N urs in gd iag n o s e s m e d ic ad is o e r by l rd

Abdominalaortic aneurysm repair

Acute pain related to surgical tissue trauma Anxiety related to threatto health status Decreased cardiac output related to: changes in intravascular volume increased systemic vascular resistance third-spacefluid shift Deficient knowledge (preoperative and postoperative care) re- lated to newly identified need for aortic surgery Ineffective breathingpatternrelated to: effects of general anesthesia endotrachealintubation presence of an abdominalincision

Abdominalinjury
Acute pain related to tissue trauma Deficient fluid volume related to active blood loss Fear related to unknown diagnosis and prognosis Risk for infection related to: penetratingwound potentialbowel rupture

ve ntil ati onper fus ion im bal an ce

Acquired immunod eficiency syndrome

Deficient fluid volume related to persistentdiarrhea associated with opportunistic infections Deficient knowledge (symptoms of disease progression, risk factors, transmission of disease, home care, and treatment op- tions) related to lack of exposure to information Grievingrelated to uncertainprognosis and change in health status Im balancednutrition:Less than body requirements related to: anorexia diarrhea medication adverse effects nausea and vomiting Impairedgas exchange related to: respiratoryfailure

Remember that your nursing diagnoses should be specific to the patientnot necessarily the disorder.

NURSING DIAGNOSES BY MEDICAL DISORDER

Im pairedoral mucous membranerelated to: masses opportunistic infections Impairedphysical mobility related to: fatigue and weakness hypoxemia medication adverse effects Ineffective airway clearance related to pneumonia Ineffective breathingpatternrelated to fatigue Ineffective therapeuticregimen management related to com- plexity of therapeuticregimen Risk for compromised human dignity related to societal preju- dice Risk for impairedskin integrityrelated to: effects of immobility medication reactions opportunistic disease effects poor nutritionalstatus Risk for infection related to immunosuppression Sexual dysfunction related to: depression fatigue fear of disease transmission fear of rejection Social isolation related to: associated societal stigma contacts fear of being infected fear of infection from social contacts

Acute alcohol withdrawal

Disturbedsensory perception (visual, auditor or tactile) y, relat- ed to underlyingpathophysiologic changes in the nervous system Disturbedthought processes related to disruptionin cognitive operations Im balancednutrition:Less than body requirements related to lack of food intake Risk for injury related to abrupt withdrawalof alcohol

ARDS can affect everything from gas exchange and fluid volume to skin integrity and verbal communication.

Acute respiratory dist ress syndrome

Deficient fluid volume related to active fluid volume loss Im balancednutrition:Less than body requirements related to in- ability to ingest food due to mechanical ventilation Impairedgas exchange related to alveolar capillary membranechanges Im pairedskin integrityrelated to immobilityand decreased nu- tritionalintake

 Impairedspontaneous ventilationrelated to respiratory muscle fatigue Impairedverbal communicationrelated to physical barriers of mechanical ventilation Ineffective airway clearance related to retainedsecretions

Acute respiratory failure

Activity intolerance related to respiratorydistress and fatigue Anxiety related to sensation of severe shortness of breath Bathing/hygiene, dressing/grooming,toileting self care deficit related to: fatigue with exertion shortness of breath at rest Im balancednutrition:Less than body requirements related to shortness of breath Impairedgas exchange related to ventilation-perfusion imbal- ance Ineffective tissue perfusion (cardiopulmonary)related to im- paired transportof oxygen across alveolar and capillary mem- branes

Adrenal hypofunction
Decreased cardiac output related to altered heart rate Deficient fluid volume related to nausea,vomiting,and diarrhea Fatiguerelated to disease process

Alzheimers disease
Bathing/hygiene, dressing/grooming,feeding, toileting self-care deficit related to cognitive impairment Caregiverrole strain related to the complexity and amount of caregivingtasks Chronic confusion related to degenerativeloss of cerebral tis- sue Constipationrelated to: inadequatediet inadequatefluid intake memory loss about toileting behavior Im balancednutrition:Less than body requirements related to: difficulty swallowing inadequatefood intake memory loss Impairedm em ory related to degenerativeloss of cerebral tissue R isk for injury related to: agnosia aphasia wanderingbehavior Wanderingrelated to cognitive impairment
I cant remember, did you already read the nursing diagnoses that are associated with Alzheimer s disease?

Amputation
Acute pain related to postoperativetissue, nerve, and bone trau- ma Disturbed body image related to loss of a body part Impairedphysical mobility related to loss of a body part Im pairedskin integrityrelated to traumaticor surgical tissue re- moval Risk for injury related to altered mobility

Amyotrophic lateral sclerosis

Caregiverrole strain related to complexity of care needs Impairedphysical mobility related to muscularatrophy Impairedspontaneous ventilationrelated to respiratory muscle loss of ennervation Impairedswallowing related to neuromuscular impairment Ineffective airway clearance related to retained secretions Ineffective health maintenancerelated to lack of gross and fine motor skills
Oh no! Anaphylaxiscan lead to respiratoryrelated death.

Anaphylaxis
Death anxiety related to acute respiratorydistress Decreased cardiac output related to altered heart rate and hypotension Impairedgas exchange related to edema of upper res- piratory tract Ineffective tissue perfusion (cardiopulmonar y, cerebral) related to impairedtransportof oxygen across alveolar and capillarymembranes

Anemia
Activity intolerance related to weakness,fatigue, and shortness of breath Fatiguerelated to disease process Hopelessness related to chronic fatigue and activity intolerance Im balancednutrition:Less than body requirements related to: anorexia fatigue lack of knowledge of need for specific nutrients (folate, iron, vitamin B12) Ineffective protection related to decreased oxygen-carrying capacity of blood Risk for impairedskin integrityrelated to: decreased mobility and bed rest tissue hypoxia

Aneurysm, cerebral
Acute pain related to aneurysm Compromised family coping related to unknown prognosis Decreased intracranial adaptive capacity related to increased intracranialpressure from brain hemorrhage R isk for acute confusion related to moderate bleeding of cere- bral artery into the brain

Aneurysm, femoral and popliteal

Acute pain related to: compression of nerves edema ischemia Deficient knowledge (preoperative and postoperative care) re- lated to lack of exposure to information Ineffective tissue perfusion (peripheral) related to thrombus formation and ischemia

Aneurysm, thoracic aortic

Acute pain related to thoracic aortic aneurysm Ineffective tissue perfusion (cardiopulmonary)related to aortic insufficiency R isk for deficient fluid volume related to compromised regula- tory mechanisms

Aneurysm, ventricular
Death anxiety related to risk of life-threatening rupture Decreased cardiac output related to arrhythmias Ineffective tissue perfusion (cardiopulmonary)related to heart failure

Angina pectoris
Activity intolerance related to development of chest pain on ex- ertion Anxiety related to situationalcrisis and shortness of breath Decreased cardiac output related to reduced stroke volume Deficient knowledge (cardiac diagnostic procedures) related to new onset of angina Readiness for enhanced managementof therapeutic regimen re- lated to perceived ability to reduce cardiovascularrisk factors

Ankylosingspondylitis
Activity intolerance related to pain and inflammation joints of Chronic pain related to deterioratingbone and cartilageof joints Deficient diversionalactivity related to pain, stiffness,and limi- tation of spinal motion Disturbedsensory perception (visual) related to eye inflamma-tion

Appendicitis
Acute pain related to inflammatoryprocess Nausea related to peritonealinflammation Risk for infection related to: possible ruptureof appendix surgical incision

Arterial occlusive disease

Acute pain related to arterialocclusion Deficient knowledge (disease and treatmentoptions) related to lack of exposure to information Disturbedsensory perception (tactile) related to arterial occlu- sion Ineffective tissue perfusion (peripheral) related to reduced arte- rial blood flow

Atelectasis
Anxiety related to shortness of breath Impairedgas exchange related to alveola r-capillary membranechanges Ineffective airway clearance related to excessive mucus

Basal cell epithelioma

Disturbed body image related to cancerous lesion Readiness for enhanced knowledge (prevention) related to will- ingness to learn how to prevent recurrence Readiness for enhanced managementof therapeutic regimen (skin care and protective measures) related to willingnessto fol- low necessary medical regimen

Bells palsy
Disturbed body image related to unilateralfacial weakness Disturbedsensory perception (gustatory) related to altered sen- sory reception Social isolation related to disturbed body image

Benign prostatic hyperplasia

Impairedurinary elim ination related to obstruction by enlarged prostate R isk for deficient fluid volume related to postoperative bleeding Sexual dysfunction related to postsurgicalrecovery time, retro- grade ejaculation,and anxiety Urinaryretention related to blockage by enlargedprostate

Bladder cancer
Deficient knowledge (disease and treatmentoptions) related to lack of exposure to information Fear related to unknown prognosis Impairedtissue integrity related radiationor to chemotherapy Impairedurinary elim ination related to bladder irritability and pain Situationallow self-esteem (postoperative) related to self- consciousness and disturbedself image after urinarydiversion surgery Acute pain related to tendernessand swelling of bony lesions Hypertherm ia related to viral infection of upper respiratory tract Im pairedskin integrityrelated to macules or papules on ex- posed body parts Ineffectiv airwa clearanc relate to respirator fungal e y e d y infection D isturbed body image related to inflammation of marginsof eyelids Effective therapeuticregimenmanagement related to ability to managesymptoms Im pairedskin integrityrelated to inflammation Acute pain related to pressure from tumor growth Anxiety related to change in health status Impairedphysical mobility related to tumor growth or postoper- ative healing response Im pairedskin integrityrelated to surgical incision for tumor removal
Blastomycosis originates as a respiratory infection but can end up affecting the skin and bones.

