C

CABG (Coronary Artery Bypass Grafting)

See Coronary Artery Bypass Grafting (CABG)

Cachexia

Adult Failure to Thrive r/t (See Thrive, failure to, Section III)

Imbalanced Nutrition: less than body requirements r/t inability to ingest food because of physiological factors

Risk for Infection: Risk factor: inadequate nutrition

Calcium Alteration

See Hypercalcemia; Hypocalcemia

Cancer

Activity Intolerance r/t side effects of treatment, weakness from cancer

Death Anxiety r/t unresolved issues regarding dying

Disturbed Body Image r/t side effects of treatment, cachexia

Decisional Conflict r/t selection of treatment choices, continuation or discontinuation of treatment, “do not resuscitate” decision

Constipation r/t side effects of medication, altered nutrition, decreased activity

Compromised family Coping r/t prolonged disease or disability progression that exhausts supportive ability of significant others

Ineffective Coping r/t personal vulnerability in situational crisis, terminal illness

Ineffective Denial r/t complicated grieving process

Fear r/t serious threat to well-being

Grieving r/t potential loss of significant others, high risk for infertility

Ineffective Health Maintenance r/t deficient knowledge regarding prescribed treatment

Hopelessness r/t loss of control, terminal illness

Insomnia r/t anxiety, pain

Impaired physical Mobility r/t weakness, neuromusculoskeletal impairment, pain

Imbalanced Nutrition: less than body requirements r/t loss of appetite, difficulty swallowing, side effects of chemotherapy, obstruction by tumor

Impaired Oral Mucous Membrane r/t chemotherapy, effects of radiation, oral pH changes, decreased oral secretions

Chronic Pain r/t metastatic cancer

Powerlessness r/t treatment, progression of disease

Ineffective Protection r/t cancer suppressing immune system

Ineffective Role Performance r/t change in physical capacity, inability to resume prior role

Self-Care deficit: specify r/t pain, intolerance to activity, decreased strength

Impaired Skin Integrity r/t immunological deficit, immobility

Social Isolation r/t hospitalization, lifestyle changes

Chronic Sorrow r/t chronic illness of cancer

Spiritual Distress r/t test of spiritual beliefs

Risk for Bleeding: Risk factor: bone marrow depression from chemotherapy

Risk for Disuse Syndrome: Risk factors: immobility, fatigue

Risk for impaired Home Maintenance: Risk factor: lack of familiarity with community resources

Risk for Infection: Risk factor: inadequate immune system

Risk for compromised Resilience: Risk factors: multiple stressors, pain, chronic illness

Risk for Spiritual Distress: Risk factor: physical illness of cancer

Readiness for enhanced Knowledge: expresses an interest in learning

Readiness for enhanced Spiritual Well-Being: desire for harmony with self, others, higher power, God, when faced with serious illness

See Chemotherapy; Child with Chronic Condition; Hospitalized Child; Leukemia; Radiation Therapy; 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

Candidiasis, Oral

Readiness for enhanced Knowledge: expresses an interest in learning

Impaired Oral Mucous Membrane r/t overgrowth of infectious agent, depressed immune function

Capillary Refill Time, Prolonged

Impaired Gas Exchange r/t ventilation perfusion imbalance

Ineffective peripheral Tissue Perfusion r/t interruption of arterial flow

See Shock, Hypovolemic

Carbon Monoxide Poisoning

See Smoke Inhalation

Cardiac Arrest

Post-Trauma Syndrome r/t experiencing serious life event

See cause of Cardiac Arrest

Cardiac Catheterization

Fear r/t invasive procedure, uncertainty of outcome of procedure

Risk for Injury: hematoma: Risk factor: invasive procedure

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

Risk for Peripheral Neurovascular Dysfunction: Risk factor: vascular obstruction

Readiness for enhanced Knowledge: expresses an interest in learning postprocedure care, treatment, and prevention of coronary artery disease.

Cardiac Disorders

Decreased Cardiac Output r/t cardiac disorder

Risk for decreased Cardiac tissue perfusion: Risk factor: cardiac disorder

See specific cardiac disorder

Cardiac Disorders in Pregnancy

Activity Intolerance r/t cardiac pathophysiology, increased demand for cardiac output because of pregnancy, weakness, fatigue

Death Anxiety r/t potential danger of condition

Compromised family Coping r/t prolonged hospitalization or maternal incapacitation that exhausts supportive capacity of significant others

Ineffective Coping r/t personal vulnerability

Interrupted Family Processes r/t hospitalization, maternal incapacitation, changes in roles

Fatigue r/t physiological, psychological, and emotional demands

Fear r/t potential maternal effects, potential poor fetal or maternal outcome

Powerlessness r/t illness-related regimen

Ineffective Role Performance r/t changes in lifestyle, expectations from disease process with superimposed pregnancy

Situational low Self-Esteem r/t situational crisis, pregnancy

Social Isolation r/t limitations of activity, bed rest or hospitalization, separation from family and friends

Risk for delayed Development: Risk factor: poor maternal oxygenation

Risk for deficient Fluid Volume: Risk factor: sudden changes in circulation after delivery of placenta

Risk for excess Fluid Volume: Risk factors: compromised regulatory mechanism with increased afterload, preload, circulating blood volume

