In this instructional video, Christina Rafano explains the PES statement—a three‑part framework (Problem, Etiology, Signs & Symptoms) that forms the core of a nursing diagnosis in care plans. She clarifies that the Problem component must be a standardized NANDA diagnosis, the Etiology (or "related to") component identifies the cause of that problem, and the Signs & Symptoms (or "as evidenced by") component lists observable data supporting the diagnosis. Rafano walks through concrete examples for three common clinical scenarios—type 1 diabetes, asthma, and coronary artery disease—showing possible NANDA problems, related‑to factors, and evidencing signs for each. She stresses the importance of selecting diagnoses that truly apply to the patient, using the official NANDA list, and avoiding invented terms. The video also points viewers to additional resources, including a Nursing SOS membership care‑plan database and a deeper dive video on writing full care plans. Throughout, she encourages learners to subscribe, engage, and apply the PES format to ace their nursing school assignments.
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In this video we are talking about what a PES statement is for a nursing diagnosis. This is something that comes up a lot in nursing school when you are writing care plans. It's called a PES statement. So if you are super confused about what that is, just like I was, we're going to talk about that in this video. We're going to walk through what it is and how to write one so that you can ace your care plans. Let's dive in. Hey there my friend. My name is Christina Rafano from nursingsos.com and one of my favorite topics to talk about on my channel is care plans. I love to talk about care plans and help walk you through it so that you can ace them. So hit that subscribe button and click the notification bell so you never miss a video. I've got lots more care plan videos coming for you soon. So what is a PES statement? You will hear this probably a lot in nursing school, especially around care plans. PES stands for Problem Etiology and Signs and Symptoms. Or some people just say symptoms, symptoms. So Problem Etiology and Symptoms. So what is the problem that the patient is experiencing? What is the etiology of it? That's just a big fancy word for what's causing it. So when you hear etiology, just think cause, like what is causing the problem in the first place. And then signs and symptoms are just symptoms. What are the things that you are seeing as a nurse or as a nursing student about that problem and the cause. So you see how that all fits together. Problem etiology or cause. And then the signs and symptoms, which is symptoms of what the problem, like what are the symptoms of that problem. So that's what PES stands for. PES Problem Etiology, Signs and symptoms. Now, the important thing about this is that this is basically the framework for a nursing diagnosis. When you write a nursing diagnosis, there's three, three parts that basically fit into those P E S kind of segments. So the P which is the problem. You are going to write your NANDA nursing diagnosis. Now, this is just you pull from a standardized list for that NANDA nursing diagnosis. You do not make those up in your mind. That is put out for nurses and nursing students by the nanda, it's called NANDA International. And they make a list of nursing diagnoses that you can use for your patients. So you're not going to make these up. You just plug that in. You choose from the list and you plug it into your care plan. That is it. Like it really is as easy as that. So that Is the problem is the problem part is the NANDA nursing diagnosis. Now the etiology part is what we call the related to so you're related to factor. So what is the cause, what is relating to the nursing diagnosis Diagnosis. What is the nursing diagnosis related to? What is it caused by? That's your related to factor. Now you're going to see this called either related to or related to factor or you'll see it abbreviated as R slash. Is that a forward slash backslash? Let me see if I can get that right. Related to so R. I'm going to say forward slash T. I might be wrong about that because I can't visualize it in my mind. But that related two factor is the E where it's the cause or the etiology and then the signs and symptoms is the as evidenced by so as evidenced by just means, signs and symptoms. Like what is the nursing diagnosis evidenced by? See how that works? So PEs problem, etiology, symptoms and then you've got your Nanda nursing diagnosis, the related two factor and the as evidence evidence by so those three parts, they fit together, you can basically consider them the same thing. Now the nursing diagnosis, as you might already know, is the first step in writing care plans in nursing school. Now, care plans in nursing school have a whole big format to them. We're specifically talking about the first part which is a nursing diagnosis, the nursing diagnosis. This is the format pes. So problem etiology, the signs and symptoms. And when you write that out, you're able to construct it as like this is what we're diagnosing this patient with. It is the nursing diagnosis. So those three parts are what the nursing diagnosis is. That's what it constitutes. That's what constitutes a nursing diagnosis. P, E, S. So I have several care plan examples that I want to go through here. And I actually got all of these from right inside our nursing SOS membership community. I have a whole care plan database inside the NMC for you. So if you are struggling with writing your care plans and you just want more examples and you want my step by step process for how to write them completely and perfectly definitely check out the nmc. I will put the link down below in the description to check out all the details. So we're going to start with diabetes type 1. So a possible nursing diagnosis. Now this is the problem of the P P, this is the problem part. This is the nursing diagnosis part which is a, it's a standardized thing. Okay, I've talked about it so many times on my channel. If you want A deep dive on how to find these NANDA nursing diagnoses. Check out this video right here, super Helpful, where I will walk you through how to actually find this list for NANDA nursing diagnoses. The thing about this is that you don't just make them up, they are actually standardized, so you don't have to just come up with it in your mind, which is actually pretty great. You just choose from a list. So some possible nursing diagnoses that you can