Blastomycosis

Blepharitis

Bone tumor

Botulism
Death anxiety related to life-threatening disorder Deficient fluid volume related to vomitingand diarrhea Ineffectiv breathin patter relate to respirator muscle e g n d y failure Acute pain related to edema and necrosis Ineffective tissue perfusion (cerebral) related to edema and necrosis Risk for acute confusion related to neurologic impairment Risk for injury related to neurologic impairment Anxiety related to: deteriorationof physical and mental function risks of treatmentoptions Decreased intracranial adaptive capacity related to brain tissue injury Disturbedthought processes related to brain mass inju ry Impairedverbal communicationrelated to damage to speech center Risk for acute confusion related to tissue damage from brain mass Risk for injury related to increased seizure potential and neuromusculareffects of brain tissue damage Decisional conflict (treatmentchoice) related to nd porisks a tentialside effects of treatmentoptions Disturbed body image related to breast surgery Fatiguerelated to effects of disease and treatments Im pairedskin integrityrelated to incision following breast surgery Ineffective sexualitypatternsrelated to perceived loss of attrac- tiveness after mastectomy Stress overload related to family needs while physicallyand emotionally taxed Im balancednutrition:Less than body requirements related to in- adequatefood intake due to illness Ineffective breathingpatternrelated to chronic abnormal dila- tion of bronchi and destructionof bronchial walls Risk for infection related to repeated damage to bronchial walls

Brain abscess

Brain tumor

Did someone say brain tumor? N o w Im getting anxious!

Breast cancer

Bronchiectasis

Bronchiolitis obliterans with organizing pneumonia

Activity intolerance related to fatigue and shortness of breath Im balancednutrition:Less than body requirements related to in- adequatefood intake due to disturbed taste and anorexia Ineffective airway clearance related to excess secretions from infection Ineffective breathingpatternrelated to inflammation of small airways

Buergers disease
Deficient knowledge (disease causes and risks, treatmentop- tions) related to new diagnosis D isturbed body image related to disease Ineffective tissue perfusion (peripheral) related to decreased blood flow to the feet and legs R isk prone health behavior related to smoking addiction

Burns
Acute pain related to tissue destructionand exposure of nerves in partiallydestroyed tissue Compromised family coping related to prolonged disease or dis- ability Contam inationrelated to infective agents at place of injury D isturbed body image related to potentialscarring Im balancednutrition:Less than body requirements related to in- creased metabolic needs of burn healing Impairedgas exchange related to airway burns and carbon monoxide inhalation Impairedphysical mobility related to movement limitationsfrom scar tissue or burn treatments Ineffective tissue perfusion (peripheral) related to: circumferentialeschar formation on arms and legs compartmentsyndrome vascular disruption Powerlessnessrelated to illness R isk for deficient fluid volume related to active loss through dis- rupted skin R isk for imbalanced body temperaturerelated to infection R isk for impairedskin integrityrelated to nonadherence of graft and impaireddonor site healing R isk for infection related to: decreased perfusion exposure to contamination impaired immunologic response loss of protective integument Risk for injury relate to continued exposure to heat or chemicals d

Cancer
Activity intolerance related to weakness from: altered protein metabolism cachexia hypoxia muscle wasting Anxiety related to diagnosis,treatmenteffects, and prognosis Chronic pain related to: chemotherapyside effects metastasis primarydisease Im balancednutrition:Less than body requirements related to: anorexia changes in taste sensation stomatitis Impairedurinary elim ination related to hemorrhagic cystitis from chemotherapy Ineffective sexualitypatternsrelated to alterationsin body im- age Readiness for enhanced hope related to decreased signs of can- cer on repeated testing and healthfulchanges in lifestyle to de- crease risk of recurrence Risk for constipation related to opioid use Risk for infection related to immunosuppression from chemotherapyand malnutrition Risk for peripheralneurovasculardysfunction related to pe- ripheral neuropathiescaused by chemotherapy Risk for situationallow self-esteem related to: hair loss role changes weight loss Sleep deprivationrelated to: alterationsin patternsof elimination anxiety fear of dying while sleeping other sequelae of cancer pain Im pairedoral mucous membranerelated to fungal infection in mouth Im pairedskin integrityrelated to fungalinfection Ineffective therm oregulation related to systemic infection R isk for impairedliver function related to fluconazole (Diflucan) or other specific systemic antifungalagents

Patients with cancer can experience imbalanced nutrition as a result of anorexia, changes in tast e, and stomatiti s. Nothing for me right now, thank s.

Candidiasis

Cardiac arrhythmias
Activity intolerance related to shortness of breath or chest pain when dysrhythmicor drug effects Anxiety related to change in health status Decreased cardiac output related to altered contractilityof heart muscle Deficient knowledge (disease and treatmentoptions) related to lack of exposure to information Fatiguerelated to arrhythmias Fear related to decreased confidence in healthstatus Ineffective coping related to inadequatelevel of control over ill- ness recurrence Ineffective tissue perfusion (cardiopulmonary)related to im- paired cardiac cycle and blood oxygenation

Cardiac surgery
Acute confusion related to: anesthesia cerebral ischemia or infarction sensory overload from intensivecare unit environment Deficient fluid volume related to blood loss Deficient knowledge (postoperative care) related to complex therapeuticregimen Dysfunctionalventilatoryweaning response related to respirato- ry complications postoperatively Impairedgas exchange related to: alveolar collapse increased pulmonaryshunt increased secretions pain

Cardiac tamponade
Decreased cardiac output related to altered preload Fear related to life-threatening disorder Ineffective breathingpatternrelated to cardiac tamponade

Cardiogenicshock
Activity intolerance related to: diminishedcardiovascularreserve hypoxemia weakness Decreased cardiac output related to heart rate abnormalitiesor diminishedcontractility Excess fluid volume related to compromised regulatory mecha- nisms Impaire gas exchang relate to ventilation-perfusio imbalance d e d n

Cardiomyopathy
Anxiety related to deteriorationin health status (medication ef- fects and adverse effects) Decreased cardiac output related to arrhythmias and ineffective pump function Deficient knowledge (disease and treatment)related to changes in regimen Ineffective breathingpatternrelated to disease process

Carotid endarterectomy
Anxiety related to threatto health status Deficient knowledge (procedure) related to unfam iliarity with procedure and hospital protocol Impairedgas exchange related to airway obstruction from tra- cheal compression or aspiration Risk for infection related to surgical incision

Carpaltunnel syndrome
Acute pain related to nerve compression Bathingor hygiene self-care deficit related to pain Risk for peripheralneurovasculardysfunction related to disease process

Cataract
Deficient knowledge (disease and treatmentoptions) related to lack of exposure to information Disturbedsensory perception (visual) related to cataract Impairedphysical mobility related to fear of injury Risk for injury related to impairedvision

Disturbances in auditory, olfactory, and visual perception can result from cerebral contusion.

Cerebral contusion
Acute pain related to headache after trauma Disturbedsensory perception (auditor olfactor visual) y, y, relat- ed to bruisingof brain tissue Risk for acute confusion related to brain injury Risk for injury related to brain injury

Cervical cancer
Acute pain related to tumor invasion Deficient knowledge (disease and treatmentoptions) related to lack of exposure to information Disturbed body image related to weight loss Fatiguerelated to cancer process and treatmenteffects Sexual dysfunction related to postcoital pain and bleeding

Chest injury, blunt

Acute pain related to injury Anxiety related to impairedoxygenation Impairedspontaneous ventilationrelated to blunt trauma Ineffective breathingpatternrelated to chest wall injury

Chlam ydia
Deficient knowledge (disease and treatmentoptions) related to lack of informationon sexually transmitted diseases Ineffective sexualitypatternsrelated to fear of spreading infec- tion Risk for infection related to untreatedpartners

Cholecystectomy
Acute pain related to gallbladderinflammation Im balancednutrition:Less than body requirements related to: altered lipid metabolism increased nutritionalneeds during healing nasogastric(NG) suction postoperativenothing-by-mouth (NPO) status preoperativenausea and vomiting Im pairedoral mucous membranerelated to NPO status and pos- sible NG suction Ineffective breathingpatternrelated to pain from high abdomi- nal incision R isk for infection (postoperative) related to obstruction of ex- ternal biliary drainage tube

Cholelithiasi , cholecystitis s
Acute pain related to gallbladderinflammation or presence of stones Im balancednutrition:Less than body requirements related to at- tacks following meals R isk for infection related to complications of disease

Chronic alcoholism
Dysfunctionalfam ily processes: Alcoholism related to alcohol abuse Im balancednutrition:Less than body requirements related to lack of food intake Ineffective coping related to: anger denial dependence Ineffective therapeuticregimen management related to denial of problem Risk for impaired liver function related to alcohol intake Risk for other-directed violence related to: disorientation impairedjudgment Risk prone health behavior related to alcohol abuse

Chronic fatigue and immunedysfunction syndrome

Fatiguerelated to illness Hopelessness related to chronic illness Sleep deprivationrelated to internalfactors

