Medical-Surgical Nursing - E-Book

Donna D. Ignatavicius; M. Linda Workman; Cherie Rebar

BOOK

Medical-Surgical Nursing - E-Book

Donna D. Ignatavicius | M. Linda Workman | Cherie Rebar

(2017)

Additional Information

Book Details

ISBN: 978-0-323-46179-5
Edition: 9
Language: English
Pages: 1668
Subjects: Geriatric medicine
Nursing
Surgical nursing

Abstract

Awarded second place in the 2018 AJN Book of the Year Awards in Medical-Surgical Nursing!

Healthcare is evolving at an incredible pace and with it, the roles and responsibilities of the medical-surgical nurse. Ensure you are fully equipped to thrive and adapt in this ever-changing nursing environment with Ignatavicius, Workman, and Rebar's Medical-Surgical Nursing: Concepts for Interprofessional Collaborative Care, 9th Edition. This trendsetting text not only covers all essential adult health knowledge, but also reinforces the application, conceptual thinking, and clinical judgment skills that today’s nurses need to stay one step ahead in delivering exceptional patient care, no matter the environment. As with previous "Iggy" editions, you’ll find a unique collaborative care approach to adult health nursing, a thorough integration of QSEN competencies, extensive NCLEX^® Exam preparation, and a direct, reader-friendly tone throughout the text. This ninth edition incorporates two emerging and complementary trends — the Core Competencies for Interprofessional Collaborative Practice and a more conceptual approach teaching and learning — areas that will ground you in how to think like a nurse and how to apply the knowledge you gain from the text to clinical practice. There are a lot of med-surg nursing texts out there, but there’s only one that combines all the information, concepts, and on-the-job realities in a way that makes perfect sense: "Iggy!"

Trendsetting QSEN integration emphasizes patient safety and evidence-based practice with Nursing Safety Priority boxes, including Drug Alerts, Critical Rescues, and Action Alerts.

UNIQUE! Emphasis on clinical judgment helps you develop skills in clinical reasoning and clinical decision-making when applying concepts to clinical situations.

Strong emphasis on NCLEX Exam preparation includes chapter-opening Learning Outcomes and chapter-ending Get Ready for the NCLEX Examination! sections organized by NCLEX Client Needs Categories, plus NCLEX Examination Challenge questions, with an answer key in the back of the book and on the Evolve companion website.

Exceptionally readable content features shorter sentences, straightforward vocabulary, and a direct, reader-friendly writing style.

