A

Abdominal Distention

Constipation r/t decreased activity, decreased fluid intake, decreased fiber intake, pathological process

Dysfunctional Gastrointestinal Motility r/t decreased perfusion of intestines, medication effect

Nausea r/t irritation of gastrointestinal tract

Imbalanced Nutrition: less than body requirements r/t nausea, vomiting

Acute Pain r/t retention of air, gastrointestinal secretions

Delayed Surgical Recovery r/t retention of gas, secretions

Abdominal Hysterectomy

See Hysterectomy

Abdominal Pain

Dysfunctional Gastrointestinal Motility r/t decreased perfusion, medication effect

Acute Pain r/t injury, pathological process

See cause of Abdominal Pain

Abdominal Surgery

Constipation r/t decreased activity, decreased fluid intake, anesthesia, opioids

Dysfunctional Gastrointestinal Motility r/t medication or anesthesia effect, trauma from surgery

Imbalanced Nutrition: less than body requirements r/t high metabolic needs, decreased ability to ingest or digest food

Acute Pain r/t surgical procedure

Ineffective peripheral Tissue Perfusion r/t immobility, abdominal surgery

Risk for Infection: Risk factor: invasive procedure

Readiness for enhanced Knowledge: expresses an interest in learning

See Surgery, Perioperative Care; Surgery, Postoperative Care; Surgery, Preoperative Care

Abdominal Trauma

Disturbed Body Image r/t scarring, change in body function, need for temporary colostomy

Ineffective Breathing Pattern r/t abdominal distention, pain

Deficient Fluid Volume r/t hemorrhage

Dysfunctional Gastrointestinal Motility r/t decreased perfusion

Acute Pain r/t abdominal trauma

Risk for Bleeding: Risk factor: trauma and possible rupture of abdominal organs

Risk for Infection: Risk factor: possible perforation of abdominal structures

Ablation, Radiofrequency Catheter

Fear r/t invasive procedure

Risk for decreased Cardiac tissue perfusion: Risk factor: catheterization of heart

Abortion, Induced

Compromised family Coping r/t unresolved feelings about decision

Acute Pain r/t surgical intervention

Chronic low Self-Esteem r/t feelings of guilt

Chronic Sorrow r/t loss of potential child

Risk for Bleeding: Risk factor: trauma from abortion

Risk for delayed Development: Risk factors: unplanned or unwanted pregnancy

Risk for Infection: Risk factors: open uterine blood vessels, dilated cervix

Risk for Post-Trauma Syndrome: Risk factor: psychological trauma of abortion

Risk for Spiritual Distress: Risk factor: perceived moral implications of decision

Readiness for enhanced Knowledge: expresses an interest in learning

Abortion, Spontaneous

Disturbed Body Image r/t perceived inability to carry pregnancy, produce child

Disabled family Coping r/t unresolved feelings about loss

Ineffective Coping r/t personal vulnerability

Interrupted Family Processes r/t unmet expectations for pregnancy and childbirth

Fear r/t implications for future pregnancies

Grieving r/t loss of fetus

Acute Pain r/t uterine contractions, surgical intervention

Situational low Self-Esteem r/t feelings about loss of fetus

Chronic Sorrow r/t loss of potential child

Risk for Bleeding: Risk factor: trauma from abortion

Risk for Infection: Risk factors: septic or incomplete abortion of products of conception, open uterine blood vessels, dilated cervix

Risk for Post-Trauma Syndrome: Risk factor: psychological trauma of abortion

Risk for Spiritual Distress: Risk factor: loss of fetus

Readiness for enhanced Knowledge: expresses an interest in learning

Abruptio Placentae <36 Weeks

Anxiety r/t unknown outcome, change in birth plans

Death Anxiety r/t unknown outcome, hemorrhage, or pain

Interrupted Family Processes r/t unmet expectations for pregnancy and childbirth

Fear r/t threat to well-being of self and fetus

Impaired Gas Exchange: placental r/t decreased uteroplacental area

Acute Pain r/t irritable uterus, hypertonic uterus

Impaired Tissue Integrity: maternal r/t possible uterine rupture

Risk for Bleeding: Risk factor: separation of placenta from uterus causing bleeding

Risk for disproportionate Growth: Risk factor: uteroplacental insufficiency

Risk for Infection: Risk factor: partial separation of placenta

Risk for disturbed Maternal/Fetal Dyad: Risk factors: trauma of process, lack of energy of mother

Risk for Shock: Risk factors: separation of placenta from uterus

Readiness for enhanced Knowledge: expresses an interest in learning

Abscess Formation

Ineffective Protection r/t inadequate nutrition, abnormal blood profile, drug therapy, depressed immune function

Impaired Tissue Integrity r/t altered circulation, nutritional deficit or excess

Readiness for enhanced Knowledge: expresses an interest in learning

Abuse, Child

See Child Abuse

Abuse, Spouse, Parent, or Significant Other

Anxiety r/t threat to self-concept, situational crisis of abuse

Caregiver Role Strain r/t chronic illness, self-care deficits, lack of respite care, extent of caregiving required

Impaired verbal Communication r/t psychological barriers of fear

Compromised family Coping r/t abusive patterns

Defensive Coping r/t low self-esteem

Dysfunctional Family Processes r/t inadequate coping skills

Insomnia r/t psychological stress

Post-Trauma Syndrome r/t history of abuse

Powerlessness r/t lifestyle of helplessness

Chronic low Self-Esteem r/t negative family interactions

Risk for self-directed Violence: Risk factor: history of abuse

Accessory Muscle Use (to Breathe)

Ineffective Breathing Pattern (See Breathing Pattern, ineffective, Section III)

See Asthma; Bronchitis; COPD (Chronic Obstructive Pulmonary Disease); Respiratory Infections, Acute Childhood