Chronic obstructive pulmonydisease

Activity intolerance related to shortness of breath Adult failure to thrive related to fatigue and chronic dyspnea of severe disease Deficient knowledge (disease processes and treatment) related to complexity of disorder Im balancednutrition:Less than body requirements related to shortness of breath during andafter meals Impairedgas exchange related to impairedexcretion of carbon dioxide Im pairedhome maintenancerelated to inadequate support sys- tems and inabilityto do tasks due to disease process Ineffective breathingpatternrelated to fatigue,or bluntingof respiratorydrive Ineffective sexualitypatternsrelated to: adverse reactions to medications change in body image change in relationshipwith spouse or partner deconditioning shortness of breath Insom nia related to: anxiety bronchodilator stimulanteffect s depression shortness of breath

Cirrhosis
Dysfunctionalfam ily processes: Alcoholism related to alcohol addiction Excess fluid volume related to fluid retention Im balanced nutrition:Less than body requirements related to: GI symptoms (anorexia, nausea, vomiting,diarrhea) inabilityto absorb nutrients Impairedgas exchange related to ventilation-perfusion imbal- ance Risk for acute confusion related to increasingammonia levels Risk for impairedliver function related to alcohol addiction Risk for impairedskin integrityrelated to edema and pruritus

Clostridium difficile infection

Anxiety related to change in health status R isk for deficient fluid volume related to diarrhea R isk for impairedskin integrityrelated to diarrhea R isk for infection related to inadequatedefenses

Cold injury
Deficient knowledge (prevention of cold injury) related to inex- perience with excessive cold Hypotherm iarelated to cold injury Risk for impairedskin integrityrelated to frostbite

Colorectal cancer
Constipationrelated to GI obstruction D iarrhearelated to inflammation malabsorption or Fatiguerelated to malnutrition anemia or Im balancednutrition:Less than body requirements related to in- ability to absorb nutrients R isk for deficient fluid volume related to diarrheaor bleeding R isk for spiritualdistress related to potentiallifethreateningdi- agnosis

Colostomy
Deficient knowledge (care of descending or sigmoid colostomy) related to unfamiliarity with altered bowel procedures Disturbed body image related to loss of control over fecal elimi- nation Risk for impairedskin integrityrelated to fecal contaminationof skin Sexual dysfunction related to change in body image

Concussion
Disturbedsensory perception (visual) related to a blow to the head Nausea related to blow to the head Risk for injury related to dizzinessand lethargy

Conjunctivitis
Risk for impairedskin integrityrelated to eye discharge and tearing Risk for infection related to contagious disease and ability to spread to other eye or other people Risk for situationallow self-esteem related to hyperemiaof eyes Activity intolerance related to exertional dyspnea Decreased cardiac output related to decreased stroke volume Grievingrelated to poor prognosis Impaire gas exchang relate to pulmonar capillar d e d y y destruction

A patient with a concussion is at risk for injuries related to dizziness and letha rgy. N ow that s a blow to the head!

C or pulmonale

Cornealabrasion
Acute pain related to eye injury Disturbedsensory perception (visual) related to eye injury Risk for injury related to poor visual acuity

Cornealulcer
Disturbedsensory perception (visual) related to corneal ulcer Risk for infection related to inadequateprimarydefenses Risk for injury related to visual blurring

Coronary artery disease

Anxiety related to angina Decreased cardiac output related to diminishedcoronary blood flow Health-seeking behaviors (learningabout risk factors) related to perceived ability to decrease risk factors Ineffective family therapeutic regimen management related to disinterest in learning emergency care procedures (use of nitro- glycerin, when to call 911, cardiopulmonaryresuscitation) Ineffective tissue perfusion (cardiopulmonary)related to ather- osclerosis

Craniotomy
Deficient knowledge (impending craniotomy) related to lack of exposure to information D isturbed body image related to hair loss and possible disrup- tion of motor function R isk for deficient fluid volume related to: diuretic therapy fluid restriction GI suction hyperthermia R isk for infection related to invasive techniques(surger y, con- tinuous intracranialmonitoring,ventriculardrains) R isk for injury related to: decreased level of consciousness drug therapy effect of anesthetics seizures

Crohns disease (irritable bowel syndrome)

Acute pain related to bowel inflammation Compromised family coping related to chronic disease D iarrhearelated to bowel inflammation Nausea related to bowel inflammation R isk for imbalancedfluid volume related to diarrhea R isk for infection related to invasive procedures (surger y, home infusions)

Cushing syndrome s
D isturbed body image related to secondary effects of excessive corticosteroid levels Excess fluid volume related to high serum corticosteroid levels R isk for impairedskin integrityrelated to secondary effects of medications R isk for infection related to the immunosuppressive action of glucocorticoids R isk for unstableglucose level related to the anti-insulin proper- ties of glucocorticoids

Dermatitis
Chronic low self-esteem related to poor body image Im pairedskin integrityrelated to inflammation, itching, or le- sions of the skin R isk for infection related to inadequateprimarydefenses

18

NURSING DIAGNOSES BY MEDICAL DISORDER

Dermatophytosis
Acute pain related to inflammation Im pairedskin integrityrelated to skin infection Readiness for enhanced managementof therapeutic regimen related to desire to follow through with treatmentregimen

Watch for signs of dehydration in a patient with diabetes insipidus. Fluid volume can be difficult to balance.

Diabetes insipidus
Constipationrelated to dehydration Deficient fluid volume related to active fluid loss Im pairedoral mucous membranerelated to dehydration

Diabetes mellitus
Compromised family coping related to prolonged disease Deficient knowledge (self-care) related to complex chronic disease Ineffective therapeuticregimen management related to: ineffective coping with chronic disorders lack of materialresources lack of support Ineffective tissue perfusion (renal, peripheral)related to com- plications of disease Risk for imbalancednutrition:More than body requirements lated to excessive calorie intake re Risk for unstableglucose level related to: inadequateendogenous insulin (type 1) inadequateendogenous insulin and insulin resistance (type 2)

Diabetic ketoacidosis
Deficient fluid volume related to osmotic diuresis or vomiting Deficient knowledge (self-care) related to lack of exposure to complex disease and therapy information Risk for injury related to: acidosis cerebral dehydration decreased perfusion hypoxemia Risk for unstableglucose level related to decreased cellular glu- cose uptake and use

Dislocation and subluxation

Acute pain related to damage to tissue Anxiety related to pain and treatment Impairedphysical mobility related to joint injury and pain

Disseminated intravascular coagulation

Acute pain related to: bleeding into organ or joint capsules hematomas tissue ischemia Deficient fluid volume related to hemorrhage Fear related to unfamiliarity with hospital environment Impairedgas exchange related to hypoxemia Im pairedskin integrityrelated to capillary fragility

D iverticulitis
Acute pain related to: bowel infection or perforation inflammation Constipationrelated to lack of roughage in diet Deficient fluid volume related to active loss and poor intake Diarrhearelated to inflammation and infection

Drug overdose

Hopelessness related to: emotional disorganization inadequateresources low self-esteem Ineffective airway clearance related to: decreased or absent gag reflex lavage procedures obstruction by tongue reduced alertness vomiting Risk prone health behavior related to drug addiction Chronic pain related to: excessive motilityof upper GI tract increased hydrochloric acid secretion increased spasm inflammation the duodenum of intragastric pressure Im balanced nutrition:Less than body requirements related to: dysphagia mouth soreness nausea and vomiting Risk for deficient fluid volume related to: diarrhea GI hemorrhage vomiting

Duodenal ulcer

20

NURSING DIAGNOSES BY MEDICAL DISORDER

Ebola virus infection

D iarrhearelated to viral infection Fear related to poor prognosis Grievingrelated to probable death from disease Hypertherm ia related to infection Im pairedskin integrityrelated to diarrhea Risk for deficient fluid volume related to diarrhea and hemor- rhage

Encephalitis Endocarditis Endometriosis Epididymitis

Acute pain related to increased intracranialpressure Disturbedthought processes related to cerebral edema Hypertherm ia related to infection Impairedphysical mobility related to possible coma

Activity intolerance related to fatigue and weakness Decreased cardiac output related to bacterial or fungal invasion of heart Hypertherm ia related to infection Acute pain related to inflammationand adhesions of endometri- al tissue Deficient knowledge (disease and treatmentoptions) related to lack of exposure to information Sexual dysfunction related to pain Acute pain related to infection Risk for infection related to inadequateprimarydefenses Sexual dysfunction related to pain, swelling, and tendernessof groin area Deficient knowledge (disease) related to lack of exposure to in- formation Fatiguerelated to antiseizuremedication side effect Readiness for enhanced managementof therapeutic regimen related to readiness to follow treatment Risk for caregiver role strain related to worry and fear about diagnosis Risk for compromised human dignity related to seizures

Epilepsy

Escherichia coli and other Enterobacteriaceae infections

Acute pain related to crampy diarrhea Deficient fluid volume related to loss through diarrheaand vom- iting D iarrhearelated to infection

Esophageal cancer
Acute pain related to: fistula surgery tumor Fatiguerelated to cachexia Im balancednutrition:Less than body requirements related to dysphasia R isk for aspirationrelated to dysphasia

Esophageal diverticula
Im balancednutrition:Less than body requirements related to dysphasiaand regurgitation R isk for aspirationrelated to dysphasiaand regurgitation R isk for infection related to inadequateprimarydefenses

Patients with extraocular motor nerve palsy may be limited in the activities in which they can participat e. I can see w hy. I mean, I cant see w hy?!

