BOOK
Medical-Surgical Nursing - E-Book
Sharon L. Lewis | Linda Bucher | Margaret M. Heitkemper | Mariann M. Harding | Jeffrey Kwong | Dottie Roberts
(2016)
Additional Information
Book Details
Abstract
Awarded first place in the 2017 AJN Book of the Year Awards in the Medical-Surgical Nursing category. Learn how to become an exceptional caregiver in today’s evolving healthcare environment! Written by a dedicated team of expert authors led by Sharon Lewis, Medical-Surgical Nursing, 10th Edition offers up-to-date coverage of the latest trends, hot topics, and clinical developments in the field. Completely revised and updated content explores patient care in various clinical settings and focuses on key topics such as patient safety, NCLEX exam preparation, evidence-based practice, and teamwork. A variety of helpful boxes and tables make it easy for you to find essential information and the accessible writing style and building-block approach make even the most complex concepts easy to grasp. Best of all — a complete collection of learning and study resources helps you learn more effectively and offers valuable, real-world preparation for clinical practice.
- Highly readable format offers you a strong foundation in medical-surgical nursing.
- Content written and reviewed by leading experts in the field ensures that information is comprehensive, current, and clinically accurate.
- Informatics boxes discuss how technology is used by nurses and patients in healthcare settings.
- Expanded coverage of evidence-based practice helps you understand how to apply the latest research to real-life patient care.
- Expanded Safety Alerts throughout the book highlight patient safety issues and focus on the latest National Patient Safety Goals.
- UNIQUE! "Levels of Care" approach explains how nursing care varies for different levels of health and illness.
- Bridge to NCLEX Examination review questions at the end of each chapter reinforce key content while helping you prepare for the NCLEX examination with both standard and alternate item format questions.
- Unfolding case studies included throughout each assessment chapter help you apply concepts and procedures to real-life patient care.
- Managing Care of Multiple Patients case studies at the end of each section help you apply your knowledge of various disorders and prioritize and delegate patient care.
- Separate chapter on genetics focuses on the practical application to nursing care of patients.
- Genetics in Clinical Practice boxes address key topics such as genetic testing, Alzheimer’s disease, sickle cell disease, and genetics-related ethical issues.
- Genetic Risk Alerts and Genetic Link headings highlight specific genetic issues related to body system assessments and disorders.
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
Front Cover | cover | ||
Inside Front Cover | ifc1 | ||
Evolve page | ES-4 | ||
Medical-Surgical Nursing | i | ||
Copyright Page | iv | ||
About the Authors | v | ||
Contributors | vii | ||
Reviewers | ix | ||
Dedication | xiii | ||
Preface | xv | ||
Organization | xv | ||
Classic Features | xv | ||
New Features | xvi | ||
Learning Supplements for Students | xvi | ||
Acknowledgments | xvii | ||
Authors of Teaching and Learning Resources | xix | ||
Table Of Contents | xxi | ||
Special Features | xxiii | ||
Assessment Abnormalities Tables | xxiii | ||
Becoming A Nurse Leader Boxes | xxiii | ||
Case Studies | xxiii | ||
End-of-Chapter Case Studies | xxiii | ||
Managing Care of Multiple Patients Case Studies | xxiii | ||
Assessment Case Studies | xxiii | ||
Complementary & Alternative TherapIES Boxes | xxiv | ||
Cultural & Ethnic Health Disparities Boxes | xxiv | ||
Diagnostic Studies Tables | xxiv | ||
Drug Therapy Tables | xxiv | ||
Emergency Management Tables | xxv | ||
Ethical/Legal Dilemmas Boxes | xxv | ||
Evidence-Based Practice Boxes | xxv | ||
Applying the Evidence Boxes | xxv | ||
Translating Research Into Practice Boxes | xxvi | ||
Focused Assessment Boxes | xxvi | ||
Gender Differences Boxes | xxvi | ||
Genetics In Clinical Practice Boxes | xxvi | ||
Gerontologic Assessment Differences Tables | xxvi | ||
Health History Tables | xxvii | ||
Healthy People Boxes | xxvii | ||
Informatics in Practice Boxes | xxvii | ||
Interprofessional Care Tables | xxvii | ||
Nursing Assessment Tables | xxviii | ||
Nursing ManagemenT Tables | xxviii | ||
Nutritional Therapy Tables | xxviii | ||
Patient & Caregiver Teaching Tables | xxix | ||
Teamwork & Collaboration Boxes | xxix | ||
Second half title page_single volume | xxxi | ||
1 Concepts in Nursing Practice | 1 | ||
1 Professional Nursing Practice | 2 | ||
Learning Outcomes | 2 | ||
Key Terms | 2 | ||
Professional Nursing Practice | 2 | ||
Domain of Nursing Practice | 2 | ||
Definitions of Nursing | 2 | ||
Nursing’s View of Humanity | 3 | ||
Scope of Nursing Practice | 3 | ||
Influences on Professional Nursing Practice | 3 | ||
Complex Health Care Environments | 3 | ||
Expanding Knowledge and Technology. | 3 | ||
Diverse Populations. | 4 | ||
Consumerism. | 4 | ||
Health Care Systems | 4 | ||
Health Care Financing. | 4 | ||
Health Policy. | 4 | ||
Healthy People Initiative | 4 | ||
Organizational Influences | 5 | ||
Professional Nursing Organizations. | 5 | ||
Quality and Safety Education for Nurses (QSEN). | 5 | ||
Patient-Centered Care | 5 | ||
Nursing Process | 5 | ||
Standardized Nursing Terminologies | 5 | ||
NANDA-I Nursing Diagnoses. | 7 | ||
Nursing Outcomes Classification (NOC). | 7 | ||
Nursing Interventions Classification (NIC). | 7 | ||
NANDA-NOC-NIC Linkages. | 7 | ||
Nursing Care Plans | 7 | ||
Continuum of Patient Care | 8 | ||
Delivery of Nursing Care | 9 | ||
Critical Thinking | 9 | ||
Teamwork and Collaboration | 9 | ||
Interprofessional Team | 9 | ||
Coordinating Care | 10 | ||
Communication. | 10 | ||
Clinical Pathways. | 10 | ||
Delegation and Assignment. | 11 | ||
Safety | 12 | ||
Serious Reportable Events | 12 | ||
National Patient Safety Goals | 12 | ||
Quality Improvement | 12 | ||
National Database of Nursing Quality Indicators | 13 | ||
Informatics | 13 | ||
Electronic Health Records | 14 | ||
Evidence-Based Practice | 15 | ||
Steps of EBP Process | 15 | ||
Step 1. | 15 | ||
Step 2. | 15 | ||
Step 3. | 15 | ||
Step 4. | 16 | ||
Step 5. | 16 | ||
Step 6. | 16 | ||
Implementing EBP | 16 | ||
Bridge to NCLEX Examination | 16 | ||
Evolve Website | 17 | ||
References | 17 | ||
2 Health Disparities and Culturally Competent Care | 18 | ||
Learning Outcomes | 18 | ||
Key Terms | 18 | ||
Determinants of Health | 18 | ||
Health Disparities and Health Equity | 19 | ||
Factors and Conditions Leading to Health Disparities | 19 | ||
Ethnicity and Race. | 19 | ||
Place. | 20 | ||
Income, Education, and Occupation. | 20 | ||
Health Literacy. | 20 | ||
Gender. | 20 | ||
Age. | 20 | ||
Sexual Orientation. | 21 | ||
Lesbian, Gay, Bisexual, and Transgender (LGBT). | 21 | ||
Health Care Provider Attitudes. | 21 | ||
Culture | 21 | ||
Cultural Competence | 23 | ||
Cultural Diversity in the Health Care Workplace | 24 | ||
Cultural Factors Affecting Health and Health Care | 24 | ||
Folk Healers and Traditions | 24 | ||
Spirituality and Religion | 24 | ||
Cross-Cultural Communication | 25 | ||
Family Roles and Relationships | 26 | ||
Personal Space | 27 | ||
Touch | 27 | ||
Nutrition | 28 | ||
Immigrants and Immigration | 28 | ||
Medications | 28 | ||
Psychologic Factors | 29 | ||
Nursing Management: Reducing Health Disparities and Increasing Cultural Competency | 29 | ||
Nurse’s Self-Assessment | 29 | ||
Patient Assessment | 29 | ||
Nursing Implementation | 30 | ||
Advocacy. | 30 | ||
Standardized Guidelines. | 30 | ||
Communication. | 30 | ||
Bridge to NCLEX Examination | 32 | ||
Evolve Website | 33 | ||
References | 33 | ||
3 Health History and Physical Examination | 34 | ||
Learning Outcomes | 34 | ||
Key Terms | 34 | ||
Data Collection | 34 | ||
Medical Focus | 34 | ||
Nursing Focus | 34 | ||
Types of Data | 35 | ||
Interview Considerations | 35 | ||
Symptom Investigation | 35 | ||
Data Organization | 35 | ||
Culturally Competent Care: Assessment | 36 | ||
Nursing History: Subjective Data | 36 | ||
Important Health Information | 36 | ||
Past Health History. | 36 | ||
Medications. | 36 | ||
Allergies. | 36 | ||
Surgery or Other Treatments. | 36 | ||
Functional Health Patterns | 38 | ||
Health Perception–Health Management Pattern. | 38 | ||
Nutritional-Metabolic Pattern. | 38 | ||
Elimination Pattern. | 38 | ||
Activity-Exercise Pattern. | 38 | ||
Sleep-Rest Pattern. | 38 | ||
Cognitive-Perceptual Pattern. | 38 | ||
Self-Perception–Self-Concept Pattern. | 38 | ||
Role-Relationship Pattern. | 38 | ||
Sexuality-Reproductive Pattern. | 39 | ||
Coping–Stress Tolerance Pattern. | 39 | ||
Value-Belief Pattern. | 39 | ||
Physical Examination: Objective Data | 39 | ||
General Survey | 39 | ||
Physical Examination | 39 | ||
Techniques. | 39 | ||
Inspection. | 39 | ||
Palpation. | 39 | ||
Percussion. | 39 | ||
Auscultation. | 40 | ||
Equipment. | 40 | ||
Organization of Examination. | 40 | ||
Recording Physical Examination. | 40 | ||
Types of Assessment | 40 | ||
Emergency Assessment | 40 | ||
Comprehensive Assessment | 40 | ||
Focused Assessment | 40 | ||
Using Assessment Approaches | 42 | ||
Problem Identification and Nursing Diagnoses | 44 | ||
Bridge to NCLEX Examination | 45 | ||
Evolve Website | 45 | ||
References | 45 | ||
4 Patient and Caregiver Teaching | 46 | ||
Learning Outcomes | 46 | ||
Key Terms | 46 | ||
Role of Patient and Caregiver Teaching | 46 | ||
Teaching-Learning Process | 46 | ||
Adult Learner | 47 | ||
Adult Learning Principles. | 47 | ||
Models to Promote Health. | 47 | ||
Nurse as Teacher | 48 | ||
Required Competencies | 48 | ||
Knowledge of Subject Matter. | 48 | ||
Communication Skills. | 48 | ||
Challenges to Nurse-Teacher Effectiveness. | 49 | ||
Caregiver Support in the Teaching-Learning Process | 49 | ||
Caregiver Stress. | 50 | ||
Regulatory Mandates for Patient Teaching | 50 | ||
Process of Patient Teaching | 51 | ||
Assessment | 51 | ||
Physical Factors. | 51 | ||
Psychologic Factors. | 51 | ||
Sociocultural Factors | 52 | ||
Health Literacy. | 52 | ||
Cultural Considerations. | 52 | ||
Socioeconomic Considerations. | 52 | ||
Learner Factors. | 53 | ||
Learning Needs. | 53 | ||
Readiness to Learn. | 53 | ||
Learning Style. | 53 | ||
Planning | 54 | ||
Setting Goals. | 54 | ||
Selecting Teaching Strategies. | 54 | ||
Learning Materials. | 54 | ||
Using Technology. | 55 | ||
Implementation | 55 | ||
Evaluation | 56 | ||
Bridge to NCLEX Examination | 58 | ||
Evolve Website | 58 | ||
References | 58 | ||
5 Chronic Illness and Older Adults | 60 | ||
Learning Outcomes | 60 | ||
Key Terms | 60 | ||
Chronic Illness | 60 | ||
Trajectory of Chronic Illness | 60 | ||
Preventing and Managing a Crisis. | 60 | ||
Carrying Out Prescribed Treatment Regimen. | 61 | ||
Controlling Symptoms. | 61 | ||
Reordering Time. | 61 | ||
Adjusting to Changes in the Course of Disease. | 61 | ||
Preventing Social Isolation. | 61 | ||
Attempting to Normalize Interactions With Others. | 61 | ||
Prevention of Chronic Illness | 61 | ||
Nursing Management: Chronic Illness | 62 | ||
Older Adults | 63 | ||
Demographics of Aging | 63 | ||
Attitudes Toward Aging | 63 | ||
Biologic Aging | 63 | ||
Age-Related Physiologic Changes | 64 | ||
Special Older Adult Populations | 64 | ||
Chronically Ill Older Adults | 64 | ||
Cognitively Impaired Older Adults | 64 | ||
Rural Older Adults | 64 | ||
Homeless Older Adults | 65 | ||
Frail Older Adults | 65 | ||
Culturally Competent Care: Older Adults | 66 | ||
Social Support for Older Adults | 66 | ||
Family Caregivers | 66 | ||
Elder Mistreatment | 66 | ||
Self-Neglect | 67 | ||
Social Services for Older Adults | 67 | ||
Medicare and Medicaid | 68 | ||
Care Alternatives for Older Adults | 68 | ||
Adult Day Care and Adult Day Health Care | 68 | ||
Home Health Care | 68 | ||
Long-Term Care Facilities | 68 | ||
Programs for All-Inclusive Care for the Elderly (PACE) | 69 | ||
Legal and Ethical Issues | 69 | ||
Nursing Management: Older Adults | 69 | ||
Nursing Assessment | 69 | ||
Planning | 70 | ||
Nursing Implementation | 70 | ||
Health Promotion. | 70 | ||
Acute and Ambulatory Care. | 71 | ||
Care Transitions. | 71 | ||
Rehabilitation. | 71 | ||
Assistive Devices. | 72 | ||
Safety. | 72 | ||
Medication Use. | 72 | ||
Depression. | 73 | ||
Use of Restraints. | 74 | ||
Sleep. | 74 | ||
Evaluation | 74 | ||
Bridge to NCLEX Examination | 75 | ||
Evolve Website | 76 | ||
References | 76 | ||
6 Stress and Stress Management | 77 | ||
Learning Outcomes | 77 | ||
Key Terms | 77 | ||
What is Stress? | 77 | ||
Is Stress Bad or Good? | 77 | ||
Factors Affecting Response to Stress | 78 | ||
Physiologic Response to Stress | 78 | ||
Nervous System | 79 | ||
Cerebral Cortex. | 79 | ||
Limbic System. | 79 | ||
Reticular Formation. | 79 | ||
Hypothalamus. | 79 | ||
Endocrine System | 79 | ||
Summary of Stress Response | 80 | ||
Immune System | 80 | ||
Mind-Body-Spirit Connection | 81 | ||
Effects of Stress on Health | 81 | ||
Coping Strategies | 82 | ||
Relaxation Strategies | 83 | ||
Relaxation Breathing | 83 | ||
Meditation | 84 | ||
Prayer. | 84 | ||
Imagery | 84 | ||
Music | 85 | ||
Massage | 85 | ||
Nursing Management: Stress | 86 | ||
Nursing Assessment | 86 | ||
Nursing Implementation | 86 | ||
Bridge to NCLEX Examination | 88 | ||
Evolve Website | 88 | ||
References | 88 | ||
7 Sleep and Sleep Disorders | 89 | ||
Learning Outcomes | 89 | ||
Key Terms | 89 | ||
Sleep | 89 | ||
Physiologic Sleep Mechanisms | 90 | ||
Sleep-Wake Cycle | 90 | ||
Wake Behavior. | 90 | ||
Sleep Behavior. | 90 | ||
Circadian Rhythms. | 90 | ||
Sleep Architecture | 90 | ||
NREM Sleep. | 91 | ||
REM Sleep. | 91 | ||
Insufficient Sleep and Sleep Disturbances | 91 | ||
Sleep Disturbances in the Hospital | 91 | ||
Sleep Disorders | 91 | ||
Insomnia | 91 | ||
Etiology and Pathophysiology | 92 | ||
Clinical Manifestations | 93 | ||
Diagnostic Studies | 93 | ||
Self-Report. | 93 | ||
Actigraphy. | 93 | ||
Polysomnography. | 93 | ||
Interprofessional Care | 93 | ||
