BOOK
Clinical Nursing Skills and Techniques - E-Book
Anne Griffin Perry | Patricia A. Potter | Wendy Ostendorf
(2017)
Additional Information
Book Details
Abstract
Get the best skills guidance on the market with Clinical Nursing Skills & Techniques, 9th Edition. Known for its clear and comprehensive coverage of over 200 basic, intermediate and advanced skills, this widely respected, bestselling text features nearly 1,000 full-color photographs and drawings, a nursing process framework, step-by-step instructions with rationales, and a focus on critical thinking and evidence-based practice. This edition also includes new coverage of patient-centered care and safety guidelines, an enhanced emphasis on QSEN core competencies, and an expanded clinical focus with specialized Clinical Debriefs, Teach-Back, and sample documentation throughout. Written by the highly respected author team of Anne Griffin Perry, Patricia A. Potter, and Wendy Ostendorf, this text offers all the guidance and tools you need to perform nursing skills with complete confidence!
- Comprehensive coverage includes 211 basic, intermediate, and advanced nursing skills.
- Coverage of QSEN core competencies incorporates the areas of delegation and collaboration; reporting and recording; safety guidelines; and teaching, pediatric, geriatric, and home care considerations into lessons.
- UNIQUE! Using Evidence in Nursing Practice chapter covers the entire process of conducting research, including collecting, evaluating, and applying evidence from published research.
- Expert team of authors and contributors include some of the most respected individuals in the nursing field.
- UNIQUE! Unexpected Outcomes and Related Interventions sections highlight what might go wrong and how to appropriately intervene.
- Framework on the five-step nursing process gives context for specific skills and their role within overall client care.
- Streamlined procedural guidelines format makes it easy learn and review basic nursing skills.
- Clinical Decision Points within skills address key safety issues or possible skill modifications for specific patient needs.
- Rationales for each skill step incorporate the latest research findings and explain why steps are performed in a specific way, including their clinical significance and benefit.
- Video clip icons indicate video clips that are related to skills and procedures in the book and related lessons in Nursing Skills Online.
- Online checklists and video clips may be downloaded to mobile devices.
- NEW! Clinical Debriefs are case-based review questions at the end of each chapter that focus on issues such as managing conflict, care prioritization, patient safety, and decision-making.
- NEW! Streamlined theory content in each chapter features a quick, easy-to-read bullet format to help reduce repetition and emphasize the clinical focus of the book.
- NEW! Sample documentation for every skill often includes notes by exception in the SBAR format.
- NEW! SI units and using generic drug names are used throughout the text to ensure content is appropriate for Canadian nurses as well.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Clinical Nursing Skills and Techniques | iii | ||
| Copyright Page | iv | ||
| Dedication | v | ||
| About the Authors | vi | ||
| Contributors | vii | ||
| Reviewers | x | ||
| Preface to the Student | xii | ||
| Preface to the Instructor | xiv | ||
| Classic Features | xiv | ||
| New to This Edition: | xiv | ||
| Table Of Contents | xv | ||
| Unit 1 Supporting the Patient Through the Health Care System | 1 | ||
| 1 Using Evidence in Nursing Practice | 1 | ||
| Outline | 1 | ||
| Objectives | 1 | ||
| Media Resources | 1 | ||
| Purpose | 1 | ||
| Standards of Care | 1 | ||
| Principles for Practice | 1 | ||
| Quality Health Care | 2 | ||
| A Case for Evidence | 2 | ||
| Steps of Evidence-Based Practice | 2 | ||
| Ask a Clinical Question | 3 | ||
| Search for the Best Evidence | 4 | ||
| Critique the Evidence | 5 | ||
| Apply the Evidence—Project Management | 8 | ||
| Outcome Measurement | 9 | ||
| Evaluate the Practice Decision or Change | 9 | ||
| Communicate and Disseminate a Practice Change | 10 | ||
| Sustaining Evidence-Based Practice Changes | 10 | ||
| Clinical Debrief | 10 | ||
| Review Questions | 10 | ||
| References | 11 | ||
| 2 Admitting, Transfer, and Discharge | 12 | ||
| Skills and Procedures | 12 | ||
| Objectives | 12 | ||
| Media Resources | 12 | ||
| Purpose | 12 | ||
| Standards of Care | 12 | ||
| Principles for Practice | 12 | ||
| Patient-Centered Care | 12 | ||
| Evidence-Based Practice | 12 | ||
| Safety Guidelines | 13 | ||
| Skill 2.1 Admitting Patients | 13 | ||
| Role of the Admission Personnel | 13 | ||
| Role of the Nurse | 15 | ||
| Delegation and Collaboration | 16 | ||
| Equipment | 16 | ||
| Step/\tRationale | 16 | ||
| Recording and Reporting | 20 | ||
| Special Considerations | 20 | ||
| Teaching | 20 | ||
| Pediatric | 20 | ||
| Gerontological | 20 | ||
| Skill 2.2 Transferring Patients | 20 | ||
| Delegation and Collaboration | 21 | ||
| Equipment | 21 | ||
| Step/\tRationale | 21 | ||
| Recording and Reporting | 23 | ||
| Special Considerations | 23 | ||
| Teaching | 23 | ||
| Pediatric | 24 | ||
| Gerontological | 24 | ||
| Long-Term Care | 24 | ||
| Skill 2.3 Discharging Patients | 24 | ||
| Delegation and Collaboration | 25 | ||
| Equipment | 25 | ||
| Step/\tRationale | 25 | ||
| Recording and Reporting | 28 | ||
| Special Considerations | 28 | ||
| Teaching | 28 | ||
| Pediatric | 28 | ||
| Gerontological | 28 | ||
| Home Care | 28 | ||
| Clinical Debrief | 29 | ||
| Review Questions | 29 | ||
| References | 29 | ||
| 3 Communication and Collaboration | 31 | ||
| Skills and Procedures | 31 | ||
| Objectives | 31 | ||
| Media Resources | 31 | ||
| Purpose | 31 | ||
| Standards of Care | 31 | ||
| Principles for Practice | 31 | ||
| Patient-Centered Care | 31 | ||
| Evidence-Based Practice | 32 | ||
| Safety Guidelines | 33 | ||
| Skill 3.1 Establishing the Nurse-Patient Relationship | 33 | ||
| Delegation and Collaboration | 33 | ||
| Step/\tRationale | 33 | ||
| Recording and Reporting | 39 | ||
| Special Considerations | 39 | ||
| Teaching Considerations | 39 | ||
| Pediatric Considerations | 39 | ||
| Gerontological Considerations | 39 | ||
| Home Care Considerations | 39 | ||
| Skill 3.2 Communicating With Patients Who Have Difficulty Coping | 39 | ||
| Delegation and Collaboration | 40 | ||
| Step/\tRationale | 40 | ||
| Recording and Reporting | 43 | ||
| Special Considerations | 43 | ||
| Teaching Considerations | 43 | ||
| Pediatric Considerations | 43 | ||
| Gerontological Considerations | 44 | ||
| Home Care Considerations | 44 | ||
| Skill 3.3 Communicating With a Cognitively Impaired Patient | 44 | ||
| Delegation and Collaboration | 44 | ||
| Step/\tRationale | 44 | ||
| Recording and Reporting | 46 | ||
| Special Considerations | 46 | ||
| Teaching Considerations | 46 | ||
| Pediatric Considerations | 46 | ||
| Gerontological Considerations | 46 | ||
| Home Care Considerations | 46 | ||
| Skill 3.4 Communicating With Colleagues | 47 | ||
| Delegation and Collaboration | 47 | ||
| Step/\tRationale | 47 | ||
| Recording and Reporting | 48 | ||
| Clinical Debrief | 49 | ||
| Review Questions | 49 | ||
| References | 49 | ||
| 4 Documentation and Informatics | 51 | ||
| Skills and Procedures | 51 | ||
| Objectives | 51 | ||
| Media Resources | 51 | ||
| Purpose | 51 | ||
| Standards of Care | 51 | ||
| Principles for Practice | 51 | ||
| Patient-Centered Care | 52 | ||
| Evidence-Based Practice | 53 | ||
| Safety Guidelines | 53 | ||
| Common Record-Keeping Forms or Screens | 55 | ||
| Admission Nursing History Forms | 55 | ||
| Flow Sheets and Graphic Records | 55 | ||
| Patient Education Record | 56 | ||
| Patient Care Summary or Kardex | 56 | ||
| Acuity Records | 56 | ||
| Standardized Care Plans | 57 | ||
| Discharge Summaries | 57 | ||
| Charting Systems | 57 | ||
| Narrative Documentation | 57 | ||
| Problem-Oriented Medical Records | 57 | ||
| Patient Database | 57 | ||
| Problem List | 58 | ||
| Plan of Care | 58 | ||
| Progress Notes | 58 | ||
| SBAR Documentation. | 58 | ||
| SOAP Documentation. | 58 | ||
| PIE Documentation. | 59 | ||
| Focus Charting. | 59 | ||
| Source Records | 59 | ||
| Charting by Exception | 60 | ||
| Critical Pathways | 60 | ||
| Home Care Documentation | 63 | ||
| Long-Term Health Care Documentation | 63 | ||
| Clinical Debrief | 64 | ||
| Review Questions | 64 | ||
| References | 65 | ||
| Unit 2 Vital Signs and Physical Assessment | 66 | ||
| 5 Vital Signs | 66 | ||
| Skills and Procedures | 66 | ||
| Objectives | 66 | ||
| Media Resources | 66 | ||
| Purpose | 66 | ||
| Standards of Care | 66 | ||
| Principles for Practice | 66 | ||
| Patient-Centered Care | 67 | ||
| Evidence-Based Practice | 67 | ||
| Safety Guidelines | 67 | ||
| Skill 5.1 Measuring Body Temperature | 68 | ||
| Delegation and Collaboration | 68 | ||
| Equipment | 68 | ||
| Step/\tRationale | 71 | ||
| Recording and Reporting | 77 | ||
| Special Considerations | 77 | ||
| Teaching | 77 | ||
| Pediatric | 77 | ||
| Gerontological | 78 | ||
| Home Care | 78 | ||
| Skill 5.2 Assessing Radial Pulse | 78 | ||
| Delegation and Collaboration | 79 | ||
| Equipment | 79 | ||
| Step/\tRationale | 79 | ||
| Recording and Reporting | 82 | ||
| Special Considerations | 82 | ||
| Teaching | 82 | ||
| Pediatric | 82 | ||
| Gerontological | 82 | ||
| Home Care | 82 | ||
| Skill 5.3 Assessing Apical Pulse | 82 | ||
| Delegation and Collaboration | 83 | ||
| Equipment | 83 | ||
| Step/\tRationale | 83 | ||