Extraocular motor nerve palsy

Anxiety related to chronic disease Bathing/hygiene feeding self-care deficit related to or vision impairment Deficient diversionalactivity related to vision impairment Disturbedsensory perception (visual) related to dysfunction of cranial nerves

Fatty liver
Acute pain related to large, tender liver Deficient knowledge (proper diet) related to lack of exposure to information Im balanced nutrition:Less than body requirements related to anorexia and liver inflammation Im balancednutrition:More than body requirements related to excess fat and calorie consumption Risk for impairedliver function related to excess fat accumula- tion in the liver

Femoral popliteal bypass

Acute pain related to surgicalincision Impairedphysical mobility related to surgeryand preexisting disability Im pairedskin integrityrelated to surgical incision and preexist- ing stasisulcers Ineffective tissue perfusion (peripheral) related to arterial insuf- ficiency Risk for infection related to inadequateprimary defenses (bro- ken skin)

Fibromyalgiasyndrome
Chronic pain related to illness Fatiguerelated to musculoskeletalpain and sleep disturbance Insom nia related to pain

Gastric cancer
Deficient fluid volume related to vomiting and decreased fluid intake Delayed surgical recovery related to decreased nutrition and primarydefenses Im balanced nutrition:Less than body requirements related to: a feeling of fullness after eating dyspepsia epigastricdiscomfort Risk for spiritualdistress related to cancer diagnosisand prog- nosis

Gastritis

Acute pain related to inflammation Deficient knowledge (prevention and treatment)related to lack of exposure to smoking, diet information,and medication use Nausea related to gastric irritation Readiness for enhanced nutrition related to willingness to in- gest nonirritatingfoods Acute pain related to intestinalflu Nausea related to bacteria,parasites,and virus inintestine Risk for deficient fluid volume related to nausea and vomiting Risk for imbalanced body temperaturerelated to infection

Gastroenteritis

Gastroesophageal reflux
Chronic pain related to reflux of gastric and duodenal contents into esophagus Deficient knowledge (treatmentoptions) related to lack of ex- posure to information R isk for aspirationrelated to reflux

Gastrointestinal hemorrhage
Deficient fluid volume related to active bleeding Deficient knowledge (potential recurrentbleeding) related to unfamiliarity with disorder Fear related to sight of blood and distressingphysical symp- toms R isk for injury related to: accumulationof toxins electrolyte imbalance inadequateorgan perfusion ulcer perforation undetected bleeding

Glaucoma
Anxiety related to progression of disease Deficient knowledge (eyedrops administration procedures) re- lated to lack of previous experience Disturbedsensory perception (visual) related to high intraocu- lar pressure and damage to optic nerve R isk for injury related to loss of peripheralvision

Glomerulonephritis
Excess fluid volume related to oliguria Im balancednutrition:Less than body requirements related to anorexia Ineffective tissue perfusion (renal) related to disease process R isk for infection related to inadequatedefenses

Goiter
Disturbed body image related to neck distention Im pairedswallowing related to swelling and distentionof neck Ineffective breathingpatternrelated to compression of trachea

Gonorrhea
Ineffective sexualitypatternsrelated to fear of spreading infec- tion Risk for infection related to inadequateprimaryresources Risk for situationallow self-esteem related to infection

Gout
Activity intolerance related to painfuljoints Acute pain related to urate deposits in joints Disturbed body image related to joint deformity

Graft rejection syndrome

Grievingrelated to loss of graft Ineffective tissue perfusion (peripheral,cardiopulmonar y, renal) related to stimulationof the complement cascade with resultant thrombosis and tissue infarction Powerlessnessrelated to loss of graft

Granulocytopenia, lymphocytopenia
Deficient knowledge (disease and treatmentoptions) related to lack of exposure to information Fatiguerelated to low white blood cell (WBC) count Hypertherm ia related to infection Risk for infection related to low WBC count

Guillain- arr syndrome B

Bathing/hygiene, feeding, toileting self-care deficit related to muscle weakness and paralysis Fear related to sudden onset of illness Impairedspontaneous ventilationrelated to muscle weakness and paralysis Ineffectiv airwa clearanc relate to neuromuscula e y e d r dysfunction Risk for urge urinary incontinence related to muscle weakness

Hantavirus pulmona syndrome ry

Hypertherm ia related to infection Impairedgas exchange related to respiratoryfailure and ventilation-perfusion imbalance Ineffective breathingpatternrelated to pulmonary infiltrateswith respiratorycompromise

Your patient s hearing loss can affect his ability to hear danger signals in the environment, putting him at risk for injury.

Headache
Acute pain related to vascular, muscle contraction Fatiguerelated to headache Ineffective coping related to recurrence of headaches

Hearing loss
Disturbedsensory perception (auditory) related to hearingloss Readiness for enhanced communicationrelated to ability to learn ways to communicatewithout adequate hearing Risk for injury relate to not hearin dange signs in environment d g r

Heart failure
Decreased cardiac output related to: altered heart rhythm decreased contractility fluid volume overload increased afterload Deficient knowledge (treatmentregimen) related to lack of ex- posure to information Excess fluid volume related to: decreased myocardial contractility decreased renal perfusion increased sodium and water retention Im balancednutrition:Less than body requirements related to decreased appetiteand unpalatability lowof sodium diet Ineffective breathingpatternrelated to fatigue Ineffective therapeuticregimenmanagement related to: complexity of regimen health beliefs negative relationshipwith caregivers Powerlessnessrelated to illness

Heat syndrome
Deficient knowledge (managementof syndrome) related to lack of exposure to information Deficient knowledge (prevention of heat syndrome) related to languagebarrier or impairedliterac or lack of y, exposure to infor- mation Hypertherm ia related to environmental heat conditions

Hemophilia
Anxiety related to risk of acute bleeding Ineffective protection related to abnormalblood profile R isk for injury related to lack of awarenessof environmental dangers R isk for traumarelated to externalfactors

Hemorrhoids
Acute pain related to inflammation hemorrhoid veins of Constipationrelated to pain Deficient knowledge (activities that increase intravenous pres- sure) related to lack of exposure to information

Hemothorax

Acute pain related to blood in pleuralcavity Anxiety related to acute shortness of breath Fear related to sudden onset of injury Ineffective breathingpatternrelated to blood in pleural cavity

Hepatic encephalopathy
Deficient fluid volume related to active loss Disturbedthought processes related to ammonia intoxication of the brain Risk for impaired liver function related to alcohol abuse

Hepatitis
Acute pain related to inflammation the liver of Deficient knowledge (home care, disease process, preventionof recurrence) related to lack of exposure to information Fatiguerelated to disease process Im balanced nutrition:Less than body requirements related to anorexia, diarrhea,nausea,or vomiting Nausea related to GI irritation Risk for activity intolerance related to increased fatigue Risk for deficient fluid volume related to vomitingand diarrhea Risk for impairedskin integrityrelated to: frequentdiarrhea prolonged bed rest pruritus Activity intolerance related to pain Acute pain related to impingementon spinal nerve roots Readiness for enhanced managementof therapeutic regimen re- lated to ability to follow through with regimen

Herniated disk

Herpes simplex

Acute pain related to cold sores and fever blisters Chronic low self-esteem related to skin lesions Ineffective sexualitypatternsrelated to fear of spreading infec- tion to sexual partner Sexual dysfunction related to sexually transmitteddisease (herpes simplex 2) Acute pain related to inflammation the dorsal root ganglia of Chronic pain related to postherpetic neuralgia Hypertherm ia related to infection Im paire skin integrit relate to localize vesicula skin lesions d y d d r

Herpes zoster

Hiatal hernia

Acute pain related to displacementor stretchingof the stomach Deficient knowledge (treatmentoptions) related to lack of ex- posure to information Im pairedswallowing related to esophagitis,ulcers, or strictures Fatiguerelated to weight loss and disease process Grievingrelated to perceived potential for loss of life Hypertherm ia related to immunosuppression Ineffective protection related to Hodgkin disease s

Hodgkins disease

Huntingtons disease
Bathing/hygiene, dressing/grooming,feeding, toileting self-care deficit related to physical deterioration Bowel incontinence related to neuromuscularimpairment Caregiverrole strain related to complexity and amount of care- giving activities Disturbedthought processes related to brain involvement Impaire physica mobilit relate to neuromuscula impairment d l y d r Impairedverbal communicationrelated to dysarthria

Hydronephrosis
Acute pain related to physical obstruction of urine flow Im paire urinar elim inatio relate to obstructio of urine flow d y n d n R isk for infection related to obstruction of urine flow

Hyperaldosteronism
Deficient knowledge (disease) related to lack of exposure to in- formation Fatiguerelated to hypokalemia Impairedurinary elim ination related to polyuria and polydipsia R isk for unstableglucose level related to hypokalemia

Hyperparathyroidism
Acute pain related to hypercalcemia,which causes bone tender- ness, pancreatitis,and peptic ulcers Hopelessness related to deterioratingcondition Im balancednutrition:Less than body requirements related to nausea and vomiting

Hyperosmolar hyperglycemic nonketotic syndrome

Deficient fluid volume related to osmotic diuresis Deficient knowledge (self-care) related to lack of exposure to complex disease and management Risk for injury related to: cerebral dehydration cerebral edema during rapid rehydration decreased perfusion glucose deprivation hypoxemia Risk for unstableglucose level related to inadequate insulin secretion or peripheralinsulin resistance

Hypertension

Patients with hypertension can be noncompliant as a result of health beliefs or cultural influences.