Section Title	Page	Action	Price
Front Cover	cover
Endsheet 2	IFC1
Priority Concept Exemplars	i
Acid-Base Balance	i
Cellular Regulation	i
Clotting	i
Cognition	i
Comfort	i
Elimination	i
Fluid and Electrolyte Balance	i
Gas Exchange	i
Glucose Regulation	i
Immunity	i
Mobility	i
Nutrition	i
Perfusion	i
Sensory Perception	i
Sexuality	i
Tissue Integrity	i
Medical-Surgical Nursing	iii
Copyright Page	iv
Consultants and Contributors	v
Reviewers	viii
Preface	x
Key Themes for the 9th Edition	x
Clinical Currency and Accuracy	xi
Outstanding Readability	xii
Ease of Access	xii
A Patient-Centered, Interprofessional Collaborative Care Approach	xii
Organization	xiii
Multinational, Multicultural, Multigenerational Focus	xiii
Additional Learning Aids	xiii
An Integrated Multimedia Resource Based on Proven Strategies for Student Engagement and Learning	xiv
Resources for Instructors	xiv
Resources for Students	xiv
Dedication	xvi
About the Authors	xvii
Acknowledgments	xviii
Table Of Contents	xix
Guide to Special Features	xxviii
Best Practice for Patient Safety and Quality Care	xxviii
Common Examples of Drug Therapy	xxix
Concept Map	xxix
Key Features	xxix
Evidence-Based Practice	xxx
Focused Assessment	xxx
Home Care Assessment	xxx
Laboratory Profile	xxx
Nursing Focus on the Older Adult	xxxi
Patient and Family Education: Preparing for Self-Management	xxxi
Quality Improvement	xxxii
Unit I Foundations for Medical-Surgical Nursing	1
1 Overview of Professional Nursing Concepts for Medical-Surgical Nursing	1
Priority and Interrelated Concepts	1
Learning Outcomes	1
Quality and Safety Education for Nurses Core Competencies	2
Patient-Centered Care	2
Definition of Patient-Centered Care	2
Scope of Patient-Centered Care	2
Attributes of Patient-Centered Care	2
Examples of Context of Patient-Centered Care to Nursing and Health Care	3
Safety	3
Definition of Safety	3
Scope of Safety	3
Attributes of Safety	4
Examples of Context of Safety to Nursing and Health Care	4
Teamwork and Interprofessional Collaboration	5
Definition of Teamwork and Interprofessional Collaboration	5
Scope of Teamwork and Interprofessional Collaboration	5
Attributes of Teamwork and Interprofessional Collaboration	5
Examples of Context of Teamwork and Interprofessional Collaboration to Nursing and Health Care	5
Communication	5
Delegation and Supervision	6
Evidence-Based Practice	6
Definition of Evidence-Based Practice	6
Scope of Evidence-Based Practice	6
Attributes of Evidence-Based Practice	7
Examples of Context of Evidence-Based Practice to Nursing and Health Care	7
Quality Improvement	7
Definition of Quality Improvement	7
Scope of Quality Improvement	7
Attributes of Quality Improvement	7
Examples of Context of Quality Improvement to Nursing and Health Care	7
Informatics and Technology	7
Definition of Informatics and Technology	7
Scope of Informatics and Technology	8
Attributes of Informatics and Technology	8
Examples of Context of Informatics and Technology for Nursing and Health Care	8
Clinical Judgment	8
Definition of Clinical Judgment	8
Scope of Clinical Judgment	8
Attributes of Clinical Judgment	8
Examples of Context of Clinical Judgment to Nursing and Health Care	8
Ethics	8
Definition of Ethics	8
Scope of Ethics	9
Attributes of Ethics	9
Examples of Context of Ethics to Nursing and Health Care	9
Health Care Organizations	9
Definition of Health Care Organizations	9
Scope of Health Care Organizations	9
Attributes of Health Care Organizations	10
Examples of Context of Health Care Organizations to Nursing and Health Care	10
Health Care Disparities	10
Definition of Health Care Disparities	10
Scope of Health Care Disparities	10
Attributes of Health Care Disparities	10
Examples of Context of Health Care Disparities to Nursing and Health Care	10
Special Needs of Older Adults	10
Special Needs of Ethnic Minorities	10
Special Needs of the LGBTQ Population	10
Get Ready for the NCLEX® Examination!	11
Key Points	11
Safe and Effective Care Environment	11
Psychosocial Integrity	11
Selected Bibliography	12
2 Overview of Health Concepts for Medical-Surgical Nursing	13
Priority and Interrelated Concepts	13
Learning Outcomes	13
Acid-Base Balance	13
Definition of Acid-Base Balance	13
Scope of Acid-Base Balance	13
Common Risk Factors for Acid-Base Imbalance	13
Physiologic Consequences of Acid-Base Imbalance	14
Assessment of Acid-Base Balance	14
Interventions to Promote Acid-Base Balance and Prevent Acid-Base Imbalance	14
Interventions for Patients With Acid-Base Imbalances	14
Cellular Regulation	14
Definition of Cellular Regulation	14
Scope of Cellular Regulation	14
Common Risk Factors for Impaired Cellular Regulation	14
Physiologic Consequences of Impaired Cellular Regulation	14
Assessment of Cellular Regulation	14
Interventions to Promote Cellular Regulation and Prevent Impaired Cellular Regulation	15
Interventions for Patients With Impaired Cellular Regulation	15
Clotting	15
Definition of Clotting	15
Scope of Clotting	15
Common Risk Factors for Inadequate Clotting	15
Physiologic Consequences of Inadequate Clotting	15
Assessment of Clotting	16
Interventions to Promote Adequate Clotting and Prevent Inadequate Clotting	16
Interventions for Patients With Inadequate Clotting	16
Cognition	16
Definition of Cognition	16
Scope of Cognition	16
Common Risk Factors for Inadequate Cognition	17
Physiologic Consequences of Inadequate Cognition	17
Assessment of Cognition	17
Interventions to Promote Cognition and Prevent Inadequate Cognition	17
Interventions for Patients With Inadequate Cognition	17
Comfort	17
Definition of Comfort	17
Scope of Comfort	17
Common Risk Factors for Decreased Comfort	17
Physiologic Consequences of Decreased Comfort	18
Assessment of Comfort	18
Interventions to Prevent Impaired Comfort	18
Interventions for Patients With Decreased Comfort	18
Elimination	18
Definition of Elimination	18
Scope of Elimination	18
Common Risk Factors for Changes in Elimination	18
Physiologic Consequences of Changes in Elimination	18
Assessment of Elimination	19
Interventions to Prevent Changes in Elimination	19
Interventions for Patients With Changes in Elimination	19
Fluid and Electrolyte Balance	19
Definition of Fluid and Electrolyte Balance	19
Scope of Fluid and Electrolyte Balance	19
Common Risk Factors for Fluid and Electrolyte Imbalance	19
Physiologic Consequences of Fluid and Electrolyte Imbalance	20
Assessment of Fluid and Electrolyte Balance	20
Interventions to Promote Fluid and Electrolyte Balance and Prevent Fluid and Electrolyte Imbalance	20
Interventions for Fluid and Electrolyte Imbalances	20
Glucose Regulation	20
Gas Exchange	20
Definition of Gas Exchange	20
Scope of Gas Exchange	21
Common Risk Factors for Decreased Gas Exchange	21
Physiologic Consequences of Decreased Gas Exchange	21
Assessment of Gas Exchange	21
Interventions to Promote Gas Exchange and Prevent Decreased Gas Exchange	21
Interventions for Decreased Gas Exchange	21
Immunity	21
Definition of Immunity	21
Scope of Immunity	22
Common Risk Factors for Changes in Immunity	22
Physiologic Consequences of Changes in Immunity	22
Assessment of Immunity	22
Interventions to Promote Immunity and Prevent Changes in Immunity	23
Interventions for Changes in Immunity	23
Mobility	23
Definition of Mobility	23
Scope of Mobility	23
Common Risk Factors for Decreased Mobility	23
Physiologic Consequences of Decreased Mobility	23
Assessment of Mobility	23
Interventions to Prevent Decreased Mobility	23
Interventions for Patients With Decreased Mobility	24
Nutrition	24
Definition of Nutrition	24
Scope of Nutrition	24
Common Risk Factors for Decreased Nutrition	24
Physiologic Consequences of Decreased Nutrition	24
Assessment of Nutrition	25
Interventions to Promote Nutrition and Prevent Decreased Nutrition	25
Interventions for Patients With Decreased Nutrition	25
Perfusion	25
Definition of Perfusion	25
Scope of Perfusion	25
Common Risk Factors for Decreased Perfusion	25
Physiologic Consequences of Decreased Perfusion	25
Assessment of Perfusion	25
Interventions to Promote Perfusion and Prevent Decreased Perfusion	25
Interventions for Decreased Perfusion	26
Sensory Perception	26
Definition of Sensory Perception	26
Scope of Sensory Perception	26
Common Risk Factors for Changes in Sensory Perception	26
Physiologic Consequences of Changes in Sensory Perception	26
Assessment of Sensory Perception	26
Interventions to Promote Sensory Perception and Prevent Changes in Sensory Perception	26
Interventions for Patients With Changes in Sensory Perception	26
Sexuality	27
Definition of Sexuality	27
Scope of Sexuality	27
Common Risk Factors for Changes in Sexuality	27
Physiologic Consequences of Changes in Sexuality	27
Assessment of Sexuality	27
Interventions to Promote Sexuality and Prevent Changes in Sexuality	27
Interventions for Patients With Changes in Sexuality	27
Tissue Integrity	27
Definition of Tissue Integrity	27
Scope of Tissue Integrity	27
Common Risk Factors for Tissue Integrity Changes	27
Physiologic Consequences of Tissue Integrity Changes	28
Assessment of Tissue Integrity	28
Interventions to Promote Tissue Integrity and Prevent Tissue Integrity Changes	28
Interventions for Tissue Integrity Changes	28
Get Ready for the NCLEX® Examination!	28
Key Points	28
Safe and Effective Care Environment	28
Health Promotion and Maintenance	28
Psychosocial Integrity	28
Physiological Integrity	28
Selected Bibliography	28
3 Common Health Problems of Older Adults	29
Priority and Interrelated Concepts	29
Learning Outcomes	29
Overview	30
Health Issues for Older Adults in Community-Based Settings	30
Decreased Nutrition and Hydration	30
Decreased Mobility	31
Stress, Loss, and Coping	32
Accidents	33
Fall Prevention	33
Driving Safety	34
Drug Use and Misuse	34
Effects of Drugs on Older Adults	34
Self-Administration of Drugs	35
Medication Assessment and Health Teaching	35
Inadequate Cognition	35
Depression	36
Dementia	37
Delirium	38
Substance Use	38
Elder Neglect and Abuse	39
Health Issues for Older Adults in Hospitals and Long-Term Care Settings	39
Problems of Sleep, Nutrition, and Continence	40
Confusion, Falls, and Skin Breakdown	40
Care Coordination and Transition Management	42
Get Ready for the NCLEX® Examination!	43
Key Points	43
Safe and Effective Care Environment	43
Health Promotion and Maintenance	43
Psychosocial Integrity	43
Physiological Integrity	43
Selected Bibliography	43
4 Assessment and Care of Patients With Pain	45
Priority and Interrelated Concepts	45
Learning Outcomes	45
Overview of Comfort Concept Exemplar Pain	45
Scope of the Problem	45
Definitions of Pain	46
Categorization of Pain by Duration	46
Acute Pain	46
Chronic Pain	47
Chronic Cancer Pain.	47
Chronic Noncancer Pain.	47
Categorization of Pain by Underlying Mechanisms	47
Nociceptive Pain	47
Neuropathic Pain	48
Interprofessional Collaborative Care	48
Assessment: Noticing	48
The Comprehensive Pain Assessment.	49
Psychosocial Assessment.	52
Assessment Challenges.	53
Interventions: Responding	54
Drug Therapy.	54
Multimodal Analgesia.	54
Routes of Administration.	54
Around-the-Clock Dosing.	54
Patient-Controlled Analgesia.	55
The Three Analgesic Groups.	55
Nonopioid Analgesics.	55
Opioid Analgesics.	56
Key Principles of Opioid Administration.	57
Physical Dependence, Tolerance, and Addiction.	58
Opioid Naïve Versus Opioid Tolerant.	58
Equianalgesia.	58
Drug Formulation Terminology.	58
Selected Opioid Analgesics.	59
Dual Mechanism Analgesics.	61
Opioids to Avoid.	61
Intraspinal Analgesia.	61
Adverse Effects of Opioid Analgesics.	62
Adjuvant Analgesics.	63
Anticonvulsants and Antidepressants.	63
Local Anesthetics.	64
Use of Placebos.	65
Nonpharmacologic Management.	65
Physical Modalities.	65
Cognitive-Behavioral Strategies.	66
Care Coordination and Transition Management	67
