkan

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Surabaya,

(Diki Alifta Rachmad)

NIM: 131511133006

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Definition of Diagnosis
According to Carpento :
Diagnosis is the careful, critical study of something to determine its nature.

Diagnosis in health care setting

- The International Classification of Disease taxonomy (ICD-10) : Physicians
- Diagnostic and Statistical Manual of Mental Disorders(DSM-V) :
Psychologists, psychiatrists, and other mental health professionals
- NANDA International, Inc. (NANDA-I) nursing diagnosis taxonomy : Nurses
Definitin of Nursing Diagnosis
- According to North American Nursing Diagnosis Association (NANDA),
1990 :
Nursing diagnosis is a clinical judgment about individual, family, or
community responses to actual or potential health problems/life process.
Nursing diagnosis provides the basis for selection of nursing interventions
to achieve outcomes for which the nurse is accountable
- Then it revised at National Conference of NANDA-I in Miami, 2008:
the nurse accountable revised to the nurse has accountability
- NANDA-I(2014) :
A nursing diagnosis is a clinical judgment concerning a human response
to health conditions/life processes, or vulnerability for that response, by
an individual, family, group, or community.
Components of nursing language
- NANDA: Nursing Diagnosis: Definitions and Classification
- NIC: Nursing Interventions Classification
- NOC: Nursing Outcomes Classification
Domain of expertise

Nursing

Medecine

Disciplin
Shared
Discipli
e
Expertis
ne
Types of nursing diagnosis :
Expertis
e
Expertis
- Problem-focused diagnosis : a clinical judgment concerning an
undesirable human response to a health condition/life process
- Risk diagnosis : a clinical judgment concerning the vulnerability for
developing
- Health promotion diagnosis : a clinical judgment concerning motivation
and desire to increase well-being and to actualize human health
potential.
- Syndrome Diagnosis : a clinical judgment concerning a specific cluster
of nursing diagnoses that occur together and through similar
interventions.
Label of nursing diagnosis
1. Descriptor or modifier
2. Focus of the diagnosis, or the key concept of the diagnosis

Examples:
fatigue (00093), constipation (00011), and anxiety (00146).
Nursing diagnosis indicators
- A nursing diagnosis does not need to contain all types of diagnostic
indicators.
- Problem-focused nursing diagnoses contain defining characteristics and
related factors.
- Health promotion diagnoses generally have only defining characteristics
- Risk diagnoses, have risk factors
Nursing diagnosis formats
_____ [nursing diagnosis] related to ______[cause/related factors] as
evidenced by ____________[symptoms/defining characteristics].
Examples:
ineffective airway clearance related to excessive mucus and asthma as
evidenced by decreased breath sounds bilaterally, crackles over left lobe and
persistent, ineffective coughing
There are somethings you need to make Nursing diagnosis, include :
- Understanding critical concepts important to nursing practice
Significant and sufficient assessmentperception, etc
- Diagnostic data: laboratory data, X-ray, etc
- Knowledge and experiences