Nursing Diagnoses: Definitions and Classification
Unknown
Twelfth Edition 2021–2023
Questions & Answers from this book
Questions and answers are connected to the referenced book and its available source material.
Chapter 1: What's New in the NANDA-I 2021–2023 Edition
Which diagnoses are listed under Class 6. Thermoregulation in the NANDA-I 2021–2023 edition?
Under Class 6. Thermoregulation, the NANDA-I 2021–2023 edition lists Hyperthermia, Hypothermia, Risk for hypothermia, Neonatal hypothermia, Risk for neonatal hypothermia, Risk for perioperative hypothermia, Ineffective thermoregulation, and Risk for ineffective thermoregulation.
What is the page range for the diagnoses in Domain 12. Comfort and its classes in the NANDA-I 2021–2023 edition?
In the 2021–2023 NANDA-I edition, the diagnoses in Domain 12. Comfort are listed from page 551 through page 565.
Chapter 2: International Considerations on the Use of the NANDA-I Nursing Diagnoses
What is the difference between the terms 'inadequate' and 'insufficient' as standardized in the NANDA-I terminology?
In NANDA-I terminology, 'inadequate' is standardized to mean a lack of quality and/or lack of quantity, while 'insufficient' is used solely to indicate a lack of quantity. This distinction was adopted in the 2021–2023 edition to improve clarity and translation consistency.
What were the reasons for removing 'risk for venous thromboembolism' and how was it replaced?
Risk for venous thromboembolism was removed because reviewers found no sufficiently distinct risk factors for venous versus arterial thromboembolism that are modifiable by independent nursing interventions. It was replaced by the broader diagnosis risk for thrombosis (00291), which includes risk factors for both types of thromboses.
Why did NANDA International, Inc. retain the acronym 'NANDA' in its name after changing its scope to an international organization in 2002?
NANDA International, Inc. retained “NANDA” because the acronym had established status in the nursing profession. It should be viewed as a trademark or brand name rather than an acronym, since it no longer represents the original name of the association.
Chapter 3: Future Improvement of the NANDA-I Terminology
Why are some current NANDA-I diagnosis labels considered symptoms rather than nursing diagnoses, and what examples are given?
Some NANDA-I labels are considered symptoms rather than nursing diagnoses because they do not fit the multiaxial structure: they name a symptom using only a focus term (axis 1), sometimes with a time qualifier (axis 6), but they lack an explicit judgment term from axis 3. Examples include constipation (00011), insomnia (00095), wandering (00154), hopelessness (00124), fear (00148), hyperthermia (00007), acute confusion (00128), chronic sorrow (00137), and acute pain (00132).
Why was the diagnosis label 'activity intolerance' (00092) revised to 'decreased activity tolerance' (00298)?
The label 'activity intolerance' was revised to 'decreased activity tolerance' because it did not fit the multiaxial diagnostic structure appropriately. The judgment term 'in-' in the original label implies 'not' or 'impossible', which is not a sensible negation of 'activity tolerance' and caused translation difficulties. The definition was reexamined and the actual judgment was 'decreased', so the label was changed to improve clarity and international consistency.
What is the issue with the diagnosis 'risk for falls' (00155) in terms of translation?
The issue is that the diagnosis label "risk for falls" (00155) uses a single English term "fall" to cover distinct types of falls, such as falling down the stairs, falling out of bed, or falling while walking. In some languages, these are separate concepts with different terms, so nurses take different precautions and report them separately. Combining them into one diagnosis may inaccurately merge different nursing problems and be dangerous.
Chapter 4: Revised Level of Evidence Criteria for Diagnosis Submission
Chapter 5: Nursing Diagnosis Basics
According to the text, what is the definition of validity of a nursing diagnosis?
The validity of a nursing diagnosis is the degree to which evidence and theory support that the diagnosis is the appropriate interpretation, for a given clinical use, of a given set of manifestations, meaning its defining characteristics.
What are the five extrapolations from the definition of validity of a diagnosis?
The five extrapolations are: (a) validity can be presented at several levels or degrees; (b) it depends on the available evidence; (c) it depends on the underlying theory; (d) it is a property of the diagnosis and not of its components; and (e) it depends on the intended clinical use.
Chapter 6: Nursing Diagnosis: An International Terminology
What are the two major levels of evidence for the validity of NANDA-I nursing diagnoses, and what do they represent?
The two major levels are Level 1, which represents the initial stages of diagnosis development that occur before the diagnosis is included in NANDA-I terminology, and Level 2, which refers to the subsequent stages of clinical development and testing after inclusion, with evidence strength depending on the robustness of the studies. Level 1 covers work from submitting a label through adding a definition and diagnostic components, while Level 2 covers conceptual validity, content validity, and clinical validity.
What are the sub-levels of Level 1 evidence for NANDA-I diagnoses and what criteria define each sub-level?
Level 1 evidence for NANDA-I diagnoses has three sub-levels: 1.1 Label only, 1.2 Label and definition, and 1.3 Diagnostic components and relationship with outcomes and interventions. Level 1.1 requires a clear diagnostic label supported by a literature review. Level 1.2 adds a clear, distinct definition that is consistent with NANDA-I's definition of a nursing diagnosis and supported by literature. Level 1.3 requires the full diagnostic structure, including components, plus a stated relationship to interventions and outcomes in other standardized terminologies.
What is terminological validity in the context of NANDA-I diagnosis validation, and what is an important requirement for studies verifying it?