Risk for impaired Gas Exchange: Risk factor: pulmonary edema

Risk for disproportionate Growth: Risk factor: poor maternal oxygenation

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

Risk for decreased Cardiac tissue perfusion: Risk factor: strain on compromised heart from work of pregnancy, delivery

Risk for compromised Resilience: Risk factors: multiple stressors, fear

Risk for Spiritual Distress: Risk factor: fear of diagnosis for self and infant

Readiness for enhanced Knowledge: expresses an interest in learning

Cardiac Dysrhythmia

See Dysrhythmia

Cardiac Output, Decreased

Decreased Cardiac Output r/t cardiac dysfunction

Cardiac Tamponade

Decreased Cardiac Output r/t fluid in pericardial sac

See Pericarditis

Cardiogenic Shock

See Shock, Cardiogenic

Caregiver Role Strain

Caregiver Role Strain (See Caregiver Role Strain, Section III)

Risk for compromised Resilience: Risk factor: stress of prolonged caregiving

Carious Teeth

See Cavities in Teeth

Carotid Endarterectomy

Fear r/t surgery in vital area

Risk for ineffective Airway Clearance: Risk factor: hematoma compressing trachea

Risk for Bleeding Risk factor: possible hematoma formation, trauma to region

Risk for ineffective Cerebral tissue perfusion: Risk factors: hemorrhage, clot formation

Readiness for enhanced Knowledge: expresses an interest in learning

Carpal Tunnel Syndrome

Impaired physical Mobility r/t neuromuscular impairment

Chronic Pain r/t unrelieved pressure on median nerve

Self-Care deficit: bathing, dressing, feeding r/t pain

Carpopedal Spasm

See Hypocalcemia

Casts

Deficient Diversional Activity r/t physical limitations from cast

Impaired physical Mobility r/t limb immobilization

Self-Care deficit: bathing, dressing, feeding r/t presence of cast(s) on upper extremities

Self-Care deficit: toileting r/t presence of cast(s) on lower extremities

Impaired Walking r/t cast(s) on lower extremities, fracture of bones

Risk for Peripheral Neurovascular Dysfunction: Risk factor: mechanical compression from cast, trauma from fracture

Risk for impaired Skin Integrity: Risk factor: unrelieved pressure on skin from cast

Readiness for enhanced Knowledge: expresses an interest in learning

See Traction and Casts

Cataract Extraction

Anxiety r/t threat of permanent vision loss, surgical procedure

Vision Loss r/t edema from surgery

Risk for Injury: Risk factors: increased intraocular pressure, accommodation to new visual field

Readiness for enhanced Knowledge: expresses an interest in learning

See Vision Impairment

Cataracts

Vision Loss r/t impaired sensory input

See Vision Impairment

Catatonic Schizophrenia

Impaired verbal Communication r/t cognitive impairment

Impaired Memory r/t cognitive impairment

Impaired physical Mobility r/t cognitive impairment, maintenance of rigid posture, inappropriate or bizarre postures

Imbalanced Nutrition: less than body requirements r/t decrease in outside stimulation, loss of perception of hunger, resistance to instructions to eat

Social Isolation r/t inability to communicate, immobility

See Schizophrenia

Catheterization, Urinary

Risk for Infection: Risk factor: invasive procedure

Readiness for enhanced Knowledge: expresses an interest in learning

Cavities in Teeth

Impaired Dentition r/t ineffective oral hygiene, barriers to self-care, economic barriers to professional care, nutritional deficits, dietary habits

Celiac Disease

Imbalanced Nutrition: less than body requirements r/t malabsorption due to immune effects of gluten

Diarrhea r/t malabsorption of food, immune effects of gluten on gastrointestinal system

Readiness for enhanced Knowledge: Expresses an interest in learning

Cellulitis

Acute Pain r/t inflammatory changes in tissues from infection

Ineffective peripheral Tissue Perfusion r/t edema of extremities

Impaired Tissue Integrity r/t inflammatory process damaging skin and underlying tissue

Risk for Vascular Trauma: Risk factor: infusion of antibiotics

Readiness for enhanced Knowledge: expresses an interest in learning

Cellulitis, Periorbital

Acute Pain r/t edema and inflammation of skin/tissues

Vision Loss r/t decreased visual field secondary to edema of eyelids

Impaired Skin Integrity r/t inflammation or infection of skin, tissues

Readiness for enhanced Knowledge: expresses an interest in learning

See Hospitalized Child

Central Line Insertion

Risk for Infection: Risk factor: invasive procedure

Risk for Vascular Trauma (See Vascular Trauma, risk for, Section III)

Readiness for enhanced Knowledge: expresses an interest in learning

Cerebral Aneurysm

See Craniectomy/Craniotomy; Intracranial Pressure, Increased; Subarachnoid Hemorrhage

Cerebral Palsy

Impaired verbal Communication r/t impaired ability to articulate or speak words because of facial muscle involvement

Deficient Diversional Activity r/t physical impairments, limitations on ability to participate in recreational activities

Impaired physical Mobility r/t spasticity, neuromuscular impairment or weakness

Imbalanced Nutrition: less than body requirements r/t spasticity, feeding or swallowing difficulties

