Additional Information
Book Details
Abstract
Fundamental Concepts and Skills for Nursing, 5th Edition provides all the basic theoretical and applied knowledge that the LPN/LVN nurse needs to practice in an expanded number of care settings, such as the community clinic, physician’s office, long-term care facility, home, and acute-care hospital setting. With an extensive art program and thorough discussion of QSEN, this text addresses topics like the physical and psychosocial needs of the patient, critical thinking for problem solving and clinical judgment, and communication — all within a strong nursing process framework. The accessible, friendly, and clear writing style appeals to students and instructors, and its rich ancillary package, including NCLEX-PN® review questions, gives students an edge on learning fundamentals.
- Concept maps give a visual example of concepts addressed in the text, help you visualize difficult material, and illustrate how a disorder’s multiple symptoms, treatments, and side effects are associated.
- Over 110 skills and steps, featuring sample documentation examples and Home Care Considerations boxes where appropriate, present step-by-step procedures in an action/rationale format.
- Life Span Considerations: The Older Adult highlight changes that occur with aging and how they affect nursing care by LPN/LVNs working in community and long-term care.
- Easy-to-follow reading level and text organization　presents information from simple to most complex, making it perfect for lower level students and those speaking English as a second language.
- Numbered objectives, divided by theory and clinical practice, provide a framework for content.
- Cultural Considerations cover biocultural variations, as well as health promotion for specific ethnic groups, so you provide culturally competent care.
- Health Promotion and Patient Teaching boxes include guidelines to prevent illness, promote health, and develop self-care strategies.
- Nursing process framework features application of the nursing process and nursing care plans to reinforce application of the nursing process in the clinical setting.
- Think Critically boxes encourage you to synthesize information and apply concepts to practice.
- Home Care Considerations boxes highlight the necessary adaptations of nursing skills and techniques for the patient in the home care setting.
- Communication boxes present examples of nurse-patient dialogues and instructive therapeutic communication techniques.
- Over 20 nursing care plans, which include critical thinking questions at the end of the text, provide you with a model for planning patient care.
- Clinical chapters provide an overview of structure and function to give you a refresher in related anatomy and physiology, including a section on aging.
- Key terms include phonetic pronunciations, which are helpful for ESL students, and text page references to find the definition.
- Standard LPN Threads features　include helpful characteristics such as full-color design, key terms, numbered objectives, key points, critical thinking questions, critical thinking activities, glossary, and references.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| deWit’s Fundamental Concepts and Skills for Nursing | i | ||
| Contents | ES1 | ||
| deWit’s Fundamental Concepts and Skills for Nursing | iii | ||
| Copyright | iv | ||
| Dedication | v | ||
| Contributors and Reviewers | vi | ||
| CONTRIBUTORS | vi | ||
| REVIEWERS | vii | ||
| LPN Advisory Board | viii | ||
| To the Instructor | ix | ||
| ORGANIZATION OF THE TEXT | ix | ||
| CONTENT | ix | ||
| SPECIAL FEATURES | x | ||
| LPN THREADS | x | ||
| TEACHING AND LEARNING PACKAGE | xi | ||
| FOR THE INSTRUCTOR | xi | ||
| FOR THE STUDENT | xi | ||
| To the Student | xii | ||
| READING AND REVIEW TOOLS | xii | ||
| CHAPTER FEATURES | xii | ||
| Acknowledgments | xiv | ||
| Contents | xv | ||
| I - Introduction to Nursing and the Health Care System | 1 | ||
| 1 - Nursing and the Health Care System | 1 | ||
| HISTORICAL OVERVIEW | 1 | ||
| NURSING IN ENGLAND AND EUROPE | 1 | ||
| Florence Nightingale | 2 | ||
| NURSING IN NORTH AMERICA | 2 | ||
| THE ART AND SCIENCE OF NURSING | 3 | ||
| EVIDENCE-BASED PRACTICE | 4 | ||
| CURRENT NURSING PRACTICE | 6 | ||
| NURSING EDUCATION PATHWAYS | 7 | ||
| PRACTICAL NURSING | 7 | ||
| REGISTERED NURSING | 7 | ||
| ADVANCED PRACTICE NURSING | 8 | ||
| DELIVERY OF NURSING CARE | 8 | ||
| PRACTICE SETTINGS | 9 | ||
| TODAY’S HEALTH CARE SYSTEM | 9 | ||
| HEALTH MAINTENANCE ORGANIZATIONS | 10 | ||
| PREFERRED PROVIDER ORGANIZATIONS | 10 | ||
| Cost Containment | 11 | ||
| THE PATIENT PROTECTION AND AFFORDABLE CARE ACT | 11 | ||
| 2 - Concepts of Health, Illness, Stress, and Health Promotion | 14 | ||
| HEALTH AND ILLNESS | 14 | ||
| TRADITIONAL VIEWS OF HEALTH AND ILLNESS | 15 | ||
| STAGES OF ILLNESS | 15 | ||
| Transition Stage | 15 | ||
| Acceptance Stage | 15 | ||
| Convalescence Stage | 15 | ||
| CURRENT VIEWS OF HEALTH AND ILLNESS | 16 | ||
| IMPLICATIONS OF CURRENT VIEWS | 17 | ||
| THE CONSUMER CONCEPT OF HEALTH AND ILLNESS | 17 | ||
| HEALTH AND ILLNESS BEHAVIORS | 17 | ||
| CULTURAL INFLUENCES ON CONCEPTS OF HEALTH AND ILLNESS | 17 | ||
| THE HOLISTIC APPROACH | 19 | ||
| MASLOW’S THEORY OF BASIC NEEDS | 19 | ||
| Physiologic Needs | 20 | ||
| Security and Belonging | 21 | ||
| Self-Esteem and Love | 21 | ||
| Self-Actualization | 22 | ||
| HOMEOSTASIS | 22 | ||
| ADAPTATION | 22 | ||
| The General Adaptation Syndrome | 24 | ||
| THE EFFECTS OF STRESS | 26 | ||
| Coping With Stress | 26 | ||
| DEFENSE MECHANISMS | 26 | ||
| STRESS-REDUCTION TECHNIQUES | 26 | ||
| HEALTH PROMOTION AND ILLNESS PREVENTION | 26 | ||
| 3 - Legal and Ethical Aspects of Nursing | 30 | ||
| SOURCE OF LAW | 31 | ||
| CIVIL AND CRIMINAL LAW | 32 | ||
| NURSE PRACTICE ACT | 32 | ||
| SCOPE OF PRACTICE | 32 | ||
| LICENSURE | 32 | ||
| Student Nurses | 32 | ||
| PROFESSIONAL ACCOUNTABILITY | 33 | ||
| Delegation | 33 | ||
| Standards of Care | 33 | ||
| PROFESSIONAL DISCIPLINE | 33 | ||
| CONTINUING EDUCATION | 33 | ||
| LAWS AND GUIDELINES AFFECTING NURSING PRACTICE | 33 | ||
| OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION | 33 | ||
| CHILD ABUSE PREVENTION AND TREATMENT ACT | 34 | ||
| DISCRIMINATION | 34 | ||
| SEXUAL HARASSMENT | 34 | ||
| GOOD SAMARITAN LAWS | 35 | ||
| PATIENT’S RIGHTS | 35 | ||
| NATIONAL PATIENT SAFETY GOALS | 35 | ||
| LEGAL DOCUMENTS | 36 | ||
| THE MEDICAL RECORD | 36 | ||
| HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT | 37 | ||
| CONSENTS AND RELEASES | 38 | ||
| WITNESSING WILLS OR OTHER LEGAL DOCUMENTS | 39 | ||
| ADVANCE DIRECTIVES | 39 | ||
| VIOLATIONS OF LAW | 39 | ||
| NEGLIGENCE AND MALPRACTICE | 39 | ||
| COMMON LEGAL ISSUES | 40 | ||
| Assault and Battery | 40 | ||
| Defamation | 40 | ||
| Invasion of Privacy | 40 | ||
| False Imprisonment | 41 | ||
| Protective devices. The inappropriate use of devices that limit a person’s mobility is a nursing action that can result in charg... | 41 | ||
| DECREASING LEGAL RISK | 42 | ||
| Nursing Competence | 42 | ||
| Incident or Occurrence Reports | 43 | ||
| Liability Insurance | 43 | ||
| ETHICS IN NURSING | 43 | ||
| CODES OF ETHICS | 43 | ||
| ETHICS COMMITTEES | 45 | ||
| ETHICAL DILEMMAS | 45 | ||
| II - The Nursing Process | 48 | ||
| 4 - The Nursing Process and Critical Thinking | 48 | ||
| CRITICAL THINKING | 50 | ||
| PROBLEM SOLVING AND DECISION MAKING | 50 | ||
| SKILLS FOR CRITICAL THINKING | 51 | ||
| CRITICAL THINKING IN NURSING | 51 | ||
| PRIORITY SETTING AND WORK ORGANIZATION | 53 | ||
| APPLICATION OF PROBLEM SOLVING AND CLINICAL REASONING | 53 | ||
| 5 - Assessment, Nursing Diagnosis, and Planning | 57 | ||
| ASSESSMENT (DATA COLLECTION) | 57 | ||
| THE INTERVIEW | 59 | ||
| MEDICAL RECORDS (CHART) REVIEW | 59 | ||
| PHYSICAL ASSESSMENT | 62 | ||
| ASSESSMENT IN LONG-TERM CARE | 63 | ||
| ASSESSMENT IN HOME HEALTH CARE | 63 | ||
| ANALYSIS | 63 | ||
| NURSING DIAGNOSIS | 64 | ||
| ETIOLOGIC FACTORS | 65 | ||
| DEFINING CHARACTERISTICS | 65 | ||
| PRIORITIZATION OF PROBLEMS | 65 | ||
| NURSING DIAGNOSIS IN LONG-TERM CARE | 66 | ||
| NURSING DIAGNOSIS IN HOME HEALTH CARE | 66 | ||
| PLANNING | 66 | ||
| EXPECTED OUTCOMES (GOALS) | 66 | ||
| PLANNING IN LONG-TERM FACILITIES | 68 | ||
| PLANNING IN HOME HEALTH CARE | 68 | ||
| INTERVENTIONS (NURSING ORDERS) | 68 | ||
| DOCUMENTATION OF THE PLAN | 69 | ||
| 6 - Implementation and Evaluation | 73 | ||
| IMPLEMENTATION | 73 | ||
| PRIORITY SETTING | 73 | ||
| CONSIDERATIONS FOR CARE DELIVERY | 74 | ||
| INTERDISCIPLINARY CARE | 74 | ||
| IMPLEMENTING CARE | 75 | ||
| Implementation in Long-term Care | 75 | ||
| Implementation in Home Health Care | 75 | ||
| DOCUMENTATION OF THE NURSING PROCESS | 75 | ||
| EVALUATION | 76 | ||
| EVALUATION IN LONG-TERM CARE | 77 | ||