use for the problem part of your PES statement are risk for unstable blood glucose, compromised family coping and deficient knowledge. Those are just three examples that I pulled. Now again, this is from for diabetes type 1. So those are just a few possible nursing diagnoses that you could use. Now, the second part of your nursing diagnosis is that etiology, what we call the related to factor. Okay, Related to. So you've got your actual NANDA nursing diagnosis, that's the problem. And then you have the related to which is that etiology or the cause. Okay, so now this cause the related to for diabetes type 1, just some possibilities are a new disease diagnosis. So the patient was just diagnosed. A lack of knowledge of the disease of the diabetes diagnosis, a lack of knowledge of it, inadequate monitoring of their intake, like their carb counting and their glucose levels, and a lack of adherence to the care plan, a lack of adherence to the management plan. So those are some possible causes and etiologies of the diabetes type one that you would put in your nursing diagnosis. Now, the as evidenced by statement is that signs and symptoms, symptoms part of the pea. So that's what we say as evidenced by so that's the symptoms. Some possibilities for this, like symptoms for diabetes that relate back to the nursing diagnosis are a new diagnosis. They they've just received their new diagnosis. Maybe they have some anxiety about it. Hyperglycemia, hypoglycemia is possible and then abnormal lab values. So those are all possible signs and sometimes that you could put into your PEA as possible symptoms that the patient could be experiencing. Now, of course, you only want to use those symptoms if your patient's actually experiencing those things. Those are just examples for you, so you could see how it fits together. Now, another example that I thought would be really helpful because a lot of patients you're going to see this a lot at clinical is asthma. So a possible nursing diagnosis for asthma could be something like impaired gas exchange, ineffective airway clearance or ineffective breathing pattern. So those could be possible problems in your PES statement, the NANDA nursing diagnosis. Right. So Impaired gas exchange, ineffective airway clearance or ineffective breathing pattern. Now that second column, the related to is going to be the etiology, right? The cause, like what is actually causing the nursing diagnosis, the problem. Okay, this for asthma, this could potentially be things like inflammation in the airway, bronchial secretion. So there's more like mucus and gunk buildup in the lungs and then obstruction of their airway. So these are all possibilities that you could use for your care plan, depending on like what your patient is actually experiencing. But those are possibilities that you could put in that etiology section. Now, the as evidenced by section of the signs and symptoms of that PES statement, these could be things like a cough, decreased oxygen saturation, increased work of breathing or wob, increased respiratory rate, adventitious breath sounds. So things like wheezes, things like that, abnormal ABG results or other lab results, those are all possible possible signs and symptoms that you might see in a patient with asthma. Now, of course, you don't want to include any of those in your care plan if your patient's not experiencing them. So make sure that what you are actually including in your care plan is what your patient is experiencing and what you actually saw at clinical and the things that you documented. But those are possibilities of things, how you would write a PES statement for a patient with asthma, you've got the problem, you've got the etiology, and you've got these signs and symptoms. Now, the last example I want to go through is coronary artery disease, another common problem that you will see at clinical. So I thought this one would be helpful for you too. So some possible nursing diagnoses, again, the problem, the nursing diagnosis is that problem section. This could be things like decreased cardiac output, ineffective tissue perfusion, or acute pain. So those could be possible nursing diagnoses that fit in that problem section. Now, of course, you don't want to choose one that doesn't apply to your patient. So make sure that whatever nursing diagnosis you choose, that it does apply to your specific patient. Then that related to section is the etiology, so what is causing it? Okay, so this could be potentially impaired cardiac muscle perfusion as an example, decreased myocardial blood flow or increased cardiac workload. So those are all good possibilities, things that you might use on your care plan for a patient with coronary artery disease. Now, that third section, the last section, the PES signs and symptoms, that's the as evidenced by SO aeb. So for a patient with CAD coronary artery disease, you might see symptoms like chest pain, shortness of breath if they have alterations in their heart rate or their heart rhythm, ECG changes, dizziness or lightheadedness or a peripheral edema. So those are all possible signs and symptoms that your patient might be experiencing and that you could include in your care plan in your PES statement for your care plan. So that is how a PES statement works inside the whole of your care plan. It is basically essentially the nursing diagnosis. So it's just those three parts of the nursing diagnosis. I don't want you to get confused when you hear some instructors saying PES statement or some saying you know your nursing diagnosis and you're related to and you're, as evidenced by those, are essentially saying the same thing. I know I was confused by that in nursing school, so I don't want you to be confused about it either. Now, the nursing diagnosis is just a part of the care plans that you will write in nursing school. There's actually a whole lot more to them. So if you need help with the rest of your care plans, definitely check out this video right here and I walk you through a deep dive in how to write out your full care plans for nursing school and ace them. So I hope that video helps. And of course, if you like this video, hit that like button, subscribe and hit the notification bell so you never miss a video. And write love in the comments below because that is what we do here on my channel. I think that's super fun. So if you loved it, write love in the comments below. And as always, my friend, go become the nurse that God created only you to be. And I will see you over there in that next video.