| Recording and Reporting | 86 | ||
| Special Considerations | 86 | ||
| Teaching | 86 | ||
| Pediatric | 86 | ||
| Gerontological | 86 | ||
| Home Care | 86 | ||
| Skill 5.4 Assessing Respirations | 87 | ||
| Delegation and Collaboration | 87 | ||
| Equipment | 87 | ||
| Step/\tRationale | 87 | ||
| Recording and Reporting | 91 | ||
| Special Considerations | 91 | ||
| Teaching | 91 | ||
| Pediatric | 91 | ||
| Gerontological | 91 | ||
| Home Care | 91 | ||
| Skill 5.5 Assessing Arterial Blood Pressure | 91 | ||
| Hypertension | 91 | ||
| Hypotension | 92 | ||
| Blood Pressure Equipment | 92 | ||
| Delegation and Collaboration | 92 | ||
| Equipment | 93 | ||
| Step/\tRationale | 93 | ||
| Recording and Reporting | 99 | ||
| Special Considerations | 99 | ||
| Teaching | 99 | ||
| Pediatric | 99 | ||
| Gerontological | 99 | ||
| Home Care | 100 | ||
| Clinical Debrief | 104 | ||
| Review Questions | 104 | ||
| References | 104 | ||
| 6 Health Assessment | 105 | ||
| Skills and Procedures | 105 | ||
| Objectives | 105 | ||
| Media Resources | 105 | ||
| Purpose | 105 | ||
| Standards of Care | 105 | ||
| Principles for Practice | 105 | ||
| Patient-Centered Care | 106 | ||
| Evidence-Based Practice | 106 | ||
| Safety Guidelines | 106 | ||
| Assessment Techniques | 108 | ||
| Inspection | 108 | ||
| Palpation | 108 | ||
| Percussion | 108 | ||
| Auscultation | 109 | ||
| Olfaction | 109 | ||
| Preparation for Assessment | 109 | ||
| Preparing the Patient | 109 | ||
| Physical Assessment of Various Age-Groups | 112 | ||
| Children and Adolescents | 112 | ||
| Older Adults | 112 | ||
| Skill 6.1 General Survey | 112 | ||
| Delegation and Collaboration | 112 | ||
| Equipment | 112 | ||
| Step/\tRationale | 112 | ||
| Recording and Reporting | 119 | ||
| Special Considerations | 119 | ||
| Teaching | 119 | ||
| Pediatric | 119 | ||
| Gerontological | 119 | ||
| Home Care | 120 | ||
| Skill 6.2 Head and Neck Assessment | 120 | ||
| Delegation and Collaboration | 120 | ||
| Equipment | 120 | ||
| Step/\tRationale | 120 | ||
| Recording and Reporting | 124 | ||
| Special Considerations | 124 | ||
| Teaching | 124 | ||
| Pediatric | 125 | ||
| Gerontological | 125 | ||
| Skill 6.3 Thorax and Lung Assessment | 125 | ||
| Delegation and Collaboration | 125 | ||
| Equipment | 125 | ||
| Step/\tRationale | 127 | ||
| Recording and Reporting | 131 | ||
| Special Considerations | 131 | ||
| Teaching | 131 | ||
| Pediatric | 132 | ||
| Gerontological | 132 | ||
| Skill 6.4 Cardiovascular Assessment | 132 | ||
| Delegation and Collaboration | 132 | ||
| Equipment | 132 | ||
| Step/\tRationale | 132 | ||
| Recording and Reporting | 142 | ||
| Special Considerations | 142 | ||
| Teaching | 142 | ||
| Pediatric | 142 | ||
| Gerontological | 142 | ||
| Skill 6.5 Abdominal Assessment | 143 | ||
| Delegation and Collaboration | 143 | ||
| Equipment | 143 | ||
| Step/\tRationale | 144 | ||
| Recording and Reporting | 149 | ||
| Special Considerations | 149 | ||
| Teaching | 149 | ||
| Pediatric | 149 | ||
| Gerontological | 149 | ||
| Skill 6.6 Genitalia and Rectum Assessment | 149 | ||
| Delegation and Collaboration | 149 | ||
| Equipment | 149 | ||
| Step/\tRationale | 150 | ||
| Recording and Reporting | 154 | ||
| Special Considerations | 154 | ||
| Teaching | 154 | ||
| Female Health Teaching | 154 | ||
| Male Health Teaching | 154 | ||
| Pediatric | 154 | ||
| Skill 6.7 Musculoskeletal and Neurological Assessment | 154 | ||
| Delegation and Collaboration | 154 | ||
| Equipment | 154 | ||
| Step/\tRationale | 155 | ||
| Recording and Reporting | 161 | ||
| Special Considerations | 161 | ||
| Teaching | 161 | ||
| Pediatric | 161 | ||
| Gerontological | 162 | ||
| Clinical Debrief | 164 | ||
| Review Questions | 164 | ||
| References | 165 | ||
| Unit 3 Special Procedures | 166 | ||
| 7 Specimen Collection | 166 | ||
| Skills and Procedures | 166 | ||
| Objectives | 166 | ||
| Media Resources | 166 | ||
| Purpose | 166 | ||
| Standards of Care | 166 | ||
| Principles for Practice | 167 | ||
| Patient-Centered Care | 167 | ||
| Evidence-Based Practice | 167 | ||
| Safety Guidelines | 167 | ||
| Skill 7.1 Urine Specimen Collection: Midstream (Clean-Voided) Urine; Sterile Urinary Catheter | 167 | ||
| Types of Urine Tests and Specimens | 167 | ||
| Delegation and Collaboration | 168 | ||
| Equipment | 168 | ||
| Clean-Voided Urine Specimen | 168 | ||
| Sterile Urine Specimen From Urinary Catheter | 168 | ||
| Step/\tRationale | 168 | ||
| Recording and Reporting | 172 | ||
| Special Considerations | 172 | ||
| Teaching | 172 | ||
| Pediatric | 172 | ||
| Gerontological | 172 | ||
| Home Care | 172 | ||
| Skill 7.2 Measuring Occult Blood in Stool | 175 | ||
| Delegation and Collaboration | 175 | ||
| Equipment | 175 | ||
| Hemoccult Test | 175 | ||
| Hematest | 175 | ||
| Step/\tRationale | 175 | ||
| Recording and Reporting | 177 | ||
| Special Considerations | 177 | ||
| Pediatric | 177 | ||
| Home Care | 177 | ||
| Skill 7.3 Measuring Occult Blood in Gastric Secretions (Gastroccult) | 178 | ||
| Delegation and Collaboration | 178 | ||
| Equipment | 178 | ||
| Step/\tRationale | 178 | ||
| Recording and Reporting | 180 | ||
| Special Considerations | 180 | ||
| Pediatric | 180 | ||
| Home Care | 180 | ||
| Skill 7.4 Collecting Nose and Throat Specimens for Culture | 180 | ||
| Delegation and Collaboration | 180 | ||
| Equipment | 180 | ||
| Step/\tRationale | 180 | ||
| Recording and Reporting | 183 | ||
| Special Considerations | 183 | ||
| Teaching | 183 | ||
| Pediatric | 183 | ||
| Gerontological | 183 | ||
| Skill 7.5 Obtaining Vaginal or Urethral Discharge Specimens | 183 | ||
| Delegation and Collaboration | 184 | ||
| Equipment | 184 | ||
| Step/\tRationale | 184 | ||
| Recording and Reporting | 186 | ||
| Special Considerations | 186 | ||
| Teaching | 186 | ||
| Pediatric | 186 | ||
| Skill 7.6 Collecting a Sputum Specimen by Suction | 187 | ||
| Delegation and Collaboration | 187 | ||
| Equipment | 187 | ||
| Step/\tRationale | 187 | ||
| Recording and Reporting | 190 | ||
| Special Considerations | 190 | ||
| Teaching | 190 | ||
| Pediatric | 190 | ||
| Skill 7.7 Obtaining Wound Drainage Specimens | 190 | ||
| Delegation and Collaboration | 190 | ||
| Equipment | 190 | ||
| Step/\tRationale | 191 | ||
| Recording and Reporting | 193 | ||
| Special Considerations | 193 | ||
| Teaching | 193 | ||
| Pediatric | 193 | ||
| Home Care | 193 | ||
| Skill 7.8 Collecting Blood Specimens and Culture by Venipuncture (Syringe and Vacutainer Method) | 193 | ||
| Delegation and Collaboration | 193 | ||
| Equipment | 194 | ||
| All Procedures | 194 | ||
| Venipuncture With Syringe | 194 | ||
| Venipuncture With Vacutainer | 194 | ||
| Blood Cultures | 194 | ||
| Central Venous Catheter Collection | 194 | ||
| Step/\tRationale | 194 | ||
| Recording and Reporting | 201 | ||
| Special Considerations | 201 | ||
| Teaching | 201 | ||
| Pediatric | 201 | ||
| Gerontological | 201 | ||
| Skill 7.9 Blood Glucose Monitoring | 202 | ||
| Delegation and Collaboration | 202 | ||
| Equipment | 202 | ||
| Step/\tRationale | 203 | ||
| Recording and Reporting | 206 | ||
| Special Considerations | 206 | ||
| Teaching | 206 | ||
| Pediatric | 206 | ||
| Gerontological | 206 | ||
| Home Care | 206 | ||
| Skill 7.10 Obtaining an Arterial Specimen for Blood Gas Measurement | 206 | ||
| Delegation and Collaboration | 207 | ||
| Equipment | 207 | ||
| Step/\tRationale | 207 | ||
| Recording and Reporting | 211 | ||
| Special Considerations | 211 | ||
| Teaching | 211 | ||
| Pediatric | 211 | ||
| Gerontological | 211 | ||
| Clinical Debrief | 212 | ||
| Review Questions | 212 | ||
| References | 212 | ||
| 8 Diagnostic Procedures | 213 | ||
| Skills and Procedures | 213 | ||
| Objectives | 213 | ||
| Media Resources | 213 | ||
| Purpose | 213 | ||
| Standards of Care | 213 | ||
| Principles for Practice | 213 | ||
| Patient-Centered Care | 214 | ||
| Evidence-Based Practice | 214 | ||
| Safety Guidelines | 214 | ||
| Before a Procedure | 214 | ||
| During a Procedure | 214 | ||
| After the Procedure | 214 | ||
| Skill 8.1 Intravenous Moderate Sedation | 215 | ||
| Delegation and Collaboration | 215 | ||
| Equipment | 215 | ||
| Step/\tRationale | 215 | ||
| Recording and Reporting | 218 | ||
| Special Considerations | 219 | ||
| Teaching | 219 | ||
| Pediatric | 219 | ||
| Gerontological | 219 | ||
| Home Care | 219 | ||
| Skill 8.2 Contrast Media Studies: Arteriogram (Angiogram), Cardiac Catheterization, and Intravenous Pyelogram | 219 | ||
| Delegation and Collaboration | 220 | ||
| Equipment | 220 | ||
| Step/\tRationale | 220 | ||
| Recording and Reporting | 224 | ||
| Special Considerations | 225 | ||
| Teaching | 225 | ||
| Pediatric | 225 | ||
| Gerontological | 225 | ||
| Home Care | 225 | ||
| Skill 8.3 Assisting With Aspirations: Bone Marrow Aspiration/Biopsy, Lumbar Puncture, Paracentesis, and Thoracentesis | 225 | ||
| Delegation and Collaboration | 227 | ||
| Equipment | 227 | ||
| Additional Equipment for Specific Aspirations | 228 | ||
| Step/\tRationale | 228 | ||
| Recording and Reporting | 231 | ||
| Special Considerations | 231 | ||
| Teaching | 231 | ||
| Pediatric | 232 | ||
| Gerontological | 232 | ||
| Home Care | 232 | ||
| Skill 8.4 Care of a Patient Undergoing Bronchoscopy | 232 | ||
| Delegation and Collaboration | 232 | ||
| Equipment | 232 | ||
| Step/\tRationale | 233 | ||
| Recording and Reporting | 235 | ||
| Special Considerations | 235 | ||
| Teaching | 235 | ||
| Pediatric | 235 | ||
| Gerontological | 235 | ||
| Home Care | 235 | ||
| Skill 8.5 Care of a Patient Undergoing Endoscopy | 236 | ||