| EVALUATION IN HOME HEALTH CARE | 77 | ||
| REVISION OF THE NURSING CARE PLAN | 77 | ||
| QUALITY IMPROVEMENT | 77 | ||
| CONSTRUCTING A NURSING CARE PLAN | 78 | ||
| III - Communication in Nursing | 84 | ||
| 7 - Documentation of Nursing Care | 84 | ||
| PURPOSES OF DOCUMENTATION | 84 | ||
| DOCUMENTATION AND THE NURSING PROCESS | 86 | ||
| THE MEDICAL RECORD | 86 | ||
| METHODS OF DOCUMENTATION (CHARTING) | 86 | ||
| SOURCE-ORIENTED OR NARRATIVE CHARTING | 88 | ||
| PROBLEM-ORIENTED MEDICAL RECORD CHARTING | 88 | ||
| FOCUS CHARTING | 89 | ||
| CHARTING BY EXCEPTION | 90 | ||
| COMPUTER-ASSISTED CHARTING | 90 | ||
| CASE MANAGEMENT SYSTEM CHARTING | 94 | ||
| THE DOCUMENTATION PROCESS | 95 | ||
| ACCURACY IN DOCUMENTATION | 95 | ||
| BREVITY IN DOCUMENTATION | 95 | ||
| LEGIBILITY AND COMPLETENESS IN DOCUMENTATION | 95 | ||
| WHAT TO DOCUMENT | 98 | ||
| General Documentation Guidelines | 98 | ||
| 8 - Communication and the Nurse-Patient Relationship | 101 | ||
| THE COMMUNICATION PROCESS | 101 | ||
| FACTORS AFFECTING COMMUNICATION | 102 | ||
| Cultural Differences | 103 | ||
| Past Experience | 103 | ||
| Emotions, Mood, and Environment | 103 | ||
| Attitude, Perceptions, and Self-Concept | 103 | ||
| COMMUNICATION SKILLS | 103 | ||
| Active Listening | 104 | ||
| Interpreting Nonverbal Messages | 104 | ||
| Obtaining Feedback | 104 | ||
| Focusing | 104 | ||
| Adjusting Style | 104 | ||
| THERAPEUTIC COMMUNICATION TECHNIQUES | 104 | ||
| USING SILENCE | 105 | ||
| ASKING OPEN-ENDED QUESTIONS | 105 | ||
| RESTATING | 106 | ||
| CLARIFYING | 106 | ||
| USING TOUCH | 106 | ||
| USING GENERAL LEADS | 106 | ||
| OFFERING OF SELF | 106 | ||
| ENCOURAGING ELABORATION | 106 | ||
| PROVIDING PATIENT EDUCATION | 106 | ||
| LOOKING AT ALTERNATIVES | 107 | ||
| SUMMARIZING | 107 | ||
| BLOCKS TO EFFECTIVE COMMUNICATION | 107 | ||
| CHANGING THE SUBJECT | 107 | ||
| OFFERING FALSE REASSURANCE | 110 | ||
| GIVING ADVICE | 110 | ||
| USING DEFENSIVE COMMENTS | 110 | ||
| ASKING PRYING OR PROBING QUESTIONS | 110 | ||
| USING CLICHÉS | 110 | ||
| LISTENING INATTENTIVELY | 110 | ||
| INTERVIEWING SKILLS | 110 | ||
| THE NURSE-PATIENT RELATIONSHIP | 111 | ||
| EMPATHY | 111 | ||
| BECOMING NONJUDGMENTAL | 112 | ||
| MAINTAINING HOPE | 112 | ||
| Application of the Nursing Process | 112 | ||
| NURSE-PATIENT COMMUNICATION | 112 | ||
| COMMUNICATING WITH THE HEARING-IMPAIRED PATIENT | 113 | ||
| COMMUNICATING WITH AN APHASIC PATIENT | 113 | ||
| COMMUNICATING WITH OLDER ADULTS | 113 | ||
| COMMUNICATING WITH CHILDREN | 114 | ||
| COMMUNICATION WITHIN THE HEALTH CARE TEAM | 114 | ||
| END-OF-SHIFT REPORT | 114 | ||
| TELEPHONING PRIMARY CARE PROVIDERS | 115 | ||
| ASSIGNMENT CONSIDERATIONS AND DELEGATING | 115 | ||
| COMPUTER COMMUNICATION | 117 | ||
| COMMUNICATION IN THE HOME AND COMMUNITY | 117 | ||
| 9 - Patient Education and Health Promotion | 120 | ||
| PURPOSES OF PATIENT EDUCATION | 120 | ||
| MODES OF LEARNING | 121 | ||
| ASSESSMENT OF LEARNING NEEDS | 121 | ||
| FACTORS AFFECTING LEARNING | 122 | ||
| Readiness to Learn | 122 | ||
| Cultural Values and Expectations | 122 | ||
| Confidence and Ability | 123 | ||
| THE PATIENT EDUCATION PLAN | 124 | ||
| RESOURCES FOR PATIENT EDUCATION | 125 | ||
| IMPLEMENTING THE PLAN | 125 | ||
| EVALUATION | 126 | ||
| DOCUMENTATION | 127 | ||
| COORDINATION WITH DISCHARGE PLANNING | 127 | ||
| 10 - Delegation, Leadership, and Management | 129 | ||
| THE CHAIN OF COMMAND | 130 | ||
| LEADERSHIP STYLES | 130 | ||
| KEYS TO EFFECTIVE LEADERSHIP | 130 | ||
| EFFECTIVE COMMUNICATION AND RELATIONSHIPS | 130 | ||
| CLINICAL COMPETENCE AND CONFIDENCE | 132 | ||
| ORGANIZATION | 132 | ||
| DELEGATION | 132 | ||
| LEADERSHIP ROLES | 133 | ||
| BEGINNING LEADERSHIP ROLES | 133 | ||
| ADVANCED LEADERSHIP ROLES | 134 | ||
| MANAGEMENT SKILLS FOR THE LICENSED PRACTICAL NURSE/LICENSED VOCATIONAL NURSE | 134 | ||
| TIME MANAGEMENT | 135 | ||
| USING THE COMPUTER | 135 | ||
| RECEIVING NEW ORDERS | 137 | ||
| TAKING VERBAL ORDERS | 137 | ||
| DOCUMENTING FOR REIMBURSEMENT | 138 | ||
| RISK MANAGEMENT | 138 | ||
| IV - Developmental, Psychosocial, and Cultural Considerations | 141 | ||
| 11 - Growth and Development: Infancy Through Adolescence | 141 | ||
| OVERVIEW OF STRUCTUREAND FUNCTION | 142 | ||
| PRENATAL DEVELOPMENT | 142 | ||
| WHAT HAPPENS IN THE GERMINAL STAGE OF PRENATAL DEVELOPMENT? | 142 | ||
| WHAT HAPPENS IN THE EMBRYONIC STAGE OF PRENATAL DEVELOPMENT? | 142 | ||
| WHAT HAPPENS IN THE FETAL STAGE OF PRENATAL DEVELOPMENT? | 142 | ||
| WHAT CAUSES MULTIPLE BIRTHS? | 142 | ||
| ADOLESCENT DEVELOPMENT | 143 | ||
| HOW DOES A GIRL MATURE INTO A WOMAN? | 143 | ||
| HOW DOES A BOY MATURE INTO A MAN? | 143 | ||
| AGE GROUPS | 143 | ||
| THEORIES OF DEVELOPMENT | 143 | ||
| PRINCIPLES OF GROWTH AND DEVELOPMENT | 145 | ||
| PRENATAL DEVELOPMENT | 145 | ||
| EVENTS IN PRENATAL DEVELOPMENT | 145 | ||
| MATERNAL INFLUENCES | 146 | ||
| INFANTS | 146 | ||
| NUTRITION | 146 | ||
| APPEARANCE AND CAPABILITIES OF NEWBORNS | 147 | ||
| PHYSICAL DEVELOPMENT | 147 | ||
| MOTOR DEVELOPMENT | 147 | ||
| COGNITIVE DEVELOPMENT | 148 | ||
| PSYCHOSOCIAL DEVELOPMENT | 148 | ||
| YOUNG CHILDREN | 149 | ||
| PHYSICAL DEVELOPMENT | 149 | ||
| MOTOR DEVELOPMENT | 150 | ||
| COGNITIVE DEVELOPMENT | 150 | ||
| PSYCHOSOCIAL DEVELOPMENT | 151 | ||
| DAY CARE AND EARLY EDUCATION | 152 | ||
| MIDDLE AND OLDER CHILDREN | 152 | ||
| PHYSICAL DEVELOPMENT | 152 | ||
| COGNITIVE DEVELOPMENT | 152 | ||
| PSYCHOSOCIAL DEVELOPMENT | 153 | ||
| PARENTING | 153 | ||
| CHILD ABUSE | 154 | ||
| ADOLESCENTS | 154 | ||
| PHYSICAL DEVELOPMENT | 154 | ||
| SEXUALITY | 155 | ||
| COGNITIVE DEVELOPMENT | 155 | ||
| PSYCHOSOCIAL DEVELOPMENT | 155 | ||
| TASKS OF ADOLESCENCE | 156 | ||
| CONCERNS IN ADOLESCENT DEVELOPMENT | 156 | ||
| Pregnancy | 156 | ||
| Employment | 157 | ||
| Chemical Abuse | 157 | ||
| Eating Disorders | 157 | ||
| Depression | 157 | ||
| Early Deaths | 157 | ||
| 12 - Adulthood and the Family | 160 | ||
| ADULTHOOD AS CONTINUING CHANGE | 160 | ||
| THEORIES OF DEVELOPMENT | 161 | ||
| SCHAIE’S THEORY OF COGNITIVE DEVELOPMENT | 161 | ||
| ERIKSON’S STAGES OF ADULT PSYCHOSOCIAL DEVELOPMENT | 161 | ||
| FAMILIES | 161 | ||
| TYPES OF FAMILIES | 161 | ||
| HISTORICAL CHANGES IN FAMILIES | 162 | ||
| DIVORCE AND FAMILIES | 162 | ||
| YOUNG ADULTS | 162 | ||
| PHYSICAL DEVELOPMENT | 163 | ||
| HEALTH CONCERNS OF YOUNG ADULTS | 163 | ||
| Risky Behavior | 163 | ||
| Stress-Related Illness | 163 | ||
| Early Disease | 163 | ||
| COGNITIVE DEVELOPMENT | 164 | ||
| Continuing Education | 164 | ||
| Careers and Work | 164 | ||
| PSYCHOSOCIAL DEVELOPMENT | 164 | ||
| DEVELOPMENTAL TASKS | 165 | ||
| Marriage | 165 | ||
| Parenting | 165 | ||
| Home Management | 165 | ||
| Developing a Social Group | 166 | ||
| Community Responsibility | 166 | ||
| MIDDLE ADULTHOOD | 166 | ||
| PHYSICAL DEVELOPMENT | 166 | ||
| HEALTH CONCERNS | 167 | ||
| COGNITIVE DEVELOPMENT | 167 | ||
| Work Life | 168 | ||
| Lifelong Learning | 168 | ||
| PSYCHOSOCIAL DEVELOPMENT | 168 | ||
| Marriage | 168 | ||
| Friendships | 168 | ||
| Parenting | 169 | ||
| Caring for Parents | 169 | ||
| Generativity | 169 | ||
| 13 - Promoting Healthy Adaptation to Aging | 172 | ||
| OVERVIEW OF AGING | 172 | ||
| THEORIES OF AGING | 173 | ||
| LONGEVITY | 173 | ||
| DEMOGRAPHICS | 174 | ||
| PHYSICAL CHANGES | 174 | ||
| HEALTH CONCERNS | 176 | ||
| HEALTH PROMOTION BEHAVIORS | 176 | ||
| COGNITIVE ASPECTS OF AGING | 177 | ||
| WISDOM AND LEARNING | 177 | ||
| MEMORY ISSUES | 177 | ||
| EMPLOYMENT AND RETIREMENT | 178 | ||
| HEALTH PROMOTION BEHAVIORS | 178 | ||
| PSYCHOSOCIAL ASPECTS OF AGING | 178 | ||
| LIFE REVIEW | 178 | ||
| FAMILY RELATIONSHIPS | 178 | ||
| SOCIAL ACTIVITY | 179 | ||
| LIVING ARRANGEMENTS | 179 | ||
| HEALTH PROMOTION BEHAVIORS | 179 | ||
| WHEN A PARENT NEEDS HELP | 180 | ||
| PLANNING AHEAD | 180 | ||
| OBSERVING CHANGES | 180 | ||
| RESOURCES FOR FAMILIES | 180 | ||
| 14 - Cultural and Spiritual Aspects of Patient Care | 183 | ||
| TRANSCULTURAL CARE | 184 | ||
| WHAT IS CULTURE? | 184 | ||
| UNDERSTANDING SPIRITUALITY | 185 | ||
| MAJOR RELIGIONS IN THE UNITED STATES AND CANADA | 185 | ||
| CHRISTIANITY | 185 | ||
| ISLAM | 186 | ||
| HINDUISM, BUDDHISM, AND TAOISM | 188 | ||
| DEVELOPING CULTURAL COMPETENCE | 189 | ||
| BARRIERS TO CULTURAL COMPETENCE | 190 | ||
| CULTURAL DIFFERENCES | 190 | ||
| COMMUNICATION | 191 | ||
| VIEW OF TIME | 191 | ||
| FAMILY ORGANIZATION AND STRUCTURE | 191 | ||
| NUTRITIONAL PRACTICES | 191 | ||
| DEATH AND DYING | 192 | ||
| HEALTH CARE BELIEFS | 192 | ||
| SUSCEPTIBILITY TO DISEASE | 194 | ||
| ?NURSING PROCESS IN TRANSCULTURAL NURSING | 194 | ||
| ?ASSESSMENT (DATA COLLECTION) | 194 | ||
| ?NURSING DIAGNOSIS | 195 | ||
| ?PLANNING | 195 | ||