Home Care Management.	67
Self-Management Education.	68
Health Care Resources.	68
Get Ready for the NCLEX® Examination!	68
Key Points	68
Safe and Effective Care Environment	68
Health Promotion and Maintenance	68
Psychosocial Integrity	68
Physiological Integrity	69
Selected Bibliography	69
5 Principles of Genetics and Genomics for Medical-Surgical Nursing	71
Priority and Interrelated Concepts	71
Learning Outcomes	71
Genetic Biology Review	72
DNA	72
DNA Structure	72
DNA Replication	73
Chromosomes	74
Gene Structure and Function	74
Phenotype	75
Genotype	76
Gene Expression	76
Protein Synthesis	76
Mutations and Variations	76
Microbiome	77
Patterns of Inheritance	77
Pedigree	77
Autosomal Dominant Pattern of Inheritance	78
Penetrance	79
Expressivity	79
Autosomal Recessive Pattern of Inheritance	79
Sex-Linked Recessive Pattern of Inheritance	79
Complex Inheritance and Familial Clustering	80
Genetic Testing	80
Purpose of Genetic Testing	80
Benefits and Risks of Genetic Testing	80
Genetic Counseling	81
Ethical Issues	81
The Role of the Medical-Surgical Nurse in Genetic Counseling	82
Communication	82
Privacy and Confidentiality	83
Information Accuracy	83
Patient Advocacy and Support	83
Get Ready for the NCLEX® Examination!	84
Key Points	84
Safe and Effective Care Environment	84
Health Promotion and Maintenance	84
Psychosocial Integrity	84
Physiological Integrity	84
Bibliography	85
6 Rehabilitation Concepts for Chronic and Disabling Health Problems	86
Priority and Interrelated Concepts	86
Learning Outcomes	86
Overview	87
Chronic and Disabling Health Conditions	87
Rehabilitation Settings	87
The Rehabilitation Interprofessional Team	88
Interprofessional Collaborative Care	89
Assessment: Noticing	89
History.	89
Physical Assessment/Signs and Symptoms.	90
Cardiovascular and Respiratory Assessment.	90
Gastrointestinal and Nutritional Assessment.	90
Renal and Urinary Assessment.	91
Neurologic and Musculoskeletal Assessment.	91
Skin and Tissue Integrity Assessment.	91
Assessment of Functional Ability.	92
Psychosocial Assessment.	92
Vocational Assessment.	92
Analysis: Interpreting	92
Planning and Implementation: Responding	93
Increasing Mobility	93
Planning: Expected Outcomes.	93
Interventions.	93
Safe Patient Handling and Mobility Practices.	93
Gait Training.	95
Increasing Functional Ability	96
Unit II Principles of Emergency Care and Disaster Preparedness	117
8 Principles of Emergency and Trauma Nursing	117
Priority and Interrelated Concepts	117
Learning Outcomes	117
The Emergency Department Environment of Care	118
Demographic Data and Vulnerable Populations	118
Special Nursing Teams—Members of the Interprofessional Team	118
Interprofessional Team Collaboration	119
Staff and Patient Safety Considerations	120
Staff Safety	120
Patient Safety	121
Scope of Emergency Nursing Practice	122
Core Competencies	122
Training and Certification	123
Emergency Nursing Principles	123
Triage	123
Emergent, Urgent, and Nonurgent Categories	124
Other Multi-Tiered Models	124
Disposition	124
Case Management	125
Patient and Family Education	125
Death in the Emergency Department	126
The Impact of Homelessness	127
Trauma Nursing Principles	127
Trauma Centers and Trauma Systems	127
Trauma Centers	127
Trauma Systems	128
Mechanism of Injury	128
Primary Survey and Resuscitation Interventions	129
A: Airway/Cervical Spine	129
B: Breathing	129
C: Circulation	129
D: Disability	130
E: Exposure	130
The Secondary Survey and Resuscitation Interventions	130
Disposition	130
Get Ready for the NCLEX® Examination!	131
Key Points	131
Safe and Effective Care Environment	131
Psychosocial Integrity	132
Physiological Integrity	132
Selected Bibliography	132
9 Care of Patients With Common Environmental Emergencies	133
Priority and Interrelated Concepts	133
Learning Outcomes	133
Heat-Related Illnesses	133
Health Promotion and Maintenance	133
Heat Exhaustion	133
Pathophysiology	133
Unit III Interprofessional Collaboration for Patients With Problems of Fluid, Electrolyte, and Acid-Base Balance	160
11 Assessment and Care of Patients With Problems of Fluid and Electrolyte Balance	160
Priority and Interrelated Concepts	160
Learning Outcomes	160
Anatomy and Physiology Review	160
Filtration	161
Physiologic Action	161
Clinical Application	161
Diffusion	162
Physiologic Action	162
Clinical Application	162
Osmosis	163
Physiologic Action	163
Clinical Application	164
Fluid Balance	164
Body Fluids	164
Hormonal Regulation of Fluid Balance	165
Significance of Fluid Balance	166
The Renin-Angiotensin II Pathway	166
Clinical Application	167
Disturbances of Fluid and Electrolyte Balance	167
Fluid and Electrolyte Balance Concept Exemplar Dehydration	167
Pathophysiology	167
Health Promotion and Maintenance	168
Interprofessional Collaborative Care	168
Assessment: Noticing	168
History.	168
Physical Assessment/Signs and Symptoms.	168
Laboratory Assessment.	169
Analysis: Interpreting	169
Planning and Implementation: Responding	169
Restoring Fluid Balance	169
Planning: Expected Outcomes.	169
Interventions.	169
Fluid Replacement.	169
Drug Therapy.	170
Preventing Injury	170
Planning: Expected Outcomes.	170
Interventions.	170
Care Coordination and Transition Management	170
Evaluation: Reflecting	170
Fluid Overload	171
Pathophysiology	171
Interprofessional Collaborative Care	171
Assessment: Noticing	171
Interventions: Responding	171
Electrolyte Balance and Imbalances	172
Sodium	173
Hyponatremia	173
Pathophysiology	173
Interprofessional Collaborative Care	173
Assessment: Noticing	173
Interventions: Responding	174
Hypernatremia	174
Pathophysiology	174
Interprofessional Collaborative Care	175
Assessment: Noticing	175
Interventions: Responding	175
Potassium	175
Hypokalemia	175
Pathophysiology	175
Interprofessional Collaborative Care	176
Assessment: Noticing	176
Interventions: Responding	176
Hyperkalemia	178
Pathophysiology	178
Interprofessional Collaborative Care	178
Assessment: Noticing	178
Interventions: Responding	178
Calcium	179
Hypocalcemia	179
Pathophysiology	179
Interprofessional Collaborative Care	179
Assessment: Noticing	179
Interventions: Responding	180
Hypercalcemia	181
Pathophysiology	181
Interprofessional Collaborative Care	181
Assessment: Noticing	181
Interventions: Responding	181
Magnesium	181
Hypomagnesemia	181
Hypermagnesemia	182
Get Ready for the NCLEX® Examination!	183
Key Points	183
Safe and Effective Care Environment	183
Health Promotion and Maintenance	183
Psychosocial Integrity	183
Physiological Integrity	183
Selected Bibliography	183
12 Assessment and Care of Patients With Problems of Acid-Base Balance	185
Priority and Interrelated Concepts	185
Learning Outcomes	185
Maintaining Acid-Base Balance	185
Acid-Base Chemistry	186
Acids	186
Bases	186
Buffers	186
Body Fluid Chemistry	187
Bicarbonate Ions	187
Relationship Between Carbon Dioxide and Hydrogen Ions	187
Sources of Acids and Bicarbonate	188
Acid-Base Regulatory Actions and Mechanisms	188
Chemical Acid-Base Control Actions	188
Respiratory Acid-Base Control Actions	189
Kidney Acid-Base Control Actions	190
Compensation	190
Acid-Base Imbalances	190
Acid-base Balance Concept Exemplar Acidosis	190
Pathophysiology	190
Metabolic Acidosis	191
Respiratory Acidosis	192
Combined Metabolic and Respiratory Acidosis	192
Interprofessional Collaborative Care	192
Assessment: Noticing	192
History.	192
Physical Assessment/Signs and Symptoms.	192
Psychosocial Assessment.	193
Laboratory Assessment.	193
Analysis: Interpreting	194
Planning and Implementation: Responding	194
Metabolic Acidosis.	195
Respiratory Acidosis	195
Improving Gas Exchange	195
Planning: Expected Outcomes.	195
Interventions.	195
Care Coordination and Transition Management	195
Evaluation: Reflecting	195
Alkalosis	195
Pathophysiology	195
Interprofessional Collaborative Care	196
Assessment: Noticing	196
Interventions: Responding	197
Get Ready for the NCLEX® Examination!	197
Key Points	197
Safe and Effective Care Environment	197
Health Promotion and Maintenance	197
Psychosocial Integrity	197
Physiological Integrity	197
Selected Bibliography	198
13 Concepts of Infusion Therapy	199
Priority and Interrelated Concepts	199
Learning Outcomes	199
Overview	199
Types of Infusion Therapy Fluids	200
Intravenous Solutions	200
Blood and Blood Components	200
Drug Therapy	201
Prescribing Infusion Therapy	201
Vascular Access Devices	201
Peripheral Intravenous Therapy	202
Short Peripheral Catheters	202
Insertion and Placement Methods	202
Site Selection and Skin Preparation	203
Midline Catheters	204
Central Intravenous Therapy	205
Peripherally Inserted Central Catheters	205
Nontunneled Percutaneous Central Venous Catheters	206
Tunneled Central Venous Catheters	207
Implanted Ports	207
Hemodialysis Catheters	208
Infusion Systems	208
Containers	208
Administration Sets	209
Secondary Administration Sets	209
Intermittent Administration Sets	209
Add-on Devices	209
Needleless Connection Devices	210
Rate-Controlling Infusion Devices	211
Nursing Care for Patients Receiving Intravenous Therapy	211
Educating the Patient	211
Performing the Nursing Assessment	212
Securing and Dressing the Catheter	212
Changing Administration Sets and Needleless Connectors	214
Controlling Infusion Pressure	214
Flushing the Catheter	214
Obtaining Blood Samples From Central Venous Catheters	215
Removing the Vascular Access Device	215
Documenting Intravenous Therapy	216
Complications of Intravenous Therapy	216
Catheter-Related Bloodstream Infection	216
Other Complications of Intravenous Therapy	216
Intravenous Therapy and Care of the Older Adult	216
Skin Care	216
Vein and Catheter Selection	222
Cardiac and Renal Changes	222
Subcutaneous Infusion Therapy	223
Intraosseous Infusion Therapy	223
Intra-Arterial Infusion Therapy	224
Intraperitoneal Infusion Therapy	225
Intraspinal Infusion Therapy	225
Get Ready for the NCLEX® Examination!	226
Key Points	226
Safe and Effective Care Environment	226
Health Promotion and Maintenance	226
Physiological Integrity	226
Selected Bibliography	227
Unit IV Interprofessional Collaboration for Perioperative Patients	228
14 Care of Preoperative Patients	228
Priority and Interrelated Concepts	228
Learning Outcomes	228
Overview	229
Categories and Purposes of Surgery	229
Surgical Settings	229
Interprofessional Collaborative Care	230
Assessment: Noticing	230
History.	230
Physical Assessment/Signs and Symptoms.	235
Psychosocial Assessment.	237
Laboratory Assessment.	237
Imaging Assessment.	237
Other Diagnostic Assessment.	238
Analysis: Interpreting	238
Planning and Implementation: Responding	238
Providing Information	238
Planning: Expected Outcomes.	238
Interventions.	238
Ensuring Informed Consent.	239
Patient Self-Determination.	241
Implementing Dietary Restrictions.	241
Administering Regularly Scheduled Drugs.	241
Intestinal Preparation.	242
Skin Preparation.	242
Preparing the Patient for Tubes, Drains, and Vascular Access.	242
Postoperative Procedures and Exercises.	242
Procedures and Exercises to Prevent Respiratory Complications.	242
Procedures and Exercises to Prevent Cardiovascular Complications.	244
Minimizing Anxiety	246
Planning: Expected Outcomes.	246
Interventions.	246
Preoperative Electronic Health Record Review.	246
Preoperative Patient Preparation.	247
Preoperative Drugs.	247
Patient Transfer to the Surgical Suite.	247
Evaluation: Reflecting	249
Get Ready for the NCLEX® Examination!	249
Key Points	249
Safe and Effective Care Environment	249
Health Promotion and Maintenance	249
Psychosocial Integrity	249
Physiological Integrity	249
Selected Bibliography	250
15 Care of Intraoperative Patients	251
Priority and Interrelated Concepts	251
Learning Outcomes	251
Overview	251
Members of the Surgical Team	252
The Surgical Suite—Patient and Team Safety	252
