Nursing diagnoses in hospitalized patients with COVID-19 in Indonesia


nursing diagnosis
nursing assessments

How to Cite

Hidayati, N., Hadi, F., Suratmi, S., Maghfiroh, I. L. ., Andarini, E., Setiawan, H., & Lutfi Sandi, Y. D. . (2022). Nursing diagnoses in hospitalized patients with COVID-19 in Indonesia . Belitung Nursing Journal, 8(1), 44–52.
Share |


Background: The COVID-19 pandemic has become a global public health issue, and the roles of nurses are very much needed in providing nursing services in the current situation. The enforcement of appropriate nursing diagnoses for patients with COVID-19 is also fundamental in determining proper nursing care to help the patients achieve maximum health.

Objective: This study aimed to describe and analyze nursing diagnoses in patients with COVID-19 treated in the isolation rooms and ICUs.

Methods: This study used a secondary data analysis from hospital medical record data of patients with COVID-19 from early December 2020 to the end of February 2021. Data were selected using a cluster random sampling technique and analyzed using descriptive statistics.

Results: The results showed that the signs and symptoms of the patients with COVID-19 that often appeared were fever, cough, shortness of breath, and decreased consciousness. The common nursing diagnoses in the hospitalized patients with COVID-19 were hyperthermia, ineffective airway clearance, gas exchange disorder, self-care deficit, spontaneous ventilation disorder, spontaneous circulation disorder, knowledge deficit, and shock risk.

Conclusion: This study offers an insight into nursing practices in the hospital setting, which can be used as a basis for nurses to perform complete nursing assessments and nursing diagnoses during the pandemic.


Copyright (c) 2022 Nur Hidayati, Farhan Hadi, Suratmi Suratmi, Isni Lailatul Maghfiroh, Esti Andarini, Henri Setiawan, Yudisa Diaz Lutfi Sandi

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Article Metrics

Abstract views: 894 | PDF views: 387


Download data is not yet available.

PlumX Metrics

Declaration of Conflicting Interest

The authors declare that they have no conflict of interest in this study.



Authors’ Contributions

All authors contributed substantial contributions to the study, critically reviewed and revised the manuscript, approved the version to be published, and agreed to be responsible for all aspects of the work. Specifically, study conception and design: NH, FH, S, ILM, EA. Data collection: FH, NH, S, ILM. Data analysis and interpretation: NH, FH, HS, YDS, EA. Drafting article: EA, HS, YDS. Critically revised the article: EA, YDS.

Data Availability

Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.


Show | Hide

Alhazzani, W., Møller, M. H., Arabi, Y. M., Loeb, M., Gong, M. N., Fan, E., . . . Dzierba, A. (2020). Surviving sepsis campaign: Guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19). Intensive Care Medicine, 46(5), 854-887.

Ando, T., & Kitaura, J. (2021). Tuning IgE: IgE-associating molecules and their effects on IgE-dependent mast cell reactions. Cells, 10(7), 1697.

Barbeta, E., Motos, A., Torres, A., Ceccato, A., Ferrer, M., Cilloniz, C., . . . Ferrando, C. (2020). SARS-CoV-2–induced acute respiratory distress syndrome: Pulmonary mechanics and gas-exchange abnormalities. Annals of the American Thoracic Society, 17(9), 1164-1168.

Barros, A. L. B. L. d., Silva, V. M. d., Santana, R. F., Cavalcante, A. M. R. Z., Vitor, A. F., Lucena, A. d. F., . . . Carmona, E. V. (2020). Brazilian nursing process research network contributions for assistance in the COVID-19 pandemic. Revista Brasileira de Enfermagem, 73(Suppl 2), e20200798.

Batool Janjua, N., Petch, S., Akhtar Birmani, S., Seyal, S., Elhassadi, E., Azam, M., . . . Babu, S. (2021). Vertical transmission, maternal thrombocytopenia, & postpartum haemorrhage in coronavirus infection-a case report. BJOG: An International Journal of Obstetrics and Gynaecology, 128(Suppl 2), 198-198.

Brasil, S., Taccone, F. S., Wahys, S. Y., Tomazini, B. M., Annoni, F., Fonseca, S., . . . De-Lima-Oliveira, M. (2021). Cerebral hemodynamics and intracranial compliance impairment in critically ill COVID-19 patients: A pilot study. Brain Sciences, 11(7), 874.