| ?IMPLEMENTATION | 195 | ||
| ?EVALUATION | 196 | ||
| 15 - Loss, Grief, and End-of-Life Care | 198 | ||
| NURSES’ ATTITUDES TOWARD END-OF-LIFE CARE | 199 | ||
| CHANGE, LOSS, AND GRIEF | 199 | ||
| CHANGE | 199 | ||
| LOSS | 199 | ||
| GRIEF | 200 | ||
| STAGES OF GRIEF | 200 | ||
| DEATH AND DYING | 201 | ||
| END-OF-LIFE CARE WITHIN THE HEALTH CARE SYSTEM | 201 | ||
| HOSPICE AND PALLIATIVE CARE | 201 | ||
| THE DYING PROCESS | 203 | ||
| Theories of Death and Dying and Emergence of Thanatology | 203 | ||
| NURSING AND THE DYING PROCESS | 204 | ||
| ?APPLICATION OF THE NURSING PROCESS | 205 | ||
| ?ASSESSMENT (DATA COLLECTION) | 205 | ||
| Use Analgesia Cautiously | 205 | ||
| ?NURSING DIAGNOSIS | 205 | ||
| ?PLANNING | 205 | ||
| ?IMPLEMENTATION | 206 | ||
| Anticipatory guidance. Anticipating death assists in preparing the family and patient by giving them guidance about physical cha... | 206 | ||
| End-stage symptom management. Many expected symptoms, such as pain, gastrointestinal distress, dyspnea, fatigue, cough, “death r... | 206 | ||
| Pain control. Although nursing research has demonstrated safe and effective principles of pain control, many terminally ill pati... | 206 | ||
| Dyspnea and respiratory distress. Difficult breathing may be seen early in the dying process in certain lung or heart disorders.... | 207 | ||
| Constipation and diarrhea. Constipation is predictable for a patient receiving opiates, experiencing decreased fluid intake and ... | 207 | ||
| Anorexia, nausea, and vomiting. Anorexia, or loss of appetite, may be due to nausea, drug side effects (especially a sore mouth)... | 207 | ||
| Dehydration. As death nears, patients spend more time sleeping or in a semiresponsive state. They take in fewer and fewer fluids... | 207 | ||
| Delirium. Dying patients may experience hallucinations or altered mental status. Search and address possible causes of delirium ... | 207 | ||
| Impaired skin integrity. Weight loss, decreased nutrition, incontinence, and inactivity all contribute to the risk of skin break... | 207 | ||
| Weakness, fatigue, and decreased ability to perform activities of daily living. Increasing weakness eventually results in the pa... | 208 | ||
| Anxiety, depression, and agitation. Emotional or psychological symptoms may be treated with appropriate drugs with good effect. ... | 208 | ||
| Spiritual distress and fear of meaninglessness. Each person needs to believe that his life has had meaning; this is the spiritua... | 208 | ||
| ?EVALUATION | 208 | ||
| SIGNS OF IMPENDING DEATH | 208 | ||
| PHYSICAL SIGNS | 208 | ||
| PSYCHOSOCIAL AND SPIRITUAL ASPECTS OF DYING | 208 | ||
| LEGAL AND ETHICAL ASPECTS OF LIFE-AND-DEATH ISSUES | 209 | ||
| ADVANCE DIRECTIVES | 209 | ||
| EUTHANASIA | 209 | ||
| ADEQUATE PAIN CONTROL | 210 | ||
| ORGAN AND TISSUE DONATION | 210 | ||
| POSTMORTEM (AFTER DEATH) CARE | 210 | ||
| V - Basic Nursing Skills | 216 | ||
| 16 - Infection Prevention and Control: Protective Mechanisms and Asepsis | 216 | ||
| INFECTIOUS AGENTS | 217 | ||
| BACTERIA | 217 | ||
| PRIONS | 219 | ||
| PROTOZOA | 219 | ||
| VIRUSES | 219 | ||
| RICKETTSIA | 219 | ||
| FUNGI | 219 | ||
| HELMINTHS | 219 | ||
| OTHER INFECTIOUS AGENTS | 219 | ||
| PROCESS (CHAIN) OF INFECTION | 219 | ||
| CAUSATIVE AGENT (LINK ONE) | 219 | ||
| RESERVOIR | 220 | ||
| Portal of Exit | 220 | ||
| MODE OF TRANSFER | 220 | ||
| PORTAL OF ENTRY | 220 | ||
| SUSCEPTIBLE HOST | 221 | ||
| Susceptibility of the Older Adult | 221 | ||
| BODY DEFENSES AGAINST INFECTION | 223 | ||
| INFLAMMATORY RESPONSE | 224 | ||
| IMMUNE RESPONSE | 224 | ||
| ASEPSIS AND CONTROL OF MICROORGANISMS | 226 | ||
| MEDICAL ASEPSIS AND SURGICAL ASEPSIS | 226 | ||
| HAND HYGIENE | 227 | ||
| STANDARD PRECAUTIONS | 231 | ||
| Gown | 232 | ||
| Mask | 232 | ||
| Protective Eyewear | 234 | ||
| Head Cover | 234 | ||
| Shoe Covers | 234 | ||
| Gloves | 234 | ||
| Latex allergy. Because of the greater exposure through glove use, more people have developed sensitivity or allergy to latex. Ex... | 234 | ||
| Disposal of Sharps | 236 | ||
| Contaminated Waste | 236 | ||
| CLEANING AND DISINFECTION | 236 | ||
| Sterilization | 237 | ||
| Radiation. Ultraviolet light can be used for disinfection. Ionizing radiation is used to sterilize drugs, foods, and other items... | 237 | ||
| SEPSIS IN THE HOME ENVIRONMENT | 237 | ||
| INFECTION CONTROL SURVEILLANCE | 237 | ||
| 17 -Infection Prevention and Control in the Hospital and Home | 242 | ||
| INFECTION PREVENTION AND CONTROL | 243 | ||
| PERSONAL PROTECTIVE EQUIPMENT | 245 | ||
| NEEDLE STICK INJURIES | 246 | ||
| ?APPLICATION OF THE NURSING PROCESS | 246 | ||
| ?ASSESSMENT (DATA COLLECTION) | 246 | ||
| ?NURSING DIAGNOSIS | 246 | ||
| ?PLANNING | 247 | ||
| ?IMPLEMENTATION | 247 | ||
| General Guidelines for Isolation Precautions | 248 | ||
| Specimen preparation and transportation. Before collecting body fluid or other potentially infectious material, verify the prima... | 248 | ||
| Soiled linens. Soiled linen is handled as little as possible. Roll it up and place it inside the linen hamper in the patient’s r... | 250 | ||
| Trash and biohazard waste. Place disposable soiled equipment and supplies inside the plastic bag lining the waste receptacle in ... | 250 | ||
| Sharps. Needles are not to be recapped before disposal. Drop all used needles, scalpel blades, IV cannulas, suture needles, and ... | 250 | ||
| Other equipment. Clean reusable equipment if it is visibly soiled, and then send it to the central processing department to be d... | 250 | ||
| Natural defenses. Institute measures to protect and enhance the patient’s natural body defenses (see Chapter 16). Protect intact... | 251 | ||
| Patient placement. Place a patient in need of Transmission-Based Precautions in a private room. An exception can be made if anot... | 251 | ||
| Transporting the patient. Avoid transporting the isolation patient unless necessary. If transporting is unavoidable, give the pa... | 251 | ||
| Infection Prevention and Control in the Home | 251 | ||
| Protective Environment | 253 | ||
| Psychological Aspects of Isolation | 253 | ||
| Infection Prevention and Control for the Nurse | 254 | ||
| Surgical Asepsis | 254 | ||
| Surgical scrub. The surgical scrub (Skill 17.1) is more lengthy and vigorous compared with normal hand washing. Its purpose is t... | 254 | ||
| Opening sterile packs and packages and setting up a sterile field. Many sterile supplies are prepared commercially and are dispo... | 255 | ||
| Sterile gloving. Sterile gloves must be used for sterile procedures. These gloves are made of various substances, including late... | 258 | ||
| Correcting breaks in asepsis. Whenever it becomes apparent that a break in surgical asepsis has occurred, you must rectify the e... | 258 | ||
| ?EVALUATION | 260 | ||
| 18 - Safely Lifting, Moving, and Positioning Patients | 267 | ||
| OVERVIEW OF THE STRUCTURE AND FUNCTION OF THE MUSCULOSKELETAL SYSTEM | 268 | ||
| WHICH STRUCTURES ARE INVOLVED IN POSITIONING AND MOVING PATIENTS? | 268 | ||
| WHAT ARE THE FUNCTIONS OF BONES FOR POSITIONING AND MOVING PATIENTS? | 268 | ||
| WHAT ARE THE FUNCTIONS OF MUSCLES FOR POSITIONING AND MOVING PATIENTS? | 268 | ||
| WHAT CHANGES IN THE SYSTEM OCCUR WITH AGING? | 268 | ||
| PRINCIPLES OF BODY MOVEMENT FOR NURSES | 269 | ||
| OBTAIN HELP WHENEVER POSSIBLE | 269 | ||
| USE YOUR LEG MUSCLES | 269 | ||
| PROVIDE STABILITY FOR MOVEMENT | 270 | ||
| USE SMOOTH, COORDINATED MOVEMENTS | 270 | ||
| KEEP LOADS CLOSE TO THE BODY | 270 | ||
| KEEP LOADS NEAR THE CENTER OF GRAVITY | 270 | ||
| PULL AND PIVOT | 271 | ||
| PRINCIPLES OF BODY MOVEMENT FOR PATIENTS | 271 | ||
| HAZARDS OF IMPROPER ALIGNMENT AND POSITIONING | 271 | ||
| Pressure Injuries | 271 | ||
| APPLICATION OF THE NURSING PROCESS | 271 | ||
| ASSESSMENT (DATA COLLECTION) | 271 | ||
| NURSING DIAGNOSIS | 272 | ||
| PLANNING | 272 | ||
| IMPLEMENTATION | 272 | ||
| Positioning | 272 | ||
| Common Positions and Their Variations | 272 | ||
| Positioning devices. Devices used for positioning include pillows, boots or splints, positioning wedges, | 277 | ||
| Moving Patients Up in Bed | 277 | ||
| Therapeutic Exercise | 280 | ||
| Lifting and Transferring | 284 | ||
| Transferring Devices | 285 | ||
| EVALUATION | 288 | ||
| 19 - Assisting With Hygiene, Personal Care, Skin Care, and the Prevention of Pressure Injuries | 295 | ||
| OVERVIEW OF THE STRUCTURE AND FUNCTIONOF THE INTEGUMENTARY SYSTEM | 296 | ||
| WHAT IS THE STRUCTURE OF THE SKIN? | 296 | ||
| WHAT ARE THE FUNCTIONS OF THE SKIN AND ITS STRUCTURES? | 296 | ||
| WHAT CHANGES IN THE SYSTEM OCCUR WITH AGING? | 296 | ||
| ?APPLICATION OF THE NURSING PROCESS | 296 | ||
| ?ASSESSMENT (DATA COLLECTION) | 296 | ||
| Factors Affecting Hygiene | 297 | ||
| Skin and Pressure Injuries | 297 | ||