| Delegation and Collaboration | 236 | ||
| Equipment | 236 | ||
| Step/\tRationale | 237 | ||
| Recording and Reporting | 239 | ||
| Special Considerations | 239 | ||
| Teaching | 239 | ||
| Pediatric | 239 | ||
| Gerontological | 239 | ||
| Home Care | 239 | ||
| Clinical Debrief | 240 | ||
| Review Questions | 240 | ||
| References | 240 | ||
| Unit 4 Infection Control | 241 | ||
| 9 Medical Asepsis | 241 | ||
| Skills and Procedures | 241 | ||
| Objectives | 241 | ||
| Media Resources | 241 | ||
| Purpose | 241 | ||
| Standards of Care | 241 | ||
| Principles for Practice | 241 | ||
| Patient-Centered Care | 242 | ||
| Evidence-Based Practice | 243 | ||
| Safety Guidelines | 243 | ||
| Skill 9.1 Hand Hygiene | 243 | ||
| Delegation and Collaboration | 243 | ||
| Equipment | 243 | ||
| Step/\tRationale | 244 | ||
| Special Considerations | 247 | ||
| Teaching Considerations | 247 | ||
| Gerontological Considerations | 247 | ||
| Home Care | 247 | ||
| Skill 9.2 Caring for Patients Under Isolation Precautions | 247 | ||
| Delegation and Collaboration | 248 | ||
| Equipment | 249 | ||
| Step/\tRationale | 249 | ||
| Recording and Reporting | 254 | ||
| Special Considerations | 254 | ||
| Teaching Considerations | 254 | ||
| Pediatric Considerations | 254 | ||
| Gerontological Considerations | 254 | ||
| Home Care Considerations | 254 | ||
| Clinical Debrief | 255 | ||
| Review Questions | 255 | ||
| References | 255 | ||
| 10 Sterile Technique | 256 | ||
| Skills and Procedures | 256 | ||
| Objectives | 256 | ||
| Media Resources | 256 | ||
| Purpose | 256 | ||
| Standards of Care | 256 | ||
| Principles of Practice | 256 | ||
| Patient-Centered Care | 257 | ||
| Evidence-Based Practice | 257 | ||
| Safety Guidelines | 257 | ||
| Skill 10.1 Applying and Removing Cap, Mask, and Protective Eyewear | 257 | ||
| Delegation and Collaboration | 257 | ||
| Equipment | 258 | ||
| Step/\tRationale | 258 | ||
| Recording and Reporting | 261 | ||
| Special Considerations | 261 | ||
| Home Care | 261 | ||
| Skill 10.2 Preparing a Sterile Field | 261 | ||
| Delegation and Collaboration | 261 | ||
| Equipment | 261 | ||
| Step/\tRationale | 261 | ||
| Recording and Reporting | 266 | ||
| Special Considerations | 266 | ||
| Home Care | 266 | ||
| Skill 10.3 Sterile Gloving | 266 | ||
| Delegation and Collaboration | 266 | ||
| Equipment | 266 | ||
| Step/\tRationale | 267 | ||
| Recording and Reporting | 270 | ||
| Special Considerations | 270 | ||
| Teaching | 270 | ||
| Clinical Debrief | 270 | ||
| Review Questions | 270 | ||
| References | 270 | ||
| Unit 5 Activity and Mobility | 271 | ||
| 11 Safe Patient Handling, Transfer, and Positioning | 271 | ||
| Skills and Procedures | 271 | ||
| Objectives | 271 | ||
| Media Resources | 271 | ||
| Purpose | 271 | ||
| Standards of Care | 271 | ||
| Principles for Practice | 271 | ||
| Patient-Centered Care | 272 | ||
| Evidence-Based Practice | 272 | ||
| Safety Guidelines | 272 | ||
| Skill 11.1 Using Safe and Effective Transfer Techniques | 272 | ||
| Delegation and Collaboration | 272 | ||
| Equipment | 273 | ||
| Step\tRationale | 273 | ||
| Recording and Reporting | 281 | ||
| Special Considerations | 281 | ||
| Teaching | 281 | ||
| Pediatric | 281 | ||
| Gerontological | 281 | ||
| Home Care | 281 | ||
| Skill 11.2 Moving and Positioning Patients in Bed | 283 | ||
| Delegation and Collaboration | 283 | ||
| Equipment | 283 | ||
| Step\tRationale | 283 | ||
| Recording and Reporting | 290 | ||
| Special Considerations | 290 | ||
| Teaching | 290 | ||
| Gerontological | 290 | ||
| Clinical Debrief | 291 | ||
| Review Questions | 291 | ||
| References | 291 | ||
| 12 Exercise and Mobility | 292 | ||
| Skills and Procedures | 292 | ||
| Objectives | 292 | ||
| Media Resources | 292 | ||
| Purpose | 292 | ||
| Standards of Care | 292 | ||
| Principles for Practice | 292 | ||
| Patient-Centered Care | 293 | ||
| Evidence-Based Practice | 293 | ||
| Safety Guidelines | 294 | ||
| Skill 12.1 Promoting Early Activity and Exercise | 294 | ||
| Delegation and Collaboration | 294 | ||
| Equipment | 294 | ||
| Step\tRationale | 294 | ||
| Recording and Reporting | 298 | ||
| Special Considerations | 298 | ||
| Home Care | 298 | ||
| Skill 12.2 Assisting With Use of Canes, Walkers, and Crutches | 311 | ||
| Delegation and Collaboration | 312 | ||
| Equipment | 312 | ||
| Step\tRationale | 312 | ||
| Recording and Reporting | 319 | ||
| Special Considerations | 319 | ||
| Teaching | 319 | ||
| Pediatric | 319 | ||
| Gerontological | 319 | ||
| Home Care | 319 | ||
| Long-Term Care | 319 | ||
| Clinical Debrief | 320 | ||
| Review Questions | 320 | ||
| References | 320 | ||
| 13 Support Surfaces and Special Beds | 322 | ||
| Skills and Procedures | 322 | ||
| Objectives | 322 | ||
| Media Resources | 322 | ||
| Purpose | 322 | ||
| Standards of Care | 322 | ||
| Principles for Practice | 322 | ||
| Patient-Centered Care | 324 | ||
| Evidence-Based Practice | 324 | ||
| Safety Guidelines | 325 | ||
| Skill 13.1 Placing a Patient on a Support Surface | 327 | ||
| Delegation and Collaboration | 329 | ||
| Equipment | 329 | ||
| Step/\tRationale | 329 | ||
| Recording and Reporting | 332 | ||
| Special Considerations | 332 | ||
| Teaching | 332 | ||
| Pediatric | 332 | ||
| Gerontological | 332 | ||
| Home Care | 332 | ||
| Skill 13.2 Placing a Patient on a Special Bed | 332 | ||
| Delegation and Collaboration | 334 | ||
| Equipment | 334 | ||
| Step/\tRationale | 334 | ||
| Recording and Reporting | 337 | ||
| Special Considerations | 337 | ||
| Teaching | 337 | ||
| Pediatric | 337 | ||
| Gerontological | 337 | ||
| Home Care | 337 | ||
| Long-Term Care | 337 | ||
| Clinical Debrief | 338 | ||
| Review Questions | 338 | ||
| References | 338 | ||
| Unit 6 Safety and Comfort | 339 | ||
| 14 Patient Safety | 339 | ||
| Skills and Procedures | 339 | ||
| Objectives | 339 | ||
| Media Resources | 339 | ||
| Purpose | 339 | ||
| Standards of Care | 339 | ||
| Principles for Practice | 339 | ||
| Patient-Centered Care | 339 | ||
| Evidence-Based Practice | 340 | ||
| Safety Guidelines | 340 | ||
| Skill 14.1 Fall Prevention in Health Care Agencies | 341 | ||
| Delegation and Collaboration | 342 | ||
| Equipment | 342 | ||
| Step/\tRationale | 342 | ||
| Recording and Reporting | 348 | ||
| Special Considerations | 348 | ||
| Teaching | 348 | ||
| Pediatric | 348 | ||
| Gerontological | 348 | ||
| Home Care | 348 | ||
| Skill 14.2 Designing a Restraint-Free Environment | 348 | ||
| Delegation and Collaboration | 349 | ||
| Equipment | 349 | ||
| Step/\tRationale | 349 | ||
| Recording and Reporting | 352 | ||
| Special Considerations | 352 | ||
| Teaching | 352 | ||
| Gerontological | 352 | ||
| Home Care | 352 | ||
| Skill 14.3 Applying Physical Restraints | 352 | ||
| Delegation and Collaboration | 353 | ||
| Equipment | 353 | ||
| Step/\tRationale | 353 | ||
| Recording and Reporting | 358 | ||
| Special Considerations | 358 | ||
| Teaching | 358 | ||
| Pediatric | 358 | ||
| Gerontological | 358 | ||
| Home Care | 358 | ||
| Skill 14.4 Seizure Precautions | 361 | ||
| Delegation and Collaboration | 361 | ||
| Equipment | 361 | ||
| Step/\tRationale | 361 | ||
| Recording and Reporting | 364 | ||
| Special Considerations | 364 | ||
| Teaching | 364 | ||
| Pediatric | 365 | ||
| Gerontological | 365 | ||
| Home Care | 365 | ||
| Clinical Debrief | 365 | ||
| Review Questions | 365 | ||
| References | 365 | ||
| 15 Disaster Preparedness | 367 | ||
| Skills and Procedures | 367 | ||
| Objectives | 367 | ||
| Media Resources | 367 | ||
| Purpose | 367 | ||
| Standards of Care | 367 | ||
| Principles for Practice | 367 | ||
| Patient-Centered Care | 370 | ||
| Evidence-Based Practice | 370 | ||
| Safety Guidelines | 372 | ||
| Skill 15.1 Care of a Patient After Biological Exposure | 373 | ||
| Delegation and Collaboration | 375 | ||
| Equipment | 375 | ||
| Step/\tRationale | 375 | ||
| Recording and Reporting | 378 | ||
| Special Considerations | 378 | ||
| Teaching | 378 | ||
| Pediatric | 378 | ||
| Gerontological | 378 | ||
| Home Care | 378 | ||
| Skill 15.2 Care of a Patient After Chemical Exposure | 379 | ||
| Delegation and Collaboration | 380 | ||
| Equipment | 380 | ||
| Step/\tRationale | 380 | ||
| Recording and Reporting | 383 | ||
| Special Considerations | 383 | ||
| Teaching | 383 | ||
| Pediatric | 383 | ||
| Gerontological | 383 | ||
| Home Care | 383 | ||
| Skill 15.3 Care of a Patient After Radiation Exposure | 384 | ||
| Delegation and Collaboration | 384 | ||
| Equipment | 384 | ||
| Step/\tRationale | 384 | ||
| Recording and Reporting | 387 | ||
| Special Considerations | 387 | ||
| Teaching | 387 | ||
| Pediatric | 387 | ||
| Gerontological | 387 | ||
| Home Care | 387 | ||
| Clinical Debrief | 387 | ||
| Review Questions | 387 | ||
| References | 387 | ||
| 16 Pain Management | 389 | ||
| Skills and Procedures | 389 | ||
| Objectives | 389 | ||
| Media Resources | 389 | ||
| Purpose | 389 | ||
| Standards of Care | 389 | ||
| Principles for Practice | 389 | ||
| Patient-Centered Care | 390 | ||
| Evidence-Based Practice | 391 | ||
| Safety Guidelines | 391 | ||
| Skill 16.1 Pain Assessment and Basic Comfort Measures | 392 | ||
| Delegation and Collaboration | 392 | ||
| Equipment | 392 | ||
| Step/\tRationale | 392 | ||
| Recording and Reporting | 397 | ||
| Special Considerations | 397 | ||
| Teaching | 397 | ||
| Pediatric | 397 | ||
| Gerontological | 398 | ||
| Home Care | 398 | ||
| Skill 16.2 Patient-Controlled Analgesia | 398 | ||
| Delegation and Collaboration | 398 | ||
| Equipment | 398 | ||
