BOOK
Nursing Interventions & Clinical Skills - E-Book
Anne Griffin Perry | Patricia A. Potter | Wendy Ostendorf
(2015)
Additional Information
Book Details
Abstract
Master nursing skills with this guide from the respected Perry, Potter & Ostendorf author team! The concise coverage in Nursing Interventions & Clinical Skills, 6th Edition makes it easy to master the clinical skills required in everyday nursing practice. Clear guidelines address 159 basic, intermediate, and advanced skills — from measuring body temperature to insertion of a peripheral intravenous device — and step-by-step instructions emphasize the use of evidence-based concepts to improve patient safety and outcomes. Its friendly, easy-to-read writing style includes a streamlined format and an Evolve companion website with review questions and handy checklists for each skill.
- Coverage of 159 skills and interventions addresses basic, intermediate, and advanced skills you'll use every day in practice.
- UNIQUE! Using Evidence in Nursing Practice chapter provides the information needed to use evidence-based practice to solve clinical problems.
- Safe Patient Care Alerts highlight unusual risks in performing skills, so you can plan ahead at each step of nursing care.
- Delegation & Collaboration guidelines help you make decisions in whether to delegate a skill to unlicensed assistive personnel, and indicates what key information must be shared.Â
- Special Considerations indicate additional risks or accommodations you may face when caring for pediatric or geriatric patients, and patients in home care settings.
- Documentation guidelines include samples of nurses’ notes showing what should be reported and recorded after performing skills.
- A consistent format for nursing skills makes it easier to perform skills, always including Assessment, Planning, Implementation, and Evaluation.
- A Glove icon identifies procedures in which clean gloves should be worn or gloves should be changed in order to minimize the risk of infection.
- Media resources include skills performance checklists on the Evolve companion website and related lessons, videos, and interactive exercises on Nursing Skills Online.
- NEW coverage of evidence-based techniques to improve patient safety and outcomes includes the concept of care bundles, structured practices that have been proven to improve the quality of care, and teach-back, a new step that shows how you can evaluate your success in patient teaching.
- NEW! Coverage of HCAHPS (Hospital Care Quality Information from the Consumer Perspective) introduces a concept now widely used to evaluate hospitals across the country.Â
- NEW! Teach-Back step shows how to evaluate the success of patient teaching, so you can be sure that the patient has mastered a task or consider trying additional teaching methods.Â
- NEW! Updated 2012 Infusion Nurses Society standards are incorporated for administering IVs, as well as other changes in evidence-based practice.
- NEW topics include communication with cognitively impaired patients, discharge planning and transitional care, and compassion fatigue for professional and family caregivers.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Brief TOC | IFC2 | ||
| Quick Reference for Standard Protocol for All Nursing Interventions | i | ||
| Before the Skill | i | ||
| During the Skill | i | ||
| Completion Protocol (End of Skill) | i | ||
| Evolve page | ii | ||
| Nursing Interventions & Clinical Skills 6E | iii | ||
| Copyright Page | iv | ||
| About the Authors | v | ||
| Anne Griffin Perry, RN, EdD, FAAN | v | ||
| Patricia A. Potter, RN, MSN, PhD, FAAN | v | ||
| Wendy R. Ostendorf, RN, MS, EdD, CNE | v | ||
| Consultants and Contributors | vi | ||
| Reviewers | viii | ||
| Acknowledgments | xi | ||
| Notes from the Authors | xi | ||
| Preface to the Student | xii | ||
| Preface to the Instructor | xiv | ||
| Key Features | xiv | ||
| New to this Edition | xiv | ||
| Ancillaries | xiv | ||
| Table Of Contents | xvi | ||
| Unit 1 Quality and Safety in Nursing Practice | 1 | ||
| 1 Using Evidence in Nursing Practice | 1 | ||
| Evolve Website/Resources List | 1 | ||
| Comparing Evidence-Based Practice with Research and Performance Improvement | 2 | ||
| Steps of Evidence-Based Practice | 3 | ||
| Ask a Clinical Question | 3 | ||
| Problem-Focused Trigger | 3 | ||
| Knowledge-Focused Trigger | 3 | ||
| Collect the Best Evidence | 4 | ||
| Critique the Evidence | 7 | ||
| Apply the Evidence | 8 | ||
| Evaluate the Practice Change | 8 | ||
| Share the Outcomes with Others | 9 | ||
| Evidence in Nursing Skills | 9 | ||
| Critical Thinking Exercises | 9 | ||
| Case Study | 9 | ||
| Review Questions | 10 | ||
| References | 11 | ||
| 2 Communication and Collaboration | 12 | ||
| Evolve Website/Resources List | 12 | ||
| Patient-Centered Care | 13 | ||
| Safety | 16 | ||
| Evidence-Based Practice | 16 | ||
| Skill 2.1 Establishing the Nurse-Patient Relationship and Interviewing | 16 | ||
| Assessment | 17 | ||
| Planning | 18 | ||
| Expected Outcomes | 18 | ||
| Delegation and Collaboration | 18 | ||
| Implementation for Establishing the Nurse-Patient Relationship and Interviewing | 19 | ||
| Evaluation | 21 | ||
| Unexpected Outcomes and Related Interventions | 21 | ||
| Recording and Reporting | 21 | ||
| Sample Documentation | 22 | ||
| Special Considerations | 22 | ||
| Pediatric | 22 | ||
| Geriatric | 22 | ||
| Home Care | 22 | ||
| Skill 2.2 Communicating with Patients Who Have Difficulty Coping | 22 | ||
| Assessment | 23 | ||
| Planning | 23 | ||
| Expected Outcomes | 23 | ||
| Delegation and Collaboration | 23 | ||
| Implementation for Communicating with Patients Who Have Difficulty Coping | 24 | ||
| Evaluation | 25 | ||
| Unexpected Outcomes and Related Interventions | 25 | ||
| Recording and Reporting | 25 | ||
| Sample Documentation | 25 | ||
| Special Considerations | 25 | ||
| Pediatric | 25 | ||
| Geriatric | 25 | ||
| Home Care Considerations | 25 | ||
| Skill 2.3 Communicating with Cognitively Impaired Patients | 26 | ||
| Assessment | 26 | ||
| Planning | 26 | ||
| Expected Outcomes | 26 | ||
| Delegation and Collaboration | 26 | ||
| Implementation for Communicating with Cognitively Impaired Patients | 26 | ||
| Evaluation | 27 | ||
| Unexpected Outcomes and Related Interventions | 27 | ||
| Recording and Reporting | 27 | ||
| Sample Documentation | 27 | ||
| Special Considerations | 27 | ||
| Pediatric | 27 | ||
| Geriatric | 27 | ||
| Home Care Considerations | 27 | ||
| Improving Interprofessional Communication | 27 | ||
| Procedural Guideline 2.1 Hand-Off Communications | 28 | ||
| Delegation and Collaboration | 28 | ||
| Equipment | 28 | ||
| Procedural Steps | 28 | ||
| Procedural Guideline 2.2 SBAR Communication | 29 | ||
| Delegation and Collaboration | 29 | ||
| Procedural Steps | 29 | ||
| Skill 2.4 Discharge Planning and Transitional Care | 29 | ||
| Assessment | 29 | ||
| Expected Outcomes | 30 | ||
| Delegation and Collaboration | 30 | ||
| Implementation for Discharge Planning and Transitional Care | 30 | ||
| Evaluation | 31 | ||
| Unexpected Outcomes and Related Interventions | 31 | ||
| Recording and Reporting | 32 | ||
| Sample Documentation | 32 | ||
| Special Considerations | 32 | ||
| Pediatric | 32 | ||
| Geriatric | 32 | ||
| Home Care Considerations | 32 | ||
| Critical Thinking Questions | 32 | ||
| Case Study | 32 | ||
| Review Questions | 33 | ||
| References | 34 | ||
| 3 Documentation and Informatics | 35 | ||
| Evolve Website/Resources List | 35 | ||
| Patient-Centered Care | 35 | ||
| Safety | 35 | ||
| Electronic Health Record | 36 | ||
| Evidence-Based Practice | 36 | ||
| Confidentiality | 36 | ||
| Legal Guidelines in Documentation | 37 | ||
| Standards | 37 | ||
| Guidelines for Quality Documentation | 37 | ||
| Factual | 37 | ||
| Accurate | 37 | ||
| Complete | 37 | ||
| Concise | 38 | ||
| Current | 38 | ||
| Organized | 38 | ||
| Methods of Recording | 39 | ||
| Procedural Guideline 3.1 Documenting Nurses’ Progress Notes | 39 | ||
| Delegation and Collaboration | 40 | ||
| Equipment | 40 | ||
| Procedural Steps | 40 | ||
| Procedural Guideline 3.2 Use of Electronic Health Records | 41 | ||
| Delegation and Collaboration | 41 | ||
| Unit 2 Patient Assessment Skills | 99 | ||
| 6 Vital Signs | 99 | ||
| Evolve Website/Evolve Resources List | 99 | ||
| Patient-Centered Care | 99 | ||
| Safety | 99 | ||
| Evidence-Based Practice | 99 | ||
| Temperature | 100 | ||
| Pulse | 100 | ||
| Respirations | 102 | ||
| Blood Pressure | 102 | ||
| Skill 6.1 Measuring Body Temperature | 107 | ||
| Assessment | 107 | ||
| Planning | 107 | ||
| Expected Outcomes | 107 | ||
| Delegation and Collaboration | 107 | ||
| Equipment | 107 | ||
| Implementation for Measuring Body Temperature | 107 | ||
| Evaluation | 112 | ||
| Unexpected Outcomes and Related Interventions | 112 | ||
| Recording and Reporting | 112 | ||
| Sample Documentation | 112 | ||
| Special Considerations | 112 | ||
| Pediatric | 112 | ||
| Geriatric | 112 | ||
| Home Care | 112 | ||
| Skill 6.2 Assessing Apical Pulse | 112 | ||
| Assessment | 113 | ||
| Planning | 113 | ||
| Expected Outcomes | 113 | ||
| Delegation and Collaboration | 113 | ||
| Equipment | 113 | ||
| Implementation for Assessing Apical Pulse | 113 | ||
| Evaluation | 114 | ||
| Unexpected Outcomes and Related Interventions | 114 | ||
| Recording and Reporting | 115 | ||
| Sample Documentation | 115 | ||
| Special Considerations | 115 | ||
| Pediatric | 115 | ||
| Geriatric | 115 | ||
| Skill 6.3 Assessing Radial Pulse | 115 | ||
| Assessment | 115 | ||
| Planning | 115 | ||
| Expected Outcomes | 115 | ||
| Delegation and Collaboration | 115 | ||
| Equipment | 115 | ||
| Implementation for Assessing Radial Pulse | 116 | ||
| Evaluation | 117 | ||
| Unexpected Outcomes and Related Interventions | 117 | ||
| Recording and Reporting | 117 | ||
| Sample Documentation | 117 | ||
| Special Considerations | 117 | ||
| Pediatric | 117 | ||
| Geriatric | 117 | ||
| Home Care | 117 | ||
| Procedural Guideline 6.1 Assessing Apical-Radial Pulse Deficit | 117 | ||
| Delegation and Collaboration | 117 | ||
| Equipment | 117 | ||
| Procedural Steps | 117 | ||
| Skill 6.4 Assessing Respirations | 118 | ||
| Assessment | 118 | ||
| Planning | 118 | ||
| Expected Outcomes | 118 | ||
| Delegation and Collaboration | 118 | ||
| Equipment | 118 | ||
| Implementation for Assessing Respirations | 119 | ||