Accident Prone

Adult Failure to Thrive r/t fatigue

Acute Confusion r/t altered level of consciousness

Ineffective Coping r/t personal vulnerability, situational crises

Ineffective Impulse Control (See Impulse Control, ineffective, Section III)

Risk for Injury: Risk factor: history of accidents

Achalasia

Ineffective Coping r/t chronic disease

Acute Pain r/t stasis of food in esophagus

Impaired Swallowing r/t neuromuscular impairment

Risk for Aspiration: Risk factor: nocturnal regurgitation

Acid-Base Imbalances

Risk for Electrolyte Imbalance: Risk factors: renal dysfunction, diarrhea, treatment-related side effects (e. g., medications, drains)

Acidosis, Metabolic

Acute Confusion r/t acid-base imbalance, associated electrolyte imbalance

Impaired Memory r/t effect of metabolic acidosis on brain function

Imbalanced Nutrition: less than body requirements r/t inability to ingest, absorb nutrients

Risk for Electrolyte Imbalance: Risk factor: effect of metabolic acidosis on renal function

Risk for Injury: Risk factors: disorientation, weakness, stupor

Risk for decreased Cardiac tissue perfusion: Risk factor: dysrhythmias from hyperkalemia

Risk for Shock: Risk factors: abnormal metabolic state, presence of acid state impairing function

Acidosis, Respiratory

Activity Intolerance r/t imbalance between oxygen supply and demand

Impaired Gas Exchange r/t ventilation-perfusion imbalance

Impaired Memory r/t hypoxia

Risk for decreased Cardiac tissue perfusion: Risk factor: dysrhythmias associated with respiratory acidosis

Acne

Disturbed Body Image r/t biophysical changes associated with skin disorder

Ineffective Self-Health Management r/t deficient knowledge (medications, personal care, cause)

Impaired Skin Integrity r/t hormonal changes (adolescence, menstrual cycle)

ACS (Acute Coronary Syndrome)

See (MI) Myocardial Infarction

Acquired Immunodeficiency Syndrome

See AIDS (Acquired Immunodeficiency Syndrome)

Acromegaly

Activity Intolerance (See Activity Intolerance, Section III)

Ineffective Airway Clearance r/t airway obstruction by enlarged tongue

Disturbed Body Image r/t changes in body function and appearance

Impaired physical Mobility r/t joint pain

Risk for decreased Cardiac tissue perfusion: Risk factor: r/t increased atherosclerosis from abnormal health status

Risk for unstable blood Glucose level: Risk factor: abnormal physical health status

Sexual Dysfunction r/t changes in hormonal secretions

Activity Intolerance, Potential to Develop

Risk for Activity Intolerance (See Activity Intolerance, risk for, Section III)

Acute Abdominal Pain

Deficient Fluid Volume r/t air and fluids trapped in bowel, inability to drink

Acute Pain r/t pathological process

Risk for dysfunctional Gastrointestinal Motility: Risk factor: ineffective gastrointestinal tissue perfusion

See cause of Abdominal Pain

Acute Alcohol Intoxication

Ineffective Breathing Pattern r/t depression of the respiratory center from excessive alcohol intake

Acute Confusion r/t central nervous system depression

Dysfunctional Family Processes r/t abuse of alcohol

Risk for Aspiration: Risk factor: depressed reflexes with acute vomiting

Risk for Infection: Risk factor: impaired immune system from malnutrition associated with chronic excessive alcohol intake

Acute Back Pain

Anxiety r/t situational crisis, back injury

Constipation r/t decreased activity, effect of pain medication

Ineffective Coping r/t situational crisis, back injury

Impaired physical Mobility r/t pain

Acute Pain r/t back injury

Readiness for enhanced Knowledge: expresses an interest in learning

Acute Confusion

See Confusion, Acute

Acute Coronary Syndrome

Risk for decreased Cardiac tissue perfusion: Risk factor (See Cardiac tissue perfusion, risk for decreased)

Acute Lymphocytic Leukemia (ALL)

See Cancer; Chemotherapy; Child with Chronic Condition; Leukemia

Acute Renal Failure

See Renal Failure

Acute Respiratory Distress Syndrome

See ARDS (Acute Respiratory Distress Syndrome)

Adams-Stokes Syndrome

See Dysrhythmia

Addiction

See Alcoholism; Drug Abuse

Addison’s Disease

Activity Intolerance r/t weakness, fatigue

Disturbed Body Image r/t increased skin pigmentation

Deficient Fluid Volume r/t failure of regulatory mechanisms

Imbalanced Nutrition: less than body requirements r/t chronic illness

Risk for Injury: Risk factor: weakness

Readiness for enhanced Knowledge: expresses an interest in learning

Adenoidectomy

Acute Pain r/t surgical incision

Ineffective Airway Clearance r/t hesitation or reluctance to cough as a result of pain, fear

Nausea r/t anesthesia effects, drainage from surgery

Acute Pain r/t surgical incision

Risk for Aspiration: Risk factors: postoperative drainage, impaired swallowing

Risk for Bleeding: Risk factors: surgical incision

Risk for deficient Fluid Volume: Risk factors: decreased intake as a result of painful swallowing, effects of anesthesia

Risk for imbalanced Nutrition: less than body requirements: Risk factors: reluctance to swallow

Readiness for enhanced Knowledge: expresses an interest in learning

Adhesions, Lysis of

See Abdominal Surgery

Adjustment Disorder

Anxiety r/t inability to cope with psychosocial stressor

Risk-prone Health Behavior r/t assault to self-esteem

Disturbed personal Identity r/t psychosocial stressor (specific to individual)

Situational low Self-Esteem r/t change in role function

Impaired Social Interaction r/t absence of significant others or peers

Adjustment Impairment

Risk-prone Health Behavior (See Health Behavior, risk-prone, Section III)

