BOOK
Essentials for Nursing Practice - E-Book
Patricia A. Potter | Anne Griffin Perry | Patricia Stockert | Amy Hall
(2018)
Additional Information
Book Details
Abstract
Get a solid foundation in essential nursing principles, concepts, and skills! Essentials for Nursing Practice, 9th Edition combines everything you need from your fundamentals course and streamlines it into a format that’s perfect for busy nursing students. The ninth edition retains many classic features, including chapter case studies, procedural guidelines, and special considerations for various age groups, along with new content including a chapter on Complementary and Alternative Therapies, interactive clinical case studies on Evolve, a new Reflective Learning section, and QSEN activities to encourage active learning. Thoroughly reviewed by nursing clinical experts and educators, this new edition ensures you learn nursing Essentials with the most accurate, up-to-date, and easy-to-understand book on the market.
- Progressive case studies are introduced at the beginning of the chapter and are then used to tie together the care plan, concept map, and clinical decision-making exercises.
- Focused Patient Assessment tables include actual questions to help you learn how to effectively phrase questions to patients as well as target physical assessment techniques.
- Nursing skills at the end of each chapter feature full-bleed coloring on the edge of the page to make them easy to locate.
- Safety guidelines for nursing skills sections precede each skills section to help you focus on safe and effective skills performance.
- Detailed care plans in the text and on Evolve demonstrate the application of the 5-step nursing process to individual patient problems to help you understand how a plan is developed and how to evaluate care.
- Unexpected outcomes and related interventions for skills alert you to possible problems and appropriate nursing action.
- Patient Teaching boxes help you plan effective teaching by first identifying an outcome, then developing strategies on how to teach, and finally, implementing measures to evaluate learning.
- Care of the Older Adult boxes highlight key aspects of nursing assessment and care for this growing population.
- Key points neatly summarize the most important content for each chapter to help you review and evaluate learning.
- Evidence-Based Practice boxes include a PICO question, summary of the results of a research study, and a F description of how the study has affected nursing practice — in every chapter.
- Patient-Centered Care boxes address racial and ethnic diversity along with the cultural differences that impact socioeconomic status, values, geography, and religion.
- 65 Skills and procedural guidelines provide clear, step-by-step instructions for providing safe nursing care.
- 5-step nursing process provides a consistent framework for clinical chapters.
- Concept maps visually demonstrate planning care for patients with multiple diagnoses.
- NOC outcomes, NIC interventions, and NANDA diagnoses are incorporated in care plans to reflect the standard used by institutions nationwide.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Brief contents | i | ||
| Essentials for Nursing Practice | iii | ||
| Copyright Page | iv | ||
| Contributors | v | ||
| Dedication | ix | ||
| Preface to the Instructor | x | ||
| Features | x | ||
| New to This Edition | x | ||
| Learning Supplements for Students | xi | ||
| Teaching Supplements for Instructors | xi | ||
| Multimedia Supplements for Instructors and Students | xi | ||
| Acknowledgments | xii | ||
| Table Of Contents | xiii | ||
| Unit 1 Concepts in Nursing | 1 | ||
| 1 Professional Nursing | 1 | ||
| Objectives | 1 | ||
| Key Terms | 1 | ||
| Media Resources | 1 | ||
| Case Study: Lucas | 2 | ||
| Introduction | 1 | ||
| History of Nursing | 2 | ||
| Florence Nightingale | 2 | ||
| The Civil War to the Beginning of the Twentieth Century | 3 | ||
| Twentieth Century | 3 | ||
| Twenty-First Century | 3 | ||
| Influences on Nursing | 3 | ||
| Health Care Reform and Costs | 3 | ||
| Demographic Changes | 4 | ||
| Medically Underserved Population | 4 | ||
| Need for Emergency Preparedness | 4 | ||
| Workplace Issues | 4 | ||
| Nursing Shortage | 4 | ||
| Professionalism | 5 | ||
| Licensed Practical Nurse/Licensed Vocational Nurse Education | 5 | ||
| Registered Nurse Education | 5 | ||
| Advanced Education | 5 | ||
| Continuing and In-Service Education | 5 | ||
| Theory | 6 | ||
| Service | 6 | ||
| Autonomy and Accountability | 6 | ||
| Code of Ethics | 6 | ||
| Developing Professionalism in Your Career | 6 | ||
| Nursing Practice | 7 | ||
| Nurse Practice Acts | 7 | ||
| Licensure and Certification | 7 | ||
| Licensure. | 7 | ||
| Certification. | 7 | ||
| Standards of Nursing Practice | 7 | ||
| Responsibilities and Roles of the Nurse | 8 | ||
| Caregiver | 8 | ||
| Advocate | 8 | ||
| Educator | 8 | ||
| Communicator | 8 | ||
| Leader | 9 | ||
| Manager | 9 | ||
| Career Development | 9 | ||
| Advanced Practice Registered Nurse. | 9 | ||
| Clinical Nurse Specialist. | 9 | ||
| Nurse Practitioner. | 9 | ||
| Certified Nurse-Midwife. | 9 | ||
| Certified Registered Nurse Anesthetist. | 9 | ||
| Nurse Educator. | 9 | ||
| Nurse Administrator. | 10 | ||
| Nurse Researcher. | 10 | ||
| Professional Nursing Organizations | 10 | ||
| Trends in Nursing | 10 | ||
| Quality and Safety Education for Nurses | 10 | ||
| Emerging Technologies | 11 | ||
| Genomics | 11 | ||
| Public Perception of Nursing | 12 | ||
| Effect of Nursing on Politics and Health Policy | 12 | ||
| Key Points | 12 | ||
| Reflective Learning | 12 | ||
| Review Questions | 12 | ||
| References | 13 | ||
| 2 Health and Wellness | 15 | ||
| Objectives | 15 | ||
| Key Terms | 15 | ||
| Media Resources | 15 | ||
| Case Study: Charlie | 16 | ||
| Introduction | 15 | ||
| Definition of Health | 15 | ||
| Models of Health and Illness | 16 | ||
| Health Belief Model | 16 | ||
| Health Promotion Model | 16 | ||
| Basic Human Needs Model | 17 | ||
| Holistic Health Model | 19 | ||
| Healthy People Documents | 19 | ||
| Variables Influencing Health Beliefs and Health Practices | 19 | ||
| Internal Variables | 19 | ||
| Developmental Stage. | 19 | ||
| Intellectual Background. | 19 | ||
| Emotional Factors. | 19 | ||
| Spiritual Factors. | 19 | ||
| External Variables | 20 | ||
| Family Role and Practices. | 20 | ||
| Socioeconomic Factors. | 20 | ||
| Health Promotion, Wellness, and Illness Prevention | 20 | ||
| Three Levels of Prevention | 20 | ||
| Risk Factors | 21 | ||
| Nonmodifiable Risk Factors. | 21 | ||
| Modifiable Risk Factors. | 22 | ||
| Environment. | 22 | ||
| Risk Factor Identification. | 23 | ||
| Changing Health Behaviors. | 23 | ||
| Illness | 24 | ||
| Acute and Chronic Illness | 24 | ||
| Self-Management | 24 | ||
| Variables Influencing Illness Behavior | 24 | ||
| Internal Variables. | 24 | ||
| External Variables. | 25 | ||
| Impact of Illness on Patient and Family | 25 | ||
| Behavioral and Emotional Changes | 25 | ||
| Impact on Body Image | 25 | ||
| Impact on Self-Concept | 25 | ||
| Impact on Family Roles and Family Dynamics | 25 | ||
| The Nurse’s Role in Health and Illness | 26 | ||
| Key Points | 26 | ||
| Reflective Learning | 27 | ||
| Review Questions | 27 | ||
| References | 27 | ||
| 3 The Health Care Delivery System | 29 | ||
| Objectives | 29 | ||
| Key Terms | 29 | ||
| Media Resources | 29 | ||
| Case Study: Dorinda Cardei | 30 | ||
| Traditional Levels of Health Care | 30 | ||
| Integrated Health Care Delivery | 31 | ||
| Preventive and Primary Health Care Services | 31 | ||
| Secondary and Tertiary Care | 33 | ||
| Hospitals. | 33 | ||
| Discharge Planning. | 34 | ||
| Intensive Care. | 35 | ||
| Mental Health Facilities. | 35 | ||
| Rural Hospitals. | 36 | ||
| Restorative Care | 36 | ||
| Home Care. | 36 | ||
| Rehabilitation. | 37 | ||
| Continuing Care | 37 | ||
| Nursing Centers. | 37 | ||
| Assisted Living. | 38 | ||
| Respite Care. | 39 | ||
| Adult Day Care Centers. | 39 | ||
| Hospice. | 39 | ||
| Health Care Costs and Quality | 40 | ||
| Patient Satisfaction | 41 | ||
| Issues in Health Care Delivery for Nursing | 42 | ||
| Nursing Shortage | 42 | ||
| Patient-Centered Care | 42 | ||
| Magnet Recognition Program | 43 | ||
| Technology in Health Care | 43 | ||
| Health Care Disparities | 44 | ||
| Key Points | 45 | ||
| Reflective Learning | 45 | ||
| Review Questions | 45 | ||
| References | 46 | ||
| 4 Community-Based Nursing Practice | 48 | ||
| Objectives | 48 | ||
| Key Terms | 48 | ||
| Media Resources | 48 | ||
| Case Study: Homeless in the Community | 48 | ||
| Introduction | 49 | ||
| Achieving Healthy Populations and Communities | 49 | ||
| Public Health Nursing | 50 | ||
| Community Health Nursing | 50 | ||
| Nursing Practice in Community Health | 50 | ||
| Community-Based Nursing | 51 | ||
| Vulnerable Populations | 51 | ||
| Immigrant Populations. | 51 | ||
| Poor and Homeless People. | 52 | ||
| People With Mental Illness. | 53 | ||
| Older Adults. | 53 | ||
| Competency in Community- Based Nursing | 53 | ||
| Caregiver | 55 | ||
| Case Manager | 55 | ||
| Educator | 55 | ||
| Epidemiologist | 55 | ||
| Community Assessment | 55 | ||
| Changing Patients’ Health | 56 | ||
| Key Points | 56 | ||
| Reflective Learning | 56 | ||
| Review Questions | 57 | ||
| References | 57 | ||
| 5 Legal Principles in Nursing | 59 | ||
| Objectives | 59 | ||
| Key Terms | 59 | ||
| Media Resources | 59 | ||
| Case Study: Lynette Donovan | 60 | ||
| Introduction | 59 | ||
| Legal Limits of Nursing | 60 | ||
| Sources of Law | 60 | ||
| Criminal Law | 61 | ||
| Torts | 61 | ||
| Standards of Care | 62 | ||
| Malpractice Insurance | 62 | ||
| Documentation | 63 | ||
| Risk Management and Quality Improvement | 64 | ||
| Good Samaritan Laws | 64 | ||
| Consent | 65 | ||
| Restraints | 66 | ||
| Death and Dying | 66 | ||
| Advance Directives | 66 | ||
| Organ and Tissue Donation | 67 | ||
| Autopsies | 67 | ||
| Confidentiality and Privacy | 67 | ||
| Confidentiality and Social Media | 68 | ||
| Other Legal Issues in Nursing Practice | 68 | ||
| Health Care Provider Orders | 68 | ||
| Nursing Students | 69 | ||
| Patient Abandonment and Assignment Issues | 69 | ||
| Controlled Substances | 69 | ||
| Reporting Obligations | 69 | ||
| Key Points | 70 | ||
| Reflective Learning | 70 | ||
| Review Questions | 71 | ||
| References | 71 | ||
| Statutes | 72 | ||
| Cases | 72 | ||
| 6 Ethics | 73 | ||
| Objectives | 73 | ||
| Key Terms | 73 | ||
| Media Resources | 73 | ||
| Case Study | 74 | ||
| Ethics | 73 | ||
| Basic Definitions | 73 | ||
| Ethical Principles | 74 | ||
| Codes of Ethics | 75 | ||
| Developing a Personal Point of View | 77 | ||
| Ethical Theory | 77 | ||
| Deontology | 77 | ||
| Utilitarianism | 77 | ||
| Virtue Ethics | 77 | ||
| Feminist Ethics | 77 | ||
| Ethics of Care | 78 | ||
| Casuistry | 78 | ||
| How to Process an Ethical Dilemma | 78 | ||
| Ethical Issues in Nursing | 79 | ||
| Care at the End of Life | 79 | ||
| Disability and Difference | 80 | ||
| Social Media | 80 | ||
| Conclusion | 80 | ||
| Key Points | 81 | ||
| Reflective Learning | 81 | ||
| Review Questions | 81 | ||
| References | 82 | ||
| 7 Evidence-Based Practice | 83 | ||
| Objectives | 83 | ||
| Key Terms | 83 | ||
| Evolve Media Resources | 83 | ||
| Case Study: Cathy and Tom | 84 | ||
| Introduction | 83 | ||
| A Case for Evidence-Based Practice | 84 | ||
| Evidence-Based Practice Steps | 85 | ||
| Cultivate a Spirit of Inquiry | 85 | ||
| Ask the Clinical Question in PICOT Format | 85 | ||
| Search for the Best Evidence | 86 | ||
| Critically Appraise the Evidence | 88 | ||
| Integrate the Best Evidence | 91 | ||
| Evaluate the Outcomes of the Practice Decision or Change | 91 | ||
| Outcomes Measurement | 92 | ||
| Process Measurement | 93 | ||
| Communicate the Outcomes of the Evidence-Based Practice Decision | 93 | ||
| Sustain Knowledge Use | 93 | ||
| Nursing Research | 93 | ||
| Quality Improvement and Performance Improvement | 95 | ||
| Quality Improvement/Performance Improvement Programs | 95 | ||
