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Medical-Surgical Nursing - E-Book

Medical-Surgical Nursing - E-Book

Donna D. Ignatavicius | M. Linda Workman

(2013)

Additional Information

Book Details

Abstract

Using a uniquely collaborative and reader-friendly approach, expert authors Donna D. Ignatavicius and M. Linda Workman cover all the latest trends, evidence-based treatment guidelines, and additional updated information needed for safe clinical practice in medical-surgical nursing. This seventh edition features an expanded emphasis on patient safety and NCLEX® Examination preparation, new ties to the QSEN priorities for patient safety, and a greater alignment with the language and focus of clinical practice. A new chapter on evidence-based practice and a wealth of effective online learning tools help solidify your mastery of medical-surgical nursing.

  • UNIQUE! Collaborative approach presents all medical, surgical, nursing, and other interventions through the lens of the nursing process.
  • Reader-friendly, direct writing style makes this one of the most readable medical-surgical nursing textbooks available.
  • UNIQUE! Cutting-edge focus on the latest trends in nursing practice and nursing education prepares you for both today and tomorrow’s nursing practice.
  • UNIQUE! Integrated tools for NCLEX preparation get you ready for your licensure examination.
    • Chapter-opening Learning Outcomes are linked to Self-Assessment Questions for the NCLEX Examination on the Evolve website.
    • Unique chapter-ending Get Ready for the NCLEX Examination! sections include Key Points organized by NCLEX Client Needs Categories.
  • UNIQUE! Focus on nursing concepts helps bridge the gap between the concepts learned in Nursing Fundamentals, and disorders content learned in the medical-surgical nursing course.
  • UNIQUE! Emphasis on clinical decision-making teaches you to apply concepts to true-to-life clinical situations.
  • UNIQUE! Concentration on the core body of knowledge for the RN level of medical-surgical nursing practice focuses your attention on "need-to-know" content to pass the NCLEX Examination and practice safely as a beginning nurse.
  • Rich array of effective learning aids includes:
    • Best Practice for Patient Safety & Quality Care
    • Best Practice for Emergency Care
    • Patient and Family Education: Preparing for Self-Management 
    • Nursing Focus on the Older Adult
    • Home Care Assessment
    • Focused Assessment
    • Common Examples of Drug Therapy
    • Evidence-Based Practice
    • Concept Maps
    • Laboratory Profiles
    • Assessment Using Gordon’s Functional Health Patterns

Table of Contents

Section Title Page Action Price
Front cover cover
Inside front cover ifc1
Half title page i
Evolve page ii
Medical-Surgical Nursing: Patient-Centered Collaborative, 7/e iii
Copyright page iv
Consultants and Contributors v
Reviewers viii
Preface ix
Key Themes for the 7th Edition ix
Clinical Currency and Accuracy x
Outstanding Readability x
Ease of Access x
A Patient-Centered Collaborative Care Approach x
Organization xi
Multinational, Multicultural, Multigenerational Focus xi
Additional Learning Aids xii
An Integrated Multimedia Resource Based on Proven Strategies for Student Engagement and Learning xii
Resources for Instructors xii
Resources for Students xiii
Dedication xiv
About The Authors xv
Acknowledgments xvi
Table of Contents xvii
Guide to Special Features xxviii
Assessment Using Gordon’s Functional Health Patterns xxviii
Best Practice for Patient Safety & Quality Care xxviii
Common Examples of Drug Therapy xxix
Concept Map xxix
Evidence-Based Practice xxix
Focused Assessment xxx
Home Care Assessment xxx
Key Features xxx
Laboratory Profile xxxi
Nursing Focus on the Older Adult xxxi
Patient and Family Education: Preparing for Self-Management xxxi
Unit I Foundations for Medical-Surgical Nursing 1
1 Introduction to Medical-Surgical Nursing 1
Learning Outcomes 1
National Patient Safety Goals 2
Protecting Five Million Lives from Harm 2
Institute of Medicine/Quality and Safety Education for Nurses Core Competencies 3
Patient-Centered Care 3
Teamwork and Collaboration 4
Communication 4
Delegation and Supervision 5
Evidence-Based Practice 5
Quality Improvement 5
Informatics 6
Safety 6
Get Ready for the Nclex® Examination! 7
Key Points 7
2 Introduction to Complementary and Alternative Therapies 8
Learning Outcomes 8
Health Promotion and Maintenance 8
Physiological Integrity 8
Overview 8
National Center for Complementary and Alternative Medicine 9
Cam Categories 9
Natural Products 9
Mind-Body Therapies 10
Imagery 11
Meditation 11
Music Therapy 11
Pet Therapy 11
Yoga 12
Acupressure and Acupuncture 12
Manipulative and Body-Based Therapies 13
Massage 13
Tai Chi 13
Other CAM Therapies 13
Get Ready for the Nclex® Examination! 14
Key Points 14
Health Promotion and Maintenance 14
Physiological Integrity 14
3 Common Health Problems of Older Adults 15
Learning Outcomes 15
Safe and Effective Care Environment 15
Health Promotion and Maintenance 15
Psychosocial Integrity 15
Physiological Integrity 15
Overview 15
Health Issues for Older Adults in Community-Based Settings 16
Decreased Nutrition and Hydration 16
Decreased Mobility 17
Stress and Loss 18
Accidents 19
Fall Prevention 19
Driving Safety 19
Drug Use and Misuse 20
Effects of Drugs on Older Adults 20
Self-Administration of Drugs 20
Medication Assessment and Health Teaching 21
Mental Health/Behavioral Health Problems 22
Depression 22
Dementia 23
Delirium 23
Alcohol Use and Abuse 24
Elder Neglect and Abuse 25
Health Care Issues for Older Adults in Hospitals and Nursing Homes 26
Sleep, Nutrition, and Incontinence 26
Confusion, Falls, and Skin Breakdown 26
Get Ready for the NCLEX® Examination! 28
Key Points 28
Safe and Effective Care Environment 28
Health Promotion and Maintenance 29
Psychosocial Integrity 29
Physiological Integrity 29
4 Cultural Aspects of Health and Illness 30
Learning Outcomes 30
Health Promotion and Maintenance 30
Psychosocial Integrity 30
Culture and Cultural Competence 31
Health and Health Care Disparities 32
Purnell’s Domains of Culture 32
Culture Overview and Communication 32
Overview and Localities 32
Homelessness 32
Communication 33
Family and Workplace Issues 33
Lesbian, Gay, Bisexual, and Transgender Health 34
Quality of LGBT Health Care 34
Biologic Ecology 35
Dwarfism 35
Ethnopharmacology 35
Nutrition 35
Spirituality 36
Health Care Practices and Practitioners 36
Get Ready for the NCLEX® Examination! 37
Key Points 37
5 Pain: 39
Learning Outcomes 39
Safe and Effective Care Environment 39
Health Promotion and Maintenance 39
Psychosocial Integrity 39
Physiological Integrity 39
Overview 40
Definitions of Pain 40
Scope of the Problem 40
Categorizing Pain 40
Acute Pain 41
Chronic Pain 41
Chronic Cancer Pain. 41
Chronic Non-Cancer Pain. 41
Theoretical Bases for Pain 41