Cognitive-Behavioral Therapy for Insomnia. | 93 | ||
Drug Therapy. | 94 | ||
Benzodiazepine Hypnotics. | 94 | ||
Non-Benzodiazepine Hypnotics. | 94 | ||
Orexin-Receptor Antagonist. | 94 | ||
Melatonin-Receptor Agonist. | 94 | ||
Antidepressants. | 94 | ||
Antihistamines. | 94 | ||
Complementary and Alternative Therapy. | 95 | ||
Nursing Management: Insomnia | 95 | ||
Nursing Assessment | 95 | ||
Nursing Diagnoses | 95 | ||
Nursing Implementation | 95 | ||
Obstructive Sleep Apnea | 96 | ||
Clinical Manifestations | 97 | ||
Diagnostic Studies | 97 | ||
Nursing and Interprofessional Management: Sleep Apnea | 97 | ||
Conservative Treatment | 97 | ||
Surgical Treatment | 98 | ||
Periodic Limb Movement Disorder | 98 | ||
Circadian Rhythm Disorders | 98 | ||
Narcolepsy | 98 | ||
Parasomnias | 99 | ||
Gerontologic Considerations: Sleep | 99 | ||
Special Sleep Needs of Nurses | 100 | ||
Bridge to NCLEX Examination | 100 | ||
Evolve Website | 101 | ||
References | 101 | ||
8 Pain | 102 | ||
Learning Outcomes | 102 | ||
Key Terms | 102 | ||
Magnitude of Pain Problem | 102 | ||
Definitions and Dimensions of Pain | 102 | ||
Pain Mechanisms | 103 | ||
Transduction. | 103 | ||
Transmission. | 104 | ||
Transmission to Spinal Cord. | 104 | ||
Dorsal Horn Processing. | 105 | ||
Transmission to Thalamus and Cortex. | 105 | ||
Perception. | 106 | ||
Modulation. | 106 | ||
Classification of Pain | 106 | ||
Nociceptive Pain | 106 | ||
Neuropathic Pain | 106 | ||
Acute and Chronic Pain | 107 | ||
Pain Assessment | 107 | ||
Elements of a Pain Assessment | 107 | ||
Pain Pattern. | 108 | ||
Location. | 109 | ||
Intensity. | 109 | ||
Quality. | 109 | ||
Associated Symptoms. | 109 | ||
Management Strategies. | 109 | ||
Impact of Pain. | 109 | ||
Patient’s Beliefs, Expectations, and Goals. | 110 | ||
Documentation | 110 | ||
Reassessment | 110 | ||
Pain Treatment | 110 | ||
Basic Principles | 110 | ||
Drug Therapy for Pain | 111 | ||
Nonopioids. | 111 | ||
Opioids. | 112 | ||
Types of Opioids. | 112 | ||
Dual-Mechanism Agents. | 114 | ||
Opioids to Avoid. | 114 | ||
Side Effects of Opioids. | 114 | ||
Adjuvant Analgesic Therapy. | 115 | ||
Corticosteroids. | 115 | ||
Antidepressants. | 117 | ||
Antiseizure Drugs. | 117 | ||
GABA-Receptor Agonist. | 117 | ||
α2-Adrenergic Agonists. | 117 | ||
Local Anesthetics. | 117 | ||
Cannabinoids. | 117 | ||
Administration | 117 | ||
Scheduling. | 117 | ||
Titration. | 117 | ||
Equianalgesic Dosing. | 117 | ||
Administration Routes. | 118 | ||
Oral. | 118 | ||
Transmucosal and buccal routes. | 118 | ||
Intranasal route. | 118 | ||
Rectal. | 118 | ||
Transdermal route. | 118 | ||
Parenteral routes. | 119 | ||
Intraspinal delivery. | 119 | ||
Implantable pumps. | 120 | ||
Patient-controlled analgesia. | 120 | ||
Interventional Therapy | 120 | ||
Therapeutic Nerve Blocks. | 120 | ||
Neuroablative Techniques. | 120 | ||
Neuroaugmentation. | 121 | ||
Nondrug Therapies for Pain | 121 | ||
Physical Pain Relief Strategies | 121 | ||
Massage. | 121 | ||
Exercise. | 121 | ||
Transcutaneous Electrical Nerve Stimulation. | 121 | ||
Acupuncture. | 121 | ||
Heat Therapy. | 122 | ||
Cold Therapy. | 122 | ||
Cognitive Therapies. | 122 | ||
Distraction. | 122 | ||
Hypnosis. | 122 | ||
Relaxation Strategies. | 122 | ||
Nursing and Interprofessional Management: Pain | 122 | ||
Effective Communication | 122 | ||
Challenges to Effective Pain Management | 122 | ||
Tolerance. | 122 | ||
Physical Dependence. | 123 | ||
Pseudoaddiction. | 123 | ||
Addiction. | 123 | ||
Risk Monitoring. | 123 | ||
Institutionalizing Pain Education and Management | 123 | ||
Ethical Issues in Pain Management | 124 | ||
Fear of Hastening Death by Administering Analgesics | 124 | ||
Requests for Assisted Suicide | 125 | ||
Use of Placebos in Pain Assessment and Treatment | 125 | ||
Gerontologic Considerations: Pain | 125 | ||
Managing Pain in Special Populations | 126 | ||
Patients Unable to Self-Report Pain | 126 | ||
Patients With Substance Abuse Problems | 126 | ||
Bridge to NCLEX Examination | 127 | ||
Evolve Website | 128 | ||
References | 128 | ||
9 Palliative Care at End of Life | 129 | ||
Learning Outcomes | 129 | ||
Key Terms | 129 | ||
Palliative Care | 129 | ||
Hospice Care | 130 | ||
Death | 131 | ||
End-of-Life Care | 132 | ||
Physical Manifestations at End of Life | 132 | ||
Psychosocial Manifestations at End of Life | 132 | ||
Bereavement and Grief | 133 | ||
Spiritual Needs | 134 | ||
Culturally Competent Care: End of Life | 134 | ||
Legal and Ethical Issues Affecting End-of-Life Care | 135 | ||
Organ and Tissue Donation | 135 | ||
Advance Care Planning and Advance Directives | 135 | ||
Resuscitation | 135 | ||
Nursing Management: End of Life | 137 | ||
Nursing Assessment | 137 | ||
Planning | 138 | ||
Nursing Implementation | 138 | ||
Psychosocial Care. | 138 | ||
Anxiety and Depression. | 138 | ||
Anger. | 138 | ||
Hopelessness and Powerlessness. | 138 | ||
Fear. | 139 | ||
Fear of pain. | 139 | ||
Fear of shortness of breath. | 139 | ||
Fear of loneliness and abandonment. | 139 | ||
Fear of meaninglessness. | 139 | ||
Communication. | 139 | ||
Physical Care. | 139 | ||
Postmortem Care. | 139 | ||
Special Needs of Caregivers and Nurses in End-of-Life Care | 142 | ||
Special Needs of Family Caregivers | 142 | ||
Special Needs of Nurses | 142 | ||
Bridge to NCLEX Examination | 143 | ||
Evolve Website | 144 | ||
References | 144 | ||
10 Substance Use Disorders | 145 | ||
Learning Outcomes | 145 | ||
Key Terms | 145 | ||
Drugs Associated With Substance Use Disorder | 145 | ||
Nicotine | 145 | ||
Effects of Use and Complications | 146 | ||
Nursing and Interprofessional Management: Tobacco Use Disorder | 146 | ||
Tobacco Cessation | 146 | ||
Alcohol | 148 | ||
Effects of Use and Complications | 148 | ||
Nursing and Interprofessional Management: Alcohol Use Disorder | 149 | ||
Alcohol Toxicity | 149 | ||
Alcohol Withdrawal Syndrome | 150 | ||
Use of Other Substances | 150 | ||
Stimulants | 150 | ||
Nursing and Interprofessional Management: Stimulant Use | 151 | ||
Toxicity | 151 | ||
Withdrawal | 151 | ||
Depressants | 152 | ||
Sedative-Hypnotics | 152 | ||
Opioids | 152 | ||
Nursing and Interprofessional Management: Depressant Use | 152 | ||
Toxicity | 152 | ||
2 Pathophysiologic Mechanisms of Disease | 159 | ||
11 Inflammation and Wound Healing | 160 | ||
Learning Outcomes | 160 | ||
Key Terms | 160 | ||
Inflammatory Response | 160 | ||
Vascular Response | 160 | ||
Cellular Response | 161 | ||
Neutrophils. | 161 | ||
Monocytes. | 161 | ||
Lymphocytes. | 161 | ||
Chemical Mediators | 161 | ||
Complement System. | 161 | ||
Prostaglandins and Leukotrienes. | 162 | ||
Exudate Formation | 162 | ||
Clinical Manifestations | 162 | ||
Fever. | 163 | ||
Types of Inflammation | 163 | ||
Nursing and Interprofessional Management: Inflammation | 163 | ||
Nursing Implementation | 163 | ||
Health Promotion. | 163 | ||
Acute Care | 164 | ||
Observation and Vital Signs. | 164 | ||
Fever. | 164 | ||
Drug Therapy. | 164 | ||
RICE. | 165 | ||
Rest. | 165 | ||
Cold and heat. | 165 | ||
Compression and immobilization. | 165 | ||
Elevation. | 165 | ||
Healing Process | 165 | ||
Regeneration | 165 | ||
Repair | 165 | ||
Primary Intention. | 165 | ||
Initial Phase. | 166 | ||
Granulation Phase. | 166 | ||
Maturation Phase and Scar Contraction. | 166 | ||
Secondary Intention. | 166 | ||
Tertiary Intention. | 166 | ||
Wound Classification | 166 | ||
Complications of Healing | 166 | ||
Nursing and Interprofessional Management: Wound Healing | 166 | ||
Nursing Assessment | 166 | ||
Nursing Implementation | 168 | ||
Clean Wounds. | 168 | ||
Contaminated Wounds. | 168 | ||
Negative-Pressure Wound Therapy. | 169 | ||
Hyperbaric Oxygen Therapy. | 170 | ||
Drug Therapy. | 170 | ||
Nutritional Therapy. | 170 | ||
Infection Prevention and Control. | 171 | ||
Psychologic Implications. | 171 | ||
Patient Teaching. | 171 | ||
Pressure Ulcers | 172 | ||
Etiology and Pathophysiology | 172 | ||
Clinical Manifestations | 172 | ||
Nursing and Interprofessional Management: Pressure Ulcers | 172 | ||
Nursing Assessment | 172 | ||
Nursing Diagnoses | 172 | ||
Planning | 172 | ||
Nursing Implementation | 174 | ||
Health Promotion. | 174 | ||
Acute Care. | 174 | ||
Ambulatory Care. | 175 | ||
Evaluation | 176 | ||
Bridge to NCLEX Examination | 176 | ||
Evolve Website | 177 | ||
References | 177 | ||
12 Genetics and Genomics | 178 | ||
Learning Outcomes | 178 | ||
Key Terms | 178 | ||
Genetics and Genomics | 178 | ||
Basic Principles of Genetics | 178 | ||
Genes. | 178 | ||
Chromosomes. | 179 | ||
DNA. | 179 | ||
RNA. | 180 | ||
Protein Synthesis. | 180 | ||
Mitosis. | 180 | ||
Meiosis. | 180 | ||
Genetic Mutations | 180 | ||
Types of Mutations. | 181 | ||
Inheritance Patterns | 181 | ||
Human Genome Project | 182 | ||
Genetic Disorders | 182 | ||
Classification of Genetic Disorders | 182 | ||
Single Gene Disorders. | 182 | ||
Multifactorial Genetic Disorders. | 182 | ||
Epigenetics. | 183 | ||
Chromosome Disorders. | 183 | ||
Genetic Testing | 183 | ||
Interpreting Genetic Test Results | 183 | ||
Direct-to-Consumer Genetic Tests | 185 | ||
Genetic Technology | 186 | ||
DNA Fingerprinting. | 186 | ||
DNA Microarray (DNA Chip). | 186 | ||
Genome-Wide Association Study (GWAS) | 186 | ||
Pharmacogenomics and Pharmacogenetics | 186 | ||
Gene Therapy | 187 | ||
Stem Cell Therapy | 187 | ||
Nursing Management: Genetics and Genomics | 188 | ||
Nursing Assessment: Family History | 189 | ||
Bridge to NCLEX Examination | 190 | ||
Evolve Website | 190 | ||
References | 190 | ||
13 Altered Immune Responses and Transplantation | 191 | ||
Learning Outcomes | 191 | ||
Key Terms | 191 | ||
Normal Immune Response | 191 | ||
Antigens | 191 | ||
Types of Immunity | 191 | ||
Innate Immunity. | 191 | ||
Acquired Immunity. | 192 | ||
Active Acquired Immunity. | 192 | ||
Passive Acquired Immunity. | 192 | ||
Lymphoid Organs | 192 | ||
Cells Involved in Immune Response | 192 | ||
Mononuclear Phagocytes. | 192 | ||
Lymphocytes. | 192 | ||
B Lymphocytes. | 192 | ||
T Lymphocytes. | 192 | ||
T cytotoxic cells. | 194 | ||
T helper cells. | 194 | ||
Natural Killer Cells. | 194 | ||
T Dendritic Cells. | 194 | ||
Cytokines | 194 | ||
Comparison of Humoral and Cell-Mediated Immunity | 194 | ||
Humoral Immunity. | 195 | ||
Cell-Mediated Immunity. | 196 | ||
Gerontologic Considerations: Effects of Aging on the Immune System | 196 | ||
Altered Immune Response | 196 | ||
Hypersensitivity Reactions | 197 | ||
Type I: IgE-Mediated Reactions. | 197 | ||
Anaphylaxis. | 197 | ||
Atopic Reactions. | 198 | ||
Type II: Cytotoxic and Cytolytic Reactions. | 199 | ||
Hemolytic Transfusion Reactions. | 199 | ||
Goodpasture Syndrome. | 199 | ||
Type III: Immune-Complex Reactions. | 199 | ||
Type IV: Delayed Hypersensitivity Reactions. | 199 | ||
Contact Dermatitis. | 200 | ||
Microbial Hypersensitivity Reactions. | 200 | ||
Allergic Disorders | 200 | ||
Assessment | 200 | ||
Diagnostic Studies | 200 | ||
Skin Tests. | 200 | ||
Procedure. | 201 | ||
Results. | 201 | ||
Precautions. | 201 | ||
Interprofessional Care | 201 | ||
Anaphylaxis. | 201 | ||
Chronic Allergies. | 201 | ||
Allergen Recognition and Control. | 201 | ||
Drug Therapy. | 202 | ||
Antihistamines. | 202 | ||
Sympathomimetic/Decongestant Drugs. | 202 | ||
Corticosteroids. | 202 | ||
Antipruritic Drugs. | 202 | ||
Mast Cell–Stabilizing Drugs. | 202 | ||
Leukotriene Receptor Antagonists. | 202 | ||
Immunotherapy. | 202 | ||
Mechanism of Action. | 203 | ||
Method of Administration. | 203 | ||
Subcutaneous immunotherapy. | 203 | ||
Sublingual immunotherapy. | 203 | ||
Nursing Management: Immunotherapy | 203 | ||
Latex Allergies | 203 | ||
Types of Latex Allergies. | 203 | ||
Latex-Food Syndrome. | 203 | ||
Nursing and Interprofessional Management: Latex Allergies | 204 | ||
Multiple Chemical Sensitivity | 204 | ||
Autoimmunity | 204 | ||
Autoimmune Diseases | 205 | ||
Apheresis | 205 | ||
Plasmapheresis. | 205 | ||
Immunodeficiency Disorders | 205 | ||
Primary Immunodeficiency Disorders | 206 | ||
Secondary Immunodeficiency Disorders | 206 | ||
Human Leukocyte Antigen System | 206 | ||
Human Leukocyte Antigen and Disease Associations | 206 | ||
Organ Transplantation | 207 | ||
Tissue Typing | 208 | ||
HLA Typing. | 208 | ||
Panel of Reactive Antibodies. | 208 | ||
Crossmatch. | 208 | ||
Transplant Rejection | 208 | ||
Hyperacute Rejection. | 208 | ||
Acute Rejection. | 208 | ||
Chronic Rejection. | 208 | ||
Immunosuppressive Therapy | 209 | ||
Calcineurin Inhibitors. | 209 | ||
Mycophenolate Mofetil. | 209 | ||
Sirolimus. | 209 | ||
Monoclonal Antibodies. | 209 | ||
Polyclonal Antibodies. | 210 | ||
Graft-Versus-Host Disease | 210 | ||
Bridge to NCLEX Examination | 211 | ||
Evolve Website | 212 | ||
References | 212 | ||
14 Infection and Human Immunodeficiency Virus Infection | 213 | ||
Learning Outcomes | 213 | ||
Key Terms | 213 | ||
Infections | 213 | ||
Types of Pathogens | 213 | ||
Emerging Infections | 215 | ||
Reemerging Infections | 215 | ||
Antimicrobial-Resistant Organisms | 216 | ||
Health Care–Associated Infections | 217 | ||
Gerontologic Considerations: Infections in Older Adults | 217 | ||
Infection Prevention and Control | 218 | ||
Occupational Safety and Health Administration (OSHA) Guidelines | 218 | ||
Infection Precautions | 218 | ||
Human Immunodeficiency Virus Infection | 218 | ||
Transmission of HIV | 218 | ||
Sexual Transmission. | 219 | ||
Contact With Blood and Blood Products. | 219 | ||
Perinatal Transmission. | 219 | ||
Pathophysiology | 219 | ||
Clinical Manifestations and Complications | 219 | ||
Acute Infection. | 219 | ||
Chronic HIV Infection | 220 | ||
Asymptomatic Infection. | 220 | ||
Symptomatic Infection. | 221 | ||
AIDS. | 221 | ||
Diagnostic Studies | 221 | ||
Diagnosis of HIV Infection. | 221 | ||
Laboratory Studies in HIV Infection. | 222 | ||
Interprofessional Care | 223 | ||
Drug Therapy for HIV Infection. | 223 | ||
Drug Therapy for Opportunistic Diseases. | 223 | ||
Preventing Transmission of HIV. | 223 | ||
Nursing Management: HIV Infection | 223 | ||
Nursing Assessment | 223 | ||
Planning | 224 | ||