Carpenito-Moyet, L. J. (2009). Nursing care plans & documentation: nursing diagnoses and collaborative problems (5th ed.). Philadelphia: Lippincott Williams & Wilkins.

Chen, R., Gao, Y., Chen, M., Jian, W., Lei, C., Zheng, J., & Li, S. (2020). Impaired pulmonary function in discharged patients with COVID-19: More work ahead. European Respiratory Journal, 56(1), 2002194.

D Amico, F., Baumgart, D. C., Danese, S., & Peyrin-Biroulet, L. (2020). Diarrhea during COVID-19 infection: Pathogenesis, epidemiology, prevention, and management. Clinical Gastroenterology and Hepatology, 18(8), 1663-1672.

de la Rica, R., Borges, M., & Gonzalez-Freire, M. (2020). COVID-19: In the eye of the cytokine storm. Frontiers in Immunology, 11, 2313.

Debuc, B., & Smadja, D. M. (2021). Is COVID-19 a new hematologic disease? Stem Cell Reviews and Reports 17(1), 4-8.

Deng, S.-Q., & Peng, H.-J. (2020). Characteristics of and public health responses to the coronavirus disease 2019 outbreak in China. Journal of Clinical Medicine, 9(2), 575.

Dewi, A., Utomo, B., & Rachman, S. (2020). Nursing care guide (PAK) for patients critical with COVID-19. Surabaya, Indonesia: Airlangga University Press.

Dhanani, L. Y., & Franz, B. (2020). The role of news consumption and trust in public health leadership in shaping COVID-19 knowledge and prejudice. Frontiers in Psychology, 11, 2812.

Fara, A., Mitrev, Z., Rosalia, R. A., & Assas, B. M. (2020). Cytokine storm and COVID-19: A chronicle of pro-inflammatory cytokines. Open Biology, 10(9), 200160.

Gerhold, L. (2020). COVID-19: risk perception and coping strategies. PsyArXiv.

Giannessi, M., Ursino, M., & Murray, W. B. (2008). The design of a digital cerebrovascular simulation model for teaching and research. Anesthesia & Analgesia, 107(6), 1997-2008.

González Aguña, A., Jiménez‐Rodríguez, M. L., Fernández‐Batalla, M., Herrero‐Jaén, S., Monsalvo‐San Macario, E., Real‐Martínez, V., & Santamaría‐García, J. M. (2021). Nursing diagnoses for coronavirus disease, COVID‐19: Identification by taxonomic triangulation. International Journal of Nursing Knowledge, 32(2), 108-116.

Guan, W.-j., Ni, Z.-y., Hu, Y., Liang, W.-h., Ou, C.-q., He, J.-x., . . . Hui, D. S. C. (2020). Clinical characteristics of coronavirus disease 2019 in China. New England Journal of Medicine, 382(18), 1708-1720.

Gulati, A., Pomeranz, C., Qamar, Z., Thomas, S., Frisch, D., George, G., . . . Sundaram, B. (2020). A comprehensive review of manifestations of novel coronaviruses in the context of deadly COVID-19 global pandemic. The American Journal of the Medical Sciences, 360(1), 5-34.

GÃœNer, H. R., HasanoÄŸlu, Ä°., & AktaÅŸ, F. (2020). COVID-19: Prevention and control measures in community. Turkish Journal of Medical Sciences, 50(SI-1), 571-577.

Guo, Y.-R., Cao, Q.-D., Hong, Z.-S., Tan, Y.-Y., Chen, S.-D., Jin, H.-J., . . . Yan, Y. (2020). The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak–an update on the status. Military Medical Research, 7(1), 1-10.

Hashemi, L., & Homayuni, H. (2017). Emotional divorce: Child’s well-being. Journal of Divorce & Remarriage, 58(8), 631-644.

Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., . . . Gu, X. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet, 395(10223), 497-506.

Hunt, R. H., East, J. E., Lanas, A., Malfertheiner, P., Satsangi, J., Scarpignato, C., & Webb, G. J. (2021). COVID-19 and gastrointestinal disease: Implications for the Gastroenterologist. Digestive Diseases, 39(2), 119-139.

