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COMMUNITY DIAGNOSIS DEFINITION A community nursing diagnosis is a clinical statement of an actual or potential health problem in a community. A nurse bases identification on her professional judgment, in order to create a plan for improvement. Basis While medical doctors treat diseases and conditions, nurses treat the physical, psychological, social or cultural problems that arise from a disease or condition. A community nursing diagnosis promotes wellness. Scope A community nursing diagnosis focuses on health promotion among a specific group of people in one place over a period of time. Therefore, a community can describe a city, a school or a given population, such as the homeless. Purpose The community nursing diagnosis is used to identify available resources, develop educational materials and plan interventions to address illness or improve health within the population. 1. Nursing diagnosis provide efficiency ,standardization and clarification 2. It provides purpose and direction 3. It facilitate research and education 4. It delineate independent nursing functions 5. It increases accountability

Components A community nursing diagnosis includes three parts: a problem or risk statement (illness or desired improvement), related factors (cause or etiology) and the signs and symptoms (based on confirmed subjective and objective assessment data).

Steps in community health nursing diagnosis

Recognition of the need Actual visit and observation of the community served What does community think or feel it needs Vital statistics and other records Routinestudies,questions,observations,examinations. Tentative status and chief problems Specific study feel pertinent and necessary This is your problem in writing with the publicity Community involvement,community prognosis and alternatives Plan, procedure and programme ,community understanding,co-orperation and participation Follow up and evaluation of the programme.

CATEGORISING COMMUNITY HEALTH DIAGNOSIS There are mainly 4 categories

a.Health problems 1.Malaria,leprosy,TB,hepatitis,and other disease 2.Malnutrition 3.Respiratory infections 4.Diarrhoea 5.Complications of pregnancy and Labour 6.Low birth weight of infants 7.Infection of eye, ear,nose,and throat 8.Worm infestations 9.Insect and snake bite 10.Dog bites and others 11.Prevalence of risk factor of RHD,hypertension. 12.Lack of health knowledge and attitude b.Health service problems 1.Lack of qualified health personnels,insufficient staff. 2.Insufficiency of and in accessibility of the materials for the treatment,insufficient drugs and other supplies. 3.Inadequate working conditions. 4.Lack of transport 5.Insufficient visit to communitymby health staff. 6.Other in Adequate ,insufficient,inefficient resources

c.Communication problems 1. No road to community 2.Bad roads 3.seasonal variations,weather and others 4.Inadequate transport 5. Floods and other disaster d. Community problems in general 1. Inadequate water supply 2. Contaminated watersupply 3. No primary education 4. Poor environmental sanitation. 5. Bad and overcrowded houses 6. Draught 7. Unempolyment 8. Poor harvest. NANDA International (formerly the North American Nursing Diagnosis Association) is a professional organization of nurses standardized nursing terminology that was officially founded in 1982 and develops, researches, disseminates and refines the nomenclature, criteria, and taxonomy of nursing diagnosis. In 2002, NANDA relaunched as NANDA International in response to the broadening scope of its membership. NANDA International published Nursing Diagnosis quarterly, which became the International journal of nursing terminologies and classification in 2002.Other related international associations are AENTDE (Spanish), AFEDI (French language) and JSND (Japan)

History
In 1973 the First National Conference on the Classification of Nursing Diagnoses was held in St. Louis, Missouri which created the National Conference Group, a task force to standardize nursing

terminology. In 1982 NANDA was formed including members from the United States and Canada. NANDA developed a nursing classification to organize nursing diagnoses into different categories. Although the taxonomy was revised to accommodate new diagnoses, in 1994 it became apparent that an overhaul was needed. In 2002 Taxonomy II, which was a revised version of Gordon's functional health patterns was released In 2002, NANDA became NANDA International in response to requests from its growing base of membership from outside North America. The acronym of NANDA was retained in the name because of the name recognition, but it is no longer merely "North American", and in fact boasts members from 32 countries as of 2010.

Taxonomy II
The current structure of NANDA's nursing diagnoses is referred to as Taxonomy II and has three levels: 13 domains, 47 classes, and 205 diagnoses. Statements of nursing diagnosis There are lot of difficulty in stating nursing because of lack of uniformity(NANDA terms) 1.Acute Severe pain of short duration ,e.g.acute urinary retention. 2.Altered-A change from usual optimum for a particular patient 3.Anticipatory-Occuring in advance eg:-anticipatory greiving 4.Chronic:- Lastingalongtime,reccurring,habitual, constant,eg:chronic pain

5.Compromised:-To lay open to danger,to endanger the interest off,eg:-ineffective family coping compromised 6.Decreased:-Smaller ,lessened,diminished lesser in size,amount or degree,eg:-decreased cardiac out put. 7.Deficit:-Amount or quantity that is less than what is necessary ,desirable or usable.eg:-divertional activity deficit. 8.Disturbance :-The state of being agitated,interrupted or interfered with eg:-Sleep pattern disturbance 9.Dysfunctional:-Abnormal ,impaired or incompleted functioning eg:-sexual functioninig 10 Excess:-Amount or quantity that is greater than what is necessary ,desirable or usable Eg:-Fluid volume deficit 11 .Impaired:-Madeworse, weakened ,damaged,reduced , deteriorated ,eg:-Social interaction impaired. 12.Ineffective:-Not producing the desired effect ,not capable of performing saticfactorily.eg:-ineffective breast feeding. 13.Less than:-A smaller amount of eg:-altered nutrition less than body requirement. 14.More than:-A larger amount of ,eg:-altered nutrition more temperature. 15.Potential:-The individual is at risk for a problem eg:-potential for injury or infection. NANDA NURSING DIAGNOSIS GENERAL Altered behaviour pattern related to,substance abuse ,i.e,addiction to drug,alcohol.