| Relationship Between Evidence-Based Practice, Research, and Quality Improvement | 96 | ||
| Key Points | 97 | ||
| Reflective Learning | 97 | ||
| Review Questions | 98 | ||
| References | 99 | ||
| Unit 2 Processes in Nursing Care | 100 | ||
| 8 Critical Thinking | 100 | ||
| Objectives | 100 | ||
| Key Terms | 100 | ||
| Media Resources | 100 | ||
| Case Study: William Myers | 101 | ||
| Introduction | 100 | ||
| Clinical Judgment in Nursing Practice | 101 | ||
| Critical Thinking Defined | 101 | ||
| Reflection | 102 | ||
| Knowing the Patient | 102 | ||
| Levels of Critical Thinking in Nursing | 103 | ||
| Basic Critical Thinking | 103 | ||
| Complex Critical Thinking | 104 | ||
| Commitment | 104 | ||
| Critical Thinking Competencies | 105 | ||
| General Critical Thinking Competencies | 105 | ||
| Scientific Method. | 105 | ||
| Problem Solving. | 105 | ||
| Decision Making. | 106 | ||
| Specific Critical Thinking Competencies | 106 | ||
| Diagnostic Reasoning and Inference. | 106 | ||
| Clinical Decision Making. | 107 | ||
| The Nursing Process as a Competency | 108 | ||
| Critical Thinking Model | 108 | ||
| Competence | 108 | ||
| Specific Knowledge Base | 108 | ||
| Experience | 110 | ||
| Attitudes for Critical Thinking | 110 | ||
| Confidence. | 110 | ||
| Thinking Independently. | 110 | ||
| Fairness. | 111 | ||
| Responsibility and Accountability. | 111 | ||
| Risk Taking. | 111 | ||
| Discipline. | 112 | ||
| Perseverance. | 112 | ||
| Creativity. | 112 | ||
| Curiosity. | 112 | ||
| Integrity. | 112 | ||
| Humility. | 112 | ||
| Standards for Critical Thinking | 112 | ||
| Intellectual Standards. | 112 | ||
| Professional Standards. | 113 | ||
| Developing Critical Thinking Skills | 113 | ||
| Critical Thinking Synthesis | 114 | ||
| Key Points | 114 | ||
| Reflective Learning | 115 | ||
| Review Questions | 115 | ||
| References | 116 | ||
| 9 Nursing Process | 117 | ||
| Objectives | 117 | ||
| Key Terms | 117 | ||
| Media Resources | 117 | ||
| Case Study: Mrs. Tillman | 118 | ||
| Introduction | 118 | ||
| Assessment | 119 | ||
| Data Collection | 119 | ||
| Types of Data. | 121 | ||
| Sources of Data. | 121 | ||
| Patient. | 121 | ||
| Family and Significant Others. | 121 | ||
| Health Care Team. | 122 | ||
| Medical Records. | 122 | ||
| Other Records and the Scientific Literature. | 122 | ||
| Nurse’s Experience. | 122 | ||
| Methods of Data Collection. | 122 | ||
| Patient-Centered Interview. | 122 | ||
| Orientation Phase Including Setting an Agenda. | 123 | ||
| Working Phase—Collecting Assessment or Nursing Health History. | 123 | ||
| Termination Phase—Ending the Interview. | 123 | ||
| Interview Techniques. | 124 | ||
| Observation. | 124 | ||
| Physical Examination. | 124 | ||
| Diagnostic and Laboratory Data. | 125 | ||
| Cultural Considerations in Assessment | 125 | ||
| Interpreting and Validating Assessment Data | 125 | ||
| Data Documentation and Communication | 126 | ||
| Nursing Diagnosis | 126 | ||
| Critical Thinking and the Nursing Diagnostic Process | 126 | ||
| Formulating the Nursing Diagnosis | 127 | ||
| Types of Nursing Diagnoses. | 130 | ||
| Components of a Nursing Diagnosis. | 130 | ||
| Diagnostic Label. | 130 | ||
| Related Factor. | 131 | ||
| Definition. | 131 | ||
| PES Format. | 131 | ||
| Cultural Relevance of Nursing Diagnoses. | 132 | ||
| Concept Mapping Nursing Diagnoses. | 132 | ||
| Sources of Diagnostic Errors. | 133 | ||
| Errors in Data Collection. | 133 | ||
| Errors in Interpretation and Analysis of Data. | 133 | ||
| Errors in Data Clustering. | 134 | ||
| Errors in the Diagnostic Statement. | 134 | ||
| Documentation and Informatics | 135 | ||
| Planning | 135 | ||
| Establishing Priorities | 135 | ||
| Critical Thinking in Setting Goals and Expected Outcomes | 136 | ||
| Goals of Care. | 136 | ||
| Role of the Patient in Goal Setting. | 136 | ||
| Expected Outcomes. | 136 | ||
| Nursing Outcomes Classification. | 137 | ||
| Guidelines for Writing Goals and Expected Outcomes. | 137 | ||
| Critical Thinking in Planning Nursing Care | 138 | ||
| Types of Interventions. | 138 | ||
| Selection of Interventions. | 139 | ||
| Nursing Interventions Classification. | 139 | ||
| Systems for Planning Nursing Care | 139 | ||
| Hand-Off Reporting. | 141 | ||
| Student Care Plans. | 141 | ||
| Concept Mapping. | 141 | ||
| Consulting Other Health Care Professionals | 145 | ||
| When to Consult. | 145 | ||
| How to Consult. | 145 | ||
| Implementation | 146 | ||
| Standard Nursing Interventions | 146 | ||
| Clinical Practice Guidelines and Protocols. | 146 | ||
| Nursing Intervention Classification Interventions. | 147 | ||
| Critical Thinking in Implementation | 147 | ||
| Implementation Process | 147 | ||
| Reassessing the Patient. | 147 | ||
| Reviewing and Revising the Care Plan. | 147 | ||
| Organizing Resources and Delivering Care. | 147 | ||
| Time Management. | 147 | ||
| Equipment. | 148 | ||
| Personnel. | 148 | ||
| Environment. | 148 | ||
| Patient. | 148 | ||
| Anticipating and Preventing Complications. | 148 | ||
| Identifying Areas of Assistance. | 148 | ||
| Implementation Skills. | 149 | ||
| Cognitive Skills. | 149 | ||
| Interpersonal Skills. | 149 | ||
| Psychomotor Skills. | 149 | ||
| Direct Care | 149 | ||
| Activities of Daily Living. | 149 | ||
| Instrumental Activities of Daily Living. | 149 | ||
| Physical Care Techniques. | 149 | ||
| Lifesaving Measures. | 150 | ||
| Counseling. | 150 | ||
| Teaching. | 150 | ||
| Controlling for Adverse Reactions. | 150 | ||
| Preventive Measures. | 150 | ||
| Indirect Care | 150 | ||
| Communicating Nursing Interventions. | 150 | ||
| Delegating, Supervising, and Evaluating Work of Other Staff Members. | 151 | ||
| Evaluation | 151 | ||
| Critical Thinking and Evaluation | 151 | ||
| Evaluation Process | 152 | ||
| Comparing Achieved Effect With Goals and Outcomes. | 152 | ||
| Collecting Data. | 152 | ||
| Interpreting and Summarizing Findings. | 152 | ||
| Recognizing Errors or Unmet Outcomes. | 152 | ||
| Revising the Care Plan. | 153 | ||
| Discontinuing a Care Plan. | 153 | ||
| Modifying a Care Plan. | 153 | ||
| Key Points | 154 | ||
| Reflective Learning | 154 | ||
| Review Questions | 155 | ||
| References | 155 | ||
| 10 Informatics and Documentation | 157 | ||
| Objectives | 157 | ||
| Key Terms | 157 | ||
| Media Resources | 157 | ||
| Case Study: Mr. Roland | 158 | ||
| Health Care Informatics | 158 | ||
| Health Care Information System | 158 | ||
| Clinical Information System | 159 | ||
| Nursing Information Systems | 159 | ||
| Clinical Decision Support Systems | 160 | ||
| Confidentiality of Medical Record and Patient Information | 160 | ||
| Security Mechanisms for Privacy and Confidentiality | 161 | ||
| Handling and Disposal of Health Care Information | 162 | ||
| Interprofessional Communication Within the Health Care Team | 162 | ||
| Purposes of Records | 163 | ||
| Communication | 163 | ||
| Legal Record of Patient Care | 163 | ||
| Health Care Reimbursement | 163 | ||
| Quality Improvement | 165 | ||
| Research | 165 | ||
| Nursing Education | 165 | ||
| Guidelines and Standards for Quality Nursing Documentation | 165 | ||
| Factual | 165 | ||
| Accurate | 166 | ||
| Current | 166 | ||
| Organized | 166 | ||
| Complete | 166 | ||
| Methods of Documentation | 167 | ||
| The Shift to Electronic Documentation | 167 | ||
| Problem-Oriented Medical Record | 168 | ||
| Database. | 168 | ||
| Problem List. | 168 | ||
| Care Plan. | 168 | ||
| Progress Notes. | 168 | ||
| Narrative Documentation | 168 | ||
| Charting by Exception | 169 | ||
| Case Management and Critical Pathways | 169 | ||
| Common Record-Keeping Forms | 169 | ||
| Nursing Admission History | 169 | ||
| Flow Sheets and Graphic Records | 170 | ||
| Patient Care Summary | 171 | ||
| Standardized Care Plans | 171 | ||
| Discharge Summary Forms | 171 | ||
| Acuity Rating Systems | 171 | ||
| Documentation in Home Care Settings | 172 | ||
| Documentation in Long-Term Care Settings | 172 | ||
| Reporting | 173 | ||
| Hand-Off Report | 173 | ||
| Change-of-Shift Report | 173 | ||
| Transfer Reports | 173 | ||
| Documentation of Telephone Reports, Telephone Orders, and Verbal Orders | 174 | ||
| Telephone Reports. | 174 | ||
| Telephone Orders and Verbal Orders. | 174 | ||
| Incident or Occurrence Reports | 174 | ||
| Key Points | 175 | ||
| Reflective Learning | 175 | ||
| Review Questions | 175 | ||
| References | 176 | ||
| 11 Communication | 178 | ||
| Objectives | 178 | ||
| Key Terms | 178 | ||
| Media Resources | 178 | ||
| Case Study: Elmer “Bud” Johnson | 179 | ||
| Introduction | 178 | ||
| The Power of Communication | 179 | ||
| Basic Elements of the Communication Process | 179 | ||
| Levels of Communication | 180 | ||
| Forms of Communication | 180 | ||
| Verbal Communication | 180 | ||
| Vocabulary. | 180 | ||
| Denotative and Connotative Meaning. | 180 | ||
| Pacing. | 181 | ||
| Intonation and Volume. | 181 | ||
| Clarity and Brevity. | 181 | ||
| Timing and Relevance. | 181 | ||
| Nonverbal Communication | 181 | ||
| Personal Appearance. | 181 | ||
| Posture and Gait. | 181 | ||
| Facial Expression. | 181 | ||
| Eye Contact. | 182 | ||
| Gestures. | 182 | ||
| Territoriality and Space. | 182 | ||
| Factors Influencing Communication | 182 | ||
| Health Literacy | 183 | ||
| The Nurse-Patient Relationship | 183 | ||
| AIDET. | 184 | ||
| Nurse–Health Team Member Relationships | 185 | ||
| Reporting. | 185 | ||
| Teamwork. | 186 | ||
| Effects of Stress. | 187 | ||
| Communication Within Caring Relationships | 187 | ||
| Establishing a Therapeutic Relationship | 187 | ||
| Professionalism. | 187 | ||
| Courtesy. | 188 | ||
| Avoid Terms of Endearment and Excessive Socializing. | 188 | ||
| Confidentiality. | 188 | ||
| Trust. | 188 | ||
| Acceptance and Respect. | 188 | ||
| Presence. | 189 | ||
| Communication Within the Nursing Process | 189 | ||
| Assessment | 189 | ||
| Physical and Emotional Factors. | 190 | ||
| Developmental Factors. | 190 | ||
| Older Adult Considerations. | 190 | ||
| Sociocultural Factors. | 190 | ||
| Language. | 190 | ||
| Gender. | 190 | ||
| Nursing Diagnosis | 191 | ||
| Planning | 191 | ||
| Goals and Outcomes. | 191 | ||
| Setting Priorities. | 191 | ||
| Collaborative Care. | 191 | ||
| Implementation | 191 | ||
| Therapeutic Communication Techniques. | 192 | ||
| Conveying Empathy. | 192 | ||
| Active Listening. | 192 | ||
| Sharing Observations. | 192 | ||
| Using Silence. | 192 | ||
| Providing Information. | 192 | ||
| Clarifying. | 192 | ||
| Focusing. | 192 | ||
| Paraphrasing. | 192 | ||
| Summarizing. | 192 | ||
| Self-Disclosure. | 193 | ||
| Instilling Hope. | 193 | ||
| Nontherapeutic Communication Techniques. | 193 | ||
| Inattentive Listening. | 193 | ||
| Overusing Medical Vocabulary. | 193 | ||
| Prying or Asking Personal Questions. | 193 | ||
| Giving Approval or Disapproval. | 193 | ||
| Changing the Subject. | 193 | ||
| Automatic Responses. | 193 | ||
| False Reassurance. | 193 | ||
| Asking for Explanations. | 193 | ||
| Arguing. | 194 | ||
| Being Defensive. | 194 | ||
| Sympathy. | 194 | ||
| Decision Making and Communication. | 194 | ||
| Assertiveness and Autonomy. | 194 | ||
| Avoiding Passive Responses. | 194 | ||
| Avoiding Aggressive Responses. | 194 | ||
| Humor. | 194 | ||
| Responding to Aggressive Behavior. | 195 | ||
| Touch. | 195 | ||
| Communicating With Patients With Special Needs. | 195 | ||
| Providing Alternative Communication Methods. | 197 | ||
| Communicating With Children. | 197 | ||
| Communicating With Older Adults. | 197 | ||
| Evaluation | 197 | ||
| Patient Outcomes. | 198 | ||
| Patient Expectations. | 198 | ||
| Key Points | 198 | ||
| Reflective Learning | 198 | ||
| Review Questions | 199 | ||
| References | 199 | ||
| 12 Patient Education | 201 | ||
| Objectives | 201 | ||
| Key Terms | 201 | ||
| Media Resources | 201 | ||
| Case Study: Latinka Drusko | 202 | ||
| Standards for Patient Education | 202 | ||
| Purposes of Patient Education | 202 | ||
| Maintenance and Promotion of Health and Illness Prevention | 202 | ||
| Restoration of Health | 202 | ||