Surgical Suite Layout	252
Minimally Invasive and Robotic Surgery	252
Health and Hygiene of the Surgical Team	255
Surgical Attire	256
Surgical Scrub	256
Anesthesia	256
General Anesthesia	257
Stages of General Anesthesia.	258
Administration of General Anesthesia.	258
Complications of General Anesthesia.	258
Local or Regional Anesthesia	260
Local Anesthesia.	260
Regional Anesthesia.	260
Complications of Local or Regional Anesthesia.	260
Moderate Sedation	261
Interprofessional Collaborative Care	262
Assessment: Noticing	262
History.	262
Electronic Health Record Review.	263
Advance Directives and Do-Not-Resuscitate Orders.	263
Allergies and Previous Reactions to Anesthesia or Transfusions.	263
Autologous Blood Transfusion.	263
Laboratory and Diagnostic Test Results.	263
Medical History and Physical Examination Findings.	264
Analysis: Interpreting	264
Planning and Implementation: Responding	264
Preventing Injury	264
Planning: Expected Outcomes.	264
Interventions.	264
Preventing Infection	267
Unit V Interprofessional Collaboration for Patients With Problems of Immunity	289
17 Principles of Inflammation and Immunity	289
Priority and Interrelated Concepts	289
Learning Outcomes	289
Overview	289
Self Versus Non-Self	289
Organization of the Immune System	290
General Immunity: Inflammation	291
Infection	292
Cell Types Involved in Inflammation	292
Neutrophils	292
Macrophages	293
Basophils	293
Eosinophils	294
Tissue Mast Cells	294
Complement	294
Phagocytosis	294
Sequence of Inflammation	294
Specific Immunity	295
Antibody-Mediated Immunity	295
Antigen-Antibody Interactions	296
Antibody Classification	298
Acquiring Antibody-Mediated Immunity	298
Cell-Mediated Immunity	299
Cell Types Involved in Cell-Mediated Immunity	299
Cytokines	299
Protection Provided by Cell-Mediated Immunity	300
Age-Related Changes in Immunity	300
Transplant Rejection	300
Hyperacute Rejection	301
Acute Rejection	301
Chronic Rejection	301
Management of Transplant Rejection	301
Get Ready for the NCLEX® Examination!	303
Key Points	303
Health Promotion and Maintenance	303
Physiological Integrity	303
Selected Bibliography	303
18 Care of Patients With Arthritis and Other Connective Tissue Diseases	304
Priority and Interrelated Concepts	304
Learning Outcomes	304
Mobility Concept Exemplar Osteoarthritis	305
Pathophysiology	305
Etiology and Genetic Risk	305
Incidence and Prevalence	305
Health Promotion and Maintenance	305
Interprofessional Collaborative Care	306
Assessment: Noticing	306
History.	306
Physical Assessment/Signs and Symptoms.	306
Psychosocial Assessment.	307
Laboratory Assessment.	307
Imaging Assessment.	307
Analysis: Interpreting	307
Planning and Implementation: Responding	307
Managing Chronic Pain	307
Planning: Expected Outcomes.	307
Interventions.	307
Nonsurgical Management.	307
Drug Therapy.	307
Nonpharmacologic Interventions.	308
Complementary and Integrative Health.	308
Surgical Management.	309
Total Hip Arthroplasty.	309
Preoperative Care.	309
Operative Procedures.	310
Postoperative Care.	311
Managing Postoperative Pain.	313
Promoting Postoperative Mobility and Activity.	313
Promoting Postoperative Self-Management.	314
Total Knee Arthroplasty.	314
Preoperative Care.	314
Operative Procedures.	315
Postoperative Care.	315
Other Joint Arthroplasties.	316
Improving Mobility	316
Planning: Expected Outcomes.	316
Interventions.	316
Care Coordination and Transition Management	316
Home Care Management.	317
Self-Management Education.	317
Health Care Resources.	317
Evaluation: Reflecting	318
Immunity Concept Exemplar Rheumatoid Arthritis	318
Pathophysiology	318
Etiology and Genetic Risk	318
Incidence and Prevalence	318
Interprofessional Collaborative Care	318
Assessment: Noticing	318
Physical Assessment/Signs and Symptoms	318
Early Signs and Symptoms.	318
Late Signs and Symptoms.	319
Psychosocial Assessment.	319
Laboratory Assessment.	320
Other Diagnostic Assessment.	321
Analysis: Interpreting	321
Planning and Implementation: Responding	321
Managing Chronic Inflammation and Pain	321
Planning: Expected Outcomes.	321
Interventions.	321
Drug Therapy.	321
First-Line Disease-Modifying Antirheumatic Drugs.	322
Biological Response Modifiers.	322
Other Drugs.	322
Nonpharmacologic Interventions.	323
Complementary and Integrative Health.	324
Promoting Mobility	324
Planning: Expected Outcomes.	324
Unit VI Interprofessional Collaboration for Patients With Problems of the Skin, Hair, and Nails	431
24 Assessment of the Skin, Hair, and Nails	431
Priority and Interrelated Concepts	431
Learning Outcomes	431
Anatomy and Physiology Review	431
Structure of the Skin	431
Structure of the Skin Appendages	432
Functions of the Skin	433
Skin Changes Associated With Aging	433
Assessment: Noticing and Interpreting	433
Patient History	433
Nutrition Status	436
Family History and Genetic Risk	436
Current Health Problems	436
Skin Assessment	436
Inspection	436
Palpation	440
Hair Assessment	441
Nail Assessment	441
Skin Assessment Techniques for Patients With Darker Skin	443
Psychosocial Assessment	444
Diagnostic Assessment	444
Laboratory Tests	444
Other Diagnostic Tests	445
Skin Biopsy.	445
Patient Preparation.	445
Procedure.	445
Follow-up Care.	445
Wood’s Light Examination.	445
Diascopy.	445
Get Ready for the NCLEX® Examination!	446
Key Points	446
Safe and Effective Care Environment	446
Health Promotion and Maintenance	446
Psychosocial Integrity	446
Physiological Integrity	446
Selected Bibliography	446
25 Care of Patients With Skin Problems	447
Priority and Interrelated Concepts	447
Learning Outcomes	447
Tissue Integrity Concept Exemplar Pressure Injuries	447
Pathophysiology	447
Mechanical Forces	448
Incidence/Prevalence	448
Health Promotion and Maintenance	448
Identification of High-Risk Patients	448
Pressure-Redistribution Techniques	451
Support Surfaces and Devices.	451
Positioning.	451
Interprofessional Collaborative Care	452
Assessment: Noticing	452
History.	452
Physical Assessment/Signs and Symptoms.	453
Wound Assessment.	453
Psychosocial Assessment.	455
Laboratory Assessment.	455
Other Diagnostic Assessments.	455
Analysis: Interpreting	455
Planning and Implementation: Responding	455
Managing Wounds	455
Planning: Expected Outcomes.	455
Interventions.	457
Nonsurgical Management.	457
Dressings.	457
Physical Therapy.	458
Drug Therapy.	458
Nutrition Therapy.	458
Technology-Based Therapies.	458
Surgical Management.	459
Preventing Infection and Wound Deterioration	459
Planning: Expected Outcomes.	459
Interventions.	459
Care Coordination and Transition Management	459
Home Care Management.	459
Self-Management Education.	460
Health Care Resources.	461
Evaluation: Reflecting	461
Minor Skin Irritations	461
Pruritus	461
Pathophysiology	461
Interprofessional Collaborative Care	461
Urticaria	462
Common Inflammations	462
Pathophysiology	462
Interprofessional Collaborative Care	462
Psoriasis	463
Pathophysiology	463
Interprofessional Collaborative Care	463
Assessment: Noticing	464
History.	464
Physical Assessment/Signs and Symptoms.	464
Planning and Implementation: Responding	464
Topical Therapy.	464
Light Therapy.	465
Systemic Therapy.	465
Emotional Support.	465
Skin Infections	466
Pathophysiology	466
Bacterial Infections	466
Viral Infections	468
Fungal Infections	468
Health Promotion and Maintenance	468
Interprofessional Collaborative Care	469
Assessment: Noticing	469
History.	469
Physical Assessment/Signs and Symptoms.	469
Laboratory Assessment.	469
Planning and Implementation: Responding	469
Parasitic Disorders	470
Pediculosis	470
Scabies	470
Bedbugs	471
Trauma	471
Pathophysiology	471
Phases of Wound Healing	471
Mechanisms of Wound Healing	473
Partial-Thickness Wounds.	473
Full-Thickness Wounds.	473
Interprofessional Collaborative Care	474
Skin Cancer	474
Pathophysiology	474
Etiology and Genetic Risk	475
Incidence/Prevalence	476
Health Promotion and Maintenance	476
Interprofessional Collaborative Care	476
Assessment: Noticing	477
Planning and Implementation: Responding	477
Surgical Management.	477
Nonsurgical Management.	477
Other Skin Disorders	478
Toxic Epidermal Necrolysis and Stevens-Johnson Syndrome	478
Get Ready for the NCLEX® Examination!	478
Key Points	478
Safe and Effective Care Environment	478
Health Promotion and Maintenance	478
Psychosocial Integrity	479
Physiological Integrity	479
Selected Bibliography	479
26 Care of Patients With Burns	481
Priority and Interrelated Concepts	481
Learning Outcomes	481
Introduction to Burn Injury	481
Pathophysiology	481
Skin Changes	481
Anatomic Changes.	481
Functional Changes.	482
Depth of Burn Injury.	482
Superficial-Thickness Wounds.	482
Partial-Thickness Wounds.	483
Full-Thickness Wounds.	484
Deep Full-Thickness Wounds.	485
Vascular Changes	485
Cardiac Changes	485
Pulmonary Changes	486
Gastrointestinal Changes	486
Metabolic Changes	486
Immunologic Changes	486
Compensatory Responses	486
Etiology	486
Incidence/Prevalence	488
Health Promotion and Maintenance	488
Resuscitation Phase of Burn Injury	489
Overview	489
Interprofessional Collaborative Care	489
Assessment: Noticing	489
History.	489
Physical Assessment/Signs and Symptoms.	489
Respiratory Assessment.	489
Direct Airway Injury.	489
Carbon Monoxide Poisoning.	490
Thermal (Heat) Injury.	490
Smoke Poisoning.	491
Pulmonary Fluid Overload.	491
External Factors.	491
Cardiovascular Assessment.	491
Kidney/Urinary Assessment.	491
Skin Assessment.	492
Gastrointestinal Assessment.	492
Laboratory Assessment.	492
Imaging Assessment.	493
Other Diagnostic Assessment.	493
Analysis: Interpreting	493
Planning and Implementation: Responding	493
Supporting Oxygenation	493
Planning: Expected Outcomes.	493
Interventions.	493
Nonsurgical Management.	493
Surgical Management.	494
Preventing Hypovolemic Shock and Inadequate Gas Exchange	494
Planning: Expected Outcomes.	494
Interventions.	494
Nonsurgical Management.	494
Surgical Management.	495
Managing Pain and Alterations in Comfort.	496
Planning: Expected Outcomes.	496
Interventions.	496
Nonsurgical Management.	496
Surgical Management.	497
Preventing Acute Respiratory Distress Syndrome (ARDS)	497
Planning: Expected Outcomes.	497
Interventions.	497
Evaluation: Reflecting	497
Acute Phase of Burn Injury	497
Overview	497
Interprofessional Collaborative Care	497
Assessment: Noticing	497
Physical Assessment/Signs and Symptoms	497
Cardiopulmonary Assessment.	497
Neuroendocrine Assessment.	497
Immune Assessment.	497
Musculoskeletal Assessment.	498
Analysis: Interpreting	498
Planning and Implementation: Responding	498
Managing Wound Care	498
Planning: Expected Outcomes.	498
Interventions.	498
Nonsurgical Management.	498
Mechanical Débridement.	498
Enzymatic Débridement.	499
Dressing the Burn Wound.	499
Standard Wound Dressings.	499
Biologic Dressings.	499
Biosynthetic Wound Dressings.	499
Synthetic Dressings.	499
Surgical Management.	499
Surgical Excision.	500
Wound Covering.	500
Minimizing Potential for Infection.	501
Planning: Expected Outcomes.	501
Interventions.	501
Nonsurgical Management.	501
Drug Therapy for Infection Prevention.	501
Drug Therapy for Treatment of Infection.	502
Providing a Safe Environment.	502
Surgical Management.	502
Minimizing Weight Loss	502
Unit VII Interprofessional Collaboration for Patients With Problems of the Respiratory System	508
27 Assessment of the Respiratory System	508
Priority and Interrelated Concepts	508
Learning Outcomes	508
Anatomy and Physiology Review	508
Upper Respiratory Tract	509
Nose and Sinuses	509
Pharynx	509
Larynx	510
Lower Respiratory Tract	510
Airways	510
Lungs	510
Accessory Muscles of Respiration	511
Oxygen Delivery and the Oxygen-Hemoglobin Dissociation Curve	512
Respiratory Changes Associated With Aging	512
Health Promotion and Maintenance	512
