H

H1N1

See Influenza

Hair Loss

Disturbed Body Image r/t psychological reaction to loss of hair

Imbalanced Nutrition: less than body requirements r/t inability to ingest food because of biological, psychological, economic factors

Halitosis

Impaired Dentition r/t ineffective oral hygiene

Impaired Oral Mucous Membrane r/t ineffective oral hygiene

Hallucinations

Anxiety r/t threat to self-concept

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

Ineffective Coping r/t distortion and insecurity of life events

Adult Failure to Thrive r/t altered mental status

Risk for Self-Mutilation: Risk factor: command hallucinations

Risk for other-directed Violence: Risk factors: catatonic excitement, manic excitement, rage or panic reactions, response to violent internal stimuli

Risk for self-directed Violence: Risk factors: catatonic excitement, manic excitement, rage or panic reactions, response to violent internal stimuli

Head Injury

Ineffective Breathing Pattern r/t pressure damage to breathing center in brainstem

Acute Confusion r/t increased intracranial pressure

Decreased Intracranial Adaptive Capacity r/t increased intracranial pressure

Risk for ineffective Cerebral tissue perfusion: Risk factors: effects of increased intracranial pressure, trauma to brain

Vision Loss r/t pressure damage to sensory centers in brain

See Neurologic Disorders

Headache

Disturbed Energy Field r/t disharmony

Acute Pain r/t lack of knowledge of pain control techniques or methods to prevent headaches

Ineffective Self-Health Management r/t lack of knowledge, identification, elimination of aggravating factors

Health Behavior, Risk-Prone

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

Health Maintenance Problems

Ineffective Health Maintenance (See Health Maintenance, ineffective, Section III)

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

Health-Seeking Person

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

Hearing Impairment

Hearing Loss r/t (See Hearing Loss, Section III)

Impaired verbal Communication r/t inability to hear own voice

Social Isolation r/t difficulty with communication

Heart Attack

See MI (Myocardial Infarction)

Heartburn

Nausea r/t gastrointestinal irritation

Acute Pain: heartburn r/t inflammation of stomach and esophagus

Risk for imbalanced Nutrition: less than body requirements: Risk factor: pain after eating

Readiness for enhanced Knowledge: expresses an interest in learning

Heart Failure

See CHF (Congestive Heart Failure)

Heart Surgery

See Coronary Artery Bypass Grafting (CABG)

Heat Stroke

Deficient Fluid Volume r/t profuse diaphoresis from high environmental temperature

Hyperthermia r/t vigorous activity, hot environment

Hematemesis

See GI Bleed (Gastrointestinal Bleeding)

Hematuria

See Kidney Stone; UTI (Urinary Tract Infection)

Hemianopia

Anxiety r/t change in vision

Unilateral Neglect r/t effects of disturbed perceptual abilities

Visual Loss r/t impaired sensory reception, transmission, integration

Risk for Injury: Risk factor: disturbed sensory perception

Hemiplegia

Anxiety r/t change in health status

Disturbed Body Image r/t functional loss of one side of body

Impaired physical Mobility r/t loss of neurological control of involved extremities

Unilateral Neglect r/t effects of disturbed perceptual abilities

Self-Care deficit: specify: r/t neuromuscular impairment

Impaired Transfer Ability r/t partial paralysis

Impaired Walking r/t loss of neurological control of involved extremities

Risk for Falls: Risk factor: impaired mobility

Risk for impaired Skin Integrity: Risk factors: alteration in sensation, immobility

See CVA (Cerebrovascular Accident)

Hemodialysis

Ineffective Coping r/t situational crisis

Interrupted Family Processes r/t changes in role responsibilities as a result of therapy regimen

Excess Fluid Volume r/t renal disease with minimal urine output

Powerlessness r/t treatment regimen

Risk for Caregiver Role Strain: Risk factor: complexity of care receiver treatment

Risk for Electrolyte Imbalance: Risk factor: effect of metabolic state on kidney function

Risk for deficient Fluid Volume: Risk factor: excessive removal of fluid during dialysis

Risk for Infection: Risk factors: exposure to blood products, risk for developing hepatitis B or C, impaired immune system

Risk for Injury: Risk factor: clotting of blood access: Risk factor: abnormal surface for blood flow

Readiness for enhanced Knowledge: expresses an interest in learning

See Renal Failure; Renal Failure, Child with Chronic Condition

Hemodynamic Monitoring

Risk for Infection: Risk factor: invasive procedure

Risk for Injury: Risk factors: inadvertent wedging of catheter, dislodgement of catheter, disconnection of catheter