Adolescent, Pregnant

Anxiety r/t situational and maturational crisis, pregnancy

Disturbed Body Image r/t pregnancy superimposed on developing body

Decisional Conflict: keeping child versus giving up child versus abortion r/t lack of experience with decision-making, interference with decision-making, multiple or divergent sources of information, lack of support system

Disabled family Coping r/t highly ambivalent family relationships, chronically unresolved feelings of guilt, anger, despair

Ineffective Coping r/t situational and maturational crisis, personal vulnerability

Ineffective Denial r/t fear of consequences of pregnancy becoming known

Interrupted Family Processes r/t unmet expectations for adolescent, situational crisis

Fear r/t labor and delivery

Delayed Growth and Development r/t pregnancy

Deficient Knowledge r/t pregnancy, infant growth and development, parenting

Imbalanced Nutrition: less than body requirements r/t lack of knowledge of nutritional needs during pregnancy and as growing adolescent

Ineffective Role Performance r/t pregnancy

Situational low Self-Esteem r/t feelings of shame and guilt about becoming or being pregnant

Impaired Social Interaction r/t self-concept disturbance

Social Isolation r/t absence of supportive significant others

Risk for impaired Attachment: Risk factor: anxiety associated with the parent role

Risk for delayed Development: Risk factor: unplanned or unwanted pregnancy

Risk for urge urinary Incontinence: Risk factor: pressure on bladder by growing uterus

Risk for disturbed Maternal/Fetal Dyad: Risk factors: immaturity, substance use

Risk for impaired Parenting: Risk factors: adolescent parent, unplanned or unwanted pregnancy, single parent

Readiness for enhanced Childbearing Process: reports appropriate prenatal lifestyle

Readiness for enhanced Knowledge: expresses an interest in learning

Adoption, Giving Child Up for

Decisional Conflict r/t unclear personal values or beliefs, perceived threat to value system, support system deficit

Ineffective Coping r/t stress of loss of child

Interrupted Family Processes r/t conflict within family regarding relinquishment of child

Grieving r/t loss of child, loss of role of parent

Insomnia r/t depression or trauma of relinquishment of child

Social Isolation r/t making choice that goes against values of significant others

Chronic Sorrow r/t loss of relationship with child

Risk for Spiritual Distress: Risk factor: perceived moral implications of decision

Readiness for enhanced Spiritual Well-Being: harmony with self regarding final decision

Adrenocortical Insufficiency

Deficient Fluid Volume r/t insufficient ability to reabsorb water

Ineffective Protection r/t inability to tolerate stress

Delayed Surgical Recovery r/t inability to respond to stress

Risk for Shock: Risk factor: deficient Fluid Volume, decreased cortisol to initiate stress response to insult to body

See Addison’s Disease; Shock, Hypovolemic

Advance Directives

Death Anxiety r/t planning for end-of-life health decisions

Decisional Conflict r/t unclear personal values or beliefs, perceived threat to value system, support system deficit

Grieving r/t possible loss of self, significant other

Readiness for enhanced Spiritual Well-Being: harmonious interconnectedness with self, others, higher power, God

Affective Disorders

See specific disorder: Depression (Major Depressive Disorder); Dysthymic Disorder; Manic Disorder, Bipolar I, Seasonal Affective Disorder

Age-Related Macular Degeneration

See Macular Degeneration

Aggressive Behavior

Fear r/t real or imagined threat to own well-being

Risk for other-directed Violence (See Violence, other-directed, risk for, Section III)

Aging

Death Anxiety r/t fear of unknown, loss of self, impact on significant others

Impaired Dentition r/t ineffective oral hygiene

Adult Failure to Thrive r/t depression, apathy, fatigue

Grieving r/t multiple losses, impending death

Ineffective Self-Health Management r/t deficient knowledge: medication, nutrition, exercise, coping strategies

Hearing Loss r/t exposure to loud noises, aging

Functional urinary Incontinence r/t impaired vision, impaired cognition, neuromuscular limitations, altered environmental factors

Impaired individual Resilience r/t aging, multiple losses

Sleep deprivation r/t aging-related sleep-stage shifts

Ineffective Thermoregulation r/t aging

Vision Loss r/t aging (see care plan on Evolve)

Risk for Caregiver Role Strain: Risk factor: inability to handle increasing needs of significant other

Risk for Injury: Risk factor: vision loss, hearing loss, decreased balance, decreased sensation in feet

Risk for Loneliness: Risk factors: inadequate support system, role transition, health alterations, depression, fatigue

Readiness for enhanced community Coping: providing social support and other resources identified as needed for elderly client

Readiness for enhanced family Coping: ability to gratify needs, address adaptive tasks

Readiness for enhanced Knowledge: specify need to improve health

Readiness for enhanced Nutrition: need to improve health

Readiness for enhanced Relationship: demonstrates understanding of partner’s insufficient function

Readiness for enhanced Self-Health Management: knowledge about medication, nutrition, exercise, coping strategies

Readiness for enhanced Sleep: need to improve sleep

Readiness for enhanced Spiritual Well-Being: one’s experience of life’s meaning, harmony with self, others, higher power, God, environment

Readiness for enhanced Urinary Elimination: need to improve health

Agitation

Acute Confusion r/t side effects of medication, hypoxia, decreased cerebral perfusion, alcohol abuse or withdrawal, substance abuse or withdrawal, sensory deprivation or overload

Sleep deprivation r/t sundown syndrome

See cause of Agitation

Agoraphobia

Anxiety r/t real or perceived threat to physical integrity

Ineffective Coping r/t inadequate support systems

Fear r/t leaving home, going out in public places

Impaired Social Interaction r/t disturbance in self-concept

Social Isolation r/t altered thought process

Agranulocytosis

Delayed Surgical Recovery r/t abnormal blood profile

Risk for Infection: Risk factor: abnormal blood profile

Readiness for enhanced Knowledge: expresses an interest in learning

AIDS (Acquired Immunodeficiency Syndrome)