Assessment: Noticing and Interpreting	515
Patient History	515
Family History and Genetic Risk	516
Current Health Problems	516
Physical Assessment	517
Assessment of the Nose and Sinuses	517
Assessment of the Pharynx, Trachea, and Larynx	517
Assessment of the Lungs and Thorax	518
Inspection.	518
Palpation.	518
Percussion.	519
Auscultation.	519
Other Indicators of Respiratory Adequacy	520
Psychosocial Assessment	521
Diagnostic Assessment	521
Laboratory Assessment	521
Imaging Assessment	521
Other Noninvasive Diagnostic Assessment	523
Pulse Oximetry.	523
Capnometry and Capnography.	523
Pulmonary Function Tests.	523
Patient Preparation.	524
Procedure.	524
Follow-Up Care.	524
Exercise Testing.	524
Other Invasive Diagnostic Assessment	524
Endoscopic Examinations.	524
Patient Preparation.	525
Procedure.	525
Unit VIII Interprofessional Collaboration for Patients With Problems of the Cardiovascular System	641
33 Assessment of the Cardiovascular System	641
Priority and Interrelated Concepts	641
Learning Outcomes	641
Anatomy and Physiology Review	642
Heart	642
Structure	642
Function	644
Sequence of Events During the Cardiac Cycle.	644
Mechanical Properties of the Heart.	645
Vascular System	645
Arterial System	645
Venous System	646
Cardiovascular Changes Associated With Aging	646
Assessment: Noticing and Interpreting	646
Patient History	646
Nutrition History	648
Family History and Genetic Risk	649
Current Health Problems	649
Functional History	651
Physical Assessment	651
General Appearance	651
Skin	651
Extremities	652
Blood Pressure	652
Venous and Arterial Pulses	653
Precordium	653
Inspection	653
Auscultation	654
Normal Heart Sounds.	654
Abnormal Heart Sounds.	654
Psychosocial Assessment	655
Diagnostic Assessment	655
Laboratory Assessment	655
Serum Markers of Myocardial Damage.	655
Serum Lipids.	656
Other Laboratory Tests.	656
Other Diagnostic Assessment	657
Cardiac Catheterization.	657
Patient Preparation.	657
Procedure.	658
Follow-Up Care.	659
Electrocardiography.	659
Electrophysiologic Studies.	659
Exercise Electrocardiography (Stress Test).	659
Patient Preparation.	659
Procedure.	660
Follow-Up Care.	660
Echocardiography.	660
Transesophageal Echocardiography.	660
Myocardial Nuclear Perfusion Imaging.	661
Computed Tomography Imaging.	661
Magnetic Resonance Imaging.	661
Get Ready for the NCLEX® Examination!	662
Key Points	662
Safe and Effective Care Environment	662
Health Promotion and Maintenance	662
Psychosocial Integrity	662
Physiological Integrity	662
Selected Bibliography	662
34 Care of Patients With Dysrhythmias	664
Priority and Interrelated Concepts	664
Learning Outcomes	664
Review of Cardiac Conduction System	664
Electrocardiography	665
Lead Systems	666
Continuous Electrocardiographic Monitoring	667
Electrocardiographic Complexes, Segments, and Intervals	667
Electrocardiographic Rhythm Analysis	670
Overview of Normal Cardiac Rhythms	671
Common Dysrhythmias	671
Pathophysiology	671
Premature Complexes	671
Bradydysrhythmias	671
Tachydysrhythmias	672
Etiology	672
Interprofessional Collaborative Care	672
Sinus Dysrhythmias	672
Sinus Tachycardia	673
Pathophysiology	673
Interprofessional Collaborative Care	673
Sinus Bradycardia	674
Pathophysiology	674
Interprofessional Collaborative Care	674
Assessment: Noticing	674
Interventions: Responding	674
Temporary Pacing.	674
Permanent Pacemaker.	675
Atrial Dysrhythmias	675
Premature Atrial Complexes	676
Supraventricular Tachycardia	676
Pathophysiology	676
Interprofessional Collaborative Care	676
Perfusion Concept Exemplar Atrial Fibrillation	678
Pathophysiology	678
Etiology and Genetic Risk	679
Incidence and Prevalence	679
Interprofessional Collaborative Care	679
Assessment: Noticing	679
History.	679
Physical Assessment/Signs and Symptoms.	679
Psychosocial Assessment.	679
Other Diagnostic Assessment.	679
Analysis: Interpreting	679
Planning and Implementation: Responding	679
Preventing Embolus Formation	679
Planning: Expected Outcomes.	679
Interventions.	679
Preventing Heart Failure	680
Planning: Expected Outcomes.	680
Interventions.	680
Nonsurgical Interventions.	680
Electrical Cardioversion.	680
Left Atrial Appendage Closure.	681
Radiofrequency Catheter Ablation.	681
Biventricular Pacing.	681
Surgical Interventions.	681
Care Coordination and Transition Management	681
Home Care.	681
Self-Management Education.	682
Health Care Resources.	682
Evaluation: Reflecting	683
Ventricular Dysrhythmias	683
Premature Ventricular Complexes	683
Pathophysiology	683
Interprofessional Collaborative Care	683
Ventricular Tachycardia	684
Unit IX Interprofessional Collaboration for Patients With Problems of the Hematologic System	795
39 Assessment of the Hematologic System	795
Priority and Interrelated Concepts	795
Learning Outcomes	795
Anatomy and Physiology Review	795
Bone Marrow	795
Blood Components	796
Accessory Organs of Blood Formation	797
Hemostasis and Blood Clotting	798
Anti-Clotting Forces	799
Hematologic Changes Associated With Aging	800
Assessment: Noticing and Interpreting	800
Patient History	800
Nutrition Status	802
Family History and Genetic Risk	802
Current Health Problems	802
Physical Assessment	802
Skin Assessment	802
Head and Neck Assessment	802
Respiratory Assessment	802
Cardiovascular Assessment	802
Kidney and Urinary Assessment	803
Musculoskeletal Assessment	803
Abdominal Assessment	803
Central Nervous System Assessment	803
Psychosocial Assessment	803
Diagnostic Assessment	803
Laboratory Tests	803
Tests of Cell Number and Function.	803
Tests Measuring Bleeding and Coagulation.	805
Imaging Assessment	806
Bone Marrow Aspiration and Biopsy	806
Patient Preparation.	806
Procedure.	806
Follow-Up Care.	806
Get Ready for the NCLEX® Examination!	807
Key Points	807
Safe and Effective Care Environment	807
Health Promotion and Maintenance	807
Psychosocial Integrity	807
Physiological Integrity	807
Selected Bibliography	807
40 Care of Patients With Hematologic Problems	808
Priority and Interrelated Concepts	808
Learning Outcomes	808
Perfusion Concept Exemplar Sickle Cell Disease	808
Pathophysiology	808
Etiology and Genetic Risk	809
Incidence and Prevalence	809
Interprofessional Collaborative Care	809
Assessment: Noticing	809
History.	809
Physical Assessment/Signs and Symptoms.	810
Psychosocial Assessment.	810
Laboratory Assessment.	810
Imaging Assessment.	811
Other Diagnostic Assessment.	811
Analysis: Interpreting	811
Planning and Implementation: Responding	811
Managing Pain	811
Planning: Expected Outcomes.	811
Interventions.	811
Preventing Sepsis, Multiple Organ Dysfunction Syndrome, and Death	812
Planning: Expected Outcomes.	812
Interventions.	812
Care Coordination and Transition Management	812
Self-Management Education.	812
Health Care Resources.	813
Evaluation: Reflecting	813
Anemia	813
Pathophysiology	814
Interprofessional Collaborative Care	815
Polycythemia Vera	816
Pathophysiology	816
Interprofessional Collaborative Care	816
Hereditary Hemochromatosis	817
Myelodysplastic Syndromes	817
Unit X Interprofessional Collaboration for Patients With Problems of the Nervous System	839
41 Assessment of the Nervous System	839
Priority and Interrelated Concepts	839
Learning Outcomes	839
Anatomy and Physiology Review	839
Nervous System Cells: Structure and Function	839
Central Nervous System: Structure and Function	840
Brain	840
Major Parts of the Brain.	840
Circulation in the Brain.	841
Spinal Cord	842
Peripheral Nervous System: Structure and Function	842
Autonomic Nervous System: Structure and Function	842
Neurologic Changes Associated With Aging	844
Health Promotion and Maintenance	845
Assessment: Noticing and Interpreting	846
Patient History	846
Physical Assessment	846
Complete Neurologic Assessment	846
Assessment of Mental Status.	846
Assessment of Cranial Nerves.	847
Assessment of Motor Function.	848
Assessment of Reflex Activity.	848
Assessment of Sensory Function.	849
Assessment of Cerebellar Function.	849
Rapid/Focused Neurologic Assessment	850
Psychosocial Assessment	850
Diagnostic Assessment	851
Laboratory Assessment	851
Imaging Assessment	851
Plain X-Rays.	851
Cerebral Angiography.	852
Patient Preparation.	852
Procedure.	852
Follow-Up Care.	852
Computed Tomography.	853
Magnetic Resonance Imaging.	853
Computed Tomography–Positron Emission Tomography.	853
Single-Photon Emission Computed Tomography.	854
Magnetoencephalography.	854
Other Diagnostic Assessment	854
Electromyography.	854
Electroencephalography.	854
Patient Preparation.	854
Procedure.	854
Follow-Up Care.	854
Evoked Potentials.	854
Lumbar Puncture.	855
Patient Preparation.	855
Procedure.	855
Follow-Up Care.	855
Transcranial Doppler Ultrasonography.	855
Get Ready for the NCLEX® Examination!	855
Key Points	855
Safe and Effective Care Environment	855
Health Promotion and Maintenance	855
Psychosocial Integrity	856
Physiological Integrity	856
Selected Bibliography	856
42 Care of Patients With Problems of the Central Nervous System	857
Priority and Interrelated Concepts	857
Learning Outcomes	857
Cognition Concept Exemplar Alzheimer’s Disease	857
Pathophysiology	857
Etiology and Genetic Risk	858
Incidence and Prevalence	859
Health Promotion and Maintenance	859
Interprofessional Collaborative Care	860
Assessment: Noticing	860
History.	860
Physical Assessment/Signs and Symptoms	860
Stages of Alzheimer’s Disease.	860
Changes in Cognition.	860
Changes in Behavior and Personality.	861
Changes in Self-Management Skills.	861
Psychosocial Assessment.	861
Laboratory and Imaging Assessment.	861
Analysis: Interpreting	861
Planning and Implementation: Responding	862
Managing Memory and Cognitive Dysfunction	862
Planning: Expected Outcomes.	862
Interventions.	862
Nonpharmacologic Management	862
Behavioral Management in a Structured Environment.	862
Complementary and Integrative Health.	863
Drug Therapy.	863
Preventing Injuries or Accidents	864
Planning: Expected Outcomes.	864
Interventions.	864
Preventing Elder Abuse	865
Planning: Expected Outcomes.	865
Interventions.	865
Care Coordination and Transition Management	866
Home Care Management.	866
Self-Management Education.	866
Health Care Resources.	867
Evaluation: Reflecting	867
Mobility Concept Exemplar Parkinson Disease	868
Pathophysiology	868
Etiology and Genetic Risk	869
Incidence and Prevalence	869
Interprofessional Collaborative Care	869
Assessment: Noticing	869
History.	869
Physical Assessment: Signs and Symptoms.	869
Laboratory and Imaging Assessment.	869
Analysis: Interpreting	870
Planning and Implementation: Responding	870
Promoting Mobility	870
Planning: Expected Outcomes.	870
Interventions	870
Nonsurgical Management.	870
Drug Therapy.	870
Other Interventions.	871
Surgical Management.	872
Promoting Self-Esteem	872
Planning: Expected Outcomes.	872
Interventions.	872
Care Coordination and Transition Management	872
Home Care Preparation.	872
Self-Management Education.	872
Health Care Resources.	872
Evaluation: Reflecting	873
Migraine Headache	873
Pathophysiology	873
Interprofessional Collaborative Care	873
Assessment: Noticing	873
Interventions: Responding	874
Abortive Therapy.	874
Preventive Therapy.	875
External Trigeminal Nerve Stimulator.	875
Complementary and Integrative Health.	875
Seizures and Epilepsy	876
Pathophysiology	876
Types of Seizures	876
Etiology and Genetic Risk	877
Interprofessional Collaborative Care	877
Assessment: Noticing	877
Interventions: Responding	877
Nonsurgical Management.	877
Drug Therapy.	877
Seizure Precautions.	878
Seizure Management.	878
Emergency Care: Acute Seizure and Status Epilepticus Management.	879
Surgical Management.	879
Vagal Nerve Stimulation.	879
Conventional Surgical Procedures.	880
Care Coordination and Transition Management	880
Meningitis	880
Pathophysiology	880
Interprofessional Collaborative Care	881