Pain Transmission 41
Attitudes and Practices Related to Pain 43
Pain Perception 44
Addiction, Pseudoaddiction, Tolerance, and Physical Dependence 44
Patient-Centered Collaborative Care 46
Assessment 46
History 46
Physical Assessment/Clinical Manifestations 46
Location of Pain. 46
Intensity and Quality of Pain. 48
Assessing Pain in Cognitively Impaired or Critically Ill Nonverbal Patients. 48
Psychosocial Assessment 49
Interventions 49
Drug Therapy 49
Non-Opioid Analgesics. 49
Nonsteroidal Anti-Inflammatory Drugs. 50
Acetaminophen. 51
Opioid Analgesics. 51
Examples of Opioid Drugs. 51
Side Effects of Opioids. 53
Common Parenteral Routes of Opioid Administration. 54
Patient-Controlled Analgesia. 54
Epidural Analgesia. 56
Intrathecal Analgesia. 57
Adjuvant Analgesics. 58
Nonpharmacologic Interventions 59
Physical Measures. 59
Cognitive-Behavioral Pain Management. 60
Other Complementary and Alternative Therapies. 61
Invasive Techniques for Chronic Pain 61
Community-Based Care 61
Home Care Management 61
Teaching for Self-Management 61
Health Care Resources 62
Get Ready for the Nclex® Examination! 62
Key Points 62
Safe and Effective Care Environment 62
Health Promotion and Maintenance 62
Psychosocial Integrity 62
Physiological Integrity 62
6 Genetic Concepts for Medical-Surgical Nursing 64
Learning Outcomes 64
Safe and Effective Care Environment 64
Health Promotion and Maintenance 64
Psychosocial Integrity 64
Physiological Integrity 64
Genetic Biology 65
DNA 66
DNA Structure 66
DNA Replication 67
Chromosomes 68
Gene Structure and Function 68
Phenotype 70
Genotype 70
Gene Expression 70
Protein Synthesis 70
Mutations 71
Point Mutations 71
Frameshift Mutations 71
Patterns of Inheritance 72
Pedigree 72
Autosomal Dominant Pattern of Inheritance 73
Penetrance 73
Expressivity 73
Autosomal Recessive Pattern of Inheritance 74
Sex-Linked Recessive Pattern of Inheritance 74
Complex Inheritance and Familial Clustering 74
Genetic Testing 74
Purpose of Genetic Testing 74
Benefits and Risks of Genetic Testing 75
Genetic Counseling 75
Ethical Issues 76
The Role of the Medical-Surgical Nurse in Genetic Counseling 77
Communication 77
Privacy and Confidentiality 77
Information Accuracy 77
Patient Advocacy and Support 77
Get Ready for the Nclex® Examination! 78
Key Points 78
Safe and Effective Care Environment 78
Health Promotion and Maintenance 78
Psychosocial Integrity 78
Physiological Integrity 78
7 Evidence-Based Practice in Medical-Surgical Nursing 79
Learning Outcomes 79
Overview 79
Definitions of Evidence-Based Practice 79
Steps of the Evidence-Based Practice Process 80
Asking “Burning” Clinical Questions 80
Qualitative Versus Quantitative Questions. 80
PICO(T) Format. 80
Finding the Best Evidence 81
Critically Appraising and Synthesizing Evidence 82
Making Recommendations to Improve Practice 83
Implementing Recommendations 83
Evaluating Outcomes 83
Models and Frameworks for Implementing Evidence-Based Practice 83
Iowa Model 83
Reavy and Tavernier Model 83
ARCC Model 83
Evidence-based Practice Improvement (Ebpi) Model 84
Steps of the EBPI Model 84
Application of the EBPI Model to Clinical Practice: A Case Study 85
Describe the Practice Problem 85
Formulate a Focused Clinical Question 85
Search for Evidence 86
Appraise and Synthesize the Evidence 86
Develop the Aim Statement 86
Implement the PDSA Cycles 86
Disseminate Best Practices 87
Get Ready for the NCLEX® Examination! 88
Key Points 88
8 Rehabilitation Concepts for Chronic and Disabling Health Problems 89
Learning Outcomes 89
Safe and Effective Care Environment 89
Health Promotion and Maintenance 89
Psychosocial Integrity 89
Physiological Integrity 89
Overview 89
Concepts Related to Rehabilitation 90
The Rehabilitation Team 90
Patient-centered Collaborative Care 92
Assessment 92
History 92
Physical Assessment/Clinical Manifestations 92
Cardiovascular and Respiratory Assessment. 93
Gastrointestinal and Nutritional Assessment. 93
Renal and Urinary Assessment. 93
Neurologic and Musculoskeletal Assessment. 93
Skin Assessment. 94
Functional Assessment 94
Psychosocial Assessment 94
Vocational Assessment 95
Analysis 95
Planning and Implementation 95
Improving Physical Mobility 95
Planning: Expected Outcomes. 95
Interventions. 95
Safe Patient Handling Practices. 95
Gait Training. 97
Increasing Functional Mobility 99
Planning: Expected Outcomes. 99
Interventions. 99
Maintaining Skin Integrity 100
Planning: Expected Outcomes. 100
Interventions. 100
Establishing Urinary Continence 101
Planning: Expected Outcomes. 101
Interventions. 101
Post-Void Residual Assessment. 101
Bladder Retraining. 101
Drug Therapy. 102
Establishing Bowel Continence 102
Planning: Expected Outcomes. 102
Interventions. 102
Community-Based Care 104
Home Care Management 104
Predischarge Assessment. 104
Leave-of-Absence Visit. 104
Teaching for Self-Management 104
Health Care Resources 105
Evaluation: Outcomes 105
Get Ready for the NCLEX® Examination! 105
Key Points 105
Safe and Effective Care Environment 105
Health Promotion and Maintenance 105
Psychosocial Integrity 105
Physiological Integrity 105
9 End-of-Life Care 106
Learning Outcomes 106
Safe and Effective Care Environment 106
Psychosocial Integrity 106
Physiological Integrity 106
Overview of Death and Dying 106
Perception of Death in the United States 106
Pathophysiology of Dying 107
Incidence of Death 107
Planning for End-of-Life and Advance Directives 107
Ethics and DNR Orders 107
Durable Power of Attorney for Health Care 108
Desired Outcomes for End-of-Life Care 108
Hospice and Palliative Care 108
Signs and Symptoms at End of Life 110
Overview 110
Patient-Centered Collaborative Care 111
Assessment 111
Physical Assessment/Clinical Manifestations 111
Psychosocial Assessment 111
Interventions 112
Pain Management 112
Complementary and Alternative Therapies. 112
Weakness Management 113
Breathlessness/Dyspnea Management 113
Nausea and Vomiting Management 114
Complementary and Alternative Therapies. 114
Restlessness and Agitation Management 115
Complementary and Alternative Therapies. 115
Seizure Management 115
Management of the Refractory Symptoms of Distress 115
Psychosocial Management 115
Assisting Patients During the Grieving Process. 115
Meeting Spiritual Needs. 117
Assisting with Survivor Bereavement. 117
Postmortem Care 118
Euthanasia 119
Get Ready for the NCLEX® Examination! 119
Key Points 119
Safe and Effective Care Environment 119
Psychosocial Integrity 120
Physiological Integrity 120
Unit II Concepts of Emergency Care and Disaster Preparedness 121
10 Concepts of Emergency and Trauma Nursing 121
Learning Outcomes 121
Safe and Effective Care Environment 121
Psychosocial Integrity 121
Physiological Integrity 121
The Emergency Department Environment of Care 122
Demographic Data 122
Special Nursing Teams 122
Interdisciplinary Team Collaboration 122
Prehospital Care Providers 122
Physicians and Other Health Care Providers 123