| Risk factors for pressure injuries. There are many risk factors in the development of pressure injuries; the most common ones ca... | 297 | ||
| ?Skin assessment for pressure injuries. Perform a skin assessment for pressure injury risk on admission. The Braden Scale for Pr... | 297 | ||
| Prevention of pressure injuries. Excellent nursing care is the main factor in the prevention of pressure injuries. It is your re... | 300 | ||
| Treatment and care for pressure injuries. The team approach is the most effective method of pressure injury treatment. The team ... | 300 | ||
| ?NURSING DIAGNOSIS | 301 | ||
| ?PLANNING | 301 | ||
| ?IMPLEMENTATION | 301 | ||
| Bathing | 301 | ||
| Types of baths. A bath may be cleansing or therapeutic, and complete or partial. With a complete bath, all areas of the patient’... | 301 | ||
| Cleansing baths. The most common type of bath is a cleansing bath. It is generally provided in a bed, tub, or shower. Bed baths ... | 302 | ||
| Therapeutic Baths. Therapeutic means having healing or medicinal qualities. Therapeutic baths are performed to achieve a desired... | 308 | ||
| Variations of the Bed Bath. A bag bath is a variation of the bed bath. Instead of using a basin, which has been found to be a po... | 309 | ||
| Back Massage | 309 | ||
| Perineal Care | 309 | ||
| Mouth Care | 310 | ||
| Mouth care for the conscious patient. To assist a patient with mouth care, raise the head of the bed 45 to 90 degrees. Wear glov... | 310 | ||
| Mouth care for the unconscious patient. Provide full mouth care to an unconscious patient at least once every 4 hours. If the pa... | 310 | ||
| Denture care. Patients with dentures who are confined to bed, are comatose, are weak, or have trouble with hand and finger dexte... | 310 | ||
| Hair Care | 310 | ||
| Brushing and combing. Use a clean brush or comb to brush from the scalp toward the hair ends to decrease pulling. Separate the h... | 313 | ||
| Shampooing. Shampooing removes dirt, soil, blood, or solutions from the hair, and it stimulates circulation of the scalp and eas... | 314 | ||
| Shaving. Shaving is the removal of hair from the surface of the skin. Women may shave their leg and/or axillary hair, whereas me... | 314 | ||
| Mustache and Beard Care. A patient with a mustache and/or beard needs daily care to these areas. Keep the facial hair clean and ... | 316 | ||
| Nail Care | 316 | ||
| Eye Care | 317 | ||
| Glasses and contacts. Store glasses in a case when not in use. Most glasses today have plastic lenses that are easier to scratch... | 317 | ||
| Removal of Contact Lenses. To remove a hard lens, perform hand hygiene and don clean gloves. Cup your nondominant hand below the... | 317 | ||
| Cleaning Contact Lenses. Lenses should be cleaned with commercial cleaning solutions. Moisten the lens and rub it gently between... | 318 | ||
| Artificial eye. Sometimes because of trauma, infection, or tumor, a patient has had an eye removed. The patient may have an arti... | 318 | ||
| Ear Care | 318 | ||
| Hearing aids. Hearing aids amplify sound and must be cleaned daily (Fig. 19.13). There are five types of hearing aids: (1) behin... | 318 | ||
| ?EVALUATION | 319 | ||
| 20 - Patient Environment and Safety | 321 | ||
| FACTORS AFFECTING THE ENVIRONMENT | 321 | ||
| TEMPERATURE | 321 | ||
| VENTILATION | 322 | ||
| HUMIDITY | 322 | ||
| LIGHTING | 322 | ||
| ODOR CONTROL | 322 | ||
| NOISE CONTROL | 322 | ||
| INTERIOR DESIGN | 323 | ||
| NEATNESS | 323 | ||
| PRIVACY | 323 | ||
| PATIENT UNIT | 323 | ||
| BEDS | 323 | ||
| BED POSITIONS | 323 | ||
| BED MAKING | 324 | ||
| SAFETY | 329 | ||
| HAZARDS | 329 | ||
| Falls | 329 | ||
| Burns | 331 | ||
| Smoking | 331 | ||
| Fire | 332 | ||
| HAZARDOUS MATERIALS | 332 | ||
| Biohazards | 332 | ||
| Bioterrorism and Other Terrorism Agents | 333 | ||
| Decontamination. When a terrorist attack has occurred, such as the one with Sarin gas in a Tokyo subway in 1995, a portable deco... | 333 | ||
| Triage and treatment. Patients are triaged as they enter the ED. The word “triage” comes from the French word trier (“to sort”),... | 334 | ||
| Poison | 335 | ||
| PROTECTIVE DEVICES | 335 | ||
| LEGAL IMPLICATIONS OF USING PROTECTIVE DEVICES | 335 | ||
| ALTERNATIVES TO PROTECTIVE DEVICES | 335 | ||
| PRINCIPLES RELATED TO THE USE OF PROTECTIVE DEVICES | 336 | ||
| DOCUMENTATION OF THE USE OF PROTECTIVE DEVICES | 339 | ||
| 21 - Measuring Vital Signs | 343 | ||
| OVERVIEW OF STRUCTURE AND FUNCTION RELATED TO THE REGULATION OF VITAL SIGNS | 344 | ||
| HOW IS BODY HEAT PRODUCED? | 344 | ||
| WHAT FACTORS AFFECT BODY HEAT PRODUCTION? | 344 | ||
| HOW IS BODY TEMPERATURE REGULATED? | 344 | ||
| HOW DOES FEVER OCCUR, AND WHAT ARE ITS PHYSIOLOGIC EFFECTS? | 345 | ||
| WHAT PHYSIOLOGIC MECHANISMS CONTROL THE PULSE? | 345 | ||
| WHAT IS RESPIRATION? | 345 | ||
| WHAT ARE THE ORGANS OF RESPIRATION? | 346 | ||
| HOW IS RESPIRATION CONTROLLED? | 347 | ||
| WHAT IS BLOOD PRESSURE? | 347 | ||
| WHAT PHYSIOLOGIC FACTORS DIRECTLY AFFECT THE BLOOD PRESSURE? | 347 | ||
| WHAT CHANGES OCCUR IN VITAL SIGNS WITH AGING? | 347 | ||
| MEASURING BODY TEMPERATURE | 347 | ||
| FACTORS INFLUENCING TEMPERATURE READINGS | 348 | ||
| PROBLEMS OF TEMPERATURE REGULATION | 349 | ||
| Hyperthermia | 349 | ||
| Hypothermia | 350 | ||
| MEASURING BODY TEMPERATURE | 350 | ||
| Taking an Oral Temperature | 350 | ||
| Taking a Rectal Temperature | 350 | ||
| Taking an Axillary Temperature | 351 | ||
| GLASS THERMOMETERS | 351 | ||
| Reading the Glass Thermometer | 351 | ||
| ELECTRONIC THERMOMETERS | 352 | ||
| Tympanic Thermometers | 352 | ||
| Temporal Artery Skin Thermometer | 353 | ||
| DISPOSABLE THERMOMETERS | 355 | ||
| ?APPLICATION OF THE NURSING PROCESS | 355 | ||
| ?ASSESSMENT (DATA COLLECTION) | 355 | ||
| ?NURSING DIAGNOSIS | 355 | ||
| ?PLANNING | 355 | ||
| ?IMPLEMENTATION | 356 | ||
| ?EVALUATION | 356 | ||
| MEASURING THE PULSE | 357 | ||
| COMMON PULSE POINTS | 357 | ||
| PULSE RATE | 358 | ||
| PULSE CHARACTERISTICS | 360 | ||
| ?APPLICATION OF THE NURSING PROCESS | 361 | ||
| MEASURING RESPIRATIONS | 361 | ||
| RESPIRATORY PATTERNS | 362 | ||
| MEASURING OXYGEN SATURATION OF THE BLOOD | 364 | ||
| MEASURING THE BLOOD PRESSURE | 364 | ||
| EQUIPMENT USED FOR MEASURING BLOOD PRESSURE | 365 | ||
| KOROTKOFF SOUNDS | 369 | ||
| HYPERTENSION | 369 | ||
| HYPOTENSION | 370 | ||
| ?APPLICATION OF THE NURSING PROCESS | 370 | ||
| PAIN, THE FIFTH VITAL SIGN | 371 | ||
| AUTOMATED VITAL SIGN MONITORS | 371 | ||
| DOCUMENTING VITAL SIGNS | 371 | ||
| RECORDING TEMPERATURE MEASUREMENTS | 371 | ||
| RECORDING PULSE MEASUREMENTS | 372 | ||
| RECORDING RESPIRATION MEASUREMENTS | 372 | ||
| RECORDING BLOOD PRESSURE MEASUREMENTS | 372 | ||
| EVALUATING VITAL SIGN TRENDS | 372 | ||
| Pulse | 373 | ||
| Respiration | 373 | ||
| Blood Pressure | 373 | ||
| 22 - Assessing Health Status | 375 | ||
| DATA COLLECTION AND ASSESSMENT | 375 | ||
| ?APPLICATION OF THE NURSING PROCESS | 376 | ||
| ?ASSESSMENT (DATA COLLECTION) | 376 | ||
| Data Collection | 376 | ||
| Psychosocial and Cultural Assessment | 376 | ||
| Physical Assessment | 376 | ||
| Physical Examination Techniques | 378 | ||
| Inspection and observation. Through the sense of sight, you are able to inspect the various parts of the body and observe the pa... | 378 | ||
| Palpation. The sense of touch can be used to obtain a great deal of clinical information about patients. Palpation involves usin... | 379 | ||
| Percussion. Percussion supplies other information about structures of the body. It involves light, quick tapping on the body sur... | 380 | ||
| Auscultation. Auscultation is the process of listening with the aid of the stethoscope to sounds produced in the body. It is par... | 380 | ||
| Olfaction. Olfaction is the sense of smell. The nose is used to identify characteristic smells associated with specific problems... | 380 | ||
| Basic Physical Examination | 380 | ||
| Height and weight. A basic nursing function is to weigh and measure the patient. Adult weight is most frequently measured on the... | 381 | ||
| Vital signs measurement. Vital signs should be measured at the time of the physical examination. If previous measurements are av... | 382 | ||
| Review of Body Systems | 382 | ||
| Head and neck. Assess the patient’s general appearance, the color and tone of the skin and its condition, the appearance of the ... | 382 | ||
| ?Chest, heart, and lungs. The chest should rise and fall with respiration symmetrically on both sides of the body. By placing th... | 383 | ||
| Skin and extremities. The skin is inspected for any rash or lesions (Table 22.2), and the assessment frequently includes the Bra... | 385 | ||
| ?The abdomen. Assess bowel sounds on admission and once per shift for all patients. Bowel sounds are produced by the contraction... | 385 | ||
