What three structural components comprise a nursing diagnosis?

October 2, 2025 •

3 min read

According to the CDC, chronic diseases linked to poor diet and lifestyle are a leading cause of death. At the heart of personalized care for these conditions, a nurse's clinical judgment is encapsulated in a nursing diagnosis. Understanding what three structural components comprise a nursing diagnosis is key to its effective application.

Quick Summary

A nursing diagnosis is built upon the PES format, consisting of three main parts: the problem statement or diagnostic label, the etiology or related factors, and the defining characteristics or signs and symptoms.

Key Points

The Three Components: A nursing diagnosis (for actual problems) is comprised of the Problem Statement (P), Etiology (E), and Defining Characteristics (S), known as the PES format.
Problem Statement: This is a standardized NANDA-I diagnostic label that clearly describes the patient's response to a health condition.
Etiology (Related Factors): The cause or contributing factor to the problem is linked by the phrase 'related to' and guides nursing interventions.
Defining Characteristics: The objective and subjective signs and symptoms that provide evidence for the diagnosis are linked by the phrase 'as evidenced by'.
Nursing vs. Medical Diagnosis: A nursing diagnosis addresses the patient's human response to an illness, while a medical diagnosis identifies the disease or condition itself.
Holistic and Dynamic: The nursing diagnosis is patient-centered and changes as the patient's condition and needs evolve, unlike a static medical diagnosis.

Introduction to the Foundation of Nursing Care

Every aspect of patient care relies on a solid foundation of clinical judgment and precise communication. The nursing diagnosis is a critical part of this foundation, serving as a framework for planning and implementing nursing interventions to achieve positive patient outcomes. Unlike a medical diagnosis, which identifies a specific disease, a nursing diagnosis focuses on the patient's human responses to their health conditions or life processes. This person-centered approach ensures that care is not just about treating the illness, but also addressing its impact on the individual's life. The standardized format used for writing a nursing diagnosis is the PES format, which explicitly outlines what three structural components comprise a nursing diagnosis for clear, consistent, and evidence-based care planning.

The Three Structural Components: The PES Format

The PES format provides a robust, standardized structure for documenting a patient's health problem. It stands for Problem, Etiology, and Symptoms. This structure is predominantly used for problem-focused diagnoses, which identify an actual health issue present at the time of the assessment.

1. The Problem Statement (P): The Diagnostic Label

The first component, the problem statement or diagnostic label, is a concise clinical judgment from NANDA International (NANDA-I) standardized terminology. These labels describe responses to health conditions or life processes. Using standardized terms ensures universal understanding among healthcare professionals, improving communication. An example is "Impaired Gas Exchange".

2. The Etiology (E): The Related Factors

The second component, etiology or related factors, details the contributing causes of the problem. It is linked by the phrase "related to". Identifying related factors, which can be physiological, psychological, environmental, or social, helps nurses target interventions effectively. For instance, Impaired Gas Exchange might be "related to bronchial airway inflammation". The related factor should be something a nurse can address.

3. The Defining Characteristics (S): The Evidenced-by Data

The final component, defining characteristics, consists of the signs and symptoms providing evidence for the diagnosis. These are connected by "as evidenced by". Both subjective and objective cues validate the diagnosis and guide intervention evaluation. Examples for Impaired Gas Exchange include "coarse rhonchi," "O2 saturation level of 88%," and "shortness of breath".

Beyond Problem-Focused: Variations in Nursing Diagnoses

While the three-part PES statement is common for actual problems, other diagnosis types have variations. Risk diagnoses, for potential problems, use a two-part statement: the diagnostic label and risk factors, like Risk for Infection as evidenced by impaired skin integrity. Health promotion diagnoses, addressing readiness for enhanced well-being, often use a one-part statement with just the label, such as Readiness for Enhanced Family Coping. Syndrome diagnoses, clusters of diagnoses occurring together, can be one-part (syndrome label) or two-part (syndrome and supporting diagnoses).

Nursing Diagnosis vs. Medical Diagnosis

Understanding the distinction between nursing and medical diagnoses is crucial. A medical diagnosis identifies a disease, while a nursing diagnosis focuses on the patient's human response. Nursing diagnoses are dynamic and change with the patient's condition, whereas medical diagnoses are typically static.


Feature	Nursing Diagnosis	Medical Diagnosis
Focus	Patient's human response to health problems or life processes (e.g., Impaired Physical Mobility).	Identification and classification of a disease or medical condition (e.g., Stroke).
Purpose	Guides the selection of nursing interventions to achieve patient outcomes within the scope of nursing practice.	Guides medical treatment and determines the illness's pathology.
Professionals	Formulated and managed by nurses independently.	Determined by physicians or advanced practice providers.
Duration	Changes as the patient's condition and needs change.	Stays the same as long as the disease or condition is present.
Example	Impaired Verbal Communication	Pneumonia

Practical Application and Conclusion

Developing a nursing diagnosis using the PES format requires careful assessment, critical thinking, and understanding of patient responses. It connects assessment findings to the care plan, facilitating communication and consistent care. This structured approach highlights the vital role of nurses in holistic patient health. For more on the nursing process, including assessment and planning, explore resources like those from OpenStax.

Frequently Asked Questions

PES is an acronym for Problem, Etiology, and Symptoms. It is the standard format for writing a problem-focused nursing diagnosis, articulating the patient's issue, its cause, and the evidence supporting it.

No, they are different. A medical diagnosis identifies a specific disease or medical condition, while a nursing diagnosis describes a patient's response to that condition. For example, a medical diagnosis might be 'pneumonia,' while a nursing diagnosis could be 'Ineffective Airway Clearance'.

Not all. The three-part PES format is primarily used for problem-focused (actual) diagnoses. Risk, health promotion, and syndrome diagnoses use two-part or one-part statements based on their specific structure.

The related factors, or etiology, explain the probable cause or contributing factors to the patient's health problem. Identifying the etiology is crucial because it helps the nurse select appropriate, targeted interventions to address the problem's underlying cause.

Defining characteristics are the observable cues, signs, and symptoms that provide evidence for the diagnostic label. They can be subjective (patient statements) or objective (assessment findings) and are used to validate that the problem exists.

A problem-focused diagnosis identifies an actual problem that exists, supported by defining characteristics. A risk diagnosis identifies a potential problem that the patient is vulnerable to developing. It does not have defining characteristics but is supported by risk factors instead.

NANDA-I (North American Nursing Diagnosis Association-International) provides standardized terminology for nursing diagnoses. This ensures that nurses worldwide use consistent and accurate language to describe patient problems, which improves communication, research, and quality of care.