I

IBS (Irritable Bowel Syndrome)

Constipation r/t low-residue diet, stress

Diarrhea r/t increased motility of intestines associated with disease process, stress

Ineffective Self-Health Management r/t deficient knowledge, powerlessness

Chronic Pain r/t spasms, increased motility of bowel

Readiness for enhanced Self-Health Management: expressed desire to manage illness and prevent onset of symptoms

ICD (Implantable Cardioverter/Defibrillator)

Decreased Cardiac Output r/t possible dysrhythmia

Readiness for enhanced Knowledge: expresses an interest in learning

IDDM (Insulin-Dependent Diabetes)

See Diabetes Mellitus

Identity Disturbance/Problems

Disturbed personal Identity r/t situational crisis, psychological impairment, chronic illness, pain

Risk for disturbed personal Identity (See Identity, personal, risk for disturbed in Section III)

Idiopathic Thrombocytopenic Purpura (ITP)

See ITP (Idiopathic Thrombocytopenic Purpura)

Ileal Conduit

Disturbed Body Image r/t presence of stoma

Ineffective Self-Health Management r/t new skills required to care for appliance and self

Ineffective Sexuality Pattern r/t altered body function and structure

Social Isolation r/t alteration in physical appearance, fear of accidental spill of urine

Risk for Latex Allergy Response: Risk factor: repeated exposures to latex associated with treatment and management of disease

Risk for impaired Skin Integrity: Risk factor: difficulty obtaining tight seal of appliance

Readiness for enhanced Knowledge: expresses an interest in learning

Ileostomy

Disturbed Body Image r/t presence of stoma

Diarrhea r/t dietary changes, alteration in intestinal motility

Deficient Knowledge r/t limited practice of stoma care, dietary modifications

Ineffective Sexuality Pattern r/t altered body function and structure

Social Isolation r/t alteration in physical appearance, fear of accidental spill of ostomy contents

Risk for impaired Skin Integrity: Risk factors: difficulty obtaining tight seal of appliance, caustic drainage

Readiness for enhanced Knowledge: expresses an interest in learning

Ileus

Deficient Fluid Volume r/t loss of fluids from vomiting, fluids trapped in bowel

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

Nausea r/t gastrointestinal irritation

Acute Pain r/t pressure, abdominal distention

Readiness for enhanced Knowledge: expresses an interest in learning

Immobility

Ineffective Breathing Pattern r/t inability to deep breathe in supine position

Acute Confusion: elderly r/t sensory deprivation from immobility

Constipation r/t immobility

Adult Failure to Thrive r/t limited physical mobility

Impaired physical Mobility r/t medically imposed bed rest

Ineffective peripheral Tissue Perfusion r/t interruption of venous flow

Powerlessness r/t forced immobility from health care environment

Impaired Walking r/t limited physical mobility, deconditioning of body

Risk for Disuse Syndrome: Risk factor: immobilization

Risk for impaired Skin Integrity: Risk factors: pressure on immobile parts, shearing forces when moved

Readiness for enhanced Knowledge: expresses an interest in learning

Immunization

Readiness for enhanced Immunization Status (See Immunization Status, readiness for enhanced, Section III)

Immunosuppression

Risk for Infection: Risk factor: immunosuppression

Impaction of Stool

Constipation r/t decreased fluid intake, less than adequate amounts of fiber and bulk-forming foods in diet, medication effect, or immobility

Imperforate Anus

Anxiety r/t ability to care for newborn

Deficient Knowledge r/t home care for newborn

Impaired Skin Integrity r/t pruritus

Impetigo

Impaired Skin Integrity r/t infectious disease

Readiness for enhanced Knowledge: expresses an interest in learning

See Communicable Diseases, Childhood

Implantable Cardioverter/Defibrillator (ICD)

See ICD (Implantable Cardioverter/Defibrillator)

Impotence

Situational low Self-Esteem r/t physiological crisis, inability to practice usual sexual activity

Sexual Dysfunction r/t altered body function

Readiness for enhanced Knowledge: treatment information for erectile dysfunction

See Erectile Dysfunction (ED)