Support Staff 123
Inpatient Unit Staff 123
Staff and Patient Safety Considerations 124
Staff Safety 124
Patient Safety 124
Scope of Emergency Nursing Practice 125
Core Competencies 125
Training and Certification 127
Emergency Nursing Principles 127
Triage 127
Emergent, Urgent, and Nonurgent Categories 127
Other Multi-Tiered Models 128
Disposition 128
Case Management 129
Patient and Family Education 129
Death in the Emergency Department 129
Trauma Nursing Principles 130
Trauma Centers and Trauma Systems 130
Trauma Centers 130
Trauma Systems 131
Mechanism of Injury 131
Primary Survey and Resuscitation Interventions 132
A: Airway/Cervical Spine 132
B: Breathing 132
C: Circulation 133
D: Disability 133
E: Exposure 133
The Secondary Survey and Resuscitation Interventions 134
Disposition 134
Get Ready for The Nclex® Examination! 134
Key Points 134
Safe and Effective Care Environment 134
Psychosocial Integrity 135
Physiological Integrity 135
11 Care of Patients with Common Environmental Emergencies 136
Learning Outcomes 136
Safe and Effective Care Environment 136
Health Promotion and Maintenance 136
Physiological Integrity 136
Heat-Related Illnesses 136
Health Promotion and Maintenance 137
Heat Exhaustion 137
Unit III Management of Patients with Fluid, Electrolyte, and Acidbase Imbalances 165
13 Assessment and Care of Patients with Fluid and Electrolyte Imbalances 165
Learning Outcomes 165
Safe and Effective Care Environment 165
Health Promotion and Maintenance 165
Physiological Integrity 165
Homeostasis 166
Anatomy and Physiology Review 166
Physiologic Influences on Fluid and Electrolyte Balance 166
Filtration 166
Physiologic Action 166
Clinical Significance 166
Diffusion 167
Physiologic Action 167
Clinical Significance 168
Osmosis 168
Physiologic Action 168
Clinical Significance 169
Fluid Balance 169
Body Fluids 169
Hormonal Regulation of Fluid Balance 171
Significance of Fluid Balance 172
The Renin-Angiotensin II Pathway 172
Clinical Application 173
Fluid Imbalances 173
Dehydration 173
Pathophysiology 173
Health Promotion and Maintenance 174
Patient-Centered Collaborative Care 175
Assessment 175
History 175
Physical Assessment/Clinical Manifestations 175
Laboratory Assessment 176
Interventions 176
Fluid Overload 178
Pathophysiology 178
Patient-Centered Collaborative Care 178
Assessment 178
Interventions 179
Electrolyte Balance and Imbalances 180
Sodium 180
Hyponatremia 181
Pathophysiology 181
Patient-Centered Collaborative Care 181
Assessment 181
Interventions 182
Hypernatremia 182
Pathophysiology 182
Patient-Centered Collaborative Care 182
Assessment 182
Interventions 183
Potassium 183
Hypokalemia 183
Pathophysiology 183
Patient-Centered Collaborative Care 184
Assessment 184
Interventions 185
Hyperkalemia 186
Pathophysiology 186
Patient-Centered Collaborative Care 186
Assessment 186
Interventions 187
Calcium 187
Hypocalcemia 188
Pathophysiology 188
Patient-Centered Collaborative Care 189
Assessment 189
Interventions 190
Hypercalcemia 190
Pathophysiology 190
Patient-Centered Collaborative Care 190
Assessment 190
Interventions 191
Phosphorus 191
Hypophosphatemia 191
Pathophysiology 191
Patient-Centered Collaborative Care 191
Assessment 191
Interventions 192
Hyperphosphatemia 192
Magnesium 192
Hypomagnesemia 193
Unit IV Management of Perioperative Patients 239
16 Care of Preoperative Patients 239
Learning Outcomes 239
Safe and Effective Care Environment 239
Psychosocial Integrity 239
Physiological Integrity 239
Overview 240
Categories and Purposes of Surgery 240
Surgical Settings 240
Patient-Centered Collaborative Care 242
Assessment 242
History 242
Physical Assessment/Clinical Manifestations 246
Psychosocial Assessment 247
Laboratory Assessment 247
Imaging Assessment 248
Other Diagnostic Assessment 248
Analysis 248
Planning and Implementation 248
Providing Information 248
Planning: Expected Outcomes. 248
Interventions. 250
Ensuring Informed Consent. 250
Patient Self-Determination. 252
Implementing Dietary Restrictions. 252
Administering Regularly Scheduled Drugs. 253
Intestinal Preparation. 253
Skin Preparation. 254
Preparing the Patient for Tubes, Drains, and Vascular Access. 254
Postoperative Procedures and Exercises. 254
Procedures and Exercises to Prevent Respiratory Complications. 256
Procedures and Exercises to Prevent Cardiovascular Complications. 256
Minimizing Anxiety 258
Planning: Expected Outcomes. 258
Interventions. 258
Preoperative Chart Review 259
Preoperative Patient Preparation 259
Preoperative Drugs 260
Patient Transfer to the Surgical Suite 260
Evaluation: Outcomes 260
Get Ready for the Nclex® Examination! 262
Key Points 262
Safe and Effective Care Environment 262
Health Promotion and Maintenance 262
Psychosocial Integrity 262
Physiological Integrity 262
17 Care of Intraoperative Patients 263
Learning Outcomes 263
Safe and Effective Care Environment 263
Psychosocial Integrity 263
Physiological Integrity 263
Overview 264
Members of the Surgical Team 264
Surgeon and Surgical Assistant 264
Anesthesia Providers 264
Perioperative Nursing Staff 264
Preparation of the Surgical Suite and Team Safety 266
Layout 266
Minimally Invasive and Robotic Surgery 267
Health and Hygiene of the Surgical Team 267
Surgical Attire 267
Surgical Scrub 270
Anesthesia 270
General Anesthesia 271
Stages of General Anesthesia 271
Administration of General Anesthesia 273
Complications from General Anesthesia 273
Local or Regional Anesthesia 275
Local Anesthesia 275
Regional Anesthesia 275
Complications of Local or Regional Anesthesia 276
Moderate Sedation 276
Patient-Centered Collaborative Care 277
Assessment 277
History 277
Medical Record Review 278
Advance Directives and Do-Not-Resuscitate Orders. 278
Allergies and Previous Reactions to Anesthesia or Transfusions. 278
Autologous Blood Transfusion. 278
Laboratory and Diagnostic Test Results. 278
Medical History and Physical Examination Findings. 279
Analysis 279
Planning and Implementation 279
Preventing Injury 279
Planning: Expected Outcomes. 279
Interventions. 279
Preventing Infection 281
Concept Overview: Protection 301
Concept Overview 301
Protection 301
Unit V Problems of Protection: Management of Patients with Problems of the Immune System 302
19 Inflammation and the Immune Response 302
Learning Outcomes 302
Physiological Integrity 302
Overview 303
Self Versus Non-Self 303
Organization of the Immune System 304
Inflammation 305
Infection 306
Cell Types Involved in Inflammation 306
Neutrophils 306
Macrophages 307
Basophils 307
Eosinophils 307
Phagocytosis 307
Sequence of Inflammatory Responses 308
Immunity 309
Antibody-Mediated Immunity 309
Antigen-Antibody Interactions 309
Antibody Classification 312
Acquiring Antibody-Mediated Immunity 312
Cell-Mediated Immunity 313
Cell Types Involved in Cell-Mediated Immunity 313
Cytokines 314
Protection Provided by Cell-Mediated Immunity 314
Transplant Rejection 314
Hyperacute Rejection 315
