APPENDIX A Nursing Diagnoses Arranged by Maslow’s Hierarchy of Needs Because human beings adapt in many ways to establish and maintain the self, health problems are much more than simple physical matters. Maslow’s Hierarchy of Needs (see diagram below) is a system of classifying human needs. Maslow’s hierarchy is based on the idea that lower level physiological needs must be met before higher level, abstract needs can be met. For nurses, Maslow’s hierarchy has special significance in decision-making and planning for care. By considering need categories as you identify client problems, you will be able to provide more holistic care. For example, a client who demands frequent attention for a seemingly trivial matter may require help with self-esteem needs. Need levels vary from client to client. If a client is short of breath, the client is probably not interested in or capable of discussing spirituality. In addition, a client’s need level may change throughout planning and intervention, so you will need to be vigilant in your assessment. All needs are relevant. Too many times physiological problems are caused by Self-actualization Self-esteem Love and belonging Safety and security Physiological needs unmet psychological problems. For example, poor self-esteem or unmet needs for love can result in use of food as a source of comfort, leading to obesity and resultant heart disease. Read the descriptions of each category in the diagram and see how you would relate them to nursing diagnoses. Compare your evaluation with how the authors categorized the nursing diagnoses according to this hierarchy. Be sure to assess clients for potential problems at all levels of the pyramid, regardless of their initial complaint. Recognition and realization of potential, growth, health, and autonomy Sense of self-worth, self-respect, independence, dignity, privacy, self-reliance Affiliation, affection, intimacy, support, reassurance Safety from physiological and psychological threats; protection, continuity, stability, lack of danger Oxygen, food, elimination, temperature control, sex, movement, rest, comfort Reprinted with permission from Nursing diagnosis referred manual, copyright 1991, Springhouse Corp. All rights reserved. PHYSIOLOGICAL NEEDS Activity intolerance Activity intolerance, risk for Airway clearance, ineffective Aspiration, risk for Autonomic Dysreflexia Bleeding, risk for Blood Pressure, risk for unstable Breastfeeding, ineffective Breastfeeding, interrupted Breastfeeding, readiness for enhanced Breast Milk, insufficient Breathing pattern, ineffective Cardiac output, decreased Cardiac output, risk for decreased Cardiac tissue perfusion, risk for decreased Cerebral tissue perfusion, risk for ineffective Comfort, impaired Comfort, readiness for enhanced Constipation Copyright © 2020 by Elsevier Inc. All rights reserved. Constipation, chronic functional Constipation, perceived Constipation, risk for Constipation, risk for chronic functional Dentition, impaired Diarrhea Eating dynamics, ineffective adolescent Eating dynamics, ineffective child Eating dynamics, ineffective infant Electrolyte imbalance, risk for Eye, risk for dry A-1 A-2 APPENDIX A Fatigue Feeding pattern, ineffective infant Fluid volume, deficient Fluid volume, excess Fluid volume, risk for deficient Fluid volume, risk for imbalanced Gas exchange, impaired Gastrointestinal motility, dysfunctional Gastrointestinal motility, risk for dysfunctional Glucose level, risk for unstable blood Hyperthermia Hypothermia Hypothermia, risk for Hypothermia, risk for Perioperative Incontinence, bowel Incontinence, functional urinary Incontinence, overflow urinary Incontinence, reflex urinary Incontinence, risk for urge urinary Incontinence, stress urinary Incontinence, urge urinary Infant behavior, disorganized Infant behavior, readiness for enhanced organized Infant behavior, risk for disorganized Injury, risk for corneal Injury, risk for urinary tract Insomnia Intracranial adaptive capacity, decreased Jaundice, neonatal Jaundice, risk for neonatal Latex Allergy response Liver function, risk for impaired Metabolic Imbalance syndrome, risk for Mobility, impaired bed Mobility, impaired physical Mobility, impaired wheelchair Mouth, risk for dry Nausea Nutrition: less than body requirements, imbalanced Obesity Oral Mucous Membrane, impaired Oral Mucous Membrane, risk for impaired Overweight Overweight, risk for Pain, acute Pain, chronic Pain syndrome, chronic Pain, labor Pressure ulcer, risk for Protection, ineffective Self-Care deficit, bathing Self-Care deficit, dressing Self-Care deficit, feeding Self-Care deficit, toileting Sexual dysfunction Sexuality pattern, ineffective Shock, risk for Sitting, impaired Skin integrity, impaired Skin integrity, risk for impaired Sleep deprivation Sleep pattern, disturbed Sleep, readiness for enhanced