Huynh, G., Nguyen, M. Q., Tran, T. T., Nguyen, V. T., Nguyen, T. V., Do, T. H. T., . . . Nguyen, T. N. H. (2020). Knowledge, attitude, and practices regarding COVID-19 among chronic illness patients at outpatient departments in Ho Chi Minh City, Vietnam. Risk Management and Healthcare Policy, 13, 1571-1578.

Izquierdo-Dominguez, A., Rojas-Lechuga, M. J., Mullol, J., & Alobid, I. (2020). Olfactory dysfunction in the COVID-19 outbreak. Journal of Investigational Allergology and Clinical Immunology, 30(5), 317-326.

Jafarzadeh, A., Chauhan, P., Saha, B., Jafarzadeh, S., & Nemati, M. (2020). Contribution of monocytes and macrophages to the local tissue inflammation and cytokine storm in COVID-19: Lessons from SARS and MERS, and potential therapeutic interventions. Life Sciences, 257, 118102.

Kang, C. K., Han, G.-C., Kim, M., Kim, G., Shin, H. M., Song, K.-H., . . . Kim, H. B. (2020). Aberrant hyperactivation of cytotoxic T-cell as a potential determinant of COVID-19 severity. International Journal of Infectious Diseases, 97, 313-321.

Kanjanaumporn, J., Aeumjaturapat, S., Snidvongs, K., Seresirikachorn, K., & Chusakul, S. (2020). Smell and taste dysfunction in patients with SARS-CoV-2 infection: A review of epidemiology, pathogenesis, prognosis, and treatment options. Asian Pacific Journal of Allergy and Immunology, 38(2), 69-77.

Keller, H. H., Carrier, N., Slaughter, S. E., Lengyel, C., Steele, C. M., Duizer, L., . . . Yoon, M. N. (2017). Prevalence and determinants of poor food intake of residents living in long-term care. Journal of the American Medical Directors Association, 18(11), 941-947.

Khan, M. A., Khan, Z. A., Charles, M., Pratap, P., Naeem, A., Siddiqui, Z., . . . Srivastava, S. (2021). Cytokine storm and mucus hypersecretion in COVID-19: Review of mechanisms. Journal of Inflammation Research, 14, 175-189.

Levi, M., & Iba, T. (2021). COVID-19 coagulopathy: Is it disseminated intravascular coagulation? Internal and Emergency Medicine, 16(2), 309-312.

Li, J.-Y., You, Z., Wang, Q., Zhou, Z.-J., Qiu, Y., Luo, R., & Ge, X.-Y. (2020). The epidemic of 2019-novel-coronavirus (2019-nCoV) pneumonia and insights for emerging infectious diseases in the future. Microbes and Infection, 22(2), 80-85.

Liu, Q., Luo, D., Haase, J. E., Guo, Q., Wang, X. Q., Liu, S., . . . Yang, B. X. (2020). The experiences of health-care providers during the COVID-19 crisis in China: A qualitative study. The Lancet Global Health, 8(6), e790-e798.

Lu, R., Zhao, X., Li, J., Niu, P., Yang, B., Wu, H., . . . Zhu, N. (2020). Genomic characterisation and epidemiology of 2019 novel coronavirus: Implications for virus origins and receptor binding. The Lancet, 395(10224), 565-574.

Marshall, M. (2020). How COVID-19 can damage the brain. Nature, 585(7825), 342-343.

Matzkin, M. E., Riviere, E., Rossi, S. P., Ponzio, R., Puigdomenech, E., Levalle, O., . . . Frungieri, M. B. (2019). β-adrenergic receptors in the up-regulation of COX2 expression and prostaglandin production in testicular macrophages: Possible relevance to male idiopathic infertility. Molecular and Cellular Endocrinology, 498, 110545.

McHenry, L. C., Slocum, H. C., Bivens, H. E., Mayes, H. A., & Hayes, G. J. (1965). Hyperventilation in awake and anesthetized man: Effects on cerebral blood flow and cerebral metabolism. Archives of Neurology, 12(3), 270-277.

Mejía, F., Medina, C., Cornejo, E., Morello, E., Vásquez, S., Alave, J., . . . Málaga, G. (2020). Oxygen saturation as a predictor of mortality in hospitalized adult patients with COVID-19 in a public hospital in Lima, Peru. PloS One, 15(12), e0244171.