See Cardiogenic Shock

Hemolytic Uremic Syndrome

Deficient Fluid Volume r/t vomiting, diarrhea

Fear r/t serious condition with unknown outcome

Fatigue r/t decreased red blood cells

Nausea r/t effects of uremia

Risk for Injury: Risk factors: decreased platelet count, seizure activity

Risk for impaired Skin Integrity: Risk factor: diarrhea

See Hospitalized Child; Renal Failure, Acute/Chronic, Child

Hemophilia

Fear r/t high risk for AIDS infection from contaminated blood products

Impaired physical Mobility r/t pain from acute bleeds, imposed activity restrictions, joint pain

Acute Pain r/t bleeding into body tissues

Risk for Bleeding: Risk factors: deficient clotting factors, child’s developmental level, age-appropriate play, inappropriate use of toys or sports equipment

Readiness for enhanced Knowledge: expresses an interest in learning

See Child with Chronic Condition; Hospitalized Child; Maturational Issues, Adolescent

Hemoptysis

Fear r/t serious threat to well-being

Risk for ineffective Airway Clearance: Risk factor: obstruction of airway with blood and mucus

Risk for deficient Fluid Volume: Risk factor: excessive loss of blood

Hemorrhage

Fear r/t threat to well-being

Deficient Fluid Volume r/t massive blood loss

See cause of Hemorrhage; Hypovolemic Shock

Hemorrhoidectomy

Anxiety r/t embarrassment, need for privacy

Constipation r/t fear of pain with defecation

Acute Pain r/t surgical procedure

Urinary Retention r/t pain, anesthetic effect

Risk for Bleeding: Risk factors: inadequate clotting, trauma from surgery

Readiness for enhanced Knowledge: expresses an interest in learning

Hemorrhoids

Impaired Comfort r/t itching in rectal area

Constipation r/t painful defecation, poor bowel habits

Readiness for enhanced Knowledge: expresses an interest in learning

Hemothorax

Deficient Fluid Volume r/t blood in pleural space

See Pneumothorax

Hepatitis

Activity Intolerance r/t weakness or fatigue caused by infection

Deficient Diversional Activity r/t isolation

Fatigue r/t infectious process, altered body chemistry

Imbalanced Nutrition: less than body requirements r/t anorexia, impaired use of proteins and carbohydrates

Acute Pain r/t edema of liver, bile irritating skin

Social Isolation r/t treatment-imposed isolation

Risk for deficient Fluid Volume: Risk factor: excessive loss of fluids from vomiting and diarrhea

Readiness for enhanced Knowledge: expresses an interest in learning

Hernia

See Hiatal Hernia; Inguinal Hernia Repair

Herniated Disk

See Low Back Pain

Herniorrhaphy

See Inguinal Hernia Repair

Herpes in Pregnancy

Fear r/t threat to fetus, impending surgery

Situational low Self-Esteem r/t threat to fetus as a result of disease process

Risk for Infection (Infant): Risk factors: transplacental transfer during primary herpes, exposure to active herpes during birth process

See Herpes Simplex II

Herpes Simplex I

Impaired Oral Mucous Membrane r/t inflammatory changes in mouth

Herpes Simplex II

Ineffective Health Maintenance r/t deficient knowledge regarding treatment, prevention, spread of disease

Acute Pain r/t active herpes lesion

Situational low Self-Esteem r/t expressions of shame or guilt

Sexual Dysfunction r/t disease process

Impaired Tissue Integrity r/t active herpes lesion

Impaired Urinary Elimination r/t pain with urination

Herpes Zoster

See Shingles

HHNC (Hyperosmolar Hyperglycemic Nonketotic Coma)

See Hyperosmolar Hyperglycemic Nonketotic Coma (HHNC)

Hiatal Hernia

Ineffective Health Maintenance r/t deficient knowledge regarding care of disease

Nausea r/t effects of gastric contents in esophagus

Imbalanced Nutrition: less than body requirements r/t pain after eating

Acute Pain r/t gastroesophageal reflux

Hip Fracture

Acute Confusion r/t sensory overload, sensory deprivation, medication side effects, advanced age, pain

Constipation r/t immobility, opioids, anesthesia

Fear r/t outcome of treatment, future mobility, present helplessness

Impaired physical Mobility r/t surgical incision, temporary absence of weight bearing, pain when walking

Acute Pain r/t injury, surgical procedure, movement

Powerlessness r/t health care environment

Self-Care deficit: specify r/t musculoskeletal impairment

Impaired Transfer Ability r/t immobilization of hip

Impaired Walking r/t temporary absence of weight bearing

Risk for Bleeding: Risk factors: postoperative complication, surgical blood loss

Risk for Infection: Risk factor: invasive procedure

Risk for Injury: Risk factors: activities such as greater than 90-degree flexion of hips that can result in dislodged prosthesis, unsteadiness when ambulating