Acute Rejection 315
Chronic Rejection 315
Management of Transplant Rejection 315
Get Ready for the Nclex® Examination! 316
key Points 316
Physiological Integrity 316
20 Care of Patients with Arthritis and Other Connective Tissue Diseases 318
Learning Outcomes 318
Safe and Effective Care Environment 318
Health Promotion and Maintenance 318
Psychosocial Integrity 318
Physiological Integrity 318
Osteoarthritis 319
Pathophysiology 319
Etiology and Genetic Risk 319
Incidence and Prevalence 320
Health Promotion and Maintenance 320
Patient-Centered Collaborative Care 320
Assessment 320
History 320
Physical Assessment/Clinical Manifestations 320
Psychosocial Assessment 321
Laboratory Assessment 321
Imaging Assessment 321
Analysis 321
Planning And Implementation 321
Managing Chronic Pain 321
Planning: Expected Outcomes. 321
Interventions. 321
Nonsurgical Management. 321
Drug Therapy. 322
Nonpharmacologic Interventions. 322
Complementary and Alternative Therapies. 323
Surgical Management. 323
Indications for Total Joint Arthroplasty. 323
Contraindications to Total Joint Arthroplasty. 323
Total Hip Arthroplasty. 324
Preoperative Care. 324
Operative Procedures. 324
Postoperative Care. 325
Preventing Hip Dislocation. 325
Preventing Venous Thromboembolism. 326
Preventing Infection. 327
Assessing for Bleeding and Managing Anemia. 327
Assessing for Neurovascular Compromise. 327
Managing Pain. 328
Promoting Mobility and Activity. 328
Promoting Self-Management. 328
Total Knee Arthroplasty. 329
Preoperative Care. 329
Operative Procedures. 329
Complementary and Alternative Therapies. 329
Postoperative Care. 329
Other Joint Arthroplasties. 330
Improving Mobility 331
Planning: Expected Outcomes. 331
Interventions. 331
Community-Based Care 332
Home Care Management 332
Teaching for Self-Management 332
Health Care Resources 332
Evaluation: Outcomes 333
Rheumatoid Arthritis 333
Pathophysiology 333
Patient-Centered Collaborative Care 333
Assessment 333
Physical Assessment/Clinical Manifestations 333
Early Disease Manifestations. 333
Late Disease Manifestations. 334
Joint Involvement. 334
Systemic Complications. 334
Associated Syndromes. 335
Psychosocial Assessment 335
Laboratory Assessment 335
Other Diagnostic Assessment 336
Interventions 336
Managing Inflammation and Pain 337
Drug Therapy. 337
Disease-Modifying Antirheumatic Drugs. 337
Nonsteroidal Anti-inflammatory Drugs. 337
Biological Response Modifiers. 337
Other Drugs. 340
Nonpharmacologic Interventions 341
Complementary and Alternative Therapies 341
Promoting Self-Management 341
Managing Fatigue 342
Enhancing Body Image 342
Community-Based Care 342
Home Care Management 342
Teaching for Self-Management 343
Health Care Resources 343
Lupus Erythematosus 343
Pathophysiology 343
Patient-Centered Collaborative Care 344
Assessment 344
Physical Assessment/Clinical Manifestations 344
Skin Involvement. 344
Other Manifestations. 345
Psychosocial Assessment 345
Laboratory Assessment 345
Interventions 345
Managing Lupus with Drug Therapy 346
Protecting the Skin 346
Community-Based Care 346
Systemic Sclerosis 347
Pathophysiology 347
Patient-Centered Collaborative Care 347
Assessment 347
Physical Assessment/Clinical Manifestations 347
Laboratory Assessment 348
Interventions 348
Community-Based Care 349
Gout 349
Pathophysiology 349
Patient-Centered Collaborative Care 349
Assessment 349
Acute Gout 349
Chronic Gout 349
Interventions 350
Drug Therapy 350
Nutrition Therapy 350
Other Connective Tissue Diseases 351
Polymyositis/Dermatomyositis 351
Systemic Necrotizing Vasculitis 351
Polymyalgia Rheumatica and Temporal Arteritis 351
Ankylosing Spondylitis 351
Reiter’s Syndrome 352
Marfan Syndrome 352
Infectious Arthritis 352
Lyme Disease 352
Pseudogout 353
Psoriatic Arthritis 353
Other Disease-Associated Arthritis 353
Fibromyalgia Syndrome 353
Chronic Fatigue Syndrome 354
Mixed Connective Tissue Disease 354
Nursing Concept Review 355
Perform and interpret focused physical assessment findings, including: 355
Respond: 355
Get Ready for the Nclex® Examination! 355
Key Points 355
Safe and Effective Care Environment 355
Health Promotion and Maintenance 355
Psychosocial Integrity 355
Physiological Integrity 356
21 Care of Patients with HIV Disease and Other Immune Deficiencies 357
Learning Outcomes 357
Safe and Effective Care Environment 357
Health Promotion and Maintenance 357
Psychosocial Integrity 357
Physiological Integrity 357
Acquired (Secondary) Immune Deficiencies 358
HIV InFection and AIDS 358
Pathophysiology 358
Etiology and Genetic Risk 358
The HIV Infectious Process. 358
HIV Classification. 360
HIV Progression. 361
Incidence/Prevalence 361
Health Promotion and Maintenance 361
Sexual Transmission 362
Parenteral Transmission 362
Perinatal Transmission 363
Transmission and Health Care Workers 363
Testing 363
Patient-Centered Collaborative Care 364
Assessment 364
History 365
Physical Assessment/Clinical Manifestations 365
Opportunistic Infections. 365
Malignancies. 367
Endocrine Complications. 367
Other Clinical Manifestations. 367
Psychosocial Assessment 368
Laboratory Assessment 368
Lymphocyte Counts. 368
Antibody Tests. 368
Viral Load Testing. 369
Other Laboratory Assessment. 369
Other Diagnostic Assessment 369
Analysis 370
Planning and Implementation 370
Preventing Infection 370
Planning: Expected Outcomes. 370
Interventions. 370
Drug Therapy. 370
Immune Enhancement. 375
Complementary and Alternative Therapies. 375
Enhancing Oxygenation 375
Planning: Expected Outcomes. 375
Interventions. 375
Managing Pain 376
Concept Overview: Oxygenation and Tissue Perfusion 541
Concept Overview 541
Oxygenation and Tissue Perfusion 541
Unit VII Problems of Oxygenation: Management of Patients with Problems of the Respiratory Tract 543
29 Assessment of the Respiratory System 543
Learning Outcomes 543
Health Promotion and Maintenance 543
Psychosocial Integrity 543
Physiological Integrity 543
Anatomy and Physiology Review 544
Upper Respiratory Tract 544
Nose and Sinuses 544
Pharynx 545
Larynx 545
Lower Respiratory Tract 546
Airways 546
Lungs 546
Accessory Muscles of Respiration 547
Oxygen Delivery and the Oxygen-Hemoglobin Dissociation Curve 547
Respiratory Changes Associated With Aging 548
Assessment methods 548
Patient History 548
Nutrition Status 550
Family History and Genetic Risk 550
Current Health Problems 550
Physical Assessment 551
Assessment of the Nose and Sinuses 551
Assessment of the Pharynx, Trachea, and Larynx 552
Assessment of the Lungs and Thorax 552
Inspection. 552
Palpation. 553
Percussion. 553
Auscultation. 553
Other Indicators of Respiratory Adequacy 555
Psychosocial Assessment 555
Diagnostic Assessment 556
Laboratory Assessment 556
Imaging Assessment 556
Other Noninvasive Diagnostic Assessment 556
Pulse Oximetry. 556
Capnometry and Capnography. 556
Pulmonary Function Tests. 558
Patient Preparation. 558
Procedure. 558
Follow-up Care. 558
Exercise Testing. 558
