WHAT’S NEW IN NANDA-1 2021-2023 EDITION

Changes have been made in this new edition based on feedback from users to address the
needs of students, clinicians, and research, as well as to provide additional support for
educators. New information has been added to assessment. Many diagnoses are revised by
international collaborators of the Diagnosis Development committee Task Force in order to
strengthen their level of evidence. The diagnostic indicators of each diagnosis were revised
to decrease ambiguity and improve clarity. Revised level of evidence criteria is presented to
ensure that all future diagnoses submitted for inclusion in the classification are at an
appropriate level of evidence to represent the current strength of nursing knowledge.
Users who are familiar with previous edition of this text may note that the diagnostic focus
is no longer highlighted in the diagnosis label. Instead, the diagnostic focus will be found
below the label for each diagnosis in the classification
DOMAIN 1 HEALTH PROMOTION DOMAIN 7 ROLE RELATIONSHIP
Health Awareness
Decreased diversional activity engagement Caregiving roles
Readiness for enhanced health literacy Impaired parenting
Sedentary Lifestyle Risk for impaired parenting
Readiness for enhanced parenting
Health Management Caregiver role strain
Risk for caregiver role strain
Risk for elopement attempt
Frail elderly syndrome Family relationships
Risk for frail elderly syndrome
Readiness for enhanced exercise engagement Risk for impaired attachment
Deficient community health Disturbed family identity syndrome
Risk-prone health behavior Risk for disturbed family identity syndrome
Ineffective health maintenance behavior Dysfunctional family processes
Ineffective health self-management Interrupted family processes
Readiness for enhanced health self- Readiness for enhanced family processes
management
Ineffective family health self-management Role performances
Ineffective home maintenance behavior
Risk for Ineffective home maintenance behavior Ineffective relationships
Readiness for enhanced home maintenance Risk for Ineffective relationships
behavior Readiness for enhanced relationship
Ineffective protection Parental role conflict
Ineffective role performance
DOMAIN 2 NUTRITION Impaired social interaction

Ingestion DOMAIN 8 SEXUALITY

Sexual function
Imbalance nutrition less than body Sexual dysfunction
requirements Ineffective sexuality pattern
Readiness for enhanced nutrition
Insufficient breastmilk production Reproduction
Ineffective breastfeeding Ineffective childbearing process
Interrupted breastfeeding Risk for Ineffective childbearing process

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Readiness for enhanced breastfeeding Readiness for enhanced childbearing process
Ineffective child eating dynamics Risk for disturbed maternal -fetal dyad
Ineffective infant feeding dynamics
Obesity DOMAIN 9 COPING/STRESS TOLERANCE
Overweight
Risk for overweight Post trauma responses
Ineffective infant suck swallow response Risk for complicated immigration transition
Impaired swallowing Post-trauma syndrome
Risk for Post-trauma syndrome
Metabolism Rape- trauma syndrome
Relocation stress syndrome
Risk for unstable glucose level Risk for Relocation stress syndrome
Neonatal hyperbilirubinemia
Risk for Neonatal hyperbilirubinemia Coping responses
Risk for impaired liver function Ineffective activity planning
Risk for metabolic syndrome Risk for Ineffective activity planning
Anxiety
Hydration Defensive coping
Risk for electrolyte imbalance Ineffective coping
Risk for imbalanced fluid volume Readiness for enhanced coping
Deficient fluid volume Ineffective community coping
Risk for Deficient fluid volume Readiness for enhanced community coping
Excess fluid volume Compromised family coping
Readiness for enhanced family coping
DOMAIN 3 ELIMINATION AND EXCHANGE Compromised family coping
Disabled family coping
Urinary Function Readiness for enhanced family coping
Death anxiety
Disability – associated urinary incontinence Ineffective denial
Impaired urinary elimination Fear
Mixed urinary incontinence Maladaptive grieving
Stress urinary incontinence Risk for Maladaptive grieving
Urge urinary incontinence Readiness for enhanced grieving
Risk for urge urinary incontinence Impaired mood regulation
Urinary retention Powerlessness
Risk for urinary retention Risk for powerlessness
Readiness for enhanced power
Gastrointestinal Function Impaired resilience

Constipation DOMAIN 10 LIFE PRINCIPLES

Risk for constipation Beliefs
Perceived constipation Readiness for enhanced spiritual wellbeing
Chronic functional constipation
Risk for chronic functional constipation Value/belief/action congruence
Impaired vowel continence Readiness for enhanced decision making
Diarrhea Decisional conflict
Dysfunctional gastrointestinal motility Impaired emancipated decision making
Risk for Dysfunctional gastrointestinal motility Risk for Impaired emancipated decision making
Readiness for enhanced emancipated decision
Respiratory Function making
Impaired gas exchange Moral distress

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 Impaired religiosity
DOMAIN 4 ACTIVITY/REST Risk for impaired religiosity
Sleep/Rest Readiness for enhanced religiosity
Insomnia Spiritual distress
Sleep deprivation Risk for Spiritual distress
Readiness for enhanced sleep
Disturbed sleep pattern DOMAIN 11 SAFTY/PROTECTION
Infection
Risk for infection
Risk for surgical site infection