| Coping With Impaired Functioning | 202 | ||
| Teaching and Learning | 203 | ||
| Role of a Nurse in Teaching and Learning | 203 | ||
| Domains of Learning | 204 | ||
| Basic Learning Principles | 205 | ||
| Motivation to Learn | 205 | ||
| Readiness to Learn | 205 | ||
| Ability to Learn | 206 | ||
| Developmental Capability | 206 | ||
| Age-Group | 206 | ||
| Physical Capability | 206 | ||
| Learning Environment | 208 | ||
| Integrating Nursing and Teaching Processes | 208 | ||
| Assessment | 208 | ||
| Ability to Learn. | 208 | ||
| Patient Expectations. | 208 | ||
| Motivation to Learn. | 209 | ||
| Teaching Environment. | 209 | ||
| Learning Styles. | 210 | ||
| Resources for Learning. | 210 | ||
| Language and Cultural Factors. | 210 | ||
| Health Literacy. | 211 | ||
| Special Needs of Children. | 211 | ||
| Middle Age Considerations. | 211 | ||
| Older Adult Considerations. | 211 | ||
| Nursing Diagnosis | 212 | ||
| Planning | 212 | ||
| Goals and Outcomes. | 212 | ||
| Setting Priorities. | 213 | ||
| Timing. | 213 | ||
| Organizing Teaching Material. | 213 | ||
| Collaborative Care. | 213 | ||
| Implementation | 213 | ||
| Teaching Approaches. | 213 | ||
| Telling. | 213 | ||
| Participating. | 213 | ||
| Entrusting. | 213 | ||
| Reinforcing. | 213 | ||
| Incorporating Teaching With Nursing Care. | 214 | ||
| Teaching Methods. | 214 | ||
| One-on-One Discussion. | 214 | ||
| Group Instruction. | 214 | ||
| Preparatory Instruction. | 215 | ||
| Demonstrations. | 215 | ||
| Analogies. | 215 | ||
| Role Play. | 215 | ||
| Simulation. | 215 | ||
| Use of Technology. | 215 | ||
| Maintaining Attention and Participation. | 216 | ||
| Illiteracy and Other Disabilities. | 216 | ||
| Cultural Awareness. | 216 | ||
| Evaluation | 217 | ||
| Patient Outcomes. | 217 | ||
| Patient Expectations. | 218 | ||
| Documentation of Patient Teaching | 218 | ||
| Key Points | 218 | ||
| Reflective Learning | 218 | ||
| Review Questions | 219 | ||
| References | 219 | ||
| 13 Managing Patient Care | 221 | ||
| Objectives | 221 | ||
| Key Terms | 221 | ||
| Media Resources | 221 | ||
| Case Study: Jennifer | 221 | ||
| Introduction | 222 | ||
| Building a Nursing Team | 222 | ||
| Nursing Care Delivery Models | 223 | ||
| Decision Making | 224 | ||
| Staff Involvement | 225 | ||
| Leadership Skills for Nursing Students | 227 | ||
| Clinical Care Coordination | 227 | ||
| Clinical Decisions. | 227 | ||
| Organizational Skills. | 227 | ||
| Priority Setting. | 227 | ||
| Use of Resources. | 229 | ||
| Time Management. | 229 | ||
| Evaluation. | 229 | ||
| Team Communication | 229 | ||
| Delegation | 230 | ||
| Key Points | 232 | ||
| Reflective Learning | 232 | ||
| Review Questions | 232 | ||
| References | 233 | ||
| Unit 3 Nursing Practice Foundations | 235 | ||
| 14 Infection Prevention and Control | 235 | ||
| Objectives | 235 | ||
| Key Terms | 235 | ||
| Media Resources | 235 | ||
| Case Study: Mrs. Eldredge | 236 | ||
| Introduction | 235 | ||
| Scientific Knowledge Base | 236 | ||
| Nature of Infection | 236 | ||
| Chain of Infection | 236 | ||
| Infectious Agent. | 236 | ||
| Reservoir. | 236 | ||
| Portal of Exit. | 237 | ||
| Modes of Transmission. | 237 | ||
| Portal of Entry. | 237 | ||
| Susceptible Host. | 238 | ||
| Course of Infection | 238 | ||
| Defenses Against Infection | 238 | ||
| Normal Flora. | 238 | ||
| Body System Defenses. | 238 | ||
| Inflammation. | 239 | ||
| Immune Response. | 239 | ||
| Health Care–Acquired Infection | 239 | ||
| Asepsis. | 239 | ||
| Nursing Knowledge Base | 241 | ||
| Critical Thinking | 242 | ||
| Synthesis | 242 | ||
| Knowledge. | 242 | ||
| Experience. | 242 | ||
| Attitudes. | 242 | ||
| Standards. | 242 | ||
| Nursing Process | 242 | ||
| Assessment | 242 | ||
| Nursing History. | 242 | ||
| Medical History. | 242 | ||
| Diet History. | 242 | ||
| Laboratory Data. | 243 | ||
| Psychosocial Factors. | 243 | ||
| Older Adult Considerations. | 243 | ||
| Patient Expectations. | 244 | ||
| Nursing Diagnosis | 244 | ||
| Planning | 245 | ||
| Goals and Outcomes. | 245 | ||
| Setting Priorities. | 245 | ||
| Collaborative Care. | 246 | ||
| Implementation | 246 | ||
| Health Promotion. | 246 | ||
| Nutrition. | 246 | ||
| Hygiene. | 246 | ||
| Immunization. | 246 | ||
| Adequate Rest and Regular Exercise. | 247 | ||
| Acute Care. | 247 | ||
| Medical Asepsis. | 247 | ||
| Control or Elimination of Infectious Agents. | 247 | ||
| Cleaning. | 247 | ||
| Disinfection and Sterilization. | 247 | ||
| Control or Elimination of Reservoirs. | 247 | ||
| Control of Portals of Exit. | 248 | ||
| Control of Transmission. | 248 | ||
| Hand Hygiene. | 249 | ||
| Isolation and Barrier Protection. | 250 | ||
| Protective Environment. | 256 | ||
| Personal Protective Equipment. | 257 | ||
| Specimen Collection. | 258 | ||
| Bagging. | 258 | ||
| Removal of Protective Equipment. | 258 | ||
| Transporting Patients. | 258 | ||
| Control of Portals of Entry. | 259 | ||
| Protection of the Susceptible Host. | 259 | ||
| Role of the Infection Prevention and Control Department. | 259 | ||
| Health Promotion in Health Care Workers and Patients. | 260 | ||
| Surgical Asepsis. | 260 | ||
| Preparation for Sterile Procedures. | 260 | ||
| Principles of Surgical Asepsis. | 260 | ||
| Restorative and Continuing Care. | 263 | ||
| Evaluation | 264 | ||
| Patient Outcomes. | 264 | ||
| Patient Expectations. | 265 | ||
| Key Points | 265 | ||
| Reflective Learning | 265 | ||
| Review Questions | 265 | ||
| References | 266 | ||
| 15 Vital Signs | 268 | ||
| Objectives | 268 | ||
| Key Terms | 268 | ||
| Media Resources | 268 | ||
| Case Study Ms. Coburn | 269 | ||
| Guidelines for Measuring Vital Signs | 269 | ||
| Body Temperature | 270 | ||
| Body Temperature Regulation | 270 | ||
| Neural and Vascular Control. | 270 | ||
| Heat Production. | 270 | ||
| Heat Loss. | 271 | ||
| Skin in Temperature Regulation. | 271 | ||
| Behavioral Control. | 271 | ||
| Considerations for Older Adults. | 271 | ||
| Temperature Alterations | 271 | ||
| Fever. | 271 | ||
| Hyperthermia. | 273 | ||
| Hypothermia. | 273 | ||
| Measurement of Temperature | 274 | ||
| Sites. | 274 | ||
| Thermometers. | 274 | ||
| Electronic Thermometers. | 275 | ||
| Chemical Thermometers. | 276 | ||
| Pulse | 276 | ||
| Locating a Peripheral Pulse | 277 | ||
| Using a Stethoscope | 277 | ||
| Assessment of Pulse | 279 | ||
| Pulse Rate. | 279 | ||
| Pulse Rhythm. | 279 | ||
| Strength and Equality. | 280 | ||
| Blood Pressure | 280 | ||
| Physiology of Arterial Blood Pressure | 280 | ||
| Blood Pressure Variations | 280 | ||
| Hypertension. | 280 | ||
| Hypotension. | 280 | ||
| Measurement of Blood Pressure | 282 | ||
| Blood Pressure Equipment. | 282 | ||
| Auscultation. | 283 | ||
| Ultrasonic Stethoscope. | 284 | ||
| Palpation. | 285 | ||
| Electronic Blood Pressure Machines. | 285 | ||
| Blood Pressure Assessment in Lower Extremities. | 285 | ||
| Assessment of Blood Pressure in Children. | 287 | ||
| Respiration | 288 | ||
| Assessment of Ventilation | 288 | ||
| Measurement of Respiration | 288 | ||
| Respiratory Rate. | 289 | ||
| Ventilatory Depth. | 289 | ||
| Ventilatory Rhythm. | 289 | ||
| Measurement of Oxygen Saturation (Pulse Oximetry) | 289 | ||
| Measurement of End-Tidal Carbon Dioxide | 289 | ||
| Special Considerations | 290 | ||
| Documenting Vital Signs | 291 | ||
| Safety Guidelines for Nursing Skills | 291 | ||
| Skill 15.1 Measuring Body Temperature | 292 | ||
| Delegation Considerations | 292 | ||
| Equipment | 292 | ||
| Step/\tRationale | 292 | ||
| Recording and Reporting | 298 | ||
| Unexpected Outcomes and Related Interventions | 298 | ||
| Skill 15.2 Assessing Radial and Apical Pulses | 299 | ||
| Delegation Considerations | 299 | ||
| Equipment | 299 | ||
| Step/\tRationale | 299 | ||
| Recording and Reporting | 302 | ||
| Unexpected Outcomes and Related Interventions | 302 | ||
| Skill 15.3 Blood Pressure Measurement | 303 | ||
| Delegation Considerations | 303 | ||
| Equipment | 303 | ||
| Step/\tRationale | 303 | ||
| Recording and Reporting | 308 | ||
| Unexpected Outcomes and Related Interventions | 308 | ||
| Skill 15.4 Assessing Respiration | 309 | ||
| Delegation Considerations | 309 | ||
| Equipment | 309 | ||
| Step/\tRationale | 309 | ||
| Recording and Reporting | 312 | ||
| Unexpected Outcomes and Related Interventions | 312 | ||
| Skill 15.5 Measuring Oxygen Saturation (Pulse Oximetry) | 313 | ||
| Delegation Considerations | 313 | ||
| Equipment | 313 | ||
| Step/\tRationale | 313 | ||
| Recording and Reporting | 315 | ||
| Unexpected Outcomes and Related Interventions | 315 | ||
| Key Points | 316 | ||
| Reflective Learning | 316 | ||
| Review Questions | 316 | ||
| References | 317 | ||
| 16 Health Assessment and Physical Examination | 318 | ||
| Objectives | 318 | ||
| Key Terms | 318 | ||
| Media Resources | 318 | ||
| Case Study: Mr. Neal | 319 | ||
| Introduction | 319 | ||
| Purposes of Health Assessment and Physical Examination | 319 | ||
| Cultural Sensitivity | 319 | ||
| Integration of Physical Assessment With Nursing Care | 320 | ||
| Skills of Physical Examination | 320 | ||
| Inspection | 320 | ||
| Palpation | 320 | ||
| Percussion | 321 | ||
| Auscultation | 321 | ||
| Olfaction | 321 | ||
| Preparation for Examination | 321 | ||
| Environment | 321 | ||
| Equipment | 322 | ||
| Physical Preparation of a Patient | 322 | ||
| Positioning. | 323 | ||
| Psychological Preparation of a Patient | 323 | ||
| Assessment of Different Age-Groups | 324 | ||
| Organization of the Examination | 325 | ||
| General Survey | 325 | ||
| General Appearance and Behavior | 325 | ||
| Vital Signs | 327 | ||
| Height and Weight | 327 | ||
| Skin, Hair, and Nails | 328 | ||
| Skin | 328 | ||
| Nursing History. | 328 | ||
| Color. | 328 | ||
| Moisture. | 330 | ||
| Temperature. | 330 | ||
| Texture. | 331 | ||
| Turgor. | 331 | ||
| Vascularity. | 331 | ||
| Edema. | 331 | ||
| Lesions. | 331 | ||
| Hair and Scalp | 331 | ||
| Nursing History. | 332 | ||
| Nails | 333 | ||
| Nursing History. | 333 | ||
| Head and Neck | 333 | ||
| Head | 334 | ||
| Nursing History. | 334 | ||
| Eyes | 335 | ||
| Nursing History. | 335 | ||
| Visual Acuity. | 335 | ||
| Visual Fields. | 335 | ||
| External Eye Structures. | 335 | ||
| Position and Alignment. | 335 | ||
| Eyebrows. | 336 | ||
| Eyelids. | 336 | ||
| Lacrimal Apparatus. | 336 | ||
| Conjunctivae and Sclerae. | 336 | ||
| Corneas. | 336 | ||
| Pupils and Irises. | 336 | ||
| Internal Eye Structures. | 337 | ||
| Ears | 337 | ||
| Nursing History. | 337 | ||
| Auricles. | 337 | ||
| Ear Canals and Eardrums. | 337 | ||
| Hearing Acuity. | 338 | ||
| Nose and Sinuses | 339 | ||
| Nursing History. | 339 | ||
| Nose. | 339 | ||
| Sinuses. | 340 | ||
| Mouth and Pharynx | 340 | ||
| Nursing History. | 340 | ||
| Lips. | 340 | ||
| Buccal Mucosa, Gums, and Teeth. | 340 | ||
| Tongue and Floor of Mouth. | 341 | ||
| Palate. | 341 | ||
| Pharynx. | 341 | ||
| Neck | 342 | ||
| Nursing History. | 342 | ||
| Neck Muscles. | 342 | ||
| Lymph Nodes. | 342 | ||
| Thyroid Gland. | 343 | ||
| Carotid Artery and Jugular Vein. | 343 | ||
| Trachea. | 343 | ||
| Thorax and Lungs | 343 | ||
| Nursing History | 345 | ||
| Posterior Thorax | 345 | ||
| Lateral Thorax | 347 | ||
| Anterior Thorax | 348 | ||
| Heart | 348 | ||
| Nursing History | 349 | ||
| Inspection and Palpation | 349 | ||
| Auscultation | 350 | ||
| Vascular System | 351 | ||
| Health History | 351 | ||
| Carotid Arteries | 351 | ||
| Jugular Veins | 352 | ||
| Peripheral Arteries and Veins | 352 | ||
| Peripheral Arteries. | 352 | ||
| Ultrasound Stethoscopes. | 353 | ||
| Tissue Perfusion. | 353 | ||
| Peripheral Veins. | 354 | ||
| Lymphatic System | 355 | ||
| Breasts | 355 | ||
| Female Breasts | 355 | ||
| Nursing History. | 357 | ||
| Inspection. | 357 | ||
| Palpation. | 358 | ||
| Male Breasts | 360 | ||
| Abdomen | 360 | ||
| Nursing History | 360 | ||
| Inspection | 361 | ||
| Skin. | 361 | ||
| Umbilicus. | 361 | ||
| Contour and Symmetry. | 361 | ||
| Enlarged Organs or Masses. | 361 | ||
| Movement or Pulsations. | 361 | ||