Skin Tests. 559
Other Invasive Diagnostic Assessment 559
Endoscopic Examinations. 559
Concept Overview: Mobility, Sensation, and Cognition 904
Concept Overview 904
Mobility, Sensation, and Cognition 904
Unit X Problems of Mobility, Sensation, and Cognition: Management of Patients with Problems of the Nervous System 905
43 Assessment of the Nervous System 905
Learning Outcomes 905
Safe and Effective Care Environment 905
Health Promotion and Maintenance 905
Psychosocial Integrity 905
Physiological Integrity 905
Anatomy and Physiology Review 906
Nervous System Cells: Structure and Function 906
Neurons 906
Neuroglial Cells 906
Central Nervous System: Structure and Function 906
Brain 906
Major Parts of the Brain. 907
Circulation in the Brain. 908
Spinal Cord 909
Ascending Tracts. 909
Descending Tracts. 909
Peripheral Nervous System: Structure and Function 910
Autonomic Nervous System: Structure and Function 911
Neurologic Changes Associated with Aging 911
Assessment Methods 913
Patient History 913
Family History and Genetic Risk 913
Current Health Problems 913
Physical Assessment 913
Assessment of Mental Status 913
Level of Consciousness and Orientation. 914
Memory and Attention. 914
Language and Higher Levels of Cognition. 915
Assessment of Cranial Nerves 915
Assessment of Sensory Function 915
Assessment of Motor Function 916
Assessment of Cerebellar Function 916
Assessment of Reflex Activity 916
Rapid Neurologic Assessment 917
Psychosocial Assessment 919
Diagnostic Assessment 919
Laboratory Assessment 919
Imaging Assessment 919
Plain X-Rays. 919
Cerebral Angiography. 919
Computed Tomography. 921
Magnetic Resonance Imaging. 921
Positron Emission Tomography. 922
Single-Photon Emission Computed Tomography. 922
Magnetoencephalography. 922
Other Diagnostic Assessment 922
Electromyography. 922
Electroencephalography. 922
Evoked Potentials. 923
Cerebral Blood Flow Evaluation. 923
Lumbar Puncture. 923
Transcranial Doppler Ultrasonography. 925
Muscle and Nerve Biopsies. 925
Nursing Concept Review 925
Physical assessment 925
Diagnostic assessment 925
Get Ready for the Nclex® Examination! 925
Key Points 925
Safe and Effective Care Environment 925
Health Promotion and Maintenance 925
Psychosocial Integrity 925
Physiological Integrity 926
44 Care of Patients with Problems of the Central Nervous System: 927
Learning Outcomes 927
Safe and Effective Care Environment 927
Health Promotion and Maintenance 927
Psychosocial Integrity 927
Physiological Integrity 927
Headaches 928
Migraine Headache 928
Pathophysiology 928
Patient-Centered Collaborative Care 928
Assessment 928
Interventions 929
Abortive Therapy 929
Preventive Therapy 930
Complementary and Alternative Therapies 931
Cluster Headache 931
Pathophysiology 931
Patient-Centered Collaborative Care 931
Assessment 931
Interventions 932
Seizures and Epilepsy 932
Pathophysiology 932
Types of Seizures 932
Etiology and Genetic Risk 933
Patient-Centered Collaborative Care 933
Assessment 933
Interventions 933
Nonsurgical Management 933
Drug Therapy. 933
Teaching for Self-Management. 933
Seizure Precautions. 935
Seizure Management. 935
Emergency Care: Acute Seizure and Status Epilepticus Management. 935
Surgical Management 936
Vagal Nerve Stimulation. 936
Conventional Surgical Procedures. 937
Infections 937
Meningitis 937
Pathophysiology 937
Patient-Centered Collaborative Care 938
Assessment 938
Physical Assessment/Clinical Manifestations 938
Laboratory Assessment 939
Other Diagnostic Assessment 939
Interventions 939
Encephalitis 940
Pathophysiology 940
Patient-Centered Collaborative Care 940
Assessment 940
Interventions 941
Parkinson Disease 941
Pathophysiology 941
Patient-Centered Collaborative Care 942
Assessment 942
Interventions 943
Nonsurgical Management 943
Drug Therapy. 943
Other Interventions. 944
Psychosocial Support. 945
Surgical Management 946
Stereotactic Pallidotomy/Thalamotomy. 946
Deep Brain Stimulation. 946
Fetal Tissue Transplantation. 946
Alzheimer’s Disease 946
Pathophysiology 946
Etiology and Genetic Risk 947
Incidence/Prevalence 947
Health Promotion and Maintenance 947
Patient-Centered Collaborative Care 947
Assessment 947
History 947
Physical Assessment/Clinical Manifestations 948
Stages of Alzheimer’s Disease. 948
Changes in Cognition. 948
Changes in Behavior and Personality. 949
Changes in Self-Management Skills. 949
Psychosocial Assessment 949
Laboratory Assessment 950
Imaging Assessment 950
Other Diagnostic Assessment 950
Analysis 950
Planning and Implementation 950
Managing Chronic Confusion 950
Planning: Expected Outcomes. 950
Interventions 950
Nonpharmacologic Management. 950
Drug Therapy. 952
Preventing Injury 952
Planning: Expected Outcomes. 952
Interventions. 952
Managing Caregiver Role Strain 954
Planning: Expected Outcomes. 954
Interventions. 954
Community-Based Care 954
Home Care Management 954
Teaching for Self-Management 955
Health Care Resources 955
Evaluation: Outcomes 955
Huntington Disease 955
Pathophysiology 955
Patient-Centered Collaborative Care 956
Nursing Concept Review 956
Perform and interpret physical assessment, including: 957
Respond by: 957
Get Ready for the Nclex® Examination! 957
Key Points 957
Safe and Effective Care Environment 957
Health Promotion and Maintenance 957
Psychosocial Integrity 957
Physiological Integrity 958
45 Care of Patients with Problems of the Central Nervous System 959
Learning Outcomes 959
Safe and Effective Care Environment 959
Health Promotion and Maintenance 959
Psychosocial Integrity 959
Physiological Integrity 959
Back Pain 960
Lumbosacral Back Pain (Low Back Pain) 960
Pathophysiology 960
Health Promotion and Maintenance 960
Patient-Centered Collaborative Care 961
Assessment 961
Physical Assessment/Clinical Manifestations 961
Diagnostic Assessment 961
Interventions 961
Nonsurgical Management 962
Acute Low Back Pain. 962
Chronic Low Back Pain. 962
Complementary and Alternative Therapies. 962
Surgical Management 963
Preoperative Care. 963
Operative Procedures. 963
Postoperative Care. 963
Minimally Invasive Surgery. 963
Conventional Open Surgery. 964
Community-Based Care 964
Home Care Management 964
Teaching for Self-Management 965
Health Care Resources 965
Cervical Neck Pain 966
Pathophysiology 966
Patient-Centered Collaborative Care 966
Spinal Cord Injury 967
Pathophysiology 967
Mechanisms of Injury 967
Etiology 968
Incidence/Prevalence 968
Patient-Centered Collaborative Care 968
Assessment 968
History 968
Physical Assessment/Clinical Manifestations 969
Initial Assessment. 969
Sensory and Motor Assessment. 969
Cardiovascular and Respiratory Assessment. 969
Gastrointestinal and Genitourinary Assessment. 970
Assessment of Patients for Long-Term Complications. 970
Psychosocial Assessment 970
Laboratory Assessment 970
Imaging Assessment 970
Analysis 970
Planning and Implementation 971
Managing the Airway and Improving Breathing 971
Concept Overview: Nutrition, Metabolism, and Bowel Elimination 1175