| Evaluation | 119 | ||
| Unexpected Outcomes and Related Interventions | 119 | ||
| Recording and Reporting | 119 | ||
| Sample Documentation | 119 | ||
| Special Considerations | 120 | ||
| Pediatric | 120 | ||
| Geriatric | 120 | ||
| Skill 6.5 Assessing Blood Pressure | 120 | ||
| Assessment | 120 | ||
| Planning | 120 | ||
| Expected Outcomes | 120 | ||
| Delegation and Collaboration | 120 | ||
| Equipment | 120 | ||
| Implementation for Assessing Blood Pressure | 121 | ||
| Evaluation | 124 | ||
| Unexpected Outcomes and Related Interventions | 124 | ||
| Recording and Reporting | 124 | ||
| Sample Documentation | 124 | ||
| Special Considerations | 124 | ||
| Pediatric | 124 | ||
| Geriatric | 124 | ||
| Home Care | 124 | ||
| Procedural Guideline 6.2 Assessing Blood Pressure Electronically | 125 | ||
| Delegation and Collaboration | 125 | ||
| Equipment | 125 | ||
| Procedural Steps | 125 | ||
| Procedural Guideline 6.3 Measuring Oxygen Saturation (Pulse Oximetry) | 126 | ||
| Delegation and Collaboration | 126 | ||
| Equipment | 126 | ||
| Procedural Steps | 126 | ||
| Critical Thinking Exercises | 128 | ||
| Case Study | 128 | ||
| Review Questions | 128 | ||
| References | 129 | ||
| 7 Health Assessment | 130 | ||
| Evolve Website/Evolve Resources List | 130 | ||
| Patient-Centered Care | 130 | ||
| Assessment Techniques | 131 | ||
| Safety | 135 | ||
| Preparation for Assessment | 135 | ||
| Preparing a Patient | 135 | ||
| Physical Assessment of Various Age-Groups | 135 | ||
| Children and Adolescents | 135 | ||
| Older Adults | 135 | ||
| Evidence-Based Practice | 136 | ||
| Skill Guidelines | 136 | ||
| Skill 7.1 General Survey | 136 | ||
| Assessment | 136 | ||
| Planning | 137 | ||
| Expected Outcomes | 137 | ||
| Delegation and Collaboration | 137 | ||
| Equipment | 137 | ||
| Implementation for General Survey | 137 | ||
| Evaluation | 142 | ||
| Unexpected Outcomes and Related Interventions | 142 | ||
| Recording and Reporting | 143 | ||
| Sample Documentation | 143 | ||
| Special Considerations | 144 | ||
| Pediatric | 144 | ||
| Geriatric | 144 | ||
| Home Care | 144 | ||
| Procedural Guideline 7.1 Monitoring Intake and Output | 144 | ||
| Delegation and Collaboration | 144 | ||
| Equipment | 145 | ||
| Procedural Steps | 145 | ||
| Skill 7.2 Assessing the Head and Neck | 146 | ||
| Assessment | 146 | ||
| Planning | 146 | ||
| Expected Outcomes | 146 | ||
| Delegation and Collaboration | 146 | ||
| Equipment | 146 | ||
| Implementation for Assessing the Head and Neck | 147 | ||
| Evaluation | 150 | ||
| Unexpected Outcomes and Related Interventions | 150 | ||
| Recording and Reporting | 150 | ||
| Sample Documentation | 150 | ||
| Special Considerations | 150 | ||
| Pediatric | 150 | ||
| Geriatric | 150 | ||
| Skill 7.3 Assessing the Thorax and Lungs | 150 | ||
| Assessment | 150 | ||
| Planning | 152 | ||
| Expected Outcomes | 152 | ||
| Delegation and Collaboration | 152 | ||
| Equipment | 152 | ||
| Implementation for Assessing the Thorax and Lungs | 153 | ||
| Evaluation | 155 | ||
| Unexpected Outcomes and Related Interventions | 155 | ||
| Recording and Reporting | 156 | ||
| Sample Documentation | 156 | ||
| Special Considerations | 156 | ||
| Pediatric | 156 | ||
| Geriatric | 156 | ||
| Skill 7.4 Cardiovascular Assessment | 156 | ||
| Assessment | 156 | ||
| Planning | 157 | ||
| Expected Outcomes | 157 | ||
| Delegation and Collaboration | 157 | ||
| Equipment | 157 | ||
| Implementation for Cardiovascular Assessment | 157 | ||
| Evaluation | 164 | ||
| Unexpected Outcomes and Related Interventions | 164 | ||
| Recording and Reporting | 164 | ||
| Sample Documentation | 164 | ||
| Special Considerations | 164 | ||
| Pediatric | 164 | ||
| Geriatric | 164 | ||
| Skill 7.5 Assessing the Abdomen | 165 | ||
| Assessment | 166 | ||
| Planning | 166 | ||
| Expected Outcomes | 166 | ||
| Delegation and Collaboration | 166 | ||
| Equipment | 167 | ||
| Implementation for Assessing the Abdomen | 167 | ||
| Evaluation | 170 | ||
| Unexpected Outcomes and Related Interventions | 170 | ||
| Recording and Reporting | 170 | ||
| Sample Documentation | 170 | ||
| Special Considerations | 170 | ||
| Pediatric | 170 | ||
| Geriatric | 170 | ||
| Skill 7.6 Assessing the Genitalia and Rectum | 170 | ||
| Assessment | 170 | ||
| Planning | 171 | ||
| Expected Outcomes | 171 | ||
| Delegation and Collaboration | 172 | ||
| Equipment | 172 | ||
| Implementation for Assessing the Genitalia and Rectum | 172 | ||
| Evaluation | 173 | ||
| Unexpected Outcomes and Related Interventions | 173 | ||
| Recording and Reporting | 173 | ||
| Sample Documentation | 173 | ||
| Special Considerations | 173 | ||
| Pediatric | 173 | ||
| Geriatric | 173 | ||
| Home Care | 173 | ||
| Skill 7.7 Musculoskeletal and Neurological Assessment | 173 | ||
| Assessment | 174 | ||
| Planning | 174 | ||
| Expected Outcomes | 174 | ||
| Delegation and Collaboration | 175 | ||
| Equipment | 175 | ||
| Implementation for Musculoskeletal and Neurological Assessment | 175 | ||
| Evaluation | 177 | ||
| Unexpected Outcomes and Related Interventions | 177 | ||
| Recording and Reporting | 178 | ||
| Sample Documentation | 178 | ||
| Special Considerations | 178 | ||
| Pediatric | 178 | ||
| Geriatric | 179 | ||
| Home Care | 179 | ||
| Critical Thinking Exercises | 179 | ||
| Case Study | 179 | ||
| Review Questions | 179 | ||
| References | 180 | ||
| 8 Specimen Collection | 181 | ||
| Evolve Website/Evolve Resources List | 181 | ||
| Patient-Centered Care | 181 | ||
| Safety | 182 | ||
| Evidence-Based Practice | 182 | ||
| Skill 8.1 Urine Specimen Collection—Midstream (Clean-Voided) Urine, Sterile Urinary Catheter | 182 | ||
| Types of Urine Tests and Specimens | 183 | ||
| Assessment | 183 | ||
| Planning | 183 | ||
| Expected Outcomes | 183 | ||
| Delegation and Collaboration | 183 | ||
| Equipment | 183 | ||
| Clean-Voided Urine Specimen | 183 | ||
| Sterile Urine Specimen from Urinary Catheter | 184 | ||
| Implementation for Urine Specimen Collection—Midstream (Clean-Voided) Urine, Sterile Urinary Catheter | 184 | ||
| Evaluation | 187 | ||
| Unexpected Outcomes and Related Interventions | 187 | ||
| Recording and Reporting | 188 | ||
| Sample Documentation | 188 | ||
| Special Considerations | 188 | ||
| Pediatric | 188 | ||
| Geriatric | 188 | ||
| Home Care | 188 | ||
| Procedural Guideline 8.1 Collecting a Timed Urine Specimen | 188 | ||
| Delegation and Collaboration | 188 | ||
| Equipment | 188 | ||
| Procedural Steps | 188 | ||
| Procedural Guideline 8.2 Urine Screening for Glucose, Ketones, Protein, Blood, and PH | 189 | ||
| Delegation and Collaboration | 189 | ||
| Equipment | 189 | ||
| Procedural Steps | 189 | ||
| Skill 8.2 Testing for Gastrointestinal Alterations—Gastroccult Test, Stool Specimen, and Hemoccult Test | 190 | ||
| Assessment | 190 | ||
| Planning | 190 | ||
| Expected Outcomes | 190 | ||
| Delegation and Collaboration | 191 | ||
| Equipment | 191 | ||
| Gastroccult Test | 191 | ||
| Stool Specimens | 191 | ||
| Hemoccult (Guaiac Test) | 191 | ||
| Implementation for Testing for Gastrointestinal Alterations—Gastroccult Test, Stool Specimen, and Hemoccult Test | 191 | ||
| Evaluation | 194 | ||
| Unexpected Outcomes and Related Interventions | 194 | ||
| Recording and Reporting | 194 | ||
| Sample Documentation | 194 | ||
| Special Considerations | 194 | ||
| Pediatric | 194 | ||
| Home Care | 194 | ||
| Skill 8.3 Collecting Nose and Throat Specimens | 194 | ||
| Assessment | 195 | ||
| Planning | 195 | ||
| Expected Outcomes | 195 | ||
| Delegation and Collaboration | 195 | ||
| Equipment | 195 | ||
| Implementation for Collecting Nose and Throat Specimens | 195 | ||
| Evaluation | 197 | ||
| Unexpected Outcomes and Related Interventions | 197 | ||
| Recording and Reporting | 197 | ||
| Sample Documentation | 197 | ||
| Special Considerations | 197 | ||
| Pediatric | 197 | ||
| Skill 8.4 Collecting a Sputum Specimen | 198 | ||
| Assessment | 198 | ||
| Planning | 198 | ||
| Expected Outcomes | 198 | ||
| Delegation and Collaboration | 198 | ||
| Equipment | 198 | ||
| Sputum Collected by Expectoration | 198 | ||
| Sputum Collected by Suction | 198 | ||
| Implementation for Collecting a Sputum Specimen | 199 | ||
| Evaluation | 200 | ||
| Unexpected Outcomes and Related Interventions | 201 | ||
| Recording and Reporting | 201 | ||
| Sample Documentation | 201 | ||
| Special Considerations | 201 | ||
| Home Care | 201 | ||
| Skill 8.5 Collecting Wound Drainage Specimens | 201 | ||
| Assessment | 201 | ||
| Planning | 201 | ||
| Expected Outcomes | 201 | ||
| Delegation and Collaboration | 202 | ||
| Equipment | 202 | ||
| Implementation for Collecting Wound Drainage Specimens | 202 | ||
| Evaluation | 203 | ||
| Unexpected Outcomes and Related Interventions | 203 | ||
| Recording and Reporting | 203 | ||
| Sample Documentation | 203 | ||
| Special Considerations | 203 | ||
| Pediatric | 203 | ||
| Home Care | 203 | ||
| Skill 8.6 Blood Glucose Monitoring | 203 | ||
| Assessment | 204 | ||
| Planning | 204 | ||
| Expected Outcomes | 204 | ||
| Delegation and Collaboration | 204 | ||
| Equipment | 204 | ||
| Implementation for Blood Glucose Monitoring | 204 | ||
| Evaluation | 206 | ||
| Unexpected Outcomes and Related Interventions | 206 | ||
| Recording and Reporting | 206 | ||
| Sample Documentation | 207 | ||
| Special Considerations | 207 | ||
| Geriatric | 207 | ||
| Home Care | 207 | ||
| Skill 8.7 Collecting Blood and Culture Specimens by Venipuncture (Syringe and Vacutainer Method) | 207 | ||
| Assessment | 207 | ||
| Planning | 208 | ||
| Expected Outcomes | 208 | ||
| Delegation and Collaboration | 208 | ||
| Equipment | 208 | ||
| All Procedures | 208 | ||
| Venipuncture with Syringe | 208 | ||
| Venipuncture with Vacutainer | 208 | ||
| Blood Cultures | 208 | ||
| Implementation for Collecting Blood and Culture Specimens by Venipuncture (Syringe and Vacutainer Method) | 208 | ||
| Evaluation | 212 | ||
| Unexpected Outcomes and Related Interventions | 212 | ||
| Recording and Reporting | 213 | ||
| Sample Documentation | 213 | ||
| Special Considerations | 213 | ||
| Pediatric | 213 | ||
| Geriatric | 213 | ||
| Critical Thinking Exercises | 213 | ||
| Case Study | 213 | ||
| Review Questions | 214 | ||
| References | 215 | ||
| 9 Diagnostic Procedures | 216 | ||
| Evolve Website/Evolve Resources List | 216 | ||