| Auscultation | 361 | ||
| Bowel Motility. | 361 | ||
| Vascular Sounds. | 362 | ||
| Palpation | 362 | ||
| Aortic Pulsation. | 363 | ||
| Female Genitalia and Reproductive Tract | 363 | ||
| Nursing History | 363 | ||
| Preparation of the Patient | 364 | ||
| External Genitalia | 364 | ||
| Speculum Examination of Internal Genitalia | 365 | ||
| Male Genitalia | 365 | ||
| Nursing History | 365 | ||
| Sexual Maturity | 366 | ||
| Penis | 366 | ||
| Scrotum | 367 | ||
| Inguinal Ring and Canal | 367 | ||
| Rectum and Anus | 368 | ||
| Nursing History | 368 | ||
| Inspection | 368 | ||
| Digital Palpation | 368 | ||
| Musculoskeletal System | 369 | ||
| Nursing History | 369 | ||
| General Inspection | 369 | ||
| Palpation | 370 | ||
| Range of Joint Motion | 371 | ||
| Muscle Tone and Strength | 371 | ||
| Neurological System | 371 | ||
| Nursing History | 372 | ||
| Mental and Emotional Status | 372 | ||
| Level of Consciousness | 373 | ||
| Behavior and Appearance | 373 | ||
| Language | 373 | ||
| Intellectual Function | 373 | ||
| Memory. | 374 | ||
| Knowledge. | 374 | ||
| Abstract Thinking. | 374 | ||
| Judgment. | 374 | ||
| Cranial Nerve Function | 374 | ||
| Sensory Function | 374 | ||
| Motor Function | 374 | ||
| Coordination. | 374 | ||
| Balance. | 374 | ||
| Reflexes. | 375 | ||
| After the Examination | 375 | ||
| Key Points | 377 | ||
| Reflective Learning | 377 | ||
| Review Questions | 377 | ||
| References | 378 | ||
| 17 Medication Administration | 379 | ||
| Objectives | 379 | ||
| Key Terms | 379 | ||
| Media Resources | 379 | ||
| Case Study: Esther Simmons | 380 | ||
| Scientific Knowledge Base | 380 | ||
| Medication Legislation and Standards | 380 | ||
| Federal Regulations. | 380 | ||
| State and Local Regulation of Medication. | 380 | ||
| Health Care Agencies and Medication Laws. | 380 | ||
| Medication Regulations and Nursing Practice. | 380 | ||
| Nontherapeutic Medication Use | 381 | ||
| Pharmacological Concepts | 381 | ||
| Medication Names. | 381 | ||
| Classification. | 381 | ||
| Medication Forms. | 382 | ||
| Pharmacokinetics as the Basis of Medication Actions | 382 | ||
| Absorption. | 383 | ||
| Route of Administration. | 383 | ||
| Ability of a Medication to Dissolve. | 383 | ||
| Blood Flow to the Site of Administration. | 383 | ||
| Body Surface Area. | 383 | ||
| Lipid Solubility. | 383 | ||
| Distribution. | 383 | ||
| Circulation. | 383 | ||
| Membrane Permeability. | 383 | ||
| Protein Binding. | 383 | ||
| Metabolism. | 383 | ||
| Excretion. | 384 | ||
| Types of Medication Action | 384 | ||
| Therapeutic Effects. | 384 | ||
| Adverse Drug Effects. | 384 | ||
| Side Effects. | 384 | ||
| Toxic Effects. | 385 | ||
| Idiosyncratic Reactions. | 385 | ||
| Allergic Reactions. | 385 | ||
| Medication Tolerance and Dependence. | 385 | ||
| Medication Interactions. | 386 | ||
| Medication Dose Responses | 386 | ||
| Routes of Administration | 387 | ||
| Oral Routes. | 387 | ||
| Sublingual Administration. | 387 | ||
| Buccal Administration. | 387 | ||
| Parenteral Routes. | 387 | ||
| Topical Administration. | 389 | ||
| Inhalation Route. | 389 | ||
| Intraocular Route. | 389 | ||
| Systems of Medication Measurement | 389 | ||
| Metric System. | 389 | ||
| Household Measurements. | 390 | ||
| Solutions. | 390 | ||
| Nursing Knowledge Base | 390 | ||
| Clinical Calculations | 390 | ||
| Conversions Within One System. | 390 | ||
| Conversion Between Systems. | 391 | ||
| Dosage Calculations. | 391 | ||
| The Ratio and Proportion Method. | 391 | ||
| The Formula Method. | 392 | ||
| Dimensional Analysis. | 392 | ||
| Pediatric Calculations. | 393 | ||
| Administering Medications | 393 | ||
| Health Care Provider’s Role. | 393 | ||
| Types of Orders in Acute Care Agencies. | 394 | ||
| Standing Orders. | 394 | ||
| prn Orders. | 394 | ||
| Single (One-Time) Orders. | 397 | ||
| STAT Orders. | 397 | ||
| NOW Orders. | 397 | ||
| Prescriptions. | 397 | ||
| Pharmacist’s Role. | 397 | ||
| Distribution Systems. | 397 | ||
| Unit Dose. | 397 | ||
| Automated Medication Dispensing Systems. | 398 | ||
| Nurse’s Role. | 398 | ||
| Medication Errors | 398 | ||
| Critical Thinking | 400 | ||
| Synthesis | 400 | ||
| Knowledge. | 400 | ||
| Experience. | 400 | ||
| Attitudes. | 400 | ||
| Standards. | 401 | ||
| Right Medication. | 401 | ||
| Right Dose. | 401 | ||
| Right Patient. | 402 | ||
| Right Route. | 402 | ||
| Right Time. | 402 | ||
| Right Documentation. | 403 | ||
| Maintaining Patients’ Rights. | 403 | ||
| Nursing Process | 404 | ||
| Assessment | 404 | ||
| History. | 404 | ||
| Allergies. | 404 | ||
| Medication History. | 404 | ||
| Diet History. | 404 | ||
| Physical Examination. | 404 | ||
| Patient’s Health Literacy Level. | 404 | ||
| Patient’s Current Condition. | 404 | ||
| Patient’s Attitude About Medication Use. | 405 | ||
| Older Adult Considerations. | 405 | ||
| Patient’s Knowledge and Understanding of Medication Therapy. | 406 | ||
| Patient Expectations. | 406 | ||
| Nursing Diagnosis | 406 | ||
| Planning | 407 | ||
| Goals and Outcomes. | 407 | ||
| Setting Priorities. | 407 | ||
| Collaborative Care. | 407 | ||
| Implementation | 407 | ||
| Health Promotion. | 407 | ||
| Patient Education and Behavioral Support. | 407 | ||
| Acute Care. | 409 | ||
| Receiving, Transcribing, and Communicating Medication Orders. | 409 | ||
| Accurate Dosage Calculation and Measurement. | 409 | ||
| Correct Administration. | 409 | ||
| Avoidance of Distractions. | 409 | ||
| Recording Medication Administration. | 410 | ||
| Restorative and Continuing Care. | 410 | ||
| Special Considerations for Administering Medications to Specific Age-Groups. | 410 | ||
| Infants and Children. | 410 | ||
| Older Adults. | 410 | ||
| Polypharmacy. | 410 | ||
| Evaluation | 412 | ||
| Patient Outcomes. | 412 | ||
| Patient Expectations. | 412 | ||
| Oral Administration | 412 | ||
| Topical Medication Applications | 413 | ||
| Skin Applications | 415 | ||
| Mucous Membrane Applications | 416 | ||
| Nasal Instillation. | 416 | ||
| Eye Instillation. | 416 | ||
| Ear Instillation. | 418 | ||
| Vaginal Instillation. | 418 | ||
| Rectal Instillation. | 418 | ||
| Administering Medications by Inhalation | 421 | ||
| Administering Medications by Irrigations | 424 | ||
| Parenteral Administration of Medications | 424 | ||
| Equipment | 424 | ||
| Syringes. | 424 | ||
| Needles. | 425 | ||
| Disposable Injection Units. | 425 | ||
| Preparing an Injection From an Ampule | 425 | ||
| Preparing an Injection From a Vial | 426 | ||
| Mixing Medications | 426 | ||
| Mixing Medications From a Vial and an Ampule. | 426 | ||
| Mixing Medications From Two Vials. | 427 | ||
| Insulin Preparation | 427 | ||
| Administering Injections | 428 | ||
| Subcutaneous Injections. | 428 | ||
| Intramuscular Injections. | 431 | ||
| Injection Sites. | 432 | ||
| Ventrogluteal Muscle. | 432 | ||
| Vastus Lateralis Muscle. | 433 | ||
| Deltoid Muscle. | 433 | ||
| Intradermal Injections. | 434 | ||
| Safety in Administering Medications by Injection | 435 | ||
| Needleless Devices. | 435 | ||
| Intravenous Administration. | 435 | ||
| Large-Volume Infusions. | 437 | ||
| Intravenous Bolus. | 437 | ||
| Volume-Controlled Infusions. | 437 | ||
| Intermittent Venous Access. | 438 | ||
| Administration of Intravenous Therapy in the Home. | 438 | ||
| Safety Guidelines for Nursing Skills | 439 | ||
| Skill 17.1 Administering Oral Medications | 439 | ||
| Delegation Considerations | 439 | ||
| Equipment | 439 | ||
| Step/\tRationale | 440 | ||
| Recording and Reporting | 444 | ||
| Unexpected Outcomes and Related Interventions | 444 | ||
| Skill 17.2 Administering Eye (Ophthalmic) Medications | 445 | ||
| Delegation and Collaboration | 445 | ||
| Equipment | 445 | ||
| Eyedrops/Ointment Only | 445 | ||
| Step/\tRationale | 445 | ||
| Recording and Reporting | 448 | ||
| Unexpected Outcomes and Related Interventions | 448 | ||
| Skill 17.3 Using Metered-Dose or Dry Powder Inhalers | 448 | ||
| Delegation and Collaboration | 448 | ||
| Equipment | 448 | ||
| Step/\tRationale | 448 | ||
| Recording and Reporting | 452 | ||
| Unexpected Outcomes and Related Interventions | 453 | ||
| Skill 17.4 Preparing Injections From Vials and Ampules | 453 | ||
| Delegation Considerations | 453 | ||
| Equipment | 453 | ||
| Medication in an Ampule | 453 | ||
| Medication in a Vial | 453 | ||
| Both | 453 | ||
| Step/\tRationale | 453 | ||
| Unexpected Outcomes and Related Interventions | 457 | ||
| Skill 17.5 Administering Injections | 457 | ||
| Delegation and Collaboration | 457 | ||
| Equipment | 457 | ||
| Step/\tRationale | 458 | ||
| Recording and Reporting | 463 | ||
| Unexpected Outcomes and Related Interventions | 463 | ||
| Skill 17.6 Administering Medications by Intravenous Bolus | 463 | ||
| Delegation Considerations | 463 | ||
| Equipment | 463 | ||
| Step/\tRationale | 463 | ||
| Recording and Reporting | 467 | ||
| Unexpected Outcomes and Related Interventions | 467 | ||
| Skill 17.7 Administering Intravenous Medications by Piggyback, Intermittent Infusion Sets, and Mini-Infusion Pumps | 468 | ||
| Delegation and Collaboration | 468 | ||
| Equipment | 468 | ||
| Piggyback or Mini-Infusion Pump | 468 | ||
| Volume-Control Administration Set | 468 | ||
| Step/\tRationale | 468 | ||
| Recording and Reporting | 473 | ||
| Unexpected Outcomes and Related Interventions | 473 | ||
| Key Points | 473 | ||
| Reflective Learning | 474 | ||
| Review Questions | 474 | ||
| References | 475 | ||
| 18 Fluid, Electrolyte, and Acid-Base Balances | 479 | ||
| Objectives | 479 | ||
| Key Terms | 479 | ||
| Media Resources | 479 | ||
| Case Study: Mrs. Reynolds | 480 | ||
| Introduction | 480 | ||
| Scientific Knowledge Base | 480 | ||
| Distribution of Body Fluids | 480 | ||
| Composition of Body Fluids | 480 | ||
| Movement of Water and Electrolytes | 481 | ||
| Fluid Balance. | 482 | ||
| Fluid Intake. | 482 | ||
| Fluid Distribution. | 482 | ||
| Fluid Output. | 482 | ||
| Antidiuretic Hormone. | 483 | ||
| Aldosterone. | 483 | ||
| Atrial Natriuretic Peptide. | 483 | ||
| Electrolyte Balance. | 483 | ||
| Sodium Regulation. | 483 | ||
| Potassium Balance. | 483 | ||
| Calcium Balance. | 483 | ||
| Magnesium Balance. | 483 | ||
| Chloride Regulation. | 483 | ||
| Bicarbonate Regulation. | 483 | ||
| Phosphate Balance. | 483 | ||
| Acid-Base Balance. | 484 | ||
| Acid Production. | 484 | ||
| Acid Buffering. | 484 | ||
| Acid Excretion. | 484 | ||
| Disturbances in Fluid, Electrolyte, and Acid-Base Balances | 484 | ||
| Fluid Imbalances. | 484 | ||
| Extracellular Fluid Volume Imbalances. | 484 | ||
| Osmolality Imbalances. | 484 | ||
| Electrolyte Imbalances | 484 | ||
| Potassium Imbalances. | 484 | ||
| Calcium Imbalances. | 486 | ||
| Magnesium Imbalances. | 486 | ||
| Chloride Imbalances. | 486 | ||
| Acid-Base Imbalances. | 486 | ||
| pH. | 486 | ||
| PaCO2. | 486 | ||
| PaO2. | 486 | ||
| SaO2. | 486 | ||
| Base Excess. | 486 | ||
| Bicarbonate. | 486 | ||
| Types of Acid-Base Imbalances. | 486 | ||
| Nursing Knowledge Base | 489 | ||
| Critical Thinking | 489 | ||
| Synthesis | 489 | ||
| Knowledge | 489 | ||
| Experience | 489 | ||
| Attitudes | 489 | ||
| Standards | 489 | ||
| Nursing Process | 490 | ||
| Assessment | 490 | ||
| Nursing History. | 490 | ||
| Age. | 490 | ||
| Older Adult Considerations. | 490 | ||
| Environment. | 490 | ||
| Dietary Intake. | 490 | ||
| Lifestyle. | 490 | ||
| Medications. | 490 | ||
| Medical History. | 491 | ||
| Physical Assessment. | 491 | ||
| Daily Weights and Fluid Intake and Output Measurement. | 493 | ||
| Laboratory Studies. | 493 | ||
| Patient Expectations. | 493 | ||
| Nursing Diagnosis | 493 | ||
| Planning | 494 | ||
| Goals and Outcomes. | 494 | ||
| Setting Priorities. | 496 | ||
| Collaborative Care. | 496 | ||
| Implementation | 496 | ||
| Health Promotion. | 496 | ||
| Acute Care. | 497 | ||
| Enteral Replacement of Fluids. | 498 | ||
| Restriction of Fluids. | 498 | ||
| Parenteral Replacement of Fluids and Electrolytes. | 499 | ||
| Parenteral Nutrition. | 499 | ||
| Intravenous Therapy. | 499 | ||
| Vascular Access Devices. | 499 | ||