| Step/\tRationale | 399 | ||
| Recording and Reporting | 402 | ||
| Special Considerations | 402 | ||
| Teaching | 402 | ||
| Pediatric | 403 | ||
| Gerontological | 403 | ||
| Skill 16.3 Epidural Analgesia | 403 | ||
| Delegation and Collaboration | 404 | ||
| Equipment | 404 | ||
| Step/\tRationale | 405 | ||
| Reporting and Recording | 408 | ||
| Special Considerations | 408 | ||
| Teaching | 408 | ||
| Pediatric | 409 | ||
| Gerontological | 409 | ||
| Home Care | 409 | ||
| Skill 16.4 Local Anesthetic Infusion Pump for Analgesia | 409 | ||
| Delegation and Collaboration | 409 | ||
| Equipment | 409 | ||
| Step/\tRationale | 410 | ||
| Reporting and Recording | 412 | ||
| Special Considerations | 412 | ||
| Teaching | 412 | ||
| Pediatric | 412 | ||
| Gerontological | 412 | ||
| Home Care | 412 | ||
| Skill 16.5 Nonpharmacological Pain Management | 412 | ||
| Relaxation and Guided Imagery | 412 | ||
| Cutaneous Stimulation | 413 | ||
| Massage | 413 | ||
| Heat and Cold | 413 | ||
| Distraction | 413 | ||
| Delegation and Collaboration | 413 | ||
| Equipment | 413 | ||
| Step/\tRationale | 414 | ||
| Recording and Reporting | 419 | ||
| Special Considerations | 419 | ||
| Teaching | 419 | ||
| Pediatric | 420 | ||
| Gerontological | 420 | ||
| Home Care | 420 | ||
| Clinical Debrief | 420 | ||
| Review Questions | 420 | ||
| References | 421 | ||
| 17 Palliative Care | 423 | ||
| Skills and Procedures | 423 | ||
| Objectives | 423 | ||
| Media Resources | 423 | ||
| Purpose | 423 | ||
| Standards of Care | 423 | ||
| Principles for Practice | 423 | ||
| Patient-Centered Care | 424 | ||
| Evidence-Based Practice | 424 | ||
| Safety Guidelines | 425 | ||
| Skill 17.1 Supporting Patients and Families in Grief | 425 | ||
| Grief | 425 | ||
| Delegation and Collaboration | 426 | ||
| Step/\tRationale | 426 | ||
| Recording and Reporting | 428 | ||
| Special Considerations | 428 | ||
| Teaching | 428 | ||
| Pediatric | 428 | ||
| Gerontological | 428 | ||
| Skill 17.2 Symptom Management at the End of Life | 428 | ||
| Delegation and Collaboration | 428 | ||
| Equipment | 428 | ||
| Step/\tRationale | 429 | ||
| Recording and Reporting | 433 | ||
| Special Considerations | 433 | ||
| Teaching | 433 | ||
| Pediatric | 433 | ||
| Gerontological | 433 | ||
| Home Care | 433 | ||
| Skill 17.3 Care of a Body After Death | 434 | ||
| Delegation and Collaboration | 434 | ||
| Equipment | 434 | ||
| Step/\tRationale | 435 | ||
| Recording and Reporting | 438 | ||
| Special Considerations | 438 | ||
| Pediatric | 438 | ||
| Gerontological | 438 | ||
| Home Care | 438 | ||
| Clinical Debrief | 438 | ||
| Review Questions | 439 | ||
| References | 439 | ||
| Unit 7 Hygiene | 441 | ||
| 18 Personal Hygiene and Bed Making | 441 | ||
| Skills and Procedures | 441 | ||
| Objectives | 441 | ||
| Media Resources | 441 | ||
| Purpose | 441 | ||
| Standards of Care | 441 | ||
| Principles for Practice | 441 | ||
| Patient-Centered Care | 442 | ||
| Evidenced-Based Practice | 442 | ||
| Safety Guidelines | 442 | ||
| The Skin | 442 | ||
| The Mouth | 444 | ||
| The Hair | 444 | ||
| The Nails | 444 | ||
| Skill 18.1 Complete or Partial Bed Bath | 445 | ||
| Delegation and Collaboration | 445 | ||
| Equipment | 446 | ||
| Step\tRationale | 446 | ||
| Recording and Reporting | 454 | ||
| Special Considerations | 454 | ||
| Teaching | 454 | ||
| Pediatric | 454 | ||
| Gerontological | 454 | ||
| Home Care | 454 | ||
| Long-Term Care | 454 | ||
| Skill 18.2 Oral Hygiene | 457 | ||
| Delegation and Collaboration | 457 | ||
| Equipment | 458 | ||
| Step\tRationale | 458 | ||
| Recording and Reporting | 462 | ||
| Special Considerations | 462 | ||
| Teaching | 462 | ||
| Pediatric | 462 | ||
| Gerontological | 462 | ||
| Home Care | 462 | ||
| Skill 18.3 Performing Mouth Care for an Unconscious or Debilitated Patient | 464 | ||
| Delegation and Collaboration | 464 | ||
| Equipment | 464 | ||
| Step\tRationale | 464 | ||
| Recording and Reporting | 467 | ||
| Special Considerations | 467 | ||
| Teaching | 467 | ||
| Home Care | 467 | ||
| Skill 18.4 Performing Nail and Foot Care | 471 | ||
| Delegation and Collaboration | 473 | ||
| Equipment | 473 | ||
| Step\tRationale | 473 | ||
| Recording and Reporting | 476 | ||
| Special Considerations | 476 | ||
| Teaching | 476 | ||
| Pediatric | 476 | ||
| Gerontological | 476 | ||
| Home Care | 477 | ||
| Clinical Debrief | 482 | ||
| Review Questions | 482 | ||
| References | 483 | ||
| 19 Care of the Eye and Ear | 484 | ||
| Skills and Procedures | 484 | ||
| Objectives | 484 | ||
| Media Resources | 484 | ||
| Purpose | 484 | ||
| Standards of Care | 484 | ||
| Principles for Practice | 484 | ||
| Patient-Centered Care | 484 | ||
| Evidence-Based Practice | 485 | ||
| Safety Guidelines | 485 | ||
| Skill 19.1 Eye Irrigation | 489 | ||
| Delegation and Collaboration | 489 | ||
| Equipment | 489 | ||
| Step/\tRationale | 489 | ||
| Recording and Reporting | 492 | ||
| Special Considerations | 492 | ||
| Teaching | 492 | ||
| Pediatric | 492 | ||
| Skill 19.2 Ear Irrigation | 492 | ||
| Delegation and Collaboration | 492 | ||
| Equipment | 492 | ||
| Step/\tRationale | 492 | ||
| Recording and Reporting | 495 | ||
| Special Considerations | 495 | ||
| Teaching | 495 | ||
| Pediatric | 495 | ||
| Home Care | 495 | ||
| Skill 19.3 Care of Hearing Aids | 495 | ||
| Delegation and Collaboration | 496 | ||
| Equipment | 496 | ||
| Step/\tRationale | 497 | ||
| Recording and Reporting | 499 | ||
| Special Considerations | 499 | ||
| Teaching | 499 | ||
| Pediatric | 499 | ||
| Gerontological | 499 | ||
| Home Care | 499 | ||
| Clinical Debrief | 500 | ||
| Review Questions | 500 | ||
| References | 500 | ||
| Unit 8 Medications | 501 | ||
| 20 Safe Medication Preparation | 501 | ||
| Outline | 501 | ||
| Objectives | 501 | ||
| Media Resources | 501 | ||
| Purpose | 501 | ||
| Standards of Care | 501 | ||
| Principles for Practice | 502 | ||
| Pharmacological Concepts | 502 | ||
| Medication Names | 502 | ||
| Classification | 502 | ||
| Medication Forms | 502 | ||
| Pharmacokinetics | 502 | ||
| Types of Medication Action | 502 | ||
| Therapeutic Effects | 503 | ||
| Adverse Effects | 503 | ||
| Side Effects | 504 | ||
| Toxic Effects | 504 | ||
| Idiosyncratic Reactions | 504 | ||
| Allergic Reactions | 504 | ||
| Medication Tolerance and Dependence | 504 | ||
| Medication Interactions | 505 | ||
| Medication Dose Responses | 505 | ||
| Routes of Administration | 505 | ||
| Medication Distribution | 506 | ||
| Computerized Provider Order Entry | 506 | ||
| Distribution Systems | 506 | ||
| Unit Dose | 506 | ||
| Automated Medication Dispensing System | 506 | ||
| Special Handling of Controlled Substances | 507 | ||
| Bar Coding | 507 | ||
| Systems of Medication Measurement | 508 | ||
| Metric System | 508 | ||
| Household Measurement | 508 | ||
| Solutions | 508 | ||
| Patient-Centered Care | 509 | ||
| Safe Medication Administration | 509 | ||
| Right Medication | 509 | ||
| Medication Orders. | 510 | ||
| Right Dose | 512 | ||
| Right Patient | 512 | ||
| Right Route | 513 | ||
| Right Time | 513 | ||
| Right Documentation | 513 | ||
| Medication Preparation | 514 | ||
| Interpreting Medication Labels | 514 | ||
| Clinical Calculation | 514 | ||
| Conversions Within One System. | 514 | ||
| Conversion Between Systems. | 514 | ||
| Dosage Calculations. | 514 | ||
| The Formula Method | 515 | ||
| Dimensional Analysis Method. | 515 | ||
| Ratio-and-Proportion Method. | 515 | ||
| Pediatric Doses. | 515 | ||
| Older Adult Dosages. | 516 | ||
| Evidence-Based Practice | 516 | ||
| Nursing Process | 516 | ||
| Assessment | 516 | ||
| Planning | 517 | ||
| Implementation | 517 | ||
| Preadministration Activities | 517 | ||
| Medication Administration | 517 | ||
| Postadministration Activities | 517 | ||
| Evaluation | 517 | ||
| Reporting Medication Errors | 518 | ||
| Patient and Family Teaching | 518 | ||
| Clinical Debrief | 519 | ||
| Review Questions | 519 | ||
| References | 519 | ||
| 21 Nonparenteral Medications | 521 | ||
| Skills and Procedures | 521 | ||
| Objectives | 521 | ||
| Media Resources | 521 | ||
| Purpose | 521 | ||
| Standards of Care | 521 | ||
| Principles for Practice | 522 | ||
| Patient-Centered Care | 522 | ||
| Evidence-Based Practice | 522 | ||
| Safety Guidelines | 523 | ||
| Skill 21.1 Administering Oral Medications | 523 | ||
| Delegation and Collaboration | 523 | ||
| Equipment | 523 | ||
| Step\tRationale | 523 | ||
| Recording and Reporting | 530 | ||
| Special Considerations | 530 | ||
| Teaching | 530 | ||
| Pediatric | 530 | ||
| Gerontological | 530 | ||
| Home Care | 530 | ||
| Skill 21.2 Administering Medications Through a Feeding Tube | 530 | ||
| Delegation and Collaboration | 531 | ||
| Equipment | 531 | ||
| Step\tRationale | 531 | ||
| Recording and Reporting | 535 | ||
| Special Considerations | 536 | ||
| Teaching | 536 | ||
| Pediatric | 536 | ||
| Skill 21.3 Applying Topical Medications to the Skin | 536 | ||
| Delegation and Collaboration | 536 | ||
| Equipment | 536 | ||
| Step\tRationale | 536 | ||
| Recording and Reporting | 541 | ||
| Special Considerations | 541 | ||
| Teaching | 541 | ||
| Gerontological | 541 | ||
| Home Care | 541 | ||
| Skill 21.4 Administering Ophthalmic Medications | 541 | ||
| Delegation and Collaboration | 542 | ||
| Equipment | 542 | ||
| Eyedrops/Ointment | 542 | ||
| Step\tRationale | 542 | ||
| Recording and Reporting | 546 | ||
| Special Considerations | 546 | ||
| Teaching | 546 | ||
| Pediatric | 546 | ||
| Gerontological | 546 | ||
| Home Care | 546 | ||
