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Book Details
Abstract
With an easy-to-read approach and unmatched learning support, Physical Examination & Health Assessment, 6th Edition offers a clear, logical, and holistic approach to physical exam across the lifespan. Detailed illustrations, summary checklists, and new learning resources ensure that you learn all the skills you need to know. This gold standard in physical exam reflects what is going on in nursing today with coverage of emerging trends and new evidence-based content. It's easy to see why this text is, far and away, #1 in this market!
This item is a stand-alone text.
- A clear, conversational writing style makes learning easier.
- A two-column format distinguishes normal findings from abnormal findings, and uses color, step-by-step photos to clarify examination techniques and expected findings.
- Over 1,000 full-color illustrations present anatomy and physiology, examination techniques, and abnormal findings.
- Developmental considerations help in caring for patients across the lifespan with age-specific assessment techniques for infants, children, adolescents, pregnant females, and older adults.
- Abnormal findings tables include over 300 pathology photos to help in recognizing, sorting, and describing abnormalities.
- Promoting a Healthy Lifestyle boxes enable patient teaching and health promotion while performing the health assessment.
- An emphasis on cultural competencies reflects today's care considerations for an increasingly diverse patient population.
- Documentation examples show how to record assessment findings in the patient's chart, using the SOAP format.
- Summary checklists provide a quick review of examination steps.
- Spanish-language translations on the inside back cover highlight important phrases for better communication during the physical examination.
- A companion Evolve website helps you review key content offering case studies with critical thinking questions, printable health promotion handouts, a head-to-toe examination video, heart and lung sounds, audio chapter summaries, and more.
- NEW evidence-based guidelines reflect a focus on conducting the most effective, qualitative exams.
- NEW Substance Use Assessment chapter addresses this increasingly critical aspect of holistic patient assessments.
- 100 new photos of step-by-step examination techniques include all-new exam panoramas for key systems.
- 100 new abnormal findings photos provide instant visual cues for findings that are unexpected or that require referral for follow-up care.
- Expanded chapter on assessment of the hospitalized adult provides a focused assessment of the patient in the hospital setting.
- New content on obesity provides current information on this growing health problem.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front cover | cover | ||
| Physical Examination & Health Assessment, 6/e | i | ||
| Copyright page | ii | ||
| Dedication | iii | ||
| About the Author | v | ||
| CONTRIBUTORS | vi | ||
| REVIEWERS | viii | ||
| Preface | ix | ||
| New to the Sixth Edition | ix | ||
| Dual Focus as Text and Reference | ix | ||
| Conceptual Approach | x | ||
| Features from Earlier Editions | x | ||
| Supplements | xi | ||
| In Conclusion | xii | ||
| Acknowledgments | xiii | ||
| Table of Contents | xv | ||
| Unit 1 Assessment of the Whole Person | 1 | ||
| 1 Evidence-Based Assessment | 1 | ||
| Assessment—Point of Entry in an Ongoing Process | 2 | ||
| Diagnostic Reasoning | 2 | ||
| Critical Thinking and the Diagnostic Process | 2 | ||
| Evidence-Based Assessment | 6 | ||
| Collecting Four Types of Data | 7 | ||
| 1. Complete (Total Health) Database | 7 | ||
| 2. Focused or Problem-Centered Database | 7 | ||
| 3. Follow-Up Database | 8 | ||
| 4. Emergency Database | 8 | ||
| Expanding the Concept of Health | 8 | ||
| CULTURE AND GENETICS | 9 | ||
| Bibliography | 10 | ||
| 2 Cultural Competence: | 11 | ||