Death Anxiety r/t fear of premature death

Disturbed Body Image r/t chronic contagious illness, cachexia

Caregiver Role Strain r/t unpredictable illness course, presence of situation stressors

Diarrhea r/t inflammatory bowel changes

Disturbed Energy Field r/t chronic illness

Interrupted Family Processes r/t distress about diagnosis of human immunodeficiency virus (HIV) infection

Fatigue r/t disease process, stress, decreased nutritional intake

Fear r/t powerlessness, threat to well-being

Grieving: family/parental r/t potential or impending death of loved one

Grieving: individual r/t loss of physical and psychosocial well-being

Hopelessness r/t deteriorating physical condition

Imbalanced Nutrition: less than body requirements r/t decreased ability to eat and absorb nutrients as a result of anorexia, nausea, diarrhea; oral candidiasis

Chronic Pain r/t tissue inflammation and destruction

Impaired individual Resilience r/t chronic illness

Situational low Self-Esteem r/t crisis of chronic contagious illness

Ineffective Sexuality Pattern r/t possible transmission of disease

Social Isolation r/t self-concept disturbance, therapeutic isolation

Spiritual Distress r/t challenged beliefs or moral system

Risk for deficient Fluid Volume: Risk factors: diarrhea, vomiting, fever, bleeding

Risk for Infection: Risk factor: inadequate immune system

Risk for Loneliness: Risk factor: social isolation

Risk for impaired Oral Mucous Membrane: Risk factor: immunological deficit

Risk for impaired Skin Integrity: Risk factors: immunological deficit, diarrhea

Risk for Spiritual Distress: Risk factor: physical illness

Readiness for enhanced Knowledge: expresses an interest in learning

See AIDS, Child; Cancer; Pneumonia

AIDS Dementia

Chronic Confusion r/t viral invasion of nervous system

See Dementia

AIDS, Child

Impaired Parenting r/t congenital acquisition of infection secondary to intravenous (IV) drug use, multiple sexual partners, history of contaminated blood transfusion

See AIDS (Acquired Immunodeficiency Syndrome); Child with Chronic Condition; Hospitalized Child; Terminally Ill Child, Adolescent; Terminally Ill Child, Infant/Toddler; Terminally Ill Child, Preschool Child; Terminally Ill Child, School-Age Child/Preadolescent; Terminally Ill Child/Death of Child, Parent

Airway Obstruction/Secretions

Ineffective Airway Clearance (See Airway Clearance, ineffective, Section III)

Alcohol Withdrawal

Anxiety r/t situational crisis, withdrawal

Acute Confusion r/t effects of alcohol withdrawal

Ineffective Coping r/t personal vulnerability

Dysfunctional Family Processes r/t abuse of alcohol

Insomnia r/t effect of alcohol withdrawal, anxiety

Imbalanced Nutrition: less than body requirements r/t poor dietary habits

Chronic low Self-Esteem r/t repeated unmet expectations

Risk for deficient Fluid Volume: Risk factors: excessive diaphoresis, agitation, decreased fluid intake

Risk for other-directed Violence: Risk factor: substance withdrawal

Risk for self-directed Violence: Risk factor: substance withdrawal

Readiness for enhanced Knowledge: expresses an interest in learning

Alcoholism

Anxiety r/t loss of control

Risk-prone Health Behavior r/t lack of motivation to change behaviors, addiction

Acute Confusion r/t alcohol abuse

Chronic Confusion r/t neurological effects of chronic alcohol intake

Defensive Coping r/t denial of reality of addiction

Disabled family Coping r/t codependency issues due to alcoholism

Ineffective Coping r/t use of alcohol to cope with life events

Ineffective Denial r/t refusal to acknowledge addiction

Dysfunctional Family Process r/t alcohol abuse

Impaired Home Maintenance r/t memory deficits, fatigue

Insomnia r/t irritability, nightmares, tremors

Impaired Memory r/t alcohol abuse

Self-Neglect r/t effects of alcohol abuse

Imbalanced Nutrition: less than body requirements r/t anorexia, inappropriate diet with increased carbohydrates

Powerlessness r/t alcohol addiction

Ineffective Protection r/t malnutrition, sleep deprivation

Chronic low Self-Esteem r/t failure at life events

Social Isolation r/t unacceptable social behavior, values

Risk for Injury: Risk factor: alteration in sensory or perceptual function

Risk for Loneliness: Risk factor: unacceptable social behavior

Risk for other-directed Violence: Risk factors: reactions to substances used, impulsive behavior, disorientation, impaired judgment

Risk for self-directed Violence: Risk factors: reactions to substances used, impulsive behavior, disorientation, impaired judgment

Alcoholism, Dysfunctional Family Processes

Dysfunctional Family Processes (See Family Processes, dysfunctional, Section III)

Alkalosis

See Metabolic Alkalosis

ALL (Acute Lymphocytic Leukemia)

See Cancer; Chemotherapy; Child with a Chronic Condition; Leukemia

Allergies

Latex Allergy Response r/t hypersensitivity to natural rubber latex

Risk for Allergy Response: Risk factor: chemical factors, dander, environmental substances, foods, insect stings, medications

Risk for Latex Allergy Response: Risk factor: repeated exposure to products containing latex

Readiness for enhanced Knowledge: expresses an interest in learning

Alopecia

Disturbed Body Image r/t loss of hair, change in appearance

Readiness for enhanced Knowledge: expresses an interest in learning

Altered Mental Status

See Confusion, Acute; Confusion, Chronic; Memory Deficit

ALS (Amyotrophic Lateral Sclerosis)