Risk for Perioperative Positioning Injury: Risk factors: immobilization, muscle weakness, emaciation

Risk for Peripheral Neurovascular Dysfunction: Risk factor: trauma, vascular obstruction, fracture

Risk for impaired Skin Integrity: Risk factor: immobility

Hip Replacement

See Total Joint Replacement (Total Hip/Total Knee/Shoulder)

Hirschsprung’s Disease

Constipation: bowel obstruction r/t inhibited peristalsis as a result of congenital absence of parasympathetic ganglion cells in distal colon

Grieving r/t loss of perfect child, birth of child with congenital defect even though child expected to be normal within 2 years

Imbalanced Nutrition: less than body requirements r/t anorexia, pain from distended colon

Acute Pain r/t distended colon, incisional postoperative pain

Impaired Skin Integrity r/t stoma, potential skin care problems associated with stoma

Readiness for enhanced Knowledge: expresses an interest in learning

See Hospitalized Child

Hirsutism

Disturbed Body Image r/t excessive hair

Hitting Behavior

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

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

HIV (Human Immunodeficiency Virus)

Fear r/t possible death

Ineffective Protection r/t depressed immune system

See AIDS (Acquired Immunodeficiency Syndrome)

Hodgkin’s Disease

See Anemia; Cancer; Chemotherapy

Homelessness

Impaired Home Maintenance r/t impaired cognitive or emotional functioning, inadequate support system, insufficient finances

Home Maintenance Problems

Impaired Home Maintenance (See Home Maintenance, impaired, Section III)

Self-Neglect r/t mental illness, substance abuse, cognitive impairment

Powerlessness r/t interpersonal interactions

Risk for Trauma: Risk factor: being in high-crime neighborhood

Hope

Readiness for enhanced Hope (See Hope, readiness for enhanced, Section III)

Hopelessness

Hopelessness (See Hopelessness, Section III)

Hospitalized Child

Activity Intolerance r/t fatigue associated with acute illness

Anxiety: separation (child) r/t familiar surroundings and separation from family and friends

Compromised family Coping r/t possible prolonged hospitalization that exhausts supportive capacity of significant people

Ineffective Coping: parent r/t possible guilt regarding hospitalization of child, parental inadequacies

Deficient Diversional Activity r/t immobility, monotonous environment, frequent or lengthy treatments, reluctance to participate, therapeutic isolation, separation from peers

Interrupted Family Processes r/t situational crisis of illness, disease, hospitalization

Fear r/t deficient knowledge or maturational level with fear of unknown, mutilation, painful procedures, surgery

Delayed Growth and Development r/t regression or lack of progression toward developmental milestones as a result of frequent or prolonged hospitalization, inadequate or inappropriate stimulation, cerebral insult, chronic illness, effects of physical disability, prescribed dependence

Hopelessness: child r/t prolonged activity restriction, uncertain prognosis

Insomnia: child or parent r/t 24-hour care needs of hospitalization

Acute Pain r/t treatments, diagnostic or therapeutic procedures, disease process

Powerlessness: child r/t health care environment, illness-related regimen

Risk for impaired Attachment: Risk factor: separation

Risk for delayed Growth and Development: regression: Risk factors: disruption of normal routine, unfamiliar environment or caregivers, developmental vulnerability of young children

Risk for Injury: Risk factors: unfamiliar environment, developmental age, lack of parental knowledge regarding safety (e.g., side rails, IV site/pole)

Risk for imbalanced Nutrition: less than body requirements: Risk factors: anorexia, absence of familiar foods, cultural preferences

Readiness for enhanced family Coping: impact of crisis on family values, priorities, goals, relationships in family

See Child with Chronic Condition

Hostile Behavior

Risk for other-directed Violence: Risk factor: antisocial personality disorder

HTN (Hypertension)

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

Imbalanced Nutrition: more than body requirements r/t lack of knowledge of relationship between diet and disease process

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

Human Immunodeficiency Virus (HIV)

See AIDS (Acquired Immunodeficiency Syndrome); HIV (Human Immunodeficiency Virus)

Humiliating Experience

Risk for compromised Human Dignity (See Human Dignity, compromised, risk for, Section III)

Huntington’s Disease

Decisional Conflict r/t whether to have children

See Neurologic Disorders

Hydrocele

Acute Pain r/t severely enlarged hydrocele

Ineffective Sexuality Pattern r/t recent surgery on area of scrotum

Hydrocephalus

Decisional Conflict r/t unclear or conflicting values regarding selection of treatment modality