| Patient-Centered Care | 216 | ||
| Safety | 217 | ||
| Evidence-Based Practice | 218 | ||
| Skill 9.1 Contrast Media Studies: Arteriogram (Angiogram), Cardiac Catheterization, Intravenous Pyelogram | 218 | ||
| Assessment | 219 | ||
| Planning | 220 | ||
| Expected Outcomes | 220 | ||
| Delegation and Collaboration | 220 | ||
| Equipment | 220 | ||
| Implementation for Contrast Media Studies: Arteriogram (Angiogram), Cardiac Catheterization, Intravenous Pyelogram | 220 | ||
| Evaluation | 223 | ||
| Unexpected Outcomes and Related Interventions | 223 | ||
| Recording and Reporting | 223 | ||
| Sample Documentation | 224 | ||
| Special Considerations | 224 | ||
| Pediatric | 224 | ||
| Geriatric | 224 | ||
| Home Care | 224 | ||
| Skill 9.2 Care of Patients Undergoing Aspirations: Bone Marrow, Lumbar Puncture, Paracentesis, Thoracentesis | 224 | ||
| Assessment | 226 | ||
| Planning | 227 | ||
| Expected Outcomes | 227 | ||
| Delegation and Collaboration | 227 | ||
| Equipment | 227 | ||
| Implementation for Care of Patients Undergoing Aspirations: Bone Marrow, Lumbar Puncture, Paracentesis, Thoracentesis | 227 | ||
| Evaluation | 229 | ||
| Unexpected Outcomes and Related Interventions | 229 | ||
| Recording and Reporting | 229 | ||
| Sample Documentation | 230 | ||
| Special Considerations | 230 | ||
| Pediatric | 230 | ||
| Geriatric | 230 | ||
| Home Care | 230 | ||
| Skill 9.3 Care of Patients Undergoing Bronchoscopy | 230 | ||
| Assessment | 230 | ||
| Planning | 231 | ||
| Expected Outcomes | 231 | ||
| Delegation and Collaboration | 231 | ||
| Equipment | 231 | ||
| Implementation for Care of Patients Undergoing Bronchoscopy | 231 | ||
| Evaluation | 233 | ||
| Unexpected Outcomes and Related Interventions | 233 | ||
| Recording and Reporting | 233 | ||
| Sample Documentation | 233 | ||
| Special Considerations | 234 | ||
| Pediatric | 234 | ||
| Geriatric | 234 | ||
| Home Care | 234 | ||
| Skill 9.4 Care of Patients Undergoing Gastrointestinal Endoscopy | 234 | ||
| Assessment | 234 | ||
| Planning | 235 | ||
| Expected Outcomes | 235 | ||
| Delegation and Collaboration | 235 | ||
| Equipment | 235 | ||
| Implementation for Care of Patients Undergoing Gastrointestinal Endoscopy | 235 | ||
| Evaluation | 236 | ||
| Unexpected Outcomes and Related Interventions | 236 | ||
| Reporting and Recording | 237 | ||
| Sample Documentation | 237 | ||
| Special Considerations | 237 | ||
| Pediatric | 237 | ||
| Geriatric | 237 | ||
| Home Care | 237 | ||
| Skill 9.5 Obtaining an Electrocardiogram | 237 | ||
| Assessment | 237 | ||
| Planning | 238 | ||
| Expected Outcomes | 238 | ||
| Delegation and Collaboration | 238 | ||
| Equipment | 238 | ||
| Implementation for Obtaining an Electrocardiogram | 238 | ||
| Evaluation | 240 | ||
| Unexpected Outcomes and Related Interventions | 240 | ||
| Recording and Reporting | 240 | ||
| Sample Documentation | 240 | ||
| Critical Thinking Exercises | 240 | ||
| Case Study | 240 | ||
| Review Questions | 241 | ||
| References | 242 | ||
| Unit 3 Basic Human Needs | 243 | ||
| 10 Bathing and Personal Hygiene | 243 | ||
| Evolve Website/Evolve Resources List | 243 | ||
| Patient-Centered Care | 243 | ||
| Safety | 243 | ||
| Evidence-Based Practice | 244 | ||
| Skill 10.1 Complete Bathing | 245 | ||
| Assessment | 245 | ||
| Planning | 246 | ||
| Expected Outcomes | 246 | ||
| Delegation and Collaboration | 246 | ||
| Equipment | 246 | ||
| Implementation for Complete Bathing | 246 | ||
| Evaluation | 252 | ||
| Unexpected Outcomes and Related Interventions | 252 | ||
| Recording and Reporting | 253 | ||
| Sample Documentation | 253 | ||
| Special Considerations | 253 | ||
| Pediatric | 253 | ||
| Geriatric | 253 | ||
| Home Care | 253 | ||
| Procedural Guideline 10.1 Perineal Care | 253 | ||
| Delegation and Collaboration | 253 | ||
| Equipment | 253 | ||
| Procedural Steps | 253 | ||
| Procedural Guideline 10.2 Oral Care for a Debilitated Patient | 255 | ||
| Delegation and Collaboration | 255 | ||
| Equipment | 255 | ||
| Procedural Steps | 255 | ||
| Procedural Guideline 10.3 Care of Dentures | 257 | ||
| Delegation and Collaboration | 257 | ||
| Equipment | 257 | ||
| Procedural Steps | 257 | ||
| Procedural Guideline 10.4 Hair Care—Combing, Shampooing, and Shaving | 258 | ||
| Delegation and Collaboration | 258 | ||
| Equipment | 258 | ||
| Procedural Steps | 259 | ||
| Procedural Guideline 10.5 Foot and Nail Care | 261 | ||
| Delegation and Collaboration | 262 | ||
| Equipment | 262 | ||
| Procedural Steps | 262 | ||
| Procedural Guideline 10.6 Making an Occupied Bed | 263 | ||
| Delegation and Collaboration | 263 | ||
| Equipment | 264 | ||
| Procedural Steps | 264 | ||
| Procedural Guideline 10.7 Making an Unoccupied Bed | 267 | ||
| Delegation and Collaboration | 267 | ||
| Equipment | 267 | ||
| Procedural Steps | 267 | ||
| Critical Thinking Exercises | 268 | ||
| Case Study | 268 | ||
| Review Questions | 268 | ||
| References | 269 | ||
| 11 Care of the Eye and Ear | 270 | ||
| Evolve Website/Evolve Resources List | 270 | ||
| Patient-Centered Care | 270 | ||
| Safety | 271 | ||
| Evidence-Based Practice | 271 | ||
| Skill 11.1 Eye Irrigation | 271 | ||
| Assessment | 272 | ||
| Planning | 272 | ||
| Expected Outcomes | 272 | ||
| Delegation and Collaboration | 272 | ||
| Equipment | 272 | ||
| Implementation for Eye Irrigation | 272 | ||
| Evaluation | 274 | ||
| Unexpected Outcomes and Related Interventions | 274 | ||
| Recording and Reporting | 274 | ||
| Sample Documentation | 274 | ||
| Special Considerations | 274 | ||
| Pediatric | 274 | ||
| Geriatric | 274 | ||
| Procedural Guideline 11.1 Eye Care for the Comatose Patient | 275 | ||
| Delegation and Collaboration | 275 | ||
| Equipment | 275 | ||
| Procedural Steps | 275 | ||
| Skill 11.2 Ear Irrigation | 275 | ||
| Assessment | 276 | ||
| Planning | 276 | ||
| Expected Outcomes | 276 | ||
| Delegation and Collaboration | 276 | ||
| Equipment | 276 | ||
| Implementation for Ear Irrigation | 277 | ||
| Evaluation | 278 | ||
| Unexpected Outcomes and Related Interventions | 278 | ||
| Recording and Reporting | 278 | ||
| Sample Documentation | 278 | ||
| Special Considerations | 278 | ||
| Pediatric | 278 | ||
| Geriatric | 278 | ||
| Home Care | 278 | ||
| Skill 11.3 Caring for a Hearing Aid | 278 | ||
| Assessment | 279 | ||
| Planning | 279 | ||
| Expected Outcomes | 279 | ||
| Delegation and Collaboration | 279 | ||
| Equipment | 279 | ||
| Implementation for Caring for a Hearing Aid | 281 | ||
| Evaluation | 282 | ||
| Unexpected Outcomes and Related Interventions | 282 | ||
| Recording and Reporting | 282 | ||
| Sample Documentation | 282 | ||
| Special Considerations | 282 | ||
| Pediatric | 282 | ||
| Geriatric | 282 | ||
| Home Care | 282 | ||
| Critical Thinking Exercises | 283 | ||
| Case Study | 283 | ||
| Review Questions | 283 | ||
| References | 284 | ||
| 12 Promoting Nutrition | 285 | ||
| Evolve Website/Evolve Resources List | 285 | ||
| Patient-Centered Care | 285 | ||
| Safety | 285 | ||
| Evidence-Based Practice | 287 | ||
| Skill 12.1 Feeding Dependent Patients | 288 | ||
| Assessment | 288 | ||
| Planning | 289 | ||
| Expected Outcomes | 289 | ||
| Delegation and Collaboration | 290 | ||
| Equipment | 290 | ||
| Implementation for Feeding Dependent Patients | 290 | ||
| Evaluation | 292 | ||
| Unexpected Outcomes and Related Interventions | 292 | ||
| Recording and Reporting | 292 | ||
| Sample Documentation | 292 | ||
| Special Considerations | 292 | ||
| Pediatric | 292 | ||
| Geriatric | 293 | ||
| Home Care | 293 | ||
| Skill 12.2 Aspiration Precautions | 293 | ||
| Assessment | 294 | ||
| Planning | 294 | ||
| Expected Outcomes | 294 | ||
| Delegation and Collaboration | 294 | ||
| Equipment | 294 | ||
| Implementation for Aspiration Precautions | 294 | ||
| Evaluation | 295 | ||
| Unexpected Outcomes and Related Interventions | 295 | ||
| Recording and Reporting | 296 | ||
| Sample Documentation | 296 | ||
| Special Considerations | 296 | ||
| Pediatric | 296 | ||
| Geriatric | 296 | ||
| Skill 12.3 Insertion and Removal of a Small-Bore Feeding Tube | 296 | ||
| Assessment | 296 | ||
| Planning | 297 | ||
| Expected Outcomes | 297 | ||
| Delegation and Collaboration | 297 | ||
| Equipment | 297 | ||
| Implementation for Insertion and Removal of a Small-Bore Feeding Tube | 298 | ||
| Evaluation | 302 | ||
| Unexpected Outcomes and Related Interventions | 302 | ||
| Recording and Reporting | 302 | ||
| Sample Documentation | 302 | ||
| Special Considerations | 302 | ||
| Pediatric | 302 | ||
| Geriatric | 302 | ||
| Home Care | 302 | ||
| Skill 12.4 Verifying Placement and Irrigating a Feeding Tube | 303 | ||
| Assessment | 303 | ||
| Planning | 303 | ||
| Expected Outcomes | 303 | ||
| Delegation and Collaboration | 303 | ||
| Equipment | 304 | ||
| Implementation for Verifying Placement and Irrigating a Feeding Tube | 304 | ||
| Evaluation | 306 | ||
| Unexpected Outcomes and Related Interventions | 306 | ||
| Recording and Reporting | 306 | ||
| Sample Documentation | 306 | ||
| Special Considerations | 306 | ||
| Pediatric | 306 | ||
| Home Care | 306 | ||
| Skill 12.5 Administering Enteral Nutrition: Nasogastric, Gastrostomy, or Jejunostomy Tube | 306 | ||
| Assessment | 307 | ||
| Planning | 308 | ||
| Expected Outcomes | 308 | ||
| Delegation and Collaboration | 308 | ||
| Equipment | 308 | ||
| Implementation for Administering Enteral Nutrition: Nasogastric, Gastrostomy, or Jejunostomy Tube | 308 | ||
| Evaluation | 311 | ||
| Unexpected Outcomes and Related Interventions | 312 | ||
| Recording and Reporting | 312 | ||
| Sample Documentation | 312 | ||
| Special Considerations | 312 | ||
| Pediatric | 312 | ||
| Geriatric | 312 | ||
| Hospitalized Adults with Diabetes | 312 | ||
| Home Care | 312 | ||
| Procedural Guideline 12.1 Site Care of Enteral Feeding Tubes | 312 | ||
| Delegation Considerations | 313 | ||
| Equipment | 313 | ||
| Procedural Steps | 313 | ||
| Critical Thinking Exercises | 313 | ||
| Case Study | 313 | ||
| Review Questions | 314 | ||
| References | 315 | ||
| 13 Pain Management | 317 | ||
| Evolve Website/Evolve Resources List | 317 | ||
| Patient-Centered Care | 317 | ||
| Safety | 318 | ||
| Evidence-Based Practice | 318 | ||
| Skill 13.1 Nonpharmacological Pain Management | 319 | ||
| Assessment | 319 | ||
| Planning | 321 | ||
| Expected Outcomes | 321 | ||