| Types of Solutions. | 499 | ||
| Equipment. | 500 | ||
| Initiating Peripheral Intravenous Access. | 500 | ||
| Regulating Infusion Flow Rate. | 501 | ||
| Maintaining the System. | 502 | ||
| Changing IV Fluid Containers, Tubing, and Dressings. | 503 | ||
| Helping Patients Protect IV Integrity. | 503 | ||
| Complications of IV Therapy. | 504 | ||
| Discontinuing Peripheral IV Access. | 504 | ||
| Blood Replacement. | 505 | ||
| Autologous Transfusion. | 506 | ||
| Allogeneic Transfusion. | 506 | ||
| ABO System. | 506 | ||
| Rh System. | 506 | ||
| Transfusion Reactions and Other Adverse Effects. | 506 | ||
| Interventions for Acid-Base Imbalances. | 507 | ||
| Arterial Blood Gas Measurement. | 507 | ||
| Restorative and Continuing Care. | 507 | ||
| Home Intravenous Therapy. | 507 | ||
| Nutritional Support. | 507 | ||
| Medication Safety. | 507 | ||
| Evaluation | 507 | ||
| Patient Outcomes. | 507 | ||
| Patient Expectations. | 508 | ||
| Safety Guidelines for Nursing Skills | 508 | ||
| Skill 18.1 Initiating Intravenous Therapy | 509 | ||
| Delegation Considerations | 509 | ||
| Equipment | 509 | ||
| Step/\tRationale | 509 | ||
| Recording and Reporting | 520 | ||
| Unexpected Outcomes and Related Interventions | 521 | ||
| Skill 18.2 Regulating Intravenous Flow Rate | 521 | ||
| Delegation Considerations | 521 | ||
| Equipment | 521 | ||
| Step/\tRationale | 522 | ||
| Recording and Reporting | 525 | ||
| Unexpected Outcomes and Related Interventions | 525 | ||
| Skill 18.3 Changing Intravenous Solution and Tubing | 526 | ||
| Delegation Considerations | 526 | ||
| Equipment | 526 | ||
| Continuous IV Infusion | 526 | ||
| Intermittent Extension Set | 526 | ||
| Step/\tRationale | 526 | ||
| Recording and Reporting | 530 | ||
| Unexpected Outcomes and Related Interventions | 530 | ||
| Skill 18.4 Changing a Peripheral Intravenous Dressing | 530 | ||
| Delegation Considerations | 530 | ||
| Equipment | 530 | ||
| Step/\tRationale | 531 | ||
| Recording and Reporting | 533 | ||
| Unexpected Outcomes and Related Interventions | 533 | ||
| Key Points | 534 | ||
| Reflective Learning | 534 | ||
| Review Questions | 534 | ||
| References | 535 | ||
| 19 Complementary, Alternative, and Integrative Therapies | 536 | ||
| Objectives | 536 | ||
| Key Terms | 536 | ||
| Media Resources | 536 | ||
| Case Study: James | 537 | ||
| Introduction | 536 | ||
| Complementary, Alternative, and Integrative Approaches to Health | 537 | ||
| Nursing-Accessible Therapies | 540 | ||
| Relaxation Therapy | 540 | ||
| Clinical Applications of Relaxation Therapy. | 541 | ||
| Limitations of Relaxation Therapy. | 541 | ||
| Meditation and Breathing | 542 | ||
| Clinical Applications of Meditation. | 542 | ||
| Limitations of Meditation. | 542 | ||
| Imagery | 542 | ||
| Clinical Applications of Imagery. | 543 | ||
| Limitations of Imagery. | 543 | ||
| Training-Specific Therapies | 543 | ||
| Animal-Assisted Therapy | 543 | ||
| Biofeedback | 544 | ||
| Acupuncture | 544 | ||
| Therapeutic Touch | 545 | ||
| Traditional Chinese Medicine | 546 | ||
| Natural Products and Herbal Therapies | 546 | ||
| Integrative Nursing Role | 548 | ||
| Key Points | 549 | ||
| Reflective Learning | 549 | ||
| Review Questions | 549 | ||
| References | 550 | ||
| Unit 4 Promoting Psychosocial Health | 551 | ||
| 20 Caring in Nursing Practice | 551 | ||
| Objectives | 551 | ||
| Key Terms | 551 | ||
| Media Resources | 551 | ||
| Case Study: Mrs. Levine | 552 | ||
| Introduction | 551 | ||
| Theoretical Views on Caring | 552 | ||
| Caring Is Primary | 553 | ||
| Leininger’s Transcultural Caring | 553 | ||
| Watson’s Transpersonal Theory of Caring | 553 | ||
| Swanson’s Theory of Caring | 554 | ||
| Summary of Theoretical Views | 555 | ||
| Patient Satisfaction | 555 | ||
| Mutual Problem Solving | 556 | ||
| Attentive Reassurance | 556 | ||
| Human Respect | 556 | ||
| Encouraging Manner | 556 | ||
| Appreciation of Unique Meanings | 556 | ||
| Healing Environment | 556 | ||
| Affiliation Needs | 557 | ||
| Basic Human Needs | 557 | ||
| Caring in Nursing Practice | 557 | ||
| Providing Presence | 557 | ||
| Touch | 558 | ||
| Listening | 558 | ||
| Knowing the Patient | 558 | ||
| Spiritual Caring | 559 | ||
| Relieving Symptoms and Suffering | 559 | ||
| Family Care | 560 | ||
| The Challenge of Caring | 560 | ||
| Key Points | 560 | ||
| Reflective Learning | 561 | ||
| Review Questions | 561 | ||
| References | 562 | ||
| 21 Cultural Competence | 563 | ||
| Objectives | 563 | ||
| Key Terms | 563 | ||
| Media Resources | 563 | ||
| Case Study Ms. Tatum | 564 | ||
| Health Disparities | 564 | ||
| Intersectionality | 565 | ||
| Racial, Ethnic, and Cultural Identity | 566 | ||
| World View | 566 | ||
| Disease and Illness | 567 | ||
| Core Measures | 567 | ||
| A Model of Cultural Competence | 568 | ||
| Cultural Awareness and Knowledge | 568 | ||
| Storytelling. | 569 | ||
| World View of Providers and Patients. | 569 | ||
| Cultural Skill | 570 | ||
| Collecting a Nursing History | 571 | ||
| Assessing Health Literacy | 572 | ||
| Culturally Based Physical Assessment | 573 | ||
| Teach-Back and Plain Language | 573 | ||
| Working With Interpreters | 574 | ||
| Cultural Encounter | 575 | ||
| Cultural Desire | 575 | ||
| Key Points | 575 | ||
| Reflective Learning | 575 | ||
| Review Questions | 576 | ||
| References | 576 | ||
| 22 Spiritual Health | 578 | ||
| Objectives | 578 | ||
| Key Terms | 578 | ||
| Media Resources | 578 | ||
| Case Study: Victoria Timms | 579 | ||
| Introduction | 578 | ||
| Scientific Knowledge Base | 579 | ||
| Nursing Knowledge Base | 579 | ||
| Spirituality | 579 | ||
| Spiritual Well-Being | 580 | ||
| Faith | 580 | ||
| Religion | 580 | ||
| Hope | 581 | ||
| Spiritual Health | 581 | ||
| The Effect of Illness on Spirituality | 581 | ||
| Acute Illness | 581 | ||
| Chronic Illness | 581 | ||
| Terminal Illness | 582 | ||
| Near-Death Experience | 582 | ||
| Critical Thinking | 583 | ||
| Synthesis | 583 | ||
| Knowledge. | 583 | ||
| Experience. | 584 | ||
| Attitudes. | 584 | ||
| Standards. | 584 | ||
| Nursing Process | 585 | ||
| Assessment | 585 | ||
| Faith. | 586 | ||
| Life and Self-Responsibility. | 586 | ||
| Connectedness. | 586 | ||
| Life Satisfaction. | 586 | ||
| Fellowship and Community. | 586 | ||
| Ritual and Practice. | 587 | ||
| Vocation. | 587 | ||
| Older Adult Considerations. | 587 | ||
| Patient Expectations. | 587 | ||
| Nursing Diagnosis | 587 | ||
| Planning | 588 | ||
| Goals and Outcomes. | 589 | ||
| Setting Priorities. | 590 | ||
| Collaborative Care. | 590 | ||
| Implementation | 591 | ||
| Health Promotion. | 591 | ||
| Establishing Presence. | 591 | ||
| Supporting a Healing Relationship. | 591 | ||
| Acute Care. | 592 | ||
| Support Systems. | 592 | ||
| Diet Therapies. | 592 | ||
| Supporting Rituals. | 592 | ||
| Restorative and Continuing Care | 592 | ||
| Prayer and Meditation. | 592 | ||
| Evaluation | 593 | ||
| Patient Outcomes. | 593 | ||
| Patient Expectations. | 594 | ||
| Key Points | 594 | ||
| Reflective Learning | 594 | ||
| Review Questions | 595 | ||
| References | 595 | ||
| 23 Growth and Development | 597 | ||
| Objectives | 597 | ||
| Key Terms | 597 | ||
| Evolve Media Resources | 597 | ||
| Case Study Crystal Taylor | 598 | ||
| Scientific Knowledge Base | 597 | ||
| Concept of Growth and Development | 597 | ||
| Theories of Human Development | 598 | ||
| Sigmund Freud. | 598 | ||
| Erikson’s Eight Stages of Development. | 598 | ||
| Piaget’s Theory of Cognitive Development. | 599 | ||
| Kohlberg’s Moral Developmental Theory. | 599 | ||
| Maslow’s Theory of Human Needs. | 599 | ||
| Nursing Knowledge Base | 600 | ||
| Conception and Fetal Development | 600 | ||
| Health Promotion. | 600 | ||
| Neonate | 600 | ||
| Unit 5 Promoting Physical Health | 703 | ||
| 28 Activity and Exercise | 703 | ||
| Objectives | 703 | ||
| Key Terms | 703 | ||
| Media Resources | 703 | ||
| Case Study: Mr. Indelicato | 704 | ||
| Introduction | 703 | ||
| Scientific Knowledge Base | 704 | ||
| Overview of Exercise and Activity | 704 | ||
| Body Alignment. | 704 | ||
| Body Balance. | 704 | ||
| Coordinated Body Movement. | 705 | ||
| Friction. | 705 | ||
| Exercise and Activity. | 705 | ||
| Regulation of Movement | 705 | ||
| Skeletal System. | 705 | ||
| Joints. | 705 | ||
| Ligaments, Tendons, and Cartilage. | 706 | ||
| Skeletal Muscles. | 706 | ||
| Muscles Concerned With Movement. | 706 | ||
| Muscles Concerned With Posture. | 706 | ||
| Muscle Groups. | 706 | ||
| Nervous System. | 706 | ||
| Proprioception. | 706 | ||
| Balance. | 706 | ||
| Principles of Transfer and Positioning Techniques | 706 | ||
| Pathological Influences on Body Alignment, Mobility, and Activity | 707 | ||
| Congenital Defects. | 707 | ||
| Disorders of Bones, Joints, and Muscles. | 707 | ||
| Central Nervous System Damage. | 707 | ||
| Musculoskeletal Trauma. | 707 | ||
| Nursing Knowledge Base | 707 | ||
| Safe Patient Handling | 707 | ||
| Transfer Techniques. | 708 | ||
| Factors Influencing Activity and Exercise | 708 | ||
| Growth and Development. | 708 | ||
| Behavioral Aspects | 709 | ||
| Cultural Background | 709 | ||
| Critical Thinking | 709 | ||
| Synthesis | 709 | ||
| Knowledge. | 709 | ||
| Experience. | 710 | ||
| Attitudes. | 710 | ||
| Standards. | 710 | ||
| Nursing Process | 710 | ||
| Assessment | 710 | ||
| Body Alignment. | 710 | ||
| Standing. | 710 | ||
| Sitting. | 710 | ||
| Recumbent. | 711 | ||
| Mobility. | 711 | ||
| Sitting. | 711 | ||
| Standing. | 711 | ||
| Range of Motion. | 712 | ||
| Gait. | 712 | ||
| Exercise. | 712 | ||
| Activity Tolerance. | 712 | ||
| Older Adult Considerations. | 712 | ||
| Patient Expectations. | 713 | ||
| Nursing Diagnosis | 713 | ||
| Planning | 713 | ||
| Goals and Outcomes. | 714 | ||
| Setting Priorities. | 715 | ||
| Collaborative Care. | 715 | ||
| Implementation | 715 | ||
| Health Promotion. | 715 | ||
| Acute Care | 715 | ||
| Early Mobility. | 715 | ||
| Walking. | 715 | ||
| Lifting Techniques. | 718 | ||
| Moving and Transferring Patients. | 718 | ||
| Range-of-Motion Exercises. | 719 | ||
| Restorative and Continuing Care. | 720 | ||
| Assistive Devices for Walking | 720 | ||
| Walkers. | 720 | ||
| Canes. | 720 | ||
| Crutches. | 720 | ||
| Measuring for Crutches. | 721 | ||
| Crutch Gait. | 722 | ||
| Crutch Walking on Stairs. | 722 | ||
| Sitting in a Chair With Crutches. | 723 | ||
| Evaluation | 725 | ||
| Patient Outcomes. | 725 | ||
| Patient Expectations. | 725 | ||
| Safety Guidelines for Nursing Skills | 725 | ||
| Skill 28.1 Promoting Early Activity and Exercise | 726 | ||
| Delegation Considerations | 726 | ||
| Equipment | 726 | ||
| Step/\tRationale | 726 | ||
| Recording and Reporting | 729 | ||
| Unexpected Outcomes and Related Interventions | 729 | ||
| Skill 28.2 Using Safe and Effective Transfer Techniques | 730 | ||
| Delegation Considerations | 730 | ||
| Equipment | 730 | ||
| Step/\tRationale | 730 | ||
| Recording and Reporting | 738 | ||
| Unexpected Outcomes and Related Interventions | 738 | ||
| Key Points | 738 | ||
| Reflective Learning | 738 | ||
| Review Questions | 738 | ||
| References | 739 | ||
| 29 Immobility | 741 | ||
| Objectives | 741 | ||
| Key Terms | 741 | ||
| Media Resources | 741 | ||
| Case Study: Mr. Paul Rogers | 742 | ||
| Introduction | 742 | ||
| Scientific Knowledge Base | 742 | ||
| Pathological Influences on Mobility | 742 | ||
| Postural Abnormalities. | 742 | ||
| Muscle Abnormalities. | 742 | ||
| Damage and Disorders Affecting the Central Nervous System. | 743 | ||
| Direct Trauma to the Musculoskeletal System. | 744 | ||
| Immobility | 744 | ||
| Cardiovascular Changes. | 744 | ||
| Respiratory Changes. | 745 | ||
| Metabolic Changes. | 745 | ||
| Fluid and Electrolyte Balances. | 745 | ||
| Gastrointestinal Changes. | 745 | ||
| Musculoskeletal Changes. | 745 | ||
| Integument Changes. | 746 | ||
| Urinary Elimination Changes. | 746 | ||
| Nursing Knowledge Base | 746 | ||
| Safe Patient Handling | 746 | ||
| Psychosocial Effects | 747 | ||
| Developmental Effects | 747 | ||
