Full Answer Section

1. Planning: Here, the nurse develops a plan of care to address the identified nursing diagnoses. This plan includes specific goals and interventions (actions) to achieve those goals.

2. Implementation: The nurse carries out the plan of care, which may involve tasks like administering medications, providing education, or performing treatments.

3. Evaluation: The nurse continuously evaluates the patient’s progress towards the goals and modifies the plan of care as needed.

Here’s how the two grading points you mentioned relate to the nursing diagnosis step:

• Addressing 2 most acute/important clinical issues: A good nursing diagnosis should focus on the two most significant problems affecting the patient’s health. These problems should be based on the assessment data and should be within the nurse’s scope of practice.

• Written within standards: Nursing diagnoses should be written according to the standards set by the North American Nursing Diagnosis Association (NANDA). This means using terminology from the NANDA list, including a “related to” phrase that describes the cause of the problem (not a medical diagnosis itself), and including an “as evidenced by” phrase that lists signs and symptoms that support the diagnosis.

For example, let’s say a nurse is assessing a patient who has just been diagnosed with diabetes. During the assessment, the nurse finds that the patient has a poor understanding of diabetes management and has high blood sugar levels. Based on this information, the nurse could develop the following nursing diagnosis:

• Deficient Knowledge related to diabetes management as evidenced by verbal reports of difficulty understanding insulin administration and blood sugar monitoring procedures.

This diagnosis meets the criteria you mentioned:

• It addresses a critical issue for the patient (lack of knowledge about diabetes management).
• It’s written according to NANDA standards (uses NANDA terminology, includes “related to” and “as evidenced by” phrases).