| Delegation and Collaboration | 321 | ||
| Equipment | 321 | ||
| Implementation for Nonpharmacological Pain Management | 321 | ||
| Evaluation | 325 | ||
| Unexpected Outcomes and Related Interventions | 325 | ||
| Recording and Reporting | 325 | ||
| Sample Documentation | 325 | ||
| Special Considerations | 326 | ||
| Pediatric | 326 | ||
| Geriatric | 326 | ||
| Home Care | 326 | ||
| Procedural Guideline 13.1 Relaxation and Guided Imagery | 326 | ||
| Delegation and Collaboration | 326 | ||
| Equipment | 327 | ||
| Procedural Steps | 327 | ||
| Skill 13.2 Pharmacological Pain Management | 328 | ||
| Assessment | 329 | ||
| Planning | 329 | ||
| Expected Outcomes | 329 | ||
| Delegation and Collaboration | 329 | ||
| Equipment | 329 | ||
| Implementation for Pharmacological Pain Management | 330 | ||
| Evaluation | 330 | ||
| Unexpected Outcomes and Related Interventions | 331 | ||
| Recording and Reporting | 331 | ||
| Sample Documentation | 331 | ||
| Special Considerations | 331 | ||
| Pediatric | 331 | ||
| Geriatric | 331 | ||
| Home Care | 331 | ||
| Skill 13.3 Patient-Controlled Analgesia | 331 | ||
| Assessment | 332 | ||
| Planning | 333 | ||
| Expected Outcomes | 333 | ||
| Delegation and Collaboration | 333 | ||
| Equipment | 333 | ||
| Implementation for Patient-Controlled Analgesia | 333 | ||
| Evaluation | 336 | ||
| Unexpected Outcomes and Related Interventions | 336 | ||
| Recording and Reporting | 336 | ||
| Sample Documentation | 336 | ||
| Special Considerations | 336 | ||
| Pediatric | 336 | ||
| Geriatric | 336 | ||
| Home Care | 337 | ||
| Skill 13.4 Epidural Analgesia | 337 | ||
| Assessment | 338 | ||
| Planning | 339 | ||
| Expected Outcomes | 339 | ||
| Delegation and Collaboration | 339 | ||
| Equipment | 339 | ||
| Implementation for Epidural Analgesia | 339 | ||
| Evaluation | 341 | ||
| Unexpected Outcomes and Related Interventions | 341 | ||
| Recording and Reporting | 341 | ||
| Sample Documentation | 342 | ||
| Special Considerations | 342 | ||
| Pediatric | 342 | ||
| Geriatric | 342 | ||
| Home Care | 342 | ||
| Skill 13.5 Local Anesthetic Infusion Pump for Analgesia | 342 | ||
| Assessment | 342 | ||
| Planning | 343 | ||
| Expected Outcomes | 343 | ||
| Delegation and Collaboration | 343 | ||
| Equipment | 343 | ||
| Home Catheter Removal | 343 | ||
| Implementation for Local Anesthetic Infusion Pump for Analgesia | 343 | ||
| Evaluation | 344 | ||
| Unexpected Outcomes and Related Interventions | 344 | ||
| Recording and Reporting | 344 | ||
| Sample Documentation | 344 | ||
| Special Considerations | 344 | ||
| Pediatric | 344 | ||
| Geriatric | 344 | ||
| Home Care | 345 | ||
| Skill 13.6 Moist and Dry Heat | 345 | ||
| Assessment | 345 | ||
| Planning | 345 | ||
| Expected Outcomes | 345 | ||
| Delegation and Collaboration | 345 | ||
| Equipment | 346 | ||
| All Moist Heat Applications | 346 | ||
| Dry Heat Applications | 346 | ||
| Implementation for Moist and Dry Heat | 346 | ||
| Evaluation | 349 | ||
| Unexpected Outcomes and Related Interventions | 349 | ||
| Recording and Reporting | 349 | ||
| Sample Documentation | 349 | ||
| Special Considerations | 349 | ||
| Pediatric | 349 | ||
| Geriatric | 349 | ||
| Home Care | 349 | ||
| Skill 13.7 Cold Application | 350 | ||
| Assessment | 350 | ||
| Planning | 350 | ||
| Expected Outcomes | 350 | ||
| Delegation Considerations | 350 | ||
| Equipment | 351 | ||
| All compresses, bags, and packs | 351 | ||
| Ice bag or gel pack | 351 | ||
| Electronically controlled cooling device | 351 | ||
| Implementation for Cold Application | 351 | ||
| Evaluation | 352 | ||
| Unexpected Outcomes and Related Interventions | 353 | ||
| Recording and Reporting | 353 | ||
| Sample Documentation | 353 | ||
| Special Considerations | 353 | ||
| Pediatric | 353 | ||
| Geriatric | 353 | ||
| Home Care | 353 | ||
| Critical Thinking Exercises | 353 | ||
| Case Study | 353 | ||
| Review Questions | 353 | ||
| References | 354 | ||
| 14 Promoting Oxygenation | 356 | ||
| Evolve Website/Evolve Resources List | 356 | ||
| Patient-Centered Care | 356 | ||
| Safety | 356 | ||
| Evidence-Based Practice | 357 | ||
| Skill 14.1 Oxygen Administration | 358 | ||
| Assessment | 358 | ||
| Planning | 359 | ||
| Expected Outcomes | 359 | ||
| Delegation and Collaboration | 359 | ||
| Equipment | 359 | ||
| Implementation for Oxygen Administration | 359 | ||
| Evaluation | 362 | ||
| Unexpected Outcomes and Related Interventions | 362 | ||
| Recording and Reporting | 362 | ||
| Sample Documentation | 362 | ||
| Special Considerations | 362 | ||
| Pediatric | 362 | ||
| Geriatric | 362 | ||
| Home Care | 362 | ||
| Skill 14.2 Airway Management: Noninvasive Interventions | 363 | ||
| Assessment | 363 | ||
| Planning | 363 | ||
| Expected Outcomes | 363 | ||
| Delegation and Collaboration | 363 | ||
| Equipment | 364 | ||
| Implementation for Airway Management: Noninvasive Interventions | 364 | ||
| Evaluation | 366 | ||
| Unexpected Outcomes and Related Interventions | 366 | ||
| Recording and Reporting | 366 | ||
| Sample Documentation | 366 | ||
| Special Considerations | 366 | ||
| Home Care | 366 | ||
| Procedural Guideline 14.1 Use of a Peak Flowmeter | 366 | ||
| Delegation and Collaboration | 366 | ||
| Equipment | 367 | ||
| Procedural Steps | 367 | ||
| Skill 14.3 Chest Physiotherapy | 367 | ||
| Assessment | 370 | ||
| Planning | 370 | ||
| Expected Outcomes | 370 | ||
| Delegation and Collaboration | 370 | ||
| Equipment | 370 | ||
| Implementation for Chest Physiotherapy | 371 | ||
| Evaluation | 372 | ||
| Unexpected Outcomes and Related Interventions | 372 | ||
| Recording and Reporting | 372 | ||
| Sample Documentation | 372 | ||
| Special Considerations | 373 | ||
| Pediatric | 373 | ||
| Geriatric | 373 | ||
| Home Care Considerations | 373 | ||
| Skill 14.4 Airway Management: Suctioning | 373 | ||
| Assessment | 373 | ||
| Planning | 375 | ||
| Expected Outcomes | 375 | ||
| Delegation and Collaboration | 375 | ||
| Equipment | 375 | ||
| Oropharyngeal (Nonsterile) and Nasotracheal (Sterile) Suctioning | 375 | ||
| Endotracheal or Tracheostomy Suctioning | 375 | ||
| Closed-System or In-Line Suctioning | 375 | ||
| Implementation for Airway Management: Suctioning | 375 | ||
| Evaluation | 381 | ||
| Unexpected Outcomes and Related Interventions | 381 | ||
| Recording and Reporting | 381 | ||
| Sample Documentation | 381 | ||
| Special Considerations | 381 | ||
| Pediatric | 381 | ||
| Geriatric | 381 | ||
| Home Care | 381 | ||
| Skill 14.5 Airway Management: Endotracheal Tube and Tracheostomy Care | 382 | ||
| Assessment | 382 | ||
| Planning | 382 | ||
| Expected Outcomes | 382 | ||
| Delegation and Collaboration | 382 | ||
| Equipment | 382 | ||
| Endotracheal Tube Care | 382 | ||
| Tracheostomy Care | 383 | ||
| Implementation for Airway Management: Endotracheal Tube and Tracheostomy Care | 383 | ||
| Evaluation | 388 | ||
| Unexpected Outcomes and Related Interventions | 388 | ||
| Recording and Reporting | 388 | ||
| Sample Documentation | 389 | ||
| Special Considerations | 389 | ||
| Pediatric | 389 | ||
| Geriatric | 389 | ||
| Home Care | 389 | ||
| Skill 14.6 Managing Closed Chest Drainage Systems | 389 | ||
| Assessment | 389 | ||
| Planning | 391 | ||
| Expected Outcomes | 391 | ||
| Delegation and Collaboration | 391 | ||
| Equipment | 391 | ||
| Implementation for Managing Closed Chest Drainage Systems | 391 | ||
| Evaluation | 395 | ||
| Unexpected Outcomes and Related Interventions | 395 | ||
| Recording and Reporting | 396 | ||
| Sample Documentation | 396 | ||
| Critical Thinking Exercises | 396 | ||
| Case Study | 396 | ||
| Review Questions | 396 | ||
| References | 398 | ||
| Unit 4 Activity and Mobility | 399 | ||
| 15 Safe Patient Handling, Transfer, and Positioning | 399 | ||
| Evolve Website/Evolve Resources List | 399 | ||
| Patient-Centered Care | 399 | ||
| Safety | 400 | ||
| Evidence-Based Practice | 400 | ||
| Skill 15.1 Transfer Techniques | 401 | ||
| Assessment | 401 | ||
| Planning | 402 | ||
| Expected Outcomes | 402 | ||
| Delegation and Collaboration | 402 | ||
| Equipment | 402 | ||
| Implementation for Transfer Techniques | 402 | ||
| Evaluation | 409 | ||
| Unexpected Outcomes and Related Interventions | 409 | ||
| Recording and Reporting | 409 | ||
| Sample Documentation | 410 | ||
| Special Considerations | 410 | ||
| Pediatric | 410 | ||
| Geriatric | 410 | ||
| Home Care | 410 | ||
| Procedural Guideline 15.1 Wheelchair Transfer Techniques | 410 | ||
| Delegation and Collaboration | 410 | ||
| Equipment | 410 | ||
| Procedural Steps | 410 | ||
| Skill 15.2 Moving and Positioning Patients in Bed | 411 | ||
| Assessment | 412 | ||
| Planning | 412 | ||
| Expected Outcomes | 412 | ||
| Delegation and Collaboration | 412 | ||
| Equipment | 412 | ||
| Implementation for Moving and Positioning Patients in Bed | 412 | ||
| Evaluation | 419 | ||
| Unexpected Outcomes and Related Interventions | 419 | ||
| Recording and Reporting | 419 | ||
| Sample Documentation | 419 | ||
| Special Considerations | 419 | ||
| Pediatric | 419 | ||
| Geriatric | 420 | ||
| Home Care | 420 | ||
| Critical Thinking Exercises | 420 | ||
| Case Study | 420 | ||
| Review Questions | 420 | ||
| References | 421 | ||
| 16 Exercise and Mobility | 422 | ||
| Evolve Website/Evolve Resources List | 422 | ||
| Patient-Centered Care | 422 | ||
| Safety | 423 | ||
| Evidence-Based Practice | 423 | ||
| Procedural Guideline 16.1 Range of Motion | 423 | ||
| Delegation and Collaboration | 424 | ||
| Equipment | 424 | ||
| Procedural Steps | 424 | ||
| Procedural Guideline 16.2 Applying Elastic Stockings and Sequential Compression Device | 427 | ||
| Delegation | 427 | ||
| Equipment | 427 | ||
| Procedural Steps | 428 | ||
| Skill 16.1 Assisting with Ambulation | 430 | ||
| Assessment | 430 | ||
| Planning | 430 | ||
| Expected Outcomes | 430 | ||
| Delegation and Collaboration | 430 | ||
| Equipment | 430 | ||
| Implementation for Assisting with Ambulation | 430 | ||
| Evaluation | 432 | ||
| Unexpected Outcomes and Related Interventions | 432 | ||
| Recording and Reporting | 432 | ||
| Sample Documentation | 432 | ||
| Special Considerations | 432 | ||
| Geriatric | 432 | ||
| Pediatric | 433 | ||
| Skill 16.2 Teaching Use of Canes, Crutches, and Walkers | 433 | ||
| Canes | 433 | ||
| Crutches | 434 | ||
| Walkers | 434 | ||
| Assessment | 434 | ||