Interrupted Family Processes r/t situational crisis

Delayed Growth and development r/t sequelae of increased intracranial pressure

Imbalanced Nutrition: less than body requirements r/t inadequate intake as a result of anorexia, nausea, vomiting, feeding difficulties

Risk for delayed Development: Risk factor: sequelae of increased intracranial pressure

Risk for disproportionate Growth: Risk factor: sequelae of increased intracranial pressure

Risk for Infection: Risk factor: sequelae of invasive procedure (shunt placement)

Risk for ineffective Cerebral tissue perfusion: Risk factors: interrupted flow, hypervolemia of cerebral ventricles

See Normal Pressure Hydrocephalus (NPH); Child with Chronic Condition; Hospitalized Child; Mental Retardation (if appropriate); Premature Infant (Child); Premature Infant (Parent)

Hygiene, Inability to Provide Own

Adult Failure to Thrive r/t depression, apathy as evidenced by inability to perform self-care

Self-Neglect (See Self-Neglect, Section III)

Bathing Self-Care deficit (See Self-Care deficit, bathing, Section III)

Hyperactive Syndrome

Decisional Conflict r/t multiple or divergent sources of information regarding education, nutrition, medication regimens; willingness to change own food habits; limited resources

Parental Role Conflict: when siblings present r/t increased attention toward hyperactive child

Compromised family Coping r/t unsuccessful strategies to control excessive activity, behaviors, frustration, anger

Ineffective Impulse Control r/t disorder of development, environment that might cause frustration or irritation

Ineffective Role Performance: parent r/t stressors associated with dealing with hyperactive child, perceived or projected blame for causes of child’s behavior, unmet needs for support or care, lack of energy to provide for those needs

Chronic low Self-Esteem r/t inability to achieve socially acceptable behaviors; frustration; frequent reprimands, punishment, or scolding for uncontrolled activity and behaviors; mood fluctuations and restlessness; inability to succeed academically; lack of peer support

Impaired Social Interaction r/t impulsive and overactive behaviors, concomitant emotional difficulties, distractibility and excitability

Risk for delayed Development: Risk factor: behavior disorders

Risk for impaired Parenting: Risk factor: disruptive or uncontrollable behaviors of child

Risk for other-directed Violence: parent or child: Risk factors: frustration with disruptive behavior, anger, unsuccessful relationships

Hyperbilirubinemia

Anxiety: parent r/t threat to infant, unknown future

Parental Role Conflict r/t interruption of family life because of care regimen

Neonatal Jaundice r/t abnormal breakdown of red blood cells following birth

Imbalanced Nutrition: less than body requirements (infant) r/t disinterest in feeding because of jaundice-related lethargy

Risk for disproportionate Growth: infant: Risk factor: disinterest in feeding because of jaundice-related lethargy

Risk for imbalanced body Temperature: infant: Risk factor: phototherapy

Risk for Injury: infant: Risk factors: kernicterus, phototherapy lights

Hypercalcemia

Decreased Cardiac Output r/t bradydysrhythmia

Impaired physical Mobility r/t decreased muscle tone

Imbalanced Nutrition: less than body requirements r/t gastrointestinal manifestations of hypercalcemia (nausea, anorexia, ileus)

Risk for Disuse Syndrome: Risk factor: comatose state impairing mobility

Hypercapnia

Fear r/t difficulty breathing

Impaired Gas Exchange r/t ventilation-perfusion imbalance, retention of carbon dioxide

See cause of Hypercapnia

Hyperemesis Gravidarum

Anxiety r/t threat to self and infant, hospitalization

Deficient Fluid Volume r/t excessive vomiting

Impaired Home Maintenance r/t chronic nausea, inability to function

Nausea r/t hormonal changes of pregnancy

Imbalanced Nutrition: less than body requirements r/t excessive vomiting

Powerlessness r/t health care regimen

Social Isolation r/t hospitalization

Hyperglycemia

Ineffective Self-Health Management r/t complexity of therapeutic regimen, decisional conflicts, economic difficulties, unsupportive family, insufficient cues to action, deficient knowledge, mistrust, lack of acknowledgment of seriousness of condition

Risk for unstable blood Glucose level (See Glucose level, blood, unstable, risk for, Section III)

See Diabetes Mellitus

Hyperkalemia

Risk for Activity Intolerance: Risk factor: muscle weakness

Risk for excess Fluid Volume: Risk factor: untreated renal failure

Risk for decreased Cardiac tissue perfusion: Risk factor: abnormal electrolyte level affecting heart electrical conduction