Concept Overview 1175
Nutrition, Metabolism, and Bowel Elimination 1175
Unit XIII Problems of Digestion, Nutrition, and Elimination: Management of Patients with Problems of the Gastrointestinal System 1177
55 Assessment of the Gastrointestinal System 1177
Learning Outcomes 1177
Safe and Effective Care Environment 1177
Health Promotion and Maintenance 1177
Psychosocial Integrity 1177
Physiological Integrity 1177
Anatomy and Physiology Review 1178
Overview of the Gastrointestinal System 1178
Structure 1178
Function 1178
Oral Cavity 1179
Esophagus 1179
Stomach 1179
Pancreas 1179
Liver and Gallbladder 1179
Small Intestine 1180
Large Intestine 1180
Gastrointestinal Changes Associated with Aging 1180
Assessment Methods 1181
Patient History 1181
Nutrition History 1181
Family History and Genetic Risk 1182
Current Health Problems 1182
Physical Assessment 1183
Inspection 1183
Auscultation 1184
Percussion 1184
Palpation 1184
Psychosocial Assessment 1184
Diagnostic Assessment 1184
Laboratory Assessment 1184
Serum Tests. 1184
Urine Tests. 1185
Stool Tests. 1185
Imaging Assessment 1185
Other Diagnostic Assessment 1187
Endoscopy. 1187
Esophagogastroduodenoscopy. 1187
Endoscopic Retrograde Cholangiopancreatography. 1188
Small Bowel Capsule Endoscopy. 1188
Colonoscopy. 1189
Patient Preparation. 1189
Procedure. 1189
Follow-up Care. 1189
Virtual Colonoscopy. 1189
Sigmoidoscopy. 1190
Gastric Analysis. 1190
Ultrasonography. 1190
Endoscopic Ultrasonography. 1191
Liver-Spleen Scan. 1191
Nursing Concept Review 1191
Physical Assessment 1191
Diagnostic Assessment 1191
Get Ready for the NCLEX® Examination! 1191
Key Points 1191
Safe and Effective Care Environment 1191
Health Promotion and Maintenance 1191
Psychosocial Integrity 1191
Physiological Integrity 1191
56 Care of Patients with Oral Cavity Problems 1192
Learning Outcomes 1192
Safe and Effective Care Environment 1192
Health Promotion and Maintenance 1192
Psychosocial Integrity 1192
Physiological Integrity 1192
Stomatitis 1193
Pathophysiology 1193
Patient-Centered Collaborative Care 1194
Assessment 1194
Interventions 1194
Oral Tumors 1195
Premalignant Lesions 1195
Leukoplakia 1195
Erythroplakia 1195
Oral Cancer 1195
Pathophysiology 1196
Squamous Cell Carcinoma 1196
Basal Cell Carcinoma 1196
Kaposi’s Sarcoma 1196
Patient-Centered Collaborative Care 1196
Assessment 1196
Interventions 1197
Nonsurgical Management 1197
Surgical Management 1198
Preoperative Care. 1198
Operative Procedures. 1198
Postoperative Care. 1198
Community-Based Care 1199
Home Care Management 1199
Teaching for Self-Management 1200
Health Care Resources 1200
Disorders Of The Salivary Glands 1200
Acute Sialadenitis 1200
Pathophysiology 1200
Patient-Centered Collaborative Care 1201
Post-Irradiation Sialadenitis 1201
Salivary Gland Tumors 1201
Nursing Concept Review 1201
Perform and interpret focused physical assessment findings, including: 1201
Respond: 1202
Get ready for the NCLEX® examination! 1202
Key Points 1202
Safe and Effective Care Environment 1202
Health Promotion and Maintenance 1202
Psychosocial Integrity 1202
Physiological Integrity 1202
57 Care of Patients with Esophageal Problems 1203
Learning Outcomes 1203
Safe and Effective Care Environment 1203
Health Promotion and Maintenance 1203
Psychosocial Integrity 1203
Physiological Integrity 1203
Gastroesophageal Reflux Disease 1203
Pathophysiology 1203
Patient-Centered Collaborative Care 1204
Assessment 1204
Physical Assessment/Clinical Manifestations 1204
Diagnostic Assessment 1205
Interventions 1205
Nonsurgical Management 1205
Nonpharmacologic Interventions. 1205
Drug Therapy. 1206
Endoscopic Therapies. 1208
Surgical Management 1208
Hiatal Hernia 1208
Pathophysiology 1208
Patient-Centered Collaborative Care 1209
Assessment 1209
Interventions 1209
Nonsurgical Management 1210
Surgical Management 1210
Preoperative Care. 1210
Operative Procedures. 1210
Postoperative Care. 1210
Community-Based Care 1211
Esophageal Tumors 1211
Pathophysiology 1211
Patient-Centered Collaborative Care 1212
Assessment 1212
History 1212
Physical Assessment/Clinical Manifestations 1212
Psychosocial Assessment 1212
Diagnostic Assessment 1213
Analysis 1213
Planning and Implementation 1213
Promoting Nutrition 1213
Planning: Expected Outcomes. 1213
Interventions. 1213
Nonsurgical Management. 1213
Surgical Management. 1214
Preoperative Care. 1215
Operative Procedures. 1215
Postoperative Care. 1215
Community-Based Care 1217
Home Care Management 1217
Teaching for Self-Management 1217
Health Care Resources 1217
Evaluation: Expected Outcomes 1217
Esophageal Diverticula 1217
Esophageal Trauma 1218
Nursing Concept Review 1218
Perform and interpret focused physical findings, including: 1218
Respond by: 1218
Get Ready FOR the NCLEX® Examination! 1219
Key Points 1219
Safe and Effective Care Environment 1219
Health Promotion and Maintenance 1219
Psychosocial Integrity 1219
Physiological Integrity 1219
58 Care of Patients with Stomach Disorders 1220
Learning Outcomes 1220
Safe and Effective Care Environment 1220
Health Promotion and Maintenance 1220
Psychosocial Integrity 1220
Physiological Integrity 1220
Gastritis 1220
Pathophysiology 1221
Types of Gastritis 1221
Etiology and Genetic Risk 1221
Acute Gastritis. 1221
Chronic Gastritis. 1221
Health Promotion and Maintenance 1221
Patient-Centered Collaborative Care 1222
Assessment 1222
Interventions 1222
Peptic Ulcer Disease 1225
Pathophysiology 1225
Types of Ulcers 1225
Complications of Ulcers 1226
Etiology and Genetic Risk 1227
Incidence/Prevalence 1227
Health Promotion and Maintenance 1227
Patient-Centered Collaborative Care 1227
Assessment 1227
History 1227
Physical Assessment/Clinical Manifestations 1228
Psychosocial Assessment 1228
Laboratory Assessment 1228
Imaging Assessment 1229
Other Diagnostic Assessment 1229
Analysis 1229
Planning and Implementation 1229
Managing Acute Pain or Chronic Pain 1229
Planning: Expected Outcomes. 1229
Interventions. 1229
Drug Therapy. 1229
Nutrition Therapy. 1230
Complementary and Alternative Therapies. 1230
Managing Upper GI Bleeding 1230
Planning: Expected Outcomes. 1230
Interventions. 1230
Nonsurgical Management. 1230
Emergency: Upper GI Bleeding. 1231
Nasogastric Tube Placement and Lavage. 1231
Endoscopic Therapy. 1231
Interventional Radiologic Procedures. 1231
Acid Suppression. 1231
Surgical Management. 1232
Community-Based Care 1232
Home Care Management 1233
Teaching for Self-Management 1233
Health Care Resources 1233
Evaluation: Outcomes 1233
Zollinger-Ellison Syndrome 1233
Pathophysiology 1233
Patient-Centered Collaborative Care 1234
Gastric Cancer 1234
Pathophysiology 1234
Etiology and Genetic Risk 1234
Incidence/Prevalence 1234
Health Promotion and Maintenance 1234
Patient-Centered Collaborative Care 1235
Assessment 1235
Interventions 1235
Nonsurgical Management 1235
Surgical Management 1235
Preoperative Care. 1236
Operative Procedures. 1236