| Planning | 434 | ||
| Expected Outcomes | 434 | ||
| Delegation and Collaboration | 434 | ||
| Equipment | 434 | ||
| Implementation for Teaching Use of Canes, Crutches, and Walkers | 435 | ||
| Evaluation | 443 | ||
| Unexpected Outcomes and Related Interventions | 443 | ||
| Recording and Reporting | 443 | ||
| Sample Documentation | 443 | ||
| Special Considerations | 443 | ||
| Pediatric | 443 | ||
| Geriatric | 443 | ||
| Home Care | 443 | ||
| Critical Thinking Exercises | 443 | ||
| Case Study | 443 | ||
| Review Questions | 444 | ||
| References | 445 | ||
| 17 Traction, Cast Care, and Immobilization Devices | 446 | ||
| Evolve Website/Evolve Resources List | 446 | ||
| Patient-Centered Care | 447 | ||
| Safety | 447 | ||
| Evidence-Based Practice | 447 | ||
| Skill 17.1 Assisting with Cast Application and Removal | 448 | ||
| Assessment | 448 | ||
| Planning | 449 | ||
| Expected Outcomes | 449 | ||
| Delegation and Collaboration | 449 | ||
| Equipment | 449 | ||
| Equipment for Cast Application (May Be on Cast Cart) (Fig. 17-2) | 449 | ||
| Equipment for Cast Removal | 449 | ||
| Implementation for Assisting with Cast Application and Removal | 449 | ||
| Evaluation | 453 | ||
| Unexpected Outcomes and Related Interventions | 453 | ||
| Recording and Reporting | 453 | ||
| Sample Documentation | 453 | ||
| Special Considerations | 454 | ||
| Pediatric | 454 | ||
| Geriatric | 454 | ||
| Home Care | 454 | ||
| Skill 17.2 Care of a Patient in Skin Traction | 455 | ||
| Assessment | 457 | ||
| Planning | 457 | ||
| Expected Outcomes | 457 | ||
| Delegation and Collaboration | 457 | ||
| Equipment | 457 | ||
| Implementation for Care of a Patient in Skin Traction | 457 | ||
| Evaluation | 459 | ||
| Unexpected Outcomes and Related Interventions | 459 | ||
| Recording and Reporting | 459 | ||
| Sample Documentation | 459 | ||
| Special Considerations | 459 | ||
| Pediatric | 459 | ||
| Geriatric | 459 | ||
| Home Care | 459 | ||
| Skill 17.3 Care of a Patient in Skeletal Traction and Pin-Site Care | 459 | ||
| Assessment | 461 | ||
| Planning | 461 | ||
| Expected Outcomes | 461 | ||
| Delegation and Collaboration | 462 | ||
| Equipment | 462 | ||
| Balanced-Suspension Skeletal Traction | 462 | ||
| Halo Traction | 462 | ||
| Pin-Site Care Supplies | 462 | ||
| Implementation for Care of a Patient in Skeletal Traction and Pin-Site Care | 462 | ||
| Evaluation | 463 | ||
| Unexpected Outcomes and Related Interventions | 463 | ||
| Recording and Reporting | 464 | ||
| Sample Documentation | 464 | ||
| Special Considerations | 464 | ||
| Pediatric | 464 | ||
| Geriatric | 464 | ||
| Home Care | 464 | ||
| Skill 17.4 Care of a Patient with an Immobilization Device | 464 | ||
| Assessment | 465 | ||
| Planning | 465 | ||
| Expected Outcomes | 465 | ||
| Delegation and Collaboration | 465 | ||
| Equipment | 466 | ||
| Implementation for Care of a Patient with an Immobilization Device | 466 | ||
| Evaluation | 467 | ||
| Unexpected Outcomes and Related Interventions | 467 | ||
| Recording and Reporting | 467 | ||
| Sample Documentation | 468 | ||
| Special Considerations | 468 | ||
| Pediatric | 468 | ||
| Geriatric | 468 | ||
| Home Care | 468 | ||
| Critical Thinking Exercises | 468 | ||
| Case Study | 468 | ||
| Review Questions | 468 | ||
| References | 469 | ||
| Unit 5 Promoting Elimination | 470 | ||
| 18 Urinary Elimination | 470 | ||
| Evolve Website/Evolve Resources List | 470 | ||
| Patient-Centered Care | 470 | ||
| Safety | 470 | ||
| Evidence-Based Practice | 470 | ||
| Procedural Guideline 18.1 Assisting with Use of a Urinal | 471 | ||
| Delegation and Collaboration | 471 | ||
| Equipment | 471 | ||
| Procedural Steps | 472 | ||
| Skill 18.1 Applying a Condom-Type External Catheter | 472 | ||
| Assessment | 472 | ||
| Planning | 473 | ||
| Expected Outcomes | 473 | ||
| Delegation and Collaboration | 473 | ||
| Equipment | 473 | ||
| Implementation for Applying a Condom-Type External Catheter | 473 | ||
| Evaluation | 475 | ||
| Unexpected Outcomes and Related Interventions | 475 | ||
| Recording and Reporting | 475 | ||
| Sample Documentation | 475 | ||
| Special Considerations | 475 | ||
| Pediatric | 475 | ||
| Geriatric | 475 | ||
| Home Care | 475 | ||
| Procedural Guideline 18.2 Bladder Scan | 475 | ||
| Delegation and Collaboration | 476 | ||
| Equipment | 476 | ||
| Procedural Steps | 476 | ||
| Skill 18.2 Insertion of a Straight or Indwelling Catheter | 477 | ||
| Assessment | 478 | ||
| Planning | 478 | ||
| Expected Outcomes | 478 | ||
| Delegation and Collaboration | 478 | ||
| Equipment | 479 | ||
| Implementation for Insertion of a Straight or Indwelling Catheter | 479 | ||
| Evaluation | 486 | ||
| Unexpected Outcomes and Related Interventions | 486 | ||
| Recording and Reporting | 487 | ||
| Sample Documentation | 487 | ||
| Special Considerations | 487 | ||
| Pediatric | 487 | ||
| Geriatric | 487 | ||
| Home Care | 487 | ||
| Skill 18.3 Removal of an Indwelling Catheter | 487 | ||
| Assessment | 487 | ||
| Planning | 488 | ||
| Expected Outcomes | 488 | ||
| Delegation and Collaboration | 488 | ||
| Equipment | 488 | ||
| Implementation for Removal of an Indwelling Catheter | 488 | ||
| Evaluation | 489 | ||
| Unexpected Outcomes and Related Interventions | 489 | ||
| Recording and Reporting | 489 | ||
| Sample Documentation | 489 | ||
| Special Considerations | 490 | ||
| Pediatric | 490 | ||
| Geriatric | 490 | ||
| Home Care | 490 | ||
| Procedural Guideline 18.3 Care of an Indwelling Catheter | 490 | ||
| Delegation and Collaboration | 490 | ||
| Equipment | 490 | ||
| Procedural Steps | 490 | ||
| Skill 18.4 Suprapubic Catheter Care | 491 | ||
| Assessment | 491 | ||
| Planning | 491 | ||
| Expected Outcomes | 491 | ||
| Delegation and Collaboration | 491 | ||
| Equipment | 491 | ||
| Implementation for Suprapubic Catheter Care | 491 | ||
| Evaluation | 493 | ||
| Unexpected Outcomes and Related Interventions | 493 | ||
| Recording and Reporting | 493 | ||
| Sample Documentation | 493 | ||
| Special Considerations | 493 | ||
| Home Care | 493 | ||
| Skill 18.5 Performing Catheter Irrigation | 493 | ||
| Assessment | 493 | ||
| Planning | 494 | ||
| Expected Outcomes | 494 | ||
| Delegation and Collaboration | 494 | ||
| Equipment | 494 | ||
| Closed Intermittent Irrigation | 494 | ||
| Closed Continuous Irrigation | 494 | ||
| Open Intermittent Irrigation | 494 | ||
| Implementation for Performing Catheter Irrigation | 495 | ||
| Evaluation | 497 | ||
| Unexpected Outcomes and Related Interventions | 497 | ||
| Recording and Reporting | 498 | ||
| Sample Documentation | 498 | ||
| Special Considerations | 498 | ||
| Home Care | 498 | ||
| Critical Thinking Exercises | 498 | ||
| Case Study | 498 | ||
| Review Questions | 498 | ||
| References | 499 | ||
| 19 Bowel Elimination and Gastric Intubation | 501 | ||
| Evolve Website/Evolve Resources List | 501 | ||
| Patient-Centered Care | 501 | ||
| Safety | 502 | ||
| Evidence-Based Practice | 502 | ||
| Procedural Guideline 19.1 Providing a Bedpan | 502 | ||
| Delegation and Collaboration | 502 | ||
| Equipment | 502 | ||
| Procedural Steps | 503 | ||
| Skill 19.1 Removing a Fecal Impaction | 505 | ||
| Assessment | 505 | ||
| Planning | 505 | ||
| Expected Outcomes | 505 | ||
| Delegation and Collaboration | 506 | ||
| Equipment | 506 | ||
| Implementation for Removing A Fecal Impaction | 506 | ||
| Evaluation | 507 | ||
| Unexpected Outcomes and Related Interventions | 507 | ||
| Recording and Reporting | 507 | ||
| Sample Documentation | 507 | ||
| Special Considerations | 507 | ||
| Pediatric | 507 | ||
| Geriatric | 507 | ||
| Home Care | 507 | ||
| Skill 19.2 Administering an Enema | 507 | ||
| Assessment | 507 | ||
| Planning | 508 | ||
| Expected Outcomes | 508 | ||
| Delegation and Collaboration | 508 | ||
| Equipment | 508 | ||
| Enema Bag Administration | 508 | ||
| Implementation for Administering an Enema | 509 | ||
| Evaluation | 512 | ||
| Unexpected Outcomes and Related Interventions | 512 | ||
| Recording and Reporting | 512 | ||
| Sample Documentation | 512 | ||
| Special Considerations | 512 | ||
| Pediatric | 512 | ||
| Geriatric | 512 | ||
| Home Care | 512 | ||
| Procedural Guideline 19.2 Applying a Fecal Containment Device | 512 | ||
| Delegation and Collaboration | 513 | ||
| Equipment | 513 | ||
| Procedural Steps | 513 | ||
| Skill 19.3 Insertion, Maintenance, and Removal of a Nasogastric Tube for Gastric Decompression | 514 | ||
| Assessment | 515 | ||
| Planning | 515 | ||
| Expected Outcomes | 515 | ||
| Delegation and Collaboration | 515 | ||
| Equipment | 515 | ||
| Implementation for Insertion, Maintenance, and Removal of a Nasogastric Tube for Gastric Decompression | 515 | ||
| Evaluation | 521 | ||
| Unexpected Outcomes and Related Interventions | 521 | ||
| Recording and Reporting | 521 | ||
| Sample Documentation | 521 | ||
| Special Considerations | 521 | ||
| Pediatric | 521 | ||
| Geriatric | 522 | ||
| Critical Thinking Exercises | 522 | ||
| Case Study | 522 | ||
| Review Questions | 522 | ||
| References | 523 | ||
| 20 Ostomy Care | 524 | ||
| Evolve Website/Evolve Resources List | 524 | ||
| Patient-Centered Care | 524 | ||
| Safety | 525 | ||
| Evidence-Based Practice | 526 | ||
| Skill 20.1 Pouching a Bowel Diversion | 526 | ||
| Assessment | 527 | ||
| Planning | 527 | ||
| Expected Outcomes | 527 | ||
| Delegation and Collaboration | 527 | ||
| Equipment | 528 | ||
| Implementation for Pouching a Bowel Diversion | 528 | ||
| Evaluation | 529 | ||
| Unexpected Outcomes and Related Interventions | 530 | ||
| Recording and Reporting | 530 | ||
| Sample Documentation | 530 | ||
| Special Considerations | 530 | ||
| Pediatric | 530 | ||
| Geriatric | 530 | ||
| Home Care | 530 | ||
| Skill 20.2 Pouching an Incontinent Urostomy | 530 | ||
| Assessment | 531 | ||
| Planning | 531 | ||
| Expected Outcomes | 531 | ||
| Delegation and Collaboration | 531 | ||
| Equipment | 531 | ||
| Implementation for Pouching an Incontinent Urostomy | 532 | ||
| Evaluation | 532 | ||
| Unexpected Outcomes and Related Interventions (see Skill 20.1) | 532 | ||
| Recording and Reporting | 533 | ||
| Sample Documentation | 533 | ||
| Special Considerations | 533 | ||
| Pediatric | 533 | ||
| Geriatric | 533 | ||
| Home Care | 533 | ||
| Skill 20.3 Catheterizing a Urinary Diversion | 533 | ||
| Assessment | 533 | ||
| Planning | 533 | ||
