R

RA (Rheumatoid Arthritis)

See Rheumatoid Arthritis (RA)

Rabies

Ineffective Health Maintenance r/t deficient knowledge regarding care of wound, isolation, and observation of infected animal

Acute Pain r/t multiple immunization injections

Risk for ineffective Cerebral tissue perfusion: Risk factor: rabies virus

Readiness for enhanced Immunization Status: desires to enhance immunization status

Radial Nerve Dysfunction

Acute Pain r/t trauma to hand or arm

See Neuropathy, Peripheral

Radiation Therapy

Activity Intolerance r/t fatigue from possible anemia

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

Diarrhea r/t irradiation effects

Fatigue r/t malnutrition from lack of appetite, nausea, and vomiting

Deficient Knowledge r/t what to expect with radiation therapy

Nausea r/t side effects of radiation

Imbalanced Nutrition: less than body requirements r/t anorexia, nausea, vomiting, irradiation of areas of pharynx and esophagus

Impaired Oral Mucous Membrane r/t irradiation effects

Ineffective Protection r/t suppression of bone marrow

Risk for Powerlessness: Risk factors: medical treatment and possible side effects

Risk for compromised Resilience: Risk factor: radiation treatment

Risk for impaired Skin Integrity: Risk factor: irradiation effects

Risk for Spiritual Distress: Risk factors: radiation treatment, prognosis

Radical Neck Dissection

See Laryngectomy

Rage

Risk-prone Health Behavior r/t multiple stressors

Impaired individual Resilience r/t poor impulse control

Stress overload r/t multiple coexisting stressors

Risk for Self-Mutilation: Risk factor: command hallucinations

Risk for Suicide: Risk factor: desire to kill self

Risk for other-directed Violence: Risk factors: panic state, manic excitement, organic brain syndrome

Rape-Trauma Syndrome

Rape-Trauma Syndrome (See Rape-Trauma Syndrome, Section III)

Chronic Sorrow r/t forced loss of virginity

Risk for ineffective Childbearing Process r/t to trauma and violence

Risk for chronic low Self-Esteem r/t perceived lack of respect from others/feeling violated

Risk for ineffective Relationship r/t to trauma and violence

Risk for Post-Trauma Syndrome: Risk factors: trauma or violence associated with rape

Risk for Powerlessness: Risk factor: inability to control thoughts about incident

Risk for Spiritual Distress: Risk factor: forced loss of virginity

Rash

Impaired Comfort r/t pruritus

Impaired Skin Integrity r/t mechanical trauma

Risk for Latex Allergy Response: Risk factor: allergy to products associated with latex

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

Readiness for enhanced Immunization Status: desire to prevent infectious disease

Rationalization

Defensive Coping r/t situational crisis, inability to accept blame for consequences of own behavior

Ineffective Denial r/t fear of consequences, actual or perceived loss

Impaired individual Resilience r/t psychological disturbance

Risk for Post-Trauma Syndrome: Risk factor: survivor’s role in event

Readiness for enhanced Communication: expressing desire to share thoughts and feelings

Readiness for enhanced Spiritual Well-Being: possibility of seeking harmony with self, others, higher power, God

Rats, Rodents in the Home

Impaired Home Maintenance r/t lack of knowledge, insufficient finances

Risk for Allergy Response r/t repeated exposure to environmental contamination

See Filthy Home Environment

Raynaud’s Disease

Deficient Knowledge r/t lack of information about disease process, possible complications, self-care needs regarding disease process and medication

Ineffective peripheral Tissue Perfusion r/t transient reduction of blood flow

RDS (Respiratory Distress Syndrome)

See Respiratory Conditions of the Neonate

Rectal Fullness

Constipation r/t decreased activity level, decreased fluid intake, inadequate fiber in diet, decreased peristalsis, side effects from antidepressant or antipsychotic therapy

Risk for Constipation: Risk factor: habitual denial or ignoring of urge to defecate

Rectal Lump

See Hemorrhoids

Rectal Pain/Bleeding

Constipation r/t pain on defecation

Deficient Knowledge r/t possible causes of rectal bleeding, pain, treatment modalities

Acute Pain r/t pressure of defecation

Risk for Bleeding: Risk factor: rectal disease

Rectal Surgery

See Hemorrhoidectomy

Rectocele Repair

Constipation r/t painful defecation

Ineffective Health Maintenance r/t deficient knowledge of postoperative care of surgical site, dietary measures, exercise to prevent constipation