Impulsiveness

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

Inactivity

Activity Intolerance r/t imbalance between oxygen supply and demand, sedentary lifestyle, weakness, immobility

Hopelessness r/t deteriorating physiological condition, long-term stress, social isolation

Impaired physical Mobility r/t intolerance to activity, decreased strength and endurance, depression, severe anxiety, musculoskeletal impairment, perceptual or cognitive impairment, neuromuscular impairment, pain, discomfort

Risk for Constipation: Risk factor: insufficient physical activity

Incompetent Cervix

See Premature Dilation of the Cervix (Incompetent Cervix)

Incontinence of Stool

Disturbed Body Image r/t inability to control elimination of stool

Bowel Incontinence r/t decreased awareness of need to defecate, loss of sphincter control

Toileting Self-Care deficit r/t cognitive impairment, neuromuscular impairment, perceptual impairment, weakness.

Situational low Self-Esteem r/t inability to control elimination of stool

Risk for impaired Skin Integrity: Risk factor: presence of stool

Incontinence of Urine

Functional urinary Incontinence r/t altered environment; sensory, cognitive, or mobility deficits

Overflow urinary Incontinence r/t relaxation of pelvic muscles and changes in urinary structures

Reflex urinary Incontinence r/t neurological impairment

Stress urinary Incontinence (See Incontinence, urinary, stress, Section III)

Urge urinary Incontinence (See Incontinence, urinary, urge, Section III)

Toileting Self-Care deficit r/t cognitive impairment

Situational low Self-Esteem r/t inability to control passage of urine

Risk for impaired Skin Integrity: Risk factor: presence of urine on perineal skin

Indigestion

Nausea r/t gastrointestinal irritation

Imbalanced Nutrition: less than body requirements r/t discomfort when eating

Induction of Labor

Anxiety r/t medical interventions, powerlessness

Decisional Conflict r/t perceived threat to idealized birth

Ineffective Coping r/t situational crisis of medical intervention in birthing process

Acute Pain r/t contractions

Situational low Self-Esteem r/t inability to carry out normal labor

Risk for Injury: maternal and fetal: Risk factors: hypertonic uterus, potential prematurity of newborn

Readiness for enhanced Family Processes: family support during induction of labor

Infant Apnea

See Premature Infant (Child); Respiratory Conditions of the Neonate; SIDS (Sudden Infant Death Syndrome)

Infant Behavior

Disorganized Infant behavior r/t pain, oral/motor problems, feeding intolerance, environmental overstimulation, lack of containment or boundaries, prematurity, invasive or painful procedures

Risk for disorganized Infant behavior: Risk factors: pain, oral/motor problems, environmental overstimulation, lack of containment or boundaries

Readiness for enhanced organized Infant behavior: stable physiologic measures, use of some self-regulatory measures

Infant Care

Readiness for enhanced Childbearing Process: a pattern of preparing for, maintaining, and strengthening care of newborn infant

Infant Feeding Pattern, Ineffective

Ineffective infant Feeding Pattern r/t prematurity, neurological impairment or delay, oral hypersensitivity, prolonged nothing-by-mouth order

Infant of Diabetic Mother

Decreased Cardiac Output r/t cardiomegaly

Deficient Fluid Volume r/t increased urinary excretion and osmotic diuresis

Delayed Growth and Development r/t prolonged and severe postnatal hypoglycemia

Imbalanced Nutrition: less than body requirements r/t hypotonia, lethargy, poor sucking, postnatal metabolic changes from hyperglycemia to hypoglycemia and hyperinsulinism

Risk for delayed Development: Risk factors: prolonged and severe postnatal hypoglycemia

Risk for impaired Gas Exchange: Risk factors: increased incidence of cardiomegaly, prematurity

Risk for unstable blood Glucose level: Risk factor: metabolic change from hyperglycemia to hypoglycemia and hyperinsulinism

Risk for disproportionate Growth: Risk factors: prolonged and severe postnatal hypoglycemia

Risk for disturbed Maternal-Fetal Dyad: Risk factor: impaired glucose metabolism

See Premature Infant (Child); Respiratory Conditions of the Neonate

Infant of Substance-Abusing Mother (Fetal Alcohol Syndrome, Crack Baby, Other Drug Withdrawal Infants)