Standing, impaired Surgical recovery, delayed Surgical recovery, risk for delayed Swallowing, impaired Thermoregulation, ineffective Tissue integrity, impaired Tissue integrity, risk for impaired Tissue Perfusion, ineffective peripheral Tissue Perfusion, risk for ineffective peripheral Transfer ability, impaired Urinary elimination, impaired Urinary Retention Vascular Trauma, risk for Venous Thromboembolism, risk for Ventilation, impaired spontaneous Ventilatory weaning response, dysfunctional Walking, impaired SAFETY AND SECURITY NEEDS Anxiety Anxiety, death Autonomic Dysreflexia Autonomic Dysreflexia, risk for Communication, impaired verbal Communication, readiness for enhanced Confusion, acute Confusion, chronic Confusion, risk for acute Contamination Contamination, risk for Contrast Media, risk for adverse reaction to iodinated Coping, ineffective community Coping, readiness for enhanced community Copyright © 2020 by Elsevier Inc. All rights reserved. Decision-Making, impaired emancipated Decision-Making, risk for impaired emancipated Disuse syndrome, risk for Emotional Control, labile Falls, risk for Family processes, dysfunctional Fear Female Genital Mutilation, risk for Frail Elderly syndrome Frail Elderly syndrome, risk for Grieving Grieving, complicated Grieving, risk for complicated Health, deficient community Health behavior, risk-prone Health maintenance, ineffective Health management, ineffective Health management, ineffective family Home maintenance, impaired Identity, risk for disturbed personal Impulse control, ineffective Infection, risk for Infection, risk for surgical site Injury, risk for Injury, risk for occupational Knowledge, deficient Knowledge, readiness for enhanced Latex Allergy response, risk for Memory, impaired Mood regulation, impaired Neonatal Abstinence syndrome Perioperative Positioning injury, risk for Peripheral Neurovascular dysfunction, risk for Poisoning, risk for Resilience, risk for impaired Sedentary lifestyle Self-Neglect Sorrow, chronic Substance Withdrawal syndrome, acute Substance Withdrawal syndrome, risk for acute Sudden Infant Death, risk for Suffocation, risk for Thermal injury, risk for Thermoregulation, risk for ineffective Trauma, risk for Unilateral Neglect Vascular Trauma, risk for Wandering APPENDIX A LOVE AND BELONGING NEEDS Anxiety Attachment, risk for impaired Caregiver Role Strain Caregiver Role Strain, risk for Childbearing process, ineffective Childbearing process, readiness for enhanced Childbearing process, risk for ineffective Coping, compromised family Coping, disabled family Coping, readiness for enhanced Coping, readiness for enhanced family Family processes, dysfunctional Family processes, interrupted Family processes, readiness for enhanced Grieving Immigration Transition, risk for complicated Loneliness, risk for Maternal–Fetal dyad, risk for disturbed Moral Distress Parenting, impaired Parenting, readiness for enhanced Parenting, risk for impaired Relationship, ineffective Relationship, readiness for enhanced Relationship, risk for ineffective Religiosity, impaired Religiosity, risk for impaired Relocation stress syndrome Relocation stress syndrome, risk for Role conflict, parental Social interaction, impaired Social isolation Sorrow, chronic Spiritual distress Spiritual distress, risk for SELF-ESTEEM NEEDS Activity planning, ineffective Activity planning, risk for ineffective Body Image, disturbed Coping, defensive Coping, ineffective Decision-Making, readiness for enhanced Decisional Conflict Denial, ineffective Diversional activity, deficient Energy Field, imbalanced Health behavior, risk-prone Hope, readiness for enhanced Hopelessness Human Dignity, risk for compromised Identity, disturbed personal Post-Trauma syndrome Post-Trauma syndrome, risk for Power, readiness for enhanced Powerlessness Powerlessness, risk for Rape-Trauma syndrome Resilience, impaired Resilience, risk for impaired Copyright © 2020 by Elsevier Inc. All rights reserved. Role performance, ineffective Self-Esteem, chronic low Self-Esteem, risk for chronic low Self-Esteem, risk for situational low Self-Esteem, situational low Self-Mutilation Self-Mutilation, risk for Social interaction, impaired Stress overload Suicide, risk for Violence, risk for other-directed Violence, risk for self-directed SELFACTUALIZATION NEEDS Childbearing process, readiness for enhanced Decision-Making, readiness for enhanced Decision-Making, readiness for enhanced emancipated Development, risk for delayed Health management, readiness for enhanced Knowledge, readiness for enhanced Literacy, readiness for enhanced health Nutrition, readiness for enhanced Power, readiness for enhanced Religiosity, readiness for enhanced Resilience, readiness for enhanced Self-Care, readiness for enhanced Self-Concept, readiness for enhanced Spiritual well-being, readiness for enhanced A-3