Acute Pain r/t surgical procedure

Urinary Retention r/t edema from surgery

Risk for Bleeding: Risk factor: surgery

Risk for urge urinary Incontinence: Risk factor: edema from surgery

Risk for Infection: Risk factors: surgical procedure, possible contamination of site with feces

Reflex Incontinence

Reflex urinary Incontinence (See Incontinence, urinary, reflex, Section III)

Regression

Anxiety r/t threat to or change in health status

Defensive Coping r/t denial of obvious problems, weaknesses

Self-Neglect r/t functional impairment

Powerlessness r/t health care environment

Impaired individual Resilience r/t psychological disturbance

Ineffective Role Performance r/t powerlessness over health status

See Hospitalized Child; Separation Anxiety

Regretful

Anxiety r/t situational or maturational crises

Death Anxiety r/t feelings of not having accomplished goals in life

Risk for Spiritual Distress: Risk factor: inability to forgive

Rehabilitation

Ineffective Coping r/t loss of normal function

Impaired physical Mobility r/t injury, surgery, psychosocial condition warranting rehabilitation

Self-Care deficit: specify r/t impaired physical mobility

Readiness for enhanced Comfort: expresses desire to enhance feeling of comfort

Readiness for enhanced Self-Concept: accepts strengths and limitations

Readiness for enhanced Self-Health Management: expression of desire to manage rehabilitation

Relationship

Ineffective Relationship

Risk for ineffective Relationship (see Section III)

Relaxation Techniques

Anxiety r/t disturbed energy field

Readiness for enhanced Comfort: expresses desire to enhance relaxation

Readiness for enhanced Religiosity: requests religious materials or experiences

Readiness for enhanced Resilience: desire to enhance resilience

Readiness for enhanced Self-Concept: willingness to enhance self-concept

Readiness for enhanced Self-Health Management: desire to manage illness

Readiness for enhanced Spiritual Well-Being: seeking comfort from higher power

Religiosity

Impaired Religiosity (See Religiosity, impaired, Section III)

Risk for impaired Religiosity (See Religiosity, impaired, risk for, Section III)

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

Religious Concerns

Spiritual Distress r/t separation from religious or cultural ties

Risk for impaired Religiosity: Risk factors: ineffective support, coping, caregiving

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

Readiness for enhanced Spiritual Well-Being: desire for increased spirituality

Relocation Stress Syndrome

Relocation Stress Syndrome (See Relocation Stress Syndrome, Section III)

Risk for Relocation Stress Syndrome (See Relocation Stress Syndrome, risk for, Section III)

Renal Failure

Activity Intolerance r/t effects of anemia, congestive heart failure

Death Anxiety r/t unknown outcome of disease

Decreased Cardiac Output r/t effects of congestive heart failure, elevated potassium levels interfering with conduction system

Impaired Comfort r/t pruritus

Ineffective Coping r/t depression resulting from chronic disease

Fatigue r/t effects of chronic uremia and anemia

Excess Fluid Volume r/t decreased urine output, sodium retention, inappropriate fluid intake

Noncompliance r/t complex medical therapy

Imbalanced Nutrition: less than body requirements r/t anorexia, nausea, vomiting, altered taste sensation, dietary restrictions

Impaired Oral Mucous Membrane r/t irritation from nitrogenous waste products

Chronic Sorrow r/t chronic illness

Spiritual Distress r/t dealing with chronic illness

Impaired Urinary Elimination r/t effects of disease, need for dialysis

Risk for Electrolyte Imbalance: Risk factor: renal dysfunction

Risk for Infection: Risk factor: altered immune functioning

Risk for Injury: Risk factors: bone changes, neuropathy, muscle weakness

Risk for impaired Oral Mucous Membrane: Risk factors: dehydration, effects of uremia

Risk for ineffective Renal Perfusion: Risk factor: renal disease

Risk for Powerlessness: Risk factor: chronic illness

Risk for Shock: Risk factor: infection

Renal Failure, Acute/Chronic, Child

Disturbed Body Image r/t growth retardation, bone changes, visibility of dialysis access devices (shunt, fistula), edema