Self-Care deficit: specify r/t neuromuscular impairments, sensory deficits

Impaired Social Interaction r/t impaired communication skills, limited physical activity, perceived differences from peers

Chronic Sorrow r/t presence of chronic disability

Risk for Falls: Risk factor: impaired physical mobility

Risk for Injury: Risk factors: muscle weakness, inability to control spasticity

Risk for impaired Parenting: Risk factor: caring for child with overwhelming needs resulting from chronic change in health status

Risk for Spiritual Distress: Risk factors: psychological stress associated with chronic illness

See Child with Chronic Condition

Cerebral Perfusion

Risk for ineffective Cerebral tissue perfusion (See Cerebral tissue perfusion, ineffective, risk for, Section III)

Cerebrovascular Accident (CVA)

See CVA (Cerebrovascular Accident)

Cervicitis

Ineffective Health Maintenance r/t deficient knowledge regarding care and prevention of condition

Ineffective Sexuality Pattern r/t abstinence during acute stage

Risk for Infection: Risk factors: spread of infection, recurrence of infection

Cesarean Delivery

Disturbed Body Image r/t surgery, unmet expectations for childbirth

Interrupted Family Processes r/t unmet expectations for childbirth

Fear r/t perceived threat to own well-being, outcome of birth

Impaired physical Mobility r/t pain

Acute Pain r/t surgical incision

Ineffective Role Performance r/t unmet expectations for childbirth

Situational low Self-Esteem r/t inability to deliver child vaginally

Risk for Bleeding: Risk factor: surgery

Risk for imbalanced Fluid Volume: Risk factors: loss of blood, fluid shifts

Risk for Infection: Risk factor: surgical incision

Risk for Urinary Retention: Risk factor: regional anesthesia

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

Readiness for enhanced Knowledge: expresses an interest in learning

Chemical Dependence

See Alcoholism; Drug Abuse; Cocaine Abuse; Substance Abuse

Chemotherapy

Death Anxiety r/t chemotherapy not accomplishing desired results

Disturbed Body Image r/t loss of weight, loss of hair

Fatigue r/t disease process, anemia, drug effects

Nausea r/t effects of chemotherapy

Imbalanced Nutrition: less than body requirements r/t side effects of chemotherapy

Impaired Oral Mucous Membrane r/t effects of chemotherapy

Ineffective Protection r/t suppressed immune system, decreased platelets

Risk for Bleeding: Risk factors: tumor eroding blood vessel, stress effects on GI system

Risk for Infection: Risk factor: immunosuppression

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

Readiness for enhanced Knowledge: expresses an interest in learning

See Cancer

Chest Pain

Fear r/t potential threat of death

Acute Pain r/t myocardial injury, ischemia

Risk for decreased Cardiac tissue perfusion: Risk factor: ventricular ischemia

See Angina; MI (Myocardial Infarction)

Chest Tubes

Ineffective Breathing Pattern r/t asymmetrical lung expansion secondary to pain

Impaired Gas Exchange r/t decreased functional lung tissue

Acute Pain r/t presence of chest tubes, injury

Risk for Injury: Risk factor: presence of invasive chest tube

Cheyne-Stokes Respiration

Ineffective Breathing Pattern r/t critical illness

See cause of Cheyne-Stokes Respiration

CHF (Congestive Heart Failure)

Activity Intolerance r/t weakness, fatigue

Decreased Cardiac Output r/t impaired cardiac function, increased preload, decreased contractility, increased afterload

Constipation r/t activity intolerance

Fatigue r/t disease process with decreased cardiac output

Fear r/t threat to one’s own well-being

Excess Fluid Volume r/t impaired excretion of sodium and water

Impaired Gas Exchange r/t excessive fluid in interstitial space of lungs

Powerlessness r/t illness-related regimen

Risk for Shock (Cardiogenic): Risk factors: decreased contractility of heart, increased afterload

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

See Child with Chronic Condition; Congenital Heart Disease/Cardiac Anomalies; Hospitalized Child

Chickenpox

See Communicable Diseases, Childhood

Child Abuse

Interrupted Family Processes r/t inadequate coping skills

Fear r/t threat of punishment for perceived wrongdoing

Delayed Growth and Development r/t inadequate caretaking, stimulation deficiencies

Insomnia r/t hypervigilance, fear

Imbalanced Nutrition: less than body requirements r/t inadequate caretaking

Acute Pain r/t physical injuries

Impaired Parenting r/t psychological impairment, physical or emotional abuse of parent, substance abuse, unrealistic expectations of child

Post-Trauma Syndrome r/t physical abuse, incest, rape, molestation

Chronic low Self-Esteem r/t lack of positive feedback, excessive negative feedback

Impaired Skin Integrity r/t altered nutritional state, physical abuse

Social Isolation: family imposed r/t fear of disclosure of family dysfunction and abuse

Risk for delayed Development: Risk factors: shaken baby syndrome, abuse

Risk for disproportionate Growth: Risk factor: abuse

Risk for Poisoning: Risk factors: inadequate safeguards, lack of proper safety precautions, accessibility of illicit substances because of impaired home maintenance