| Demographic Profile of the United States | 11 | ||
| Immigration | 12 | ||
| New National Standards | 12 | ||
| Linguistic Competence | 12 | ||
| Health Disparities | 14 | ||
| Cultural Competence and Cultural Care | 14 | ||
| Heritage | 14 | ||
| Culture | 14 | ||
| Ethnicity | 14 | ||
| Religion | 15 | ||
| Spirituality and Religion | 15 | ||
| Socialization | 16 | ||
| Heritage Assessment | 17 | ||
| Health-Related Beliefs and Practices | 19 | ||
| Developmental Competence | 20 | ||
| Traditional Causes of Illness | 21 | ||
| Biomedical | 21 | ||
| Naturalistic | 21 | ||
| Magicoreligious | 21 | ||
| Healing and Culture | 22 | ||
| Folk Healers | 23 | ||
| Transcultural Expression of Illness | 25 | ||
| Transcultural Expression of Pain | 25 | ||
| Culture-Bound Syndromes | 26 | ||
| Culture and Treatment | 26 | ||
| Culture and Disease Prevalence | 27 | ||
| Steps to Cultural Competency | 27 | ||
| Bibliography | 28 | ||
| Websites of Interest | 28 | ||
| 3 The Interview | 29 | ||
| The Process of Communication | 29 | ||
| Sending | 30 | ||
| Receiving | 30 | ||
| Internal Factors | 30 | ||
| Liking Others. | 30 | ||
| Empathy. | 30 | ||
| The Ability to Listen. | 30 | ||
| External Factors | 30 | ||
| Ensure Privacy. | 30 | ||
| Refuse Interruptions. | 30 | ||
| Physical Environment | 31 | ||
| Dress | 31 | ||
| Note-Taking. | 31 | ||
| Tape and Video Recording. | 31 | ||
| Electronic Health Recording (EHR). | 32 | ||
| Techniques of Communication | 32 | ||
| Introducing the Interview | 32 | ||
| The Working Phase | 32 | ||
| Open-Ended Questions | 32 | ||
| Closed or Direct Questions | 33 | ||
| Responses—Assisting the Narrative | 33 | ||
| Facilitation. | 33 | ||
| Silence. | 33 | ||
| Reflection. | 33 | ||
| Empathy. | 34 | ||
| Clarification. | 34 | ||
| Confrontation. | 34 | ||
| Interpretation. | 34 | ||
| Explanation. | 34 | ||
| Summary. | 34 | ||
| Ten Traps of Interviewing | 35 | ||
| 1. Providing False Assurance or Reassurance. | 35 | ||
| 2. Giving Unwanted Advice. | 35 | ||
| 3. Using Authority. | 35 | ||
| 4. Using Avoidance Language. | 35 | ||
| 5. Engaging in Distancing. | 35 | ||
| 6. Using Professional Jargon. | 35 | ||
| 7. Using Leading or Biased Questions. | 36 | ||
| 8. Talking Too Much. | 36 | ||
| 9. Interrupting. | 36 | ||
| 10. Using “Why” Questions. | 36 | ||
| Nonverbal Skills | 36 | ||
| Physical Appearance. | 36 | ||
| Posture. | 36 | ||
| Gestures. | 36 | ||
| Facial Expression. | 37 | ||
| Eye Contact. | 37 | ||
| Voice. | 37 | ||
| Touch. | 37 | ||
| Closing the Interview | 37 | ||
| Developmental Competence | 37 | ||
| Interviewing the Parent | 37 | ||
| The Infant | 38 | ||
| The Preschooler | 38 | ||
| The School-Age Child | 39 | ||
| The Adolescent | 39 | ||
| The Older Adult | 40 | ||
| Interviewing People with Special Needs | 40 | ||
| Hearing-Impaired People | 40 | ||
| Acutely Ill People | 41 | ||
| People Under the Influence of Street Drugs or Alcohol | 41 | ||
| Personal Questions | 41 | ||
| Sexually Aggressive People | 41 | ||
| Crying | 42 | ||
| Anger | 42 | ||
| Threat of Violence | 42 | ||
| Anxiety | 42 | ||
| culture and genetics | 42 | ||
| Cross-Cultural Communication | 42 | ||
| Cultural Perspectives on Professional Interactions | 43 | ||
| Etiquette | 43 | ||
| Space and Distance | 44 | ||
| Cultural Considerations on Gender | 44 | ||
| Cultural Considerations on Sexual Orientation | 45 | ||
| Overcoming Communication Barriers | 45 | ||
| Working With (and Without) an Interpreter | 45 | ||
| Nonverbal Cross-Cultural Communication | 47 | ||
| Touch | 48 | ||
| Bibliography | 48 | ||
| Websites of Interest | 48 | ||
| 4 The Complete Health History | 49 | ||
| The Health History—The Adult | 49 | ||
| Biographic Data | 49 | ||
| Source of History | 50 | ||
| Reason for Seeking Care* | 50 | ||
| Present Health or History of Present Illness | 50 | ||
| Past Health | 51 | ||
| Childhood Illnesses. | 51 | ||
| Accidents or Injuries. | 52 | ||