Moller, N., Beckwith, R., Butler, P. C., Christensen, N. J., Ørskov, H., & Alberti, K. (1989). Metabolic and hormonal responses to exogenous hyperthermia in man. Clinical Endocrinology, 30(6), 651-660.

Motta Junior, J. d. S., Miggiolaro, A. F. R. d. S., Nagashima, S., de Paula, C. B. V., Baena, C. P., Scharfstein, J., & de Noronha, L. (2020). Mast cells in alveolar septa of COVID-19 patients: A pathogenic pathway that may link interstitial edema to immunothrombosis. Frontiers in Immunology, 11, 2369.

Nascimento, T. F., Almeida, G. M. F. d., Bello, M. P., Silva, R. P. L. d., & Fontes, C. M. B. (2021). Coronavirus infections: Health care planning based on Orem's Nursing Theory. Revista Brasileira de Enfermagem, 74(Suppl 1), e20200281.

Noris, M., Benigni, A., & Remuzzi, G. (2020). The case of complement activation in COVID-19 multiorgan impact. Kidney International, 98(2), 314-322.

Nursalam. (2015). Nursing research methodology: Practical approach (4th ed.). Jakarta, Indonesia: Salemba Medika.

Ostergaard, L. (2021). SARS CoV‐2 related microvascular damage and symptoms during and after COVID‐19: Consequences of capillary transit‐time changes, tissue hypoxia and inflammation. Physiological Reports, 9(3), e14726.

Panigada, M., Bottino, N., Tagliabue, P., Grasselli, G., Novembrino, C., Chantarangkul, V., . . . Tripodi, A. (2020). Hypercoagulability of COVID‐19 patients in intensive care unit: A report of thromboelastography findings and other parameters of hemostasis. Journal of Thrombosis and Haemostasis, 18(7), 1738-1742.

Persson, C. (2021). Early humoral defence: Contributing to confining COVID‐19 to conducting airways? Scandinavian Journal of Immunology, 93(6), e13024.

Petersson, J., & Glenny, R. W. (2014). Gas exchange and ventilation–perfusion relationships in the lung. European Respiratory Journal, 44(4), 1023-1041.

Petrishchev, N. N., Khalepo, O. V., Vavilenkova, Y. A., & Vlasov, T. D. (2020). COVID-19 and vascular disorders (literature review). Regional Blood Circulation and Microcirculation, 19(3), 90-98.

Rahman, A., Tabassum, T., Araf, Y., Al Nahid, A., Ullah, M. A., & Hosen, M. J. (2021). Silent hypoxia in COVID-19: Pathomechanism and possible management strategy. Molecular Biology Reports 48, 3863-3869.

Rasmussen, S. A., Smulian, J. C., Lednicky, J. A., Wen, T. S., & Jamieson, D. J. (2020). Coronavirus disease 2019 (COVID-19) and pregnancy: What obstetricians need to know. American Journal of Obstetrics and Gynecology, 222(5), 415-426.

Richardson, D. P., & Lovegrove, J. A. (2021). Nutritional status of micronutrients as a possible and modifiable risk factor for COVID-19: A UK perspective. British Journal of Nutrition, 125(6), 678-684.

Rony, M. K. K., Bala, S. D., Rahman, M. M., Dola, A. J., Kayesh, I., Islam, M. T., . . . Rahman, S. (2021). Experiences of front-line nurses caring for patients with COVID-19 in Bangladesh: A qualitative study. Belitung Nursing Journal, 7(5), 380-386.

Roudsari, P. P., Alavi-Moghadam, S., Payab, M., Sayahpour, F. A., Aghayan, H. R., Goodarzi, P., . . . Arjmand, B. (2020). Auxiliary role of mesenchymal stem cells as regenerative medicine soldiers to attenuate inflammatory processes of severe acute respiratory infections caused by COVID-19. Cell and Tissue Banking, 21, 405-425.

Shanthanna, H., Strand, N. H., Provenzano, D. A., Lobo, C. A., Eldabe, S., Bhatia, A., . . . Narouze, S. (2020). Caring for patients with pain during the COVID‐19 pandemic: Consensus recommendations from an international expert panel. Anaesthesia, 75(7), 935-944.

Sholihah, L. (2020). The role and competence of nurses in handling a pandemic in COVID-19 cases: Literature review. Universitas Pendidikan Indonesia, Bandung, Indonesia. Retrieved from

Stendardi, L., Binazzi, B., & Scano, G. (2008). Pathophysiology of dyspnea. Patologia Dell’Apparato Respiratorio, 23(4), 208–218.