See Amyotrophic Lateral Sclerosis (ALS)

Alzheimer’s Disease

Caregiver Role Strain r/t duration and extent of caregiving required

Chronic Confusion r/t loss of cognitive function

Compromised family Coping r/t interrupted family processes

Adult Failure to Thrive r/t difficulty in reasoning, judgment, memory, concentration

Fear r/t loss of self

Impaired Home Maintenance r/t impaired cognitive function, inadequate support systems

Hopelessness r/t deteriorating condition

Insomnia r/t neurological impairment, daytime naps

Impaired Memory r/t neurological disturbance

Impaired physical Mobility r/t severe neurological dysfunction

Self-Neglect r/t loss of cognitive function

Powerlessness r/t deteriorating condition

Self-Care deficit: specify r/t loss of cognitive function, psychological impairment

Social Isolation r/t fear of disclosure of memory loss

Wandering r/t cognitive impairment, frustration, physiological state

Risk for Injury: Risk factor: confusion

Risk for Loneliness: Risk factor: potential social isolation

Risk for Relocation Stress Syndrome: Risk factors: impaired psychosocial health, decreased health status

Risk for other-directed Violence: Risk factors: frustration, fear, anger, loss of cognitive function

Readiness for enhanced Knowledge: Caregiver: expresses an interest in learning

See Dementia

AMD (Age-Related Macular Degeneration)

See Macular Degeneration

Amenorrhea

Imbalanced Nutrition: less than body requirements r/t inadequate food intake

See Sexuality, Adolescent

AMI (Acute Myocardial Infarction)

See MI (Myocardial Infarction)

Amnesia

Acute Confusion r/t alcohol abuse, delirium, dementia, drug abuse

Dysfunctional Family Processes r/t alcohol abuse, inadequate coping skills

Impaired Memory r/t excessive environmental disturbance, neurological disturbance

Post-Trauma Syndrome r/t history of abuse, catastrophic illness, disaster, accident

Amniocentesis

Anxiety r/t threat to self and fetus, unknown future

Decisional Conflict r/t choice of treatment pending results of test

Risk for Infection: Risk factor: invasive procedure

Amnionitis

See Chorioamnionitis

Amniotic Membrane Rupture

See Premature Rupture of Membranes

Amputation

Disturbed Body Image r/t negative effects of amputation, response from others

Grieving r/t loss of body part, future lifestyle changes

Impaired physical Mobility r/t musculoskeletal impairment, limited movement

Acute Pain r/t surgery, phantom limb sensation

Chronic Pain r/t surgery, phantom limb sensation

Ineffective peripheral Tissue Perfusion r/t impaired arterial circulation

Impaired Skin integrity r/t poor healing, prosthesis rubbing

Risk for Bleeding: Risk factor: vulnerable surgical site

Readiness for enhanced Knowledge: expresses an interest in learning

Amyotrophic Lateral Sclerosis (ALS)

Death Anxiety r/t impending progressive loss of function leading to death

Ineffective Breathing Pattern r/t compromised muscles of respiration

Impaired verbal Communication r/t weakness of muscles of speech, deficient knowledge of ways to compensate and alternative communication devices

Decisional Conflict: ventilator therapy r/t unclear personal values or beliefs, lack of relevant information

Impaired individual Resilience r/t chronic debilitating illness

Chronic Sorrow r/t chronic illness

Impaired Swallowing r/t weakness of muscles involved in swallowing

Impaired Spontaneous Ventilation r/t weakness of muscles of respiration

Risk for Aspiration: Risk factor: impaired swallowing

Risk for Spiritual Distress: Risk factor: chronic debilitating condition

See Neurologic Disorders

Anal Fistula

See Hemorrhoidectomy

Anaphylactic Shock

Ineffective Airway Clearance r/t laryngeal edema, bronchospasm

Latex Allergy Response r/t abnormal immune mechanism response

Impaired Spontaneous Ventilation r/t acute airway obstruction from anaphylaxis process

Anaphylaxis Prevention

Risk for Allergy Response (See Allergy Response, risk for, Section III)

Anasarca

Excess Fluid Volume r/t excessive fluid intake, cardiac/renal dysfunction, loss of plasma proteins

Risk for impaired Skin Integrity: Risk factor: impaired circulation to skin from edema

See cause of Anasarca

Anemia

Anxiety r/t cause of disease

Impaired Comfort r/t feelings of always being cold from decreased hemoglobin and decreased metabolism

Fatigue r/t decreased oxygen supply to the body, increased cardiac workload

Impaired Memory r/t change in cognition from decreased oxygen supply to the body

Delayed Surgical Recovery r/t decreased oxygen supply to body, increased cardiac workload

Risk for Bleeding (See Bleeding, risk for, Section III)

Risk for Injury: Risk factor: alteration in peripheral sensory perception

Readiness for enhanced Knowledge: expresses an interest in learning

Anemia, in Pregnancy

Anxiety r/t concerns about health of self and fetus

Fatigue r/t decreased oxygen supply to the body, increased cardiac workload

Risk for delayed Development: Risk factor: reduction in the oxygen-carrying capacity of blood

Risk for Infection: Risk factor: reduction in oxygen-carrying capacity of blood

Risk for disturbed Maternal/Fetal Dyad: Risk factor: compromised oxygen transport

Readiness for enhanced Knowledge: expresses an interest in learning

Anemia, Sickle Cell

See Anemia; Sickle Cell Anemia/Crisis

Anencephaly

See Neural Tube Defects

Aneurysm, Abdominal Surgery

Risk for deficient Fluid Volume: Risk factor: hemorrhage r/t potential abnormal blood loss