Ineffective Airway Clearance r/t pooling of secretions from the lack of adequate cough reflex, effects of viral or bacterial lower airway infection as a result of altered protective state

Interrupted Breastfeeding r/t use of drugs or alcohol by mother

Diarrhea r/t effects of withdrawal, increased peristalsis from hyperirritability

Ineffective infant Feeding Pattern r/t uncoordinated or ineffective sucking reflex

Delayed Growth and Development r/t effects of maternal use of drugs, effects of neurological impairment, decreased attentiveness to environmental stimuli or inadequate stimuli

Disorganized Infant behavior r/t exposure and or withdrawal from toxic substances (alcohol and drugs)

Ineffective Childbearing Process r/t inconsistent prenatal health visits, suboptimal maternal nutrition, substance abuse

Insomnia r/t hyperirritability or hypersensitivity to environmental stimuli

Imbalanced Nutrition: less than body requirements r/t feeding problems; uncoordinated or ineffective suck and swallow; effects of diarrhea, vomiting, or colic associated with maternal substance abuse

Impaired Parenting r/t impaired or absent attachment behaviors, inadequate support systems

Risk for delayed Development: Risk factor: substance abuse

Risk for disproportionate Growth: Risk factor: substance abuse

Risk for Infection: skin, meningeal, respiratory: Risk factor: stress effects of withdrawal

See Cerebral Palsy; Child with Chronic Condition; Crack Baby; Failure to Thrive, Nonorganic; Hospitalized Child; Hyperactive Syndrome; Premature Infant (Child); SIDS (Sudden Infant Death Syndrome)

Infantile Polyarteritis

See Kawasaki Disease

Infection

Hyperthermia r/t increased metabolic rate

Ineffective Protection r/t inadequate nutrition, abnormal blood profiles, drug therapies, treatments

Risk for Vascular Trauma: Risk factor: infusion of antibiotics

Infection, Potential for

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

Infertility

Ineffective Self-Health Management r/t deficient knowledge about infertility

Powerlessness r/t infertility

Chronic Sorrow r/t inability to conceive a child

Spiritual Distress r/t inability to conceive a child

Inflammatory Bowel Disease (Child and Adult)

Ineffective Coping r/t repeated episodes of diarrhea

Diarrhea r/t effects of inflammatory changes of the bowel

Deficient Fluid Volume r/t frequent and loose stools

Imbalanced Nutrition: less than body requirements r/t anorexia, decreased absorption of nutrients from gastrointestinal tract

Acute Pain r/t abdominal cramping and anal irritation

Impaired Skin Integrity r/t frequent stools, development of anal fissures

Social Isolation r/t diarrhea

See Child with Chronic Condition; Crohn’s Disease; Hospitalized Child; Maturational Issues, Adolescent

Influenza

Deficient Fluid Volume r/t inadequate fluid intake

Ineffective Self-Health Management r/t lack of knowledge regarding preventive immunizations

Ineffective Thermoregulation r/t infectious process

Acute Pain r/t inflammatory changes in joints

Readiness for enhanced Knowledge: about information to prevent or treat influenza

Inguinal Hernia Repair

Impaired physical Mobility r/t pain at surgical site and fear of causing hernia to rupture

Acute Pain r/t surgical procedure

Urinary Retention r/t possible edema at surgical site

Risk for Infection: Risk factor: surgical procedure

Injury

Risk for Falls: Risk factors: orthostatic hypotension, impaired physical mobility, diminished mental status

Risk for Injury: Risk factor: environmental conditions interacting with client’s adaptive and defensive resources

Risk for Thermal Injury: Risk factor: cognitive impairment, inadequate supervision, developmental level

Insanity

See Mental Illness, Psychosis

Insomnia

See Insomnia, Section III)

Insulin Shock

See Hypoglycemia

Intermittent Claudication

Deficient Knowledge r/t lack of knowledge of cause and treatment of peripheral vascular diseases