Terminological validity refers to the adequacy of interpretations obtained from health records when terms are used to represent components of a nursing diagnosis. It is verified through documentation of defining characteristics, related factors, and risk factors in health records, typically using large samples of records. An important requirement for such studies is verification of the adequacy, precision, and accuracy of the records used, since recorded terms alone do not guarantee valid interpretations.
Chapter 7: Clinical Reasoning: From Assessment to Diagnosis
What are the four sub-levels of diagnostic content validation in the NANDA-I terminology, and what distinguishes each sub-level?
The four sub-levels are initial validity (2.2.1), potential validity (2.2.2), advanced validity (2.2.3), and consolidated validity (2.2.4) of diagnostic content. They differ by both the number of experts and their expertise level: initial uses a small sample of beginner/advanced beginner experts; potential uses a large sample with the same beginner profile; advanced uses a small sample of proficient/expert experts; consolidated uses a large sample of proficient/expert experts.
Why is clinical validity considered the highest and most desirable level for a diagnosis to remain in the NANDA-I classification?
Clinical validity is considered the highest and most desirable level because it produces evidence about how a diagnosis actually functions in clinical practice, such as its applicability to real populations, the accuracy of its defining characteristics for diagnostic inference, screening, differentiation, prognosis, and the factors that contribute to its occurrence. This level has the most subdivisions and requires that content validation has already been completed, ensuring the diagnosis is tested against real clinical use before being retained in the classification.
Chapter 8: Clinical Application: Data Analysis to Determine Appropriate Nursing Diagnosis
What is the purpose of prognostic validity in nursing diagnoses and what statistical techniques are used to establish it?
Prognostic validity aims to identify defining characteristics that indicate the prognosis of a nursing diagnosis, based on diagnostic cohort studies that track patients over time. Statistical techniques used include measures of relative risk, incidence coefficients, survival rates, and multivariate models such as generalized estimation equations and Cox proportional hazards models.
How is generalizable validity of defining characteristics established according to the text?
Generalizable validity of defining characteristics is established through systematic reviews of defining characteristics that seek to identify clinical signs and symptoms allowing generalized interpretation of a nursing diagnosis across populations. These reviews are based on clinical construct validation studies of the same diagnosis conducted in different populations with similar methods and measures of diagnostic accuracy. To confirm this type of validity, meta-analysis techniques are applied to establish summary measures of sensitivity and specificity.
Chapter 9: Introduction to the NANDA International Taxonomy of Nursing Diagnoses
What is the difference between diagnosis-specific causal validity and causal validity of exposure variable?
Diagnosis-specific causal validity (level 2.3.8) tests whether multiple risk or related factors are causally linked to one particular diagnosis, usually through case-control studies. Causal validity of exposure variable (level 2.3.9) tests whether one etiological factor can causally influence a group of diagnoses, usually through exposure cohort studies, and can help establish causal chains or syndrome diagnoses.
Which authors proposed a middle range theory on causation and validation of nursing diagnoses?
The middle range theory on causation and validation of nursing diagnoses was proposed by Lopes MVO, Silva VM, and Herdman TH.
Chapter 10: Specifications and Definitions Within the NANDA International Taxonomy of Nursing Diagnoses
What is the difference between chronic pain (00133) and chronic pain syndrome (00255)?
Chronic pain (00133) is recurrent or persistent pain lasting at least 3 months that significantly affects daily functioning or well-being. Chronic pain syndrome (00255) is a syndrome diagnosis: in addition to chronic pain, it significantly impacts other human responses, so it includes other nursing diagnoses such as disturbed sleep pattern, fatigue, impaired physical mobility, or social isolation.
Which diagnoses are included under the class 'Self-esteem' in Domain 6?
Under Domain 6, Class 2 (Self-esteem), the diagnoses are chronic low self-esteem (00119), risk for chronic low self-esteem (00224), situational low self-esteem (00120), and risk for situational low self-esteem (00153).
According to Kamitsuru's Tripartite Model of Nursing Practice, what are the three components that drive nursing actions, and which one is based on nursing's unique disciplinary knowledge?
The three components are medical diagnoses, nursing diagnoses, and organizational protocols. The component based on nursing's unique disciplinary knowledge is nursing diagnoses.
Chapter 11: Glossary of Terms
What are the seven diagnostic axes in NANDA-I and what does each represent?
The seven axes are: Axis 1, the focus of the diagnosis; Axis 2, the subject of the diagnosis (individual, caregiver, family, group, community); Axis 3, judgment (e.g., impaired, ineffective); Axis 4, location; Axis 5, age; Axis 6, time; and Axis 7, status of the diagnosis (problem-focused, health promotion, risk). They parallel the International Standards Reference Model and are used as dimensions of the human response in the diagnostic process.
What are the defining characteristics of impaired wheelchair mobility?
Impaired wheelchair mobility is characterized by limitations in independently operating a wheelchair within the environment. These include difficulty bending or leaning to reach objects, folding or unfolding the wheelchair, locking brakes on a manual wheelchair, navigating through doors or elevators, and operating a power wheelchair's charger, motors, drive mode, and speed. Additional characteristics include difficulty moving the wheelchair on inclines, declines, curbs, stairs, and uneven or even surfaces, as well as difficulty with transfers, sitting balance, weight shifts, and performing pressure relief.
What is the definition of chronic low self-esteem according to the NANDA-I 2021-2023 edition?
Chronic low self-esteem is defined as a long-standing negative perception of self-worth, self-acceptance, self-respect, competence, and attitude toward self.
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