Risk for Infection: Risk factor: invasive procedure

Risk for ineffective Gastrointestinal Perfusion (See Gastrointestinal Perfusion, ineffective, risk for, Section III)

Risk for ineffective Renal Perfusion: Risk factor: prolonged ischemia of kidneys

See Abdominal Surgery

Aneurysm, Cerebral

See Craniectomy/Craniotomy; Subarachnoid Hemorrhage (if aneurysm has ruptured)

Anger

Anxiety r/t situational crisis

Risk-prone Health Behavior r/t assault to self-esteem, disability requiring change in lifestyle, inadequate support system

Defensive Coping r/t inability to acknowledge responsibility for actions and results of actions

Fear r/t environmental stressor, hospitalization

Grieving r/t significant loss

Powerlessness r/t health care environment

Risk for compromised Human Dignity: Risk factors: inadequate participation in decision-making, perceived dehumanizing treatment, perceived humiliation, exposure of the body, cultural incongruity

Risk for Post-Trauma Syndrome: Risk factor: inadequate social support

Risk for other-directed Violence: Risk factors: history of violence, rage reaction

Risk for self-directed Violence: Risk factors: history of violence, history of abuse, rage reaction

Angina

Activity Intolerance r/t acute pain, dysrhythmias

Anxiety r/t situational crisis

Decreased Cardiac Output r/t myocardial ischemia, medication effect, dysrhythmia

Ineffective Coping r/t personal vulnerability to situational crisis of new diagnosis, deteriorating health

Ineffective Denial r/t deficient knowledge of need to seek help with symptoms

Grieving r/t pain, loss of health

Acute Pain r/t myocardial ischemia

Ineffective Sexuality Pattern r/t disease process, medications, loss of libido

Readiness for enhanced Knowledge: expresses an interest in learning

Angiocardiography (Cardiac Catheterization)

See Cardiac Catheterization

Angioplasty, Coronary

Fear r/t possible outcome of interventional procedure

Ineffective peripheral Tissue Perfusion r/t vasospasm, hematoma formation

Risk for Bleeding: Risk factors: possible damage to coronary artery, hematoma formation

Risk for decreased Cardiac tissue perfusion: Risk factors: ventricular ischemia, dysrhythmias

Readiness for enhanced Knowledge: expresses an interest in learning

Anomaly, Fetal/Newborn (Parent Dealing with)

Anxiety r/t threat to role functioning, situational crisis

Decisional Conflict: interventions for fetus or newborn r/t lack of relevant information, spiritual distress, threat to value system

Parental Role Conflict r/t separation from newborn, intimidation with invasive or restrictive modalities, specialized care center policies

Disabled family Coping r/t chronically unresolved feelings about loss of perfect baby

Ineffective Coping r/t personal vulnerability in situational crisis

Interrupted Family Processes r/t unmet expectations for perfect baby, lack of adequate support systems

Fear r/t real or imagined threat to baby, implications for future pregnancies, powerlessness

Grieving r/t loss of ideal child

Hopelessness r/t long-term stress, deteriorating physical condition of child, lost spiritual belief

Deficient Knowledge r/t limited exposure to situation

Impaired Parenting r/t interruption of bonding process

Powerlessness r/t complication threatening fetus or newborn

Situational low Self-Esteem r/t perceived inability to produce a perfect child

Social Isolation r/t alterations in child’s physical appearance, altered state of wellness

Chronic Sorrow r/t loss of ideal child, inadequate bereavement support

Spiritual Distress r/t test of spiritual beliefs

Risk for impaired Attachment: Risk factor: ill infant unable to effectively initiate parental contact as result of altered behavioral organization

Risk for disorganized Infant behavior: Risk factor: congenital disorder

Risk for impaired Parenting: Risk factors: interruption of bonding process; unrealistic expectations for self, infant, or partner; perceived threat to own emotional survival; severe stress; lack of knowledge

Risk for Spiritual Distress: Risk factor: lack of normal child to raise and carry on family name

Anorectal Abscess

Disturbed Body Image r/t odor and drainage from rectal area

Acute Pain r/t inflammation of perirectal area

Risk for Constipation: Risk factor: fear of painful elimination

Readiness for enhanced Knowledge: expresses an interest in learning

Anorexia

Deficient Fluid Volume r/t inability to drink

Imbalanced Nutrition: less than body requirements r/t loss of appetite, nausea, vomiting, laxative abuse.

Delayed Surgical Recovery r/t inadequate nutritional intake

Anorexia Nervosa

Activity Intolerance r/t fatigue, weakness

Disturbed Body Image r/t misconception of actual body appearance

Constipation r/t lack of adequate food, fiber, and fluid intake

Defensive Coping r/t psychological impairment, eating disorder

Disabled family Coping r/t highly ambivalent family relationships

Ineffective Denial r/t fear of consequences of therapy, possible weight gain

Diarrhea r/t laxative abuse

Interrupted Family Processes r/t situational crisis

Imbalanced Nutrition: less than body requirements r/t inadequate food intake, excessive exercise

Chronic low Self-Esteem r/t repeated unmet expectations

Ineffective Sexuality Pattern r/t loss of libido from malnutrition

Ineffective family Therapeutic Regimen Management r/t family conflict, excessive demands on family associated with complexity of condition and treatment

Risk for Infection: Risk factor: malnutrition resulting in depressed immune system

Risk for Spiritual Distress: Risk factor: low self-esteem

See Maturational Issues, Adolescent

Anosmia (Smell, Loss of Ability to)

Imbalanced Nutrition: less than body requirements r/t loss of appetite associated with loss of smell