| Skill 21.5 Administering Ear Medications | 547 | ||
| Equipment | 547 | ||
| Delegation and Collaboration | 547 | ||
| Step\tRationale | 547 | ||
| Recording and Reporting | 550 | ||
| Pediatric | 550 | ||
| Skill 21.6 Administering Nasal Instillations | 550 | ||
| Delegation and Collaboration | 550 | ||
| Equipment | 550 | ||
| Step\tRationale | 550 | ||
| Recording and Reporting | 554 | ||
| Special Considerations | 554 | ||
| Teaching | 554 | ||
| Pediatric | 554 | ||
| Skill 21.7 Using Metered-Dose Inhalers (MDIs) | 554 | ||
| Delegation and Collaboration | 554 | ||
| Equipment | 554 | ||
| Step\tRationale | 555 | ||
| Recording and Reporting | 559 | ||
| Special Considerations | 559 | ||
| Teaching | 559 | ||
| Pediatric | 559 | ||
| Gerontological | 560 | ||
| Home Care | 560 | ||
| Skill 21.8 Using Small-Volume Nebulizers | 561 | ||
| Delegation and Collaboration | 561 | ||
| Equipment | 561 | ||
| Step\tRationale | 561 | ||
| Recording and Reporting | 564 | ||
| Special Considerations | 564 | ||
| Teaching | 564 | ||
| Pediatric | 564 | ||
| Gerontological | 564 | ||
| Home Care | 564 | ||
| Skill 21.9 Administering Vaginal Instillations | 565 | ||
| Delegation and Collaboration | 565 | ||
| Equipment | 565 | ||
| Step\tRationale | 565 | ||
| Recording and Reporting | 569 | ||
| Special Considerations | 569 | ||
| Teaching | 569 | ||
| Gerontological | 569 | ||
| Skill 21.10 Administering Rectal Suppositories | 569 | ||
| Delegation and Collaboration | 569 | ||
| Equipment | 569 | ||
| Step\tRationale | 570 | ||
| Recording and Reporting | 572 | ||
| Special Considerations | 572 | ||
| Teaching | 572 | ||
| Pediatric | 572 | ||
| Gerontological | 572 | ||
| Clinical Debrief | 573 | ||
| Review Questions | 573 | ||
| References | 573 | ||
| 22 Parenteral Medications | 575 | ||
| Skills and Procedures | 575 | ||
| Objectives | 575 | ||
| Media Resources | 575 | ||
| Purpose | 575 | ||
| Standards of Care | 575 | ||
| Principles for Practice | 575 | ||
| Patient-Centered Care | 576 | ||
| Evidence-Based Practice | 576 | ||
| Safety Guidelines | 576 | ||
| Needlestick Prevention | 577 | ||
| Equipment | 578 | ||
| Syringes | 578 | ||
| Needles | 579 | ||
| Disposable Injection Units | 579 | ||
| Skill 22.1 Preparing Injections: Ampules and Vials | 580 | ||
| Delegation and Collaboration | 580 | ||
| Equipment | 581 | ||
| Step\tRationale | 581 | ||
| Skill 22.2 Administering Intradermal Injections | 589 | ||
| Delegation and Collaboration | 589 | ||
| Equipment | 589 | ||
| Step\tRationale | 589 | ||
| Recording and Reporting | 593 | ||
| Special Considerations | 593 | ||
| Teaching | 593 | ||
| Pediatric | 593 | ||
| Gerontological | 593 | ||
| Skill 22.3 Administering Subcutaneous Injections | 593 | ||
| Special Considerations for Administration of Insulin | 594 | ||
| Special Considerations for Administration of Heparin | 594 | ||
| Delegation and Collaboration | 595 | ||
| Equipment | 595 | ||
| Step\tRationale | 595 | ||
| Recording and Reporting | 600 | ||
| Special Considerations | 600 | ||
| Teaching | 600 | ||
| Pediatric | 600 | ||
| Gerontological | 600 | ||
| Home Care | 600 | ||
| Skill 22.4 Administering Intramuscular Injections | 600 | ||
| Injection Sites | 601 | ||
| Ventrogluteal Site | 601 | ||
| Vastus Lateralis Muscle | 601 | ||
| Deltoid Muscle | 602 | ||
| Delegation and Collaboration | 602 | ||
| Equipment | 603 | ||
| Step\tRationale | 603 | ||
| Recording and Reporting | 606 | ||
| Special Considerations | 606 | ||
| Teaching | 606 | ||
| Pediatric | 607 | ||
| Gerontological | 607 | ||
| Home Care | 607 | ||
| Skill 22.5 Administering Medications by Intravenous Bolus | 607 | ||
| Delegation and Collaboration | 608 | ||
| Equipment | 608 | ||
| Step\tRationale | 608 | ||
| Recording and Reporting | 613 | ||
| Special Considerations | 613 | ||
| Teaching | 613 | ||
| Pediatric | 613 | ||
| Gerontological | 613 | ||
| Home Care | 613 | ||
| Skill 22.6 Administering Intravenous Medications by Piggyback, Intermittent Infusion Sets, and Mini-Infusion Pumps | 614 | ||
| Needle Safety | 614 | ||
| Delegation and Collaboration | 614 | ||
| Equipment | 614 | ||
| Step\tRationale | 615 | ||
| Recording and Reporting | 620 | ||
| Special Considerations | 620 | ||
| Teaching | 620 | ||
| Pediatric | 620 | ||
| Gerontological | 620 | ||
| Home Care | 620 | ||
| Skill 22.7 Administering Continuous Subcutaneous Medications | 620 | ||
| Delegation and Collaboration | 621 | ||
| Equipment | 621 | ||
| Step\tRationale | 621 | ||
| Recording and Reporting | 624 | ||
| Special Considerations | 624 | ||
| Teaching | 624 | ||
| Pediatric | 625 | ||
| Gerontological | 625 | ||
| Home Care | 625 | ||
| Clinical Debrief | 625 | ||
| Review Questions | 625 | ||
| References | 626 | ||
| Unit 9 Oxygenation | 627 | ||
| 23 Oxygen Therapy | 627 | ||
| Skills and Procedures | 627 | ||
| Objectives | 627 | ||
| Media Resources | 627 | ||
| Purpose | 627 | ||
| Standards of Care | 627 | ||
| Principles for Practice | 627 | ||
| Patient-Centered Care | 628 | ||
| Evidence-Based Practice | 628 | ||
| Safety Guidelines | 628 | ||
| Skill 23.1 Applying an Oxygen-Delivery Device | 629 | ||
| Oxygen-Delivery Devices | 629 | ||
| Nasal Cannula | 631 | ||
| Oxygen Mask | 632 | ||
| Delegation and Collaboration | 633 | ||
| Equipment | 633 | ||
| Step/\tRationale | 633 | ||
| Recording and Reporting | 636 | ||
| Special Considerations | 636 | ||
| Teaching | 636 | ||
| Pediatric | 636 | ||
| Gerontological | 636 | ||
| Home Care | 636 | ||
| Skill 23.2 Administering Oxygen Therapy to a Patient With an Artificial Airway | 636 | ||
| Delegation and Collaboration | 636 | ||
| Equipment | 637 | ||
| Step/\tRationale | 637 | ||
| Recording and Reporting | 639 | ||
| Special Considerations | 639 | ||
| Teaching | 639 | ||
| Home Care | 639 | ||
| Skill 23.3 Using Incentive Spirometry | 639 | ||
| Delegation and Collaboration | 640 | ||
| Equipment | 640 | ||
| Step/\tRationale | 640 | ||
| Recording and Reporting | 642 | ||
| Special Considerations | 642 | ||
| Teaching | 642 | ||
| Pediatric | 642 | ||
| Gerontological | 642 | ||
| Skill 23.4 Care of a Patient Receiving Noninvasive Positive-Pressure Ventilation | 642 | ||
| Delegation and Collaboration | 643 | ||
| Equipment | 643 | ||
| Step/\tRationale | 643 | ||
| Recording and Reporting | 646 | ||
| Special Considerations | 646 | ||
| Teaching | 646 | ||
| Home Care | 646 | ||
| Skill 23.5 Care of a Patient on a Mechanical Ventilator | 649 | ||
| Modes of Positive-Pressure Mechanical Ventilation | 649 | ||
| Alarms and Settings | 649 | ||
| Ventilator-Associated Events | 649 | ||
| Delegation and Collaboration | 652 | ||
| Equipment | 652 | ||
| Step/\tRationale | 652 | ||
| Recording and Reporting | 657 | ||
| Special Considerations | 658 | ||
| Teaching | 658 | ||
| Pediatric | 658 | ||
| Gerontological | 658 | ||
| Home Care | 658 | ||
| Clinical Debrief | 658 | ||
| Review Questions | 658 | ||
| References | 659 | ||
| 24 Performing Chest Physiotherapy | 660 | ||
| Skills and Procedures | 660 | ||
| Objectives | 660 | ||
| Media Resources | 660 | ||
| Purpose | 660 | ||
| Standards of Care | 660 | ||
| Principles for Practice | 660 | ||
| Patient-Centered Care | 661 | ||
| Evidence-Based Practice | 661 | ||
| Safety Guidelines | 661 | ||
| Skill 24.1 Performing Postural Drainage | 662 | ||
| Delegation and Collaboration | 662 | ||
| Equipment | 662 | ||
| Step/\tRationale | 665 | ||
| Recording and Reporting | 667 | ||
| Special Considerations | 667 | ||
| Teaching | 667 | ||
| Pediatric | 667 | ||
| Gerontological | 667 | ||
| Home Care | 667 | ||
| Clinical Debrief | 671 | ||
| Review Questions | 671 | ||
| References | 671 | ||
| 25 Airway Management | 672 | ||
| Skills and Procedures | 672 | ||
| Objectives | 672 | ||
| Media Resources | 672 | ||
| Purpose | 672 | ||
| Standards of Care | 672 | ||
| Principles for Practice | 672 | ||
| Patient-Centered Care | 672 | ||
| Evidence-Based Practice | 673 | ||
| Safety Guidelines | 673 | ||
| Skill 25.1 Performing Oropharyngeal Suctioning | 674 | ||
| Delegation and Collaboration | 674 | ||
| Equipment | 674 | ||
| Step/\tRationale | 674 | ||
| Recording and Reporting | 677 | ||
| Special Considerations | 677 | ||
| Teaching | 677 | ||
| Pediatric | 677 | ||
| Gerontological | 677 | ||
| Home Care | 677 | ||
| Long-Term Care | 677 | ||
| Skill 25.2 Airway Suctioning | 677 | ||
| Artificial Airway Suctioning | 678 | ||
| Endotracheal Tubes | 678 | ||
| Tracheostomy Tubes | 678 | ||
| Delegation and Collaboration | 679 | ||
| Equipment | 679 | ||
| Step/\tRationale | 679 | ||
| Recording and Reporting | 686 | ||
| Special Considerations | 686 | ||
| Teaching | 686 | ||
| Pediatric | 686 | ||
| Gerontological | 687 | ||
| Home Care | 687 | ||
| Skill 25.3 Performing Endotracheal Tube Care | 689 | ||
| Delegation and Collaboration | 689 | ||
| Equipment | 689 | ||
| Step/\tRationale | 690 | ||
| Recording and Reporting | 695 | ||
| Special Considerations | 695 | ||
| Teaching | 695 | ||
| Pediatric | 695 | ||
| Gerontological | 695 | ||
| Skill 25.4 Performing Tracheostomy Care | 696 | ||
| Delegation and Collaboration | 697 | ||
| Equipment | 697 | ||
| Step/\tRationale | 698 | ||
| Recording and Reporting | 703 | ||
| Special Considerations | 703 | ||
| Teaching | 703 | ||
| Pediatric | 704 | ||
| Gerontological | 704 | ||
| Home Care | 704 | ||
| Clinical Debrief | 704 | ||
| Review Questions | 704 | ||
| References | 704 | ||
| 26 Cardiac Care | 706 | ||
| Skills and Procedures | 706 | ||
| Objectives | 706 | ||
| Media Resources | 706 | ||
| Purpose | 706 | ||