Tan, Y.-K., Goh, C., Leow, A. S. T., Tambyah, P. A., Ang, A., Yap, E.-S., . . . Chan, B. P. L. (2020). COVID-19 and ischemic stroke: A systematic review and meta-summary of the literature. Journal of Thrombosis and Thrombolysis, 50(3), 587-595.

Thille, A. W., Esteban, A., Fernández-Segoviano, P., Rodriguez, J.-M., Aramburu, J.-A., Vargas-Errázuriz, P., . . . Frutos-Vivar, F. (2013). Chronology of histological lesions in acute respiratory distress syndrome with diffuse alveolar damage: A prospective cohort study of clinical autopsies. The Lancet Respiratory Medicine, 1(5), 395-401.

Tim Pokja SDKI DPP PPNI. (2017). Indonesian nursing diagnosis standards (1st ed.). Jakarta: Dewan Pengurus Pusat Perasatuan Perawat Nasional Indonesia.

Tsai, P.-H., Lai, W.-Y., Lin, Y.-Y., Luo, Y.-H., Lin, Y.-T., Chen, H.-K., . . . Chen, S.-D. (2021). Clinical manifestation and disease progression in COVID-19 infection. Journal of the Chinese Medical Association, 84(1), 3-8.

Uzzan, M., Corcos, O., Martin, J. C., Treton, X., & Bouhnik, Y. (2020). Why is SARS-CoV-2 infection more severe in obese men? The gut lymphatics–Lung axis hypothesis. Medical Hypotheses, 144, 110023.

Vale, A. J. M., Fernandes, A. C. L., Guzen, F. P., Pinheiro, F. I., De Azevedo, E. P., & Cobucci, R. N. (2021). Susceptibility to COVID-19 in pregnancy, labor, and postpartum period: Immune system, vertical transmission, and breastfeeding. Frontiers in Global Women's Health, 2, 8.

Vaporidi, K., Akoumianaki, E., Telias, I., Goligher, E. C., Brochard, L., & Georgopoulos, D. (2020). Respiratory drive in critically ill patients. Pathophysiology and clinical implications. American Journal of Respiratory and Critical Care Medicine, 201(1), 20-32.

Viana-Llamas, M. C., Arroyo-Espliguero, R., Silva-Obregón, J. A., Uribe-Heredia, G., Núñez-Gil, I., García-Magallón, B., . . . Rodríguez-Guinea, I. (2021). Hypoalbuminemia on admission in COVID-19 infection: An early predictor of mortality and adverse events. A retrospective observational study. Medicina Clinica, 156(9), 428-436.

Waters, C. M., Roan, E., & Navajas, D. (2012). Mechanobiology in lung epithelial cells: Measurements, perturbations, and responses. Comprehensive Physiology, 2(1), 1-29.

Wei, X.-S., Wang, X., Niu, Y.-R., Ye, L.-L., Peng, W.-B., Wang, Z.-H., . . . Ma, W.-L. (2020). Diarrhea is associated with prolonged symptoms and viral carriage in corona virus disease 2019. Clinical Gastroenterology and Hepatology, 18(8), 1753-1759.

Wijaya, D. Y., & Yulianto, A. (2021). Prototype of smart door using RFID technology with Internet of Things (IoT). CoMBInES-Conference on Management, Business, Innovation, Education and Social Sciences, 1(1), 196-204.

Ye, Q., Wang, B., Zhang, T., Xu, J., & Shang, S. (2020). The mechanism and treatment of gastrointestinal symptoms in patients with COVID-19. American Journal of Physiology-Gastrointestinal and Liver Physiology, 319(2), G245-G252.

Zhang, Y., Wang, Z., Zhang, Y., Tong, H., Zhang, Y., & Lu, T. (2020). Potential mechanisms for traditional Chinese medicine in treating airway mucus hypersecretion associated with coronavirus disease 2019. Frontiers in Molecular Biosciences, 7, 358.

Zhou, C., Yue, X. D., Zhang, X., Shangguan, F., & Zhang, X. Y. (2021). Self-efficacy and mental health problems during COVID-19 pandemic: A multiple mediation model based on the Health Belief Model. Personality and Individual Differences, 179, 110893.