Assessment: Noticing	881
Interventions: Responding	882
Encephalitis	883
Pathophysiology	883
Interprofessional Collaborative Care	883
Assessment: Noticing	883
Interventions: Responding	884
Get Ready for the NCLEX® Examination!	884
Key Points	884
Safe and Effective Care Environment	884
Health Promotion and Maintenance	884
Psychosocial Integrity	885
Physiological Integrity	885
Selected Bibliography	885
43 Care of Patients With Problems of the Central Nervous System	887
Priority and Interrelated Concepts	887
Learning Outcomes	887
Immunity Concept Exemplar Multiple Sclerosis	888
Pathophysiology	888
Etiology	888
Incidence/Prevalence	888
Interprofessional Collaborative Care	888
Assessment: Noticing	888
History.	888
Physical Assessment/Signs and Symptoms.	889
Psychosocial Assessment.	889
Laboratory Assessment.	890
Other Diagnostic Assessment.	890
Analysis: Interpreting	890
Planning and Implementation: Responding	890
Managing Potential for Infection and Impaired Immunity	890
Planning: Expected Outcomes.	890
Interventions.	890
Improving Mobility	891
Planning Expected Outcomes.	891
Interventions.	891
Managing Decreased Visual Acuity and Cognition	892
Planning: Expected Outcomes.	892
Interventions.	892
Complementary and Integrative Health.	892
Care Coordination and Transition Management	892
Home Care Management.	892
Self-Management Education.	892
Health Care Resources.	894
Evaluation: Reflecting	894
Mobility Concept Exemplar Spinal Cord Injury	894
Pathophysiology	894
Mechanisms of Injury	894
Etiology	895
Incidence/Prevalence	895
Interprofessional Collaborative Care	895
Assessment: Noticing	895
History.	895
Physical Assessment/Signs and Symptoms	896
Initial Assessment.	896
Sensory Perception and Mobility Assessment.	896
Cardiovascular and Respiratory Assessment.	896
Gastrointestinal and Genitourinary Assessment.	896
Assessment of Patients for Long-Term Complications.	897
Psychosocial Assessment.	897
Laboratory and Imaging Assessment.	897
Analysis: Interpreting	897
Planning and Implementation: Responding	897
Managing the Airway and Improving Breathing	897
Planning: Expected Outcomes.	897
Interventions.	897
Monitoring for Cardiovascular Instability	898
Planning: Expected Outcomes.	898
Interventions.	898
Preventing Secondary Spinal Cord Injury	899
Planning: Expected Outcomes.	899
Interventions.	899
Spinal Immobilization and Stabilization.	899
Drug Therapy.	900
Surgical Management.	900
Managing Decreased Mobility	900
Planning: Expected Outcomes.	900
Interventions.	900
Care Coordination and Transition Management	901
Home Care Management.	901
Self-Management Education.	902
Health Care Resources.	903
Evaluation: Reflecting	903
Back Pain	903
Low Back Pain (Lumbosacral Back Pain)	903
Pathophysiology	903
Health Promotion and Maintenance	904
Interprofessional Collaborative Care	904
Assessment: Noticing	904
Physical Assessment/Signs and Symptoms.	904
Imaging Assessment.	905
Interventions: Responding	905
Nonsurgical Management.	905
Surgical Management.	906
Preoperative Care.	906
Operative Procedures.	906
Postoperative Care.	906
Care Coordination and Transition Management	908
Home Care Management.	908
Self-Management Education.	908
Health Care Resources.	909
Cervical Neck Pain	909
Pathophysiology	909
Interprofessional Collaborative Care	909
Get Ready for the nclex® Examination!	910
Key Points	910
Safe and Effective Care Environment	910
Health Promotion and Maintenance	910
Psychosocial Integrity	910
Physiological Integrity	911
Selected Bibliography	911
44 Care of Patients With Problems of the Peripheral Nervous System	912
Priority and Interrelated Concepts	912
Learning Outcomes	912
Immunity Concept Exemplar Guillain-Barré Syndrome	912
Pathophysiology	912
Etiology	913
Incidence/Prevalence	914
Interprofessional Collaborative Care	914
Assessment: Noticing	914
Physical Assessment/Signs and Symptoms.	914
Diagnostic Assessment.	914
Analysis: Interpreting	914
Planning and Implementation: Responding	914
Preventing Respiratory and/or Cardiovascular Distress or Failure	914
Planning: Expected Outcomes.	914
Interventions.	914
Improving Mobility and Preventing Complications of Immobility	916
Planning: Expected Outcomes.	916
Interventions.	916
Care Coordination and Transition Management	916
Home Care Management.	916
Health Care Resources.	917
Evaluation: Reflecting	917
Myasthenia Gravis	917
Pathophysiology	917
Interprofessional Collaborative Care	917
Assessment: Noticing	917
Physical Assessment/Signs and Symptoms.	917
Diagnostic Assessment.	918
Interventions: Responding	919
Nonsurgical Management.	919
Providing Respiratory Support.	919
Promoting Mobility.	919
Administering Drug Therapy.	919
Cholinesterase Inhibitor Drugs.	919
Emergency Care: Myasthenic Crisis.	920
Emergency Care: Cholinergic Crisis.	920
Immunosuppressants.	920
Other Interventions.	920
Surgical Management.	921
Care Coordination and Transition Management	921
Home Care Management.	921
Self-Management Education.	922
Health Care Resources.	922
Restless Legs Syndrome	922
Pathophysiology	922
Unit XI Interprofessional Collaboration for Patients With Problems of the Sensory System	957
46 Assessment of the Eye and Vision	957
Priority and Interrelated Concepts	957
Learning Outcomes	957
Anatomy and Physiology Review	957
Structure	957
Layers of the Eyeball	957
Refractive Structures and Media	958
External Structures	958
Muscles, Nerves, and Blood Vessels	959
Function	960
Eye Changes Associated With Aging	961
Health Promotion and Maintenance	961
Assessment: Noticing and Interpreting	962
Patient History	962
Nutrition History	962
Family History and Genetic Risk	963
Current Health Problems	963
Physical Assessment	963
Inspection	963
Vision Testing	963
Psychosocial Assessment	964
Diagnostic Assessment	965
Laboratory Assessment	965
Imaging Assessment	965
Other Diagnostic Assessment	965
Get ready for the NCLEX® Examination!	967
Key Points	967
Safe and Effective Care Environment	967
Health Promotion and Maintenance	967
Psychosocial Integrity	967
Physiological Integrity	967
Selected Bibliography	967
47 Care of Patients With Eye and Vision Problems	968
Priority and Interrelated Concepts	968
Learning Outcomes	968
Sensory Perception Concept Exemplar Cataract	968
Pathophysiology	968
Etiology and Genetic Risk	968
Incidence/Prevalence	968
Health Promotion and Maintenance	969
Interprofessional Collaborative Care	969
Assessment: Noticing	969
History.	969
Physical Assessment/Clinical Signs and Symptoms.	969
Psychosocial Assessment.	969
Analysis: Interpreting	969
Planning and Implementation: Responding	969
Improving Vision	969
Planning: Expected Outcomes.	969
Interventions: Responding.	969
Preoperative Care.	969
Operative Procedures.	970
Postoperative Care.	970
Care Coordination and Transition Management	971
Home Care Management.	971
Self-Management Education.	971
Health Care Resources.	971
Evaluation: Reflecting	972
Sensory Perception Concept Exemplar Glaucoma	972
Pathophysiology	972
Etiology and Genetic Risk	972
Incidence/Prevalence	972
Health Promotion and Maintenance	972
Interprofessional Collaborative Care	972
Assessment: Noticing	972
Physical Assessment/Clinical Signs and Symptoms.	972
Diagnostic Assessment.	974
Analysis: Interpreting	974
Planning and Implementation: Responding	974
Supporting Visual Acuity via Health Teaching	974
Planning: Expected Outcomes.	974
Interventions	974
Nonsurgical Management.	974
Surgical Management.	975
Care Coordination and Transition Management	975
Home Care Management.	975
Self-Management Education.	975
Health Care Resources.	976
Evaluation: Reflecting	976
Corneal Disorders	977
Corneal Abrasion, Ulceration, and Infection	977
Unit XII Interprofessional Collaboration for Patients With Problems of the Musculoskeletal System	1004
49 Assessment of the Musculoskeletal System	1004
Priority and Interrelated Concepts	1004
Learning Outcomes	1004
Anatomy and Physiology Review	1005
Skeletal System	1005
Bones	1005
Types and Structure.	1005
Function.	1005
Joints	1006
Muscular System	1007
Musculoskeletal Changes Associated With Aging	1007
Health Promotion and Maintenance	1007
Assessment: Noticing and Interpreting	1008
Patient History	1008
Nutrition History	1008
Family History and Genetic Risk	1008
Current Health Problems	1008
Assessment of the Skeletal System	1009
General Inspection	1009
Posture and Gait.	1009
Mobility and Functional Assessment.	1009
Neurovascular Assessment	1010
Assessment of the Muscular System	1011
Psychosocial Assessment	1011
Diagnostic Assessment	1011
Laboratory Assessment	1011
Imaging Assessment	1011
Radiography.	1011
Nuclear Scans.	1011
Magnetic Resonance Imaging.	1012
Ultrasonography.	1013
Other Diagnostic Assessment	1013
Biopsies.	1013
Electromyography.	1013
Arthroscopy.	1013
Patient Preparation.	1013
Procedure.	1013
Follow-Up Care.	1014
Get Ready for the NCLEX® Examination!	1014
Key Points	1014
Safe and Effective Care Environment	1014
Health Promotion and Maintenance	1014
Psychosocial Integrity	1014
Physiological Integrity	1014
Selected Bibliography	1014
50 Care of Patients With Musculoskeletal Problems	1015
Priority Concepts and Exemplars	1015
Learning Outcomes	1015
Cellular Regulation Concept Exemplar Osteoporosis	1015
Pathophysiology	1015
Etiology and Genetic Risk	1016
Incidence and Prevalence	1017
Health Promotion and Maintenance	1017
Interprofessional Collaborative Care	1018
Assessment: Noticing	1018
Physical Assessment/Signs and Symptoms.	1018
Psychosocial Assessment.	1019
Laboratory Assessment.	1019
Imaging Assessment.	1019
Analysis: Interpreting	1020
Planning and Implementation: Responding	1020
Planning: Expected Outcomes.	1020
Interventions.	1020
Nutrition Therapy.	1020
Lifestyle Changes.	1020
Drug Therapy.	1020
Calcium and Activated Vitamin D (D3).	1020
Bisphosphonates.	1021
Estrogen Agonist/Antagonists.	1021
Other Drugs.	1021
Care Coordination and Transition Management	1022
Home Care Management.	1022
Self-Management Education.	1022
Health Care Resources.	1022
Osteomyelitis	1022
Pathophysiology	1022
Interprofessional Collaborative Care	1023
Assessment: Noticing	1023
Interventions: Responding	1023
Nonsurgical Management.	1024
Surgical Management.	1024
Bone Tumors	1024
Pathophysiology	1024
Benign Bone Tumors	1024
Malignant Bone Tumors	1025
Interprofessional Collaborative Care	1025
Assessment: Noticing	1025
Interventions	1026
Nonsurgical Management.	1026
Drug Therapy.	1026
Radiation Therapy.	1026
Interventional Radiology.	1026
Surgical Management.	1026
Preoperative Care.	1026
Operative Procedures.	1026
Postoperative Care.	1027
Care Coordination and Transition Management	1027
Home Care Management.	1027
Self-Management Education.	1027
Health Care Resources.	1028
Disorders of the Hand	1028
Disorders of the Foot	1028
Common Foot Deformities	1028
Plantar Fasciitis	1029
Other Problems of the Foot	1029
Get Ready for the NCLEX® Examination!	1030
Key Points	1030
Safe and Effective Care Environment	1030
Health Promotion and Maintenance	1030
Psychosocial Integrity	1030
Physiological Integrity	1030
Selected Bibliography	1030
51 Care of Patients With Musculoskeletal Trauma	1031
Priority and Interrelated Concepts	1031
Learning Outcomes	1031
Mobility Concept Exemplar Fractures	1032
Pathophysiology	1032
Classification of Fractures	1032
Stages of Bone Healing	1032
Complications of Fractures	1032
Acute Compartment Syndrome.	1033
Hemorrhage and Hypovolemic Shock.	1034
Fat Embolism Syndrome.	1034
Venous Thromboembolism.	1034
Infection.	1035
Chronic Complications.	1035
Etiology and Genetic Risk	1035
Incidence and Prevalence	1035
Health Promotion and Maintenance	1035
Interprofessional Collaborative Care	1035
Assessment: Noticing	1035
History.	1035
Physical Assessment/Signs and Symptoms.	1036
Psychosocial Assessment.	1036
Laboratory Assessment.	1037