Acute Pain r/t decreased circulation to extremities with activity

Ineffective peripheral Tissue Perfusion r/t interruption of arterial flow

Risk for Injury: Risk factor: tissue hypoxia

Readiness for enhanced Knowledge: prevention of pain and impaired circulation

See Peripheral Vascular Disease (PVD)

Internal Cardioverter/Defibrillator (ICD)

See ICD (Implantable Cardioverter/Defibrillator)

Internal Fixation

Impaired Walking r/t repair of fracture

Risk for Infection: Risk factors: traumatized tissue, broken skin

See Fracture

Interstitial Cystitis

Acute Pain r/t inflammatory process

Impaired Urinary Elimination r/t inflammation of bladder

Risk for Infection: Risk factor: suppressed inflammatory response

Readiness for enhanced Knowledge: expresses an interest in learning

Intervertebral Disk Excision

See Laminectomy

Intestinal Obstruction

See Ileus, Bowel Obstruction

Intestinal Perforation

See Peritonitis

Intoxication

Anxiety r/t loss of control of actions

Acute Confusion r/t alcohol abuse

Ineffective Coping r/t use of mind-altering substances as a means of coping

Impaired Memory r/t effects of alcohol on mind

Risk for Aspiration: Risk factors: diminished mental status, vomiting

Risk for Falls: Risk factor: diminished mental status

Risk for other-directed Violence: Risk factor: inability to control thoughts and actions

Intraaortic Balloon Counterpulsation

Anxiety r/t device providing cardiovascular assistance

Decreased Cardiac Output r/t failing heart needing counterpulsation

Compromised family Coping r/t seriousness of significant other’s medical condition

Impaired physical Mobility r/t restriction of movement because of mechanical device

Risk for Peripheral Neurovascular Dysfunction: Risk factors: vascular obstruction of balloon catheter, thrombus formation, emboli, edema

Intracranial Pressure, Increased

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

Acute Confusion r/t increased intracranial pressure

Adult Failure to Thrive r/t undetected changes from increased intracranial pressure

Decreased Intracranial Adaptive Capacity r/t sustained increase in intracranial pressure

Impaired Memory r/t neurological disturbance

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

Risk for ineffective Cerebral tissue perfusion: Risk factors: body position, cerebral vessel circulation deficits

See cause of Increased Intracranial Pressure

Intrauterine Growth Retardation

Anxiety: maternal r/t threat to fetus

Ineffective Coping: maternal r/t situational crisis, threat to fetus

Impaired Gas exchange r/t insufficient placental perfusion

Delayed Growth and Development r/t insufficient supply of oxygen and nutrients

Imbalanced Nutrition: less than body requirements r/t insufficient placenta

Situational low Self-Esteem: maternal r/t guilt about threat to fetus

Spiritual Distress r/t unknown outcome of fetus

Risk for Powerlessness: Risk factor: unknown outcome of fetus

Intravenous Therapy

Risk for Vascular Trauma: Risk factor: infusion of irritating chemicals

Intubation, Endotracheal or Nasogastric

Disturbed Body Image r/t altered appearance with mechanical devices

Impaired verbal Communication r/t endotracheal tube

Imbalanced Nutrition: less than body requirements r/t inability to ingest food because of the presence of tubes

Impaired Oral Mucous Membrane r/t presence of tubes

Acute Pain r/t presence of tube

Iodine Reaction with Diagnostic Testing

Risk for adverse reaction to iodinated Contrast media: Risk factor (See reaction to iodinated Contrast media, risk for adverse, Section III)

Irregular Pulse

See Dysrhythmia

Irritable Bowel Syndrome (IBS)

See IBS (Irritable Bowel Syndrome)

Isolation

Impaired individual Resilience (See Resilience, individual, impaired, Section III)

Social Isolation (See Social Isolation, Section III)

Itching

Impaired Comfort r/t inflammation of skin causing itching

Risk for impaired Skin Integrity: Risk factor: scratching, dry skin

ITP (Idiopathic Thrombocytopenic Purpura)

Deficient Diversional Activity r/t activity restrictions, safety precautions

Ineffective Protection r/t decreased platelet count

Risk for Bleeding: Risk factors: decreased platelet count, developmental level, age-appropriate play

See Hospitalized Child