Is stress a diagnosis?

RN007 · Sep 10, 2006

I use Ackley's Nursing Diagnosis Handbook and it offers (I put ** around nursing diagnoses):

*Anxiety* r/t ...

Disturbed *Energy* field r/t ...

*Fear* r/t ...

*Ineffective Coping* r/t ...

Readiness for enhanced *Communication* r/t ...

Readiness for enhanced *Spiritual* well-being r/t ...

Risk for *Post-trauma* syndrome r/t ...

*Self-esteem* disturbance r/t ...

Good luck with your care plan!

nur2007sing · Sep 11, 2006

Thanks for the help. I ended up using altered health maintence

Daytonite, BSN, RN · Sep 12, 2006

hi, nur2007sing!

stress is a symptom. the answer to your question is no, nanda does not have a diagnosis for stress. they do, however, have several other nursing diagnoses that may, i said may, fit your needs. the reason i say this is because you also have to look at other signs and symptoms that the patient has been exhibiting to make a proper decision about which nursing diagnosis to choose. those other nursing diagnoses might be:

anxiety
fear
ineffective coping
self-esteem disturbance

i would recommend that you try to expand your assessment of this patient's stress if you can. stress is a very vague term. can you think of any of the physical signs she exhibited to indicate her stress such as pacing, nail biting, inability to sit still, or the expressions on their face. these are called the defining symptoms that are a necessary part of the nursing diagnosis you use. they become the part that follows the aeb (as evidenced by) part of your diagnostic statement.

every nursing diagnosis has defining symptoms just like every medical diagnosis has a set of defining symptoms. a good care plan book would help you to understand this part of picking a nursing diagnosis. it is a crucial concept that you must learn.

based on what you have put into your two posts to this thread i am worried that you may have chosen the wrong nursing diagnosis for this patient. altered health maintenance (the proper nanda teminology is: ineffective health maintenance) is the "inability to identify, manage, and/or seek out help to maintain health" (nursing diagnoses: definitions & classification 2005 - 2006, nanda, page 90). that doesn't sound anywhere near what you described as your patient. furthermore, stress is not one of the defining characteristics of this diagnosis. almost all the defining characteristics of this diagnosis relate to not seeking help or the patient not reporting or expressing any interest in improving their current health situation. did you have assessment data to support that?

i noticed in looking at all the other posts you have made that you haven't made any to the student nursing forums. you will get better responses to questions like this on those forums. i invite you to visit them. you will find many, many students who are having the same problems as you. here are the links:

https://allnurses.com/forums/f205/ - nursing student assistance forums

https://allnurses.com/forums/f50/ - the general nursing student discussion forum

you should also check out these threads that are on these two websites. they were specifically earmarked to help students with their care planning process. you will find a great deal of helpful information within those threads. please feel free to pm (private message) me if you have any questions about care plans as i have a good understanding of nanda and nursing diagnosis and will give you constructive help.

https://allnurses.com/forums/f205/desperately-need-help-careplans-170689.html - desperately need help with careplans (in nursing student assistance forum)

https://allnurses.com/forums/f50/careplans-help-please-r-t-aeb-121128-7.html - careplans help please! (with the r\t and aeb) (in general nursing student discussion forum)

https://allnurses.com/forums/f205/health-assessment-resources-techniques-forms-145091.html - health assessment resources, techniques, and forms (in nursing student assistance forum)

welcome to allnurses! :welcome: hope to see you on the allnurses nursing student forums!