Imaging Assessment.	1037
Analysis: Interpreting	1037
Planning and Implementation: Responding	1037
Managing Acute Pain	1037
Planning: Expected Outcomes.	1037
Interventions.	1037
Emergency Care: Fracture.	1037
Nonsurgical Management.	1038
Closed Reduction and Immobilization.	1038
Splints and Orthopedic Boots/Shoes.	1038
Casts.	1039
Traction.	1040
Drug Therapy.	1041
Physical Therapy.	1041
Management of Chronic Regional Pain Syndrome.	1041
Surgical Management.	1042
Preoperative Care.	1042
Operative Procedures.	1042
Postoperative Care.	1042
Procedures for Nonunion.	1043
Increasing Mobility	1043
Planning: Expected Outcomes.	1043
Interventions.	1043
Promoting Mobility.	1043
Preventing Complications of Immobility.	1044
Preventing and Monitoring for Neurovascular Compromise	1044
Planning: Expected Outcomes.	1044
Interventions.	1044
Preventing Infection	1045
Planning: Expected Outcomes.	1045
Interventions.	1045
Care Coordination and Transition Management	1045
Home Care Management.	1045
Self-Management Education.	1045
Health Care Resources.	1045
Evaluation: Reflecting	1046
Selected Fractures of Specific Sites	1046
Upper-Extremity Fractures	1046
Lower-Extremity Fractures	1047
Fractures of the Hip	1047
Other Fractures of the Lower Extremity	1048
Fractures of the Chest and Pelvis	1049
Compression Fractures of the Spine	1050
Perfusion Concept Exemplar Amputations	1050
Pathophysiology	1050
Types of Amputation	1050
Levels of Amputation	1051
Complications of Amputation	1051
Health Promotion and Maintenance	1052
Interprofessional Collaborative Care	1052
Assessment: Noticing	1052
Physical Assessment/Signs and Symptoms.	1052
Psychosocial Assessment.	1052
Diagnostic Assessment.	1052
Analysis: Interpreting	1052
Planning and Implementation: Responding	1053
Monitoring for Decreased Tissue Perfusion	1053
Unit XII Interprofessional Collaboration for Patients With Problems of the Gastrointestinal System	1061
52 Assessment of the Gastrointestinal System	1061
Priority and Interrelated Concepts	1061
Learning Outcomes	1061
Anatomy and Physiology Review	1061
Structure	1061
Function	1062
Oral Cavity	1062
Esophagus	1062
Stomach	1063
Pancreas	1063
Liver and Gallbladder	1063
Small Intestine	1064
Large Intestine	1064
Gastrointestinal Changes Associated With Aging	1064
Assessment: Noticing and Interpreting	1065
Patient History	1065
Nutrition History	1065
Family History and Genetic Risk	1066
Current Health Problems	1066
Physical Assessment	1066
Inspection	1067
Auscultation	1067
Percussion	1067
Palpation	1067
Psychosocial Assessment	1068
Diagnostic Assessment	1068
Laboratory Assessment	1068
Urine Tests.	1068
Stool Tests.	1068
Imaging Assessment	1070
Other Diagnostic Assessment	1070
Endoscopy.	1070
Esophagogastroduodenoscopy.	1070
Endoscopic Retrograde Cholangiopancreatography.	1071
Small Bowel Capsule Endoscopy.	1071
Colonoscopy.	1072
Patient Preparation.	1072
Procedure.	1072
Follow-Up Care.	1072
Virtual Colonoscopy.	1073
Sigmoidoscopy.	1073
Ultrasonography.	1073
Endoscopic Ultrasonography.	1073
Liver-Spleen Scan.	1073
Get Ready for the NCLEX® Examination!	1074
Key Points	1074
Safe and Effective Care Environment	1074
Health Promotion and Maintenance	1074
Psychosocial Integrity	1074
Physiological Integrity	1074
Selected Bibliography	1074
53 Care of Patients With Oral Cavity Problems	1075
Priority and Interrelated Concepts	1075
Learning Outcomes	1075
Tissue Integrity Concept Exemplar Stomatitis	1076
Pathophysiology	1076
Etiology and Genetic Risk	1076
Incidence/Prevalence	1076
Health Promotion and Maintenance	1076
Interprofessional Collaborative Care	1076
Assessment: Noticing	1076
Analysis: Interpreting	1077
Planning and Implementation: Responding	1077
Preserving Tissue Integrity	1077
Planning: Expected Outcomes.	1077
Interventions.	1077
Minimizing Alterations in Comfort	1078
Planning: Expected Outcomes.	1078
Interventions.	1078
Care Coordination and Transition Management	1078
Home Care Management.	1078
Self-Management Education.	1078
Evaluation: Reflecting	1078
Oral Cavity Disorders	1078
Oral Tumors: Premalignant Lesions	1078
Leukoplakia	1078
Erythroplakia	1079
Oral Cancer	1079
Pathophysiology	1079
Interprofessional Collaborative Care	1079
Assessment: Noticing	1079
Interventions	1080
Nonsurgical Management.	1080
Surgical Management.	1081
Preoperative Care.	1081
Operative Procedures.	1082
Postoperative Care.	1082
Care Coordination and Transition Management	1083
Home Care Management.	1083
Self-Management Education.	1083
Health Care Resources.	1084
Disorders of the Salivary Glands	1084
Acute Sialadenitis	1084
Pathophysiology	1084
Interprofessional Collaborative Care	1084
Post-Irradiation Sialadenitis	1085
Salivary Gland Tumors	1085
Get Ready for the NCLEX® Examination!	1085
Key Points	1085
Safe and Effective Care Environment	1085
Health Promotion and Maintenance	1085
Psychosocial Integrity	1086
Physiological Integrity	1086
Selected Bibliography	1086
54 Care of Patients With Esophageal Problems	1087
Priority and Interrelated Concepts	1087
Learning Outcomes	1087
Nutrition Concept Exemplar Gastroesophageal Reflux Disease (GERD)	1087
Pathophysiology	1087
Health Promotion and Maintenance	1088
Interprofessional Collaborative Care	1088
Assessment: Noticing	1088
Physical Assessment/Signs and Symptoms.	1088
Diagnostic Assessment.	1089
Analysis: Interpreting	1089
Planning and Implementation: Responding	1089
Balancing Nutrition	1089
Planning: Expected Outcomes.	1089
Unit XIV Interprofessional Collaboration for Patients With Problems of the Endocrine System	1234
61 Assessment of the Endocrine System	1234
Priority and Interrelated Concepts	1234
Learning Outcomes	1234
Anatomy and Physiology Review	1235
Hypothalamus and Pituitary Glands	1236
Gonads	1237
Adrenal Glands	1237
Adrenal Cortex	1237
Adrenal Medulla	1238
Thyroid Gland	1238
Parathyroid Glands	1239
Pancreas	1239
Endocrine Changes Associated With Aging	1240
Assessment: Noticing and Interpreting	1240
Patient History	1240
Nutrition History	1240
Family History and Genetic Risk	1240
Current Health Problems	1240
Physical Assessment	1241
Inspection	1241
Palpation	1242
Auscultation	1242
Psychosocial Assessment	1242
Diagnostic Assessment	1242
Laboratory Tests	1242
Assays.	1243
Provocative/Suppression Tests.	1243
Urine Tests.	1243
Genetic Testing.	1243
Tests for Glucose.	1243
Imaging Assessment	1243
Other Diagnostic Assessment	1243
Get Ready for the NCLEX® Examination!	1244
Key Points	1244
Safe and Effective Care Environment	1244
Health Promotion and Maintenance	1244
Psychosocial Integrity	1244
Physiological Integrity	1244
Selected Bibliography	1244
62 Care of Patients With Pituitary and Adrenal Gland Problems	1245
Priority and Interrelated Concepts	1245
Learning Outcomes	1245
Disorders of the ANTERIOR Pituitary Gland	1245
Hypopituitarism	1245
Pathophysiology	1245
Interprofessional Collaborative Care	1246
Assessment: Noticing	1246
Interventions: Responding	1247
Hyperpituitarism	1247
Pathophysiology	1247
Interprofessional Collaborative Care	1248
Assessment: Noticing	1248
Interventions: Responding	1248
Nonsurgical Management.	1248
Surgical Management.	1249
Preoperative Care.	1249
Operative Procedures.	1249
Postoperative Care.	1249
Disorders of the Posterior Pituitary Gland	1250
Diabetes Insipidus	1250
Pathophysiology	1250
Interprofessional Collaborative Care	1250
Assessment: Noticing	1250
Interventions: Responding	1251
Syndrome of Inappropriate Antidiuretic Hormone	1251
Pathophysiology	1251
Interprofessional Collaborative Care	1251
Assessment: Noticing	1251
Interventions: Responding	1252
Disorders of the Adrenal Gland	1253
Adrenal Gland Hypofunction	1253
Pathophysiology	1253
Interprofessional Collaborative Care	1254
Assessment: Noticing	1254
History.	1254
Physical Assessment/Signs and Symptoms.	1254
Psychosocial Assessment.	1254
Diagnostic Assessment.	1254
Imaging Assessment.	1254
Interventions: Responding	1254
Fluid and Electrolyte Balance Concept Exemplar Hypercortisolism (Cushing’s Disease)	1255
Pathophysiology	1255
Etiology	1256
Incidence and Prevalence	1256
Interprofessional Collaborative Care	1256
Assessment: Noticing	1256
History.	1256
Physical Assessment/Signs and Symptoms.	1256
Psychosocial Assessment.	1257
Laboratory Assessment.	1257
Imaging Assessment.	1257
Analysis: Interpreting	1257
Planning and Implementation: Responding	1257
Restoring Fluid Volume Balance	1258
Planning: Expected Outcomes.	1258
Interventions.	1258
Nonsurgical Management.	1258
Surgical Management.	1258
Preoperative Care.	1258
Operative Procedures.	1259
Postoperative Care.	1259
Preventing Injury.	1259
Unit XV Interprofessional Collaboration for Patients With Problems of the Renal/Urinary System	1321
65 Assessment of the Renal/Urinary System	1321
Priority and Interrelated Concepts	1321
Learning Outcomes	1321
Anatomy and Physiology Review	1322
Kidneys	1322
Structure	1322
Gross Anatomy.	1322
Microscopic Anatomy.	1323
Function	1323
Regulatory Functions.	1323
Hormonal Functions.	1326
Ureters	1327
Urinary Bladder	1327
Structure	1327
Function	1327
Urethra	1327
Kidney and Urinary Changes Associated With Aging	1328
Kidney Changes	1328
Urinary Changes	1328
Assessment: Noticing and Interpreting	1329
Patient History	1329
Nutrition History	1329
Medication History	1329
Family History and Genetic Risk	1330
Current Health Problem	1330
Physical Assessment	1330
Assessment of the Kidneys, Ureters, and Bladder	1330
Assessment of the Urethra	1331
Psychosocial Assessment	1331
Diagnostic Assessment	1331
Laboratory Assessment	1331
Blood Tests.	1331
Urine Tests	1332
Urinalysis.	1332
Urine for Culture and Sensitivity.	1335
Composite Urine Collections.	1335
Creatinine Clearance.	1335
Urine Electrolytes.	1336
Urine Osmolarity.	1336
Bedside Sonography/Bladder Scanners.	1336
Imaging Assessment	1337
Kidney, Ureter, and Bladder X-rays.	1337
Computed Tomography.	1337
Magnetic Resonance Imaging.	1338
Kidney Ultrasonography.	1338
Renal Scan.	1339
Renal Arteriography (Angiography).	1339
Cystoscopy and Cystourethroscopy	1339
Patient Preparation.	1339
Procedure.	1339
Unit XVI Interprofessional Collaboration for Patients With Problems of the Reproductive System	1428
69 Assessment of the Reproductive System	1428
Priority and Interrelated Concepts	1428
Learning Outcomes	1428
Anatomy and Physiology Review	1428
Structure and Function of the Female Reproductive System	1428
External Genitalia	1428
Internal Genitalia	1429
Breasts	1429
Structure and Function of the Male Reproductive System	1430
Reproductive Changes Associated With Aging	1431
Health Promotion and Maintenance	1431
Assessment: Noticing and Interpreting	1431
Patient History	1431
Nutrition History	1432
Family History and Genetic Risk	1432
Current Health Problems	1432
Physical Assessment	1433
Assessment of the Female Reproductive System	1433
Assessment of the Male Reproductive System	1433
Psychosocial Assessment	1433
Diagnostic Assessment	1433
Laboratory Assessment	1433
Imaging Assessment	1435
Computed Tomography.	1435
Hysterosalpingography.	1435
Mammography.	1435
Ultrasonography.	1436
Magnetic Resonance Imaging.	1436
Endoscopic Studies	1436
Colposcopy.	1436
Laparoscopy.	1436
Hysteroscopy.	1437
Biopsy Studies	1437
Cervical Biopsy.	1437
Endometrial Biopsy.	1437
Breast Biopsy.	1438
Prostate Biopsy.	1438
Get Ready for the NCLEX® Examination!	1438
Key Points	1438
Health Promotion and Maintenance	1438
Psychosocial Integrity	1438
Physiological Integrity	1439
Selected Bibliography	1439
70 Care of Patients With Breast Disorders	1440
Priority and Interrelated Concepts	1440
Learning Outcomes	1440
Cellular Regulation Concept Exemplar Breast Cancer	1440
Pathophysiology	1440
Noninvasive Breast Cancers	1441
Invasive Breast Cancers	1441
Breast Cancer in Men	1441
Breast Cancer in Young Women	1441