| Critical Thinking | 747 | ||
| Synthesis | 747 | ||
| Knowledge. | 747 | ||
| Experience. | 748 | ||
| Attitudes. | 748 | ||
| Standards. | 748 | ||
| Nursing Process | 748 | ||
| Assessment | 748 | ||
| Mobility. | 748 | ||
| Respiratory System. | 751 | ||
| Metabolic System. | 752 | ||
| Cardiovascular System. | 752 | ||
| Skin Integrity. | 752 | ||
| Elimination Systems. | 753 | ||
| Pain. | 753 | ||
| Psychosocial Condition. | 753 | ||
| Development. | 754 | ||
| Fall Risks. | 754 | ||
| Older Adult Considerations. | 754 | ||
| Patient Expectations. | 754 | ||
| Nursing Diagnosis | 755 | ||
| Planning | 755 | ||
| Goals and Outcomes. | 756 | ||
| Setting Priorities. | 756 | ||
| Collaborative Care. | 756 | ||
| Implementation | 757 | ||
| Health Promotion. | 759 | ||
| Respiratory System. | 760 | ||
| Metabolic System. | 760 | ||
| Cardiovascular System. | 760 | ||
| Musculoskeletal System. | 760 | ||
| Skin Integrity. | 761 | ||
| Elimination System. | 761 | ||
| Psychosocial Problems. | 761 | ||
| Developmental Changes. | 761 | ||
| Acute Care. | 761 | ||
| Respiratory System. | 761 | ||
| Cardiovascular System. | 762 | ||
| Musculoskeletal System. | 766 | ||
| Positioning Techniques. | 766 | ||
| Fowler’s and Semi-Fowler’s Positions. | 767 | ||
| Supine Position. | 767 | ||
| Prone Position. | 767 | ||
| Thirty-Degree Lateral Position. | 767 | ||
| Sims’ Position. | 768 | ||
| Safe Patient Handling and Movement. | 768 | ||
| Transfer Techniques. | 768 | ||
| Range of Motion. | 769 | ||
| Integumentary System. | 769 | ||
| Psychosocial Problems. | 769 | ||
| Developmental Changes. | 769 | ||
| Restorative and Continuing Care. | 769 | ||
| Evaluation | 770 | ||
| Patient Outcomes. | 770 | ||
| Patient Expectations. | 770 | ||
| Safety Guidelines for Nursing Skills | 770 | ||
| Skill 29.1 Moving and Positioning Patients in Bed | 771 | ||
| Delegation Considerations | 771 | ||
| Equipment | 771 | ||
| Step/\tRationale | 771 | ||
| Recording and Reporting | 778 | ||
| Unexpected Outcomes and Related Interventions | 778 | ||
| Key Points | 778 | ||
| Reflective Learning | 779 | ||
| Review Questions | 779 | ||
| References | 779 | ||
| 30 Safety | 782 | ||
| Objectives | 782 | ||
| Key Terms | 782 | ||
| Media Resources | 782 | ||
| Case Study: Mr. Gonzales | 783 | ||
| Introduction | 782 | ||
| Scientific Knowledge Base | 785 | ||
| Basic Human Needs | 785 | ||
| Oxygen. | 785 | ||
| Nutrition. | 786 | ||
| Temperature. | 786 | ||
| Physical Hazards | 786 | ||
| Motor Vehicle Accidents. | 786 | ||
| Poison. | 787 | ||
| Fire. | 787 | ||
| Falls. | 787 | ||
| Disasters. | 787 | ||
| Pathogen Transmission. | 787 | ||
| Immunization. | 787 | ||
| Pollution. | 787 | ||
| Nursing Knowledge Base | 787 | ||
| Factors Influencing Patient Safety | 787 | ||
| Developmental Level | 788 | ||
| Infant, Toddler, and Preschooler. | 788 | ||
| School-Age Child. | 788 | ||
| Adolescent. | 788 | ||
| Adult. | 788 | ||
| Older Adult. | 788 | ||
| Other Risk Factors | 788 | ||
| Lifestyle. | 788 | ||
| Impaired Mobility. | 788 | ||
| Sensory Impairments. | 788 | ||
| Cognitive Impairments. | 788 | ||
| Safety Awareness. | 788 | ||
| Risks in the Health Care Agency | 789 | ||
| Chemical Exposure. | 789 | ||
| Falls. | 789 | ||
| Patient-Inherent Accidents. | 789 | ||
| Procedure-Related Accidents. | 789 | ||
| Equipment-Related Accidents. | 789 | ||
| Workplace Safety | 790 | ||
| Critical Thinking | 790 | ||
| Synthesis | 790 | ||
| Knowledge. | 790 | ||
| Experience. | 790 | ||
| Attitudes. | 790 | ||
| Standards. | 791 | ||
| Nursing Process | 791 | ||
| Assessment | 791 | ||
| Older Adult Considerations. | 792 | ||
| Patient Expectations. | 792 | ||
| Nursing Diagnosis | 792 | ||
| Planning | 793 | ||
| Goals and Outcomes. | 793 | ||
| Setting Priorities. | 793 | ||
| Collaborative Care. | 793 | ||
| Implementation | 793 | ||
| Health Promotion. | 795 | ||
| Developmental Interventions | 795 | ||
| Infant, Toddler, and Preschooler. | 795 | ||
| School-Age Child. | 796 | ||
| Adolescent. | 796 | ||
| Adult. | 796 | ||
| Older Adult. | 797 | ||
| Environmental Interventions. | 797 | ||
| Basic Needs. | 797 | ||
| General Preventive Measures. | 799 | ||
| Acute Care. | 799 | ||
| Falls. | 799 | ||
| Restraints. | 799 | ||
| Side Rails. | 801 | ||
| Fires. | 801 | ||
| Electrical Accidents. | 802 | ||
| Radiation. | 802 | ||
| Disasters. | 802 | ||
| Workplace Violence Prevention. | 802 | ||
| Evaluation | 803 | ||
| Patient Outcomes. | 803 | ||
| Patient Expectations. | 803 | ||
| Safety Guidelines for Nursing Skills | 804 | ||
| Skill 30.1 Applying Physical Restraints | 804 | ||
| Delegation Considerations | 804 | ||
| Equipment | 804 | ||
| Step/\tRationale | 804 | ||
| Recording and Reporting | 808 | ||
| Unexpected Outcomes and Related Interventions | 808 | ||
| Key Points | 809 | ||
| Reflective Learning | 809 | ||
| Review Questions | 809 | ||
| References | 810 | ||
| 31 Hygiene | 812 | ||
| Objectives | 812 | ||
| Key Terms | 812 | ||
| Media Resources | 812 | ||
| Case Study: Mrs. Winkler | 813 | ||
| Introduction | 812 | ||
| Scientific Knowledge Base | 813 | ||
| Skin | 813 | ||
| Oral Cavity and Teeth | 813 | ||
| Eyes, Ears, and Nose | 814 | ||
| Feet, Hands, and Nails | 814 | ||
| Hair | 815 | ||
| Nursing Knowledge Base | 815 | ||
| Physical and Mental Status | 815 | ||
| Socioeconomic Status | 815 | ||
| Developmental Stage | 815 | ||
| Skin. | 815 | ||
| Mouth. | 816 | ||
| Eyes, Ears, and Nose. | 816 | ||
| Feet and Nails. | 816 | ||
| Hair. | 816 | ||
| Personal Preferences | 816 | ||
| Cultural Variables | 816 | ||
| Critical Thinking | 817 | ||
| Synthesis | 817 | ||
| Knowledge. | 817 | ||
| Experience. | 817 | ||
| Attitudes. | 817 | ||
| Standards. | 817 | ||
| Nursing Process | 817 | ||
| Assessment | 817 | ||
| Self-Care Ability. | 818 | ||
| Assessment of the Skin. | 819 | ||
| Assessment of the Feet and Nails. | 819 | ||
| Assessment of the Oral Cavity. | 820 | ||
| Assessment of the Hair and Hair Care. | 822 | ||
| Assessment of the Eyes, Ears, and Nose. | 822 | ||
| Patients at Risk for Hygiene Problems. | 824 | ||
| Older Adult Considerations. | 824 | ||
| Patient Expectations. | 824 | ||
| Nursing Diagnosis | 825 | ||
| Planning | 826 | ||
| Goals and Outcomes. | 826 | ||
| Setting Priorities. | 826 | ||
| Collaborative Care. | 826 | ||
| Implementation | 828 | ||
| Health Promotion. | 828 | ||
| Skin Care. | 828 | ||
| Oral Care. | 828 | ||
| Care of Eyes, Ears, and Nose. | 829 | ||
| Nail and Foot Care. | 830 | ||
| Hair Care. | 830 | ||
| Acute Care. | 830 | ||
| Bathing and Skin Care. | 830 | ||
| Perineal Care. | 832 | ||
| Oral Care. | 833 | ||
| Denture Care. | 837 | ||
| Backrub. | 837 | ||
| Care of Eyes, Ears, and Nose. | 838 | ||
| Basic Eye Care. | 838 | ||
| Eyeglasses. | 838 | ||
| Contact Lenses. | 838 | ||
| Ear Care. | 838 | ||
| Nasal Care. | 838 | ||
| Nail and Foot Care. | 838 | ||
| Hair Care. | 839 | ||
| Shaving. | 840 | ||
| Mustache and Beard Care. | 842 | ||
| Restorative and Continuing Care. | 842 | ||
| Bathing and Skin Care. | 842 | ||
| Oral Care. | 843 | ||
| Hearing Aid Care. | 843 | ||
| Patient’s Room Environment. | 843 | ||
| Maintaining Comfort. | 844 | ||
| Room Equipment. | 844 | ||
| Beds. | 844 | ||
| Bed Making. | 844 | ||
| Evaluation | 850 | ||
| Patient Outcomes. | 850 | ||
| Patient Expectations. | 850 | ||
| Safety Guidelines for Nursing Skills | 851 | ||
| Safety Considerations | 851 | ||
| Skill 31.1 Bathing and Perineal Care | 851 | ||
| Delegation Considerations | 851 | ||
| Equipment | 851 | ||
| Step/\tRationale | 851 | ||
| Recording and Reporting | 862 | ||
| Unexpected Outcomes and Related Interventions | 862 | ||
| Key Points | 862 | ||
| Reflective Learning | 863 | ||
| Review Questions | 863 | ||
| References | 863 | ||
| 32 Oxygenation | 865 | ||
| Objectives | 865 | ||
| Key Terms | 865 | ||
| Media Resources | 865 | ||
| Case Study: Mr. King | 866 | ||
| Scientific Knowledge Base | 866 | ||
| Cardiopulmonary Physiology | 866 | ||
| Structure and Function of the Pulmonary System | 866 | ||
| Ventilation. | 867 | ||
| Oxygen Transport. | 867 | ||
| Carbon Dioxide Transport. | 867 | ||
| Alterations of the Pulmonary System: Factors Affecting Ventilation and Oxygen Transport | 868 | ||
| Hypoxia. | 868 | ||
| Hypoxemia. | 868 | ||
| Hypoventilation. | 868 | ||
| Hyperventilation. | 868 | ||
| Structure and Function of the Circulatory System | 869 | ||
| Regulation of Blood Flow. | 869 | ||
| Conduction System. | 869 | ||
| Alterations of the Circulatory System | 870 | ||
| Decreased Cardiac Output. | 870 | ||
| Myocardial Ischemia. | 870 | ||
| Impaired Valvular Function. | 871 | ||
| Left-Sided Heart Failure. | 871 | ||
| Right-Sided Heart Failure. | 871 | ||
| Hypovolemia. | 871 | ||
| Disturbances in Conduction. | 871 | ||
| Factors Affecting Oxygenation | 871 | ||
| Decreased Oxygen-Carrying Capacity. | 871 | ||
| Decreased Inspired Oxygen Concentration. | 871 | ||
| Increased Metabolic Rate. | 871 | ||
| Conditions Affecting Chest Wall Movement. | 873 | ||
| Musculoskeletal Abnormalities. | 873 | ||
| Nervous System Diseases. | 873 | ||
| Trauma. | 873 | ||
| Nursing Knowledge Base | 874 | ||
| Developmental Factors | 874 | ||
| Premature Infants. | 874 | ||
| Infants and Toddlers. | 874 | ||
| School-Age Children and Adolescents. | 874 | ||
| Young and Middle-Age Adults. | 874 | ||
| Older Adults. | 874 | ||
| Lifestyle Factors | 874 | ||
| Nutrition. | 874 | ||
| Hydration. | 874 | ||
| Exercise. | 875 | ||
| Cigarette Smoking. | 875 | ||
| Substance Abuse. | 875 | ||
| Stress. | 875 | ||
| Environmental Factors | 876 | ||
| Critical Thinking | 876 | ||
| Synthesis | 876 | ||
| Knowledge. | 876 | ||
| Experience. | 876 | ||
| Attitudes. | 876 | ||
| Standards. | 877 | ||
| Nursing Process | 877 | ||
| Assessment | 877 | ||
| Nursing History. | 877 | ||
| Risk Factors. | 877 | ||
| Fatigue. | 877 | ||
| Pain. | 878 | ||
| Breathing Patterns. | 878 | ||
| Cough. | 878 | ||
| Respiratory Infections. | 878 | ||
| Medication Use. | 878 | ||
| Older Adult Considerations. | 878 | ||
| Patient Expectations. | 879 | ||
| Physical Examination. | 879 | ||
| Diagnostic Tests. | 879 | ||
| Nursing Diagnosis | 881 | ||
| Planning | 881 | ||
| Goals and Outcomes. | 881 | ||
| Setting Priorities. | 881 | ||
| Collaborative Care. | 881 | ||
| Implementation | 881 | ||
| Health Promotion. | 883 | ||
| Influenza and Pneumococcal Vaccine. | 883 | ||
| Environmental Modifications. | 884 | ||
| Diet and Exercise. | 885 | ||
| Acute Care. | 885 | ||
| Dyspnea Management. | 885 | ||
| Oxygen Therapy. | 885 | ||
| Safety Precautions With Oxygen Therapy. | 885 | ||
| Oxygen Supply. | 885 | ||
| Methods of Oxygen Delivery. | 886 | ||
| Home Oxygen. | 886 | ||
| Mobilization of Pulmonary Secretions. | 889 | ||
| Hydration. | 889 | ||
| Humidification. | 889 | ||
| Nebulization. | 889 | ||
| Maintenance of a Patent Airway. | 889 | ||
| Coughing and Deep Breathing Techniques. | 889 | ||
| Cascade Cough. | 889 | ||
| Huff Cough. | 889 | ||
| Quad Cough. | 889 | ||
| Suctioning Techniques. | 889 | ||
| Oropharyngeal and Nasopharyngeal Suctioning. | 889 | ||
| Orotracheal and Nasotracheal Suctioning. | 890 | ||
| Tracheal Suctioning. | 890 | ||
| Artificial Airways. | 890 | ||
| Oral Airway. | 890 | ||
| Tracheal Airway. | 890 | ||
| Chest Physiotherapy. | 890 | ||
| Postural Drainage. | 890 | ||
| Chest Percussion. | 891 | ||
| Vibration. | 892 | ||
| High-Frequency Chest Wall Compression. | 892 | ||
| Maintenance or Promotion of Lung Expansion. | 892 | ||
| Ambulation. | 892 | ||
| Positioning. | 892 | ||
| Incentive Spirometry. | 893 | ||
| Chest Tubes. | 893 | ||
| Special Considerations. | 894 | ||
| Chest Tube Removal. | 894 | ||
| Noninvasive Ventilation. | 894 | ||
| Restoration of Cardiopulmonary Functioning. | 895 | ||
| Cardiopulmonary Resuscitation. | 895 | ||
| Restorative and Continuing Care. | 896 | ||
| Respiratory Muscle Training. | 896 | ||
| Breathing Exercises. | 896 | ||
| Evaluation | 896 | ||
| Patient Outcomes. | 896 | ||
| Patient Expectations. | 897 | ||