Hypernatremia

Risk for deficient Fluid Volume: Risk factors: abnormal water loss, inadequate water intake

Hyperosmolar Hyperglycemic Nonketotic Coma (HHNC)

Acute Confusion r/t dehydration, electrolyte imbalance

Deficient Fluid Volume r/t polyuria, inadequate fluid intake

Risk for Electrolyte Imbalance: Risk factors: effect of metabolic state on kidney function

Risk for Injury: seizures: Risk factors: hyperosmolar state, electrolyte imbalance

See Diabetes Mellitus; Diabetes Mellitus, Juvenile

Hyperphosphatemia

Deficient Knowledge r/t dietary changes needed to control phosphate levels

See Renal Failure

Hypersensitivity to Slight Criticism

Defensive Coping r/t situational crisis, psychological impairment, substance abuse

Hypertension (HTN)

See HTN (Hypertension)

Hyperthermia

Hyperthermia (See Hyperthermia, Section III)

Hyperthyroidism

Anxiety r/t increased stimulation, loss of control

Diarrhea r/t increased gastric motility

Insomnia r/t anxiety, excessive sympathetic discharge

Imbalanced Nutrition: less than body requirements r/t increased metabolic rate, increased gastrointestinal activity

Risk for Injury: eye damage: Risk factor: protruding eyes without sufficient lubrication

Readiness for enhanced Knowledge: expresses an interest in learning

Hyperventilation

Ineffective Breathing Pattern r/t anxiety, acid-base imbalance

See cause of Hyperventilation

Hypocalcemia

Activity Intolerance r/t neuromuscular irritability

Ineffective Breathing Pattern r/t laryngospasm

Imbalanced Nutrition: less than body requirements r/t effects of vitamin D deficiency, renal failure, malabsorption, laxative use

Hypoglycemia

Acute Confusion r/t insufficient blood glucose to brain

Ineffective Self-Health Management r/t deficient knowledge regarding disease process, self-care

Imbalanced Nutrition: less than body requirements r/t imbalance of glucose and insulin level

Risk for unstable blood Glucose level (See Glucose level, blood, unstable, risk for, Section III)

See Diabetes Mellitus; Diabetes Mellitus, Juvenile

Hypokalemia

Activity Intolerance r/t muscle weakness

Risk for decreased Cardiac tissue perfusion: Risk factor: possible dysrhythmia from electrolyte imbalance

Hypomagnesemia

Imbalanced Nutrition: less than body requirements r/t deficient knowledge of nutrition, alcoholism

See Alcoholism

Hypomania

Insomnia r/t psychological stimulus

See Manic Disorder, Bipolar I

Hyponatremia

Acute Confusion r/t electrolyte imbalance

Excess Fluid Volume r/t excessive intake of hypotonic fluids

Risk for Injury: Risk factors: seizures, new onset of confusion

Hypoplastic Left Lung

See Congenital Heart Disease/Cardiac Anomalies

Hypotension

Decreased Cardiac Output r/t decreased preload, decreased contractility

Risk for deficient Fluid Volume: Risk factor: excessive fluid loss

Risk for ineffective Cerebral tissue perfusion: Risk factors: hypovolemia, decreased contractility, decreased afterload

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

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

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

See cause of Hypotension

Hypothermia

Hypothermia (See Hypothermia, Section III)

Hypothyroidism

Activity Intolerance r/t muscular stiffness, shortness of breath on exertion

Constipation r/t decreased gastric motility

Impaired Gas Exchange r/t respiratory depression

Imbalanced Nutrition: more than body requirements r/t decreased metabolic process

Impaired Skin Integrity r/t edema, dry or scaly skin

Hypovolemic Shock

See Shock, Hypovolemic

Hypoxia

Acute Confusion r/t decreased oxygen supply to brain

Fear r/t breathlessness

Impaired Gas Exchange r/t altered oxygen supply, inability to transport oxygen

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

Hysterectomy

Constipation r/t opioids, anesthesia, bowel manipulation during surgery

Ineffective Coping r/t situational crisis of surgery

Grieving r/t change in body image, loss of reproductive status

Acute Pain r/t surgical injury

Sexual Dysfunction r/t disturbance in self-concept

Urinary Retention r/t edema in area, anesthesia, opioids, pain

Risk for Bleeding: Risk factor: surgical procedure

Risk for Constipation: Risk factors: opioids, anesthesia, bowel manipulation during surgery

Risk for ineffective peripheral Tissue Perfusion: Risk factor: deficient knowledge of aggravating factors

Readiness for enhanced Knowledge: Expresses an interest in learning

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