Nursing Implementation | 224 | ||
Health Promotion. | 224 | ||
Prevention of HIV Infection. | 224 | ||
Decreasing risks related to sexual intercourse. | 225 | ||
Decreasing risks related to drug use. | 225 | ||
Decreasing risks of perinatal transmission. | 226 | ||
Decreasing risks at work. | 226 | ||
HIV Testing. | 227 | ||
Acute Care | 227 | ||
Early Intervention. | 227 | ||
Initial response to diagnosis of HIV. | 227 | ||
Antiretroviral therapy. | 227 | ||
Delaying disease progression. | 228 | ||
Acute Exacerbations. | 229 | ||
Ambulatory Care. | 229 | ||
Stigma of HIV. | 229 | ||
Disease and Drug Side Effects. | 230 | ||
End-of-Life Care. | 230 | ||
Evaluation | 230 | ||
Gerontologic Considerations: HIV Infection | 231 | ||
Bridge to NCLEX Examination | 232 | ||
Evolve Website | 232 | ||
References | 232 | ||
15 Cancer | 234 | ||
Learning Outcomes | 234 | ||
Key Terms | 234 | ||
Biology of Cancer | 235 | ||
Defect in Cell Proliferation | 235 | ||
Defect in Cell Differentiation | 236 | ||
Genetic Link | 236 | ||
Development of Cancer | 236 | ||
Initiation. | 236 | ||
Genetic Link | 237 | ||
Carcinogens. | 237 | ||
Chemical carcinogens. | 237 | ||
Radiation. | 237 | ||
Viral carcinogens. | 237 | ||
Promotion. | 237 | ||
Progression. | 238 | ||
Role of the Immune System | 238 | ||
Escape Mechanisms From Immunologic Surveillance. | 239 | ||
Oncofetal Antigens and Tumor Markers. | 239 | ||
Benign Versus Malignant Neoplasms | 240 | ||
Classification of Cancer | 240 | ||
Anatomic Site Classification | 240 | ||
Histologic Classification | 241 | ||
Extent of Disease Classification | 241 | ||
Clinical Staging. | 241 | ||
TNM Classification System. | 241 | ||
Prevention and Early Detection of Cancer | 241 | ||
Diagnosis of Cancer | 242 | ||
Biopsy. | 243 | ||
Interprofessional Care | 243 | ||
Treatment Goals | 243 | ||
Cure. | 243 | ||
Control. | 244 | ||
Palliation. | 244 | ||
Personalized Cancer Medicine | 244 | ||
Surgical Therapy | 245 | ||
Prevention | 245 | ||
Cure or Control | 245 | ||
Supportive and Palliative Care | 245 | ||
Chemotherapy | 245 | ||
Effect on Cells | 245 | ||
Classification of Chemotherapy Drugs | 246 | ||
Preparation of Chemotherapy | 246 | ||
Methods of Administration | 246 | ||
Regional Chemotherapy Administration | 246 | ||
Intraarterial Chemotherapy. | 246 | ||
Intraperitoneal Chemotherapy. | 247 | ||
Intrathecal or Intraventricular Chemotherapy. | 248 | ||
Intravesical Bladder Chemotherapy. | 248 | ||
Effects of Chemotherapy on Normal Tissues | 248 | ||
Treatment Plan | 248 | ||
Radiation Therapy | 248 | ||
Effects of Radiation | 249 | ||
Principles of Radiobiology | 249 | ||
Simulation and Treatment Planning | 249 | ||
Treatment | 249 | ||
External Radiation. | 250 | ||
Internal Radiation. | 250 | ||
Nursing Management: Chemotherapy and Radiation Therapy | 250 | ||
Nursing Implementation | 250 | ||
Bone Marrow Suppression. | 250 | ||
Fatigue. | 253 | ||
Gastrointestinal Effects. | 253 | ||
Nausea and Vomiting. | 253 | ||
Diarrhea. | 254 | ||
Mucositis. | 254 | ||
Anorexia. | 254 | ||
Skin Reactions | 255 | ||
Radiation Skin Changes. | 255 | ||
Chemotherapy Skin Changes. | 255 | ||
Pulmonary Effects. | 256 | ||
Cardiovascular Effects. | 256 | ||
Cognitive Effects. | 256 | ||
Reproductive Effects. | 256 | ||
Late Effects of Radiation and Chemotherapy | 256 | ||
Immunotherapy and Targeted Therapy | 257 | ||
Side Effects of Immunotherapy and Targeted Therapy | 257 | ||
Nursing Management: Immunotherapy and Targeted Therapy | 258 | ||
Hormone Therapy | 259 | ||
Hematopoietic Growth Factors | 259 | ||
Hematopoietic Stem Cell Transplantation | 259 | ||
Types of Hematopoietic Stem Cell Transplants | 260 | ||
Procedures | 260 | ||
Harvest Procedures. | 260 | ||
Preparative Regimens and Stem Cell Infusions. | 261 | ||
Complications. | 261 | ||
Gene Therapy | 261 | ||
Complications of Cancer | 261 | ||
Nutritional Problems | 261 | ||
Malnutrition | 261 | ||
Altered Taste Sensation (Dysgeusia) | 262 | ||
Cancer Cachexia | 262 | ||
Infection | 262 | ||
Oncologic Emergencies | 262 | ||
Obstructive Emergencies | 264 | ||
Metabolic Emergencies | 264 | ||
Infiltrative Emergencies | 264 | ||
Cancer Pain | 264 | ||
Pain Assessment | 264 | ||
Pain Management | 264 | ||
Coping with Cancer and Treatment | 265 | ||
Gerontologic Considerations: Cancer | 266 | ||
Cancer Survivorship | 266 | ||
Culturally Competent Care: Cancer | 267 | ||
Bridge to NCLEX Examination | 267 | ||
Evolve Website | 268 | ||
References | 268 | ||
16 Fluid, Electrolyte, and Acid-Base Imbalances | 270 | ||
Learning Outcomes | 270 | ||
Key Terms | 270 | ||
Homeostasis | 270 | ||
Water Content of the Body | 270 | ||
Body Fluid Compartments | 271 | ||
Calculation of Fluid Gain or Loss | 271 | ||
Electrolytes | 271 | ||
Measurement of Electrolytes | 271 | ||
Electrolyte Composition of Fluid Compartments | 271 | ||
Mechanisms Controlling Fluid and Electrolyte Movement | 271 | ||
Diffusion | 271 | ||
Facilitated Diffusion | 272 | ||
Active Transport | 272 | ||
Osmosis | 272 | ||
Measurement of Osmolality. | 273 | ||
Osmotic Movement of Fluids. | 273 | ||
Hydrostatic Pressure | 273 | ||
Oncotic Pressure | 273 | ||
Fluid Movement in Capillaries | 273 | ||
Fluid Shifts | 273 | ||
Shifts of Plasma to Interstitial Fluid. | 273 | ||
Elevation of Venous Hydrostatic Pressure. | 274 | ||
Decrease in Plasma Oncotic Pressure. | 274 | ||
Elevation of Interstitial Oncotic Pressure. | 274 | ||
Shifts of Interstitial Fluid to Plasma. | 274 | ||
Fluid Spacing | 274 | ||
Regulation of Water Balance | 274 | ||
Hypothalamic-Pituitary Regulation | 274 | ||
Renal Regulation | 275 | ||
Adrenal Cortical Regulation | 275 | ||
Cardiac Regulation | 275 | ||
Gastrointestinal Regulation | 275 | ||
Gerontologic Considerations: Fluid and Electrolytes | 276 | ||
Fluid Volume Imbalances | 276 | ||
Fluid Volume Deficit | 276 | ||
3 Perioperative Care | 300 | ||
17 Preoperative Care | 301 | ||
Learning Outcomes | 301 | ||
Key Terms | 301 | ||
Surgical Settings | 301 | ||
Patient Interview | 302 | ||
Nursing Assessment of Preoperative Patient | 302 | ||
Subjective Data | 302 | ||
Psychosocial Assessment. | 302 | ||
Anxiety. | 302 | ||
Common Fears. | 303 | ||
Hope. | 304 | ||
Past Health History. | 304 | ||
Medications. | 304 | ||
Allergies. | 305 | ||
Review of Systems. | 305 | ||
Cardiovascular System. | 305 | ||
Respiratory System. | 305 | ||
Neurologic System. | 305 | ||
Genitourinary System. | 306 | ||
Hepatic System. | 306 | ||
Integumentary System. | 306 | ||
Musculoskeletal System. | 306 | ||
Endocrine System. | 306 | ||
Immune System. | 306 | ||
Fluid and Electrolyte Status. | 306 | ||
Nutritional Status. | 306 | ||
Objective Data | 307 | ||
Physical Examination. | 307 | ||
Diagnostic Studies. | 308 | ||
Nursing Management: Preoperative Patient | 308 | ||
Preoperative Teaching | 308 | ||
General Surgery Information. | 308 | ||
Ambulatory Surgery Information. | 309 | ||
Legal Preparation for Surgery | 309 | ||
Consent for Surgery. | 309 | ||
Day-of-Surgery Preparation | 310 | ||
Nursing Role. | 310 | ||
Preoperative Medications. | 311 | ||
Transportation to Operating Room | 311 | ||
Culturally Competent Care: Preoperative Patient | 311 | ||
Gerontologic Considerations: Preoperative Patient | 312 | ||
Bridge to NCLEX Examination | 313 | ||
Evolve Website | 314 | ||
References | 314 | ||
18 Intraoperative Care | 315 | ||
Learning Outcomes | 315 | ||
Key Terms | 315 | ||
Physical Environment of the Operating Room | 315 | ||
Department Layout | 315 | ||
Holding Area | 315 | ||
Operating Room | 316 | ||
Surgical Team | 316 | ||
Registered Nurse | 316 | ||
Licensed Practical/Vocational Nurse and Surgical Technologist | 317 | ||
Surgeon and Assistant | 317 | ||
Registered Nurse First Assistant | 317 | ||
Anesthesia Care Provider | 318 | ||
Nursing Management: Patient Before Surgery | 318 | ||
Psychosocial Assessment | 318 | ||
Physical Assessment | 318 | ||
Chart Review | 319 | ||
Admitting the Patient | 319 | ||
Nursing Management: Patient During Surgery | 319 | ||
Room Preparation | 319 | ||
Transferring Patient | 319 | ||
Scrubbing, Gowning, and Gloving | 320 | ||
Basic Aseptic Technique | 320 | ||
Assisting Anesthesia Care Provider | 320 | ||
Safety Considerations | 321 | ||
Positioning Patient | 321 | ||
Preventing Hypothermia | 322 | ||
Preparing Surgical Site | 322 | ||
Nursing Management: Patient After Surgery | 322 | ||
Anesthesia | 322 | ||
Anesthesia Techniques | 322 | ||
Moderate to Deep Sedation | 322 | ||
Monitored Anesthesia Care | 322 | ||
General Anesthesia | 322 | ||
IV Agents. | 323 | ||
Inhalation Agents. | 323 | ||
Adjuncts to General Anesthesia. | 323 | ||
Dissociative Anesthesia. | 323 | ||
Local and Regional Anesthesia | 324 | ||
Methods of Administration. | 324 | ||
Spinal and Epidural Anesthesia. | 325 | ||
Gerontologic Considerations: Patient During Surgery | 327 | ||
Catastrophic Events in the Operating Room | 327 | ||
Anaphylactic Reactions | 327 | ||
Malignant Hyperthermia | 327 | ||
Bridge to NCLEX Examination | 328 | ||
Evolve Website | 329 | ||
References | 329 | ||
19 Postoperative Care | 330 | ||
Learning Outcomes | 330 | ||
Key Terms | 330 | ||
Postoperative Care of Surgical Patient | 330 | ||
Postanesthesia Care Unit Admission | 330 | ||
PACU Progression. | 330 | ||
Phase I Initial Assessment. | 331 | ||
Respiratory Problems | 332 | ||
Etiology | 332 | ||
PACU. | 332 | ||
Clinical Unit. | 335 | ||
Nursing Management: Respiratory Problems | 335 | ||
Nursing Assessment | 335 | ||
Nursing Diagnoses | 335 | ||
Nursing Implementation | 336 | ||
Cardiovascular Problems | 336 | ||
Etiology | 336 | ||
PACU. | 336 | ||
Clinical Unit. | 337 | ||
Nursing Management: Cardiovascular Problems | 337 | ||
Nursing Assessment | 337 | ||
Nursing Diagnoses | 338 | ||
Nursing Implementation | 338 | ||
4 Problems Related to Altered Sensory Input | 349 | ||
20 Assessment of Visual and Auditory Systems | 350 | ||
Learning Outcomes | 350 | ||
Key Terms | 350 | ||
Visual System | 350 | ||
Structures and Functions of Visual System | 350 | ||
Structures and Functions of Vision | 350 | ||
Eyeball. | 350 | ||
Refractive Media. | 350 | ||
Refractive Errors. | 351 | ||
Visual Pathways. | 351 | ||
External Structures and Functions | 352 | ||
Internal Structures and Functions | 352 | ||
Gerontologic Considerations: Effects of Aging on Visual System | 352 | ||
Assessment of Visual System | 352 | ||
Subjective Data | 352 | ||
Important Health Information | 352 | ||
Past Health History. | 352 | ||
Medications. | 354 | ||
Surgery or Other Treatments. | 354 | ||
Functional Health Patterns. | 354 | ||
Health Perception–Health Management Pattern. | 354 | ||
Nutritional-Metabolic Pattern. | 355 | ||
Elimination Pattern. | 355 | ||
Activity-Exercise Pattern. | 355 | ||
Sleep-Rest Pattern. | 355 | ||
Cognitive-Perceptual Pattern. | 355 | ||
Self-Perception–Self-Concept Pattern. | 355 | ||
Role-Relationship Pattern. | 355 | ||
Sexuality-Reproductive Pattern. | 355 | ||
Coping–Stress Tolerance Pattern. | 355 | ||
Value-Belief Pattern. | 355 | ||
Objective Data | 355 | ||
Physical Examination. | 355 | ||
Initial Observation. | 355 | ||
Assessing Functional Status | 358 | ||
Visual acuity. | 358 | ||
Extraocular muscle functions. | 358 | ||
Pupil function and intraocular pressure. | 358 | ||
Assessing Structures. | 358 | ||
Eyebrows, eyelashes, and eyelids. | 358 | ||
Conjunctiva and sclera. | 358 | ||
Cornea. | 358 | ||
Iris. | 358 | ||
Retina and optic nerve. | 358 | ||
Special Assessment Techniques | 359 | ||
Color Vision. | 359 | ||
Stereopsis. | 359 | ||
Diagnostic Studies of Visual System | 359 | ||
Auditory System | 360 | ||
Structures and Functions of Auditory System | 360 | ||
External Ear | 360 | ||
Middle Ear | 360 | ||
Inner Ear | 361 | ||
Transmission of Sound. | 361 | ||
Gerontologic Considerations: Effects of Aging on Auditory System | 361 | ||
Assessment of Auditory System | 361 | ||
Subjective Data | 362 | ||
Important Health Information | 362 | ||
Past Health History. | 362 | ||
Medications. | 362 | ||
Surgery or Other Treatments. | 362 | ||
Functional Health Patterns. | 362 | ||
Health Perception–Health Management Pattern. | 363 | ||
Nutritional-Metabolic Pattern. | 363 | ||
Elimination Pattern. | 363 | ||
Activity-Exercise Pattern. | 363 | ||
Sleep-Rest Pattern. | 363 | ||
Cognitive-Perceptual Pattern. | 363 | ||
Self-Perception–Self-Concept Pattern. | 363 | ||
Role-Relationship Pattern. | 363 | ||
Sexuality-Reproductive Pattern. | 363 | ||
Coping–Stress Tolerance Pattern. | 363 | ||
Value-Belief Pattern. | 363 | ||
Objective Data | 363 | ||
Physical Examination. | 363 | ||
External Ear. | 364 | ||
External Auditory Canal and Tympanum. | 364 | ||
Diagnostic Studies of Auditory System | 364 | ||
Audiometry | 364 | ||
Specialized Tests | 364 | ||
Bridge to NCLEX Examination | 366 | ||
Evolve Website | 366 | ||
References | 366 | ||
21 Visual and Auditory Problems | 367 | ||
Learning Outcomes | 367 | ||
Key Terms | 367 | ||
Visual Problems | 367 | ||
Refractive Errors | 367 | ||
Nonsurgical Corrections | 368 | ||
Corrective Glasses. | 368 | ||
Contact Lenses. | 368 | ||
Surgical Therapy | 368 | ||
Laser. | 368 | ||
Implant. | 368 | ||
Visual Impairment | 368 | ||
Nursing Management: Visual Impairment | 369 | ||
Nursing Assessment | 369 | ||
Planning | 369 | ||
Nursing Implementation | 369 | ||
Health Promotion. | 369 | ||
Acute Care. | 369 | ||
Ambulatory Care. | 369 | ||
Optical Devices for Vision Enhancement. | 369 | ||
Nonoptical Methods for Vision Enhancement. | 369 | ||
Non–24-Hour Sleep-Wake Disorder. | 369 | ||
Evaluation | 370 | ||
Gerontologic Considerations: Visual Impairment | 370 | ||
Eye Trauma | 370 | ||
Extraocular Disorders | 370 | ||
Inflammation and Infection | 370 | ||
Conjunctivitis | 371 | ||
Bacterial Infections. | 371 | ||
Viral Infections. | 371 | ||
Chlamydial Infections. | 371 | ||
Allergic Conjunctivitis. | 371 | ||
Keratitis | 372 | ||
Bacterial Infections. | 372 | ||
Viral Infections. | 372 | ||
Other Causes of Keratitis. | 372 | ||
Corneal Ulcer. | 372 | ||
Nursing Management: Inflammation and Infection | 372 | ||