Etiology and Genetic Risk	1442
Incidence and Prevalence	1442
Health Promotion and Maintenance	1443
Mammography	1443
Breast Self-Awareness/Self-Examination	1443
Clinical Breast Examination	1443
Options for High-Risk Women	1443
Interprofessional Collaborative Care	1445
Assessment: Noticing	1445
History.	1445
Physical Assessment/Signs and Symptoms.	1445
Psychosocial Assessment.	1445
Laboratory Assessment.	1445
Imaging Assessment.	1446
Other Diagnostic Assessment.	1446
Analysis: Interpreting	1446
Planning and Implementation: Responding	1446
Decreasing the Risk for Metastasis	1446
Planning: Expected Outcomes.	1446
Interventions.	1446
Nonsurgical Management.	1446
Complementary and Integrative Health.	1446
Surgical Management.	1447
Preoperative Care.	1447
Operative Procedures.	1447
Postoperative Care.	1448
Breast Reconstruction.	1449
Adjuvant Therapy.	1450
Radiation Therapy.	1451
Drug Therapy.	1451
Stem Cell Transplantation.	1452
Developing Coping Strategies	1452
Planning: Expected Outcomes.	1452
Interventions.	1452
Care Coordination and Transition Management	1452
Home Care Management.	1452
Self-Management Education.	1453
Postoperative Mastectomy Teaching.	1453
Psychosocial Preparation.	1454
Health Care Resources.	1454
Evaluation: Reflecting	1454
Benign Breast Disorders	1455
Fibroadenoma	1455
Fibrocystic Breast Condition	1455
Pathophysiology	1455
Interprofessional Collaborative Care	1455
Issues of Large-Breasted Women	1456
Issues of Small-Breasted Women	1456
Get Ready for the NCLEX® Examination!	1457
Key Points	1457
Safe and Effective Care Environment	1457
Health Promotion and Maintenance	1457
Psychosocial Integrity	1457
Physiological Integrity	1457
Selected Bibliography	1457
71 Care of Patients With Gynecologic Problems	1459
Priority and Interrelated Concepts	1459
Learning Outcomes	1459
Sexuality Concept Exemplar Uterine Leiomyoma	1459
Pathophysiology	1459
Etiology and Genetic Risk	1460
Incidence and Prevalence	1460
Interprofessional Collaborative Care	1460
Assessment: Noticing	1460
Physical Assessment/Signs and Symptoms.	1460
Psychosocial Assessment.	1460
Diagnostic Assessment.	1460
Analysis: Interpreting	1460
Planning and Implementation: Responding	1461
Managing Bleeding	1461
Planning: Expected Outcomes.	1461
Interventions.	1461
Nonsurgical Management.	1461
Surgical Management.	1461
Uterus-Sparing Surgeries.	1461
Hysterectomy.	1461
Preoperative Care.	1461
Operative Procedures.	1462
Postoperative Care.	1462
Care Coordination and Transition Management	1463
Home Care Management.	1463
Self-Management Education.	1463
Health Care Resources.	1463
Evaluation: Reflecting	1463
Pelvic Organ Prolapse	1464
Pathophysiology	1464
Interprofessional Collaborative Care	1464
Assessment: Noticing	1464
Interventions: Responding	1464
Nonsurgical Management.	1464
Surgical Management.	1464
Endometrial (Uterine) Cancer	1465
Pathophysiology	1465
Interprofessional Collaborative Care	1466
Assessment: Noticing	1466
Interventions: Responding	1466
Surgical Management.	1466
Nonsurgical Management.	1466
Radiation Therapy.	1466
Drug Therapy.	1467
Complementary and Integrative Health.	1467
Care Coordination and Transition Management	1467
Ovarian Cancer	1467
Pathophysiology	1467
Interprofessional Collaborative Care	1468
Assessment: Noticing	1468
Interventions: Responding	1468
Care Coordination and Transition Management	1468
Cervical Cancer	1469
Pathophysiology	1469
Health Promotion and Maintenance	1469
Interprofessional Collaborative Care	1469
Assessment: Noticing	1469
Physical Assessment/Signs and Symptoms.	1469
Diagnostic Assessment.	1469
Interventions: Responding	1470
Surgical Management.	1470
Nonsurgical Management.	1470
Vulvovaginitis	1470
Pathophysiology	1470
Interprofessional Collaborative Care	1471
Toxic Shock Syndrome	1471
Get Ready for the NCLEX® Examination!	1471
Key Points	1471
Safe and Effective Care Environment	1471
Health Promotion and Maintenance	1471
Psychosocial Integrity	1472
Physiological Integrity	1472
Selected Bibliography	1472
72 Care of Patients With Male Reproductive Problems	1473
Priority and Interrelated Concepts	1473
Learning Outcomes	1473
Elimination Concept Exemplar Benign Prostatic Hyperplasia	1474
Pathophysiology	1474
Etiology and Genetic Risk	1474
Incidence and Prevalence	1474
Interprofessional Collaborative Care	1474
Assessment: Noticing	1474
History.	1474
Physical Assessment/Signs and Symptoms.	1474
Psychosocial Assessment.	1476
Laboratory Assessment.	1476
Other Diagnostic Assessment.	1477
Analysis: Interpreting	1477
Planning and Implementation: Responding	1477
Improving Urinary Elimination	1477
Planning: Expected Outcomes.	1477
Interventions.	1477
Nonsurgical Management.	1477
Drug Therapy.	1477
Complementary and Integrative Health.	1477
Other Nonsurgical Interventions.	1477
Surgical Management.	1479
Preoperative Care.	1479
Operative Procedures.	1479
Postoperative Care.	1479
Improving Self-Esteem	1480
Planning: Expected Outcomes.	1480
Interventions.	1481
Care Coordination and Transition Management	1481
Home Care Preparation.	1481
Self-Management Education.	1481
Health Care Resources.	1481
Evaluation: Reflecting	1481
Cellular Regulation Concept Exemplar Prostate Cancer	1481
Pathophysiology	1481
Etiology	1482
Incidence and Prevalence	1482
Health Promotion and Maintenance	1482
Interprofessional Collaborative Care	1482
Assessment: Noticing	1482
History.	1482
Physical Assessment/Signs and Symptoms.	1482
Psychosocial Assessment.	1483
Laboratory Assessment.	1483
Other Diagnostic Assessment.	1483
Analysis: Interpreting	1483
Planning and Implementation: Responding	1483
Preventing Metastasis	1483
Planning: Expected Outcomes.	1483
Interventions.	1483
Active Surveillance.	1483
Surgical Management.	1484
Preoperative Care.	1484
Operative Procedures.	1484
Postoperative Care.	1484
Nonsurgical Management.	1485
Radiation Therapy.	1485
Drug Therapy.	1485
Care Coordination and Transition Management	1485
Home Care Management.	1485
Self-Management Education.	1486
Health Care Resources.	1486
Evaluation: Reflecting	1486
Testicular Cancer	1486
Pathophysiology	1486
Interprofessional Collaborative Care	1487
Assessment: Noticing	1487
Physical Assessment/Signs and Symptoms.	1487
Psychosocial Assessment.	1487
Laboratory Assessment.	1487
Other Diagnostic Assessment.	1487
Interventions: Responding.	1487
Surgical Management.	1488
Preoperative Care.	1488
Operative Procedures.	1488
Postoperative Care.	1488
Nonsurgical Management.	1488
Care Coordination and Transition Management	1489
Erectile Dysfunction	1489
Pathophysiology	1489
Interprofessional Collaborative Care	1489
Get Ready for the NCLEX® Examination!	1490
Key Points	1490
Safe and Effective Care Environment	1490
Health Promotion and Maintenance	1490
Psychosocial Integrity	1490
Physiological Integrity	1490
Selected Bibliography	1491
73 Care of Transgender Patients	1492
Priority and Interrelated Concepts	1492
Learning Outcomes	1492
Safe and Effective Care Environment	1492
Health Promotion and Maintenance	1492
Psychosocial Integrity	1492
Physiological Integrity	1492
Patient-Centered Terminology	1493
Transgender Health Issues	1494
Stress and Transgender Health	1494
The Need to Improve Transgender Health Care	1494
Interprofessional Collaborative Care	1495
Assessment: Noticing	1495
History.	1496
Physical Assessment.	1497
Psychosocial Assessment.	1497
Interventions: Responding	1497
Nonsurgical Management.	1497
Drug Therapy.	1497
Drugs for MtF Patients.	1497
Drugs for FtM Patients.	1498
Reproductive Health Options.	1499
Voice and Communication Therapy.	1499
Surgical Management.	1499
Feminizing Surgeries for MtF Patients.	1499
Preoperative Care.	1500
Operative Procedures.	1500
Postoperative Care.	1500
Masculinizing Surgeries for FtM Patients.	1500
Care Coordination and Transition Management	1501
Get Ready for the NCLEX® Examination!	1502
Key Points	1502
Safe and Effective Care Environment	1502
Health Promotion and Maintenance	1502
Psychosocial Integrity	1502
Physiological Integrity	1502
Selected Bibliography	1502
74 Care of Patients With Sexually Transmitted Infections	1504
Priority and Interrelated Concepts	1504
Learning Outcomes	1504
Safe and Effective Care Environment	1504
Health Promotion and Maintenance	1504
Psychosocial Integrity	1504
Physiological Integrity	1504
Overview	1504
Health Promotion and Maintenance	1505
Genital Herpes	1506
Pathophysiology	1506
Interprofessional Collaborative Care	1506
Assessment: Noticing	1506
Interventions: Responding	1507
Drug Therapy.	1507
Self-Management Education.	1507
Syphilis	1508
Pathophysiology	1508
Interprofessional Collaborative Care	1509
Assessment: Noticing	1509
Interventions: Responding	1509
Condylomata Acuminata (Genital Warts)	1510
Pathophysiology	1510
Interprofessional Collaborative Care	1510
Assessment: Noticing	1510
Interventions: Responding	1511
Drug Therapy.	1511
Self-Management Education.	1511
Chlamydia Infection	1511
Pathophysiology	1511
Interprofessional Collaborative Care	1511
Assessment: Noticing	1511
Interventions: Responding	1512
Gonorrhea	1512
Pathophysiology	1512
Interprofessional Collaborative Care	1512
Assessment: Noticing	1512
Interventions: Responding	1513
Drug Therapy.	1513
Self-Management Education.	1514
Sexuality Concept Exemplar Pelvic Inflammatory Disease	1514
Pathophysiology	1514
Interprofessional Collaborative Care	1514
Assessment: Noticing	1514
History.	1514
Physical Assessment/Signs and Symptoms.	1515
Psychosocial Assessment.	1515
Laboratory Assessment.	1515
Other Diagnostic Assessment.	1515
Analysis: Interpreting	1515
Planning and Implementation: Responding	1515
Managing Infection	1515
Planning: Expected Outcomes.	1515
Interventions.	1515
Care Coordination and Transition Management.	1516
Home Care Management.	1516
Self-Management Education.	1516
Health Care Resources.	1517
Evaluation: Reflecting	1517
Get Ready for the NCLEX® Examination!	1517
Key Points	1517
Safe and Effective Care Environment	1517
Health Promotion and Maintenance	1517
Psychosocial Integrity	1517
Physiological Integrity	1517
Selected Bibliography	1518
Glossary	G-1
A	G-1
B	G-4
C	G-5
D	G-9
E	G-11
F	G-13
G	G-14
H	G-15
I	G-17
J	G-19
K	G-19
L	G-19
M	G-20
N	G-22
O	G-23
P	G-24
Q	G-28
R	G-29
S	G-30
T	G-33
U	G-35
V	G-35
W	G-36
X	G-37
Z	G-37
NCLEX® Examination Challenges Answer Key	AK-1
Chapter 3	AK-1
Chapter 4	AK-1
Chapter 5	AK-1
Chapter 6	AK-1
Chapter 7	AK-1
Chapter 8	AK-1
Chapter 9	AK-1
Chapter 10	AK-1
Chapter 11	AK-1
Chapter 12	AK-1
Chapter 13	AK-1
Chapter 14	AK-1
Chapter 15	AK-1
Chapter 16	AK-1
Chapter 17	AK-1
Chapter 18	AK-1
Chapter 19	AK-1
Chapter 20	AK-1
Chapter 21	AK-1
Chapter 22	AK-1
Chapter 23	AK-1
Chapter 24	AK-1
Chapter 25	AK-1
Chapter 26	AK-1
Chapter 27	AK-1
Chapter 28	AK-1
Chapter 29	AK-1
Chapter 30	AK-1
Chapter 31	AK-1
Chapter 32	AK-1
Chapter 33	AK-1
Chapter 34	AK-1
Chapter 35	AK-1
Chapter 36	AK-1
Chapter 37	AK-1
Chapter 38	AK-1
Chapter 39	AK-1
Chapter 40	AK-1
Chapter 41	AK-1
Chapter 42	AK-1
Chapter 43	AK-1
Chapter 44	AK-1
Chapter 45	AK-2
Chapter 46	AK-2
Chapter 47	AK-2
Chapter 48	AK-2
Chapter 49	AK-2
Chapter 50	AK-2
Chapter 51	AK-2
Chapter 52	AK-2
Chapter 53	AK-2
Chapter 54	AK-2
Chapter 55	AK-2
Chapter 56	AK-2
Chapter 57	AK-2
Chapter 58	AK-2
Chapter 59	AK-2
Chapter 60	AK-2
Chapter 61	AK-2
Chapter 62	AK-2
Chapter 63	AK-2
Chapter 64	AK-2
Chapter 65	AK-2
Chapter 66	AK-2
Chapter 67	AK-2
Chapter 68	AK-2
Chapter 69	AK-2
Chapter 70	AK-2
Chapter 71	AK-2
Chapter 72	AK-2
Chapter 73	AK-2
Chapter 74	AK-2
Index	I-1
A	I-1
B	I-6
C	I-10
D	I-18
E	I-21
F	I-24
G	I-26
H	I-28
I	I-33
J	I-36
K	I-36
L	I-37
M	I-38
N	I-42
O	I-44
P	I-47
Q	I-54
R	I-54
S	I-56
T	I-61
U	I-65
V	I-66
W	I-68
X	I-68
Y	I-68
Z	I-68
Endsheet 3	IBC1

Medical-Surgical Nursing - E-Book

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