Decreased cardiac output related to decreased stroke volume Excess fluid volume related to compromised regulatory mechanisms Ineffective therapeuticregimen management related to deficient knowledge Noncompliance (treatment)related to health beliefs and culturalinfluences

Hypogl cemia y

Fatiguerelated to hypoglycemia Ineffective therapeuticregimen management related to complexity of the disease and deficient knowledge Risk for injury related to: excessive exercise inappropriateexogenous insulin use lack of food Decreased cardiac output related to cardiac arrhythmias Im balancednutrition:Less than body requirements related to in- ability to ingest foods due to dysphagia Ineffective coping related to situationalcrisis

Hypoparathyroidism

Hypothyroidism
Decreased cardiac output related to cardiac arrhythmias Disturbed body image related to periorbitaledema and upper eyelid droop Disturbedthought processes related to decreasing mental sta- bility andforgetfulness Risk for imbalanced body temperaturerelated to decreased sen- sitivityof thermoreceptors

Hypovolemic shock
Decrease cardia outpu relate to altere heart rate and rhythm d c t d d Impaire gas exchang relate to ventilation-perfusio imbalance d e d n Ineffective coping related to threatto life Ineffective tissue perfusion (cerebral, cardiopulmonar y, renal, peripheral)related to hypovolemia R isk for deficient fluid volume related to: disease processes iatrogenic interventions surgical interventions R isk for injury related to complications from ischemia

Ileal conduit urina diversion ry

Deficient knowledge (care of an ilealconduit) related to lack of exposure to information D isturbed body image related to urinarydiversion Impaire urinar eliminatio relate to creation of an ileal conduit d y n d R isk for infection related to GI or genitourinary anastomosis breakdown or leakage Sexual dysfunction related to cystectomy and possible ejacula- tory incompetence with prostatectomy

Infertility
Complicated grievingrelated to multiplemiscarriages Ineffective coping related to uncertaintyof future pregnancies Situationallow self-esteem related to infertility

Inflamm atory bowel disease

Chronic pain related to abdominaldistention Deficient fluid volume related to decreased fluid intake and in- creased fluid loss through diarrhea Im balancednutrition:Less than body requirements related to: decreased nutrientintake increased nutrientloss possible decreased bowel absorption Im pairedskin integrityrelated to frequentstools and altered nu- tritionalstatus Ineffective sexualitypatternsrelated to diminished physical en- ergy and persistence of uncomfortable physical symptoms Insom nia related to: anxiety related to hospitalization nocturnaldefecation R isk for infection related to: bowel perforation general debilitation immunosuppression Social isolation related to dependent behavior

Influenza
Hypertherm ia related to infection Ineffective communitytherapeuticregimen management related to insufficientsupply of influenzavaccine Risk for imbalancedfluid volume related to fever, cough, decreased oral intake Risk for infection related to inadequateprimary and secondary defenses to prevent secondary bacterial invasion Acute pain related to tension on herniatedcontents Ineffective tissue perfusion (gastrointestinal) related to diver- sion of bowel through hernia Risk for infection related to complete obstruction

Inguinalhernia

Intestinal obstruction
Acute pain related to abdominaldistention Constipationrelated to intestinalobstruction Ineffective tissue perfusion (gastrointestinal) related to obstruc- tion Risk for deficient fluid volume related to intestinal obstruction

Joint replacement
Acute pain related to surgery Impairedphysical mobility related to joint surgery Risk for infection related to incision

Kaposis sarcoma
Acute pain related to lesions that break down or impinge on nerves and organs Grievingrelated to threatof death in advanced disease and when associated with human immunodeficiencyvirus Im pairedskin integrityrelated to disease process Ineffective breathingpatternrelated to bronchial blockage and hypoventilation
Your patient may have excess fluid volume related to the function of his transplanted kidney. My pail runneth over

K idneytransplant
Acute pain related to frequentinvasive procedures and surgery Disturbed body image related to effects of steroid therapy Excess fluid volume related to function of transplanted kidney Ineffective coping related to sensory overload Noncompliance (drug regimen) related to adverse drug effects and complicated multidrugregimen Risk for infection related to immunosuppression

Laminectomy
Acute pain related to: immobility muscle spasm paresthesiasecondary to surgicaltraumaand postoperative edema Deficient knowledge (preoperativeand postoperativecare) related to lack of exposure to information Ineffective tissue perfusion (renal) related to: anesthesia anxiety cord edema injury to the spinal nerve roots innervating the bladder opioids pain supine positioning Risk for deficient fluid volume related to: blood loss during surgery hemorrhageat the incision site retroperitonealhemorrhage vascularinjury

Laryngealcancer
Acute pain related to drinkingcitrus or hot liquid or tumor pres- sure Grievingrelated to potentialloss of significantother Im balancednutrition:Less than body requirements related to impairedswallowing Impairedswallowing related to tumor Impairedverbal communicationrelated to laryngectomy

Legionnai disease res

D iarrhearelated to infection Fatiguerelated to infection Hypertherm ia related to infection Ineffective airway clearance related to increased mucus produc- tion R isk for infection related to inadequateimmune defenses to prevent secondary bacterial invasion

Leukemia
Activity intolerance related to: depressed nutritionalstatus fatigue secondary to rapid destructionof leukemic cells tissue hypoxia secondary to anemia Acute pain related to physical, biological, or chemical agents Deficient knowledge (therapeuticmodality and choice and care of vascular access device) related to lack of exposure to informa- tion Fatiguerelated to rapid destructionof leukemic cells Hopelessness related to prognosis Im balanced nutrition:Less than body requirements related to: anorexia chemotherapy nausea taste perception changes vomiting Im pairedoral mucous membranerelated to: cytotoxic effects of chemotherapy immunosuppressionsecondary to disease Ineffective coping related to uncertainprognosis and multiple diseaseand treatment-induced losses Ineffective protection related to severe immunosuppressionas- sociated with bone marrow transplantation peripheralstem cell transplantation or protocol Readiness for enhanced immunization status related to success- ful bone marrow transplantation Risk for deficient fluid volume related to risk of hemorrhage Risk for infection related to immunosuppression Acute pain related to liver abscess Anxiety related to change in health status Impairedgas exchange related to abnormalbreathing rate and rhythm due to pain Risk for imbalanced body temperaturerelated to infection

Remember that every patient may have different needs. The nursing diagnoses listed here are those that are most commonly associated with each medical condition.

L iver abscess

L iver failure

Im balanced nutrition:Less than body requirements related to catabolism caused by liver disease Im pairedskin integrityrelated to: ascites increased bleeding tendencies jaundice malnutrition Risk for acute confusion related to hepatic encephalopathysyn- drome Risk for imbalancedfluid volume related to ascites Risk for infection related to liver disease Acute pain related to surgery Compromised family coping related to prolonged disease Im balancednutrition:Less than body requirements related to: anorexia chronic illness initial postoperative nothing-by-mouth status Ineffective breathingpatternrelated to prolonged general anes- thesia and a large abdominalincision Readiness for enhanced hope related to new liver R isk for deficient fluid volume related to high-dose steroid ther- apy and fluid loss R isk for impairedliver function related to surgeryand disease process R isk for infection related to surgical incision and immunosu pression p-

L iver transplantation

Lungabscess
Hypertherm ia related to infection Impairedgas exchange related to altered oxygen supply Ineffective airway clearance related to increased secretions

Lungcancer
Activity intolerance related to imbalance between oxygen sup- ply and demand Im balancednutrition:Less than body requirements related to in- ability to ingest food Ineffective airway clearance related to fatigue Powerlessnessrelated to perceived mortality

Lupus erythematosus
Decreased cardiac output related to pericarditis, myocarditis,or endocarditis Hypertherm ia related to immunosuppression Impairedphysical mobility related to joint inflammation Im pairedskin integrityrelated to rashes Risk prone health behavior related to disability

Lyme disease
Acute pain related to arthritis Anxiety related to long treatmentcourse Fatiguerelated to infection Im pairedskin integrityrelated to rash

Lymphoma,non-Hodgkin s
Anxiety related to unknown hospital procedures and threat to health status Deficient knowledge (self-care of vascularaccess device, in- cluding peripherallyor centrally inserted venous cathetersor sub- cutaneous ports) related to lack of exposure to information Disturbed body image related to effects of chemotherapy or ra- diation therapy Im balancednutrition:Less than body requirements related to: altered oral mucous membrane anorexia fatigue nausea and vomiting taste alterations Im pairedskin integrityrelated to effects of radiationtherapy Ineffective protection related to immunosuppression Risk for infection related to: chemotherapy leukopenia,lymphopeniafrom bone marrow involvement radiationtherapyeffects

Maculardegeneration
Disturbedsensory perception (visual) related to aging process Impairedphysical mobility related to vision impairment Powerlessnessrelated to illness progression

Malignant melanoma
Disturbed body image related to skin lesion on head or neck Im pairedskin integrityrelated to sore, inflamed,itchy skin le- sion Readiness for enhanced managementof therapeutic regimen re- lated to understanding treatmentprotocols

Mastectomy
Anxiety related to fear of cancer recurrence Deficient knowledge (treatmentoptions) related to lack of ex- posure to information Disturbed body image related to loss of a body part Risk for infection related to incision