Dry Eye Disorders | 373 | ||
Strabismus | 373 | ||
Corneal Disorders | 373 | ||
Corneal Scars | 373 | ||
Keratoconus | 373 | ||
Corneal Transplant. | 373 | ||
Intraocular Disorders | 373 | ||
Cataract | 373 | ||
Etiology and Pathophysiology | 374 | ||
Clinical Manifestations and Diagnostic Studies | 374 | ||
Interprofessional Care | 374 | ||
Nonsurgical Therapy. | 374 | ||
Surgical Therapy. | 374 | ||
Preoperative Phase. | 374 | ||
Intraoperative Phase. | 374 | ||
Postoperative Phase. | 375 | ||
Nursing Management: Cataracts | 375 | ||
Nursing Assessment | 375 | ||
Nursing Diagnoses | 375 | ||
Planning | 375 | ||
Nursing Implementation | 375 | ||
Health Promotion. | 375 | ||
Acute Care. | 375 | ||
Ambulatory Care. | 376 | ||
Evaluation | 376 | ||
Gerontologic Considerations: Cataracts | 376 | ||
Retinopathy | 376 | ||
Retinal Detachment | 376 | ||
Etiology and Pathophysiology | 377 | ||
Clinical Manifestations and Diagnostic Studies | 377 | ||
Interprofessional Care | 377 | ||
Surgical Therapy | 377 | ||
Laser Photocoagulation and Cryopexy. | 377 | ||
Scleral Buckling. | 377 | ||
Intraocular Procedures. | 377 | ||
Postoperative Considerations. | 378 | ||
Age-Related Macular Degeneration | 378 | ||
Etiology and Pathophysiology | 378 | ||
Clinical Manifestations and Diagnostic Studies | 378 | ||
Interprofessional Care | 378 | ||
Glaucoma | 379 | ||
Etiology and Pathophysiology | 379 | ||
Clinical Manifestations | 379 | ||
Diagnostic Studies | 379 | ||
Interprofessional Care | 379 | ||
Chronic Open-Angle Glaucoma. | 380 | ||
Acute Angle-Closure Glaucoma. | 380 | ||
Nursing Management: Glaucoma | 380 | ||
Nursing Assessment | 380 | ||
Nursing Diagnoses | 380 | ||
Planning | 380 | ||
Nursing Implementation | 380 | ||
Health Promotion. | 380 | ||
Acute Care. | 382 | ||
Ambulatory Care. | 382 | ||
Evaluation | 382 | ||
Gerontologic Considerations: Glaucoma | 382 | ||
Intraocular Inflammation and Infection | 382 | ||
Ocular Tumors | 382 | ||
Enucleation | 382 | ||
Ocular Manifestations of Systemic Diseases | 383 | ||
Auditory Problems: External Ear and Canal | 383 | ||
Trauma | 383 | ||
External Otitis | 383 | ||
Nursing and Interprofessional Management: External Otitis | 383 | ||
Cerumen and Foreign Bodies in External Ear Canal | 384 | ||
Malignancy of External Ear | 384 | ||
Middle Ear and Mastoid | 384 | ||
Otitis Media | 384 | ||
Acute Otitis Media | 384 | ||
Otitis Media With Effusion | 384 | ||
Chronic Otitis Media and Mastoiditis | 384 | ||
Nursing and Interprofessional Management: Chronic Otitis Media | 385 | ||
Otosclerosis | 385 | ||
Inner Ear Problems | 386 | ||
Ménière’s Disease | 386 | ||
Nursing and Interprofessional Management: Ménière’s Disease | 386 | ||
Benign Paroxysmal Positional Vertigo | 386 | ||
Acoustic Neuroma | 387 | ||
Hearing Loss and Deafness | 387 | ||
Types of Hearing Loss | 387 | ||
Conductive Hearing Loss. | 387 | ||
Sensorineural Hearing Loss. | 387 | ||
Mixed Hearing Loss. | 387 | ||
Central and Functional Hearing Loss. | 387 | ||
Classification of Hearing Loss. | 388 | ||
Clinical Manifestations | 388 | ||
Tinnitus and Hearing Loss. | 388 | ||
Nursing and Interprofessional Management: Hearing Loss and Deafness | 388 | ||
Health Promotion | 388 | ||
Environmental Noise Control. | 388 | ||
Immunizations. | 389 | ||
Ototoxic Substances. | 389 | ||
Assistive Devices and Techniques | 389 | ||
Hearing Aids. | 389 | ||
Speech Reading. | 390 | ||
Sign Language. | 390 | ||
Cochlear Implant. | 390 | ||
Assistive Listening Devices. | 391 | ||
Gerontologic Considerations: Hearing Loss | 391 | ||
Bridge to NCLEX Examination | 392 | ||
Evolve Website | 393 | ||
References | 393 | ||
22 Assessment of Integumentary System | 394 | ||
Learning Outcomes | 394 | ||
Key Terms | 394 | ||
Structures and Functions of Skin and Appendages | 394 | ||
Structures | 394 | ||
Epidermis. | 394 | ||
Dermis. | 395 | ||
Subcutaneous Tissue. | 395 | ||
Skin Appendages. | 395 | ||
Functions of Integumentary System | 396 | ||
Gerontologic Considerations: Effects of Aging on Integumentary System | 396 | ||
Assessment of Integumentary System | 397 | ||
Subjective Data | 397 | ||
Important Health Information | 398 | ||
Past Health History. | 398 | ||
Medications. | 398 | ||
Surgery or Other Treatments. | 398 | ||
Functional Health Patterns | 398 | ||
Health Perception–Health Management Pattern. | 398 | ||
Nutritional-Metabolic Pattern. | 399 | ||
Elimination Pattern. | 399 | ||
Activity-Exercise Pattern. | 400 | ||
Sleep-Rest Pattern. | 400 | ||
Cognitive-Perceptual Pattern. | 400 | ||
Self-Perception–Self-Concept Pattern. | 400 | ||
Role-Relationship Pattern. | 400 | ||
Sexuality-Reproductive Pattern. | 400 | ||
Coping–Stress Tolerance Pattern. | 400 | ||
Value-Belief Pattern. | 400 | ||
Objective Data | 400 | ||
Physical Examination. | 400 | ||
Inspection. | 400 | ||
Palpation. | 401 | ||
Assessment of Dark Skin | 402 | ||
Diagnostic Studies of Integumentary System | 405 | ||
Bridge to NCLEX Examination | 406 | ||
Evolve Website | 406 | ||
References | 406 | ||
23 Integumentary Problems | 407 | ||
Learning Outcomes | 407 | ||
Key Terms | 407 | ||
Health Promotion | 407 | ||
Environmental Hazards | 407 | ||
Sun Exposure. | 407 | ||
Irritants and Allergens. | 409 | ||
Radiation. | 409 | ||
Rest and Sleep | 409 | ||
Exercise | 409 | ||
Hygiene | 409 | ||
Nutrition | 409 | ||
Self-Treatment | 410 | ||
Skin Cancer | 410 | ||
Risk Factors | 410 | ||
Nonmelanoma Skin Cancer | 410 | ||
Actinic Keratosis | 411 | ||
Basal Cell Carcinoma | 411 | ||
Squamous Cell Carcinoma | 411 | ||
Malignant Melanoma | 411 | ||
Clinical Manifestations | 411 | ||
Interprofessional Care | 411 | ||
Atypical or Dysplastic Nevus | 413 | ||
Skin Infections and Infestations | 413 | ||
Bacterial Infections | 413 | ||
Viral Infections | 415 | ||
Infestations and Insect Bites | 415 | ||
Fungal Infections | 417 | ||
Allergic Dermatologic Problems | 417 | ||
Benign Dermatologic Problems | 417 | ||
Interprofessional Care: Dermatologic Problems | 420 | ||
Diagnostic Studies | 420 | ||
Interprofessional Therapy | 420 | ||
Phototherapy. | 420 | ||
Radiation Therapy. | 420 | ||
Laser Technology. | 420 | ||
Drug Therapy | 420 | ||
Antibiotics. | 420 | ||
Corticosteroids. | 421 | ||
Antihistamines. | 421 | ||
Topical Fluorouracil. | 421 | ||
Immunomodulators. | 421 | ||
Diagnostic and Surgical Therapy | 422 | ||
Skin Scraping. | 422 | ||
Electrodessication and Electrocoagulation. | 422 | ||
Curettage. | 422 | ||
Punch Biopsy. | 422 | ||
Cryosurgery. | 422 | ||
Excision. | 422 | ||
Nursing Management: Dermatologic Problems | 422 | ||
Ambulatory Care | 422 | ||
Wet Compresses. | 422 | ||
Baths. | 423 | ||
Topical Medications. | 423 | ||
Control of Pruritus. | 424 | ||
Prevention of Spread. | 424 | ||
Prevention of Secondary Infections. | 424 | ||
Specific Skin Care. | 424 | ||
Psychologic Effects of Chronic Dermatologic Problems. | 424 | ||
Cosmetic Procedures | 425 | ||
Elective Surgery | 425 | ||
Laser Surgery. | 425 | ||
Face-Lift. | 425 | ||
Liposuction. | 426 | ||
Nursing Management: Cosmetic Surgery | 426 | ||
Preoperative Management | 426 | ||
Postoperative Management | 426 | ||
Skin Grafts | 426 | ||
Uses | 426 | ||
Types | 427 | ||
Bridge to NCLEX Examination | 428 | ||
Evolve Website | 428 | ||
References | 428 | ||
24 Burns | 429 | ||
Learning Outcomes | 429 | ||
Key Terms | 429 | ||
Types of Burn Injury | 429 | ||
Thermal Burns | 429 | ||
Chemical Burns | 429 | ||
Smoke and Inhalation Injury | 430 | ||
Metabolic Asphyxiation. | 430 | ||
Upper Airway Injury. | 430 | ||
Lower Airway Injury. | 431 | ||
Electrical Burns | 431 | ||
Cold Thermal Injury | 431 | ||
Classification of Burn Injury | 431 | ||
Depth of Burn | 431 | ||
Extent of Burn | 432 | ||
Location of Burn | 433 | ||
Patient Risk Factors | 433 | ||
Prehospital and Emergency Care | 433 | ||
Phases of Burn Management | 434 | ||
Emergent Phase | 434 | ||
Pathophysiology | 434 | ||
Fluid and Electrolyte Shifts. | 434 | ||
Inflammation and Healing. | 436 | ||
Immunologic Changes. | 437 | ||
Clinical Manifestations | 437 | ||
Complications | 437 | ||
Cardiovascular System. | 437 | ||
Respiratory System. | 437 | ||
Other Cardiopulmonary Problems. | 437 | ||
Urinary System. | 438 | ||
Nursing and Interprofessional Management: Emergent Phase | 438 | ||
Airway Management | 438 | ||
Fluid Therapy | 439 | ||
Wound Care | 439 | ||
Other Care Measures | 441 | ||
Drug Therapy | 441 | ||
Analgesics and Sedatives. | 441 | ||
Tetanus Immunization. | 441 | ||
Antimicrobial Agents. | 441 | ||
Venous Thromboembolism Prophylaxis. | 442 | ||
Nutritional Therapy | 442 | ||
Acute Phase | 442 | ||
Pathophysiology | 442 | ||
Clinical Manifestations | 442 | ||
Laboratory Values | 442 | ||
Sodium. | 442 | ||
Potassium. | 443 | ||
Complications | 443 | ||
Infection. | 443 | ||
Cardiovascular and Respiratory Systems. | 443 | ||
Neurologic System. | 443 | ||
Musculoskeletal System. | 443 | ||
Gastrointestinal System. | 443 | ||
Endocrine System. | 443 | ||
Nursing and Interprofessional Management: Acute Phase | 443 | ||
Wound Care | 443 | ||
Excision and Grafting | 444 | ||
Cultured Epithelial Autografts. | 445 | ||
Artificial Skin. | 445 | ||
Pain Management | 445 | ||
Physical and Occupational Therapy | 446 | ||
Nutritional Therapy | 446 | ||
Rehabilitation Phase | 446 | ||
Pathophysiologic Changes and Clinical Manifestations | 446 | ||
Complications | 446 | ||
Nursing and Interprofessional Management: Rehabilitation Phase | 447 | ||
Gerontologic Considerations: Burns | 447 | ||
Emotional/Psychologic Needs of Patients and Caregivers | 447 | ||
Special Needs of Nurses | 448 | ||
Bridge to NCLEX Examination | 449 | ||
Evolve Website | 450 | ||
References | 450 | ||
5 Problems of Oxygenation: Ventilation | 452 | ||
25 Assessment of Respiratory System | 453 | ||
Learning Outcomes | 453 | ||
Key Terms | 453 | ||
Structures and Functions of Respiratory System | 453 | ||
Upper Respiratory Tract | 453 | ||
Lower Respiratory Tract | 454 | ||
Surfactant. | 455 | ||
Blood Supply. | 455 | ||
Chest Wall | 455 | ||
Physiology of Respiration | 456 | ||
Oxygenation. | 456 | ||
Ventilation. | 456 | ||
Compliance and Resistance. | 456 | ||
Arterial Blood Gases. | 456 | ||
Mixed Venous Blood Gases. | 456 | ||
Oximetry. | 457 | ||
CO2 Monitoring. | 457 | ||
Control of Respiration | 458 | ||
Chemoreceptors. | 458 | ||
Mechanical Receptors. | 458 | ||
Respiratory Defense Mechanisms | 458 | ||
Filtration of Air. | 458 | ||
Mucociliary Clearance System. | 458 | ||
Cough Reflex. | 458 | ||
Reflex Bronchoconstriction. | 459 | ||
Alveolar Macrophages. | 459 | ||
Gerontologic Considerations: Effects of Aging on Respiratory System | 459 | ||
Assessment of Respiratory System | 459 | ||
Subjective Data | 459 | ||
Important Health Information | 459 | ||
Past Health History. | 459 | ||
Medications. | 460 | ||
Surgery or Other Treatments. | 460 | ||
Functional Health Patterns. | 460 | ||
Health Perception–Health Management Pattern. | 460 | ||
Nutritional-Metabolic Pattern. | 462 | ||
Elimination Pattern. | 462 | ||
Activity-Exercise Pattern. | 462 | ||
Sleep-Rest Pattern. | 462 | ||
Cognitive-Perceptual Pattern. | 462 | ||
Self-Perception–Self-Concept Pattern. | 462 | ||
Role-Relationship Pattern. | 462 | ||
Sexuality-Reproductive Pattern. | 462 | ||
Coping–Stress Tolerance Pattern. | 462 | ||
Value-Belief Pattern. | 463 | ||
Objective Data | 463 | ||
Physical Examination. | 463 | ||
Nose. | 463 | ||
Mouth and Pharynx. | 463 | ||
Neck. | 463 | ||
Thorax and Lungs. | 463 | ||
Inspection. | 463 | ||
Palpation. | 464 | ||
Percussion. | 465 | ||
Auscultation. | 466 | ||
Diagnostic Studies of Respiratory System | 467 | ||
Sputum Studies | 467 | ||
Skin Tests | 467 | ||
Endoscopy | 467 | ||
Bronchoscopy. | 467 | ||
Lung Biopsy | 471 | ||
Thoracentesis | 472 | ||
Pulmonary Function Tests | 472 | ||
Bridge to NCLEX Examination | 473 | ||
Evolve Website | 474 | ||
References | 474 | ||
26 Upper Respiratory Problems | 475 | ||
Learning Outcomes | 475 | ||
Key Terms | 475 | ||
Problems of Nose and Paranasal Sinuses | 475 | ||
Deviated Septum | 475 | ||
Nasal Fracture | 475 | ||
Rhinoplasty | 476 | ||
Nursing Management: Nasal Surgery | 476 | ||
Epistaxis | 476 | ||
Nursing and Interprofessional Management: Epistaxis | 476 | ||
Allergic Rhinitis | 477 | ||
Clinical Manifestations | 478 | ||
Nursing and Interprofessional Management: Allergic Rhinitis | 478 | ||
Acute Viral Rhinitis | 478 | ||
Nursing and Interprofessional Management: Acute Viral Rhinitis | 480 | ||
Influenza | 480 | ||
Etiology and Pathophysiology | 480 | ||
Clinical Manifestations | 481 | ||
Diagnostic Studies | 481 | ||
Nursing and Interprofessional Management: Influenza | 481 | ||
Sinusitis | 482 | ||
Clinical Manifestations | 483 | ||
Nursing and Interprofessional Management: Sinusitis | 483 | ||
Obstruction of Nose and Sinuses | 483 | ||
Nasal Polyps | 483 | ||
Foreign Bodies | 484 | ||
Problems of Pharynx | 484 | ||
Acute Pharyngitis | 484 | ||
Clinical Manifestations | 484 | ||
Nursing and Interprofessional Management: Acute Pharyngitis | 484 | ||
Peritonsillar Abscess | 484 | ||
Problems of Trachea and Larynx | 484 | ||
Airway Obstruction | 484 | ||
Tracheostomy | 485 | ||
Nursing Management: Tracheostomy | 486 | ||
Acute Care | 486 | ||
Chronic Care | 489 | ||
Swallowing Dysfunction | 489 | ||
Speech With a Tracheostomy Tube | 489 | ||
Decannulation | 490 | ||
Laryngeal Polyps | 490 | ||
Head and Neck Cancer | 491 | ||
Clinical Manifestations | 491 | ||
Diagnostic Studies | 491 | ||
Staging of Head and Neck Cancer | 491 | ||
Interprofessional Care | 491 | ||
Surgical Therapy. | 491 | ||
Radiation Therapy. | 492 | ||
Chemotherapy and Targeted Therapy. | 492 | ||
Nutritional Therapy. | 492 | ||
Physical Therapy. | 493 | ||
Speech Therapy. | 493 | ||
Nursing Management: Head and Neck Cancer | 493 | ||
Nursing Assessment | 493 | ||
Nursing Diagnoses | 493 | ||
Planning | 494 | ||
Nursing Implementation | 494 | ||
Health Promotion. | 494 | ||
Acute Care. | 494 | ||
Surgical Therapy. | 494 | ||
Radiation Therapy. | 495 | ||
Stoma Care. | 495 | ||