| ?Genitalia, anus, and rectum. Unless the patient has a specific complaint in these areas, the nurse does not visually assess the... | 388 | ||
| ?NURSING DIAGNOSIS | 388 | ||
| ?PLANNING | 388 | ||
| ?IMPLEMENTATION | 388 | ||
| Assisting With a Physical Examination | 391 | ||
| Positioning and draping. You will prepare the patient for the particular type of examination the examiner is going to perform. M... | 391 | ||
| Elements of the physical examination. Before a pelvic examination, the patient should empty the bladder. If a urine specimen is ... | 392 | ||
| Special Focused Examinations | 394 | ||
| ?EVALUATION | 396 | ||
| 23 - ADMITTING, TRANSFERRING, AND DISCHARGING PATIENTS | 398 | ||
| TYPES OF ADMISSIONS | 398 | ||
| ROUTINE ADMISSIONS | 398 | ||
| EMERGENCY ADMISSIONS | 399 | ||
| ADMISSION PROCESS | 399 | ||
| PREADMISSION PROCEDURES AND REQUIREMENTS | 399 | ||
| Authorization for Admission | 399 | ||
| Admitting Department Function | 399 | ||
| Laboratory Work and X-Ray Examinations | 399 | ||
| DAY OF ADMISSION | 399 | ||
| Patient Orientation to the Nursing Unit | 399 | ||
| Care of patient belongings. Hospitals provide little space for personal belongings, but patients may find great comfort in weari... | 400 | ||
| Initial Nursing Assessment (Data Collection) | 401 | ||
| Initiating the Medical Record | 401 | ||
| REACTIONS TO ADMISSION | 402 | ||
| PLAN OF CARE | 402 | ||
| PATIENT TRANSFER TO ANOTHER HOSPITAL UNIT | 402 | ||
| DISCHARGING THE PATIENT | 403 | ||
| DISCHARGE TO AN EXTENDED-CARE OR REHABILITATION FACILITY | 403 | ||
| DISCHARGE HOME | 403 | ||
| Home Health Care | 404 | ||
| Discharge Against Medical Advice | 404 | ||
| DEATH OF A PATIENT | 404 | ||
| PROVIDING SUPPORT FOR SIGNIFICANT OTHERS | 404 | ||
| PRONOUNCEMENT OF DEATH | 404 | ||
| AUTOPSIES | 405 | ||
| ORGAN DONATION | 405 | ||
| 24 - Diagnostic Tests and Specimen Collection | 407 | ||
| DIAGNOSTIC TESTS AND PROCEDURES | 408 | ||
| ?APPLICATION OF THE NURSING PROCESS | 408 | ||
| ?ASSESSMENT (DATA COLLECTION) | 408 | ||
| ?NURSING DIAGNOSIS | 408 | ||
| ?PLANNING | 408 | ||
| ?IMPLEMENTATION | 408 | ||
| Laboratory Tests | 409 | ||
| Hematology tests. Hematology is the study of blood and its components. The complete blood count (CBC) provides information about... | 409 | ||
| Blood chemistry tests. Blood chemistries are commonly obtained to detect changes in biochemical reactions in the body and to det... | 410 | ||
| Serology tests. Serology tests are based on the analysis of blood serum. They are important in diagnosing many diseases stemming... | 411 | ||
| Urinalysis. Analysis of urine provides valuable information about the kidney function and other biologic processes within the bo... | 411 | ||
| Other laboratory tests. Other laboratory tests performed are bacteriologic, histologic, and cytologic tests. Specimens of blood,... | 411 | ||
| Ultrasonography | 416 | ||
| Radiology Procedures | 416 | ||
| X-ray studies, fluoroscopy, and cineradiography. Different types of radiation are used for diagnosis and treatment of disease: a... | 416 | ||
| Radionuclide scans. Radionuclide scans are based on the fact that various organs and soft tissues of the body attract and concen... | 418 | ||
| Computed tomography. CT scans of various organs and parts of the body are used to confirm a diagnosis, plan treatment, evaluate ... | 421 | ||
| Magnetic resonance imaging. Magnetic resonance imaging (MRI) is a noninvasive method of differentiating normal from abnormal tis... | 421 | ||
| Positron emission tomography scans. Positron emission tomography (PET) scans are used to diagnose cancer, heart disease, and som... | 422 | ||
| Cardiopulmonary Studies and Procedures | 422 | ||
| Electrocardiogram. The electrocardiogram (ECG or EKG) was one of the first diagnostic tests of heart activity. It remains import... | 422 | ||
| Cardiac catheterization. Cardiac catheterization is a procedure used to determine the function of the heart, valves, and coronar... | 422 | ||
| Angiography and arteriography. Angiography and arteriography are used to locate lesions, occluded vessels, tumors, and malformed... | 424 | ||
| Treadmill stress test. The treadmill stress test measures the cardiac heart rate and blood pressure response to clinically contr... | 425 | ||
| Pulmonary function tests. Pulmonary function tests provide information about respiratory function, lung capacity, and diffusion ... | 425 | ||
| Capnography. Capnography is used to detect respiratory depression, particularly after surgery for patients with epidural analges... | 425 | ||
| Endoscopic Examinations | 425 | ||
| Bronchoscopy. A bronchoscope is used to inspect the larynx, the trachea, and bronchi. An informed consent is required. The patie... | 425 | ||
| Gastroscopy. Gastroscopy is the visual inspection of the upper digestive tract and the stomach to obtain specimens of gastric co... | 425 | ||
| Proctosigmoidoscopy. Proctosigmoidoscopy is the visual inspection of the lower bowel and is used to check the lining for ulcerat... | 426 | ||
| Colonoscopy. Colonoscopy is the inspection of the entire large intestine for polyps, areas of inflammation, and malignant lesion... | 426 | ||
| Cystoscopy. Cystoscopy is the visual inspection of the interior of the bladder for the collection of biopsy specimens, collectio... | 427 | ||
| Endoscopic retrograde cholangiopancreatography. Endoscopic retrograde cholangiopancreatography (ERCP) is used to identify a caus... | 427 | ||
| Aspirations | 427 | ||
| Electroencephalography | 428 | ||
| Other Diagnostic Tests | 430 | ||
| ?EVALUATION | 430 | ||
| VI - Meeting Basic Physiologic Needs | 436 | ||
| 25 - Fluid, Electrolyte, and Acid-Base Balance | 436 | ||
| COMPOSITION OF BODY FLUIDS | 436 | ||
| WATER | 436 | ||
| ELECTROLYTES | 438 | ||
| NONELECTROLYTES | 438 | ||
| BLOOD | 438 | ||
| DISTRIBUTION OF BODY FLUIDS | 438 | ||
| MOVEMENT OF FLUID AND ELECTROLYTES | 438 | ||
| Passive Transport | 439 | ||
| Diffusion. Diffusion is the process by which substances freely move back and forth across the membrane until they are evenly dis... | 439 | ||
| Osmosis. Osmosis refers to the movement of a pure solvent (liquid) across a membrane. In the body, water diffuses by osmosis. Wh... | 439 | ||
| Filtration. Filtration is the movement of water and suspended substances outward through a semipermeable membrane. The pumping a... | 440 | ||
| Active Transport | 440 | ||
| FLUID AND ELECTROLYTE IMBALANCES | 440 | ||
| DEFICIENT FLUID VOLUME | 441 | ||
| Dehydration | 441 | ||
| EXCESS FLUID VOLUME | 442 | ||
| Edema | 442 | ||
| ELECTROLYTE IMBALANCES | 442 | ||
| Sodium Imbalances | 442 | ||
| Hyponatremia. A deficit of sodium in the blood is called hyponatremia (Na+ less than 135 mEq/L). This can occur from sodium loss... | 442 | ||
| Hypernatremia. When the serum sodium concentration rises above 145 mEq/L, a state of hypernatremia exists. This occurs when ther... | 445 | ||
| Potassium Imbalances | 445 | ||
| ?Hypokalemia. When the potassium level falls below 3.5 mEq/L, hypokalemia exists. Extra potassium must be given to help correct ... | 445 | ||
| Hyperkalemia. When the serum potassium level rises above 5.0 mEq/L, a state of hyperkalemia exists. Patients with renal failure,... | 446 | ||
| Calcium Imbalances | 446 | ||
| Hypocalcemia. When the calcium level drops below 8.4 mg/dL, hypocalcemia occurs. This can result from nutritional deficiency of ... | 446 | ||
| Hypercalcemia. Hypercalcemia, a serum calcium level above 10.6 mg/dL, can occur during periods of lengthy immobilization when ca... | 446 | ||
| Magnesium Imbalances | 446 | ||
| ?Hypomagnesemia. Hypomagnesemia, a serum level below 1.3 mEq/L, can result from numerous situations including decreased magnesiu... | 446 | ||
| Hypermagnesemia. Hypermagnesemia, a serum level above 2.1 mEq/L, occurs rarely and usually in the presence of renal failure, alt... | 446 | ||
| Anion Imbalances | 446 | ||
| ACID-BASE BALANCE | 447 | ||
| PH | 447 | ||
| BICARBONATE | 447 | ||
| CONTROL MECHANISMS | 447 | ||
| ACID-BASE IMBALANCES | 447 | ||
| RESPIRATORY ACIDOSIS | 449 | ||
| METABOLIC ACIDOSIS | 449 | ||
| Effects of Acidosis | 449 | ||
| RESPIRATORY ALKALOSIS | 449 | ||
| METABOLIC ALKALOSIS | 450 | ||
| Effects of Alkalosis | 450 | ||
| ?APPLICATION OF THE NURSING PROCESS | 450 | ||
| ?ASSESSMENT (DATA COLLECTION) | 450 | ||
| ?NURSING DIAGNOSIS | 451 | ||
| ?PLANNING | 451 | ||
| ?IMPLEMENTATION | 451 | ||
| ?Recording Intake and Output | 453 | ||
| ?EVALUATION | 455 | ||
| 26 - Concepts of Basic Nutrition and Cultural Considerations | 458 | ||
| OVERVIEW OF THE STRUCTURE AND FUNCTION OFTHE GASTROINTESTINAL SYSTEM | 459 | ||
| WHICH STRUCTURES ARE INVOLVED IN THE GASTROINTESTINAL (DIGESTIVE) SYSTEM? | 459 | ||