Postoperative Care. 1236
Community-Based Care 1238
Home Care Management 1238
Teaching for Self-Management 1238
Health Care Resources 1238
Nursing Concept Review 1238
Perform and interpret physical assessment, including: 1238
Respond by: 1238
Get Ready for the NCLEX® Examination! 1239
Key Points 1239
Safe and Effective Care Environment 1239
Health Promotion and Maintenance 1239
Psychosocial Integrity 1239
Physiological Integrity 1239
59 Care of Patients with Noninflammatory Intestinal Disorders 1240
Learning Outcomes 1240
Safe and Effective Care Environment 1240
Health Promotion and Maintenance 1240
Psychosocial Integrity 1240
Physiological Integrity 1240
Irritable Bowel Syndrome 1240
Pathophysiology 1240
Patient-Centered Collaborative Care 1241
Assessment 1241
Interventions 1242
Complementary and Alternative Therapies 1242
Herniation 1243
Pathophysiology 1243
Health Promotion and Maintenance 1243
Patient-Centered Collaborative Care 1244
Assessment 1244
Interventions 1244
Nonsurgical Management 1244
Surgical Management 1244
Colorectal Cancer 1245
Pathophysiology 1245
Etiology and Genetic Risk 1245
Incidence/Prevalence 1246
Health Promotion and Maintenance 1246
Patient-Centered Collaborative Care 1246
Assessment 1246
History 1246
Physical Assessment/Clinical Manifestations 1246
Psychosocial Assessment 1247
Laboratory Assessment 1247
Imaging Assessment 1247
Other Diagnostic Assessment 1247
Analysis 1247
Planning and Implementation 1247
Preventing or Controlling Metastasis 1247
Planning: Expected Outcomes. 1247
Interventions. 1247
Nonsurgical Management. 1248
Radiation Therapy. 1248
Drug Therapy. 1248
Surgical Management. 1248
Preoperative Care. 1248
Operative Procedures. 1249
Postoperative Care. 1249
Colostomy Management. 1249
Wound Management. 1251
Assisting with the Grieving Process 1251
Planning: Expected Outcomes. 1251
Interventions. 1251
Community-Based Care 1252
Home Care Management 1252
Teaching for Self-Management 1252
Colostomy Care. 1252
Psychosocial Concerns. 1253
Health Care Resources 1253
Evaluation: Outcomes 1254
Intestinal Obstruction 1254
Pathophysiology 1254
Etiology 1254
Incidence/Prevalence 1255
Patient-Centered Collaborative Care 1255
Assessment 1255
History 1255
Physical Assessment/Clinical Manifestations 1255
Laboratory Assessment 1256
Imaging Assessment 1256
Other Diagnostic Assessment 1256
Interventions 1256
Nonsurgical Management 1256
Nasogastric Tubes. 1256
Other Nonsurgical Interventions. 1256
Surgical Management 1257
Preoperative Care. 1257
Operative Procedures. 1257
Postoperative Care. 1257
Community-Based Care 1257
Home Care Management 1258
Teaching for Self-Management 1258
Health Care Resources 1258
Abdominal Trauma 1258
Pathophysiology 1258
Patient-Centered Collaborative Care 1258
Assessment 1258
Interventions 1259
Emergency Care: Abdominal Trauma 1259
Intra-abdominal Pressure Monitoring 1259
Surgical Management 1260
Polyps 1260
Concept Overview: Urinary Elimination 1463
Concept Overview 1463
Urinary Elimination 1463
Unit XV Problems of Excretion: Management of Patients with Problems of the Renal/Urinary System 1465
68 Assessment of the Renal/Urinary System 1465
Learning Outcomes 1465
Safe and Effective Care Environment 1465
Health Promotion and Maintenance 1465
Psychosocial Integrity 1465
Physiological Integrity 1465
Anatomy and Physiology Review 1466
Kidneys 1466
Structure 1466
Gross Anatomy. 1466
Microscopic Anatomy. 1466
Function 1468
Regulatory Functions. 1468
Hormonal Functions. 1470
Ureters 1471
Urinary Bladder 1471
Structure 1471
Function 1472
Urethra 1472
Kidney and Urinary System Changes Associated with Aging 1472
Kidney Changes 1472
Urinary Changes 1473
Assessment Methods 1473
Patient History 1473
Nutrition History 1474
Medication History 1475
Family History and Genetic Risk 1475
Current Health Problems 1475
Physical Assessment 1475
Assessment of the Kidneys, Ureters, and Bladder 1475
Assessment of the Urethra 1476
Psychosocial Assessment 1476
Diagnostic Assessment 1476
Laboratory Assessment 1476
Blood Tests. 1476
Urine Tests 1477
Urinalysis. 1477
Urine for Culture and Sensitivity. 1480
Composite Urine Collections. 1480
Creatinine Clearance. 1481
Urine Electrolytes. 1481
Urine Osmolarity. 1481
Bedside Sonography/Bladder Scanners. 1482
Imaging Assessment 1482
Kidney, Ureter, and Bladder X-rays. 1482
Intravenous Urography. 1482
Patient Preparation. 1482
Procedure. 1484
Follow-up Care. 1484
Computed Tomography. 1484
Cystography and Cystourethrography. 1485
Renography (Kidney Scan). 1485
Ultrasonography. 1485
Renal Arteriography (Angiography). 1485
Cystoscopy and Cystourethroscopy 1485
Patient Preparation. 1485
Procedure. 1485
Follow-up Care. 1485
Retrograde Procedures. 1486
Other Diagnostic Assessments 1486
Urodynamic Studies. 1486
Kidney Biopsy 1486
Patient Preparation. 1486
Procedure. 1487
Follow-up Care. 1487
Nursing Concept Review 1487
Vital signs 1487
Physical assessment 1487
Psychological assessment 1487
Laboratory assessment 1487
Get Ready for the Nclex® Examination! 1488
Key Points 1488
Safe and Effective Care Environment 1488
Health Promotion and Maintenance 1488
Psychosocial Integrity 1488
Physiological Integrity 1488
69 Care of Patients with Urinary Problems 1489
Learning Outcomes 1489
Safe and Effective Care Environment 1489
Health Promotion and Maintenance 1489
Psychosocial Integrity 1489
Physiological Integrity 1489
Infectious Disorders 1490
Cystitis 1490
Pathophysiology 1490
Etiology and Genetic Risk 1491
Incidence/Prevalence 1492
Health Promotion and Maintenance 1492
Patient-Centered Collaborative Care 1492
Assessment 1492
Physical Assessment/Clinical Manifestations 1492
Laboratory Assessment 1493
Other Diagnostic Assessment 1493
Interventions 1494
Nonsurgical Management 1494
Drug Therapy. 1494
Nutrition Therapy. 1494
Comfort Measures. 1494
Surgical Management 1494
Community-Based Care 1494
Urethritis 1496
Pathophysiology 1496
Patient-Centered Collaborative Care 1497
Noninfectious Disorders 1497
Urethral Strictures 1497
Urinary Incontinence 1497
Pathophysiology 1497
Etiology and Genetic Risk 1499
Incidence/Prevalence 1499
Patient-Centered Collaborative Care 1499
Assessment 1499
History 1499
Physical Assessment/Clinical Manifestations 1500
Laboratory Assessment 1500
Imaging Assessment 1500
Other Diagnostic Assessment 1500
Analysis 1500
Planning and Implementation 1501
Reducing Stress Urinary Incontinence 1501
Planning: Expected Outcomes. 1501
Interventions. 1501
Nonsurgical Management. 1501
Surgical Management. 1502
Preoperative Care. 1502
Operative Procedures. 1502
Postoperative Care. 1502
Reducing Urge Urinary Incontinence 1503
Planning: Expected Outcomes. 1503
Interventions. 1503
Drug Therapy. 1503
Nutrition Therapy. 1504
Behavioral Interventions. 1504
Reducing Reflex Urinary Incontinence 1505
Concept Overview: Sexuality 1574
Concept Overview 1574
Sexuality 1574