Psychosocial Needs. | 495 | ||
Ambulatory Care. | 495 | ||
Evaluation | 496 | ||
Bridge to NCLEX Examination | 497 | ||
Evolve Website | 497 | ||
References | 497 | ||
27 Lower Respiratory Problems | 499 | ||
Learning Outcomes | 499 | ||
Key Terms | 499 | ||
Lower Respiratory Tract Infections | 499 | ||
Acute Bronchitis | 499 | ||
Pertussis | 500 | ||
Pneumonia | 500 | ||
Etiology | 500 | ||
Types of Pneumonia | 501 | ||
Community-Acquired Pneumonia. | 501 | ||
Hospital-Acquired Pneumonia. | 501 | ||
Aspiration Pneumonia. | 501 | ||
Necrotizing Pneumonia. | 502 | ||
Opportunistic Pneumonia. | 502 | ||
Pathophysiology | 502 | ||
Clinical Manifestations | 502 | ||
Complications | 503 | ||
Diagnostic Studies | 503 | ||
Interprofessional Care | 503 | ||
Drug Therapy. | 504 | ||
Nutritional Therapy. | 504 | ||
Nursing Management: Pneumonia | 505 | ||
Nursing Assessment | 505 | ||
Nursing Diagnoses | 505 | ||
Planning | 505 | ||
Nursing Implementation | 505 | ||
Health Promotion. | 505 | ||
Acute Care. | 506 | ||
Ambulatory Care. | 506 | ||
Evaluation | 506 | ||
Tuberculosis | 506 | ||
Etiology and Pathophysiology | 506 | ||
Classification | 507 | ||
Clinical Manifestations | 507 | ||
Complications | 508 | ||
Diagnostic Studies | 508 | ||
Tuberculin Skin Test. | 508 | ||
Interferon-γ Release Assays. | 508 | ||
Chest X-ray. | 508 | ||
Bacteriologic Studies. | 508 | ||
Interprofessional Care | 508 | ||
Drug Therapy | 509 | ||
Active TB Disease. | 509 | ||
Latent Tuberculosis Infection. | 509 | ||
Bacille-Calmette-Guerin Vaccine. | 510 | ||
Nursing Management: Tuberculosis | 510 | ||
Nursing Assessment | 510 | ||
Nursing Diagnoses | 511 | ||
Planning | 511 | ||
Nursing Implementation | 511 | ||
Health Promotion. | 511 | ||
Acute Care. | 511 | ||
Ambulatory Care. | 511 | ||
Evaluation. | 511 | ||
Atypical Mycobacteria | 511 | ||
Pulmonary Fungal Infections | 512 | ||
Lung Abscess | 512 | ||
Etiology and Pathophysiology | 512 | ||
Clinical Manifestations and Complications | 512 | ||
Diagnostic Studies | 512 | ||
Nursing and Interprofessional Management: Lung Abscess | 512 | ||
Environmental Lung Diseases | 513 | ||
Clinical Manifestations | 513 | ||
Interprofessional Care | 513 | ||
Lung Cancer | 513 | ||
Etiology | 514 | ||
Pathophysiology | 514 | ||
Paraneoplastic Syndrome. | 514 | ||
Clinical Manifestations | 515 | ||
Diagnostic Studies | 515 | ||
Staging. | 516 | ||
Screening for Lung Cancer. | 516 | ||
Interprofessional Care | 516 | ||
Surgical Therapy. | 516 | ||
Radiation Therapy. | 516 | ||
Stereotactic Body Radiotherapy. | 516 | ||
Chemotherapy. | 516 | ||
Targeted Therapy. | 516 | ||
Immunotherapy. | 517 | ||
Other Therapies | 517 | ||
Prophylactic Cranial Radiation. | 517 | ||
Bronchoscopic Laser Therapy. | 517 | ||
Photodynamic Therapy. | 517 | ||
Airway Stenting. | 517 | ||
Radiofrequency Ablation. | 517 | ||
Nursing Management: Lung Cancer | 517 | ||
Nursing Assessment | 517 | ||
Nursing Diagnoses | 517 | ||
Planning | 517 | ||
Nursing Implementation | 517 | ||
Health Promotion. | 517 | ||
Acute Care. | 517 | ||
Ambulatory Care. | 518 | ||
Evaluation | 518 | ||
Other Types of Lung Tumors | 518 | ||
Chest Trauma and Thoracic Injuries | 519 | ||
Pneumothorax | 519 | ||
Types of Pneumothorax | 519 | ||
Spontaneous Pneumothorax. | 519 | ||
Iatrogenic Pneumothorax. | 520 | ||
Tension Pneumothorax. | 520 | ||
Hemothorax. | 520 | ||
Chylothorax. | 521 | ||
Interprofessional Care | 521 | ||
Fractured Ribs | 521 | ||
Flail Chest | 521 | ||
Chest Tubes and Pleural Drainage | 522 | ||
Chest Tube Insertion | 522 | ||
Flutter or Heimlich Valve | 522 | ||
Pleural Drainage | 522 | ||
Nursing Management: Chest Drainage | 524 | ||
Chest Tube Removal | 524 | ||
Chest Surgery | 524 | ||
Preoperative Care | 524 | ||
Surgical Procedures | 524 | ||
Thoracotomy. | 524 | ||
Video-Assisted Thoracic Surgery. | 526 | ||
Postoperative Care | 527 | ||
Restrictive Respiratory Disorders | 527 | ||
Pleural Effusion | 527 | ||
Types | 527 | ||
Clinical Manifestations | 527 | ||
Thoracentesis | 527 | ||
Interprofessional Care | 528 | ||
Pleurisy | 528 | ||
Atelectasis | 528 | ||
Interstitial Lung Diseases | 528 | ||
Idiopathic Pulmonary Fibrosis | 528 | ||
Sarcoidosis | 528 | ||
Vascular Lung Disorders | 529 | ||
Pulmonary Edema | 529 | ||
Pulmonary Embolism | 529 | ||
Etiology and Pathophysiology | 529 | ||
Clinical Manifestations | 529 | ||
Complications | 529 | ||
Diagnostic Studies | 530 | ||
Interprofessional Care | 530 | ||
Drug Therapy. | 530 | ||
Surgical Therapy. | 531 | ||
Nursing Management: Pulmonary Embolism | 531 | ||
Nursing Implementation | 531 | ||
Evaluation | 531 | ||
Pulmonary Hypertension | 531 | ||
Idiopathic Pulmonary Arterial Hypertension | 531 | ||
Etiology and Pathophysiology | 531 | ||
Clinical Manifestations and Diagnostic Studies | 531 | ||
Nursing and Interprofessional Management: Pulmonary Hypertension | 532 | ||
Secondary Pulmonary Arterial Hypertension | 533 | ||
Cor Pulmonale | 533 | ||
Clinical Manifestations and Diagnostic Studies | 533 | ||
Nursing and Interprofessional Management: Cor Pulmonale | 533 | ||
Lung Transplantation | 533 | ||
Preoperative Care | 533 | ||
Surgical Procedure | 534 | ||
Postoperative Care | 534 | ||
Bridge to NCLEX Examination | 535 | ||
Evolve Website | 536 | ||
References | 536 | ||
28 Obstructive Pulmonary Diseases | 538 | ||
Learning Outcomes | 538 | ||
Key Terms | 538 | ||
Asthma | 539 | ||
Risk Factors for Asthma and Triggers of Asthma Attacks | 539 | ||
Genetics. | 539 | ||
Immune Response. | 539 | ||
Allergens. | 539 | ||
Exercise. | 539 | ||
Air Pollutants. | 539 | ||
Occupational Factors. | 540 | ||
Respiratory Tract Infections. | 540 | ||
Nose and Sinus Problems. | 540 | ||
Drugs and Food Additives. | 540 | ||
Gastroesophageal Reflux Disease. | 540 | ||
Psychologic Factors. | 540 | ||
Pathophysiology | 540 | ||
Clinical Manifestations | 542 | ||
Classification of Asthma | 542 | ||
Complications | 543 | ||
Diagnostic Studies | 543 | ||
Interprofessional Care | 544 | ||
Intermittent and Persistent Asthma. | 544 | ||
Acute Asthma Exacerbations. | 545 | ||
Drug Therapy | 547 | ||
Antiinflammatory Drugs | 547 | ||
Corticosteroids. | 547 | ||
Leukotriene Modifiers. | 547 | ||
Anti-IgE. | 549 | ||
Anti-Interleukin 5. | 549 | ||
Bronchodilators. | 549 | ||
β2-Adrenergic Agonist Drugs. | 549 | ||
Methylxanthines. | 551 | ||
Anticholinergic Drugs. | 551 | ||
Inhalation Devices for Drug Delivery. | 551 | ||
Inhalers. | 551 | ||
Nebulizers. | 551 | ||
Patient Teaching Related to Drug Therapy. | 552 | ||
Nonprescription Combination Drugs. | 553 | ||
Nursing Management: Asthma | 553 | ||
Nursing Assessment | 553 | ||
Nursing Diagnoses | 553 | ||
Planning | 553 | ||
Nursing Implementation | 554 | ||
Health Promotion. | 554 | ||
Acute Care. | 554 | ||
Ambulatory Care. | 554 | ||
Evaluation | 557 | ||
Chronic Obstructive Pulmonary Disease | 557 | ||
Etiology | 558 | ||
Cigarette Smoking. | 558 | ||
Occupational Chemicals and Dusts. | 558 | ||
Air Pollution. | 558 | ||
Infection. | 558 | ||
Genetics. | 558 | ||
α1-Antitrypsin (AAT) Deficiency. | 558 | ||
Genetic Link | 558 | ||
Aging. | 559 | ||
Asthma. | 559 | ||
Gender. | 559 | ||
Pathophysiology | 559 | ||
Clinical Manifestations | 560 | ||
Complications | 561 | ||
Diagnostic Studies | 561 | ||
Classification of COPD | 562 | ||
Interprofessional Care: Stable COPD | 562 | ||
Smoking Cessation. | 562 | ||
Drug Therapy. | 562 | ||
Interprofessional Care: COPD Complications | 563 | ||
Cor Pulmonale. | 563 | ||
Acute Exacerbations. | 564 | ||
Acute Respiratory Failure. | 565 | ||
Interprofessional Care: Other COPD Treatments | 565 | ||
Oxygen Therapy. | 565 | ||
Methods of Administration. | 565 | ||
Humidification and Nebulization. | 565 | ||
Complications | 565 | ||
Combustion. | 565 | ||
CO2 narcosis. | 565 | ||
O2 toxicity. | 565 | ||
Infection. | 565 | ||
Chronic Oxygen Therapy at Home. | 568 | ||
Breathing Retraining. | 568 | ||
Airway Clearance Techniques. | 569 | ||
Effective Coughing. | 569 | ||
Chest Physiotherapy. | 569 | ||
Postural drainage. | 570 | ||
Percussion. | 570 | ||
Vibration. | 570 | ||
Airway Clearance Devices. | 570 | ||
High-Frequency Chest Wall Oscillation. | 570 | ||
Nutritional Therapy for COPD. | 570 | ||
Surgical Therapy for COPD. | 571 | ||
Gerontologic Considerations: COPD | 571 | ||
Nursing Management: Chronic Obstructive Pulmonary Disease | 572 | ||
Nursing Assessment | 572 | ||
Nursing Diagnoses | 572 | ||
Planning | 572 | ||
Nursing Implementation | 572 | ||
Health Promotion. | 572 | ||
Acute Care. | 573 | ||
Ambulatory Care. | 573 | ||
Pulmonary Rehabilitation. | 573 | ||
Activity Considerations. | 573 | ||
Psychosocial Considerations. | 574 | ||
Sexuality and Sexual Activity. | 575 | ||
Sleep. | 575 | ||
End-of-Life Considerations. | 575 | ||
Evaluation | 576 | ||
Cystic Fibrosis | 576 | ||
Etiology and Pathophysiology | 576 | ||
Genetic Link. | 576 | ||
Clinical Manifestations | 577 | ||
Complications | 578 | ||
Diagnostic Studies | 578 | ||
Interprofessional Care | 578 | ||
Nursing Management: Cystic Fibrosis | 579 | ||
Nursing Assessment | 579 | ||
Nursing Diagnoses | 579 | ||
Planning | 579 | ||
Nursing Implementation | 579 | ||
Bronchiectasis | 580 | ||
Etiology and Pathophysiology | 580 | ||
Clinical Manifestations | 580 | ||
Diagnostic Studies | 580 | ||
Interprofessional Care | 581 | ||
Nursing Management: Bronchiectasis | 581 | ||
Bridge to NCLEX Examination | 582 | ||
Evolve Website | 583 | ||
References | 583 | ||
6 Problems of Oxygenation: Transport | 586 | ||
29 Assessment of Hematologic System | 587 | ||
Learning Outcomes | 587 | ||
Key Terms | 587 | ||
Structures and Functions of Hematologic System | 587 | ||
Bone Marrow | 587 | ||
Blood | 587 | ||
Plasma. | 587 | ||
Blood Cells. | 588 | ||
Erythrocytes. | 588 | ||
Leukocytes. | 589 | ||
Granulocytes. | 589 | ||
Lymphocytes. | 590 | ||
Monocytes. | 590 | ||
Thrombocytes. | 590 | ||
Normal Iron Metabolism | 590 | ||
Normal Clotting Mechanisms | 590 | ||
Vascular Injury and Subendothelial Exposure. | 590 | ||
Platelet Adhesion. | 591 | ||
Platelet Activation. | 591 | ||
Platelet Aggregation. | 591 | ||
Platelet Plug Formation. | 591 | ||
Clot Retraction and Dissolution. | 591 | ||
Spleen | 592 | ||
Lymph System | 592 | ||
Liver | 592 | ||
Gerontologic Considerations: Effects of Aging on Hematologic System | 593 | ||
Assessment of Hematologic System | 593 | ||
Subjective Data | 593 | ||
Important Health Information | 593 | ||
Past Health History. | 593 | ||
Medications. | 593 | ||
Surgery or Other Treatments. | 594 | ||
Functional Health Patterns. | 594 | ||
Health Perception–Health Management Pattern. | 594 | ||
Nutritional-Metabolic Pattern. | 594 | ||
Elimination Pattern. | 594 | ||
Activity-Exercise Pattern. | 594 | ||
Sleep-Rest Pattern. | 594 | ||
Cognitive-Perceptual Pattern. | 594 | ||
Self-Perception–Self-Concept Pattern. | 594 | ||
Role-Relationship Pattern. | 595 | ||
Sexuality-Reproductive Pattern. | 595 | ||
Coping–Stress Tolerance Pattern. | 595 | ||
Value-Belief Pattern. | 596 | ||
Objective Data | 596 | ||
Physical Examination. | 596 | ||
Lymph Node Assessment. | 596 | ||
Palpation of Liver or Spleen. | 598 | ||
Skin Assessment. | 598 | ||
Diagnostic Studies of Hematologic System | 599 | ||
Laboratory Studies | 599 | ||
Complete Blood Count. | 599 | ||
Red Blood Cells. | 599 | ||
White Blood Cells. | 599 | ||
Platelet Count. | 600 | ||
Blood Typing and Rh Factor. | 600 | ||
Iron Metabolism. | 601 | ||
Biopsies | 602 | ||
Bone Marrow Examination. | 602 | ||
Lymph Node Biopsy. | 604 | ||
Molecular Cytogenetics and Gene Analysis | 604 | ||
Bridge to NCLEX Examination | 605 | ||
Evolve Website | 605 | ||
References | 605 | ||
30 Hematologic Problems | 606 | ||
Learning Outcomes | 606 | ||
Key Terms | 606 | ||
Anemia | 606 | ||
Definition and Classification | 606 | ||
Clinical Manifestations | 607 | ||
Integumentary Manifestations. | 607 | ||
Cardiopulmonary Manifestations. | 608 | ||
Nursing and Interprofessional Management: Anemia | 608 | ||
Nursing Assessment | 608 | ||
Nursing Diagnoses | 608 | ||
Planning | 608 | ||
Nursing Implementation | 608 | ||
Gerontologic Considerations: Anemia | 608 | ||
Anemia Caused by Decreased Erythrocyte Production | 609 | ||
Iron-Deficiency Anemia | 609 | ||
Etiology | 609 | ||
Clinical Manifestations | 610 | ||
Diagnostic Studies | 610 | ||
Interprofessional Care | 610 | ||
Drug Therapy. | 610 | ||
Nursing Management: Iron-Deficiency Anemia | 611 | ||
Thalassemia | 611 | ||
Etiology | 611 | ||
Genetic Link. | 611 | ||
Clinical Manifestations | 611 | ||
Interprofessional Care | 612 | ||
Megaloblastic Anemias | 612 | ||
Megaloblastic Anemia: Cobalamin (Vitamin B12) Deficiency | 612 | ||
Etiology | 612 | ||
Pernicious Anemia. | 612 | ||
Other Causes of Cobalamin Deficiency. | 612 | ||
Clinical Manifestations | 612 | ||
Diagnostic Studies | 613 | ||
Interprofessional Care | 613 | ||
Megaloblastic Anemia: Folic Acid Deficiency | 613 | ||
Nursing Management: Megaloblastic Anemia | 613 | ||
Anemia of Chronic Disease | 613 | ||
Aplastic Anemia | 614 | ||
Etiology | 614 | ||
Clinical Manifestations | 614 | ||
Diagnostic Studies | 614 | ||
Nursing and Interprofessional Management: Aplastic Anemia | 614 | ||
Anemia Caused by Blood Loss | 614 | ||
Acute Blood Loss | 614 | ||
Clinical Manifestations | 615 | ||
Diagnostic Studies | 615 | ||
Interprofessional Care | 615 | ||
Nursing Management: Acute Blood Loss | 615 | ||
Chronic Blood Loss | 615 | ||
Anemia Caused by Increased Erythrocyte Destruction | 615 | ||
Sickle Cell Disease | 616 | ||
Etiology and Pathophysiology | 616 | ||
Genetic Link. | 616 | ||
Sickling Episodes. | 616 | ||
Clinical Manifestations | 617 | ||
Complications | 617 | ||
Diagnostic Studies | 617 | ||
Nursing and Interprofessional Management: Sickle Cell Disease | 617 | ||
Acquired Hemolytic Anemia | 619 | ||
Other Red Blood Cell Disorders | 619 | ||
Hemochromatosis | 619 | ||
7 Problems of Oxygenation: Perfusion | 657 | ||
31 Assessment of Cardiovascular System | 658 | ||
Learning Outcomes | 658 | ||
Key Terms | 658 | ||
Structures and Functions of Cardiovascular System | 658 | ||