| Serious or Chronic Illnesses. | 52 | ||
| Hospitalizations. | 52 | ||
| Operations. | 52 | ||
| Obstetric History. | 52 | ||
| Immunizations. | 52 | ||
| Last Examination Date. | 52 | ||
| Allergies. | 52 | ||
| Current Medications. | 52 | ||
| Family History | 52 | ||
| CULTURE AND GENETICS | 54 | ||
| Review of Systems | 54 | ||
| General Overall Health State. | 54 | ||
| Skin. | 55 | ||
| Hair. | 55 | ||
| Unit 2 Approach to the Clinical Setting | 115 | ||
| 8 Assessment Techniques and the Clinical Setting | 115 | ||
| Outline | 115 | ||
| Cultivating Your Senses | 115 | ||
| Inspection | 115 | ||
| Palpation | 115 | ||
| Percussion | 116 | ||
| The Stationary Hand | 116 | ||
| The Striking Hand | 116 | ||
| Production of Sound | 117 | ||
| Auscultation | 118 | ||
| Setting | 118 | ||
| Equipment | 119 | ||
| A Clean Field | 120 | ||
| A Safer Environment | 120 | ||
| The Clinical Setting | 121 | ||
| General Approach | 121 | ||
| Hands On | 121 | ||
| Developmental Competence | 122 | ||
| The Infant | 122 | ||
| Position | 122 | ||
| Unit 3 Physical Examination | 203 | ||
| 12 Skin, Hair, and Nails | 203 | ||
| Outline | 203 | ||
| Structure and Function | 203 | ||
| Skin | 203 | ||
| Epidermis | 203 | ||
| Dermis | 204 | ||
| Subcutaneous Layer | 204 | ||
| Epidermal Appendages | 204 | ||
| Hair | 204 | ||
| Sebaceous Glands | 205 | ||
| Sweat Glands | 205 | ||
| Nails | 205 | ||
| Function of the Skin | 205 | ||
| Developmental Competence | 205 | ||
| Infants and Children | 205 | ||
| The Pregnant Woman | 206 | ||
| The Aging Adult | 206 | ||
| Culture and genetics | 206 | ||
| Subjective Data | 207 | ||
| Objective Data | 211 | ||
| Documentation and Critical Thinking | 227 | ||
| Sample Charting | 227 | ||
| Subjective | 227 | ||
| Objective | 227 | ||
| Assessment | 227 | ||
| Focused Assessment: Clinical Case Study 1* | 228 | ||
| Unit 4 Integration of the Health System | 763 | ||
| 27 The Complete Health Assessment: | 763 | ||
| Documentation and Critical Thinking | 781 | ||
| Recording the Data | 781 | ||
| Health History | 781 | ||
| Biographic Data | 781 | ||
| Past Health | 781 | ||
| Family History | 782 | ||
| Review of Systems | 782 | ||
| Functional Assessment | 783 | ||
| Perception of Health | 783 | ||
| Physical Examination | 784 | ||
| Measurement | 784 | ||
| Head-To-Toe Examination | 784 | ||
| Assessment | 785 | ||
| 28 Bedside Assessment of the Hospitalized Adult | 787 | ||
| Using SBAR for Staff Communication | 793 | ||
| Bibliography | 793 | ||
| 29 The Pregnant Woman | 795 | ||
| Outline | 795 | ||
| Structure and Function | 795 | ||
| Pregnancy and the Endocrine Placenta | 795 | ||
| Changes During Normal Pregnancy | 796 | ||
| First Trimester | 796 | ||
| Second Trimester | 797 | ||
| Third Trimester | 797 | ||
| Determining Weeks of Gestation | 798 | ||
| Weight Gain in Pregnancy | 798 | ||
| Developmental Competence | 798 | ||
| Culture and genetics | 799 | ||
| Subjective Data | 799 | ||
| Objective Data | 806 | ||
| Documentation and Critical Thinking | 820 | ||
| Focused Assessment: Clinical Case Study 1 | 820 | ||
| Subjective | 820 | ||
| Objective | 820 | ||
| Assessment | 820 | ||
| Plan | 820 | ||
| Focused Assessment: Clinical Case Study 2 | 821 | ||
| Subjective | 821 | ||
| Objective | 821 | ||
| Assessment | 821 | ||
| Plan | 821 | ||
| Abnormal Findings FOR ADVANCED PRACTICE | 822 | ||
| Summary Checklist: The Pregnant Woman | 828 | ||
| Bibliography | 827 | ||
| 30 Functional Assessment of the Older Adult | 829 | ||
| Functional Ability | 830 | ||
| Activities of Daily Living | 830 | ||
| The Katz Index of Independence in ADL | 830 | ||
| Additional Activity-of-Daily-Living Instruments | 831 | ||
| Instrumental Activities of Daily Living | 832 | ||
| Lawton Instrumental Activities of Daily Living | 832 | ||
| Additional IADL Instruments | 832 | ||
| Advanced Activities of Daily Living | 832 | ||
| Measuring Physical Performance | 832 | ||