Unit XVI Problems of Reproduction: Management of Patients with Problems of the Reproductive System 1575
72 Assessment of the Reproductive System 1575
Learning Outcomes 1575
Health Promotion and Maintenance 1575
Psychosocial Integrity 1575
Physiological Integrity 1575
Anatomy and Physiology Review 1576
Structure and Function of the Female Reproductive System 1576
External Genitalia 1576
Internal Genitalia 1576
Breasts 1577
Structure and Function of the Male Reproductive System 1577
Reproductive Changes Associated with Aging 1578
Assessment Methods 1578
Patient History 1578
Nutrition History 1579
Family History and Genetic Risk 1579
Current Health Problems 1580
Physical Assessment 1580
Assessment of the Female Reproductive System 1580
Assessment of the Male Reproductive System 1581
Psychosocial Assessment 1581
Diagnostic Assessment 1581
Laboratory Assessment 1581
Imaging Assessment 1583
General X-rays. 1583
Computed Tomography. 1583
Hysterosalpingography. 1583
Mammography. 1583
Other Diagnostic Assessment 1583
Ultrasonography. 1583
Magnetic Resonance Imaging. 1584
Endoscopic Studies 1584
Colposcopy. 1584
Laparoscopy. 1584
Patient Preparation. 1584
Procedure. 1584
Follow-up Care. 1585
Hysteroscopy. 1585
Biopsy Studies 1585
Cervical Biopsy. 1585
Endometrial Biopsy. 1585
Breast Biopsy. 1586
Prostate Biopsy. 1586
Nursing Concept Review 1586
Physical assessment 1586
Psychosocial assessment 1586
Laboratory assessment 1586
Get Ready for the Nclex® Examination! 1587
Key Points 1587
Health Promotion and Maintenance 1587
Psychosocial Integrity 1587
Physiological Integrity 1587
73 Care of Patients with Breast Disorders 1588
Learning Outcomes 1588
Safe and Effective Care Environment 1588
Health Promotion and Maintenance 1588
Psychosocial Integrity 1588
Physiological Integrity 1588
Benign Breast Disorders 1588
Fibroadenoma 1589
Fibrocystic Breast Condition 1589
Pathophysiology 1589
Patient-Centered Collaborative Care 1589
Ductal Ectasia 1590
Intraductal Papilloma 1590
Issues of Large-Breasted Women 1590
Issues of Small-Breasted Women 1590
Gynecomastia 1591
Breast Cancer 1591
Pathophysiology 1591
Noninvasive Breast Cancers 1591
Invasive Breast Cancers 1592
Breast Cancer in Men 1592
Breast Cancer in Young Women 1592
Etiology and Genetic Risk 1592
Incidence/Prevalence 1593
Health Promotion and Maintenance 1593
Mammography 1594
Breast Self-Awareness/Self-Examination 1594
Clinical Breast Examination 1595
Options for High-Risk Women 1597
Patient-Centered Collaborative Care 1597
Assessment 1597
History 1597
Physical Assessment/Clinical Manifestations 1598
Psychosocial Assessment 1598
Laboratory Assessment 1598
Imaging Assessment 1598
Other Diagnostic Assessment 1599
Analysis 1599
Planning and Implementation 1599
Developing Coping Strategies 1599
Bibliography 1668
Chapter 1 1668
Chapter 2 1668
Chapter 3 1669
Chapter 4 1670
Chapter 5 1670
Chapter 6 1671
Chapter 7 1671
Chapter 8 1672
Chapter 9 1673
Chapter 10 1673
Chapter 11 1674
Chapter 12 1675
Chapter 13 1675
Chapter 14 1676
Chapter 15 1676
Chapter 16 1677
Chapter 17 1678
Chapter 18 1679
Chapter 19 1680
Chapter 20 1680
Chapter 21 1681
Chapter 22 1682
Chapter 23 1683
Chapter 24 1683
Chapter 25 1684
Chapter 26 1685
Chapter 27 1685
Chapter 28 1687
Chapter 29 1688
Chapter 30 1688
Chapter 31 1689
Chapter 32 1689
Chapter 33 1690
Chapter 34 1691
Chapter 35 1692
Chapter 36 1693
Chapter 37 1695
Chapter 38 1696
Chapter 39 1697
Chapter 40 1697
Chapter 41 1698
Chapter 42 1698
Chapter 43 1700
Chapter 44 1700
Chapter 45 1701
Chapter 46 1701
Chapter 47 1702
Chapter 48 1702
Chapter 49 1703
Chapter 50 1703
Chapter 51 1703
Chapter 52 1704
Chapter 53 1704
Chapter 54 1705
Chapter 55 1706
Chapter 56 1706
Chapter 57 1706
Chapter 58 1707
Chapter 59 1707
Chapter 60 1708
Chapter 61 1708
Chapter 62 1709
Chapter 63 1709
Chapter 64 1710
Chapter 65 1710
Chapter 66 1711
Chapter 67 1711
Chapter 68 1712
Chapter 69 1712
Chapter 70 1713
Chapter 71 1714
Chapter 72 1716
Chapter 73 1716
Chapter 74 1717
Chapter 75 1717
Chapter 76 1718
Appendixes 1720
Appendix A Do-Not-Use Abbreviations and Symbols 1720
Appendix B Communication Quick Reference for Spanish-Speaking Patients 1723
The Body—El Cuerpo (ehl koo-EHR-poh) 1723
Common Instructions to Be Used with the Body Parts 1723
More Parts of the Body 1724
Organs 1724
Essential Phrases 1724
Description of Pain 1725
Preliminary Examination 1725
Obtaining a Blood Sample 1725
Obtaining Blood from a Finger Stick 1726
Obtaining a Urine Sample 1726
Obtaining a Stool Specimen 1726
Obtaining a Sputum Specimen 1726
Orders 1726
Description of Tubes 1726
Glossary 1727
A 1727
B 1731
C 1733
D 1738
E 1740
F 1742
G 1743
H 1744
I 1747
J 1749
K 1749
L 1750
M 1751
N 1754
O 1755
P 1757
Q 1762
R 1762
S 1764
T 1767
U 1769
V 1770
W 1771
X 1771
Z 1772
NCLEX® Examination Challenges—Answer Key AK1
Chapter 2 AK1
Chapter 3 AK1
Chapter 4 AK1
Chapter 5 AK1
Chapter 8 AK1
Chapter 9 AK1
Chapter 10 AK1
Chapter 11 AK1
Chapter 12 AK1
Chapter 13 AK1
Chapter 14 AK1
Chapter 15 AK1
Chapter 16 AK1
Chapter 17 AK1
Chapter 18 AK1
Chapter 20 AK1
Chapter 21 AK1
Chapter 22 AK1
Chapter 24 AK1
Chapter 25 AK1
Chapter 26 AK1
Chapter 27 AK1
Chapter 28 AK1
Chapter 29 AK1
Chapter 30 AK1
Chapter 31 AK1
Chapter 32 AK1
Chapter 33 AK1
Chapter 34 AK1
Chapter 35 AK1
Chapter 36 AK1
Chapter 37 AK1
Chapter 38 AK1
Chapter 39 AK1
Chapter 40 AK1
Chapter 41 AK1
Chapter 42 AK1
Chapter 43 AK1
Chapter 44 AK1
Chapter 45 AK1
Chapter 46 AK1
Chapter 47 AK1
Chapter 48 AK1
Chapter 49 AK2
Chapter 50 AK2
Chapter 51 AK2
Chapter 52 AK2
Chapter 53 AK2
Chapter 54 AK2
Chapter 55 AK2
Chapter 56 AK2
Chapter 57 AK2
Chapter 58 AK2
Chapter 59 AK2
Chapter 60 AK2
Chapter 61 AK2
Chapter 62 AK2
Chapter 63 AK2
Chapter 64 AK2
Chapter 65 AK2
Chapter 66 AK2
Chapter 67 AK2
Chapter 68 AK2
Chapter 69 AK2
Chapter 70 AK2
Chapter 71 AK2
Chapter 72 AK2
Chapter 73 AK2
Chapter 74 AK2
Chapter 75 AK2
Chapter 76 AK2
Illustration Credits IC1
Chapter 2 IC1
Chapter 3 IC1
Chapter 4 IC1
Chapter 5 IC1
Chapter 6 IC1
Chapter 7 IC1
Chapter 8 IC1
Chapter 9 IC1
Chapter 10 IC1
Chapter 11 IC1
Chapter 12 IC1
Chapter 13 IC1
Chapter 14 IC1
Chapter 15 IC1
Chapter 16 IC1
Chapter 17 IC2
Chapter 18 IC2
Chapter 19 IC2
Chapter 20 IC2
Chapter 21 IC2
Chapter 22 IC2
Chapter 23 IC2
Chapter 24 IC2
Chapter 25 IC2
Chapter 26 IC2
Chapter 27 IC2
Chapter 28 IC2
Chapter 29 IC2
Chapter 30 IC2
Chapter 31 IC2
Chapter 32 IC3
Chapter 33 IC3
Chapter 34 IC3
Chapter 36 IC3
Chapter 37 IC3
Chapter 38 IC3
Chapter 40 IC3
Chapter 42 IC3
Chapter 44 IC3
Chapter 45 IC3
Chapter 47 IC3
Chapter 48 IC3
Chapter 49 IC3
Chapter 52 IC3
Chapter 54 IC3
Chapter 56 IC4
Chapter 59 IC4
Chapter 60 IC4
Chapter 63 IC4
Chapter 64 IC4
Chapter 65 IC4
Chapter 67 IC4
Chapter 68 IC4
Chapter 69 IC4
Chapter 70 IC4
Chapter 71 IC4
Chapter 73 IC4
Chapter 75 IC4
Chapter 76 IC4
Index I1
A I1
B I7
C I12
D I23
E I27
F I31
G I34
H I36
I I42
J I47
K I48
L I49
M I52
N I56
O I59
P I61
Q I71
R I71
S I75
T I82
U I86
V I88
W I90
X I91
Y I92
Z I92
Inside back cover ibc1