| Safety Guidelines for Nursing Skills | 897 | ||
| Skill 32.1 Suctioning | 898 | ||
| Delegation Considerations | 898 | ||
| Equipment | 898 | ||
| Step/\tRationale | 898 | ||
| Recording and Reporting | 906 | ||
| Unexpected Outcomes and Related Interventions | 907 | ||
| Skill 32.2 Care of Patients With Chest Tubes | 907 | ||
| Delegation and Collaboration | 907 | ||
| Equipment | 907 | ||
| Step/\tRationale | 907 | ||
| Recording and Reporting | 913 | ||
| Unexpected Outcomes and Related Interventions | 913 | ||
| Key Points | 914 | ||
| Reflective Learning | 914 | ||
| Review Questions | 914 | ||
| References | 915 | ||
| 33 Sleep | 917 | ||
| Objectives | 917 | ||
| Key Terms | 917 | ||
| Media Resources | 917 | ||
| Case Study: Walter Murphy | 918 | ||
| Introduction | 917 | ||
| Scientific Knowledge Base | 917 | ||
| Physiology of Sleep | 917 | ||
| Circadian Rhythms. | 917 | ||
| Sleep Regulation. | 918 | ||
| Stages of Sleep. | 918 | ||
| Sleep Cycle. | 919 | ||
| Functions of Sleep | 919 | ||
| Dreams. | 920 | ||
| Sleep Disorders | 920 | ||
| Insomnia. | 920 | ||
| Sleep Apnea. | 920 | ||
| Narcolepsy. | 920 | ||
| Sleep Deprivation. | 921 | ||
| Parasomnias. | 921 | ||
| Nursing Knowledge Base | 921 | ||
| Sleep and Rest | 921 | ||
| Sleep Requirements and Patterns Throughout the Life Span | 921 | ||
| Neonates. | 921 | ||
| Infants. | 921 | ||
| Toddlers and Preschoolers. | 921 | ||
| School-Age Children. | 921 | ||
| Adolescents. | 922 | ||
| Young Adults. | 922 | ||
| Middle-Age Adults. | 922 | ||
| Older Adults. | 922 | ||
| Factors Affecting Sleep | 922 | ||
| Physical Illness. | 922 | ||
| Drugs and Substances. | 922 | ||
| Lifestyle. | 922 | ||
| Usual Sleep Patterns and Excessive Daytime Sleepiness. | 923 | ||
| Emotional Stress. | 924 | ||
| Environment. | 924 | ||
| Exercise and Fatigue. | 924 | ||
| Food and Caloric Intake. | 924 | ||
| Critical Thinking | 924 | ||
| Synthesis | 924 | ||
| Knowledge. | 925 | ||
| Experience. | 925 | ||
| Attitudes. | 925 | ||
| Standards. | 925 | ||
| Nursing Process | 925 | ||
| Assessment | 925 | ||
| Sources for Sleep Assessment. | 925 | ||
| Sleep History. | 926 | ||
| Sleep Pattern and Quality. | 926 | ||
| Description of Sleeping Problems. | 926 | ||
| Sleep Diary. | 927 | ||
| Physical Illness. | 927 | ||
| Medications. | 927 | ||
| Current Life Events. | 927 | ||
| Emotional and Mental Status. | 927 | ||
| Bedtime Routines. | 927 | ||
| Bedtime Environment. | 928 | ||
| Behaviors of Sleep Deprivation. | 928 | ||
| Older Adult Considerations. | 928 | ||
| Patient Expectations. | 928 | ||
| Nursing Diagnosis | 928 | ||
| Planning | 928 | ||
| Goals and Outcomes. | 928 | ||
| Setting Priorities. | 929 | ||
| Collaborative Care. | 931 | ||
| Implementation | 931 | ||
| Health Promotion. | 931 | ||
| Environmental Controls. | 931 | ||
| Promoting Bedtime Routines. | 933 | ||
| Promoting Comfort. | 933 | ||
| Promoting Activity. | 933 | ||
| Stress Reduction. | 933 | ||
| Bedtime Snacks. | 934 | ||
| Pharmacological Approaches to Promoting Sleep. | 934 | ||
| Acute Care. | 935 | ||
| Managing Environmental Stimuli. | 935 | ||
| Safety. | 935 | ||
| Comfort Measures. | 935 | ||
| Restorative and Continuing Care. | 935 | ||
| Maintaining Activity. | 935 | ||
| Reducing Sleep Disruption. | 936 | ||
| Evaluation | 936 | ||
| Patient Care. | 936 | ||
| Patient Expectations. | 936 | ||
| Key Points | 936 | ||
| Reflective Learning | 937 | ||
| Review Questions | 937 | ||
| References | 937 | ||
| 34 Pain Management | 939 | ||
| Objectives | 939 | ||
| Key Terms | 939 | ||
| Media Resources | 939 | ||
| Case Study: Mrs. Ellis | 940 | ||
| Introduction | 939 | ||
| Scientific Knowledge Base | 940 | ||
| Nature of Pain | 940 | ||
| Physiology of Pain | 940 | ||
| Transduction. | 940 | ||
| Transmission. | 940 | ||
| Perception. | 941 | ||
| Modulation. | 941 | ||
| Neurotransmitters. | 941 | ||
| Gate Control Theory of Pain. | 941 | ||
| Physiological Responses. | 942 | ||
| Behavioral Responses. | 942 | ||
| Types of Pain | 942 | ||
| Acute/Transient Pain. | 942 | ||
| Chronic/Persistent Pain. | 943 | ||
| Chronic Episodic Pain. | 943 | ||
| Cancer Pain. | 943 | ||
| Idiopathic Pain. | 943 | ||
| Nursing Knowledge Base | 944 | ||
| Knowledge, Attitudes, and Beliefs | 944 | ||
| Factors Influencing Pain | 944 | ||
| Physiological Factors | 944 | ||
| Age. | 944 | ||
| Fatigue. | 944 | ||
| Neurological Function. | 944 | ||
| Gender. | 944 | ||
| Social Factors | 945 | ||
| Attention. | 945 | ||
| Previous Experience. | 945 | ||
| Family and Social Support. | 945 | ||
| Spiritual Factors. | 945 | ||
| Cultural Factors. | 945 | ||
| Psychological Factors | 945 | ||
| Meaning of Pain. | 945 | ||
| Anxiety. | 945 | ||
| Depression. | 945 | ||
| Coping Style. | 946 | ||
| Critical Thinking | 946 | ||
| Synthesis | 946 | ||
| Knowledge. | 946 | ||
| Experience. | 946 | ||
| Attitudes. | 946 | ||
| Standards. | 946 | ||
| Nursing Process | 947 | ||
| Assessment | 947 | ||
| Older Adult Considerations. | 948 | ||
| Patient’s Expression of Pain. | 948 | ||
| Patients Unable to Self-Report Pain. | 948 | ||
| Characteristics of Pain. | 949 | ||
| Timing (Onset, Duration, and Pattern). | 949 | ||
| Precipitating Factors. | 949 | ||
| Quality. | 949 | ||
| Relief Measures. | 949 | ||
| Region/Location. | 949 | ||
| Severity. | 949 | ||
| Effect of Pain on Patient. | 950 | ||
| Concomitant Symptoms. | 951 | ||
| Patient Expectations. | 951 | ||
| Documentation. | 951 | ||
| Nursing Diagnosis | 951 | ||
| Planning | 952 | ||
| Goals and Outcomes. | 952 | ||
| Setting Priorities. | 954 | ||
| Collaborative Care. | 954 | ||
| Implementation | 955 | ||
| Health Promotion. | 955 | ||
| Maintaining Wellness. | 955 | ||
| Nonpharmacological Pain-Relief Measures. | 956 | ||
| Reducing Pain Reception and Perception. | 956 | ||
| Anticipatory Guidance. | 956 | ||
| Distraction. | 956 | ||
| Cutaneous Stimulation. | 956 | ||
| Relaxation and Guided Imagery. | 957 | ||
| Acute Care | 958 | ||
| Pharmacological Pain Therapy. | 958 | ||
| Analgesics. | 958 | ||
| Patient-Controlled Analgesia. | 959 | ||
| Perineural Local Anesthetic Infusion. | 960 | ||
| Local Anesthetics. | 961 | ||
| Epidural Analgesia. | 961 | ||
| Patients With Cancer Pain. | 962 | ||
| Restorative and Continuing Care. | 963 | ||
| Opioid Infusions. | 963 | ||
| Palliative Care. | 964 | ||
| Hospice. | 964 | ||
| Evaluation | 964 | ||
| Patient Outcomes. | 964 | ||
| Patient Expectations. | 965 | ||
| Safety Guidelines for Nursing Skills | 965 | ||
| Skill 34.1 Patient-Controlled Analgesia | 965 | ||
| Delegation Considerations | 965 | ||
| Equipment | 965 | ||
| Step/\tRationale | 965 | ||
| Recording and Reporting | 969 | ||
| Unexpected Outcomes and Related Interventions | 969 | ||
| Key Points | 969 | ||
| Reflective Learning | 970 | ||
| Review Questions | 970 | ||
| References | 970 | ||
| 35 Nutrition | 972 | ||
| Objectives | 972 | ||
| Key Terms | 972 | ||
| Media Resources | 972 | ||
| Case Study: Mrs. Gonzalez | 973 | ||
| Introduction | 972 | ||
| Scientific Knowledge Base | 973 | ||
| Principles of Nutrition | 973 | ||
| Nutrients. | 973 | ||
| Carbohydrates. | 973 | ||
| Proteins. | 973 | ||
| Fats. | 974 | ||
| Vitamins. | 974 | ||
| Minerals. | 974 | ||
| Water. | 974 | ||
| Digestion. | 975 | ||
| Absorption. | 975 | ||
| Elimination. | 975 | ||
| Metabolism. | 975 | ||
| Storage. | 975 | ||
| Dietary Guidelines | 975 | ||
| Dietary Reference Intakes. | 975 | ||
| MyPlate Guidelines and 2015–2020 Dietary Guidelines for Americans. | 975 | ||
| Healthy People 2020. | 976 | ||
| Nursing Knowledge Base | 976 | ||
| Alternative Food Patterns | 976 | ||
| Developmental Needs | 978 | ||
| Infants Through School Age. | 978 | ||
| Breastfeeding. | 978 | ||
| Breast Milk Substitutes. | 978 | ||
| Introduction to Solid Food. | 978 | ||
| Adolescents. | 978 | ||
| Young and Middle-Age Adults. | 978 | ||
| Pregnancy. | 979 | ||
| Lactation. | 979 | ||
| Older Adults. | 979 | ||
| Overweight and Obesity | 979 | ||
| Critical Thinking | 980 | ||
| Synthesis | 980 | ||
| Knowledge. | 980 | ||
| Experience. | 980 | ||
| Attitudes. | 980 | ||
| Standards. | 980 | ||
| Nursing Process | 980 | ||
| Assessment | 980 | ||
| Screening. | 980 | ||
| Nutrition Assessment. | 981 | ||
| Diet History. | 981 | ||
| Medication History. | 981 | ||
| Older Adult Considerations. | 982 | ||
| Patients at Risk for Nutritional Problems. | 982 | ||
| Physical Examination. | 982 | ||
| Anthropometry. | 982 | ||
| Laboratory Values. | 982 | ||
| Dysphagia. | 983 | ||
| Dysphagia Screening. | 984 | ||
| Patient Expectations. | 984 | ||
| Nursing Diagnosis | 984 | ||
| Planning | 984 | ||
| Goals and Outcomes. | 984 | ||
| Setting Priorities. | 987 | ||
| Collaborative Care. | 987 | ||
| Implementation | 987 | ||
| Health Promotion. | 987 | ||
| Acute Care. | 988 | ||
| Providing a Comfortable Environment. | 990 | ||
| Assisting Patients With Feeding. | 990 | ||
| Dysphagia. | 991 | ||
| Dysphagia Diet Management. | 991 | ||
| Patients With Disabilities. | 991 | ||
| Interventions for Patients Unable to Meet Nutritional Needs Orally. | 991 | ||
| Enteral Tube Feedings. | 991 | ||
| Initiating Tube Feedings. | 992 | ||
| Gastrostomy/Jejunostomy Tube Placement. | 993 | ||
| Parenteral Nutrition. | 996 | ||
| Initiating Parenteral Nutrition. | 996 | ||
| Caring for the Patient Receiving Parenteral Nutrition. | 996 | ||
| Restorative and Continuing Care | 999 | ||
| Diet Therapy in Disease Management. | 999 | ||
| Medical Nutrition Therapy. | 999 | ||
| Home Care. | 999 | ||
| Evaluation | 999 | ||
| Patient Outcomes. | 999 | ||
| Patient Expectations. | 999 | ||
| Safety Guidelines for Nursing Skills | 1000 | ||
| Skill 35.1 Aspiration Precautions | 1000 | ||
| Delegation Considerations | 1000 | ||
| Equipment | 1000 | ||
| Step/\tRationale | 1001 | ||
| Recording and Reporting | 1003 | ||
| Unexpected Outcomes and Related Interventions | 1003 | ||
| Skill 35.2 Inserting a Nasogastric or Nasointestinal Feeding Tube | 1003 | ||
| Delegation Considerations | 1003 | ||
| Equipment | 1003 | ||
| Insertion | 1003 | ||
| Removal | 1003 | ||
| Step/\tRationale | 1003 | ||
| Recording and Reporting | 1009 | ||
| Unexpected Outcomes and Related Interventions | 1009 | ||
| Skill 35.3 Administering Enteral Nutrition Via Nasoenteric, Gastrostomy, or Jejunostomy Tubes | 1009 | ||
| Delegation Considerations | 1009 | ||
| Equipment | 1009 | ||
| Step/\tRationale | 1009 | ||
| Recording and Reporting | 1013 | ||
| Unexpected Outcomes and Related Interventions | 1014 | ||
| Key Points | 1014 | ||
| Reflective Learning | 1014 | ||
| Review Questions | 1015 | ||
| References | 1015 | ||
| 36 Urinary Elimination | 1018 | ||
| Objectives | 1018 | ||
| Key Terms | 1018 | ||
| Media Resources | 1018 | ||
| Case Study: Mrs. Vallero | 1019 | ||
| Introduction | 1018 | ||
| Scientific Knowledge Base | 1019 | ||
| Anatomy and Physiology of the Urinary Tract | 1019 | ||
| Kidneys. | 1019 | ||
| Ureters. | 1019 | ||
| Bladder. | 1020 | ||
| Urethra. | 1020 | ||
| Act of Urination | 1020 | ||
| Factors Influencing Urination | 1020 | ||
| Common Urinary Elimination Problems | 1020 | ||
| Urinary Retention. | 1020 | ||
| Urinary Tract Infections. | 1020 | ||
| Urinary Incontinence. | 1021 | ||
| Urinary Diversions. | 1023 | ||
| Nursing Knowledge Base | 1024 | ||
| Infection Control and Hygiene | 1024 | ||
| Developmental Considerations | 1024 | ||
| Psychosocial Implications | 1024 | ||
| Critical Thinking | 1024 | ||
| Synthesis | 1024 | ||
| Knowledge. | 1024 | ||
| Experience. | 1025 | ||
| Attitudes. | 1025 | ||
| Standards. | 1025 | ||
| Nursing Process | 1025 | ||
| Assessment | 1025 | ||
| Nursing History. | 1026 | ||
| Pattern of Urination. | 1026 | ||
| Symptoms of Urinary Alterations. | 1026 | ||
| Factors Affecting Voiding. | 1026 | ||
| Older Adult Considerations. | 1026 | ||
| Physical Assessment. | 1026 | ||
| Kidneys. | 1026 | ||
| Bladder. | 1026 | ||
| External Genitalia and Urethral Meatus. | 1029 | ||
| Perineal Skin. | 1029 | ||
| Assessment of Urine. | 1029 | ||
| Intake and Output. | 1029 | ||