| WHAT ARE THE FUNCTIONS OF THE ORGANS OF THE GASTROINTESTINAL SYSTEM? | 459 | ||
| WHAT CHANGES IN THE DIGESTIVE SYSTEM OCCUR WITH AGING? | 460 | ||
| DIETARY GUIDELINES | 460 | ||
| USDA MYPLATE AND THE 2015 DIETARY GUIDELINES FOR AMERICANS | 460 | ||
| PROTEIN | 462 | ||
| FUNCTIONS OF PROTEIN | 462 | ||
| FOOD SOURCES OF PROTEIN | 462 | ||
| DIETARY REFERENCE INTAKES OF PROTEIN | 462 | ||
| PROTEIN DEFICIENCY | 463 | ||
| PROTEIN EXCESS | 463 | ||
| VEGETARIAN DIETS | 463 | ||
| CARBOHYDRATES | 464 | ||
| FUNCTIONS OF CARBOHYDRATES | 464 | ||
| SIMPLE CARBOHYDRATES | 464 | ||
| COMPLEX CARBOHYDRATES (STARCHES) | 464 | ||
| RECOMMENDATIONS FOR INTAKE | 464 | ||
| FIBER | 465 | ||
| FATS (LIPIDS) | 465 | ||
| FUNCTIONS OF FAT | 465 | ||
| FOOD SOURCES OF FAT | 466 | ||
| VITAMINS | 466 | ||
| MINERALS | 467 | ||
| WATER | 469 | ||
| FACTORS THAT INFLUENCE NUTRITION | 469 | ||
| AGE | 472 | ||
| ILLNESS | 472 | ||
| EMOTIONAL STATUS | 472 | ||
| ECONOMIC STATUS | 472 | ||
| RELIGION | 472 | ||
| CULTURE | 472 | ||
| FOOD SAFETY | 472 | ||
| CULTURAL INFLUENCES ON NUTRITION | 473 | ||
| AFRICAN AMERICAN | 473 | ||
| HISPANIC AMERICAN | 473 | ||
| ASIAN AMERICAN | 473 | ||
| MIDDLE EASTERN AMERICAN | 473 | ||
| NUTRITION COUNSELING | 473 | ||
| NUTRITIONAL NEEDS THROUGHOUT THE LIFE SPAN | 473 | ||
| INFANTS | 473 | ||
| TODDLERS AND PRESCHOOL CHILDREN | 475 | ||
| SCHOOL-AGE CHILDREN | 475 | ||
| ADOLESCENTS | 475 | ||
| ADULTS | 475 | ||
| OLDER ADULTS | 476 | ||
| ?APPLICATION OF THE NURSING PROCESS | 477 | ||
| ?ASSESSMENT (DATA COLLECTION) | 477 | ||
| ?NURSING DIAGNOSIS | 479 | ||
| ?PLANNING | 479 | ||
| ?IMPLEMENTATION | 479 | ||
| Patient and Family Education | 480 | ||
| ?EVALUATION | 480 | ||
| 27 - Nutritional Therapy and Assisted Feeding | 484 | ||
| THE GOALS OF NUTRITIONAL THERAPY | 485 | ||
| THE POSTOPERATIVE PATIENT | 487 | ||
| HEALTH ISSUES RELATED TO NUTRITION | 487 | ||
| FEEDING AND EATING DISORDERS | 487 | ||
| Anorexia Nervosa | 488 | ||
| Bulimia nervosa. Bulimia nervosa is an eating disorder characterized by episodic binge eating, followed by behaviors designed to... | 488 | ||
| Binge eating disorders. Binge eating is defined as recurrent episodes of consuming significantly more food in a defined period o... | 488 | ||
| OBESITY | 489 | ||
| PREGNANCY | 490 | ||
| SUBSTANCE-RELATED AND ADDICTIVE DISORDERS | 490 | ||
| CARDIOVASCULAR DISEASE | 491 | ||
| DIABETES MELLITUS | 491 | ||
| HIV/AIDS | 493 | ||
| ASSISTED FEEDING | 494 | ||
| NASOGASTRIC AND ENTERAL TUBES | 495 | ||
| PERCUTANEOUS ENDOSCOPIC GASTROSTOMY OR JEJUNOSTOMY TUBES | 496 | ||
| FEEDING TUBES AND PUMPS | 500 | ||
| TOTAL PARENTERAL NUTRITION | 504 | ||
| ?APPLICATION OF THE NURSING PROCESS | 505 | ||
| ?ASSESSMENT (DATA COLLECTION) | 505 | ||
| ?NURSING DIAGNOSIS | 505 | ||
| ?PLANNING | 505 | ||
| ?IMPLEMENTATION | 505 | ||
| ?EVALUATION | 505 | ||
| Documentation | 506 | ||
| 28 - Assisting with Respiration and Oxygen Delivery | 508 | ||
| WHAT ARE THE FUNCTIONS OF THE RESPIRATORY STRUCTURES? | 509 | ||
| WHAT CHANGES OCCUR WITH AGING THAT AFFECT RESPIRATION? | 509 | ||
| HYPOXEMIA | 510 | ||
| SYMPTOMS OF HYPOXIA | 510 | ||
| PULSE OXIMETRY | 511 | ||
| AIRWAY OBSTRUCTION AND RESPIRATORY ARREST | 511 | ||
| CLEARING RESPIRATORY SECRETIONS | 513 | ||
| THE EFFECTIVE COUGH | 513 | ||
| POSTURAL DRAINAGE | 518 | ||
| OXYGEN ADMINISTRATION | 518 | ||
| CANNULA | 522 | ||
| MASKS | 522 | ||
| ARTIFICIAL AIRWAYS | 522 | ||
| NASOPHARYNGEAL SUCTIONING | 524 | ||
| TRACHEOBRONCHIAL SUCTIONING | 526 | ||
| TRACHEOSTOMY | 529 | ||
| CHEST DRAINAGE TUBES | 529 | ||
| ?APPLICATION OF THE NURSING PROCESS | 530 | ||
| ?ASSESSMENT (DATA COLLECTION) | 530 | ||
| ?NURSING DIAGNOSIS | 532 | ||
| ?PLANNING | 532 | ||
| ?IMPLEMENTATION | 533 | ||
| Tracheostomy Care | 535 | ||
| Chest Tube Care | 538 | ||
| Nebulizer Treatments | 538 | ||
| Patient Education | 538 | ||
| ?EVALUATION | 539 | ||
| Documentation | 539 | ||
| 29 - Promoting Urinary Elimination | 541 | ||
| OVERVIEW OF STRUCTURE AND FUNCTION OF THE URINARY SYSTEM | 542 | ||
| WHICH STRUCTURES ARE INVOLVED IN URINARY ELIMINATION? | 542 | ||
| WHAT ARE THE FUNCTIONS OF THE URINARY STRUCTURES FOR ELIMINATION? | 542 | ||
| WHAT FACTORS CAN INTERFERE WITH URINARY ELIMINATION? | 543 | ||
| WHAT CHANGES IN THE SYSTEM OCCUR WITH AGING? | 543 | ||
| NORMAL URINARY ELIMINATION | 543 | ||
| FACTORS AFFECTING NORMAL URINATION | 543 | ||
| CHARACTERISTICS OF NORMAL URINE | 543 | ||
| Color | 543 | ||
| Clarity | 544 | ||
| Odor | 544 | ||
| Specific Gravity | 544 | ||
| pH. The acidity or alkalinity of urine is measured in units called pH. The pH of normal urine is slightly acidic, ranging from 5... | 544 | ||
| ALTERATIONS IN URINARY ELIMINATION | 544 | ||
| ?APPLICATION OF THE NURSING PROCESS | 545 | ||
| ?ASSESSMENT (DATA COLLECTION) | 545 | ||
| Urine Specimen Collection | 545 | ||
| Voided Specimen for Urinalysis. Inspection of the urine is the next step in the assessment. For a simple voided specimen for uri... | 545 | ||
| Midstream (Clean-Catch) Urine Specimen. This procedure is used to obtain a specimen for a culture and sensitivity test when a UT... | 546 | ||
| Specimen from an Indwelling Catheter. A specimen may be obtained from the self-sealing port of an indwelling catheter system (Fi... | 546 | ||
| Sterile Catheterized Specimen. When a sterile specimen is ordered and the patient does not have an indwelling catheter in place,... | 546 | ||
| 24-Hour Urine Specimen. All urine voided during the 24-hour period is collected in the designated container and stored on ice if... | 546 | ||
| Urinary Collection Bag. This device is used to obtain a urine specimen from an infant or toddler. The skin is cleaned, and then ... | 547 | ||
| Strained Specimen. If patient is suspected of having a urinary stone, all urine is strained when voided. Usually a fine sieve is... | 547 | ||
| ?NURSING DIAGNOSIS | 547 | ||
| ?PLANNING | 548 | ||
| ?IMPLEMENTATION | 548 | ||
| Assisting With Use of a Urinal | 550 | ||
| Helping a Patient Urinate | 553 | ||
| Types of Urinary Catheters | 553 | ||
| Performing Catheterization | 554 | ||
| The Nurse’s Role in Preventing Catheter-Related Urinary Tract Infections | 563 | ||
| The Suprapubic Catheter | 563 | ||
| Intermittent Self-Catheterization | 564 | ||
| Bladder Irrigation or Instillation | 565 | ||
| Assisting the Patient Who Is Incontinent | 568 | ||
| Urinary Diversion Care | 569 | ||
| ?EVALUATION | 570 | ||
| Documentation | 570 | ||
| 30 - Promoting Bowel Elimination | 572 | ||
| OVERVIEW OF THE STRUCTURE AND FUNCTION OF THE INTESTINAL SYSTEM | 573 | ||
| WHICH STRUCTURES OF THE INTESTINAL SYSTEM ARE INVOLVED IN WASTE ELIMINATION? | 573 | ||
| WHAT ARE THE FUNCTIONS OF THE INTESTINES? | 573 | ||
| WHAT EFFECT DOES AGING HAVE ON THE INTESTINAL TRACT? | 574 | ||
| CHARACTERISTICS OF STOOL | 574 | ||
| NORMAL CHARACTERISTICS OF STOOL | 574 | ||
| ABNORMAL CHARACTERISTICS OF STOOL | 574 | ||
| HYPOACTIVE BOWEL AND CONSTIPATION | 574 | ||
| HYPERACTIVE BOWEL AND DIARRHEA | 576 | ||
| FECAL INCONTINENCE | 577 | ||
| ?APPLICATION OF THE NURSING PROCESS | 577 | ||
| ?ASSESSMENT (DATA COLLECTION) | 577 | ||
| ?NURSING DIAGNOSIS | 577 | ||
| ?PLANNING | 577 | ||
| ?IMPLEMENTATION | 578 | ||
| ?EVALUATION | 580 | ||
| Documentation | 580 | ||
| RECTAL SUPPOSITORIES | 580 | ||
| ENEMAS | 580 | ||
| TYPES OF ENEMAS | 580 | ||
| Retention Enema | 580 | ||
| AMOUNT AND TEMPERATURE OF SOLUTION | 580 | ||
| RECOMMENDED POSITION | 581 | ||
| RECTAL TUBE | 581 | ||
| FECAL IMPACTION | 583 | ||
| BOWEL TRAINING FOR INCONTINENCE | 584 | ||
| BOWEL OSTOMY | 585 | ||
| OSTOMY CARE | 587 | ||
| Skin Care | 587 | ||
| Applying an Ostomy Appliance | 588 | ||
| Irrigating a Colostomy | 588 | ||
| 31 - Pain, Comfort, and Sleep | 593 | ||
| PAIN AND DISCOMFORT | 594 | ||
| THEORIES OF PAIN | 594 | ||
| Gate Control Theory | 595 | ||
| Endorphins | 595 | ||
| TYPES OF PAIN | 595 | ||
| Acute Pain | 595 | ||
| Chronic Pain | 597 | ||
| Nociceptive Pain | 597 | ||
| Neuropathic Pain | 597 | ||
| Phantom Pain | 597 | ||
| ?APPLICATION OF THE NURSING PROCESS | 597 | ||
| ?ASSESSMENT (DATA COLLECTION) | 597 | ||
| Perception of Pain | 597 | ||
| Pain Scales | 598 | ||
| ?NURSING DIAGNOSIS | 599 | ||
| ?PLANNING | 599 | ||
| ?IMPLEMENTATION | 599 | ||
| Nonmedicinal Methods of Pain Control | 599 | ||
| Transcutaneous electrical nerve stimulation. Transcutaneous electrical nerve stimulation (TENS) uses a small electrical stimulat... | 599 | ||
| Percutaneous electrical nerve stimulation. A treatment showing promise for relief of lower back pain, such as that caused by sci... | 601 | ||
| Binders and braces. Binders are cloths wrapped around a limb or body part. They are effective in relieving pain associated with ... | 601 | ||