Deficient Diversional Activity r/t immobility during dialysis

See Child with Chronic Condition; Hospitalized Child; Renal Failure

Renal Failure, Nonoliguric

Anxiety r/t change in health status

Risk for deficient Fluid Volume: Risk factor: loss of large volumes of urine

See Renal Failure

Renal Transplantation, Donor

Decisional Conflict r/t harvesting of kidney from traumatized donor

Moral Distress r/t conflict among decision makers, end-of-life decisions, time constraints for decision-making

Spiritual Distress r/t grieving from loss of significant person

Readiness for enhanced Communication: expressing thoughts and feelings about situation

Readiness for enhanced family Coping: decision to allow organ donation

Readiness for enhanced Decision-Making: expresses desire to enhance understanding and meaning of choices

Readiness for enhanced Resilience: decision to donate organs

Readiness for enhanced Spirituality: inner peace resulting from allowance of organ donation

See Nephrectomy

Renal Transplantation, Recipient

Anxiety r/t possible rejection, procedure

Impaired Health Maintenance r/t long-term home treatment after transplantation, diet, signs of rejection, use of medications

Deficient Knowledge r/t specific nutritional needs, possible paralytic ileus, fluid or sodium restrictions

Ineffective Protection r/t immunosuppression therapy

Impaired Urinary Elimination r/t possible impaired renal function

Risk for Bleeding: Risk factor: surgical procedure

Risk for Infection: Risk factor: use of immunosuppressive therapy to control rejection

Risk for ineffective Renal Perfusion: Risk factor: transplanted kidney

Risk for Shock: Risk factor: possible hypovolemia

Risk for Spiritual Distress: Risk factor: obtaining transplanted kidney from someone’s traumatic loss

Readiness for enhanced Spiritual Well-Being: acceptance of situation

See Kidney Transplant

Respiratory Acidosis

See Acidosis, Respiratory

Respiratory Conditions of the Neonate (Respiratory Distress Syndrome [RDS], Meconium Aspiration, Diaphragmatic Hernia)

Ineffective Airway Clearance r/t sequelae of attempts to breathe in utero resulting in meconium aspiration

Ineffective Breathing Pattern r/t prolonged ventilator dependence

Fatigue r/t increased energy requirements and metabolic demands

Impaired Gas Exchange r/t decreased surfactant, immature lung tissue

Risk for Infection: Risk factors: tissue destruction or irritation as a result of aspiration of meconium fluid

See Bronchopulmonary Dysplasia; Hospitalized Child; Premature Infant, Child

Respiratory Distress

See Dyspnea

Respiratory Distress Syndrome (RDS)

See Respiratory Conditions of the Neonate

Respiratory Infections, Acute Childhood (Croup, Epiglottitis, Pertussis, Pneumonia, Respiratory Syncytial Virus)

Activity Intolerance r/t generalized weakness, dyspnea, fatigue, poor oxygenation

Ineffective Airway Clearance r/t excess tracheobronchial secretions

Anxiety/Fear r/t oxygen deprivation, difficulty breathing

Ineffective Breathing Pattern r/t inflamed bronchial passages, coughing

Deficient Fluid Volume r/t insensible losses (fever, diaphoresis), inadequate oral fluid intake

Impaired Gas Exchange r/t insufficient oxygenation as a result of inflammation or edema of epiglottis, larynx, bronchial passages

Hyperthermia r/t infectious process

Imbalanced Nutrition: less than body requirements r/t anorexia, fatigue, generalized weakness, poor sucking and breathing coordination, dyspnea

Risk for Aspiration: Risk factors: inability to coordinate breathing, coughing, sucking

Risk for Infection: transmission to others: Risk factor: virulent infectious organisms

Risk for Injury (to pregnant others): Risk factors: exposure to aerosolized medications (e.g., ribavirin, pentamidine), resultant potential fetal toxicity

Risk for Suffocation: Risk factors: inflammation of larynx, epiglottis

See Hospitalized Child

Respiratory Syncytial Virus

See Respiratory Infections, Acute Childhood

Restless Leg Syndrome

Insomnia r/t leg discomfort during sleep relieved by frequent leg movement

Sleep deprivation r/t frequent leg movements

See Stress

Retarded Growth and Development

See Growth and Development Lag

Retching

Nausea r/t chemotherapy, postsurgical anesthesia, irritation to gastrointestinal system, stimulation of neuropharmacological mechanisms

Imbalanced Nutrition: less than body requirements r/t inability to ingest food

Retinal Detachment

Anxiety r/t change in vision, threat of loss of vision

Deficient Knowledge r/t symptoms, need for early intervention to prevent permanent damage