Mechanicalventilation
Bathing/hygiene, dressing/grooming,feeding, toileting self-care deficit related to impairedmobility status, pain Deficient fluid volume related to: altered oral intake fluid retention osmotic diuresis Deficient knowledge (peripheral parenteral nutrition [PPN] catheter care and therapy) related to lack of experience with PPN Fear related to inabilityto speak and dependence on life support Im balancednutrition:Less than body requirements related to in- ability to ingest nutrientsorally or digest them satisfactoril or to increased need y, Im pairedbed mobility related to ventilator Impairedgas exchange related to insufficientoxygen levels Ineffective airway clearance related to: increased secretions presence of an endotrachealtube underlyingdisease R isk for impairedskin integrityrelated to physical immobility R isk for infection related to central venous catheter R isk for injury related to complications of PPN catheter inser- tion R isk for injury related to: bypassed safety alarm mechanisms increased intrathoracicpressure mechanical breakdown patientdeterioration

M ni res disease
Deficient knowledge (symptom preventionand control mea- sures) related to recent onset of disease Disturbedsensory perception (auditor , kinesthetic) y related to disease process Impairedphysical mobility related to vertigo

Meningitis
Acute pain related to headache, joint involvement,muscle aches from infection Hypertherm ia related to infection Ineffective tissue perfusion (cerebral) related to increased in- tracranialpressure Risk for injury related to seizures

Metabolic acidosis
Acute confusion related to increased body acid Deficient fluid volume related to active loss from diarrheaand vomiting Ineffective breathingpatternrelated to fatigue and Kussmaul respirations s Nausea related to GI distress

Metabolic alkalosis
Disturbedthought processes related to acid-base imbalance Ineffective breathingpatternrelated to hypoventilation Risk for injury related to muscle weakness

Multiplemyeloma
Acute pain related to neoplasm that infiltrates the bone Fatiguerelated to illness Risk for infection related to immunosuppression

Multiplesclerosis
Compromised family coping related to effects of progressive, debilitatingdisease on family members and resultantalterationin role-relatedbehavior patterns Constipationrelated to decreased peristalsis Dressing/grooming self-care deficit related to neuromuscularimpairment Fatiguerelated to weakness and spasticity Impairedphysical mobility related to demyelinization Impairedverbal communicationrelated to dysarthria Interruptedfam ily processes related to role disturbance and un- certain future Powerlessnessrelated to remissions and exacerbations of ill- ness Readiness for enhanced comfort related to acceptance of care and support of significantothers

 Risk for injury related to: gait impairment vertigo vision disturbances Sexual dysfunction related to fatigue, decreased sensation, mus- cle spasm, or urinaryincontinence Situationallow self-esteem related to progressive, debilitatingeffects of disease Urinary retention related to sensorimotor deficits

R i s k f o r i n j u r y r e l a t e d t o m y o c a r d i a l i s c h e m i a , i n

Myasthenia gravis
Activity intolerance related to muscle fatigue and weakness Dressing/groomingself care deficit related to neuromuscularin- volvement Fatigue related to muscle weakness Impaired swallowing related to cerebellar dysfunction Ineffective airway clearance related to impaired ability to cough Ineffective therapeuticregimenmanagement related to insuffi- cient knowledge of disease Risk for injury related to vision disturbance and weakness Risk for spiritual distress related to chronic illness R isk for urge urinary incontinence related to neuromuscularin- volvement

Myocardial infarction
Activity intolerance related to weakness and fatigue Acute pain (chest) related to decreased myocardial oxygenation Death anxiety related to diagnosis Decreased cardiac output related to altered heart rate, rhythm Deficient knowledge (diagnostic procedures, therapeutic inter- ventions, and long-range implications for lifestyle changes) relat- ed to complex diagnosis and therapeutic regimen Impairedgas exchange related to ventilation-perfusion imbal- ance Ineffective coping related to fear of death, anxiet y, denial, or depression Risk for constipation related to diet, bed rest, or medications

jury, necrosis, inflammation, arrhythmias or

Says here that patients can experience death anxiety related to a diagnosis of myocardial infarction. Y ikes!

Myocarditis
Activity intolerance related to weakness and fatigue Decreased cardiac output related to arrhythmias Fatiguerelated to infection

Nephrectom y

Acute pain related to surgical procedure Ineffective airway clearance related to: anesthesia immobility location of incision pain presence of chest tube Risk for imbalancedfluid volume related to decreased renal reserve and third-spacefluid shiftingimmediately after surgery Risk for perioperativepositioning related to flank positioning and outermost arm positioning Im balancednutrition:Less than body requirements related to high-protein,low-sodium diet Risk for imbalancedfluid volume related to disease process Risk for infection related to immunosuppression

Nephrotic syndrome

Neuritis, peripheral
Disturbedsensory perception (tactile) related to degenerationof peripheralnerves Impairedphysical mobility related to muscle weakness Risk for injury related to disturbed sensory perception

Neurogenic bladder
Reflex urinary incontinence related to neuromuscular dysfunc- tion of the lower urinarytract Risk for compromised human dignity related to incontinence Risk for infection related to incomplete emptying of bladder

Obesity
Activity intolerance related to deconditioned status and exces- sive energy demands secondary to obesity D isturbed body image related to social stigma of obesity Im balanced nutrition: More than body requirements related to: dysfunctionaleating patterns energy expenditureimbalance excess food intake inheriteddisposition sedentaryactivity level Impairedgas exchange related to ventilation-perfusion imbal- ance Impaired physical mobility related to fatigue with minimal exer- tion, joint or back discomfort, limitation of motion from extra skin folds

 R isk for impairedskin integrityrelated to: altered circulation (edema) multiple moist skin folds nutritionaldeficit Social isolation related to size too large for standard seating and body image disturbance

Osteoa rthritis

Osteomyelitis

Activity intolerance related to pain Chronic pain related to deteriorationof joint cartilage Im pairedhome maintenancerelated to inadequate support sys- tems, decreased range of motion with increased joint pain Acute pain related to inflammation Deficient knowledge (prolonged treatmentregimenfor infec- tion and measuresto prevent recurrence) related to new diagnosis Impairedphysical mobility related to pain R isk for disuse syndrome related to prolonged infection, pain, and immobilization R isk for injury related to use of antibiotics with high potentialfor toxic effects Anxiety related to change in health status D isturbed body image related to joint deformity Ineffective sexualitypatternsrelated to pain R isk for traumarelated to bone loss

Osteoporosis

Otosclerosis

Ovarian cancer

Deficient knowledge (disease) related to lack of exposure to in- formation Disturbedsensory perception (auditory) related to decreased motion of bones of the middle ear R isk for infection related to surgery Constipationrelated to GI obstruction Deficient knowledge (disease and treatmentoptions) related to lack of exposure to information Grievingrelated to potentialloss Urinaryretention related to obstruction

Ovarian cyst
Acute pain related to complications of ovarian cysts that cause acute abdominalsymptoms Anxiety related to laparoscopic surgery Ineffective sexualitypatternsrelated to irregularor prolonged bleeding

Paget s disease
Acute pain related to impingementof abnormalbone on spinal cord Bathing/hygiene, dressing/grooming,toileting self-care deficit related to musculoskeletalimpairment Disturbed body image related to musculoskeletalimpairment Impairedphysical mobility related to asymmetrical bowing of tibia andfemur

Pancreatic cancer
Acute pain related to tumor pressure Anxiety related to threatof death and disease status Caregiverrole strain related to illness severity Im balancednutrition:Less than body requirements related to: impaireddigestion loss of appetite pain vomiting
Watch patients with panc reatitis for signs of imbalanced nutrition. Im feeling queasy just looking at this list.

Pancreatitis
Acute pain related to: abscess formation or hemorrhaging autodigestiveprocesses and necrosis edema of the pancreas and surroundingtissues peritonitis Im balanced nutrition:Less than body requirements related to: gastric suction impaireddigestion nothing-by-mouth status vomiting Nausea related to gastric distention Risk for deficient fluid volume related to: fluid shifts hemorrhage hyperglycemia vomiting Risk for infection related to traumaand chronic disease

 R isk for injury related to: alcoholism hypovolemia pulmonaryinsults

Parkinsons disease
Activity intolerance related to neuromuscularimpairment Bathing/hygiene, dressing/groomingself-care deficit related to neuromuscularimpairment Im pairedhome maintenancerelated to disease effects R isk for aspirationrelated to impaired muscles of swallowing R isk for falls related to impairedgait and balance

Pelvic inflamm atory disease

Acute pain related to inflammation R isk for infection related to inadequateprimarydefenses Sexual dysfunction related to malaiseand profuse, purulentvaginaldischarge

Peptic ulcers
Acute pain related to ulcers Deficient knowledge (ulcer preventionand care) related to lack of exposure to information Nausea related to GI distress

Percutaneous transluminal coronary angioplasty

Acute pain related to restrictionson mobility and percutaneous puncture at groin site Anxiety related to known risks associated with the procedure Deficient knowledge (postdischarge care) related to lack of exposure to information R isk for injury related to break in skin and presence of foreign body intravascularly

Pericarditi s

Acute pain related to inflammation pericardium of Decreased cardiac output related to pericarditis Ineffective tissue perfusion (cardiopulmonary)related to de- creased cellular exchange

Periphe vascular disease ral

Activity intolerance related to pain Impaire physica mobilit relate to pain and activit intolerance d l y d y Impairedtissue integrity(peripheral) related to decreased oxy- genation Risk for peripheralneurovasculardysfunction related to vascu- lar obstruction