nur2007sing · Sep 13, 2006

hi, nur2007sing!
stress is a symptom. the answer to your question is no, nanda does not have a diagnosis for stress. they do, however, have several other nursing diagnoses that may, i said may, fit your needs. the reason i say this is because you also have to look at other signs and symptoms that the patient has been exhibiting to make a proper decision about which nursing diagnosis to choose. those other nursing diagnoses might be:
anxiety
fear
ineffective coping
self-esteem disturbance
i would recommend that you try to expand your assessment of this patient's stress if you can. stress is a very vague term. can you think of any of the physical signs she exhibited to indicate her stress such as pacing, nail biting, inability to sit still, or the expressions on their face. these are called the defining symptoms that are a necessary part of the nursing diagnosis you use. they become the part that follows the aeb (as evidenced by) part of your diagnostic statement.
every nursing diagnosis has defining symptoms just like every medical diagnosis has a set of defining symptoms. a good care plan book would help you to understand this part of picking a nursing diagnosis. it is a crucial concept that you must learn.
based on what you have put into your two posts to this thread i am worried that you may have chosen the wrong nursing diagnosis for this patient. altered health maintenance (the proper nanda teminology is: ineffective health maintenance) is the "inability to identify, manage, and/or seek out help to maintain health" (nursing diagnoses: definitions & classification 2005 - 2006, nanda, page 90). that doesn't sound anywhere near what you described as your patient. furthermore, stress is not one of the defining characteristics of this diagnosis. almost all the defining characteristics of this diagnosis relate to not seeking help or the patient not reporting or expressing any interest in improving their current health situation. did you have assessment data to support that?
i noticed in looking at all the other posts you have made that you haven't made any to the student nursing forums. you will get better responses to questions like this on those forums. i invite you to visit them. you will find many, many students who are having the same problems as you. here are the links:
https://allnurses.com/forums/f205/ - nursing student assistance forums
https://allnurses.com/forums/f50/ - the general nursing student discussion forum
you should also check out these threads that are on these two websites. they were specifically earmarked to help students with their care planning process. you will find a great deal of helpful information within those threads. please feel free to pm (private message) me if you have any questions about care plans as i have a good understanding of nanda and nursing diagnosis and will give you constructive help.
https://allnurses.com/forums/f205/desperately-need-help-careplans-170689.html - desperately need help with careplans (in nursing student assistance forum)
https://allnurses.com/forums/f50/careplans-help-please-r-t-aeb-121128-7.html - careplans help please! (with the r\t and aeb) (in general nursing student discussion forum)
https://allnurses.com/forums/f205/health-assessment-resources-techniques-forms-145091.html - health assessment resources, techniques, and forms (in nursing student assistance forum)
welcome to allnurses! :welcome: hope to see you on the allnurses nursing student forums!

wow! thank you for taking the time and energy to help me. my patient is overweight due to the stressors she states she has in her life. these include trying to balace a professional, family and school commitments. i choose ineffective health maintenance related to increased food consumption in response to stressors and insufficient energy expenditure for intake.

i can understand however that her stress is a result not a cause of her being overweight. i do think ineffective coping would have been a better diagnosis though.

thank you

Antikigirl, ASN, RN · Sep 14, 2006

Heck I say look under NURSING! LOL! That is a Dx right? LOL~!

NO I agree with the above...stress is a very broad term, and not something that nurses can focus on very specifically. That is why NANDA breaks it down into dx terms for nursing we can help one at a time! And remember...no such thing as a one nursing dx plan! LOL! (wish there was! LOL!).

I haven't written a care plan since RN school, and I giggled last week when I was going through our care plan sheet (which is pre printed) and actually checked OTHER and said "Knowlege deficit r/t inability to understand Medcial Staff AEB verbalized confirmation of deaf/mute status by MD and caregiver and the inablity to communicate to me when direct questions asked to pt using american sign language and written word. (she couldn't read, couldn't write, couldn 't read lips, didn't know american sign language...I felt horrible!!!!!!!! I used pictures as much as possible and common sence hand gestures for assessments..that seemed to work...she was 46~!).

If there had been a NANDA for Deaf Mute..things would be simpler but not specific! (oh I added much more too...suprised the other RN's and myself I knew how to write these things! LOL!).

Daytonite, BSN, RN · Sep 14, 2006

nur2007sing. . .I would be very interested in knowing what comments your instructor has to give you about your care plan.

TriageRN_34. . .join us on the nursing student forums and help out with this nursing diagnosis stuff. Last year I found it was the biggest stumbling block for the students. They don't have problems with the nursing interventions. It's always getting to and choosing the correct nursing diagnosis. I never learned this in school because I was in nursing school back in 1973 when we were taught to care plan by problems. I was introduced to nursing diagnosis when I went back for my BSN, but it was in it's early stages of evolution. Now, that I am also studying health information management and have been a medical coder I have a much better understanding of what NANDA has been doing. They are standardizing all these diagnoses because they are designed to be entered into computer databases. Therefore, we all have to know what we are choosing when we use a diagnosis. I really took a good look at the NANDA printed materials and a couple of careplan books over the summer to acquaint myself with what was going on. As far as I can figure out, I seem to be about the only RN who has even attempted to help the students understand this whole mystery of nursing diagnosis at all (if I'm even half-way good at doing that). Would sure like to see other RNs pitch in. Interested?