Altered body temperature related to infection /inflammation/injury. Altered bowel function related to consumption of food or water.

Altered self concept related to pregnancy. Altered body image chrelatedtoburns./accidents/amputation. Altered comfort related to pain(specify back ache,head ache,etc.)

Altered elimination related to rectal prolapse or piles.


Activity Intolerance Risk for Activity Intolerance Impaired Adjustment Ineffective Airway Clearance Latex Allergy Response Risk for Latex Allergy Response Anxiety Death Anxiety Risk for Aspiration Risk for Impaired Parent/Infant/Child Attachment Autonomic Dysreflexia Risk for Autonomic Dysreflexia Disturbed Body Image Risk for Imbalanced Body Temperature Bowel Incontinence Effective Breastfeeding Ineffective Breastfeeding Interrupted Breastfeeding

Ineffective Breathing Pattern Decreased Cardiac Output Caregiver Role Strain Risk for Caregiver Role Strain Impaired Verbal Communication Readiness for Enhanced Communication Decisional Conflict (Specify) Parental Role Conflict Acute Confusion

Chronic Confusion Constipation Perceived Constipation Risk for Constipation Defensive Coping Ineffective Coping Readiness for Enhanced Coping Ineffective Community Coping Readiness for Enhanced Community Coping Compromised Family Coping Disabled Family Coping Readiness for Enhanced Family Coping Risk for Sudden Infant Death Syndrome Ineffective Denial Impaired Dentition Risk for Delayed Development Diarrhea Risk for Disuse Syndrome Deficient Diversional Activity

Energy Field Disturbance Impaired Environmental Interpretation Syndrome Adult Failure to Thrive Risk for Falls Dysfunctional Family Processes: Alcoholism Interrupted Family Processes Readiness for Enhanced Family Processes Fatigue Fear Readiness for Enhanced Fluid Balance Deficient Fluid Volume Excess Fluid Volume Risk for Deficient Fluid Volume Risk for Imbalanced Fluid Volume Impaired Gas Exchange Anticipatory Grieving Dysfunctional Grieving Risk for Dysfunctional Grieving Delayed Growth and Development Risk for Disproportionate Growth Ineffective Health Maintenance Health-Seeking Behaviors (Specify) Impaired Home Maintenance Hopelessness Hyperthermia Hypothermia Disturbed Personal Identity Functional Urinary Incontinence

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Reflex Urinary Incontinence Stress Urinary Incontinence Total Urinary Incontinence Urge Urinary Incontinence Risk for Urge Urinary Incontinence Disorganized Infant Behavior Risk for Disorganized Infant Behavior Readiness for Enhanced Organized Infant Behavior Ineffective Infant Feeding Pattern Risk for Infection Risk for Injury Risk for Perioperative-Positioning Injury Decreased Intracranial Adaptive Capacity Deficient Knowledge Readiness for Enhanced Knowledge (Specify) Risk for Loneliness Impaired Memory Impaired Bed Mobility Impaired Physical Mobility Impaired Wheelchair Mobility Nausea Unilateral Neglect Noncompliance Imbalanced Nutrition: Less than Body Requirements Imbalanced Nutrition: More than Body Readiness for Enhanced Nutrition Risk for Imbalanced Nutrition: More than

Requirements

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BodyRequirements

Impaired Oral Mucous Membrane Acute Pain Chronic Pain Readiness for Enhanced Parenting Impaired Parenting Risk for Impaired Parenting Risk for Peripheral Neurovascular Dysfunction Risk for Poisoning Post-Trauma Syndrome Risk for Post-Trauma Syndrome Powerlessness Risk for Powerlessness Ineffective Protection Rape-Trauma Syndrome Rape-Trauma Syndrome: Compound Reaction Rape-Trauma Syndrome: Silent Reaction Impaired Religiosity Readiness for Enhanced Religiosity Risk for Impaired Religiosity Relocation Stress Syndrome Risk for Relocation Stress Syndrome Ineffective Role Performance Sedentary Life Style Bathing/Hygiene Self-Care Deficit Dressing/Grooming Self-Care Deficit Feeding Self-Care Deficit Toileting Self-Care Deficit

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Readiness for Enhanced Self-Concept Chronic Low Self-Esteem Situational Low Self-Esteem Risk for Situational Low Self-Esteem Self-Mutilation Risk for Self-Mutilation Disturbed Sensory Perception (Specify: Visual,

Auditory, Kinesthetic, Gustatory, Tactile, Olfactory)


Sexual Dysfunction Ineffective Sexuality Patterns Impaired Skin Integrity Risk for Impaired Skin Integrity Sleep Deprivation Disturbed Sleep Pattern Readiness for Enhanced Sleep Impaired Social Interaction Social Isolation Chronic Sorrow Spiritual Distress Risk for Spiritual Distress Readiness for Enhanced Spiritual Well-Being Risk for Suffocation Risk for Suicide Delayed Surgical Recovery Impaired Swallowing Effective Therapeutic Regimen Management Ineffective Therapeutic Regimen Management

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Readiness for Enhanced Management of TherapeuticRegimen Ineffective Community Therapeutic RegimenManagement Ineffective Family Therapeutic Regimen Management Ineffective Thermoregulation Disturbed Thought Processes Impaired Tissue Integrity Ineffective Tissue Perfusion (Specify Type:

Renal,Cerebral, Cardiopulmonary, Gastrointestinal,Peripheral)


Impaired Transfer Ability Risk for Trauma Impaired Urinary Elimination Readiness for Enhanced Urinary Elimination Urinary Retention Impaired Spontaneous Ventilation Dysfunctional Ventilatory Weaning Response Risk for Other-Directed Violence Risk for Self-Directed Violence Impaired Walking Wandering