Perirectal abscess and fistula

Acute pain related to abscess and fistula Delayed surgical recovery related to inflammation Situationallow self-esteem related to difficult healing process

Peritonitis
Acute pain related to inflammation Nausea related to increased GI pressure Risk for infection related to inadequateprimarydefenses

Permanent pacemakerinsertion
Bathing/hygiene self-care deficit related to bed rest and activity limitations Deficient knowledge (self-care after discharge) related to unfa- miliar therapeuticintervention Disturbed body image related to dependence on pacemaker Risk for infection related to surgical disruptionof skin barrier

Pituitary tumor
Acute pain related to tumor pressure Deficient knowledge (surgical options) related to lack of expo- sure to information Disturbedsensory perception (visual) related to unilateralblindness Risk for injury related to dementia

Pleural effusion and empyema

Fatiguerelated to weakness Hypertherm ia related to infection Ineffective breathingpatternrelated to pain and increased work of breathing

Pleurisy
Acut pain relate to inflammatio of viscera and parieta pleurae e d n l l Impairedgas exchange related to altered oxygen supply Ineffective breathingpattern related limited movement on af- fected side

Pneumocystis carinii pneumonia

Fatiguerelated to infection Grievingrelated to poor prognosis Ineffective breathingpatternrelated to fatigue R isk for imbalanced body temperaturerelated to infection

Pneumonia
Acute pain related to fever and pleuritic irritation Bathing/hygiene self-care deficit related to weakness and tired- ness Deficient fluid volume related to active fluid volume loss Deficient knowledge (treatmentregimen) related to lack of ex- posure to information Impaire gas exchang relate to ventilation-perfusio d e d n imbalance Ineffective airway clearance related to retainedsecretions R isk for infection related to stress and other risk factors Acute pain related to air trapped in the intrapleural space Fear related to sudden onset of illness Impaire gas exchang relate to ventilation-perfusio d e d n imbalance Ineffective tissue perfusion (cardiopulmonary)related to col- lapsed lung Acute pain related to kidney mass Deficient knowledge (illness) related to lack of exposure to in- formation Ineffective tissue perfusion (renal) related to kidney mass
Lack of exposure to information can lead to deficient knowledgeabout an illness. I thought I might do a little reading about polycystic kidney diseas e.

Pneumothorax

Polycystic kidneydisease

Polycythemia vera
Acute pain related to headache Deficient knowledge (disease and treatment)related to lack of exposure to information Disturbedsensory perception (visual) related to hypervolemia Impairedgas exchange related to dyspnea

Potassium imbalance
Decreased cardiac output related to arrhythmias D iarrhearelated to hypercalcemiaand hypocalcemia Nausea related to GI distress

Pressure ulcers
Im balancednutrition:Less than body requirements related to in- ability to digest and absorb nutrients Impairedphysical mobility related to musculoskeletaland neu- romuscularimpairment Im pairedskin integrityrelated to: altered circulation altered sensation impairedphysical mobility mechanical factors Risk for infection related to impairedskin integrity

Prost atectomy

Acute pain related to: bladder spasms catheter obstruction surgicalintervention urethralstricture Risk for deficient fluid volume related to prostatic or incisional bleeding after surgery Risk for infection (postoperative) related to: abdominaldrain placement preoperativestatus urinarycatheter Risk for situationallow self-esteem related to: incontinence potentialimpotence sexual alterations Sexual dysfunction (decreased libido) related to: decreased self-esteem fear of incontinence impotence related to parasympathetic nerve damage (from radical prostatectomy) infertilityrelated to retrogradeejaculation (from transure- thral resection of the prostate and suprapubic prostatectomy) Urge urinary incontinence related to: decrease in detrusor muscle sphinctertone traum ato the bladder neck urinary catheter removal Urinaryretention related to urinary catheter obstruction

Prost atic cancer

Acute pain related to physical, biological, or chemical agents Anxiety related to change in health status Sexual dysfunction related to impotence Urinaryretention related to obstruction

Prost atitis
Acute pain related to infection and destructionof tissue Hypertherm ia related to infection Impairedurinary elim ination related to infection

Pseudomembranous enterocolitis
Deficient fluid volume related to active loss D iarrhearelated to inflammation Im pairedskin integrityrelated to severe diarrhea

Psoriasis
D isturbed body image related to itchy, dry, cracked, and en- crusted lesions on body parts Im pairedskin integrityrelated to itchy, dry, cracked, and en- crusted lesions Social isolation related to disturbed body image

Pulmona edema ry
Decreased cardiac output related to tachycardia Dysfunctionalventilatoryweaning response related to anxiety Excess fluid volume related to fluid accumulationin extravas-cular spaces of the lungs Ineffective breathingpatternrelated to diminishedlung compli- ance

Pulmonary embolism and infarction

Activity intolerance related to imbalance between oxygen sup- ply and demand Acute pain related to biological injury Compromised family coping related to potentiallylifethreaten-ing situation Decrease cardia outpu relate to altere heart rate and rhythm d c t d d Deficient fluid volume related to active fluid volume loss Deficient knowledge (treatmentregimen) related to complex disorder and therapy Impaire gas exchang relate to ventilation-perfusio mismatch d e d n

Pulmona hypertension ry
Bathing/hygiene, dressing/groomingself-care deficit related to fatigue Decrease cardia outpu relate to altere heart rate and rhythm d c t d d Ineffective breathingpatternrelated to hypertrophyof small pulmonaryarteries Ineffectiv tissue perfusio (cardiopulmonary related to e n ) impaired transportof oxygen across alveolar and capillary membranes

Pyelonephritis
Excess fluid volume related to compromised regulatory mecha- nisms Hypertherm ia related to infection Impairedurinary elim ination related to urgenc y, burning,or nocturia Risk for infection related to inadequateprimary and secondary defenses

Radioactive implant for cervical cancer

Ineffective sexualitypatternsrelated to vaginaltissue changes or fear of radioactivity Risk for disuse syndrome related to imposed bed rest Risk for injury related to dislodgmentof the implant
Patients with Raynaud disease s are at risk for impaired skin integrity related to decreased sensation. Is it cold in here, or is it just me?

Rape-trauma syndrome
Rape-trauma syndrome related to rape or attemptedrape Rape-trauma syndrome:Compound reaction related to rape Rape-trauma syndrome: Silent reaction related to rape Situationallow self-esteem related to rape

Raynaud disease s
Disturbedsensory perception (tactile) related to decreased oxy- genation Ineffective tissue perfusion (peripheral) related to decreased arterialblood flow Risk for impairedskin integrityrelated to decreased sensation and ischemia

Renal calculi
Acute pain related to obstruction of ureter or kidney by renal calculi Deficient knowledge (disease) related to lack of exposure to in- formation R isk for infection related to trauma Urinaryretention related to ureter obstruction by renal calculi

Renal dialysis
Acute pain related to hemodialysistreatment Im balancednutrition:Less than body requirements related to: abdominaldistention anorexia nausea stomatitis Impairedphysical mobility related to lengthytreatmentregimen Ineffective breathingpatternrelated to elevation of diaphragmduring peritonealdialysis exchanges and reduced mobility R isk for acute confusion related to consequences of long-term dialysis treatment R isk for fluid imbalancerelated to dialysis R isk for infection related to invasiveprocedure R isk for injury related to: bleeding from the area around the vascular access device potentialfor thrombosis, stenosis, or hematomaof vascular access R isk for injury (perforation or ileus) related to catheter inser- tion or irritationfrom dialysate

Renal failure, acute

Deficient knowledge (acute renal failure and dialysis) related to lack of exposure to informationon complex disease and its man- agement Excess fluid volume related to sodium and water retention Im balancednutrition:Less than body requirements related to anorexia, nausea and vomiting,and restricted dietary intake Impairedurinary elim ination related to disease process R isk for infection related to decreased immune response and skin changes secondary to uremia R isk for injury related to uremic syndrome

Renal failure, chronic

Caregiverrole strain related to illness chronicity Chronic low self-esteem related to chronic disease Disturbedthought processes related to: acidosis fluid and electrolyte imbalances uremic toxins Excess fluid volume related to fluid retention Im balancednutrition:Less than body requirements related to: altered metabolism of proteins,lipids, and carbohydrates anorexia diarrhea GI inflammation with poor absorption nausea and vomiting restricteddietary intake Im pairedoral mucous membranerelated to accumulationof urea and ammonia Noncompliance (treatmentregimen) related to: deficient knowledge denial lack of resources lack of social support systems Risk for impairedskin integrityrelated to: abnormalblood clotting anemia calcium phosphate deposits on the skin capillary fragility decreased activity of oil and sweat glands retention of pigments scratching Sexual dysfunction related to the effects of uremia on the en- docrine system and central nervous system and to the psychoso- cial impact of chronic renal failureand its treatment

Respiratory acidosis
Decreased cardiac output related to altered heart rate and rhythm Impairedgas exchange related to ventilatory-perfusion imbal- ance Ineffective breathingpatternrelated to hypoventilation

Respiratory alkalosis
Anxiety related to hyperventilation Impaire gas exchang relate to ventilatory-perfusio imbalance d e d n Ineffective breathingpatternrelated to hyperventilation

Retinal detachment
Disturbedsensory perception (visual) related to loosening of retina Impairedphysical mobility related to vision disturbance Ineffective coping related to decreased vision and impending surgery

Rheumatoid arthritis
Activity intolerance related to pain and swelling of joints Chronic pain related to inflammation joints of D isturbed body image related to arthriticjoints Ineffective health maintenancerelated to lack of mobility