Antepartum Period

See Pregnancy, Normal; Prenatal Care, Normal

Anterior Repair, Anterior Colporrhaphy

Urinary Retention r/t edema of urinary structures

Risk for urge urinary Incontinence: Risk factor: trauma to bladder

Readiness for enhanced Knowledge: expresses an interest in learning

See Vaginal Hysterectomy

Anticoagulant Therapy

Risk for Bleeding: Risk factors: altered clotting function from anticoagulant

Risk for deficient Fluid Volume: hemorrhage: Risk factor: altered clotting mechanism

Readiness for enhanced Knowledge: expresses an interest in learning

Antisocial Personality Disorder

Defensive Coping r/t excessive use of projection

Ineffective Coping r/t frequently violating the norms and rules of society

Hopelessness r/t abandonment

Impaired Social Interaction r/t sociocultural conflict, chemical dependence, inability to form relationships

Spiritual Distress r/t separation from religious or cultural ties

Ineffective family Therapeutic Regimen Management r/t excessive demands on family

Risk for Loneliness: Risk factor: inability to interact appropriately with others

Risk for impaired Parenting: Risk factors: inability to function as parent or guardian, emotional instability

Risk for Self-Mutilation: Risk factors: self-hatred, depersonalization

Risk for other-directed Violence: Risk factor: history of violence, altered thought patterns

Anuria

See Renal Failure

Anxiety

See Anxiety, Section III

Anxiety Disorder

Ineffective Activity Planning r/t unrealistic perception of events

Anxiety r/t unmet security and safety needs

Death Anxiety r/t fears of unknown, powerlessness

Decisional Conflict r/t low self-esteem, fear of making a mistake

Defensive Coping r/t overwhelming feelings of dread

Disabled family Coping r/t ritualistic behavior, actions

Ineffective Coping r/t inability to express feelings appropriately

Ineffective Denial r/t overwhelming feelings of hopelessness, fear, threat to self

Disturbed Energy Field r/t hopelessness, helplessness

Insomnia r/t psychological impairment, emotional instability

Powerlessness r/t lifestyle of helplessness

Self-Care deficit r/t ritualistic behavior, activities

Sleep deprivation r/t prolonged psychological discomfort

Risk for Spiritual Distress: Risk factor: psychological distress

Readiness for enhanced Knowledge: expresses an interest in learning

Aortic Aneurysm Repair (Abdominal Surgery)

See Abdominal Surgery; Aneurysm, Abdominal Surgery

Aortic Valvular Stenosis

See Congenital Heart Disease/Cardiac Anomalies

Aphasia

Anxiety r/t situational crisis of aphasia

Impaired verbal Communication r/t decrease in circulation to brain

Ineffective Coping r/t loss of speech

Ineffective Health Maintenance r/t deficient knowledge regarding information on aphasia and alternative communication techniques

Aplastic Anemia

Activity Intolerance r/t imbalance between oxygen supply and demand

Fear r/t ability to live with serious disease

Risk for Bleeding: Risk factor: inadequate clotting factors

Risk for Infection: Risk factor: inadequate immune function

Readiness for enhanced Knowledge: expresses an interest in learning

Apnea in Infancy

See Premature Infant (Child); Premature Infant (Parent); SIDS (Sudden Infant Death Syndrome)

Apneustic Respirations

Ineffective Breathing Pattern r/t perception or cognitive impairment, neurological impairment

See cause of Apneustic Respirations

Appendectomy

Deficient Fluid Volume r/t fluid restriction, hypermetabolic state, nausea, vomiting

Acute Pain r/t surgical incision

Delayed Surgical Recovery r/t rupture of appendix

Risk for Infection: Risk factors: perforation or rupture of appendix, surgical incision, peritonitis

Readiness for enhanced Knowledge: expresses an interest in learning

See Hospitalized Child; Surgery, Postoperative

Appendicitis

Deficient Fluid Volume r/t anorexia, nausea, vomiting

Acute Pain r/t inflammation

Risk for Infection: Risk factor: possible perforation of appendix

Readiness for enhanced Knowledge: expresses an interest in learning

Apprehension

Anxiety r/t threat to self-concept, threat to health status, situational crisis

Death Anxiety r/t apprehension over loss of self, consequences to significant others

ARDS (Acute Respiratory Distress Syndrome)

Ineffective Airway Clearance r/t excessive tracheobronchial secretions

Death Anxiety r/t seriousness of physical disease

Impaired Gas Exchange r/t damage to alveolar capillary membrane, change in lung compliance

Impaired Spontaneous Ventilation r/t damage to alveolar capillary membrane

See Ventilator Client

Arrhythmia

See Dysrhythmia

Arterial Insufficiency

Ineffective peripheral Tissue Perfusion r/t interruption of arterial flow

Delayed Surgical Recovery r/t ineffective tissue perfusion

Arthritis

Activity Intolerance r/t chronic pain, fatigue, weakness

Disturbed Body Image r/t ineffective coping with joint abnormalities

Impaired physical Mobility r/t joint impairment

Chronic Pain r/t progression of joint deterioration

Self-Care deficit: specify r/t pain with movement, damage to joints

Readiness for enhanced Knowledge: expresses an interest in learning

See JRA (Juvenile Rheumatoid Arthritis)

Arthrocentesis

Acute Pain r/t invasive procedure

Arthroplasty (Total Hip Replacement)

See Total Joint Replacement (Total Knee, Total Hip, Shoulder); Surgery, Perioperative; Surgery, Postoperative; Surgery, Preoperative

Arthroscopy

Impaired physical Mobility r/t surgical trauma of knee

Readiness for enhanced Knowledge: expresses an interest in learning

Ascites

Ineffective Breathing Pattern r/t increased abdominal girth

Imbalanced Nutrition: less than body requirements r/t loss of appetite

Chronic Pain r/t altered body function

Readiness for enhanced Knowledge: expresses an interest in learning

See cause of Ascites; Cancer; Cirrhosis

Asperger’s Syndrome

Ineffective Relationship r/t poor communication skills, lack of empathy

See Autism

Asphyxia, Birth

Ineffective Breathing Pattern r/t depression of breathing reflex secondary to anoxia