Heart | 658 | ||
Structure. | 658 | ||
Blood Flow Through Heart. | 658 | ||
Heart Valves. | 658 | ||
Blood Supply to Myocardium. | 658 | ||
Conduction System. | 659 | ||
Electrocardiogram. | 660 | ||
Mechanical System. | 660 | ||
Factors Affecting Cardiac Output. | 660 | ||
Cardiac Reserve. | 661 | ||
Vascular System | 661 | ||
Blood Vessels. | 661 | ||
Arteries and Arterioles. | 661 | ||
Capillaries. | 661 | ||
Veins and Venules. | 661 | ||
Regulation of Cardiovascular System | 661 | ||
Autonomic Nervous System. | 661 | ||
Effect on Heart. | 661 | ||
Effect on Blood Vessels. | 661 | ||
Baroreceptors. | 661 | ||
Chemoreceptors. | 662 | ||
Blood Pressure | 662 | ||
Measurement of Arterial Blood Pressure. | 662 | ||
Pulse Pressure and Mean Arterial Pressure. | 662 | ||
Gerontologic Considerations: Effects of Aging on the Cardiovascular System | 662 | ||
Assessment of Cardiovascular System | 663 | ||
Subjective Data | 663 | ||
Important Health Information | 663 | ||
History of Present Illness. | 663 | ||
Past Health History. | 663 | ||
Medications. | 663 | ||
Surgery or Other Treatments. | 663 | ||
Functional Health Patterns. | 663 | ||
Health Perception–Health Management Pattern. | 664 | ||
Nutritional-Metabolic Pattern. | 664 | ||
Elimination Pattern. | 664 | ||
Activity-Exercise Pattern. | 664 | ||
Sleep-Rest Pattern. | 664 | ||
Cognitive-Perceptual Pattern. | 664 | ||
Self-Perception–Self-Concept Pattern. | 664 | ||
Role-Relationship Pattern. | 664 | ||
Sexuality-Reproductive Pattern. | 665 | ||
Coping–Stress Tolerance Pattern. | 665 | ||
Values-Belief Pattern. | 666 | ||
Objective Data | 666 | ||
Physical Examination | 666 | ||
Vital Signs. | 666 | ||
Peripheral Vascular System | 666 | ||
Inspection. | 666 | ||
Palpation. | 666 | ||
8 Problems of Ingestion, Digestion, Absorption, and Elimination | 832 | ||
38 Assessment of Gastrointestinal System | 833 | ||
Learning Outcomes | 833 | ||
Key Terms | 833 | ||
Structures and Functions of Gastrointestinal System | 833 | ||
Ingestion | 834 | ||
Mouth. | 834 | ||
Pharynx. | 834 | ||
Esophagus. | 835 | ||
Digestion and Absorption | 835 | ||
Stomach. | 835 | ||
Small Intestine. | 835 | ||
Physiology of Digestion. | 835 | ||
Elimination | 836 | ||
Large Intestine. | 836 | ||
Liver, Biliary Tract, and Pancreas | 837 | ||
Liver. | 837 | ||
Bilirubin Metabolism. | 837 | ||
Biliary Tract. | 838 | ||
Pancreas. | 838 | ||
Gerontologic Considerations: Effects of Aging on Gastrointestinal System | 839 | ||
Assessment of Gastrointestinal System | 839 | ||
Subjective Data | 839 | ||
Important Health Information | 839 | ||
Past Health History. | 839 | ||
Medications. | 839 | ||
Surgery or Other Treatments. | 840 | ||
Functional Health Patterns. | 840 | ||
Health Perception–Health Management Pattern. | 840 | ||
Nutritional-Metabolic Pattern. | 841 | ||
Elimination Pattern. | 842 | ||
Activity-Exercise Pattern. | 842 | ||
Sleep-Rest Pattern. | 842 | ||
Cognitive-Perceptual Pattern. | 842 | ||
Self-Perception–Self-Concept Pattern. | 842 | ||
Role-Relationship Pattern. | 842 | ||
Sexuality-Reproductive Pattern. | 842 | ||
Coping–Stress Tolerance Pattern. | 842 | ||
Value-Belief Pattern. | 842 | ||
Objective Data | 842 | ||
Physical Examination | 842 | ||
Mouth | 842 | ||
Inspection. | 842 | ||
Palpation. | 842 | ||
Abdomen. | 843 | ||
Inspection. | 843 | ||
Auscultation. | 843 | ||
Percussion. | 844 | ||
Palpation. | 844 | ||
Rectum and Anus. | 845 | ||
Diagnostic Studies of Gastrointestinal System | 845 | ||
Radiologic Studies | 845 | ||
Upper Gastrointestinal Series. | 845 | ||
Lower Gastrointestinal Series. | 845 | ||
Virtual Colonoscopy. | 851 | ||
Endoscopy | 851 | ||
Liver Biopsy | 851 | ||
Liver Function Studies | 852 | ||
Bridge to NCLEX Examination | 853 | ||
Evolve Website | 853 | ||
References | 853 | ||
39 Nutritional Problems | 854 | ||
Learning Outcomes | 854 | ||
Key Terms | 854 | ||
Nutritional Problems | 854 | ||
Normal Nutrition | 854 | ||
Vegetarian Diet | 855 | ||
Culturally Competent Care: Nutrition | 856 | ||
Malnutrition | 856 | ||
Etiology of Malnutrition | 856 | ||
Contributing Factors to Malnutrition | 857 | ||
Socioeconomic Factors. | 857 | ||
Physical Illnesses. | 857 | ||
Incomplete Diets. | 857 | ||
Drug-Nutrient Interactions. | 858 | ||
Pathophysiology of Starvation | 858 | ||
Impact of Inflammation. | 858 | ||
Clinical Manifestations | 859 | ||
Diagnostic Studies | 859 | ||
History and Physical Examination. | 859 | ||
Laboratory Studies. | 859 | ||
Anthropometric Measurements. | 859 | ||
Functional Measurements. | 859 | ||
Nursing and Interprofessional Management: Malnutrition | 859 | ||
Nursing Assessment | 859 | ||
Nursing Diagnoses | 861 | ||
Planning | 861 | ||
Nursing Implementation | 861 | ||
Health Promotion. | 861 | ||
Acute Care. | 862 | ||
Ambulatory Care. | 863 | ||
Evaluation | 863 | ||
Gerontologic Considerations: Malnutrition | 863 | ||
Specialized Nutritional Support | 865 | ||
Oral Feeding | 865 | ||
Enteral Nutrition | 865 | ||
Orogastric, Nasogastric, and Nasointestinal Tubes. | 865 | ||
Gastrostomy and Jejunostomy Tubes. | 865 | ||
Tube Feedings and Safety. | 866 | ||
Patient Position. | 866 | ||
Aspiration Risk. | 866 | ||
Tube Position. | 867 | ||
Site Care. | 868 | ||
Tube Patency. | 868 | ||
Misconnection. | 868 | ||
Gerontologic Considerations: Enteral Nutrition | 868 | ||
Parenteral Nutrition | 869 | ||
Composition. | 869 | ||
Calories. | 869 | ||
Protein. | 869 | ||
Electrolytes. | 869 | ||
Trace Elements and Vitamins. | 869 | ||
Methods of Administration. | 869 | ||
Central Parenteral Nutrition. | 869 | ||
Peripheral Parenteral Nutrition. | 870 | ||
Nursing Management: Parenteral Nutrition | 870 | ||
Complications | 870 | ||
Home Nutritional Support | 871 | ||
Eating Disorders | 871 | ||
Anorexia Nervosa | 871 | ||
Bulimia Nervosa | 872 | ||
Bridge to NCLEX Examination | 872 | ||
Evolve Website | 873 | ||
References | 873 | ||
40 Obesity | 874 | ||
Learning Outcomes | 874 | ||
Key Terms | 874 | ||
Obesity | 874 | ||
Classifications of Body Weight and Obesity | 874 | ||
Body Mass Index. | 874 | ||
Waist Circumference. | 874 | ||
Waist-to-Hip Ratio. | 875 | ||
Body Shape. | 875 | ||
Epidemiology of Obesity | 875 | ||
Etiology and Pathophysiology | 875 | ||
Genetic Link | 877 | ||
Physiologic Regulatory Mechanisms in Obesity. | 877 | ||
Environmental Factors. | 878 | ||
Psychosocial Factors. | 878 | ||
Health Risks Associated With Obesity | 878 | ||
Cardiovascular Problems | 879 | ||
Diabetes Mellitus | 879 | ||
Gastrointestinal and Liver Problems | 879 | ||
Respiratory and Sleep Problems | 880 | ||
Musculoskeletal Problems | 880 | ||
Cancer | 880 | ||
Metabolic Syndrome | 880 | ||
Psychosocial Problems | 880 | ||
Nursing and Interprofessional Management: Obesity | 880 | ||
Nursing Assessment | 880 | ||
Planning | 881 | ||
Nursing Implementation | 881 | ||
Nutritional Therapy. | 881 | ||
Exercise. | 883 | ||
Behavior Modification. | 883 | ||
Support Groups. | 884 | ||
Drug Therapy | 884 | ||
Appetite-Suppressing Drugs. | 884 | ||
Nursing Interventions Related to Drug Therapy. | 884 | ||
Bariatric Surgical Therapy | 885 | ||
Restrictive Surgeries | 885 | ||
Adjustable Gastric Banding. | 885 | ||
Sleeve Gastrectomy (Gastric Sleeve). | 885 | ||
Gastric Plication. | 885 | ||
Intragastric Balloons. | 885 | ||
Combination of Restrictive and Malabsorptive Surgery | 885 | ||
Roux-en-Y Gastric Bypass. | 885 | ||
Implantable Gastric Stimulation | 887 | ||
Nursing Management: Perioperative Care of the Obese Patient | 887 | ||
Nursing Implementation | 887 | ||
Preoperative Care. | 888 | ||
9 Problems of Urinary Function | 1014 | ||
44 Assessment of Urinary System | 1015 | ||
Learning Outcomes | 1015 | ||
Key Terms | 1015 | ||
Structures and Functions of Urinary System | 1015 | ||
Kidneys | 1015 | ||
Macrostructure. | 1015 | ||
Microstructure. | 1016 | ||
Blood Supply. | 1016 | ||
Physiology of Urine Formation. | 1016 | ||
Glomerular Function. | 1016 | ||
Tubular Function. | 1017 | ||
Other Functions of Kidneys. | 1017 | ||
Ureters | 1018 | ||
Bladder | 1018 | ||
Urethra | 1019 | ||
Urethrovesical Unit | 1019 | ||
Gerontologic Considerations: Effects of Aging on Urinary System | 1019 | ||
Assessment of Urinary System | 1020 | ||
Subjective Data | 1020 | ||
Important Health Information | 1020 | ||
Past Health History. | 1020 | ||
Medications. | 1020 | ||
Surgery or Other Treatments. | 1020 | ||
Functional Health Patterns. | 1020 | ||
Health Perception–Health Management Pattern. | 1020 | ||
Nutritional-Metabolic Pattern. | 1021 | ||
Elimination Pattern. | 1021 | ||
Activity-Exercise Pattern. | 1022 | ||
Sleep-Rest Pattern. | 1022 | ||
Cognitive-Perceptual Pattern. | 1022 | ||
Self-Perception–Self-Concept Pattern. | 1022 | ||
Role-Relationship Pattern. | 1022 | ||
Sexuality-Reproductive Pattern. | 1022 | ||
Objective Data | 1023 | ||
Physical Examination | 1023 | ||
Inspection. | 1023 | ||
Palpation. | 1023 | ||
Percussion. | 1023 | ||
Auscultation. | 1023 | ||
Diagnostic Studies of Urinary System | 1024 | ||
Urine Studies | 1024 | ||
Urinalysis. | 1024 | ||
Creatinine Clearance. | 1031 | ||
Urodynamic Studies | 1031 | ||
Bridge to NCLEX Examination | 1031 | ||
Evolve Website | 1032 | ||
References | 1032 | ||
45 Renal and Urologic Problems | 1033 | ||
Learning Outcomes | 1033 | ||
Key Terms | 1033 | ||
Infectious and Inflammatory Disorders of Urinary System | 1033 | ||
Urinary Tract Infection | 1033 | ||
Classification of Urinary Tract Infection | 1034 | ||
Etiology and Pathophysiology | 1034 | ||
Clinical Manifestations | 1034 | ||
Diagnostic Studies | 1035 | ||
Interprofessional Care | 1036 | ||
Nursing Management: Urinary Tract Infection | 1036 | ||
Nursing Assessment | 1036 | ||
Nursing Diagnoses | 1036 | ||
Planning | 1036 | ||
Nursing Implementation | 1036 | ||
Health Promotion. | 1036 | ||
Prevention of CAUTI. | 1037 | ||
Acute Care. | 1037 | ||
Ambulatory Care. | 1037 | ||
Evaluation | 1038 | ||
Acute Pyelonephritis | 1038 | ||
Etiology and Pathophysiology | 1038 | ||
Clinical Manifestations and Diagnostic Studies | 1038 | ||
Interprofessional Care | 1038 | ||
Nursing Management: Acute Pyelonephritis | 1038 | ||
Nursing Assessment | 1038 | ||
Nursing Diagnoses | 1039 | ||
Planning | 1039 | ||
Nursing Implementation | 1039 | ||
Evaluation | 1039 | ||
Chronic Pyelonephritis | 1039 | ||
Urethritis | 1039 | ||
Urethral Diverticula | 1040 | ||
Interstitial Cystitis/Painful Bladder Syndrome | 1040 | ||
Clinical Manifestations and Diagnostic Studies | 1040 | ||
Interprofessional Care | 1040 | ||
Nursing Management: Interstitial Cystitis/Painful Bladder Syndrome | 1041 | ||
Genitourinary Tuberculosis | 1041 | ||
Immunologic Disorders of Kidney | 1041 | ||
Glomerulonephritis | 1041 | ||
Acute Poststreptococcal Glomerulonephritis | 1041 | ||
Nursing and Interprofessional Management: Acute Poststreptococcal Glomerulonephritis | 1042 | ||
Goodpasture Syndrome | 1043 | ||
Rapidly Progressive Glomerulonephritis | 1043 | ||
Chronic Glomerulonephritis | 1043 | ||
Nephrotic Syndrome | 1043 | ||
Etiology and Clinical Manifestations | 1043 | ||
Nursing and Interprofessional Management: Nephrotic Syndrome | 1044 | ||
Obstructive Uropathies | 1044 | ||
Urinary Tract Calculi | 1045 | ||
Etiology and Pathophysiology | 1045 | ||
Types of Urinary Calculi | 1045 | ||
Clinical Manifestations | 1046 | ||
Diagnostic Studies | 1046 | ||
Interprofessional Care | 1047 | ||
Endourologic Procedures. | 1047 | ||
Lithotripsy. | 1047 | ||
Surgical Therapy. | 1048 | ||
Nutritional Therapy. | 1048 | ||
Nursing Management: Urinary Tract Calculi | 1048 | ||
Nursing Assessment | 1048 | ||
Nursing Diagnoses | 1048 | ||
Planning | 1049 | ||
Nursing Implementation | 1049 | ||
Evaluation | 1049 | ||
Strictures | 1049 | ||
Ureteral Strictures | 1049 | ||
Urethral Strictures | 1050 | ||
Renal Trauma | 1050 | ||
Renal Vascular Problems | 1050 | ||
Nephrosclerosis | 1050 | ||
Renal Artery Stenosis | 1050 | ||
Renal Vein Thrombosis | 1051 | ||
Hereditary Kidney Diseases | 1051 | ||
Polycystic Kidney Disease | 1051 | ||
Genetic Link | 1051 | ||
Nursing and Interprofessional Management: Polycystic Kidney Disease | 1052 | ||
Medullary Cystic Disease | 1052 | ||
Alport Syndrome | 1052 | ||
Urinary Tract Tumors | 1052 | ||
Kidney Cancer | 1052 | ||
Clinical Manifestations and Diagnostic Studies | 1053 | ||
Nursing and Interprofessional Management: Kidney Cancer | 1053 | ||
Bladder Cancer | 1053 | ||
Clinical Manifestations and Diagnostic Studies | 1054 | ||
Nursing and Interprofessional Management: Bladder Cancer | 1054 | ||
Surgical Therapy | 1054 | ||
Radiation Therapy, Chemotherapy, and Immunotherapy | 1055 | ||
Intravesical Therapy | 1055 | ||
Bladder Dysfunction | 1055 | ||
Urinary Incontinence | 1055 | ||
Etiology and Pathophysiology | 1055 | ||
Diagnostic Studies | 1055 | ||
Interprofessional Care | 1055 | ||
Drug Therapy. | 1057 | ||
Surgical Therapy. | 1057 | ||
Nursing Management: Urinary Incontinence | 1058 | ||
Urinary Retention | 1059 | ||
Etiology and Pathophysiology | 1060 | ||
Diagnostic Studies | 1060 | ||
Interprofessional Care | 1060 | ||
Drug Therapy. | 1060 | ||
Surgical Therapy. | 1060 | ||
Nursing Management: Urinary Retention | 1060 | ||
Catheterization | 1060 | ||
Indications for and Complications of Catheterization | 1060 | ||
Catheter Construction | 1061 | ||
Types of Catheters | 1061 | ||
Urethral Catheterization | 1061 | ||
Ureteral Catheters | 1062 | ||
Suprapubic Catheters | 1062 | ||
Nephrostomy Tubes | 1062 | ||
Intermittent Catheterization | 1062 | ||
Surgery of the Urinary Tract | 1063 | ||
Renal and Ureteral Surgery | 1063 | ||
Surgical Procedure | 1063 | ||
Laparoscopic Nephrectomy. | 1063 | ||
Preoperative Management | 1063 | ||
Postoperative Management | 1063 | ||
Urine Output. | 1063 | ||
Respiratory Status. | 1063 | ||
Abdominal Distention. | 1063 | ||
Urinary Diversion | 1063 | ||
Incontinent Urinary Diversion | 1064 | ||
Continent Urinary Diversions | 1065 | ||
Orthotopic Bladder Reconstruction | 1065 | ||
Nursing Management: Urinary Diversion | 1065 | ||
Preoperative Management | 1065 | ||