Risk for Suffocation: Risk factors: unattended child, unsafe environment

Risk for Trauma: Risk factors: inadequate precautions, cognitive or emotional difficulties

Childbearing Problems

Ineffective Childbearing Process (See Childbearing Process, ineffective, Section III)

Risk for ineffective Childbearing Process: Risk factors: (See Childbearing Process, risk for ineffective, Section III)

Child Neglect

See Child Abuse; Failure to Thrive, Nonorganic

Child with Chronic Condition

Activity Intolerance r/t fatigue associated with chronic illness

Decisional Conflict r/t treatment options, conflicting values

Parental Role Conflict r/t separation from child as a result of chronic illness, home care of child with special needs, interruptions of family life resulting from home care regimen

Compromised family Coping r/t prolonged overconcern for child; distortion of reality regarding child’s health problem, including extreme denial about its existence or severity

Disabled family Coping r/t prolonged disease or disability progression that exhausts supportive capacity of significant others

Ineffective Coping: child r/t situational or maturational crises

Deficient Diversional Activity r/t immobility, monotonous environment, frequent or lengthy treatments, reluctance to participate, self-imposed social isolation

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

Delayed Growth and Development r/t effects of physical disability, prescribed dependence, separation from significant others

Ineffective Health Maintenance r/t exhausting family resources (finances, physical energy, support systems)

Impaired Home Maintenance r/t overtaxed family members (e.g., exhausted, anxious)

Hopelessness: child r/t prolonged activity restriction, long-term stress, lack of involvement in or passively allowing care as a result of parental overprotection

Insomnia: child or parent r/t time-intensive treatments, exacerbation of condition, 24-hour care needs

Deficient Knowledge r/t knowledge or skill acquisition regarding health practices, acceptance of limitations, promotion of maximal potential of child, self-actualization of rest of family

Imbalanced Nutrition: less than body requirements r/t anorexia, fatigue from physical exertion

Imbalanced Nutrition: more than body requirements r/t effects of steroid medications on appetite

Chronic Pain r/t physical, biological, chemical, or psychological factors

Powerlessness: child r/t health care environment, illness-related regimen, lifestyle of learned helplessness

Chronic low Self-Esteem r/t actual or perceived differences; peer acceptance; decreased ability to participate in physical, school, and social activities

Ineffective Sexuality Pattern: parental r/t disrupted relationship with sexual partner

Impaired Social Interaction r/t developmental lag or delay, perceived differences

Social Isolation: family r/t actual or perceived social stigmatization, complex care requirements

Chronic Sorrow r/t developmental stages and missed opportunities or milestones that bring comparisons with social or personal norms, unending caregiving as reminder of loss

Risk for delayed Development: Risk factor: chronic illness

Risk for disproportionate Growth: Risk factor: chronic illness

Risk for Infection: Risk factor: debilitating physical condition

Risk for impaired Parenting: Risk factors: impaired or disrupted bonding, caring for child with perceived overwhelming care needs

Readiness for enhanced family Coping: impact of crisis on family values, priorities, goals, or relationships; changes in family choices to optimize wellness

Childbirth

Readiness for enhanced Childbearing Process (See Childbearing Process, readiness for enhanced, Section III)

See Labor, Normal; Postpartum, Normal Care

Chills

Hyperthermia r/t infectious process

Chlamydia Infection

See STD (Sexually Transmitted Disease)

Chloasma

Disturbed Body Image r/t change in skin color

Choking or Coughing with Eating

Impaired Swallowing r/t neuromuscular impairment

Risk for Aspiration: Risk factors: depressed cough and gag reflexes

Cholecystectomy

Imbalanced Nutrition: less than body requirements r/t high metabolic needs, decreased ability to digest fatty foods

Acute Pain r/t trauma from surgery

Risk for deficient Fluid Volume: Risk factors: restricted intake, nausea, vomiting

Readiness for enhanced Knowledge: expresses an interest in learning

See Abdominal Surgery

Cholelithiasis

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

Acute Pain r/t obstruction of bile flow, inflammation in gallbladder

Readiness for enhanced Knowledge: expresses an interest in learning

Chorioamnionitis

Anxiety r/t threat to self and infant

Grieving r/t guilt about potential loss of ideal pregnancy and birth

Hyperthermia r/t infectious process

Situational low Self-Esteem r/t guilt about threat to infant’s health

Risk for delayed Growth and Development: Risk factor: risk of preterm birth

Risk for Infection: Risk factor: infection transmission from mother to fetus; infection in fetal environment

Chronic Confusion

See Confusion, Chronic

Chronic Lymphocytic Leukemia

See Cancer; Chemotherapy; Leukemia

Chronic Obstructive Pulmonary Disease (COPD)

See COPD (Chronic Obstructive Pulmonary Disease)

Chronic Pain

See Pain, Chronic

Chronic Renal Failure

See Renal Failure

Chvostek’s Sign

See Hypocalcemia

Circumcision

Acute Pain r/t surgical intervention

Risk for Bleeding: Risk factor: surgical trauma

Risk for Infection: Risk factor: surgical wound

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

Cirrhosis

Chronic Confusion r/t chronic organic disorder with increased ammonia levels, substance abuse