| Expected Outcomes | 533 | ||
| Delegation and Collaboration | 533 | ||
| Equipment | 534 | ||
| Implementation for Catheterizing a Urinary Diversion | 534 | ||
| Evaluation | 535 | ||
| Unexpected Outcomes and Related Interventions | 535 | ||
| Recording and Reporting | 535 | ||
| Sample Documentation | 535 | ||
| Special Considerations | 535 | ||
| Home Care | 535 | ||
| Critical Thinking Exercises | 535 | ||
| Case Study | 535 | ||
| Review Questions | 535 | ||
| References | 536 | ||
| Unit 6 Medication Administration | 537 | ||
| 21 Preparation for Safe Medication Administration | 537 | ||
| Evolve Website/Evolve Resources List | 537 | ||
| Patient-Centered Care | 537 | ||
| Safety | 538 | ||
| Evidence-Based Practice | 538 | ||
| Pharmacokinetics | 538 | ||
| Drug Actions | 539 | ||
| Mechanism of Action | 539 | ||
| Medication Dose Responses | 539 | ||
| Types of Medication Action | 539 | ||
| Therapeutic Effects | 539 | ||
| Side Effects | 539 | ||
| Adverse Effects | 540 | ||
| Toxic Effects | 540 | ||
| Idiosyncratic Reactions | 540 | ||
| Allergic Reactions | 540 | ||
| Medication Interactions | 540 | ||
| Medication Tolerance and Dependence | 541 | ||
| Medication Misuse | 541 | ||
| Administering Medications | 541 | ||
| Medication Orders | 541 | ||
| Communication and Transcription of Orders | 542 | ||
| Medication Errors | 542 | ||
| Distribution Systems | 542 | ||
| Unit-Dose System | 543 | ||
| Automated Medication Dispensing Systems | 543 | ||
| Medication Administration Record | 543 | ||
| Six Rights of Medication Administration | 543 | ||
| Right Medication | 543 | ||
| Right Dose | 544 | ||
| Right Patient | 544 | ||
| Right Route | 545 | ||
| Right Time | 545 | ||
| Right Documentation | 545 | ||
| Medication Preparation | 546 | ||
| Interpreting Medication Labels | 546 | ||
| Dosage Calculations | 546 | ||
| Systems of Measurement | 547 | ||
| Metric System | 547 | ||
| Household Measurements | 547 | ||
| Solutions | 547 | ||
| Dosage Calculations | 547 | ||
| Example 1 | 547 | ||
| Example 2 | 548 | ||
| Example 3 | 548 | ||
| Nursing Process | 548 | ||
| Assessment | 548 | ||
| Planning | 549 | ||
| Implementation | 549 | ||
| Preadministration Activities | 549 | ||
| Drug Administration | 549 | ||
| Postadministration Activities | 549 | ||
| Evaluation | 550 | ||
| Patient and Family Teaching | 550 | ||
| Teaching Patients About Side Effects | 550 | ||
| Patient’s Activities of Daily Living | 551 | ||
| Evaluating Teaching Effectiveness | 551 | ||
| Special Handling of Controlled Substances | 551 | ||
| Handling Chemotherapy Medications | 551 | ||
| Special Considerations | 552 | ||
| Pediatric | 552 | ||
| Geriatric | 552 | ||
| Critical Thinking Exercises | 552 | ||
| Case Study | 552 | ||
| Review Questions | 553 | ||
| References | 554 | ||
| 22 Administration of Nonparenteral Medications | 555 | ||
| Evolve Website/Evolve Resources List | 555 | ||
| Patient-Centered Care | 555 | ||
| Safety | 556 | ||
| Evidence-Based Practice | 556 | ||
| Skill 22.1 Administering Oral Medications | 557 | ||
| Assessment | 558 | ||
| Planning | 558 | ||
| Expected Outcomes | 558 | ||
| Delegation and Collaboration | 558 | ||
| Equipment | 558 | ||
| Implementation for Administering Oral Medications | 559 | ||
| Evaluation | 563 | ||
| Unexpected Outcomes and Related Interventions | 564 | ||
| Recording and Reporting | 564 | ||
| Sample Documentation | 564 | ||
| Special Considerations | 564 | ||
| Pediatric | 564 | ||
| Geriatric | 564 | ||
| Home Care | 564 | ||
| Skill 22.2 Administering Medications Through a Feeding Tube | 565 | ||
| Assessment | 565 | ||
| Planning | 565 | ||
| Expected Outcomes | 565 | ||
| Delegation and Collaboration | 565 | ||
| Equipment | 565 | ||
| Implementation for Administering Medications Through a Feeding Tube | 566 | ||
| Evaluation | 569 | ||
| Unexpected Outcomes and Related Interventions | 569 | ||
| Recording and Reporting | 569 | ||
| Sample Documentation | 569 | ||
| Special Considerations | 569 | ||
| Geriatric | 569 | ||
| Home Care | 569 | ||
| Skill 22.3 Applying Topical Medications to the Skin | 569 | ||
| Assessment | 569 | ||
| Planning | 570 | ||
| Expected Outcomes | 570 | ||
| Delegation and Collaboration | 570 | ||
| Equipment | 570 | ||
| Implementation for Applying Topical Medications to the Skin | 570 | ||
| Evaluation | 574 | ||
| Unexpected Outcomes and Related Interventions | 574 | ||
| Recording and Reporting | 574 | ||
| Sample Documentation | 574 | ||
| Special Considerations | 574 | ||
| Geriatric | 574 | ||
| Home Care | 575 | ||
| Skill 22.4 Instilling Eye and Ear Medications | 575 | ||
| Assessment | 575 | ||
| Planning | 575 | ||
| Expected Outcomes | 575 | ||
| Delegation and Collaboration | 576 | ||
| Equipment | 576 | ||
| Eyedrops or Ointment | 576 | ||
| Eardrops | 576 | ||
| Implementation for Instilling Eye and Ear Medications | 576 | ||
| Evaluation | 580 | ||
| Unexpected Outcomes and Related Interventions | 580 | ||
| Recording and Reporting | 580 | ||
| Sample Documentation | 580 | ||
| Special Considerations | 580 | ||
| Pediatric | 580 | ||
| Geriatric | 581 | ||
| Home Care | 581 | ||
| Skill 22.5 Using Metered-Dose Inhalers | 581 | ||
| Assessment | 581 | ||
| Planning | 582 | ||
| Expected Outcomes | 582 | ||
| Delegation and Collaboration | 582 | ||
| Equipment | 582 | ||
| Implementation for Using Metered-Dose Inhalers | 582 | ||
| Evaluation | 585 | ||
| Unexpected Outcomes and Related Interventions | 585 | ||
| Recording and Reporting | 586 | ||
| Sample Documentation | 586 | ||
| Special Considerations | 586 | ||
| Pediatric | 586 | ||
| Geriatric | 586 | ||
| Home Care | 586 | ||
| Skill 22.6 Using Small-Volume Nebulizers | 586 | ||
| Assessment | 586 | ||
| Planning | 587 | ||
| Expected Outcomes | 587 | ||
| Delegation and Collaboration | 587 | ||
| Equipment | 587 | ||
| Implementation for Using Small-Volume Nebulizers | 587 | ||
| Evaluation | 589 | ||
| Unexpected Outcomes and Related Interventions | 589 | ||
| Recording and Reporting | 589 | ||
| Sample Documentation | 590 | ||
| Special Considerations | 590 | ||
| Pediatric | 590 | ||
| Geriatric | 590 | ||
| Home Care | 590 | ||
| Procedural Guideline 22.1 Administering Vaginal Medications | 590 | ||
| Delegation and Collaboration | 590 | ||
| Equipment | 590 | ||
| Procedural Steps | 591 | ||
| Procedural Guideline 22.2 Administering Rectal Suppositories | 592 | ||
| Delegation and Collaboration | 592 | ||
| Equipment | 592 | ||
| Procedural Steps | 593 | ||
| Critical Thinking Exercises | 594 | ||
| Case Study | 594 | ||
| Review Questions | 594 | ||
| References | 595 | ||
| 23 Administration of Parenteral Medications | 597 | ||
| Evolve Website/Evolve Resources List | 597 | ||
| Patient-Centered Care | 597 | ||
| Safety | 598 | ||
| Needlestick Prevention | 598 | ||
| Evidence-Based Practice | 599 | ||
| Skill 23.1 Preparing Injections: Vials and Ampules | 599 | ||
| Syringes | 599 | ||
| Needles | 600 | ||
| Disposable Injection Units | 600 | ||
| Ampules and Vials | 600 | ||
| Assessment | 602 | ||
| Planning | 602 | ||
| Expected Outcomes | 602 | ||
| Delegation and Collaboration | 602 | ||
| Equipment | 602 | ||
| Medication in an Ampule | 602 | ||
| Medication in a Vial | 602 | ||
| Both | 602 | ||
| Implementation for Preparing Injections: Vials and Ampules | 602 | ||
| Evaluation | 606 | ||
| Unexpected Outcomes and Related Interventions | 606 | ||
| Procedural Guideline 23.1 Mixing Parenteral Medications in One Syringe | 606 | ||
| Delegation and Collaboration | 607 | ||
| Equipment | 607 | ||
| Procedural Steps | 607 | ||
| Skill 23.2 Administering Subcutaneous Injections | 609 | ||
| Special Considerations for Administration of Insulin | 610 | ||
| Special Considerations for Administration of Heparin | 610 | ||
| Assessment | 611 | ||
| Planning | 611 | ||
| Expected Outcomes | 611 | ||
| Delegation and Collaboration | 611 | ||
| Equipment | 611 | ||
| Implementation for Administering Subcutaneous Injections | 611 | ||
| Evaluation | 614 | ||
| Unexpected Outcomes and Related Interventions | 614 | ||
| Recording and Reporting | 614 | ||
| Sample Documentation | 614 | ||
| Special Considerations | 614 | ||
| Pediatric | 614 | ||
| Geriatric | 614 | ||
| Home Care | 614 | ||
| Skill 23.3 Administering Intramuscular Injections | 614 | ||
| Injection Sites | 615 | ||
| Ventrogluteal Muscle | 615 | ||
| Vastus Lateralis Muscle | 616 | ||
| Deltoid Muscle | 616 | ||
| Assessment | 616 | ||
| Planning | 617 | ||
| Expected Outcomes | 617 | ||
| Delegation and Collaboration | 617 | ||
| Equipment | 617 | ||
| Implementation for Administering Intramuscular Injections | 618 | ||
| Evaluation | 620 | ||
| Unexpected Outcomes and Related Interventions | 620 | ||
| Recording and Reporting | 620 | ||
| Sample Documentation | 620 | ||
| Special Considerations | 620 | ||
| Pediatric | 620 | ||
| Geriatric | 620 | ||
| Home Care | 620 | ||
| Skill 23.4 Administering Intradermal Injections | 620 | ||
| Assessment | 621 | ||
| Planning | 621 | ||
| Expected Outcomes | 621 | ||
| Delegation and Collaboration | 621 | ||
| Equipment | 621 | ||
| Implementation for Administering Intradermal Injections | 621 | ||
| Evaluation | 623 | ||
| Unexpected Outcomes and Related Interventions | 623 | ||
| Recording and Reporting | 624 | ||
| Sample Documentation | 624 | ||
| Special Considerations | 624 | ||
| Pediatric | 624 | ||
| Geriatric | 624 | ||
| Skill 23.5 Administering Medications by Intravenous Bolus | 624 | ||
| Assessment | 625 | ||
| Planning | 625 | ||
| Expected Outcomes | 625 | ||
| Delegation and Collaboration | 625 | ||
| Equipment | 625 | ||
| Implementation for Administering Medications by Intravenous Bolus | 625 | ||
| Evaluation | 628 | ||
| Unexpected Outcomes and Related Interventions | 628 | ||
| Recording and Reporting | 628 | ||
| Sample Documentation | 629 | ||
| Special Considerations | 629 | ||
| Pediatric | 629 | ||
| Geriatric | 629 | ||
| Home Care | 629 | ||
| Skill 23.6 Administering Intravenous Medications by Piggyback and Syringe Pumps | 629 | ||
| Piggyback | 629 | ||
| Syringe Pump | 629 | ||
| Assessment | 629 | ||
| Planning | 630 | ||
| Expected Outcomes | 630 | ||
| Delegation and Collaboration | 630 | ||
| Equipment | 630 | ||
| Piggyback or Syringe Pump | 630 | ||
| Implementation for Administering Intravenous Medications by Piggyback and Syringe Pumps | 630 | ||