Postoperative Management | 1065 | ||
Bridge to NCLEX Examination | 1067 | ||
Evolve Website | 1068 | ||
References | 1068 | ||
46 Acute Kidney Injury and Chronic Kidney Disease | 1069 | ||
Learning Outcomes | 1069 | ||
Key Terms | 1069 | ||
Acute Kidney Injury | 1069 | ||
Etiology and Pathophysiology | 1070 | ||
Prerenal. | 1070 | ||
Intrarenal. | 1070 | ||
Postrenal. | 1071 | ||
Clinical Manifestations | 1071 | ||
Oliguric Phase. | 1071 | ||
Urinary Changes. | 1071 | ||
Fluid Volume. | 1072 | ||
Metabolic Acidosis. | 1072 | ||
Sodium Balance. | 1072 | ||
Potassium Excess. | 1072 | ||
Hematologic Disorders. | 1072 | ||
Waste Product Accumulation. | 1072 | ||
Neurologic Disorders. | 1072 | ||
Diuretic Phase. | 1072 | ||
Recovery Phase. | 1072 | ||
Diagnostic Studies | 1072 | ||
Interprofessional Care | 1073 | ||
Nutritional Therapy. | 1074 | ||
Nursing Management: Acute Kidney Injury | 1074 | ||
Nursing Assessment | 1074 | ||
Nursing Diagnoses | 1074 | ||
Planning | 1074 | ||
Nursing Implementation | 1074 | ||
Health Promotion. | 1074 | ||
Acute Care. | 1075 | ||
Ambulatory Care. | 1075 | ||
Evaluation | 1075 | ||
Gerontologic Considerations: Acute Kidney Injury | 1075 | ||
Chronic Kidney Disease | 1075 | ||
Clinical Manifestations | 1076 | ||
Urinary System. | 1076 | ||
Metabolic Disturbances | 1076 | ||
Waste Product Accumulation. | 1076 | ||
Altered Carbohydrate Metabolism. | 1076 | ||
Elevated Triglycerides. | 1077 | ||
Electrolyte and Acid-Base Imbalances | 1077 | ||
Potassium. | 1077 | ||
Sodium. | 1077 | ||
Calcium and Phosphate. | 1077 | ||
Magnesium. | 1077 | ||
Metabolic Acidosis. | 1077 | ||
Hematologic System | 1077 | ||
Anemia. | 1077 | ||
Bleeding Tendencies. | 1078 | ||
Infection. | 1078 | ||
Cardiovascular System. | 1078 | ||
Respiratory System. | 1078 | ||
Gastrointestinal System. | 1078 | ||
Neurologic System. | 1078 | ||
Musculoskeletal System. | 1078 | ||
Integumentary System. | 1079 | ||
Reproductive System. | 1079 | ||
Psychologic Changes. | 1079 | ||
Diagnostic Studies | 1079 | ||
Interprofessional Care | 1079 | ||
Drug Therapy | 1080 | ||
Hyperkalemia. | 1080 | ||
Hypertension. | 1081 | ||
CKD-MBD. | 1081 | ||
Anemia. | 1081 | ||
Dyslipidemia. | 1082 | ||
Complications of Drug Therapy. | 1082 | ||
Nutritional Therapy | 1082 | ||
Protein Restriction. | 1082 | ||
Fluid Restriction. | 1082 | ||
Sodium and Potassium Restriction. | 1083 | ||
Phosphate Restriction. | 1083 | ||
Nursing Management: Chronic Kidney Disease | 1083 | ||
Nursing Assessment | 1083 | ||
Nursing Diagnoses | 1083 | ||
Planning | 1083 | ||
Nursing Implementation | 1083 | ||
Health Promotion. | 1083 | ||
Acute Care. | 1084 | ||
Ambulatory Care. | 1084 | ||
Evaluation | 1084 | ||
Dialysis | 1084 | ||
General Principles of Dialysis | 1085 | ||
Peritoneal Dialysis | 1085 | ||
Catheter Placement | 1085 | ||
Dialysis Solutions and Cycles | 1086 | ||
Peritoneal Dialysis Systems | 1086 | ||
Automated Peritoneal Dialysis. | 1086 | ||
Continuous Ambulatory Peritoneal Dialysis. | 1086 | ||
Complications of Peritoneal Dialysis | 1087 | ||
Exit Site Infection. | 1087 | ||
Peritonitis. | 1087 | ||
Hernias. | 1087 | ||
Lower Back Problems. | 1087 | ||
Bleeding. | 1087 | ||
Pulmonary Complications. | 1087 | ||
Protein Loss. | 1087 | ||
Effectiveness of Chronic Peritoneal Dialysis | 1087 | ||
Hemodialysis | 1087 | ||
Vascular Access Sites | 1087 | ||
Arteriovenous Fistulas and Grafts. | 1087 | ||
Temporary Vascular Access. | 1088 | ||
Dialyzers | 1089 | ||
Procedure for Hemodialysis | 1089 | ||
Settings and Schedules for Hemodialysis. | 1090 | ||
Complications of Hemodialysis | 1090 | ||
Hypotension. | 1090 | ||
Muscle Cramps. | 1090 | ||
Loss of Blood. | 1091 | ||
Hepatitis. | 1091 | ||
Effectiveness of Hemodialysis | 1091 | ||
Continuous Renal Replacement Therapy | 1091 | ||
Wearable Artificial Kidney | 1092 | ||
Kidney Transplantation | 1092 | ||
Recipient Selection | 1092 | ||
Histocompatibility Studies | 1093 | ||
Donor Sources | 1093 | ||
Live Donors. | 1093 | ||
Deceased Donors. | 1093 | ||
Surgical Procedure | 1094 | ||
Live Donor. | 1094 | ||
Kidney Transplant Recipient. | 1094 | ||
Nursing Management: Kidney Transplant Recipient | 1095 | ||
Preoperative Care | 1095 | ||
Postoperative Care | 1095 | ||
Live Donor. | 1095 | ||
Kidney Transplant Recipient. | 1095 | ||
Immunosuppressive Therapy | 1095 | ||
Complications of Transplantation | 1095 | ||
Rejection. | 1095 | ||
Infection. | 1095 | ||
Cardiovascular Disease. | 1096 | ||
Malignancies. | 1096 | ||
Recurrence of Original Kidney Disease. | 1096 | ||
Corticosteroid-Related Complications. | 1096 | ||
Gerontologic Considerations: Chronic Kidney Disease | 1096 | ||
Bridge to NCLEX Examination | 1098 | ||
Evolve Website | 1099 | ||
References | 1099 | ||
10 Problems Related to Regulatory and Reproductive Mechanisms | 1101 | ||
47 Assessment of Endocrine System | 1102 | ||
Learning Outcomes | 1102 | ||
Key Terms | 1102 | ||
Structures and Functions of Endocrine System | 1102 | ||
Glands | 1102 | ||
Hormones | 1102 | ||
Hormone Receptors. | 1103 | ||
Lipid-Soluble and Water-Soluble Hormones. | 1103 | ||
Regulation of Hormonal Secretion. | 1103 | ||
Simple Feedback. | 1103 | ||
Nervous System Control. | 1104 | ||
Rhythms. | 1105 | ||
Hypothalamus | 1105 | ||
Pituitary | 1105 | ||
Anterior Pituitary. | 1105 | ||
Posterior Pituitary. | 1105 | ||
Pineal Gland | 1106 | ||
Thyroid Gland | 1106 | ||
Thyroxine and Triiodothyronine. | 1107 | ||
Calcitonin. | 1107 | ||
Parathyroid Glands | 1107 | ||
Parathyroid Hormone. | 1107 | ||
Adrenal Glands | 1107 | ||
Adrenal Medulla. | 1107 | ||
Adrenal Cortex. | 1107 | ||
Cortisol. | 1107 | ||
Aldosterone. | 1108 | ||
Adrenal Androgens. | 1108 | ||
Pancreas | 1108 | ||
Glucagon. | 1108 | ||
Insulin. | 1108 | ||
Gerontologic Considerations: Effects of Aging on Endocrine System | 1108 | ||
Assessment of Endocrine System | 1108 | ||
Subjective Data | 1109 | ||
Important Health Information | 1109 | ||
Past Health History. | 1109 | ||
Medications. | 1109 | ||
Surgery or Other Treatments. | 1109 | ||
Functional Health Patterns. | 1109 | ||
Health Perception–Health Management Pattern. | 1109 | ||
Nutritional-Metabolic Pattern. | 1109 | ||
Elimination Pattern. | 1109 | ||
Activity-Exercise Pattern. | 1109 | ||
Sleep-Rest Pattern. | 1110 | ||
Cognitive-Perceptual Pattern. | 1110 | ||
Self-Perception–Self-Concept Pattern. | 1110 | ||
Role-Relationship Pattern. | 1110 | ||
Sexuality-Reproductive Pattern. | 1111 | ||
Coping–Stress Tolerance Pattern. | 1111 | ||
Value-Belief Pattern. | 1111 | ||
Objective Data | 1111 | ||
Physical Examination. | 1111 | ||
Integument. | 1111 | ||
Head. | 1112 | ||
Neck. | 1112 | ||
Thorax. | 1112 | ||
Abdomen. | 1112 | ||
Extremities. | 1112 | ||
Genitalia. | 1112 | ||
Diagnostic Studies of Endocrine System | 1114 | ||
Bridge to NCLEX Examination | 1119 | ||
Evolve Website | 1119 | ||
References | 1119 | ||
48 Diabetes Mellitus | 1120 | ||
Learning Outcomes | 1120 | ||
Key Terms | 1120 | ||
Diabetes Mellitus | 1120 | ||
Etiology and Pathophysiology | 1120 | ||
Normal Glucose and Insulin Metabolism. | 1120 | ||
Type 1 Diabetes Mellitus. | 1121 | ||
11 Problems Related to Movement and Coordination | 1293 | ||
55 Assessment of Nervous System | 1294 | ||
Learning Outcomes | 1294 | ||
Key Terms | 1294 | ||
Structures and Functions of Nervous System | 1294 | ||
Cells of Nervous System | 1294 | ||
Neurons. | 1294 | ||
Glial Cells. | 1294 | ||
Nerve Regeneration | 1295 | ||
Nerve Impulse | 1295 | ||
Synapse. | 1295 | ||
Neurotransmitters. | 1295 | ||
Central Nervous System | 1296 | ||
Spinal Cord. | 1296 | ||
Ascending Tracts. | 1296 | ||
Descending Tracts. | 1296 | ||
Reflex Arc. | 1296 | ||
Lower and Upper Motor Neurons. | 1296 | ||
Brain. | 1296 | ||
Cerebrum. | 1296 | ||
Brainstem. | 1297 | ||
Cerebellum. | 1297 | ||
Ventricles and Cerebrospinal Fluid. | 1298 | ||
Peripheral Nervous System | 1298 | ||
Spinal Nerves. | 1298 | ||
Cranial Nerves. | 1299 | ||
Autonomic Nervous System. | 1299 | ||
Cerebral Circulation | 1299 | ||
Blood-Brain Barrier. | 1299 | ||
Protective Structures | 1300 | ||
Meninges. | 1300 | ||
Skull. | 1300 | ||
Vertebral Column. | 1300 | ||
Gerontologic Considerations: Effects of Aging on Nervous System | 1301 | ||
Assessment of Nervous System | 1301 | ||
Subjective Data | 1301 | ||
Important Health Information | 1301 | ||
Past Health History. | 1301 | ||
Medications. | 1302 | ||
Surgery or Other Treatments. | 1302 | ||
Functional Health Patterns. | 1302 | ||
Health Perception–Health Management Pattern. | 1302 | ||
Nutritional-Metabolic Pattern. | 1302 | ||
Elimination Pattern. | 1303 | ||
Activity-Exercise Pattern. | 1303 | ||
Sleep-Rest Pattern. | 1303 | ||
Cognitive-Perceptual Pattern. | 1303 | ||
Self-Perception–Self-Concept Pattern. | 1304 | ||
Role-Relationship Pattern. | 1304 | ||
Sexuality-Reproductive Pattern. | 1304 | ||
Coping–Stress Tolerance Pattern. | 1304 | ||
Value-Belief Pattern. | 1304 | ||
Objective Data | 1304 | ||
Physical Examination. | 1304 | ||
Mental Status. | 1304 | ||
Cranial Nerves. | 1304 | ||
Olfactory nerve. | 1306 | ||
Optic nerve. | 1306 | ||
Oculomotor, trochlear, and abducens nerves. | 1306 | ||
Motor System. | 1306 | ||
Sensory System. | 1306 | ||
Touch, pain, and temperature. | 1306 | ||
Vibration sense. | 1307 | ||
Position sense. | 1307 | ||
Cortical sensory functions. | 1307 | ||
Reflexes. | 1307 | ||
Diagnostic Studies of Nervous System | 1307 | ||
Bridge to NCLEX Examination | 1312 | ||
Evolve Website | 1313 | ||
References | 1313 | ||
56 Acute Intracranial Problems | 1314 | ||
Learning Outcomes | 1314 | ||
Key Terms | 1314 | ||
Intracranial Pressure | 1314 | ||
Regulation and Maintenance of Intracranial Pressure | 1314 | ||
Normal Intracranial Pressure. | 1314 | ||
Normal Compensatory Adaptations. | 1315 | ||
Cerebral Blood Flow | 1315 | ||
Autoregulation of Cerebral Blood Flow. | 1315 | ||
Pressure Changes. | 1315 | ||
Factors Affecting Cerebral Blood Flow. | 1316 | ||
Increased Intracranial Pressure | 1316 | ||
Mechanisms of Increased Intracranial Pressure | 1316 | ||
Cerebral Edema | 1316 | ||
Vasogenic Cerebral Edema. | 1316 | ||
Cytotoxic Cerebral Edema. | 1317 | ||
Interstitial Cerebral Edema. | 1317 | ||
Clinical Manifestations | 1317 | ||
Change in Level of Consciousness. | 1317 | ||
Changes in Vital Signs. | 1318 | ||
Ocular Signs. | 1318 | ||
Decrease in Motor Function. | 1318 | ||
Headache. | 1318 | ||
Vomiting. | 1318 | ||
Complications | 1318 | ||
Diagnostic Studies | 1319 | ||
Monitoring ICP and Cerebral Oxygenation | 1319 | ||
Indications for Intracranial Pressure Monitoring. | 1319 | ||
Methods of Measuring ICP. | 1319 | ||
Cerebrospinal Fluid Drainage. | 1320 | ||
Cerebral Oxygenation Monitoring. | 1321 | ||
Interprofessional Care | 1322 | ||
Drug Therapy. | 1322 | ||
Nutritional Therapy. | 1322 | ||
Nursing Management: Increased Intracranial Pressure | 1323 | ||
Nursing Assessment | 1323 | ||
Glasgow Coma Scale. | 1323 | ||
Neurologic Assessment. | 1323 | ||
Nursing Diagnoses | 1324 | ||
Planning | 1324 | ||
Nursing Implementation | 1324 | ||
Acute Care | 1324 | ||
Respiratory Function. | 1324 | ||
Fluid and Electrolyte Balance. | 1325 | ||
Monitoring ICP. | 1325 | ||
Body Position. | 1325 | ||
Protection From Injury. | 1325 | ||
Psychologic Considerations. | 1326 | ||
Evaluation | 1326 | ||
Head Injury | 1326 | ||
Types of Head Injuries | 1326 | ||
Scalp Lacerations. | 1326 | ||
Skull Fractures. | 1326 | ||
Head Trauma. | 1327 | ||
Diffuse Injury. | 1327 | ||
Diffuse axonal injury. | 1327 | ||
Focal Injury. | 1327 | ||
Complications | 1328 | ||
Epidural Hematoma. | 1328 | ||
Subdural Hematoma. | 1329 | ||
Intracerebral Hematoma. | 1329 | ||
Diagnostic Studies and Interprofessional Care | 1329 | ||
Nursing Management: Head Injury | 1330 | ||
Nursing Assessment | 1330 | ||
Nursing Diagnoses | 1330 | ||
Planning | 1330 | ||
Nursing Implementation | 1330 | ||
Health Promotion. | 1330 | ||
Acute Care. | 1330 | ||
Ambulatory Care. | 1332 | ||
Evaluation | 1333 | ||
Brain Tumors | 1333 | ||
Types | 1333 | ||
Clinical Manifestations and Complications | 1333 | ||
Diagnostic Studies | 1334 | ||
Interprofessional Care | 1334 | ||
Surgical Therapy. | 1334 | ||
Ventricular Shunts. | 1335 | ||
Radiation Therapy and Stereotactic Radiosurgery. | 1335 | ||
Chemotherapy and Targeted Therapy. | 1335 | ||
Other Therapies. | 1335 | ||
Nursing Management: Brain Tumors | 1335 | ||
Nursing Assessment | 1335 | ||
Nursing Diagnoses | 1335 | ||
Planning | 1336 | ||
Nursing Implementation | 1336 | ||
Evaluation | 1336 | ||
Cranial Surgery | 1336 | ||
Types | 1336 | ||
Craniotomy. | 1336 | ||
Stereotactic Radiosurgery. | 1337 | ||
Nursing Management: Cranial Surgery | 1337 | ||
Nursing Implementation | 1337 | ||
Acute Care. | 1337 | ||
Ambulatory Care. | 1338 | ||
Inflammatory Conditions of the Brain | 1338 | ||
Brain Abscess | 1338 | ||
Bacterial Meningitis | 1339 | ||
Etiology and Pathophysiology | 1339 | ||
Clinical Manifestations | 1339 | ||
Complications | 1339 | ||
Diagnostic Studies | 1340 | ||
Interprofessional Care | 1340 | ||
Nursing Management: Bacterial Meningitis | 1340 | ||
Nursing Assessment | 1340 | ||
Nursing Diagnoses | 1340 | ||
Planning | 1340 | ||
Nursing Implementation | 1340 | ||
Health Promotion. | 1340 | ||
Acute Care. | 1340 | ||
Ambulatory Care. | 1341 | ||
Evaluation | 1341 | ||
Viral Meningitis | 1341 | ||
Encephalitis | 1341 | ||
Clinical Manifestations and Diagnostic Studies | 1342 | ||
Nursing and Interprofessional Management: Encephalitis | 1342 | ||
Bridge to NCLEX Examination | 1343 | ||
Evolve Website | 1343 | ||
References | 1343 | ||
57 Stroke | 1345 | ||
Learning Outcomes | 1345 | ||
Key Terms | 1345 | ||
Pathophysiology of Stroke | 1346 | ||
Anatomy of Cerebral Circulation | 1346 | ||
Regulation of Cerebral Blood Flow | 1346 | ||
Risk Factors for Stroke | 1346 | ||
Nonmodifiable Risk Factors | 1347 | ||
Modifiable Risk Factors | 1347 | ||
Transient Ischemic Attack | 1347 | ||
Types of Stroke | 1348 | ||
Ischemic Stroke | 1348 | ||
Thrombotic Stroke. | 1348 | ||
Embolic Stroke. | 1349 | ||
Hemorrhagic Stroke | 1349 | ||
