Nursing Diagnoses

What exactly is a "nursing diagnosis"? Isn't the doctor the one who diagnoses people? Well, yes. The term "nursing diagnosis" can be a little misleading, and indeed, was very confusing to me when I first started nursing school. A nursing diagnosis is not the same thing as a medical diagnosis - it is not the formal labelling of a patient's condition. That's a physician's job - to assess the patient and figure out what the problem is. The nurse's job is to assess the patient and figure out what practical problems they may face. For example, if a patient has a history of dizziness and is taking a medication that makes them sleepy, a possible nursing diagnosis would be "at risk for falls". This is not a medical diagnosis, but rather a statement of a problem the patient may face that the nurse can intervene in and work to prevent or relieve. It's basically a way for nurses to critically consider how they will care for their patients, and what interventions should take priority.

A nursing practice guideline found here offers a list of possible nursing diagnoses for an obese patient. Five of these nursing diagnoses are below:

• Imbalanced nutrition: more than body requirements
• Knowledge deficit
• Ineffective Health Maintenance
• Activity intolerance (related to impaired mobility)
• Sedentary Lifestyle

 The chart below further explores the first nursing diagnosis.

Nursing diagnosis: Imbalanced nutrition: more than body requirements
Actual or potential problem	Actual problem. For this hypothetical patient, it has already been demonstrated that they consume more calories than their metabolism requires. A potential problem would be described in a nursing diagnosis as “at risk for _____”
What is the problem related to?	This may be related to several issues which we have already discussed. Imbalanced nutrition may be related to deficient knowledge, cultural habits, and limited access to fresh foods.
Plan and desired outcome	Discuss the patient’s current dietary habits. Educate the patient concerning their body’s metabolic needs, how this relates to losing weight (decreasing calorie intake prompts the body to metabolize fats for energy), and how to use a tool like the MyPlate Food Tracker to assess and maintain a balanced diet. Desired outcome is gradual, consistent loss of weight (about 1-2 pounds per week) through a balanced and calorie-limited diet.
Nursing intervention	Provide the education and conversation discussed above, as well as encouragement and continued support during this difficult lifestyle change. Promote enrollment in a cooking class to increase patient’s confidence in preparing healthy meals. Offer information on any local weight loss support groups, particularly ones focusing on proper nutrition.