| Evaluation | 634 | ||
| Unexpected Outcomes and Related Interventions | 634 | ||
| Recording and Reporting | 634 | ||
| Sample Documentation | 634 | ||
| Special Considerations | 634 | ||
| Pediatric | 634 | ||
| Geriatric | 634 | ||
| Home Care | 634 | ||
| Skill 23.7 Administering Medications by Continuous Subcutaneous Infusion | 634 | ||
| As sessment | 635 | ||
| Planning | 636 | ||
| Expected Outcomes | 636 | ||
| Delegation and Collaboration | 636 | ||
| Equipment | 636 | ||
| Initiation of CSQI | 636 | ||
| Discontinuing CSQI | 636 | ||
| Implementation for Administering Medications by Continuous Subcutaneous INFUSION | 636 | ||
| Evaluation | 638 | ||
| Unexpected Outcomes and Related Interventions | 638 | ||
| Recording and Reporting | 639 | ||
| Sample Documentation | 639 | ||
| Special Considerations | 639 | ||
| Pediatric | 639 | ||
| Geriatric | 639 | ||
| Home Care | 639 | ||
| Critical Thinking Exercises | 639 | ||
| Case Study | 639 | ||
| Review Questions | 639 | ||
| References | 640 | ||
| Unit 7 Dressings and Wound Care | 642 | ||
| 24 Wound Care and Irrigation | 642 | ||
| Evolve Website/Evolve Resources List | 642 | ||
| Patient-Centered Care | 642 | ||
| Safety | 644 | ||
| Evidence-Based Practice | 644 | ||
| Procedural Guideline 24.1 Performing a Wound Assessment | 644 | ||
| Delegation and Collaboration | 645 | ||
| Equipment | 645 | ||
| Procedural Steps | 645 | ||
| Skill 24.1 Performing a Wound Irrigation | 646 | ||
| Assessment | 646 | ||
| Planning | 647 | ||
| Expected Outcomes | 647 | ||
| Delegation and Collaboration | 647 | ||
| Equipment | 647 | ||
| Implementation for Performing a Wound Irrigation | 647 | ||
| Evaluation | 648 | ||
| Unexpected Outcomes and Related Interventions | 648 | ||
| Recording and Reporting | 648 | ||
| Sample Documentation | 648 | ||
| Special Considerations | 648 | ||
| Pediatric | 648 | ||
| Geriatric | 649 | ||
| Home Care | 649 | ||
| Skill 24.2 Managing Wound Drainage Evacuation | 649 | ||
| Assessment | 649 | ||
| Planning | 649 | ||
| Expected Outcomes | 649 | ||
| Delegation and Collaboration | 650 | ||
| Equipment | 650 | ||
| Implementation for Managing Wound Drainage Evacuation | 650 | ||
| Evaluation | 652 | ||
| Unexpected Outcomes and Related Interventions | 652 | ||
| Recording and Reporting | 652 | ||
| Sample Documentation | 652 | ||
| Special Considerations | 652 | ||
| Pediatric | 652 | ||
| Geriatric | 652 | ||
| Home Care | 652 | ||
| Skill 24.3 Removing Sutures and Staples | 652 | ||
| Assessment | 653 | ||
| Planning | 653 | ||
| Expected Outcomes | 653 | ||
| Delegation and Collaboration | 653 | ||
| Equipment | 653 | ||
| Implementation for Removing Sutures and Staples | 653 | ||
| Evaluation | 656 | ||
| Unexpected Outcomes and Related Interventions | 656 | ||
| Recording and Reporting | 656 | ||
| Sample Documentation | 656 | ||
| Special Considerations | 656 | ||
| Pediatric | 656 | ||
| Geriatric | 656 | ||
| Skill 24.4 Negative-Pressure Wound Therapy | 656 | ||
| Assessment | 657 | ||
| Planning | 657 | ||
| Expected Outcomes | 657 | ||
| Delegation and Collaboration | 657 | ||
| Equipment | 657 | ||
| Implementation for Negative-Pressure Wound Therapy | 658 | ||
| Evaluation | 660 | ||
| Unexpected Outcomes and Related Interventions | 660 | ||
| Recording and Reporting | 660 | ||
| Sample Documentation | 660 | ||
| Special Considerations | 660 | ||
| Pediatric | 660 | ||
| Geriatric | 660 | ||
| Home Care | 660 | ||
| Critical Thinking Exercises | 660 | ||
| Case Study | 660 | ||
| Review Questions | 661 | ||
| References | 662 | ||
| 25 Pressure Ulcers | 663 | ||
| Evolve Website/Evolve Resources List | 663 | ||
| Wound Healing | 663 | ||
| Patient-Centered Care | 664 | ||
| Safety | 664 | ||
| Evidence-Based Practice | 665 | ||
| Skill 25.1 Pressure Ulcer Risk Assessment and Prevention Strategies | 666 | ||
| Assessment | 666 | ||
| Planning | 667 | ||
| Expected Outcomes | 667 | ||
| Delegation and Collaboration | 668 | ||
| Equipment | 668 | ||
| Implementation for Pressure Ulcer Risk Assessment and Prevention Strategies | 668 | ||
| Evaluation | 670 | ||
| Unexpected Outcomes and Related Interventions | 670 | ||
| Recording and Reporting | 670 | ||
| Sample Documentation | 670 | ||
| Special Considerations | 670 | ||
| Pediatric | 670 | ||
| Geriatric | 670 | ||
| Home Care | 670 | ||
| Procedural Guideline 25.1 Selection of a Pressure-Redistribution Support Surface | 671 | ||
| Delegation and Collaboration | 671 | ||
| Equipment | 671 | ||
| Procedural Steps | 671 | ||
| Skill 25.2 Treatment of Pressure Ulcers and Wound Management | 674 | ||
| Assessment | 674 | ||
| Planning | 675 | ||
| Expected Outcomes | 675 | ||
| Delegation and Collaboration | 675 | ||
| Equipment | 675 | ||
| Implementation for Treatment of Pressure Ulcers and Wound Management | 677 | ||
| Evaluation | 679 | ||
| Unexpected Outcomes and Related Interventions | 679 | ||
| Recording and Reporting | 679 | ||
| Sample Documentation | 679 | ||
| Special Considerations | 679 | ||
| Pediatric | 679 | ||
| Geriatric | 679 | ||
| Home Care | 680 | ||
| Critical Thinking Exercises | 680 | ||
| Case Study | 680 | ||
| Review Questions | 680 | ||
| References | 681 | ||
| 26 Dressings, Bandages, and Binders | 683 | ||
| Evolve Website/Evolve Resources List | 683 | ||
| Patient-Centered Care | 683 | ||
| Safety | 686 | ||
| Evidence-Based Practice | 686 | ||
| Skill 26.1 Applying a Gauze Dressing (Dry and Moist-to-Dry) | 687 | ||
| Assessment | 687 | ||
| Planning | 688 | ||
| Expected Outcomes | 688 | ||
| Delegation and Collaboration | 688 | ||
| Equipment | 688 | ||
| Implementation for Applying a Gauze Dressing (Dry and Moist-To-Dry) | 688 | ||
| Evaluation | 693 | ||
| Unexpected Outcomes and Related Interventions | 693 | ||
| Recording and Reporting | 693 | ||
| Sample Documentation | 693 | ||
| Special Considerations | 694 | ||
| Pediatric | 694 | ||
| Geriatric | 694 | ||
| Home Care | 694 | ||
| Skill 26.2 Applying a Pressure Bandage | 694 | ||
| Assessment | 694 | ||
| Planning | 694 | ||
| Expected Outcomes | 694 | ||
| Delegation and Collaboration | 694 | ||
| Equipment | 694 | ||
| Implementation for Applying a Pressure Bandage | 695 | ||
| Evaluation | 696 | ||
| Unexpected Outcomes and Related Interventions | 696 | ||
| Recording and Reporting | 696 | ||
| Sample Documentation | 696 | ||
| Special Considerations | 696 | ||
| Pediatric | 696 | ||
| Geriatric | 696 | ||
| Home Care | 696 | ||
| Procedural Guideline 26.1 Applying a Transparent Dressing | 697 | ||
| Delegation and Collaboration | 697 | ||
| Equipment | 697 | ||
| Procedural Steps | 697 | ||
| Skill 26.3 Applying Hydrocolloid, Hydrogel, Foam, or Alginate Dressings | 698 | ||
| Assessment | 698 | ||
| Planning | 699 | ||
| Expected Outcomes | 699 | ||
| Delegation and Collaboration | 699 | ||
| Equipment | 699 | ||
| Implementation for Applying Hydrocolloid, Hydrogel, Foam, or Alginate Dressings | 699 | ||
| Evaluation | 702 | ||
| Unexpected Outcomes and Related Interventions | 702 | ||
| Recording and Reporting | 702 | ||
| Sample Documentation | 703 | ||
| Special Considerations | 703 | ||
| Pediatric | 703 | ||
| Geriatric | 703 | ||
| Home Care | 703 | ||
| Procedural Guideline 26.2 Applying Gauze and Elastic Bandages | 703 | ||
| Delegation and Collaboration | 703 | ||
| Equipment | 703 | ||
| Procedural Steps | 703 | ||
| Procedural Guideline 26.3 Applying a Binder | 706 | ||
| Delegation and Collaboration | 706 | ||
| Equipment | 706 | ||
| Procedural Steps | 706 | ||
| Critical Thinking Exercises | 707 | ||
| Case Study | 707 | ||
| Review Questions | 708 | ||
| References | 709 | ||
| Unit 8 Complex Nursing Interventions | 710 | ||
| 27 Intravenous and Vascular Access Therapy | 710 | ||
| Evolve Website/Evolve Resources List | 710 | ||
| Patient-Centered Care | 710 | ||
| Safety | 711 | ||
| Evidence-Based Practice | 711 | ||
| Skill 27.1 Insertion of a Short-Peripheral Intravenous Device | 711 | ||
| Assessment | 712 | ||
| Planning | 713 | ||
| Expected Outcomes | 713 | ||
| Delegation and Collaboration | 713 | ||
| Equipment | 713 | ||
| Implementation for Insertion of a Short-Peripheral Intravenous Device | 713 | ||
| Evaluation | 721 | ||
| Unexpected Outcomes and Related Interventions | 721 | ||
| Recording and Reporting | 721 | ||
| Sample Documentation | 722 | ||
| Special Considerations | 722 | ||
| Pediatric | 722 | ||
| Geriatric | 722 | ||
| Home Care | 722 | ||
| Skill 27.2 Regulating Intravenous Infusion Flow Rates | 722 | ||
| Assessment | 723 | ||
| Planning | 723 | ||
| Expected Outcomes | 723 | ||
| Delegation and Collaboration | 723 | ||
| Equipment | 723 | ||
| Implementation for Regulating Intravenous Infusion Flow Rates | 724 | ||
| Evaluation | 726 | ||
| Unexpected Outcomes and Related Interventions | 726 | ||
| Recording and Reporting | 726 | ||
| Sample Documentation | 726 | ||
| Special Considerations | 726 | ||
| Pediatric | 726 | ||
| Geriatric | 726 | ||
| Home Care | 727 | ||
| Skill 27.3 Maintenance of an Intravenous Site | 727 | ||
| Assessment | 727 | ||
| Planning | 728 | ||
| Expected Outcomes | 728 | ||
| Delegation and Collaboration | 728 | ||
| Equipment | 728 | ||
| Changing a Short-Peripheral IV Dressing | 728 | ||
| Changing Infusion Tubing | 728 | ||
| Changing Infusion Container | 728 | ||
| Implementation for Maintenance of an Intravenous Site | 729 | ||
| Evaluation | 733 | ||
| Unexpected Outcomes and Related Interventions | 733 | ||
| Recording and Reporting | 733 | ||
| Sample Documentation | 734 | ||
| Special Considerations | 734 | ||
| Pediatric | 734 | ||
| Geriatric | 734 | ||
| Home Care | 734 | ||
| Procedural Guideline 27.1 Discontinuing a Short-Peripheral Intravenous Device | 734 | ||
| Delegation and Collaboration | 734 | ||
| Equipment | 734 | ||
| Procedural Steps | 734 | ||
| Skill 27.4 Managing Central Vascular Access Devices | 735 | ||
| Assessment | 737 | ||
| Planning | 737 | ||
| Expected Outcomes | 737 | ||
| Delegation and Collaboration | 737 | ||
| Equipment | 737 | ||
| Site Care and Dressing Change | 737 | ||
| Changing the Injection Cap | 737 | ||
| Flushing a Positive Pressure Device | 738 | ||
| Discontinuation of Nontunneled Catheter or PICC | 738 | ||
| Implementation for Managing Central Vascular Access Devices | 738 | ||
| Evaluation | 741 | ||
| Unexpected Outcomes | 741 | ||
| Recording and Reporting | 741 | ||