Intracerebral Hemorrhage. | 1349 | ||
Subarachnoid Hemorrhage. | 1349 | ||
Clinical Manifestations of Stroke | 1350 | ||
Motor Function | 1350 | ||
Communication | 1351 | ||
Affect | 1351 | ||
Intellectual Function | 1351 | ||
Spatial-Perceptual Alterations | 1351 | ||
Elimination | 1352 | ||
Diagnostic Studies for Stroke | 1352 | ||
Interprofessional Care for Stroke | 1353 | ||
Preventive Therapy | 1353 | ||
Preventive Drug Therapy. | 1353 | ||
Left Atrial Appendage Occlusion. | 1353 | ||
Surgical/Endovascular Therapy for TIA and Stroke Prevention. | 1353 | ||
Acute Care for Ischemic Stroke | 1354 | ||
Drug Therapy for Ischemic Stroke. | 1355 | ||
Endovascular Therapy for Ischemic Stroke. | 1355 | ||
Acute Care for Hemorrhagic Stroke | 1355 | ||
Drug Therapy for Hemorrhagic Stroke. | 1355 | ||
Surgical Therapy for Hemorrhagic Stroke. | 1355 | ||
Rehabilitation Care | 1356 | ||
Core Measures for Stroke | 1356 | ||
Nursing Management: Stroke | 1356 | ||
Nursing Assessment | 1356 | ||
Nursing Diagnoses | 1357 | ||
Planning | 1357 | ||
Nursing Implementation | 1358 | ||
Health Promotion. | 1358 | ||
Acute Care | 1358 | ||
Respiratory System. | 1358 | ||
Neurologic System. | 1359 | ||
Cardiovascular System. | 1359 | ||
Musculoskeletal System. | 1359 | ||
Integumentary System. | 1360 | ||
Gastrointestinal System. | 1360 | ||
Urinary System. | 1360 | ||
Nutrition. | 1360 | ||
Communication. | 1361 | ||
Sensory-Perceptual Alterations. | 1361 | ||
Coping. | 1362 | ||
Ambulatory Care. | 1362 | ||
Rehabilitation. | 1363 | ||
Musculoskeletal Function. | 1363 | ||
Stroke Survivorship and Coping. | 1364 | ||
Sexual Function. | 1365 | ||
Community Integration. | 1365 | ||
Gerontologic Considerations: Stroke | 1365 | ||
Bridge to NCLEX Examination | 1366 | ||
Evolve Website | 1367 | ||
References | 1367 | ||
58 Chronic Neurologic Problems | 1368 | ||
Learning Outcomes | 1368 | ||
Key Terms | 1368 | ||
Headaches | 1368 | ||
Tension-Type Headache | 1370 | ||
12 Nursing Care in Critical Care Settings | 1553 | ||
65 Critical Care | 1554 | ||
Learning Outcomes | 1554 | ||
Key Terms | 1554 | ||
Critical Care Nursing | 1554 | ||
Critical Care Units | 1554 | ||
Critical Care Nurse | 1555 | ||
Critical Care Patient | 1555 | ||
Common Problems of Critical Care Patients. | 1556 | ||
Anxiety. | 1556 | ||
Pain. | 1556 | ||
Impaired Communication. | 1556 | ||
Sleep. | 1556 | ||
Sensory-Perceptual Problems. | 1557 | ||
Nutrition. | 1557 | ||
Issues Related to Caregivers | 1557 | ||
Culturally Competent Care: Critical Care Patients | 1558 | ||
Hemodynamic Monitoring | 1558 | ||
Hemodynamic Terminology | 1559 | ||
Cardiac Output and Cardiac Index. | 1559 | ||
Preload. | 1559 | ||
Afterload. | 1560 | ||
Vascular Resistance. | 1560 | ||
Contractility. | 1560 | ||
Principles of Invasive Pressure Monitoring | 1560 | ||
Types of Invasive Pressure Monitoring | 1561 | ||
Arterial Blood Pressure. | 1561 | ||
Measurements. | 1561 | ||
Complications. | 1562 | ||
Arterial Pressure–Based Cardiac Output. | 1562 | ||
Measurements. | 1562 | ||
Pulmonary Artery Flow-Directed Catheter. | 1563 | ||
Pulmonary Artery Catheter Insertion. | 1564 | ||
Central Venous or Right Atrial Pressure Measurement. | 1564 | ||
Venous Oxygen Saturation Monitoring. | 1564 | ||
Noninvasive Arterial Oxygenation Monitoring | 1565 | ||
Noninvasive Hemodynamic Monitoring: Impedance Cardiography | 1566 | ||
Nursing and Interprofessional Management: Hemodynamic Monitoring | 1566 | ||
Circulatory Assist Devices | 1566 | ||
Intraaortic Balloon Pump | 1566 | ||
Effects of Counterpulsation. | 1567 | ||
Complications With IABP Therapy. | 1567 | ||
Ventricular Assist Devices | 1568 | ||
Implantable Artificial Heart | 1569 | ||
Nursing and Interprofessional Management: Circulatory Assist Devices | 1569 | ||
Artificial Airways | 1569 | ||
Endotracheal Tubes | 1569 | ||
Endotracheal Intubation Procedure | 1570 | ||
Nursing and Interprofessional Management: Artificial Airway | 1570 | ||
Maintaining Correct Tube Placement | 1571 | ||
Maintaining Proper Cuff Inflation | 1571 | ||
Monitoring Oxygenation and Ventilation | 1571 | ||
Maintaining Tube Patency | 1571 | ||
Providing Oral Care and Maintaining Skin Integrity | 1572 | ||
Fostering Comfort and Communication | 1573 | ||
Complications of Endotracheal Intubation | 1573 | ||
Mechanical Ventilation | 1574 | ||
Types of Mechanical Ventilation | 1574 | ||
Negative Pressure Ventilation. | 1574 | ||
Positive Pressure Ventilation. | 1574 | ||
Volume Ventilation. | 1574 | ||
Pressure Ventilation. | 1574 | ||
Settings of Mechanical Ventilators | 1574 | ||
Modes of Volume Ventilation | 1575 | ||
Assist-Control Ventilation. | 1575 | ||
Synchronized Intermittent Mandatory Ventilation. | 1576 | ||
Modes of Pressure Ventilation | 1576 | ||
Pressure Support Ventilation. | 1576 | ||
Pressure-Control and Pressure-Control Inverse Ratio Ventilation. | 1576 | ||
Airway Pressure Release Ventilation. | 1577 | ||
Other Modes. | 1577 | ||
Other Ventilatory Maneuvers | 1577 | ||
Positive End-Expiratory Pressure. | 1577 | ||
Continuous Positive Airway Pressure. | 1577 | ||
Automatic Tube Compensation. | 1577 | ||
Bilevel Positive Airway Pressure. | 1577 | ||
High-Frequency Oscillatory Ventilation. | 1578 | ||
Nitric Oxide. | 1578 | ||
Prone Positioning. | 1578 | ||
Extracorporeal Membrane Oxygenation. | 1578 | ||
Complications of Positive Pressure Ventilation | 1578 | ||
Cardiovascular System. | 1578 | ||
Pulmonary System | 1578 | ||
Barotrauma. | 1578 | ||
Volutrauma. | 1578 | ||
Alveolar Hypoventilation. | 1578 | ||
Alveolar Hyperventilation. | 1579 | ||
Ventilator-Associated Pneumonia. | 1579 | ||
Sodium and Water Imbalance. | 1579 | ||
Neurologic System. | 1579 | ||
Gastrointestinal System. | 1580 | ||
Musculoskeletal System. | 1580 | ||
Psychosocial Needs. | 1580 | ||
Ventilator Disconnection or Malfunction. | 1581 | ||
Nutritional Therapy: Patient Receiving Positive Pressure Ventilation | 1581 | ||
Weaning From Positive Pressure Ventilation and Extubation | 1582 | ||
Chronic Mechanical Ventilation | 1582 | ||
Nursing Management: Mechanical Ventilation | 1584 | ||
Other Critical Care Content | 1584 | ||
Bridge to NCLEX Examination | 1585 | ||
Evolve Website | 1585 | ||
References | 1585 | ||
66 Shock, Sepsis, and Multiple Organ Dysfunction Syndrome | 1587 | ||
Learning Outcomes | 1587 | ||
Key Terms | 1587 | ||
Shock | 1587 | ||
Classification of Shock | 1587 | ||
Cardiogenic Shock. | 1587 | ||
Hypovolemic Shock. | 1589 | ||
Distributive Shock | 1590 | ||
Neurogenic Shock. | 1590 | ||
Anaphylactic Shock. | 1590 | ||
Septic Shock. | 1592 | ||
Obstructive Shock. | 1593 | ||
Stages of Shock | 1594 | ||
Initial Stage. | 1594 | ||
Compensatory Stage. | 1594 | ||
Progressive Stage. | 1594 | ||
Refractory Stage. | 1596 | ||
Diagnostic Studies | 1596 | ||
Interprofessional Care: General Measures | 1596 | ||
Oxygen and Ventilation. | 1596 | ||
Fluid Resuscitation. | 1596 | ||
Drug Therapy. | 1598 | ||
Sympathomimetic Drugs. | 1598 | ||
Vasodilator Drugs. | 1598 | ||
Nutritional Therapy. | 1598 | ||
Interprofessional Care: Specific Measures | 1598 | ||
Cardiogenic Shock. | 1598 | ||
Hypovolemic Shock. | 1601 | ||
Septic Shock. | 1601 | ||
Neurogenic Shock. | 1601 | ||
Anaphylactic Shock. | 1601 | ||
Obstructive Shock. | 1602 | ||
Nursing Management: Shock | 1602 | ||
Nursing Assessment | 1602 | ||
Nursing Diagnoses | 1602 | ||
Planning | 1602 | ||
Nursing Implementation | 1602 | ||
Health Promotion. | 1602 | ||
Acute Care. | 1602 | ||
Neurologic Status. | 1603 | ||
Cardiovascular Status. | 1603 | ||
Respiratory Status. | 1603 | ||
Renal Status. | 1603 | ||
Body Temperature and Skin Changes. | 1603 | ||
Gastrointestinal Status. | 1603 | ||
Personal Hygiene. | 1603 | ||
Emotional Support and Comfort. | 1604 | ||
Ambulatory Care. | 1604 | ||
Evaluation | 1604 | ||
Systemic Inflammatory Response Syndrome and Multiple Organ Dysfunction Syndrome | 1604 | ||
Etiology and Pathophysiology | 1604 | ||
Organ and Metabolic Dysfunction. | 1605 | ||
Clinical Manifestations of SIRS and MODS | 1605 | ||
Nursing and Interprofessional Management: SIRS and MODS | 1606 | ||
Prevention and Treatment of Infection | 1606 | ||
Maintenance of Tissue Oxygenation | 1607 | ||
Nutritional and Metabolic Needs | 1607 | ||
Support of Failing Organs | 1607 | ||
Bridge to NCLEX Examination | 1608 | ||
Evolve Website | 1608 | ||
References | 1608 | ||
67 Acute Respiratory Failure and Acute Respiratory Distress Syndrome | 1609 | ||
Learning Outcomes | 1609 | ||
Key Terms | 1609 | ||
Acute Respiratory Failure | 1609 | ||
Etiology and Pathophysiology | 1610 | ||
Hypoxemic Respiratory Failure. | 1610 | ||
Ventilation-Perfusion Mismatch. | 1610 | ||
Shunt. | 1611 | ||
Diffusion Limitation. | 1611 | ||
Alveolar Hypoventilation. | 1612 | ||
Interrelationship of Mechanisms. | 1612 | ||
Hypercapnic Respiratory Failure. | 1612 | ||
Airway and Alveoli Abnormalities. | 1612 | ||
Central Nervous System Abnormalities. | 1612 | ||
Chest Wall Abnormalities. | 1612 | ||
Neuromuscular Conditions. | 1612 | ||
Tissue Oxygen Needs. | 1612 | ||
Clinical Manifestations | 1612 | ||
Consequences of Hypoxemia and Hypoxia. | 1613 | ||
Specific Clinical Manifestations. | 1613 | ||
Diagnostic Studies | 1614 | ||
Nursing and Interprofessional Management: Acute Respiratory Failure | 1614 | ||
Nursing Assessment | 1615 | ||
Nursing Diagnoses | 1615 | ||
Planning | 1615 | ||
Prevention | 1615 | ||
Respiratory Therapy | 1615 | ||
Oxygen Therapy. | 1615 | ||
Mobilization of Secretions. | 1616 | ||
Effective Coughing and Positioning. | 1616 | ||
Hydration. | 1617 | ||
Humidification. | 1617 | ||
Chest Physiotherapy. | 1617 | ||
Airway Suctioning. | 1617 | ||
Positive Pressure Ventilation. | 1617 | ||
Drug Therapy | 1618 | ||
Relief of Bronchospasm. | 1618 | ||
Reduction of Airway Inflammation. | 1618 | ||
Reduction of Pulmonary Congestion. | 1618 | ||
Treatment of Pulmonary Infections. | 1618 | ||
Reduction of Anxiety, Pain, and Agitation. | 1618 | ||
Medical Supportive Therapy | 1619 | ||
Treating the Underlying Cause. | 1619 | ||
Maintaining Adequate Cardiac Output. | 1619 | ||
Maintaining Adequate Hemoglobin Concentration. | 1619 | ||
Nutritional Therapy | 1619 | ||
Evaluation | 1619 | ||
Gerontologic Considerations: Respiratory Failure | 1619 | ||
Acute Respiratory Distress Syndrome | 1620 | ||
Etiology and Pathophysiology | 1620 | ||
Injury or Exudative Phase. | 1621 | ||
Reparative or Proliferative Phase. | 1622 | ||
Fibrotic Phase. | 1622 | ||
Clinical Progression | 1622 | ||
Clinical Manifestations and Diagnostic Studies | 1622 | ||
Complications | 1623 | ||
Ventilator-Associated Pneumonia. | 1623 | ||
Barotrauma. | 1623 | ||
Volutrauma. | 1623 | ||
Stress Ulcers. | 1623 | ||
Renal Failure. | 1623 | ||
Nursing and Interprofessional Management: Acute Respiratory Distress Syndrome | 1623 | ||
Nursing Assessment | 1624 | ||
Nursing Diagnoses | 1624 | ||
Planning | 1624 | ||
Oxygen Administration. | 1624 | ||
Positive Pressure Ventilation. | 1624 | ||
Positioning Strategies. | 1624 | ||
Medical Supportive Therapy | 1625 | ||
Maintenance of Cardiac Output and Tissue Perfusion. | 1625 | ||
Maintenance of Nutrition and Fluid Balance. | 1625 | ||
Evaluation | 1625 | ||
Bridge to NCLEX Examination | 1627 | ||
Evolve Website | 1627 | ||
References | 1627 | ||
68 Emergency and Disaster Nursing | 1628 | ||
Learning Outcomes | 1628 | ||
Key Terms | 1628 | ||
Care of Emergency Patient | 1628 | ||
Triage | 1628 | ||
Primary Survey | 1630 | ||
A = Alertness and Airway. | 1630 | ||
B = Breathing. | 1630 | ||
C = Circulation. | 1630 | ||
D = Disability. | 1632 | ||
E = Exposure and Environmental Control. | 1632 | ||
F = Facilitate Adjuncts and Family. | 1632 | ||
G = Get Resuscitation Adjuncts. | 1632 | ||
Secondary Survey | 1632 | ||
H = History and Head-to-Toe Assessment. | 1632 | ||
Head, Neck, and Face. | 1633 | ||
Chest. | 1633 | ||
Abdomen and Flanks. | 1633 | ||
Pelvis and Perineum. | 1634 | ||
Extremities. | 1634 | ||
I = Inspect Posterior Surfaces. | 1634 | ||
Acute Care and Evaluation | 1634 | ||
Cardiac Arrest and Therapeutic Hypothermia | 1634 | ||
Death in the Emergency Department | 1635 | ||
Gerontologic Considerations: Emergency Care | 1635 | ||
Environmental Emergencies | 1636 | ||
Heat-Related Emergencies | 1636 | ||
Heat Cramps | 1637 | ||
Heat Exhaustion | 1637 | ||
Heatstroke | 1637 | ||
Interprofessional Care. | 1637 | ||
Cold-Related Emergencies | 1637 | ||
Frostbite | 1637 | ||
Hypothermia | 1638 | ||
Interprofessional Care. | 1639 | ||
Submersion Injuries | 1639 | ||
Interprofessional Care | 1640 | ||
Stings and Bites | 1640 | ||
Hymenopteran Stings | 1640 | ||
Tick Bites | 1641 | ||
Animal and Human Bites | 1641 | ||
Interprofessional Care. | 1642 | ||
Poisonings | 1642 | ||
Violence | 1644 | ||
Agents of Terrorism | 1645 | ||
Emergency and Mass Casualty Incident Preparedness | 1645 | ||
Bridge to NCLEX Examination | 1647 | ||
Evolve Website | 1647 | ||
References | 1648 | ||
Appendixes | 1650 | ||
Appendix A Basic Life Support for Health Care Professionals | 1650 | ||
Cardiopulmonary Resuscitation | 1650 | ||
Chest Compressions | 1650 | ||
Defibrillation | 1651 | ||
Airway and Breathing | 1651 | ||
Hands-Only CPR | 1652 | ||
References* | 1652 | ||
Appendix B Nursing Diagnoses | 1653 | ||
Appendix C Laboratory Reference Intervals | 1655 | ||
Glossary | 1663 | ||
A | 1663 | ||
B | 1663 | ||
C | 1663 | ||
D | 1664 | ||
E | 1665 | ||
F | 1665 | ||
G | 1665 | ||
H | 1665 | ||
I | 1666 | ||
J | 1666 | ||
K | 1666 | ||
L | 1667 | ||
M | 1667 | ||
N | 1667 | ||
O | 1668 | ||
P | 1668 | ||
R | 1669 | ||
S | 1669 | ||
T | 1670 | ||
U | 1670 | ||
V | 1670 | ||
W | 1670 | ||
Index | I-1 | ||
A | I-1 | ||
B | I-7 | ||
C | I-10 | ||
D | I-17 | ||
E | I-20 | ||
F | I-23 | ||
G | I-25 | ||
H | I-27 | ||
I | I-31 | ||
J | I-34 | ||
K | I-35 | ||
L | I-35 | ||
M | I-37 | ||
N | I-40 | ||
O | I-42 | ||
P | I-44 | ||
Q | I-51 | ||
R | I-51 | ||
S | I-53 | ||
T | I-58 | ||
U | I-61 | ||
V | I-62 | ||
W | I-64 | ||
X | I-65 | ||
Y | I-65 | ||
Z | I-65 | ||
Endsheet 5 | IBC5 | ||
Abbreviations | IBC6 |