| Standards of Care | 706 | ||
| Principles for Practice | 706 | ||
| Patient-Centered Care | 706 | ||
| Evidence-Based Practice | 706 | ||
| Indications | 706 | ||
| Contraindications | 706 | ||
| Safety Guidelines | 707 | ||
| Skill 26.1 Obtaining a 12-Lead Electrocardiogram | 707 | ||
| Delegation and Collaboration | 708 | ||
| Equipment | 708 | ||
| Step/\tRationale | 708 | ||
| Recording and Reporting | 710 | ||
| Special Considerations | 710 | ||
| Skill 26.2 Applying a Cardiac Monitor | 710 | ||
| Delegation and Collaboration | 710 | ||
| Equipment | 711 | ||
| Step/\tRationale | 711 | ||
| Recording and Reporting | 713 | ||
| Special Considerations | 713 | ||
| Pediatric | 713 | ||
| Clinical Debrief | 713 | ||
| Review Questions | 713 | ||
| References | 713 | ||
| 27 Closed Chest Drainage Systems | 714 | ||
| Skills and Procedures | 714 | ||
| Objectives | 714 | ||
| Media Resources | 714 | ||
| Purpose | 714 | ||
| Standards of Care | 714 | ||
| Principles for Practice | 714 | ||
| Patient-Centered Care | 717 | ||
| Evidence-Based Practice | 717 | ||
| Safety Guidelines | 717 | ||
| Skill 27.1 Managing Closed Chest Drainage Systems | 718 | ||
| Water-Seal Systems | 718 | ||
| Two-Chamber Water-Seal System | 718 | ||
| Three-Chamber Water-Seal System | 718 | ||
| Waterless Systems | 719 | ||
| Two-Chamber Waterless System | 719 | ||
| Three-Chamber Waterless System | 720 | ||
| Dry Suction System | 720 | ||
| Delegation and Collaboration | 720 | ||
| Equipment | 721 | ||
| Step\tRationale | 721 | ||
| Recording and Reporting | 727 | ||
| Special Considerations | 727 | ||
| Teaching | 727 | ||
| Pediatric | 727 | ||
| Gerontological | 727 | ||
| Home Care | 727 | ||
| Skill 27.2 Assisting With Removal of Chest Tubes | 728 | ||
| Delegation and Collaboration | 728 | ||
| Equipment | 728 | ||
| Step\tRationale | 728 | ||
| Recording and Reporting | 730 | ||
| Special Considerations | 730 | ||
| Teaching | 730 | ||
| Pediatric | 730 | ||
| Skill 27.3 Autotransfusion of Chest Tube Drainage | 731 | ||
| Delegation and Collaboration | 731 | ||
| Equipment | 731 | ||
| Step\tRationale | 731 | ||
| Recording and Reporting | 733 | ||
| Special Considerations | 733 | ||
| Teaching | 733 | ||
| Clinical Debrief | 734 | ||
| Review Questions | 734 | ||
| References | 734 | ||
| 28 Emergency Measures for Life Support | 735 | ||
| Skills and Procedures | 735 | ||
| Objectives | 735 | ||
| Media Resources | 735 | ||
| Purpose | 735 | ||
| Standards of Care | 735 | ||
| Principles of Practice | 735 | ||
| Patient-Centered Care | 735 | ||
| Evidence-Based Practice | 736 | ||
| Safety Guidelines | 736 | ||
| Skill 28.1 Inserting an Oropharyngeal Airway | 736 | ||
| Delegation and Collaboration | 736 | ||
| Equipment | 737 | ||
| Step/\tRationale | 737 | ||
| Recording and Reporting | 739 | ||
| Special Considerations | 739 | ||
| Pediatric | 739 | ||
| Skill 28.2 Using an Automated External Defibrillator | 739 | ||
| Delegation and Collaboration | 739 | ||
| Equipment | 739 | ||
| Step/\tRationale | 739 | ||
| Recording and Reporting | 741 | ||
| Special Considerations | 741 | ||
| Teaching | 741 | ||
| Pediatric | 741 | ||
| Home Care | 742 | ||
| Skill 28.3 Code Management | 742 | ||
| Delegation and Collaboration | 744 | ||
| Equipment | 744 | ||
| Step/\tRationale | 745 | ||
| Recording and Reporting | 750 | ||
| Special Considerations | 750 | ||
| Teaching | 750 | ||
| Pediatric | 750 | ||
| Gerontological | 750 | ||
| Home Care | 750 | ||
| Clinical Debrief | 750 | ||
| Review Questions | 750 | ||
| References | 750 | ||
| Unit 10 Fluid Balance | 751 | ||
| 29 Intravenous and Vascular Access Therapy | 751 | ||
| Skills and Procedures | 751 | ||
| Objectives | 751 | ||
| Media Resources | 751 | ||
| Purpose | 751 | ||
| Standards of Care | 751 | ||
| Principles for Practice | 751 | ||
| Intravenous Catheters | 752 | ||
| Intravenous Solutions | 752 | ||
| Patient-Centered Care | 752 | ||
| Evidence-Based Practice | 753 | ||
| Safety Guidelines | 753 | ||
| Skill 29.1 Insertion of a Short-Peripheral Intravenous Device | 754 | ||
| Delegation and Collaboration | 754 | ||
| Equipment | 755 | ||
| Step/\tRationale | 756 | ||
| Recording and Reporting | 767 | ||
| Special Considerations | 767 | ||
| Teaching | 767 | ||
| Pediatric | 767 | ||
| Gerontological | 768 | ||
| Home Care | 768 | ||
| Skill 29.2 Regulating Intravenous Flow Rates | 768 | ||
| Delegation and Collaboration | 769 | ||
| Equipment | 769 | ||
| Step/\tRationale | 769 | ||
| Recording and Reporting | 773 | ||
| Special Considerations | 773 | ||
| Teaching | 773 | ||
| Pediatric | 773 | ||
| Gerontological | 773 | ||
| Home Care | 773 | ||
| Skill 29.3 Changing Intravenous Solutions | 774 | ||
| Delegation and Collaboration | 774 | ||
| Equipment | 774 | ||
| Step/\tRationale | 774 | ||
| Recording and Reporting | 777 | ||
| Special Considerations | 777 | ||
| Teaching | 777 | ||
| Home Care | 777 | ||
| Skill 29.4 Changing Infusion Tubing | 777 | ||
| Delegation and Collaboration | 777 | ||
| Equipment | 777 | ||
| Step/\tRationale | 778 | ||
| Recording and Reporting | 780 | ||
| Special Considerations | 780 | ||
| Teaching | 780 | ||
| Home Care | 780 | ||
| Skill 29.5 Changing a Short-Peripheral Intravenous Dressing | 781 | ||
| Delegation and Collaboration | 781 | ||
| Equipment | 781 | ||
| Step/\tRationale | 781 | ||
| Recording and Reporting | 784 | ||
| Special Considerations | 784 | ||
| Teaching | 784 | ||
| Pediatric | 784 | ||
| Gerontological | 784 | ||
| Home Care | 784 | ||
| Skill 29.6 Managing Central Vascular Access Devices | 785 | ||
| Delegation and Collaboration | 787 | ||
| Equipment | 787 | ||
| Step/\tRationale | 788 | ||
| Recording and Reporting | 798 | ||
| Special Considerations | 798 | ||
| Teaching | 798 | ||
| Pediatric | 798 | ||
| Gerontological | 798 | ||
| Home Care | 798 | ||
| Clinical Debrief | 798 | ||
| Review Questions | 799 | ||
| References | 799 | ||
| 30 Blood Transfusions | 800 | ||
| Skills and Procedures | 800 | ||
| Objectives | 800 | ||
| Media Resources | 800 | ||
| Purpose | 800 | ||
| Standards of Care | 800 | ||
| Principles for Practice | 800 | ||
| ABO System | 800 | ||
| Rh System | 801 | ||
| Human Leukocyte Antigen System | 802 | ||
| Patient-Centered Care | 802 | ||
| Evidence-Based Practice | 803 | ||
| Safety Guidelines | 803 | ||
| Skill 30.1 Initiating Blood Therapy | 805 | ||
| Delegation and Collaboration | 806 | ||
| Equipment | 807 | ||
| Step/\tRationale | 807 | ||
| Recording and Reporting | 813 | ||
| Special Considerations | 813 | ||
| Teaching | 813 | ||
| Pediatric | 813 | ||
| Gerontological | 813 | ||
| Home Care | 813 | ||
| Skill 30.2 Monitoring for Adverse Transfusion Reactions | 814 | ||
| Delegation and Collaboration | 814 | ||
| Step/\tRationale | 814 | ||
| Recording and Reporting | 817 | ||
| Special Considerations | 817 | ||
| Teaching | 817 | ||
| Pediatric | 817 | ||
| Gerontological | 817 | ||
| Home Care | 817 | ||
| Clinical Debrief | 817 | ||
| Review Questions | 817 | ||
| References | 818 | ||
| Unit 11 Nutrition | 819 | ||
| 31 Oral Nutrition | 819 | ||
| Skills and Procedures | 819 | ||
| Objectives | 819 | ||
| Media Resources | 819 | ||
| Purpose | 819 | ||
| Standards of Care | 819 | ||
| Principles for Practice | 819 | ||
| Patient-Centered Care | 820 | ||
| Evidence-Based Practice | 820 | ||
| Safety Guidelines | 821 | ||
| Skill 31.1 Performing a Nutritional Screening and Physical Examination | 821 | ||
| Delegation and Collaboration | 821 | ||
| Equipment | 822 | ||
| Step/\tRationale | 822 | ||
| Recording and Reporting | 825 | ||
| Special Considerations | 825 | ||
| Teaching | 825 | ||
| Gerontological | 826 | ||
| Pediatric | 826 | ||
| Home Care | 826 | ||
| Skill 31.2 Assisting an Adult Patient With Oral Nutrition | 826 | ||
| Delegation and Collaboration | 827 | ||
| Equipment | 827 | ||
| Step/\tRationale | 827 | ||
| Recording and Reporting | 831 | ||
| Special Considerations | 831 | ||
| Teaching | 831 | ||
| Pediatric | 831 | ||
| Gerontological | 832 | ||
| Home Care | 832 | ||
| Skill 31.3 Aspiration Precautions | 832 | ||
| Dysphagia Evaluation | 832 | ||
| Dysphagia Management | 833 | ||
| Consequences of Dysphagia | 833 | ||
| Delegation and Collaboration | 833 | ||
| Equipment | 834 | ||
| Step/\tRationale | 834 | ||
| Recording and Reporting | 836 | ||
| Special Considerations | 836 | ||
| Pediatric | 836 | ||
| Gerontological | 836 | ||
| Home Care | 837 | ||
| Clinical Debrief | 837 | ||
| Review Questions | 837 | ||
| References | 837 | ||
| 32 Enteral Nutrition | 839 | ||
| Skills and Procedures | 839 | ||
| Objectives | 839 | ||
| Media Resources | 839 | ||
| Purpose | 839 | ||
| Standards of Care | 839 | ||
| Principles for Practice | 839 | ||
| Patient-Centered Care | 839 | ||
| Evidence-Based Practice | 840 | ||
| Safety Guidelines | 840 | ||
| Skill 32.1 Inserting and Removing a Small-Bore Nasogastric or Nasoenteric Feeding Tube | 840 | ||
| Delegation and Collaboration | 841 | ||
| Equipment | 841 | ||
| Insertion | 841 | ||
| Removal | 841 | ||
| Step/\tRationale | 841 | ||
| Recording and Reporting | 846 | ||
| Special Considerations | 846 | ||
| Teaching | 846 | ||
| Pediatric | 846 | ||
| Gerontological | 847 | ||
| Home Care | 847 | ||
| Skill 32.2 Verifying Feeding Tube Placement | 847 | ||
| Delegation and Collaboration | 848 | ||
| Equipment | 848 | ||
| Step/\tRationale | 848 | ||
| Recording and Reporting | 850 | ||
| Special Considerations | 850 | ||
| Teaching | 850 | ||
| Pediatric | 850 | ||
| Home Care | 850 | ||
| Skill 32.3 Irrigating a Feeding Tube | 850 | ||