Ineffective Coping r/t uncertainty of child outcome

Fear (parental) r/t concern over safety of infant

Impaired Gas Exchange r/t poor placental perfusion, lack of initiation of breathing by newborn

Grieving r/t loss of “perfect” child, concern of loss of future abilities

Impaired Spontaneous Ventilation r/t brain injury

Risk for impaired Attachment: Risk factors: ill infant who is unable to initiate parental contact, hospitalization in critical care environment

Risk for delayed Development: Risk factor: lack of oxygen to brain

Risk for disproportionate Growth: Risk factor: lack of oxygen to brain

Risk for disorganized Infant behavior: Risk factor: lack of oxygen to brain

Risk for Injury: Risk factor: lack of oxygen to brain

Risk for ineffective Cerebral tissue perfusion: Risk factor: poor placental perfusion or cord compression resulting in lack of oxygen to brain

Aspiration, Danger of

Risk for Aspiration (See Aspiration, risk for, Section III)

Assault Victim

Post-Trauma Syndrome r/t assault

Rape-Trauma Syndrome r/t rape

Impaired individual Resilience r/t frightening experience, post-trauma stress response

Risk for Post-Trauma Syndrome: Risk factors: perception of event, inadequate social support, unsupportive environment, diminished ego strength, duration of event

Risk for Spiritual Distress: Risk factors: physical, psychological stress

Assaultive Client

Risk for Injury: Risk factors: confused thought process, impaired judgment

Risk for other-directed Violence: Risk factors: paranoid ideation, anger

Asthma

Activity Intolerance r/t fatigue, energy shift to meet muscle needs for breathing to overcome airway obstruction

Ineffective Airway Clearance r/t tracheobronchial narrowing, excessive secretions

Anxiety r/t inability to breathe effectively, fear of suffocation

Disturbed Body Image r/t decreased participation in physical activities

Ineffective Breathing Pattern r/t anxiety

Ineffective Coping r/t personal vulnerability to situational crisis

Ineffective Self-Health Management (See Self-Health Management, ineffective, in Section III)

Impaired Home Maintenance r/t deficient knowledge regarding control of environmental triggers

Sleep deprivation r/t ineffective breathing pattern, cough

Readiness for enhanced Self-Health Management (See Self-Health Management, readiness for enhanced, in Section III)

Readiness for enhanced Knowledge: expresses an interest in learning

See Child with Chronic Condition; Hospitalized Child

Ataxia

Anxiety r/t change in health status

Disturbed Body Image r/t staggering gait

Impaired physical Mobility r/t neuromuscular impairment

Risk for Falls: Risk factors: gait alteration, instability

Atelectasis

Ineffective Breathing Pattern r/t loss of functional lung tissue, depression of respiratory function or hypoventilation because of pain

Impaired Gas Exchange r/t decreased alveolar-capillary surface

See condition causing Atelectasis

Atherosclerosis

See MI (Myocardial Infarction); CVA (Cerebrovascular Accident); Peripheral Vascular Disease (PVD)

Athlete’s Foot

Impaired Skin Integrity r/t effects of fungal agent

Readiness for enhanced Knowledge: expresses an interest in learning

See Itching; Pruritus

ATN (Acute Tubular Necrosis)

See Renal Failure

Atrial Fibrillation

See Dysrhythmia

Atrial Septal Defect

See Congenital Heart Disease/Cardiac Anomalies

Attention Deficit Disorder

Risk-prone Health Behavior r/t intense emotional state

Disabled family Coping r/t significant person with chronically unexpressed feelings of guilt, anxiety, hostility, and despair

Ineffective Impulse Control r/t (See Impulse Control, ineffective, Section III)

Chronic low Self-Esteem r/t difficulty in participating in expected activities, poor school performance

Social Isolation r/t unacceptable social behavior

Risk for delayed Development: Risk factor: behavior disorders

Risk for Falls: Risk factor: rapid non-thinking behavior

Risk for Loneliness: Risk factor: social isolation

Risk for impaired Parenting: Risk factor: lack of knowledge of factors contributing to child’s behavior

Risk for Spiritual Distress: Risk factor: poor relationships

Auditory Problems

See Hearing Impairment

Autism

Impaired verbal Communication r/t speech and language delays

Compromised family Coping r/t parental guilt over etiology of disease, inability to accept or adapt to child’s condition, inability to help child and other family members seek treatment

Delayed Growth and Development r/t difficulty developing relationships with other human beings, inability to identify own body as separate from those of other people, inability to integrate concept of self

Disturbed personal Identity r/t inability to distinguish between self and environment, inability to identify own body as separate from those of other people, inability to integrate concept of self

Self-Neglect r/t impaired socialization

Impaired Social Interaction r/t communication barriers, inability to relate to others, failure to develop peer relationships

Risk for delayed Development: Risk factor: autism

Risk for Loneliness: Risk factors: difficulty developing relationships with other people

Risk for Self-Mutilation: Risk factor: autistic state

Risk for other-directed Violence: Risk factors: frequent destructive rages toward others secondary to extreme response to changes in routine, fear of harmless things

Risk for self-directed Violence: Risk factors: frequent destructive rages toward self, secondary to extreme response to changes in routine, fear of harmless things

See Child with Chronic Condition; Mental Retardation

Autonomic Dysreflexia

Autonomic Dysreflexia r/t bladder distention, bowel distention, noxious stimuli

Risk for Autonomic Dysreflexia: Risk factors: bladder distention, bowel distention, noxious stimuli

Autonomic Hyperreflexia

See Autonomic Dysreflexia