Defensive Coping r/t inability to accept responsibility to stop drinking

Fatigue r/t malnutrition

Ineffective Health Maintenance r/t deficient knowledge regarding correlation between lifestyle habits and disease process

Nausea r/t irritation to gastrointestinal system

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

Chronic Pain r/t liver enlargement

Chronic low Self-Esteem r/t chronic illness

Chronic Sorrow r/t presence of chronic illness

Risk for Bleeding: Risk factors: impaired blood coagulation, bleeding from portal hypertension

Risk for Injury: Risk factors: substance intoxication, potential delirium tremens

Risk for impaired Oral Mucous Membrane: Risk factors: altered nutrition, inadequate oral care

Risk for impaired Skin Integrity: Risk factors: altered nutritional state, altered metabolic state

Cleft Lip/Cleft Palate

Ineffective Airway Clearance r/t common feeding and breathing passage, postoperative laryngeal, incisional edema

Ineffective Breastfeeding r/t infant anomaly

Impaired verbal Communication r/t inadequate palate function, possible hearing loss from infected eustachian tubes

Fear: parental r/t special care needs, surgery

Grieving r/t loss of perfect child

Ineffective infant Feeding Pattern r/t cleft lip, cleft palate

Impaired physical Mobility r/t imposed restricted activity, use of elbow restraints

Impaired Oral Mucous Membrane r/t surgical correction

Acute Pain r/t surgical correction, elbow restraints

Impaired Skin Integrity r/t incomplete joining of lip, palate ridges

Chronic Sorrow r/t birth of child with congenital defect

Risk for Aspiration: Risk factor: common feeding and breathing passage

Risk for disturbed Body Image: Risk factors: disfigurement, speech impediment

Risk for delayed Development: Risk factor: inadequate nutrition resulting from difficulty feeding

Risk for deficient Fluid Volume: Risk factor: inability to take liquids in usual manner

Risk for disproportionate Growth: Risk factor: inability to feed with normal techniques

Risk for Infection: Risk factors: invasive procedure, disruption of eustachian tube development, aspiration

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

Clotting Disorder

Fear r/t threat to well-being

Risk for Bleeding: Risk factor: impaired clotting

Readiness for enhanced Knowledge: expresses an interest in learning

See Anticoagulant Therapy; DIC (Disseminated Intravascular Coagulation); Hemophilia

Cocaine Abuse

Ineffective Breathing Pattern r/t drug effect on respiratory center

Chronic Confusion r/t excessive stimulation of nervous system by cocaine

Ineffective Coping r/t inability to deal with life stresses

Risk for decreased Cardiac tissue perfusion r/t increase in sympathetic response in the body damaging the heart

See Drug Abuse; Substance Abuse

Cocaine Baby

See Crack Baby; Infant of Substance-Abusing Mother

Codependency

Caregiver Role Strain r/t codependency

Impaired verbal Communication r/t psychological barriers

Decisional Conflict r/t support system deficit

Ineffective Coping r/t inadequate support systems

Ineffective Denial r/t unmet self-needs

Powerlessness r/t lifestyle of helplessness

Cold, Viral

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

Readiness for enhanced Knowledge: expresses an interest in learning

Colectomy

Constipation r/t decreased activity, decreased fluid intake

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

Acute Pain r/t recent surgery

Risk for Infection: Risk factor: invasive procedure

Readiness for enhanced Knowledge: expresses an interest in learning

See Abdominal Surgery

Colitis

Diarrhea r/t inflammation in colon

Deficient Fluid Volume r/t frequent stools

Acute Pain r/t inflammation in colon

Readiness for enhanced Knowledge: expresses an interest in learning

See Crohn’s Disease; Inflammatory Bowel Disease (Child and Adult)

Collagen Disease

See specific disease (e.g., Lupus Erythematosus; JRA [Juvenile Rheumatoid Arthritis]); Congenital Heart Disease/Cardiac Anomalies

Colostomy

Disturbed Body Image r/t presence of stoma, daily care of fecal material

Ineffective Sexuality Pattern r/t altered body image, self-concept

Social Isolation r/t anxiety about appearance of stoma and possible leakage of stool

Risk for Constipation: Risk factor: inappropriate diet

Risk for Diarrhea: Risk factor: inappropriate diet

Risk for impaired Skin Integrity: Risk factor: irritation from bowel contents

Readiness for enhanced Knowledge: expresses an interest in learning

Colporrhaphy, Anterior

See Vaginal Hysterectomy

Coma

Death Anxiety: significant others r/t unknown outcome of coma state

Interrupted Family Processes r/t illness or disability of family member

Functional urinary Incontinence r/t presence of comatose state

Self-Care deficit: specify r/t neuromuscular impairment

Ineffective family Therapeutic Regimen Management r/t complexity of therapeutic regimen

Risk for Aspiration: Risk factors: impaired swallowing, loss of cough or gag reflex

Risk for Disuse Syndrome: Risk factor: altered level of consciousness impairing mobility

Risk for Injury: Risk factor: potential seizure activity

Risk for impaired Oral Mucous Membrane: Risk factor: dry mouth, inability to do own mouth care

Risk for impaired Skin Integrity: Risk factor: immobility

Risk for Spiritual Distress: significant others: Risk factors: loss of ability to relate to loved one, unknown outcome of coma