Salmonellosis
D iarrhearelated to GI distress Hypertherm ia related to infection Risk for deficient fluid volume related to diarrhea

Sarcoidosis
Activity intolerance related to pain Decreased cardiac output related to arrhythmias Deficient knowledge (disease and treatment)related to lack of exposure to information Ineffective breathingpatternrelated to pain

Scabies

Im pairedskin integrityrelated to skin infection Ineffective sexual patternsrelated to fear of spreadinginfection Social isolation related to fear of spreadinginfection Acute confusion related to postictal state Deficient knowledge (seizure management)related to lack of exposure to information Impairedm em ory related to neurologic disturbance Ineffective airway clearance related to: airway occlusion by tongue or foreign body apnea excessive secretions jaw clenching loss of consciousness Ineffectiv therapeuti regime managem en relate to e c n t d deficient knowledge of disease, seizure care, and community resources R isk for injury related to excessive uncontrolled muscle activity R isk for traumarelated to internalfactors

Seizure disorder

Septic arthritis
Acute pain related to inflammation joints of Anxiety related to threatto health androles Risk for infection related to inadequateprimary and secondary defenses

Septic shock
Acute confusion related to decreased cerebral tissue perfusion D iarrhearelated to GI irritation Hypertherm ia related to infection Im balancednutrition:Less than body requirements related to in- adequateintake and active fluid and nutrientloss Impairedgas exchange related to ventilation-perfusion imbal- ance and diffusion defects Ineffective coping related to threatto life Risk for injury due to complications related to ischemia or bleeding

Sinusitis
Acute pain related to inflammation and pressure Fatiguerelated to infection Risk for infection related to inadequateprimarydefenses

Sjgrens syndrome
Disturbedsensory perception (visual) related to ocular dryness Fatiguerelated to disease process Im pairedoral mucous membranerelated to oral dryness

Skin grafts
Deficient knowledge (home care of donor and graft sites) relat- ed to lack of exposure to information Disturbed body image related to wound and potential scarring Im balancednutrition:Less than body requirements related to in- creased metabolic needs secondary to tissue healing Impairedphysical mobility related to position and movement limitations Risk for infection of donor site related to surgical excision

Spinal cord injury

Bathing/hygiene, dressing/grooming,feeding, toileting self- care deficit related to spinal cord injury Constipationrelated to loss of voluntarybowel control Decreased cardiac output related to autonomic dysfunction and immobility Deficien diversiona activit relate to loss of t l y d mobilit or function y D isturbed body image related to physical disability Im balancednutrition:Less than body requirements related to acute injury Impairedgas exchange related to loss of use of phrenic nerve, intercostalmuscles, or abdominal muscles secondary to the spinal injury Im pairedhome maintenancerelated to inadequate support systems Impairedphysical mobility related to muscularparalysis Impairedurinary elim ination related to interruptionof neur- al innervation Incontinence,bowel and total urinary related to neuromus-cular enervation Ineffective airway clearance related to loss of use of intercostal muscles R isk for autonomic dysreflexia related to damage to spinal cord with another associated stressor R isk for infection related to catheterization

Spinal cord injuries can cause many deficits related to self-care. Brush up on the ones listed here.

Spinal neoplasm
Impairedphysical mobility related to neuromuscular impai - ment r Incontinence,bowel and total urinary related to neurologic dys- function R isk for autonomic dysreflexia related to spinal cord injury or lesion R isk for impairedskin integrityrelated to: altered nutritionalstatus altered sensation mechanical factors moisture from incontinence physical immobilization

Squamous cell carcinoma

Anxiety related to threatto health status Im pairedskin integrityrelated to invasive tumor of skin Ineffective therapeuticregimen management related to defi- cient knowledge

Stomatitis
Acute pain related to swollen and easily bruised gums and mu- cous membranes Im pairedoral mucous membranerelated to: chemical irritants infection malnutrition vitamindeficiency or mechanicalirritants(ill-fitting dentures, braces) Risk for infection related to immunosuppression

Stroke
Bathing/hygiene, dressing/grooming,feeding, toileting self-care deficit related to: neuromuscularimpairment perceptual cognitive impairment weakness or lack of motivation Caregiverrole strain related to increased care needs Chronic confusion related to cerebral injury Deficient knowledge (stroke management)related to lack of ex- posure to informationon self-care Impairedphysical mobility related to damage to motor cortex or motor pathways Impairedverbal communicationrelated to cerebral injury Ineffective airway clearance related to hemiplegic effects of a stroke Ineffective tissue perfusion (cerebral) related to clot or hemor- rhage Risk for disuse syndrome related to neuromuscularimpairment Unilateral neglect related to cerebral injury

Syphilis

Ineffective coping related to situationalcrisis Ineffective sexualitypatternsrelated to fear of spreadingillness Risk for infection related to externalfactors

Tendinitis and bursitis

Activity intolerance related to pain and stiffness Acute pain related to inflammation Ineffective role performance related to restricted movement of joint due to pain

Thoracotomy
Acute pain related to surgical incision Deficient knowledge (treatmentregimen) related to unfam iliari- with thoracotomy ty Impairedgas exchange related to: analgesic medications atelectasis hypoventilationfrom anesthesia pain thickened secretions R isk for infection related to surgical incision and endotracheal intubation

T hrombocytopenia
Decreased cardiac output related to tachycardia Deficient knowledge (disease and treatment)related to lack of exposure to information Fatiguerelated to disease process R isk for injury related to possible bleeding from lack of platelets

T hrombophlebitis
Acute pain related to vessel obstruction and edema Deficient knowledge (treatmentregimen) related to lack of ex- posure to information Ineffective tissue perfusion (peripheral) related to interruptionof venous flow

Thyroid cancer
Deficient knowledge (treatmentregimen) related to lack of ex- posure to information Impairedswallowing related to pressure of thyroid nodule Ineffective breathingpatternrelated to enlargedthyroid nodule

Toxic shock syndrome

D iarrhearelated to infection Fear related to sudden onset of illness Hypertherm ia related to infection

Tracheostomy
Im pairedskin integrityrelated to humidit , moisture,or y mucus accumulation Ineffective breathingpatternrelated to trachealtube dislodg- ment or plugging Risk for aspirationrelated to impaired swallowing and vomiting Risk for injury (poor oxygenation related to suctionin ) g procedure Impairedgas exchange related to: head injury pulmonaryinjury shock Impairedphysical mobility related to orthopedic injury Risk for imbalancedfluid volume related to hypov- olemia or cardiac injury Risk for injury (complications) related to: hypermetabolicstate impaired immunologic defenses stress Risk for posttraumasyndrome related to perception of event and sudden, unexpected injury

Trauma

Trigeminal neuralgia can cause acute pain. What nerve!

Trigeminalneuralgia
Acute pain related to disorder of the fifth cranial nerve Anxiety related to threatto health Ineffective coping related to inadequatelevel of per- ception of control

Tuberculosis
Deficient knowledge (disease process) related to lack of exposure to information Ineffective airway clearance related to tracheo- bronchial obstruction or secretions Ineffective breathingpatternrelated to decreased en- ergy or fatigue Risk for infection related to altered primarydefenses Social isolation related to fear of spreadingdisease

Ulcerative colitis
Anxiety related to change in health status D iarrhearelated to inflammation colon of Fatiguerelated to loss of fluids and diarrhea Im balancednutrition:Less than body requirements related to in- ability to absorb nutrients Ineffective role performance related to frequentdiarrhea

Urina tract infection ry

Acute pain related to inflammationand muscle spasms Deficient knowledge (disease process) related to lack of expo- sure to information Impairedurinary elim ination related to obstruction

Urolithiasis
Acute pain related to: incision passage of calculus fragments procedural manipulation Deficient knowledge (potential causes of calculus formation) related to lack of exposure to information Im pairedurinary elimination: Dysuria,oliguria,pyuria,or fre- quency related to: calculus fragmentpassage hematuria infection obstruction

Uterine cancer

Acute pain related to cancer Im balanced nutrition:Less than body requirements related to cancer Spiritualdistress related to chronic illness Anxiety related to change in health status D isturbed body image related to biophysical factors Stress urinary incontinence related to weak pelvic musculature

Uterine prolapse

Valvularheart disease
Activity intolerance related to fatigue and dyspnea on exertion Anxiety related to change in health status Decreased cardiac output related to mechanical disruption Ineffective breathingpatternrelated to decreased energy and fa- tigue

Vascular retinopathy
Disturbedsensory perception (visual) related to disturbed blood supply to the eye Ineffective coping related to chronic illness R isk for injury related to loss of vision

Vasculitis
Disturbed body image related to illness Im balanced nutrition:Less than body requirements related to anorexia of disease process Ineffective tissue perfusion (cerebral, cardiopulmonar y, gastro- intestinal,renal, peripheral) related to inflamed vessels causing impairedblood flow to nearby organs Risk for infection related to impaired defenses

Vulvovaginitis

Acute pain related to inflammation Ineffective sexualitypatternsrelated to vaginal inflammation, itching, irritation and Risk for infection related to inadequateprimarydefenses Acute pain related to traum ato nerve endings Im pairedskin integrityrelated to penetrationof skin Risk for contaminationrelated to detrimentalhome environ- mentalfactors Risk for deficien fluid volume related to active loss from trauma t Risk for infection related to inadequateprimarydefenses

Wounds