| Delegation and Collaboration | 850 | ||
| Equipment | 850 | ||
| Step/\tRationale | 851 | ||
| Recording and Reporting | 852 | ||
| Special Considerations | 852 | ||
| Pediatric | 852 | ||
| Skill 32.4 Administering Enteral Nutrition: Nasoenteric, Gastrostomy, or Jejunostomy Tube | 852 | ||
| Delegation and Collaboration | 853 | ||
| Equipment | 853 | ||
| Step/\tRationale | 853 | ||
| Recording and Reporting | 857 | ||
| Special Considerations | 857 | ||
| Teaching | 857 | ||
| Pediatric | 857 | ||
| Gerontological | 857 | ||
| Home Care | 857 | ||
| Clinical Debrief | 859 | ||
| Review Questions | 859 | ||
| References | 860 | ||
| 33 Parenteral Nutrition | 861 | ||
| Skills and Procedures | 861 | ||
| Objectives | 861 | ||
| Media Resources | 861 | ||
| Purpose | 861 | ||
| Standards of Care | 861 | ||
| Principles for Practice | 861 | ||
| Patient-Centered Care | 861 | ||
| Evidence-Based Practice | 862 | ||
| Safety Guidelines | 863 | ||
| Skill 33.1 Administering Central Parenteral Nutrition | 864 | ||
| Delegation and Collaboration | 865 | ||
| Equipment | 865 | ||
| Step/\tRationale | 865 | ||
| Recording and Reporting | 868 | ||
| Special Considerations | 868 | ||
| Teaching | 868 | ||
| Pediatric | 868 | ||
| Gerontological | 868 | ||
| Home Care | 868 | ||
| Skill 33.2 Administering Peripheral Parenteral Nutrition With Lipid (Fat) Emulsion | 869 | ||
| Delegation and Collaboration | 869 | ||
| Equipment | 869 | ||
| Step/\tRationale | 869 | ||
| Recording and Reporting | 872 | ||
| Special Considerations | 872 | ||
| Teaching | 872 | ||
| Pediatric | 872 | ||
| Gerontological | 872 | ||
| Home Care | 872 | ||
| Clinical Debrief | 872 | ||
| Review Questions | 872 | ||
| References | 872 | ||
| Unit 12 Elimination | 873 | ||
| 34 Urinary Elimination | 873 | ||
| Skills and Procedures | 873 | ||
| Objectives | 873 | ||
| Media Resources | 873 | ||
| Purpose | 873 | ||
| Standards of Care | 873 | ||
| Principles for Practice | 873 | ||
| Patient-Centered Care | 874 | ||
| Evidence-Based Practice | 874 | ||
| Safety Guidelines | 874 | ||
| Skill 34.1 Insertion of a Straight or an Indwelling Urinary Catheter | 876 | ||
| Delegation and Collaboration | 877 | ||
| Equipment | 877 | ||
| Step/\tRationale | 878 | ||
| Recording and Reporting | 886 | ||
| Special Considerations | 886 | ||
| Teaching | 886 | ||
| Pediatric | 886 | ||
| Gerontological | 887 | ||
| Home Care | 887 | ||
| Skill 34.2 Care and Removal of an Indwelling Catheter | 887 | ||
| Delegation and Collaboration | 887 | ||
| Equipment | 887 | ||
| Step/\tRationale | 887 | ||
| Recording and Reporting | 891 | ||
| Special Considerations | 891 | ||
| Teaching | 891 | ||
| Pediatric | 891 | ||
| Gerontological | 891 | ||
| Home Care | 891 | ||
| Skill 34.3 Performing Closed Urinary Catheter Irrigation | 893 | ||
| Delegation and Collaboration | 893 | ||
| Equipment | 893 | ||
| Closed Intermittent Irrigation | 893 | ||
| Closed Continuous Irrigation | 893 | ||
| Step/\tRationale | 893 | ||
| Recording and Reporting | 897 | ||
| Special Considerations | 897 | ||
| Teaching | 897 | ||
| Home Care | 897 | ||
| Skill 34.4 Applying a Condom-Type External Catheter | 897 | ||
| Delegation and Collaboration | 897 | ||
| Equipment | 897 | ||
| Step/\tRationale | 897 | ||
| Recording and Reporting | 900 | ||
| Special Considerations | 900 | ||
| Teaching | 900 | ||
| Pediatric | 900 | ||
| Gerontological | 900 | ||
| Home Care | 900 | ||
| Skill 34.5 Suprapubic Catheter Care | 900 | ||
| Delegation and Collaboration | 901 | ||
| Equipment | 901 | ||
| Step/\tRationale | 901 | ||
| Recording and Reporting | 903 | ||
| Special Considerations | 903 | ||
| Teaching | 903 | ||
| Home Care | 903 | ||
| Clinical Debrief | 904 | ||
| Review Questions | 904 | ||
| References | 904 | ||
| 35 Bowel Elimination and Gastric Intubation | 905 | ||
| Skills and Procedures | 905 | ||
| Objectives | 905 | ||
| Media Resources | 905 | ||
| Purpose | 905 | ||
| Standards of Care | 905 | ||
| Principles of Practice | 905 | ||
| Patient-Centered Care | 906 | ||
| Evidence-Based Practice | 906 | ||
| Safety Guidelines | 906 | ||
| Skill 35.1 Providing a Bedpan | 907 | ||
| Delegation and Collaboration | 907 | ||
| Equipment | 907 | ||
| Step/\tRationale | 907 | ||
| Recording and Reporting | 911 | ||
| Special Considerations | 911 | ||
| Pediatric | 911 | ||
| Gerontological | 912 | ||
| Skill 35.2 Removing Fecal Impaction Digitally | 912 | ||
| Delegation and Collaboration | 912 | ||
| Equipment | 912 | ||
| Step/\tRationale | 912 | ||
| Recording and Reporting | 915 | ||
| Special Considerations | 915 | ||
| Pediatric | 915 | ||
| Gerontological | 915 | ||
| Skill 35.3 Administering an Enema | 915 | ||
| Delegation and Collaboration | 915 | ||
| Equipment | 915 | ||
| Step/\tRationale | 916 | ||
| Recording and Reporting | 920 | ||
| Special Considerations | 920 | ||
| Pediatric | 920 | ||
| Gerontological | 920 | ||
| Home Care | 920 | ||
| Skill 35.4 Insertion, Maintenance, and Removal of a Nasogastric Tube for Gastric Decompression | 922 | ||
| Delegation and Collaboration | 923 | ||
| Equipment | 923 | ||
| Step/\tRationale | 923 | ||
| Recording and Reporting | 929 | ||
| Special Considerations | 929 | ||
| Gerontological | 929 | ||
| Clinical Debrief | 930 | ||
| Review Questions | 930 | ||
| References | 930 | ||
| 36 Ostomy Care | 931 | ||
| Skills and Procedures | 931 | ||
| Objectives | 931 | ||
| Media Resources | 931 | ||
| Purpose | 931 | ||
| Standards of Care | 931 | ||
| Principles for Practice | 931 | ||
| Patient-Centered Care | 931 | ||
| Evidence-Based Practice | 933 | ||
| Safety Guidelines | 933 | ||
| Skill 36.1 Pouching a Colostomy or an Ileostomy | 933 | ||
| Delegation and Collaboration | 934 | ||
| Equipment | 934 | ||
| Step/\tRationale | 934 | ||
| Recording and Reporting | 938 | ||
| Special Considerations | 938 | ||
| Teaching | 938 | ||
| Pediatric | 938 | ||
| Gerontological | 938 | ||
| Home Care | 938 | ||
| Skill 36.2 Pouching a Urostomy | 938 | ||
| Delegation and Collaboration | 938 | ||
| Equipment | 939 | ||
| Step/\tRationale | 939 | ||
| Recording and Reporting | 941 | ||
| Special Considerations | 941 | ||
| Teaching | 941 | ||
| Pediatric | 941 | ||
| Gerontological | 941 | ||
| Home Care | 941 | ||
| Skill 36.3 Catheterizing a Urinary Diversion | 942 | ||
| Delegation and Collaboration | 942 | ||
| Equipment | 942 | ||
| Step/\tRationale | 942 | ||
| Recording and Reporting | 944 | ||
| Special Considerations | 944 | ||
| Teaching | 944 | ||
| Clinical Debrief | 944 | ||
| Review Questions | 944 | ||
| References | 944 | ||
| Unit 13 Care of the Surgical Patient | 945 | ||
| 37 Preoperative and Postoperative Care | 945 | ||
| Skills and Procedures | 945 | ||
| Objectives | 945 | ||
| Media Resources | 945 | ||
| Purpose | 945 | ||
| Standards of Care | 945 | ||
| Principles for Practice | 945 | ||
| Patient-Centered Care | 946 | ||
| Evidence-Based Practice | 946 | ||
| Safety Guidelines | 946 | ||
| Skill 37.1 Preoperative Assessment | 947 | ||
| Delegation and Collaboration | 947 | ||
| Equipment | 947 | ||
| Step/\tRationale | 947 | ||
| Recording and Reporting | 951 | ||
| Special Considerations | 951 | ||
| Pediatric | 951 | ||
| Gerontological | 951 | ||
| Skill 37.2 Preoperative Teaching | 951 | ||
| Delegation and Collaboration | 951 | ||
| Equipment | 952 | ||
| Step/\tRationale | 952 | ||
| Recording and Reporting | 959 | ||
| Special Considerations | 959 | ||
| Teaching | 959 | ||
| Pediatric | 959 | ||
| Gerontological | 959 | ||
| Home Care | 959 | ||
| Skill 37.3 Physical Preparation for Surgery | 960 | ||
| Delegation and Collaboration | 961 | ||
| Equipment | 961 | ||
| Step/\tRationale | 961 | ||
| Recording and Reporting | 964 | ||
| Special Considerations | 964 | ||
| Pediatric | 964 | ||
| Gerontological | 964 | ||
| Skill 37.4 Providing Immediate Anesthesia Recovery in the Postanesthesia Care Unit | 964 | ||
| Delegation and Collaboration | 965 | ||
| Equipment | 965 | ||
| Step/\tRationale | 965 | ||
| Recording and Reporting | 971 | ||
| Special Considerations | 971 | ||
| Teaching | 971 | ||
| Pediatric | 971 | ||
| Gerontological | 972 | ||
| Home Care | 972 | ||
| Skill 37.5 Providing Early Postoperative and Convalescent Phase Recovery | 972 | ||
| Delegation and Collaboration | 972 | ||
| Equipment | 972 | ||
| Step/\tRationale | 972 | ||
| Recording and Reporting | 976 | ||
| Special Considerations | 976 | ||
| Teaching | 976 | ||
| Pediatric | 976 | ||
| Gerontological | 976 | ||
| Home Care | 976 | ||
| Clinical Debrief | 977 | ||
| Review Questions | 977 | ||
| References | 977 | ||
| 38 Intraoperative Care | 978 | ||
| Skills and Procedures | 978 | ||
| Objectives | 978 | ||
| Media Resources | 978 | ||
| Purpose | 978 | ||
| Standards of Care | 978 | ||
| Principles for Practice | 978 | ||
| Patient-Centered Care | 979 | ||
| Evidence-Based Practice | 980 | ||
| Safety Guidelines | 981 | ||
| Skill 38.1 Surgical Hand Antisepsis | 981 | ||
| Delegation and Collaboration | 981 | ||
| Equipment | 981 | ||
| Step/\tRationale | 981 | ||
| Recording and Reporting | 985 | ||
| Skill 38.2 Donning a Sterile Gown and Closed Gloving | 985 | ||
| Delegation and Collaboration | 985 | ||
| Equipment | 985 | ||
| Step/\tRationale | 985 | ||
| Recording and Reporting | 988 | ||
| Clinical Debrief | 989 | ||
| Review Questions | 989 | ||
| References | 989 | ||
| Unit 14 Dressings and Wound Care | 990 | ||
| 39 Pressure Injury Prevention and Care | 990 | ||
| Skills and Procedures | 990 | ||
| Objectives | 990 | ||
| Media Resources | 990 | ||
| Purpose | 990 | ||