| Application of heat and cold. The application of heat or cold, or the alternate application of first one and then the other, can... | 601 | ||
| Relaxation. Relaxation, or tension release, is helpful in reducing pain, and it allows the patient to obtain greater relief from... | 602 | ||
| Biofeedback. Biofeedback is a specialized relaxation technique using a machine that measures the degree of muscular tension with... | 602 | ||
| Distraction. Distraction assists the patient in focusing on something other than the pain. Patients frequently do this inadverte... | 603 | ||
| Guided imagery and meditation. These methods differ from relaxation in that they are mental rather than physical techniques. In ... | 603 | ||
| Music. Music can be used alone as a source of distraction from pain. It is frequently used effectively in conjunction with other... | 603 | ||
| Hypnosis. Hypnosis is also called therapeutic suggestion. It involves inducing a trance-like state using focusing and relaxation... | 603 | ||
| Massage. Massage has long been used to induce relaxation and bring relief from muscle and structural pain. A nightly back rub ca... | 604 | ||
| Medical Methods of Pain Control | 604 | ||
| Analgesic medications. When pain medications are ordered for patients experiencing pain, you are responsible for monitoring the ... | 604 | ||
| Oral medications. Oral medications have been traditionally used for mild to moderate pain. Recent advances, however, have made a... | 604 | ||
| Topical medications. Various topical preparations, such as capsaicin, ibuprofen, diclofenac, or menthol cream or gels, may provi... | 605 | ||
| Injected medications. IM or subcutaneous injection of pain medication is usually used for severe pain and only for a relatively ... | 605 | ||
| Intravenous medications. IV pain medication may be given as a bolus (concentrated dose given rapidly), as a slow push (over a fe... | 605 | ||
| Patient-controlled analgesia. Currently, the most common method used for injectable opioids in acute care is PCA (analgesia dose... | 605 | ||
| Epidural analgesia. The epidural route has been used for anesthesia for many years. Epidural analgesia, however, is a newer form... | 607 | ||
| Implantable pumps. Patients with chronic severe pain may have a small pump implanted and attached to an intraspinal catheter to ... | 608 | ||
| ?EVALUATION | 608 | ||
| SLEEP | 608 | ||
| FUNCTIONS OF SLEEP | 609 | ||
| STAGES OF SLEEP | 609 | ||
| NORMAL SLEEP REQUIREMENTS | 609 | ||
| FACTORS AFFECTING SLEEP | 610 | ||
| SLEEP DISORDERS | 610 | ||
| Insomnia | 610 | ||
| Sleep Apnea | 610 | ||
| Snoring | 611 | ||
| Narcolepsy | 611 | ||
| ?APPLICATION OF THE NURSING PROCESS | 611 | ||
| ?ASSESSMENT (DATA COLLECTION) | 611 | ||
| ?NURSING DIAGNOSIS | 611 | ||
| ?PLANNING | 611 | ||
| ?IMPLEMENTATION | 611 | ||
| ?EVALUATION | 612 | ||
| 32 - COMPLEMENTARY AND ALTERNATIVE THERAPIES | 614 | ||
| COMPLEMENTARY AND ALTERNATIVE MEDICINE | 614 | ||
| MIND AND BODY INTERVENTIONS | 615 | ||
| ACUPUNCTURE | 615 | ||
| YOGA | 615 | ||
| CHIROPRACTIC | 616 | ||
| MASSAGE THERAPY | 616 | ||
| RELAXATION THERAPY | 616 | ||
| IMAGERY | 616 | ||
| MEDITATION | 616 | ||
| BIOFEEDBACK | 616 | ||
| BIOFIELD THERAPIES | 616 | ||
| Qi Gong | 617 | ||
| Reiki | 617 | ||
| Therapeutic Touch | 617 | ||
| HYPNOTHERAPY | 617 | ||
| MUSIC, ART, AND DANCE THERAPY | 617 | ||
| HUMOR | 617 | ||
| PRAYER | 617 | ||
| NATURAL PRODUCTS | 617 | ||
| HERBAL THERAPY AND DIETARY SUPPLEMENTS | 617 | ||
| AROMATHERAPY | 619 | ||
| OTHER COMPLEMENTARY INTERVENTIONS | 619 | ||
| HOMEOPATHIC MEDICINE | 619 | ||
| NATUROPATHIC MEDICINE | 619 | ||
| TRADITIONAL CHINESE MEDICINE | 619 | ||
| AYURVEDA | 619 | ||
| SHAMANISM | 619 | ||
| FOLK MEDICINE | 620 | ||
| AMERICAN INDIAN MEDICINE | 620 | ||
| THE NURSE’S ROLE IN COMPLEMENTARY AND ALTERNATIVE THERAPIES | 620 | ||
| VII - Medication Administration | 622 | ||
| 33 - Pharmacology and Preparation for Drug Administration | 622 | ||
| PHARMACOLOGY | 622 | ||
| CLASSIFICATION OF DRUGS | 623 | ||
| LEGAL CONTROL OF DRUGS | 625 | ||
| Drug Standards | 626 | ||
| BASIC CONCEPTS OF PHARMACOLOGY | 626 | ||
| Drug Action and Pharmacokinetics | 626 | ||
| Absorption. To reach the cellular level, solid drugs in the form of capsules, pills, or powders must be dissolved within the bod... | 626 | ||
| Other Factors Affecting Drug Action. Distribution to tissues and the cellular site of action depends on the drug’s chemical and ... | 626 | ||
| Drug Response and Pharmacodynamics | 627 | ||
| Drug and Food Incompatibilities | 629 | ||
| MEDICATION ADMINISTRATION AND SAFETY | 629 | ||
| CONSIDERATIONS FOR INFANTS AND CHILDREN | 631 | ||
| CONSIDERATIONS FOR THE OLDER ADULT | 632 | ||
| CONSIDERATIONS FOR HOME CARE | 633 | ||
| PROBLEMS OF NONADHERENCE | 633 | ||
| ?APPLICATION OF THE NURSING PROCESS | 634 | ||
| ?ASSESSMENT (DATA COLLECTION) | 634 | ||
| ?NURSING DIAGNOSIS | 636 | ||
| ?PLANNING | 636 | ||
| ?IMPLEMENTATION | 637 | ||
| Calculating the Drug Dosage to Be Given | 638 | ||
| Examples of Conversion Problems. Sometimes it is necessary to perform mathematical conversions to obtain the correct dose. The e... | 638 | ||
| Drug Problem Formula. You have an order for glipizide, 2.5 mg PO (D = dose desired). On hand you have glipizide, 5 mg/tablet (H ... | 639 | ||
| Practicing the Six Rights | 639 | ||
| Give the Right Drug. Check MARs against the prescriber’s original orders in the medical record to make certain that the order wa... | 639 | ||
| ?Give the Right Dose. Many medication errors occur because the dosage given to the patient is not the dosage ordered. Carefully ... | 639 | ||
| Give the Right Drug by the Right Route. The fact that the patient does not feel the need for pain medication by injection anymor... | 640 | ||
| Give the Right Drug at the Right Time. The times at which patients are to receive medications should be written down on the work... | 640 | ||
| Give the right drug to the right patient. You must identify the patient correctly using two identifiers. Check the wristband inf... | 640 | ||
| Document at the right time. Record the drug given, the dose, the time, the route, and your initials when documenting on a MAR. S... | 640 | ||
| ?EVALUATION | 641 | ||
| 34 - Administering Oral, Topical, and Inhalant Medications | 644 | ||
| NURSING RESPONSIBILITIES IN MEDICATION ADMINISTRATION | 645 | ||
| MEDICATION ORDERS | 645 | ||
| TYPES OF ORDERS | 646 | ||
| REGULARLY SCHEDULED OR ROUTINE MEDICATION ORDERS | 647 | ||
| DOSAGE OF MEDICATIONS | 647 | ||
| ROUTES OF ORAL AND TOPICAL MEDICATION ADMINISTRATION | 647 | ||
| MEDICATION ADMINISTRATION AND TECHNOLOGY | 648 | ||
| MEDICATION ADMINISTRATION RECORD | 649 | ||
| MEDICATION ADMINISTRATION SYSTEMS | 649 | ||
| UNIT-DOSE SYSTEM | 649 | ||
| PRESCRIPTION SYSTEM | 650 | ||
| PREPARATION OF ORAL CONTROLLED SUBSTANCES FROM A DISPENSER | 650 | ||
| TOPICAL DRUGS | 652 | ||
| ?APPLICATION OF THE NURSING PROCESS | 652 | ||
| ?ASSESSMENT (DATA COLLECTION) | 652 | ||
| ?NURSING DIAGNOSIS | 652 | ||
| ?PLANNING | 653 | ||
| ?IMPLEMENTATION | 653 | ||
| Oral Medication | 653 | ||
| Eye and Ear Medications | 658 | ||
| Nasal Medications | 660 | ||
| Inhalation Medications | 661 | ||
| Vaginal Medications | 662 | ||
| Rectal Medications | 664 | ||
| Topical Skin Medications | 664 | ||
| Administering Medications via Feeding Tube | 667 | ||
| ?EVALUATION | 669 | ||
| Documentation | 669 | ||
| MEDICATION ERRORS | 669 | ||
| 35 - Administering Intradermal, Subcutaneous, and Intramuscular Injections | 673 | ||
| PRINCIPLES OF PARENTERAL INJECTIONS | 674 | ||
| ROUTES FOR PARENTERAL MEDICATION | 674 | ||
| ?INTRADERMAL ROUTE | 675 | ||
| SUBCUTANEOUS ROUTE | 675 | ||
| INTRAMUSCULAR ROUTE | 675 | ||
| INJECTION EQUIPMENT | 676 | ||
| TYPES OF SYRINGES | 676 | ||
| MEASUREMENT SCALES | 676 | ||
| NEEDLE GAUGE AND LENGTH | 676 | ||
| PREVENTING NEEDLE STICKS | 677 | ||
| SYRINGE AND NEEDLE SELECTION | 678 | ||
| PREPARING THE SYRINGE FOR USE | 678 | ||
| PARENTERAL SOLUTIONS | 678 | ||
| USING A MEDICATION AMPULE | 678 | ||
| USING A MEDICATION VIAL | 680 | ||
| RECONSTITUTION OF A DRUG | 681 | ||
| COMPATIBILITY OF MEDICATIONS | 681 | ||
| ?APPLICATION OF THE NURSING PROCESS | 683 | ||
| ?ASSESSMENT (DATA COLLECTION) | 683 | ||
| ?NURSING DIAGNOSIS | 683 | ||
| ?PLANNING | 684 | ||
| ?IMPLEMENTATION | 684 | ||
| Intradermal Injections | 684 | ||
| Subcutaneous Injections | 686 | ||
| Intramuscular Injections | 690 | ||
| Intramuscular injections in children. It is preferable to find another way to give medication to children because IM injections ... | 694 | ||
| The Z-track technique. With IM injections, medication can leak upward into the subcutaneous tissues, causing staining, bruising,... | 695 | ||
| Anaphylactic Shock | 695 | ||
| ?EVALUATION | 696 | ||