See cause of Coma

Comfort, Loss of

Impaired Comfort (See Comfort, impaired, Section III)

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

Communicable Diseases, Childhood (e.g., Measles, Mumps, Rubella, Chickenpox, Scabies, Lice, Impetigo)

Impaired Comfort r/t pruritus, inflammation or infection of skin, subdermal organisms

Deficient Diversional Activity r/t imposed isolation from peers, disruption in usual play activities, fatigue, activity intolerance

Ineffective Health Maintenance r/t nonadherence to appropriate immunization schedules, lack of prevention of transmission of infection

Acute Pain r/t impaired skin integrity, edema

Risk for Infection: transmission to others: Risk factor: contagious organisms

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

See Meningitis/Encephalitis; Respiratory Infections, Acute Childhood; Reye’s Syndrome

Communication

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

Communication Problems

Impaired verbal Communication (See Communication, verbal, impaired, Section III)

Community Coping

Ineffective community Coping (See Coping, community, ineffective, Section III)

Readiness for enhanced community Coping: community sense of power to manage stressors, social supports available, resources available for problem solving

Community Health Problems

Deficient community Health r/t (See Health, deficient, community, Section III)

Compartment Syndrome

Fear r/t possible loss of limb, damage to limb

Acute Pain r/t pressure in compromised body part

Ineffective peripheral Tissue Perfusion r/t increased pressure within compartment

Compulsion

See OCD (Obsessive-Compulsive Disorder)

Conduction Disorders (Cardiac)

See Dysrhythmia

Confusion, Acute

Acute Confusion r/t older than 70 years of age with hospitalization, alcohol abuse, delirium, dementia, drug abuse

Adult Failure to Thrive r/t confusion

Confusion, Chronic

Chronic Confusion r/t dementia, Korsakoff’s psychosis, multi-infarct dementia, cerebrovascular accident, head injury

Adult Failure to Thrive r/t confusion

Impaired Memory r/t fluid and electrolyte imbalance, neurological disturbances, excessive environmental disturbances, anemia, acute or chronic hypoxia, decreased cardiac output

See Alzheimer’s Disease; Dementia

Confusion, Possible

Risk for acute Confusion: Risk factor (See Confusion, acute, risk for, Section III)

Congenital Heart Disease/Cardiac Anomalies

Activity Intolerance r/t fatigue, generalized weakness, lack of adequate oxygenation

Ineffective Breathing Pattern r/t pulmonary vascular disease

Decreased Cardiac Output r/t cardiac dysfunction

Excess Fluid Volume r/t cardiac dysfunction, side effects of medication

Impaired Gas Exchange r/t cardiac dysfunction, pulmonary congestion

Delayed Growth and Development r/t inadequate oxygen and nutrients to tissues

Imbalanced Nutrition: less than body requirements r/t fatigue, generalized weakness, inability of infant to suck and feed, increased caloric requirements

Risk for delayed Development: Risk factor: inadequate oxygen and nutrients to tissues

Risk for deficient Fluid Volume: Risk factor: side effects of diuretics

Risk for disproportionate Growth: Risk factor: inadequate oxygen and nutrients to tissues

Risk for disorganized Infant behavior: Risk factor: invasive procedures

Risk for Poisoning: Risk factor: potential toxicity of cardiac medications

Risk for ineffective Thermoregulation: Risk factor: neonatal age

See Child with Chronic Condition; Hospitalized Child

Congestive Heart Failure (CHF)

See CHF (Congestive Heart Failure)

Conjunctivitis

Acute Pain r/t inflammatory process

Vision Loss r/t change in visual acuity resulting from inflammation

Consciousness, Altered Level of

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

Chronic Confusion r/t multi-infarct dementia, Korsakoff’s psychosis, head injury, cerebrovascular accident, neurological deficit

Adult Failure to Thrive r/t altered level of consciousness

Functional urinary Incontinence r/t neurological dysfunction

Decreased Intracranial Adaptive Capacity r/t brain injury

Impaired Memory r/t neurological disturbances

Self-Care deficit: specify r/t neuromuscular impairment

Risk for Aspiration: Risk factors: impaired swallowing, loss of cough or gag reflex

Risk for Disuse Syndrome: Risk factors: impaired mobility resulting from altered level of consciousness

Risk for impaired Oral Mucous Membrane: Risk factor: dry mouth, interrupted oral care

Risk for ineffective Cerebral tissue perfusion: Risk factor: increased intracranial pressure, altered cerebral perfusion

Risk for impaired Skin Integrity: Risk factor: immobility

See cause of Altered Level of Consciousness

Constipation

Constipation (See Constipation, Section III)

Constipation, Perceived

Perceived Constipation (See Constipation, perceived, Section III)

Constipation, Risk for

Risk for Constipation: Risk factors (See Constipation, risk for, Section III)

Contamination

Contamination (See Contamination, Section III)

Risk for Contamination: Risk factors (See Contamination, risk for, Section III)

Continent Ileostomy (Kock Pouch)

Ineffective Coping r/t stress of disease, exacerbations caused by stress

Imbalanced Nutrition: less than body requirements r/t malabsorption from disease process

Risk for Injury: Risk factors: failure of valve, stomal cyanosis, intestinal obstruction