| Characteristics of Urine. | 1030 | ||
| Color. | 1030 | ||
| Clarity. | 1031 | ||
| Odor. | 1031 | ||
| Laboratory and Diagnostic Testing. | 1031 | ||
| Urinalysis. | 1031 | ||
| Timed Urine Tests. | 1031 | ||
| Clean-Catch Midstream Specimen. | 1032 | ||
| Urine for Culture and Sensitivity. | 1033 | ||
| Diagnostic Examinations. | 1033 | ||
| Nursing Diagnosis | 1033 | ||
| Planning | 1033 | ||
| Goals and Outcomes. | 1034 | ||
| Setting Priorities. | 1034 | ||
| Collaborative Care. | 1037 | ||
| Implementation | 1037 | ||
| Health Promotion. | 1037 | ||
| Patient Education. | 1037 | ||
| Promoting Normal Micturition. | 1037 | ||
| Maintaining Elimination Habits. | 1037 | ||
| Maintaining Adequate Fluid Intake. | 1037 | ||
| Promoting Complete Bladder Emptying. | 1037 | ||
| Preventing Infection. | 1038 | ||
| Acute Care. | 1038 | ||
| Catheterization. | 1038 | ||
| Types of Catheters. | 1039 | ||
| Catheter Sizes. | 1039 | ||
| Catheter Changes. | 1040 | ||
| Closed Drainage Systems. | 1040 | ||
| Routine Catheter Care. | 1040 | ||
| Catheter Removal. | 1041 | ||
| Suprapubic Catheters. | 1042 | ||
| Condom Catheters. | 1042 | ||
| Urinary Diversions. | 1042 | ||
| Medications. | 1044 | ||
| Restorative Care and Continuing Care. | 1044 | ||
| Lifestyle Changes. | 1044 | ||
| Pelvic Floor Muscle Training. | 1044 | ||
| Bladder Retraining. | 1044 | ||
| Toileting Schedules. | 1044 | ||
| Intermittent Catheterization. | 1045 | ||
| Skin Care. | 1045 | ||
| Evaluation | 1045 | ||
| Patient Outcomes. | 1045 | ||
| Patient Expectations. | 1046 | ||
| Safety Guidelines for Nursing Skills | 1046 | ||
| Skill 36.1 Inserting and Removing Straight/Intermittent or Indwelling Catheters | 1046 | ||
| Delegation Considerations | 1046 | ||
| Equipment | 1046 | ||
| Step/\tRationale | 1046 | ||
| Recording and Reporting | 1056 | ||
| Unexpected Outcomes and Related Interventions | 1056 | ||
| Key Points | 1056 | ||
| Reflective Learning | 1056 | ||
| Review Questions | 1057 | ||
| References | 1057 | ||
| 37 Bowel Elimination | 1059 | ||
| Objectives | 1059 | ||
| Key Terms | 1059 | ||
| Media Resources | 1059 | ||
| Case Study: Mr. Gutierrez | 1060 | ||
| Scientific Knowledge Base | 1059 | ||
| Anatomy and Physiology of the Gastrointestinal Tract | 1059 | ||
| Mouth. | 1060 | ||
| Esophagus. | 1060 | ||
| Stomach. | 1060 | ||
| Small Intestine. | 1060 | ||
| Large Intestine. | 1061 | ||
| Anus. | 1061 | ||
| Defecation. | 1061 | ||
| Nursing Knowledge Base | 1061 | ||
| Bowel Elimination Problems | 1062 | ||
| Constipation. | 1062 | ||
| Impaction. | 1063 | ||
| Diarrhea. | 1063 | ||
| Fecal Incontinence. | 1064 | ||
| Flatulence. | 1064 | ||
| Hemorrhoids. | 1064 | ||
| Intestinal Diversions/Ostomies. | 1064 | ||
| Other Diversion Procedures. | 1065 | ||
| Critical Thinking | 1065 | ||
| Synthesis | 1065 | ||
| Knowledge. | 1065 | ||
| Experience. | 1066 | ||
| Attitudes. | 1066 | ||
| Standards. | 1066 | ||
| Nursing Process | 1067 | ||
| Assessment | 1067 | ||
| Health History. | 1067 | ||
| Older Adult Considerations. | 1068 | ||
| Physical Assessment. | 1068 | ||
| Laboratory and Diagnostic Examinations | 1068 | ||
| Laboratory Tests. | 1068 | ||
| Fecal Specimens. | 1068 | ||
| Diagnostic Examinations. | 1070 | ||
| Patient Expectations. | 1070 | ||
| Nursing Diagnosis | 1070 | ||
| Planning | 1072 | ||
| Goals and Outcomes. | 1072 | ||
| Setting Priorities. | 1072 | ||
| Collaborative Care. | 1075 | ||
| Implementation | 1075 | ||
| Health Promotion. | 1075 | ||
| Diet. | 1075 | ||
| Exercise. | 1076 | ||
| Timing and Privacy. | 1076 | ||
| Promotion of Normal Defecation. | 1076 | ||
| Acute Care. | 1076 | ||
| Positioning on Bedpan. | 1076 | ||
| Medications. | 1076 | ||
| Nasogastric Tube for Gastric Decompression. | 1079 | ||
| Enemas. | 1079 | ||
| Digital Removal of Stool. | 1080 | ||
| Management of Patients With Fecal Incontinence or Diarrhea. | 1080 | ||
| Continuing and Restorative Care. | 1080 | ||
| Bowel Training. | 1080 | ||
| Ostomy Care. | 1080 | ||
| Maintenance of Skin Integrity. | 1081 | ||
| Evaluation | 1083 | ||
| Patient Outcomes. | 1083 | ||
| Patient Expectations. | 1083 | ||
| Safety Guidelines for Nursing Skills | 1084 | ||
| Skill 37.1 Inserting and Maintaining a Nasogastric Tube for Gastric Decompression | 1084 | ||
| Delegation Considerations | 1084 | ||
| Equipment | 1084 | ||
| Step/\tRationale | 1084 | ||
| Recording and Reporting | 1090 | ||
| Unexpected Outcomes and Related Interventions | 1090 | ||
| Skill 37.2 Administering a Cleansing Enema | 1091 | ||
| Delegation Considerations | 1091 | ||
| Equipment | 1091 | ||
| Enema Bag Administration | 1091 | ||
| Prepackaged Enema | 1091 | ||
| Step/\tRationale | 1091 | ||
| Recording and Reporting | 1094 | ||
| Unexpected Outcomes and Related Interventions | 1094 | ||
| Skill 37.3 Pouching an Ostomy | 1095 | ||
| Delegation Considerations | 1095 | ||
| Equipment | 1095 | ||
| Step/\tRationale | 1095 | ||
| Recording and Reporting | 1097 | ||
| Unexpected Outcomes and Related Interventions | 1098 | ||
| Key Points | 1098 | ||
| Reflective Learning | 1098 | ||
| Review Questions | 1098 | ||
| References | 1099 | ||
| 38 Skin Integrity and Wound Care | 1100 | ||
| Objectives | 1100 | ||
| Key Terms | 1100 | ||
| Media Resources | 1100 | ||
| Case Study: Mr. Martinez | 1101 | ||
| Scientific Knowledge Base | 1101 | ||
| Pressure Injuries | 1101 | ||
| Pressure Injury Classification | 1101 | ||
| Factors Contributing to Pressure Injury Formation. | 1104 | ||
| Shear. | 1104 | ||
| Friction. | 1105 | ||
| Moisture. | 1105 | ||
| Nutrition. | 1105 | ||
| Age. | 1105 | ||
| Origins of Pressure Injuries. | 1105 | ||
| Wound-Healing Process | 1105 | ||
| Partial-Thickness Wound Repair. | 1106 | ||
| Inflammatory Response. | 1106 | ||
| Epidermal Repair. | 1106 | ||
| Dermal Repair. | 1107 | ||
| Full-Thickness Wound Repair. | 1107 | ||
| Hemostasis Phase. | 1107 | ||
| Inflammation Phase. | 1107 | ||
| Proliferative Phase. | 1107 | ||
| Remodeling Phase. | 1107 | ||
| Complications of Wound Healing | 1107 | ||
| Hemorrhage. | 1107 | ||
| Infection. | 1107 | ||
| Dehiscence. | 1107 | ||
| Evisceration. | 1107 | ||
| Nursing Knowledge Base | 1108 | ||
| Prediction and Prevention | 1108 | ||
| Critical Thinking | 1108 | ||
| Synthesis | 1108 | ||
| Knowledge. | 1110 | ||
| Experience. | 1110 | ||
| Attitudes. | 1110 | ||
| Standards. | 1111 | ||
| Nursing Process | 1112 | ||
| Assessment | 1112 | ||
| Pressure Injuries. | 1112 | ||
| Skin. | 1112 | ||
| Mobility. | 1113 | ||
| Nutrition Status. | 1113 | ||
| Wounds. | 1113 | ||
| Emergency Setting. | 1114 | ||
| Stable Setting. | 1114 | ||
| Wound Cultures. | 1115 | ||
| Patient Expectations. | 1115 | ||
| Nursing Diagnosis | 1115 | ||
| Planning | 1116 | ||
| Goals and Outcomes. | 1116 | ||
| Setting Priorities. | 1116 | ||
| Collaborative Care. | 1116 | ||
| Implementation | 1117 | ||
| Health Promotion. | 1117 | ||
| Positioning. | 1117 | ||
| Topical Skin Care. | 1119 | ||
| Support Surfaces. | 1120 | ||
| Nutrition. | 1122 | ||
| Acute Care | 1123 | ||
| Pressure Injuries. | 1123 | ||
| Wounds | 1123 | ||
| First Aid for Wounds. | 1123 | ||
| Hemostasis. | 1125 | ||
| Cleansing. | 1125 | ||
| Protection. | 1125 | ||
| Dressings. | 1125 | ||
| Purpose. | 1125 | ||
| Type. | 1126 | ||
| Changing Dressings. | 1126 | ||
| Securing Dressings. | 1127 | ||
| Comfort Measures. | 1127 | ||
| Wound Cleansing. | 1127 | ||
| Wound Irrigation. | 1127 | ||
| Suture Care. | 1127 | ||
| Drainage Evacuation. | 1128 | ||
| Bandages and Binders. | 1128 | ||
| Principles for Application of Bandages and Binders. | 1128 | ||
| Binder Application. | 1129 | ||
| Abdominal Binder. | 1129 | ||
| Slings. | 1129 | ||
| Bandage Application. | 1130 | ||
| Heat and Cold Therapy. | 1130 | ||
| Body Responses to Heat and Cold. | 1131 | ||
| Local Effects of Heat and Cold. | 1132 | ||
| Factors Influencing Heat and Cold Tolerance. | 1134 | ||
| Assessment for Temperature Tolerance. | 1134 | ||
| Patient Education and Safety. | 1134 | ||
| Applying Heat and Cold. | 1134 | ||
| Choice of Moist or Dry. | 1135 | ||
| Warm Moist Compresses. | 1135 | ||
| Warm Soaks. | 1135 | ||
| Sitz Bath. | 1135 | ||
| Commercial Hot Packs. | 1135 | ||
| Aquathermia and Dry Heat. | 1135 | ||
| Hot-Water Bottles. | 1135 | ||
| Electric Heating Pads. | 1136 | ||
| Cold Moist Compresses. | 1136 | ||
| Cold Soaks. | 1136 | ||
| Ice Bag or Collar. | 1136 | ||
| Commercial Cold Packs. | 1136 | ||
| Restorative and Continuing Care. | 1136 | ||
| Evaluation | 1137 | ||
| Patient Outcomes. | 1137 | ||
| Patient Expectations. | 1137 | ||
| Safety Guidelines for Nursing Skills | 1137 | ||
| Skill 38.1 Assessment of Patient for Pressure Injury: Risk and Skin Assessment | 1138 | ||
| Delegation Considerations | 1138 | ||
| Equipment | 1138 | ||
| Step/\tRationale | 1138 | ||
| Recording and Reporting | 1144 | ||
| Unexpected Outcomes and Related Interventions | 1144 | ||
| Skill 38.2 Treating Pressure Injuries | 1144 | ||
| Delegation Considerations | 1144 | ||
| Equipment | 1144 | ||
| Step/\tRationale | 1144 | ||
| Recording and Reporting | 1149 | ||
| Unexpected Outcomes | 1149 | ||
| Skill 38.3 Negative-Pressure Wound Therapy | 1150 | ||
| Delegation Considerations | 1150 | ||
| Equipment | 1150 | ||
| Step/\tRationale | 1150 | ||
| Unexpected Outcomes and Related Interventions | 1154 | ||
| Recording and Reporting | 1154 | ||
| Skill 38.4 Applying Dressings: Dry, Damp-to-Dry, and Transparent | 1154 | ||
| Delegation Considerations | 1154 | ||
| Equipment | 1154 | ||
| Step/\tRationale | 1154 | ||
| Recording and Reporting | 1161 | ||
| Unexpected Outcomes and Related Interventions | 1161 | ||
| Skill 38.5 Performing Wound Irrigation | 1161 | ||
| Delegation Considerations | 1161 | ||
| Equipment | 1162 | ||
| Step/\tRationale | 1162 | ||
| Recording and Reporting | 1165 | ||
| Unexpected Outcomes and Related Interventions | 1165 | ||
| Key Points | 1165 | ||
| Reflective Learning | 1165 | ||
| Review Questions | 1166 | ||
| References | 1166 | ||
| 39 Sensory Alterations | 1168 | ||
| Objectives | 1168 | ||
| Key Terms | 1168 | ||
| Media Resources | 1168 | ||
| Case Study: Mrs. Alicea | 1169 | ||
| Introduction | 1168 | ||
| Scientific Knowledge Base | 1168 | ||
| Normal Sensation | 1168 | ||
| Types of Sensory Alterations | 1169 | ||
| Sensory Deficits. | 1169 | ||
| Sensory Deprivation. | 1169 | ||
| Sensory Overload. | 1169 | ||
| Nursing Knowledge Base | 1170 | ||
| Critical Thinking | 1172 | ||
| Synthesis | 1172 | ||
| Knowledge. | 1172 | ||
| Experience. | 1173 | ||
| Attitudes. | 1173 | ||
| Standards. | 1173 | ||
| Nursing Process | 1173 | ||
| Assessment | 1173 | ||
| Sensory Status. | 1173 | ||
| Physical Examination. | 1173 | ||
| Patients at Risk. | 1173 | ||
| Patient’s Lifestyle. | 1175 | ||
| Socialization. | 1175 | ||
| Self-Care Management. | 1175 | ||
| Psychosocial Adjustment. | 1175 | ||
| Health Promotion Practices. | 1175 | ||
| Hazards. | 1175 | ||
| Meaningful Stimuli. | 1175 | ||
| Environmental Stimuli. | 1176 | ||
| Communication Methods. | 1176 | ||
| Patient Expectations. | 1176 | ||
| Nursing Diagnosis | 1176 | ||
| Planning | 1177 | ||
| Goals and Outcomes. | 1177 | ||
| Setting Priorities. | 1179 | ||
| Collaborative Care. | 1179 | ||
| Implementation | 1179 | ||
| Health Promotion. | 1179 | ||
| Screening and Prevention. | 1179 | ||
| Managing Environmental Hazards. | 1180 | ||
| Use of Assistive Aids. | 1180 | ||
| Promoting Meaningful Stimulation. | 1180 | ||
| Establishing Safe Environments. | 1181 | ||
| Visual Adaptations. | 1181 | ||
| Hearing Adaptations. | 1181 | ||
| Smell and Tactile Adaptations. | 1181 | ||
| Index | 1239 | ||
| A | 1239 | ||
| B | 1241 | ||
| C | 1243 | ||
| D | 1246 | ||
| E | 1248 | ||
| F | 1250 | ||
| G | 1251 | ||
| H | 1252 | ||
| I | 1254 | ||
| J | 1257 | ||
| K | 1257 | ||
| L | 1257 | ||
| M | 1258 | ||
| N | 1259 | ||
| O | 1262 | ||
| P | 1263 | ||
| Q | 1267 | ||
| R | 1267 | ||
| S | 1268 | ||
| T | 1272 | ||
| U | 1274 | ||
| V | 1274 | ||
| W | 1275 | ||
| X | 1275 | ||
| Y | 1275 | ||
| Z | 1275 | ||
| Inside Back Cover | ibc1 |