| Documentation | 696 | ||
| 36 - Administering Intravenous Solutions and Medications | 699 | ||
| INTRAVENOUS THERAPY | 700 | ||
| LICENSED PRACTICAL NURSE/LICENSED VOCATIONAL NURSE’S ROLE IN INTRAVENOUS THERAPY | 700 | ||
| TYPES OF INTRAVENOUS SOLUTION | 700 | ||
| EQUIPMENT FOR INTRAVENOUS ADMINISTRATION | 703 | ||
| ADMINISTRATION SETS | 703 | ||
| Primary Intravenous Set | 703 | ||
| Secondary, or Piggyback, Intravenous Set | 704 | ||
| Parallel, or Y, Intravenous Set | 704 | ||
| Controlled-Volume Intravenous Set | 704 | ||
| Filters | 705 | ||
| INFUSION PUMPS AND CONTROLLERS | 705 | ||
| VENOUS ACCESS DEVICES | 707 | ||
| Intravenous Needles and Catheters | 707 | ||
| Infusion Port | 709 | ||
| COMPLICATIONS OF INTRAVENOUS THERAPY | 709 | ||
| INFILTRATION | 709 | ||
| EXTRAVASATION | 709 | ||
| PHLEBITIS | 710 | ||
| BLOODSTREAM INFECTION | 710 | ||
| OTHER COMPLICATIONS | 710 | ||
| ?APPLICATION OF THE NURSING PROCESS | 710 | ||
| ?ASSESSMENT (DATA COLLECTION) | 710 | ||
| ?NURSING DIAGNOSIS | 711 | ||
| ?PLANNING | 711 | ||
| Calculation of Flow Rates | 712 | ||
| ?IMPLEMENTATION | 712 | ||
| Initiating Intravenous Therapy | 713 | ||
| Selection of the intravenous site. Selection of a vein for IV use depends on several factors, including the vein’s accessibility... | 713 | ||
| Managing Intravenous Therapy | 717 | ||
| Keeping the intravenous solution running. A primary responsibility is to check the IV at least every 60 minutes and observe each... | 718 | ||
| Administering Intravenous Medications | 718 | ||
| Administering Heparin Infusions | 723 | ||
| Administering Antineoplastic Medications | 726 | ||
| Discontinuing an Intravenous Infusion | 726 | ||
| Administering Blood and Blood Products | 728 | ||
| Total Parenteral Nutrition | 730 | ||
| ?EVALUATION | 731 | ||
| Documentation | 731 | ||
| VIII - Care of the Surgical and Immobile Patient | 733 | ||
| 37 - Care of the Surgical Patient | 733 | ||
| REASONS FOR SURGERY | 734 | ||
| PATIENTS AT HIGHER RISK FOR SURGICAL COMPLICATIONS | 734 | ||
| PERIOPERATIVE NURSING | 735 | ||
| ENHANCEMENTS TO SURGICAL TECHNIQUE | 735 | ||
| LASER SURGERY | 735 | ||
| FIBEROPTIC SURGERY | 735 | ||
| ROBOTIC SURGERY | 736 | ||
| ANESTHESIA | 736 | ||
| GENERAL ANESTHESIA | 736 | ||
| REGIONAL ANESTHESIA | 736 | ||
| PROCEDURAL (MODERATE) SEDATION ANESTHESIA | 736 | ||
| LOCAL ANESTHESIA | 736 | ||
| PREOPERATIVE PROCEDURES | 737 | ||
| SURGICAL CONSENT | 737 | ||
| SURGICAL SITE IDENTIFICATION | 737 | ||
| PHYSICAL EXAMINATION | 737 | ||
| ?APPLICATION OF THE NURSING PROCESS | 738 | ||
| PREOPERATIVE CARE | 738 | ||
| ?ASSESSMENT (DATA COLLECTION) | 738 | ||
| ?NURSING DIAGNOSIS | 739 | ||
| ?PLANNING | 739 | ||
| ?IMPLEMENTATION | 739 | ||
| Patient Education for Postoperative Exercises | 739 | ||
| NPO Status | 741 | ||
| Elimination | 741 | ||
| Expected Tubes and Equipment | 741 | ||
| Rest and Sedation | 741 | ||
| Pain Control | 741 | ||
| Skin Preparation | 741 | ||
| Immediate Preoperative Care | 741 | ||
| Preoperative medications. Most preoperative medications are given intravenously in the surgical holding area rather than on the ... | 743 | ||
| Preparation of the Patient Unit | 743 | ||
| ?EVALUATION | 743 | ||
| INTRAOPERATIVE CARE | 747 | ||
| ?ROLE OF THE SCRUB PERSON AND CIRCULATING NURSE | 748 | ||
| ?POSTANESTHESIA IMMEDIATE CARE | 748 | ||
| Postanesthesia Care Unit | 748 | ||
| ?POSTANESTHESIA CARE IN THE SAME-DAY SURGERY UNIT | 748 | ||
| POSTOPERATIVE CARE | 749 | ||
| ?ASSESSMENT (DATA COLLECTION) | 749 | ||
| ?NURSING DIAGNOSIS | 749 | ||
| ?PLANNING | 750 | ||
| IMPLEMENTATION | 751 | ||
| Protect the Patient from Injury | 751 | ||
| Promote Respiratory Function | 751 | ||
| Promote Circulation | 752 | ||
| Maintain Fluid Balance | 752 | ||
| Promote Gastrointestinal Function | 754 | ||
| Promote Comfort | 754 | ||
| Rest and Activity | 755 | ||
| Prevent Infection | 755 | ||
| Complications of Surgery | 755 | ||
| EVALUATION | 755 | ||
| 38 - Providing Wound Care and Treating Pressure Injuries | 759 | ||
| TYPES OF WOUNDS AND THE HEALING PROCESS | 760 | ||
| PHASES OF WOUND HEALING | 761 | ||
| FACTORS AFFECTING WOUND HEALING | 762 | ||
| AGE | 762 | ||
| NUTRITION | 762 | ||
| LIFESTYLE | 762 | ||
| MEDICATIONS | 765 | ||
| IX - Caring for the Elderly | 815 | ||
| 40 - Common Physical Care Problems of the Older Adult | 815 | ||
| GETTING OLDER | 815 | ||
| IMMOBILITY | 815 | ||
| NURSING INTERVENTIONS TO PROMOTE MOBILITY | 816 | ||
| PREVENTING FALLS | 818 | ||
| ALTERATION IN ELIMINATION | 819 | ||
| URINARY INCONTINENCE | 819 | ||
| Nursing Interventions for Urinary Incontinence | 819 | ||
| CONSTIPATION AND FECAL IMPACTION | 820 | ||
| Nursing Interventions for Constipation and Fecal Impaction | 820 | ||
| ALTERATION IN NUTRITION | 820 | ||
| NURSING INTERVENTIONS FOR NUTRITIONAL SUPPORT | 821 | ||
| SENSORY DEFICITS | 821 | ||
| VISION DEFICITS | 821 | ||
| Nursing Interventions for the Visually Impaired | 822 | ||
| HEARING DEFICIT | 823 | ||
| Nursing Interventions for the Hearing Impaired | 823 | ||
| SEXUALITY | 823 | ||
| POLYPHARMACY | 824 | ||
| NURSING INTERVENTIONS FOR POLYPHARMACY | 825 | ||
| 41 - Common Psychosocial Care Problems of the Older Adult | 830 | ||
| ASSESSMENT OF COGNITIVE CHANGES IN OLDER ADULTS | 831 | ||
| CONFUSION | 831 | ||
| DELIRIUM | 831 | ||
| DEMENTIA | 832 | ||
| Specific Interventions for Confusion and Disorientation | 832 | ||
| Psychosocial Measures. A behavioral approach is essential to enhance the quality of life for an older adult with confusion or di... | 832 | ||
| Pharmacotherapy. Before administering medications to deal with problem behaviors, first implement all other types of nursing int... | 833 | ||
| Family Support. It is important to provide emotional and social support to the patient with dementia and to significant others. ... | 834 | ||
| ALZHEIMER DISEASE | 834 | ||
| Treatment and Nursing Interventions for Alzheimer Disease | 835 | ||
| SAFETY FOR THE COGNITIVELY IMPAIRED | 835 | ||
| BEHAVIORS ASSOCIATED WITH COGNITIVE DISORDERS | 835 | ||
| Agitation, Hostility, and Paranoia | 835 | ||
| Wandering | 836 | ||
| Sundown Syndrome | 836 | ||
| Eating Problems | 837 | ||
| DEPRESSION, ALCOHOLISM, AND SUICIDE | 837 | ||
| INTERVENTIONS FOR DEPRESSION, ALCOHOLISM, AND SUICIDE PREVENTION | 838 | ||
| CRIMES AGAINST OLDER ADULTS | 839 | ||
| ELDER ABUSE | 839 | ||
| SCAMS AND WHITE COLLAR CRIME | 840 | ||
| FUTURE ISSUES OF CONCERN TO OLDER ADULTS | 840 | ||
| PLANNING FOR THE FUTURE | 841 | ||
| A - Standard Steps for All Nursing Procedures | 843 | ||
| AT THE BEGINNING OF THE PROCEDURE | 843 | ||
| STEP A: PERFORM THE TASK ACCORDING TO PROTOCOL | 843 | ||
| STEP B: CHECK THE ORDER, COLLECT THE EQUIPMENT AND SUPPLIES, AND PERFORM HAND HYGIENE | 843 | ||
| STEP C: IDENTIFY AND PREPARE THE PATIENT; INTRODUCE YOURSELF | 843 | ||
| STEP D: PROVIDE PRIVACY AND INSTITUTE SAFETY PRECAUTIONS; ARRANGE THE SUPPLIES AND EQUIPMENT | 843 | ||
| DURING THE PROCEDURE | 844 | ||
| STEP E: USE STANDARD PRECAUTIONS AND ASEPTIC TECHNIQUE AS APPROPRIATE | 844 | ||
| AT THE END OF THE PROCEDURE | 844 | ||
| STEP X: REMOVE GLOVES AND OTHER PROTECTIVE EQUIPMENT | 844 | ||
| STEP Y: RESTORE THE UNIT. COLLECT THE USED EQUIPMENT; DISPOSE OF, CLEAN, OR STORE ITEMS IN THE PROPER PLACES | 844 | ||
| STEP Z: DOCUMENT AND REPORT THE PROCEDURE | 844 | ||
| B - NFLPN Nursing Practice Standards for the Licensed Practical/Vocational Nurse | 845 | ||
| NURSING PRACTICE STANDARDS FOR THE LICENSED PRACTICAL/VOCATIONAL NURSE | 845 | ||
| PREFACE | 845 | ||
| THE CODE FOR LICENSED PRACTICAL/VOCATIONAL NURSES | 845 | ||
| INTRODUCTORY STATEMENT | 845 | ||
| Definition | 845 | ||
| Scope | 845 | ||
| STANDARDS | 845 | ||
| Legal/Ethical Status | 846 | ||
| C - American Nurses Association Codeof Ethics for Nurses | 847 | ||
| D - STANDARD PRECAUTIONS | 848 | ||
| IV STANDARD PRECAUTIONS | 848 | ||
| IV.A Hand Hygiene | 848 | ||
| IV.B Personal Protective Equipment | 848 | ||
| IV.C Respiratory Hygiene/Cough Etiquette | 849 | ||
| IV.D Patient Placement | 849 | ||
| IV.F Care of the Environment | 850 | ||
| IV.G Textiles and Laundry | 850 | ||
| IV.H Safe Injection Practices | 850 | ||
| IV.J Worker Safety | 850 | ||
| E - Most Common Laboratory Test Values | 851 | ||
| F - NANDA-I Approved Nursing Diagnoses, 2015-2017* | 854 | ||
| Reader References | 857 | ||
| Glossary | 866 | ||
| Index | 882 | ||
| A | 882 | ||
| B | 885 | ||
| C | 886 | ||
| D | 891 | ||
| E | 893 | ||
| F | 895 | ||
| G | 896 | ||
| H | 896 | ||
| I | 899 | ||
| J | 901 | ||
| K | 902 | ||
| L | 902 | ||
| M | 903 | ||
| N | 905 | ||
| O | 907 | ||
| P | 908 | ||
| Q | 912 | ||
| R | 912 | ||
| S | 913 | ||
| T | 917 | ||
| U | 918 | ||
| V | 919 | ||
| W | 920 | ||
| X | 920 | ||
| Y | 920 | ||
| Z | 920 |