Readiness for enhanced Knowledge: expresses an interest in learning

See Abdominal Surgery, Crohn’s Disease

Contraceptive Method

Decisional Conflict: method of contraception r/t unclear personal values or beliefs, lack of experience or interference with decision-making, lack of relevant information, support system deficit

Ineffective Sexuality Pattern r/t fear of pregnancy

Readiness for enhanced Self-Health Management: requesting information about available and appropriate birth control methods

Convulsions

Anxiety r/t concern over controlling convulsions

Impaired Memory r/t neurological disturbance

Risk for Aspiration: Risk factor: impaired swallowing

Risk for delayed Development: Risk factor: seizures

Risk for Injury: Risk factor: seizure activity

Readiness for enhanced Knowledge: expresses an interest in learning

See Seizure Disorders, Adult; Seizure Disorders, Childhood

COPD (Chronic Obstructive Pulmonary Disease)

Activity Intolerance r/t imbalance between oxygen supply and demand

Ineffective Airway Clearance r/t bronchoconstriction, increased mucus, ineffective cough, infection

Anxiety r/t breathlessness, change in health status

Death Anxiety r/t seriousness of medical condition, difficulty being able to “catch breath,” feeling of suffocation

Interrupted Family Processes r/t role changes

Impaired Gas Exchange r/t ventilation-perfusion inequality

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

Imbalanced Nutrition: less than body requirements r/t decreased intake because of dyspnea, unpleasant taste in mouth left by medications, increased need for calories from work of breathing

Powerlessness r/t progressive nature of disease

Self-Care deficit: specify: r/t fatigue from the increased work of breathing

Chronic low Self-Esteem r/t chronic illness

Sleep deprivation r/t breathing difficulties when lying down

Impaired Social Interaction r/t social isolation because of oxygen use, activity intolerance

Chronic Sorrow r/t presence of chronic illness

Risk for Infection: Risk factor: stasis of respiratory secretions

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

Coping

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

Coping Problems

Defensive Coping (See Coping, defensive, Section III)

Ineffective Coping (See Coping, ineffective, Section III) See Community Coping; Family Problems

Corneal Reflex, Absent

Risk for Injury: Risk factors: accidental corneal abrasion, drying of cornea

Corneal Transplant

Risk for Infection: Risk factors: invasive procedure, surgery

Readiness for enhanced Self-Health Management: describes need to rest and avoid strenuous activities during healing phase

Coronary Artery Bypass Grafting (CABG)

Decreased Cardiac Output r/t dysrhythmia, depressed cardiac function, change in preload, contractility or afterload

Fear r/t outcome of surgical procedure

Deficient Fluid Volume r/t intraoperative blood loss, use of diuretics in surgery

Acute Pain r/t traumatic surgery

Risk for Perioperative Positioning Injury: Risk factors: hypothermia, extended supine position

Readiness for enhanced Knowledge: expresses an interest in learning

Costovertebral Angle Tenderness

See Kidney Stone; Pyelonephritis

Cough, Ineffective

Ineffective Airway Clearance r/t decreased energy, fatigue, normal aging changes

See Bronchitis; COPD (Chronic Obstructive Pulmonary Disease); Pulmonary Edema

Crack Abuse

See Cocaine Abuse; Drug Abuse; Substance Abuse

Crack Baby

Disorganized Infant behavior r/t prematurity, drug withdrawal, lack of attachment

Risk for impaired Attachment: Risk factors: parent’s inability to meet infant’s needs, substance abuse

Risk for disturbed Maternal/Fetal Dyad: Risk factor: substance abuse

See Infant of Substance-Abusing Mother

Crackles in Lungs, Coarse

Ineffective Airway Clearance r/t excessive secretions in airways, ineffective cough

See cause of Coarse Crackles in Lungs

Crackles in Lungs, Fine

Ineffective Breathing Pattern r/t fatigue, surgery, decreased energy

See Bronchitis or Pneumonia (if from pulmonary infection); CHF (Congestive Heart Failure) (if cardiac in origin); Infection

Craniectomy/Craniotomy

Adult Failure to Thrive r/t altered cerebral tissue perfusion, decreased cognition

Fear r/t threat to well-being

Decreased Intracranial Adaptive Capacity r/t brain injury, intracranial hypertension

Impaired Memory r/t neurological surgery

Acute Pain r/t recent brain surgery, increased intracranial pressure

Risk for Injury: Risk factor: potential confusion

Risk for ineffective Cerebral tissue perfusion: Risk factors: cerebral edema, increased intracranial pressure

See Coma (if relevant)

Crepitation, Subcutaneous

See Pneumothorax

Crisis

Anxiety r/t threat to or change in environment, health status, interaction patterns, situation, self-concept, or role functioning; threat of death of self or significant other

Death Anxiety r/t feelings of hopelessness associated with crisis

Compromised family Coping r/t situational or developmental crisis

Ineffective Coping r/t situational or maturational crisis

Disturbed Energy Field r/t disharmony caused by crisis

Fear r/t crisis situation

Grieving r/t potential significant loss

Impaired individual Resilience r/t onset of crisis

Situational low Self-Esteem r/t perception of inability to handle crisis

Stress overload (See Stress overload, Section III)