| Sample Documentation | 742 | ||
| Special Considerations | 742 | ||
| Pediatric | 742 | ||
| Geriatric | 742 | ||
| Home Care | 742 | ||
| Skill 27.5 Administration of Parenteral Nutrition | 742 | ||
| Assessment | 743 | ||
| Planning | 743 | ||
| Expected Outcomes | 743 | ||
| Delegation and Collaboration | 743 | ||
| Equipment | 743 | ||
| Implementation for Administration of Parenteral Nutrition | 743 | ||
| Evaluation | 745 | ||
| Unexpected Outcomes and Related Interventions | 745 | ||
| Recording and Reporting | 746 | ||
| Sample Documentation | 746 | ||
| Special Considerations | 746 | ||
| Pediatric | 746 | ||
| Geriatric | 746 | ||
| Home Care | 746 | ||
| Skill 27.6 Transfusion of Blood Products | 746 | ||
| Assessment | 747 | ||
| Planning | 747 | ||
| Expected Outcomes | 747 | ||
| Delegation and Collaboration | 748 | ||
| Equipment | 748 | ||
| Optional Equipment | 748 | ||
| Implementation for Transfusion of Blood Products | 748 | ||
| Evaluation | 751 | ||
| Unexpected Outcomes and Related Interventions | 751 | ||
| Recording and Reporting | 751 | ||
| Sample Documentation | 752 | ||
| Special Considerations | 752 | ||
| Pediatric | 752 | ||
| Geriatric | 752 | ||
| Home Care | 752 | ||
| Critical Thinking Exercises | 752 | ||
| Case Study | 752 | ||
| Review Questions | 752 | ||
| References | 753 | ||
| 28 Preoperative and Postoperative Care | 755 | ||
| Evolve Website/Evolve Resources List | 755 | ||
| Patient-Centered Care | 755 | ||
| Safety | 756 | ||
| Evidence-Based Practice | 756 | ||
| Skill 28.1 Preoperative Assessment | 757 | ||
| Planning | 757 | ||
| Expected Outcomes | 757 | ||
| Delegation and Collaboration | 757 | ||
| Equipment | 757 | ||
| Implementation for Preoperative Assessment | 757 | ||
| Evaluation | 759 | ||
| Unexpected Outcomes and Related Interventions | 759 | ||
| Recording and Reporting | 760 | ||
| Sample Documentation | 760 | ||
| Special Considerations | 760 | ||
| Pediatric | 760 | ||
| Geriatric | 760 | ||
| Skill 28.2 Preoperative Teaching | 760 | ||
| Assessment | 760 | ||
| Planning | 761 | ||
| Expected Outcomes | 761 | ||
| Delegation and Collaboration | 761 | ||
| Equipment | 761 | ||
| Implementation for Preoperative Teaching | 761 | ||
| Evaluation | 765 | ||
| Unexpected Outcomes and Related Interventions | 765 | ||
| Recording and Reporting | 766 | ||
| Sample Documentation | 766 | ||
| Special Considerations | 766 | ||
| Pediatric | 766 | ||
| Geriatric | 766 | ||
| Home Care | 766 | ||
| Skill 28.3 Physical Preparation for Surgery | 766 | ||
| Assessment | 766 | ||
| Planning | 766 | ||
| Expected Outcomes | 766 | ||
| Delegation and Collaboration | 766 | ||
| Equipment | 767 | ||
| Implementation for Physical Preparation For Surgery | 767 | ||
| Evaluation | 769 | ||
| Unexpected Outcomes and Related Interventions | 769 | ||
| Recording and Reporting | 769 | ||
| Sample Documentation | 769 | ||
| Special Considerations | 769 | ||
| Pediatric | 769 | ||
| Geriatric | 769 | ||
| Skill 28.4 Providing Immediate Anesthesia Recovery in the Postanesthesia Care Unit | 769 | ||
| Assessment | 771 | ||
| Planning | 771 | ||
| Expected Outcomes | 771 | ||
| Delegation and Collaboration | 772 | ||
| Equipment | 772 | ||
| Implementation for Providing Immediate Anesthesia Recovery In The Postanesthesia Care Unit | 772 | ||
| Evaluation | 774 | ||
| Unexpected Outcomes and Related Interventions | 774 | ||
| Recording and Reporting | 775 | ||
| Sample Documentation | 775 | ||
| Special Considerations | 775 | ||
| Pediatric | 775 | ||
| Geriatric | 775 | ||
| Home Care | 776 | ||
| Skill 28.5 Providing Early Postoperative and Convalescent Phase Recovery | 776 | ||
| Assessment | 776 | ||
| Planning | 776 | ||
| Expected Outcomes | 776 | ||
| Delegation and Collaboration | 776 | ||
| Equipment | 776 | ||
| Implementation for Providing Early Postoperative And Convalescent Phase Recovery | 777 | ||
| Evaluation | 779 | ||
| Unexpected Outcomes and Related Interventions | 779 | ||
| Recording and Reporting | 779 | ||
| Sample Documentation | 779 | ||
| Special Considerations | 779 | ||
| Pediatric | 779 | ||
| Geriatric | 779 | ||
| Home Care | 779 | ||
| Critical Thinking Exercises | 780 | ||
| Case Study | 780 | ||
| Review Questions | 780 | ||
| References | 781 | ||
| 29 Emergency Measures for Life Support in the Hospital Setting | 782 | ||
| Evolve Website/Evolve Resources List | 782 | ||
| Patient-Centered Care | 782 | ||
| Safety | 782 | ||
| Evidence-Based Practice | 783 | ||
| Skill 29.1 Inserting an Oropharyngeal Airway | 783 | ||
| Assessment | 783 | ||
| Planning | 784 | ||
| Expected Outcomes | 784 | ||
| Delegation and Collaboration | 784 | ||
| Equipment | 784 | ||
| Implementation for Inserting an Oropharyngeal Airway | 784 | ||
| Evaluation | 785 | ||
| Unexpected Outcomes and Related Interventions | 785 | ||
| Recording and Reporting | 785 | ||
| Sample Documentation | 785 | ||
| Special Considerations | 785 | ||
| Pediatric | 785 | ||
| Skill 29.2 Using an Automated External Defibrillator | 785 | ||
| Assessment | 785 | ||
| Planning | 786 | ||
| Expected Outcomes | 786 | ||
| Delegation and Collaboration | 786 | ||
| Equipment | 786 | ||
| Implementation for Using an Automated External Defibrillator | 786 | ||
| Evaluation | 788 | ||
| Unexpected Outcomes and Related Interventions | 788 | ||
| Recording and Reporting | 788 | ||
| Sample Documentation | 788 | ||
| Special Considerations | 788 | ||
| Pediatric | 788 | ||
| Home Care | 788 | ||
| Skill 29.3 Code Management | 788 | ||
| Assessment | 788 | ||
| Planning | 790 | ||
| Expected Outcomes | 790 | ||
| Delegation and Collaboration | 790 | ||
| Equipment | 790 | ||
| Implementation for Code Management | 790 | ||
| Evaluation | 794 | ||
| Unexpected Outcomes and Related Interventions | 794 | ||
| Recording and Reporting | 794 | ||
| Sample Documentation | 794 | ||
| Special Considerations | 794 | ||
| Pediatric | 794 | ||
| Geriatric | 794 | ||
| Critical Thinking Exercises | 795 | ||
| Case Study | 795 | ||
| Review Questions | 795 | ||
| References | 796 | ||
| Unit 9 Supportive Nursing Interventions | 797 | ||
| 30 Palliative Care | 797 | ||
| Evolve Website/Evolve Resources List | 797 | ||
| Patient-Centered Care | 797 | ||
| Safety | 799 | ||
| Evidence-Based Practice | 800 | ||
| Nurses’ Self-Care: Addressing Compassion Fatigue | 800 | ||
| Skill 30.1 Supporting Patients and Families in Grief | 800 | ||
| Assessment | 800 | ||
| Planning | 801 | ||
| Expected Outcomes | 801 | ||
| Delegation and Collaboration | 801 | ||
| Implementation for Supporting Patients and Families in Grief | 801 | ||
| Evaluation | 802 | ||
| Unexpected Outcomes and Related Interventions | 802 | ||
| Recording and Reporting | 802 | ||
| Sample Documentation | 802 | ||
| Special Considerations | 802 | ||
| Pediatric | 802 | ||
| Geriatric | 802 | ||
| Home Care | 802 | ||
| Skill 30.2 Symptom Management at End of Life | 803 | ||
| Assessment | 803 | ||
| Planning | 803 | ||
| Expected Outcomes | 803 | ||
| Delegation and Collaboration | 804 | ||
| Equipment | 804 | ||
| Implementation for Symptom Management at the End of Life | 804 | ||
| Evaluation | 806 | ||
| Unexpected Outcomes and Related Interventions | 806 | ||
| Recording and Reporting | 806 | ||
| Sample Documentation | 806 | ||
| Special Considerations | 806 | ||
| Pediatric | 806 | ||
| Geriatric | 806 | ||
| Home Care | 806 | ||
| Skill 30.3 Care of the Body After Death | 806 | ||
| Assessment | 806 | ||
| Planning | 807 | ||
| Expected Outcomes | 807 | ||
| Delegation and Collaboration | 807 | ||
| Equipment | 807 | ||
| Implementation for Care of the Body after Death | 807 | ||
| Evaluation | 809 | ||
| Unexpected Outcomes and Related Interventions | 809 | ||
| Recording and Reporting | 809 | ||
| Sample Documentation | 809 | ||
| Special Considerations | 809 | ||
| Pediatric | 809 | ||
| Geriatric | 809 | ||
| Home Care | 809 | ||
| Critical Thinking Exercises | 809 | ||
| Case Study | 809 | ||
| Review Questions | 810 | ||
| References | 811 | ||
| 31 Home Care Safety | 813 | ||
| Evolve Website/Evolve Resources List | 813 | ||
| Client-Centered Care | 813 | ||
| Safety | 813 | ||
| Evidence-Based Practice | 814 | ||
| Skill 31.1 Home Environment Safety | 814 | ||
| Assessment | 814 | ||
| Planning | 815 | ||
| Expected Outcomes | 815 | ||
| Delegation and Collaboration | 815 | ||
| Equipment | 815 | ||
| Implementation for Home Environment Safety | 815 | ||
| Evaluation | 817 | ||
| Unexpected Outcomes and Related Interventions | 817 | ||
| Recording and Reporting | 819 | ||
| Sample Documentation | 819 | ||
| Special Considerations | 819 | ||
| Pediatric | 819 | ||
| Geriatric | 819 | ||
| Home Care | 819 | ||
| Skill 31.2 Home Safety for Clients with Cognitive Deficits | 819 | ||
| Assessment | 820 | ||
| Planning | 820 | ||
| Expected Outcomes | 820 | ||
| Delegation and Collaboration | 820 | ||
| Equipment | 820 | ||
| Implementation for Home Safety for Clients with Cognitive Deficits | 821 | ||
| Evaluation | 822 | ||
| Unexpected Outcomes and Related Interventions | 822 | ||
| Recording and Reporting | 822 | ||
| Sample Documentation | 822 | ||
| Special Considerations | 822 | ||
| Pediatric | 822 | ||
| Geriatric | 822 | ||
| Skill 31.3 Medication and Medical Device Safety | 822 | ||
| Assessment | 822 | ||
| Planning | 823 | ||
| Expected Outcomes | 823 | ||
| Delegation and Collaboration | 823 | ||
| Equipment | 823 | ||
| Implementation for Medication and Medical Device Safety | 823 | ||
| Evaluation | 825 | ||
| Unexpected Outcomes and Related Interventions | 825 | ||
| Recording and Reporting | 826 | ||
| Sample Documentation | 826 | ||
| Special Considerations | 826 | ||
| Pediatric | 826 | ||
| Geriatric | 826 | ||
| Critical Thinking Questions | 826 | ||
| Case Study | 826 | ||
| Review Questions | 826 | ||
| References | 827 | ||
| Appendixes | 829 | ||
| Appendix A Answer Key to End-of-Chapter Exercises | 829 | ||
| Chapter 1 | 829 | ||
| Index | 851 | ||
| A | 851 | ||
| B | 851 | ||
| C | 852 | ||
| D | 854 | ||
| E | 855 | ||
| F | 856 | ||
| G | 857 | ||
| H | 857 | ||
| I | 858 | ||
| J | 859 | ||
| K | 859 | ||
| L | 859 | ||
| M | 860 | ||
| N | 860 | ||
| O | 861 | ||
| P | 862 | ||
| Q | 863 | ||
| R | 863 | ||
| S | 863 | ||
| T | 865 | ||
| U | 866 | ||
| V | 866 | ||
| W | 866 | ||
| Y | 867 | ||
| Z | 867 | ||
| Index of Skills | 868 |