Vision Loss r/t impaired visual impairment

Risk for impaired Home Maintenance: Risk factors: postoperative care, activity limitations, care of affected eye

Risk for compromised Resilience: Risk factor: possible loss of vision

See Vision Impairment

Retinopathy, Diabetic

See Diabetic Retinopathy

Retinopathy of Prematurity (ROP)

Risk for Injury: Risk factors: prolonged mechanical ventilation, ROP secondary to 100% oxygen environment

See Retinal Detachment

Reye’s Syndrome

Ineffective Breathing Pattern r/t neuromuscular impairment

Compromised family Coping r/t acute situational crisis

Deficient Fluid Volume r/t vomiting, hyperventilation

Excess Fluid Volume: cerebral r/t cerebral edema

Impaired Gas Exchange r/t hyperventilation, sequelae of increased intracranial pressure

Grieving r/t uncertain prognosis and sequelae

Ineffective Health Maintenance r/t deficient knowledge regarding use of salicylates during viral illness of child

Imbalanced Nutrition: less than body requirements r/t effects of liver dysfunction, vomiting

Situational low Self-Esteem: family r/t negative perceptions of self, perceived inability to manage family situation, expressions of guilt

Impaired Skin Integrity r/t effects of decorticate or decerebrate posturing, seizure activity

Risk for Injury: Risk factors: combative behavior, seizure activity

Risk for impaired Liver Function: Risk factor: infection

Risk for ineffective Cerebral tissue perfusion: Risk factor: infection

See Hospitalized Child

Rh Factor Incompatibility

Anxiety r/t unknown outcome of pregnancy

Neonatal Jaundice r/t Rh factor incompatibility

Deficient Knowledge r/t treatment regimen from lack of experience with situation

Powerlessness r/t perceived lack of control over outcome of pregnancy

Risk for Injury: fetal: Risk factors: intrauterine destruction of red blood cells, transfusions

Risk for Neonatal Jaundice r/t Rh factor incompatibility

Readiness for enhanced Self-Health Management: prenatal care, compliance with diagnostic and treatment regimen

Rhabdomyolysis

Ineffective Coping r/t seriousness of condition

Impaired physical Mobility r/t myalgia and muscle weakness

Impaired Urinary Elimination r/t presence of myoglobin in the kidneys

Risk for deficient Fluid Volume: Risk factor: reduced blood flow to kidneys

Risk for ineffective Renal Perfusion: Risk factor: possible renal failure

Risk for Shock: Risk factor: hypovolemia

Readiness for enhanced Self-Health Management: seeks information to avoid condition

See Renal Failure

Rheumatic Fever

See Endocarditis

Rheumatoid Arthritis (RA)

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

Risk for compromised Resilience: Risk factor: chronic, painful, progressive disease

See Arthritis; JRA (Juvenile Rheumatoid Arthritis)

Rib Fracture

Ineffective Breathing Pattern r/t fractured ribs

Acute Pain r/t movement, deep breathing

See Ventilator Client (if relevant)

Ridicule of Others

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

Risk for Post-Trauma Syndrome: Risk factor: perception of the event

Ringworm of Body

Impaired Comfort r/t pruritus

Impaired Skin Integrity r/t presence of macules associated with fungus

See Itching; Pruritus

Ringworm of Nails

Disturbed Body Image r/t appearance of nails, removed nails

Ringworm of Scalp

Disturbed Body Image r/t possible hair loss (alopecia)

See Itching; Pruritus

Risk for Relocation Stress Syndrome

Risk for Relocation Stress Syndrome (See Relocation Stress Syndrome, risk for, Section III)

Roaches, Invasion of Home with

Impaired Home Maintenance r/t lack of knowledge, insufficient finances

See Filthy Home Environment

Role Performance, Altered

Ineffective Role Performance (See Role Performance, ineffective, Section III)

ROP (Retinopathy of Prematurity)

See Retinopathy of Prematurity (ROP)

Risk for dry Eye r/t mechanical ventilation

RSV (Respiratory Syncytial Virus)

See Respiratory Infection, Acute Childhood

Rubella

See Communicable Diseases, Childhood

Rubor of Extremities

Ineffective peripheral Tissue Perfusion r/t interruption of arterial flow

See Peripheral Vascular Disease (PVD)

Ruptured Disk

See Low Back Pain