Risk for Spiritual Distress: Risk factors: physical or psychological stress, natural disasters, situational losses, maturational losses

Crohn’s Disease

Anxiety r/t change in health status

Ineffective Coping r/t repeated episodes of diarrhea

Diarrhea r/t inflammatory process

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

Imbalanced Nutrition: less than body requirements r/t diarrhea, altered ability to digest and absorb food

Acute Pain r/t increased peristalsis

Powerlessness r/t chronic disease

Risk for deficient Fluid Volume: Risk factor: abnormal fluid loss with diarrhea

Croup

See Respiratory Infections, Acute Childhood

Cryosurgery for Retinal Detachment

See Retinal Detachment

Cushing’s Syndrome

Activity Intolerance r/t fatigue, weakness

Disturbed Body Image r/t change in appearance from disease process

Excess Fluid Volume r/t failure of regulatory mechanisms

Sexual Dysfunction r/t loss of libido

Impaired Skin Integrity r/t thin vulnerable skin from effects of increased cortisol

Risk for Infection: Risk factor: suppression of immune system caused by increased cortisol levels

Risk for Injury: Risk factors: decreased muscle strength, brittle bones

Readiness for enhanced Knowledge: expresses an interest in learning

Cuts (Wounds)

See Lacerations

CVA (Cerebrovascular Accident)

Anxiety r/t situational crisis, change in physical or emotional condition

Disturbed Body Image r/t chronic illness, paralysis

Caregiver Role Strain r/t cognitive problems of care receiver, need for significant home care

Impaired verbal Communication r/t pressure damage, decreased circulation to brain in speech center informational sources

Chronic Confusion r/t neurological changes

Constipation r/t decreased activity

Ineffective Coping r/t disability

Adult Failure to Thrive r/t neurophysiological changes

Interrupted Family Processes r/t illness, disability of family member

Grieving r/t loss of health

Impaired Home Maintenance r/t neurological disease affecting ability to perform activities of daily living

Functional urinary Incontinence r/t neurological dysfunction

Reflex urinary Incontinence r/t loss of feeling to void

Impaired Memory r/t neurological disturbances

Impaired physical Mobility r/t loss of balance and coordination

Unilateral Neglect r/t disturbed perception from neurological damage

Self-Care deficit: specify r/t decreased strength and endurance, paralysis

Impaired Social Interaction r/t limited physical mobility, limited ability to communicate

Impaired Swallowing r/t neuromuscular dysfunction

Impaired Transfer Ability r/t limited physical mobility

Vision Loss r/t pressure damage to visual centers in the brain

Impaired Walking r/t loss of balance and coordination

Risk for Aspiration: Risk factors: impaired swallowing, loss of gag reflex

Risk for Disuse Syndrome: Risk factor: paralysis

Risk for Falls: Risk factor: paralysis, decreased balance

Risk for Injury: Risk factor: vision loss, decreased tissue perfusion with loss of sensation

Risk for ineffective Cerebral tissue perfusion: Risk factor: clot, emboli, or hemorrhage from cerebral vessel

Risk for impaired Skin Integrity: Risk factor: immobility

Readiness for enhanced Knowledge: Expresses an interest in learning

Cyanosis, Central with Cyanosis of Oral Mucous Membranes

Impaired Gas Exchange r/t alveolar-capillary membrane changes

Cyanosis, Peripheral with Cyanosis of Nail Beds

Ineffective peripheral Tissue Perfusion r/t interruption of arterial flow, severe vasoconstriction, cold temperatures

Cystic Fibrosis

Activity Intolerance r/t imbalance between oxygen supply and demand

Ineffective Airway clearance r/t increased production of thick mucus

Anxiety r/t dyspnea, oxygen deprivation

Disturbed Body Image r/t changes in physical appearance, treatment of chronic lung disease (clubbing, barrel chest, home oxygen therapy)

Impaired Gas Exchange r/t ventilation-perfusion imbalance

Impaired Home Maintenance r/t extensive daily treatment, medications necessary for health

Imbalanced Nutrition: less than body requirements r/t anorexia; decreased absorption of nutrients, fat; increased work of breathing

Chronic Sorrow r/t presence of chronic disease

Risk for Caregiver Role Strain: Risk factors: illness severity of care receiver, unpredictable course of illness

Risk for deficient Fluid Volume: Risk factors: decreased fluid intake, increased work of breathing

Risk for Infection: Risk factors: thick, tenacious mucus; harboring of bacterial organisms; immunocompromised state

Risk for Spiritual Distress: Risk factor: presence of chronic disease

See 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

Cystitis

Acute Pain: dysuria r/t inflammatory process in bladder and urethra

Impaired Urinary Elimination: frequency r/t urinary tract infection

Urge urinary Incontinence: Risk factor: infection in bladder

Readiness for enhanced Knowledge: expresses an interest in learning

Cystocele

Stress urinary Incontinence r/t prolapsed bladder

Readiness for enhanced Knowledge: expresses an interest in learning

Cystoscopy

Urinary Retention r/t edema in urethra obstructing flow of urine

Risk for Infection: Risk factor: invasive procedure

Readiness for enhanced Knowledge: expresses an interest in learning