Activity/ exercise

Decreased activity intolerance Physical injury

Risk for decreased activity intolerance
Risk for disused syndrome
Impaired bed mobility
Impaired physical mobility
Impaired wheelchair mobility
Impaired sitting
Impaired standing
Impaired transfer ability
Impaired walking
Energy balance
Imbalance energy field
Fatigue
Wandering
Cardiovascular/Pulmonary response
Ineffective breathing pattern
Decreased cardiac output
Risk for decreased cardiac output
Risk for impaired cardiovascular function
Ineffective lymphedema self-management
Risk for Ineffective lymphedema self-
management
Impaired spontaneous ventilation
Risk for unstable blood pressure
Risk for thrombosis
Risk for decreased cardiac tissue perfusion
Risk for ineffective cerebral tissue perfusion
Dysfunctional ventilatory weaning response
Dysfunctional adult ventilatory weaning
response
Self-care
Bathing self-care deficit
Dressing self-care deficit
Ineffective airway clearance
Risk for aspiration
Risk for bleeding
Impaired dentition
Risk for dry eye
Ineffective dry eye self-management
Risk for dry mouth
Risk for adult falls
Risk for child falls
Risk for injury
Risk for corneal injury
Nipple areola complex injury
Risk for areola complex injury
Risk for urinary tract injury
Risk for perioperative positioning injury
Risk for thermal injury
Impaired oral mucus membrane injury
Risk for peripheral neurovascular dysfunction
Risk for physical trauma
Risk for vascular trauma
Adult pressure trauma
Risk for adult pressure trauma
Child pressure injury
Risk for child pressure injury
Risk for shock
Impaired skin integrity
Risk for impaired skin integrity
Risk for sudden infant death
Risk for suffocation
Delayed surgical recovery
Risk for Delayed surgical recovery
Impaired tissue integrity
Risk for impaired tissue integrity
Violence
Risk for female genital mutilation
Risk for other- directed violence

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Feeding self-care deficit Risk for self- directed violence
Toileting self-care deficit Self-mutilation
Readiness for enhanced self-care Risk for Self-mutilation
Self-neglect Risk for suicidal behavior

DOMAIN 5 PERCEPTION/COGNITION Environmental hazards

Contamination
Attention Risk for contamination
Unilateral neglect Risk for occupational injury
Risk for poisoning
Cognition
Acute confusion
Risk for acute confusion
Chronic confusion Defensive processes
Labile emotional control Risk for adverse reaction to iodinated contrast
Ineffective impulse control media
Deficient knowledge Risk for allergy reaction
Readiness for enhanced knowledge Risk for latex allergy reaction
Impaired memory
Disturbed thought process Thermoregulation
Hyperthermia
Communication Hypothermia
Risk for hyperthermia
Readiness for enhanced communication Risk for hypothermia
Impaired verbal communication Risk for neonatal hypothermia
Risk for perioperative hypothermia
DOMAIN 6 SELF PERCEPTION Ineffective thermoregulation
Risk for Ineffective thermoregulation
Self-concept
DOMAIN 12 COMFORT
Hopelessness
Readiness for enhanced hope Physical comfort
Risk for compromised human dignity Impaired comfort
Disturbed personal identity Readiness for enhanced comfort
Readiness for enhanced self-concept Nausea
Acute pain
Self-esteem Chronic pain
Chronic pain syndrome
Chronic low self esteem Labor pain
Risk for chronic low self esteem
Situational low self esteem Environmental comfort
Risk for Situational low self esteem Impaired comfort
Readiness for enhanced comfort
Body image
Disturbed body image Social comfort
Impaired comfort
Readiness for enhanced comfort
Risk for loneliness
Social isolation

Growth/ development

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 Development
Delayed child development
Risk for Delayed child development
Impaired infant motor development
Risk for impaired infant motor development

NEW NANDA -1 NURSING DIAGNOSES 2021-2023

New Nursing Diagnoses
A significant body of work representing new and revised nursing diagnoses was
submitted to the NANDA-I Diagnosis Development committee. Forty-six new
diagnoses were approved by the Diagnosis Development committee and were
presented to the NANDA-1 Board of Directors and are new included here for
members and users of the terminology. Each new diagnosis presented in the
following table.
DOMAIN DIAGNOSIS
1. Health promotion Risk for elopement attempt
Readiness for enhanced exercise engagement
Ineffective health maintenance behaviors
Ineffective health self management
Ineffective home maintenance behavior
Risk for Ineffective home maintenance behavior
Readiness for enhanced home maintenance behavior

2. Nutrition Ineffective infant suck-swallow response

Risk for metabolic syndrome

3. Elimination and Exchange Disability associated urinary incontinence

Mixed urinary incontinence
Risk for urinary retention
Impaired bowel continence

4. Activity /rest Decreased activity tolerance

Risked for increased activity tolerance
Risk for impaired vascular function

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5. Perception/cognition
7 Role relationship
9 Coping /stress tolerance
11 Safety/Protection
Growth/development
REFERENCE
NANDA International, Inc . Nursing Diagnoses definition and classification (2020 – 2023 12th edition)
retrieved from https://www.thieme.com/images/stories/epaper-NANDA_NursingDiagnoses_21/#4
Ineffective lymphedema self- management
Riske for Ineffective lymphedema self- management
Risk for thrombosis
Dysfunctional adult ventilatory weaning response
Disturbed thought process
Disturbed family identity syndrome
Risk for disturbed family identity syndrome
Maladaptive grieving
Risk for Maladaptive grieving
Readiness for enhanced grieving
Ineffective dry eye self- management
Risk for adult falls
Risk for child falls
Nipple areolar complex injury
Risk for nipple -areolar complex injury
Child pressure injury
Risk for child pressure injury
Adult pressure injury
Risk for adult pressure injury
Neonatal pressure injury
Risk for neonatal pressure injury
Risk for suicidal behavior
Neonatal hypothermia
Delayed child development
Risk for delayed child development
Delayed infant motor development
Risk for delayed infant motor development
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