| Assessment of Risk for Functional Decline During Hospitalization | 834 | ||
| Assessment of Cognition | 835 | ||
| Depression and Function | 835 | ||
| Social Domain | 836 | ||
| Caregiver Assessment | 837 | ||
| Assessment of Caregiver Burden | 837 | ||
| Contexts of Care | 837 | ||
| Acute Care Setting | 837 | ||
| Community | 838 | ||
| Home Care | 839 | ||
| Nursing Facilities | 839 | ||
| Assistive Living | 839 | ||
| Continuing Care Retirement Communities | 839 | ||
| Maintaining Independence | 839 | ||
| Exercise | 839 | ||
| Health Care Maintenance | 840 | ||
| Environmental Assessment | 840 | ||
| Older Adult Drivers | 840 | ||
| Sleep | 841 | ||
| Spiritual Assessment | 842 | ||
| Special Considerations | 843 | ||
| Cultural Considerations | 843 | ||
| Assessing Those in Pain | 844 | ||
| Assessing Older Adults with Altered Cognition | 844 | ||
| Bibliography | 844 | ||
| Illustration Credits | 847 | ||
| Chapter 1 | 847 | ||
| Chapter 2 | 847 | ||
| Chapter 4 | 847 | ||
| Chapter 5 | 847 | ||
| Chapter 7 | 847 | ||
| Chapter 8 | 847 | ||
| Chapter 9 | 847 | ||
| Chapter 10 | 847 | ||
| Chapter 11 | 847 | ||
| Chapter 12 | 848 | ||
| Chapter 13 | 849 | ||
| Chapter 14 | 849 | ||
| Chapter 15 | 850 | ||
| Chapter 16 | 851 | ||
| Chapter 17 | 851 | ||
| Chapter 18 | 851 | ||
| Chapter 19 | 852 | ||
| Chapter 20 | 852 | ||
| Chapter 21 | 852 | ||
| Chapter 22 | 852 | ||
| Chapter 23 | 853 | ||
| Chapter 24 | 853 | ||
| Chapter 25 | 853 | ||
| Chapter 26 | 853 | ||
| Chapter 28 | 853 | ||
| Chapter 29 | 853 | ||
| Chapter 30 | 854 | ||
| Index | 855 | ||
| A | 855 | ||
| B | 857 | ||
| C | 858 | ||
| D | 860 | ||
| E | 861 | ||
| F | 862 | ||
| G | 863 | ||
| H | 864 | ||
| I | 866 | ||
| J | 867 | ||
| K | 867 | ||
| L | 867 | ||
| M | 868 | ||
| N | 870 | ||
| O | 871 | ||
| P | 872 | ||
| Q | 875 | ||
| R | 875 | ||
| S | 876 | ||
| T | 878 | ||
| U | 879 | ||
| V | 879 | ||
| W | 880 | ||
| X | 880 | ||
| Y | 880 | ||
| Z | 880 | ||
| Endsheet 2 | ibc_2 | ||
| Endsheet 3 | ibc_3 | ||
| Endsheet 4 | ibc_4 | ||
| Endsheet 5 | ibc_5 | ||
| Endsheet 6 | ibc_6 | ||
| Endsheet 7 | ibc_7 | ||
| APPENDIX A-1: Recommended Immunization Schedule for Persons Aged 0 Through 6 Years—United States • 2010 | e1 | ||
| APPENDIX A-2: Recommended Immunization Schedule for Persons Aged 7 Through 18 Years—United States • 2010 | e3 | ||
| APPENDIX A-3: Catch-up Immunization Schedule for Persons Aged 4 Months Through 18 Years Who Start Late or Who Are More Than 1 Month Behind—United States • 2010 | e5 | ||
| APPENDIX B-1: Standard Precautions | e9 | ||
| Standard Precautions | e9 | ||
| APPENDIX B-2: Transmission-Based Precautions | e12 | ||
| APPENDIX C: Body Mass Index Table | e13 | ||
| Appendix D: Sample Growth Charts for Girls and Boys (Height and Weight) | e15 | ||
| Appendix E-1: Blood Pressure Levels for the 50th, 90th, 95th, and 99th Percentiles of Blood Pressure for Girls Ages 1 to 17 Years by Percentiles of Height | e21 | ||
| Appendix E-2: Blood Pressure Levels for the 50th, 90th, 95th, and 99th Percentiles of Blood Pressure for Boys Ages 1 to 17 Years by Percentiles of Height | e23 | ||
| Appendix F: Dietary Reference Intakes (DRIs): Estimated Average Requirements | e25 | ||
| Food and Nutrition Board, Institute of Medicine, National Academies | e25 | ||
| Appendix G: Pattern of Normal Prenatal Weight Gain | e27 | ||
| Appendix H-1: Selected Percentiles of Triceps Skinfold Thickness and Bone-Free Upper Arm Area by Height in U.S. Men, Age 25 to 54 Years, with Small, Medium, and Large Frames | e29 | ||
| Appendix H-2: Selected Percentiles of Triceps Skinfold Thickness and Bone-Free Upper Arm Area by Height in U.S. Women, Age 25 to 54 Years, with Small, Medium, and Large Frames | e30 | ||
| Appendix I: Percentiles of Upper Arm Circumference (mm) and Estimated Upper Arm Muscle Circumference (mm) | e31 | ||
| Appendix J: Frame Size by Elbow Breadth of Male and Female Adults in the United States | e33 | ||
| Appendix K | e35 |