| Standards of Care | 990 | ||
| Principles for Practice | 990 | ||
| Patient-Centered Care | 993 | ||
| Evidence-Based Practice | 993 | ||
| Safety Guidelines | 994 | ||
| Skill 39.1 Risk Assessment, Skin Assessment, and Prevention Strategies | 995 | ||
| Delegation and Collaboration | 996 | ||
| Equipment | 997 | ||
| Step/\tRationale | 997 | ||
| Recording and Reporting | 1003 | ||
| Special Considerations | 1003 | ||
| Teaching | 1003 | ||
| Pediatric | 1003 | ||
| Gerontological | 1003 | ||
| Home Care | 1003 | ||
| Skill 39.2 Treatment of Pressure Injuries | 1003 | ||
| Delegation and Collaboration | 1004 | ||
| Equipment | 1004 | ||
| Step/\tRationale | 1005 | ||
| Recording and Reporting | 1010 | ||
| Special Considerations | 1010 | ||
| Teaching | 1010 | ||
| Gerontological | 1010 | ||
| Home Care | 1010 | ||
| Long-Term Care | 1010 | ||
| Clinical Debrief | 1010 | ||
| Review Questions | 1010 | ||
| References | 1011 | ||
| 40 Wound Care and Irrigation | 1012 | ||
| Skills and Procedures | 1012 | ||
| Objectives | 1012 | ||
| Media Resources | 1012 | ||
| Purpose | 1012 | ||
| Standards of Care | 1012 | ||
| Principles for Practice | 1012 | ||
| Patient-Centered Care | 1015 | ||
| Evidence-Based Practice | 1015 | ||
| Safety Guidelines | 1015 | ||
| Skill 40.1 Performing a Wound Irrigation | 1017 | ||
| Delegation and Collaboration | 1018 | ||
| Equipment | 1018 | ||
| Step/\tRationale | 1019 | ||
| Recording and Reporting | 1022 | ||
| Special Considerations | 1022 | ||
| Teaching | 1022 | ||
| Pediatric | 1022 | ||
| Gerontological | 1022 | ||
| Home Care | 1022 | ||
| Skill 40.2 Removing Sutures and Staples | 1022 | ||
| Delegation and Collaboration | 1023 | ||
| Equipment | 1023 | ||
| Step/\tRationale | 1023 | ||
| Recording and Reporting | 1027 | ||
| Special Considerations | 1027 | ||
| Teaching | 1027 | ||
| Pediatric | 1027 | ||
| Gerontological | 1027 | ||
| Skill 40.3 Managing Wound Drainage Evacuation | 1027 | ||
| Delegation and Collaboration | 1028 | ||
| Equipment | 1028 | ||
| Step/\tRationale | 1028 | ||
| Recording and Reporting | 1032 | ||
| Special Considerations | 1032 | ||
| Teaching | 1032 | ||
| Pediatric | 1032 | ||
| Gerontological | 1032 | ||
| Home Care | 1032 | ||
| Skill 40.4 Negative-Pressure Wound Therapy | 1032 | ||
| Delegation and Collaboration | 1033 | ||
| Equipment | 1033 | ||
| Step/\tRationale | 1033 | ||
| Recording and Reporting | 1037 | ||
| Special Considerations | 1037 | ||
| Teaching | 1037 | ||
| Pediatric | 1037 | ||
| Gerontological | 1037 | ||
| Home Care | 1037 | ||
| Clinical Debrief | 1037 | ||
| Review Questions | 1037 | ||
| References | 1038 | ||
| 41 Dressings, Bandages, and Binders | 1039 | ||
| Skills and Procedures | 1039 | ||
| Objectives | 1039 | ||
| Media Resources | 1039 | ||
| Purpose | 1039 | ||
| Standards of Care | 1039 | ||
| Principles for Practice | 1039 | ||
| Patient-Centered Care | 1040 | ||
| Evidence-Based Practice | 1040 | ||
| Safety Guidelines | 1040 | ||
| Skill 41.1 Applying a Dressing (Dry and Damp-to-Dry) | 1042 | ||
| Delegation and Collaboration | 1043 | ||
| Equipment | 1043 | ||
| Step/\tRationale | 1044 | ||
| Recording and Reporting | 1050 | ||
| Special Considerations | 1050 | ||
| Teaching | 1050 | ||
| Pediatric | 1050 | ||
| Gerontological | 1050 | ||
| Home Care | 1050 | ||
| Skill 41.2 Applying a Pressure Bandage | 1050 | ||
| Delegation and Collaboration | 1051 | ||
| Equipment | 1051 | ||
| Step/\tRationale | 1051 | ||
| Recording and Reporting | 1053 | ||
| Special Considerations | 1053 | ||
| Teaching | 1053 | ||
| Pediatric | 1053 | ||
| Gerontological | 1053 | ||
| Home Care | 1053 | ||
| Skill 41.3 Applying a Transparent Dressing | 1053 | ||
| Delegation and Collaboration | 1053 | ||
| Equipment | 1053 | ||
| Step/\tRationale | 1054 | ||
| Recording and Reporting | 1056 | ||
| Special Considerations | 1056 | ||
| Teaching | 1056 | ||
| Pediatric | 1056 | ||
| Gerontologic | 1056 | ||
| Home Care | 1056 | ||
| Skill 41.4 Applying a Hydrocolloid, Hydrogel, Foam, or Alginate Dressing | 1056 | ||
| Delegation and Collaboration | 1057 | ||
| Equipment | 1057 | ||
| Step/\tRationale | 1057 | ||
| Recording and Reporting | 1062 | ||
| Special Considerations | 1062 | ||
| Teaching | 1062 | ||
| Pediatric | 1062 | ||
| Gerontological | 1062 | ||
| Clinical Debrief | 1066 | ||
| Review Questions | 1066 | ||
| References | 1066 | ||
| 42 Therapeutic Use of Heat and Cold | 1067 | ||
| Skills and Procedures | 1067 | ||
| Objectives | 1067 | ||
| Media Resources | 1067 | ||
| Purpose | 1067 | ||
| Standards of Care | 1067 | ||
| Principles for Practice | 1067 | ||
| Patient-Centered Care | 1067 | ||
| Evidence-Based Practice | 1068 | ||
| Safety Guidelines | 1068 | ||
| Skill 42.1 Application of Moist Heat (Compress and Sitz Bath) | 1069 | ||
| Delegation and Collaboration | 1070 | ||
| Equipment | 1070 | ||
| Step/\tRationale | 1070 | ||
| Recording and Reporting | 1074 | ||
| Special Considerations | 1074 | ||
| Teaching | 1074 | ||
| Pediatric | 1074 | ||
| Gerontological | 1074 | ||
| Home Care | 1074 | ||
| Skill 42.2 Applying Aquathermia and Dry Heat | 1074 | ||
| Delegation and Collaboration | 1074 | ||
| Equipment | 1075 | ||
| Step/\tRationale | 1075 | ||
| Recording and Reporting | 1077 | ||
| Special Considerations | 1077 | ||
| Teaching | 1077 | ||
| Pediatric | 1077 | ||
| Gerontological | 1077 | ||
| Home Care | 1077 | ||
| Skill 42.3 Application of Cold | 1077 | ||
| Delegation and Collaboration | 1078 | ||
| Equipment | 1078 | ||
| Step/\tRationale | 1078 | ||
| Recording and Reporting | 1081 | ||
| Special Considerations | 1081 | ||
| Teaching | 1081 | ||
| Pediatric | 1081 | ||
| Gerontological | 1081 | ||
| Skill 42.4 Caring for Patients Requiring Hypothermia or Hyperthermia Blankets | 1081 | ||
| Delegation and Collaboration | 1081 | ||
| Equipment | 1082 | ||
| Step/\tRationale | 1082 | ||
| Recording and Reporting | 1083 | ||
| Special Considerations | 1084 | ||
| Teaching | 1084 | ||
| Pediatric | 1084 | ||
| Gerontological | 1084 | ||
| Clinical Debrief | 1084 | ||
| Review Questions | 1084 | ||
| References | 1084 | ||
| Unit 15 Home Care | 1085 | ||
| 43 Home Care Safety | 1085 | ||
| Skills and Procedures | 1085 | ||
| Objectives | 1085 | ||
| Media Resources | 1085 | ||
| Purpose | 1085 | ||
| Standards of Care | 1085 | ||
| Principles for Practice | 1085 | ||
| Client-Centered Care | 1085 | ||
| Evidence-Based Practice | 1086 | ||
| Safety Guidelines | 1086 | ||
| Skill 43.1 Home Environment Assessment and Safety | 1086 | ||
| Delegation and Collaboration | 1086 | ||
| Equipment | 1086 | ||
| Step/\tRationale | 1087 | ||
| Recording and Reporting | 1095 | ||
| Special Considerations | 1095 | ||
| Teaching | 1095 | ||
| Pediatric | 1095 | ||
| Gerontological | 1095 | ||
| Skill 43.2 Adapting the Home Setting for Clients With Cognitive Deficits | 1096 | ||
| Delegation and Collaboration | 1096 | ||
| Equipment | 1096 | ||
| Step/\tRationale | 1096 | ||
| Recording and Reporting | 1101 | ||
| Special Considerations | 1101 | ||
| Teaching | 1101 | ||
| Pediatric | 1101 | ||
| Gerontological | 1101 | ||
| Skill 43.3 Medication and Medical Device Safety | 1102 | ||
| Delegation and Collaboration | 1102 | ||
| Equipment | 1102 | ||
| Step/\tRationale | 1102 | ||
| Recording and Reporting | 1106 | ||
| Special Considerations | 1106 | ||
| Teaching | 1106 | ||
| Pediatric | 1106 | ||
| Clinical Debrief | 1106 | ||
| Review Questions | 1106 | ||
| References | 1107 | ||
| 44 Home Care Teaching | 1108 | ||
| Skills and Procedures | 1108 | ||
| Objectives | 1108 | ||
| Media Resources | 1108 | ||
| Purpose | 1108 | ||
| Standards of Care | 1108 | ||
| Principles for Practice | 1108 | ||
| Client-Centered Care | 1108 | ||
| Evidence-Based Practice | 1109 | ||
| Safety Guidelines | 1109 | ||
| Skill 44.1 Teaching Clients to Measure Body Temperature | 1109 | ||
| Delegation and Collaboration | 1110 | ||
| Equipment | 1110 | ||
| Step/\tRationale | 1110 | ||
| Recording and Reporting | 1112 | ||
| Special Considerations | 1112 | ||
| Teaching | 1112 | ||
| Pediatric | 1113 | ||
| Gerontological | 1113 | ||
| Skill 44.2 Teaching Blood Pressure and Pulse Measurement | 1113 | ||
| Delegation and Collaboration | 1113 | ||
| Equipment | 1113 | ||
| Step/\tRationale | 1114 | ||
| Recording and Reporting | 1117 | ||
| Special Considerations | 1117 | ||
| Teaching | 1117 | ||
| Pediatric | 1117 | ||
| Gerontological | 1118 | ||
| Skill 44.3 Teaching Intermittent Self-Catheterization | 1118 | ||
| Delegation and Collaboration | 1118 | ||
| Equipment | 1118 | ||
| Step/\tRationale | 1118 | ||
| Recording and Reporting | 1121 | ||
| Special Considerations | 1121 | ||
| Teaching | 1121 | ||
| Pediatric | 1121 | ||
| Gerontological | 1121 | ||
| Skill 44.4 Using Home Oxygen Equipment | 1121 | ||
| Delegation and Collaboration | 1123 | ||
| Equipment | 1123 | ||
| Step/\tRationale | 1124 | ||
| Recording and Reporting | 1127 | ||
| Special Considerations | 1127 | ||
| Teaching | 1127 | ||
| Pediatric | 1128 | ||
| Gerontological | 1128 | ||
| Skill 44.5 Teaching Home Tracheostomy Care and Suctioning | 1128 | ||
| Delegation and Collaboration | 1128 | ||
| Equipment | 1128 | ||
| Step/\tRationale | 1128 | ||
| Recording and Reporting | 1132 | ||
| Special Considerations | 1132 | ||
| Teaching | 1132 | ||
| Pediatric | 1132 | ||
| Gerontological | 1133 | ||
| Skill 44.6 Teaching Medication Self-Administration | 1133 | ||
| Delegation and Collaboration | 1133 | ||
| Equipment | 1133 | ||
| Step/\tRationale | 1133 | ||
| Recording and Reporting | 1137 | ||
| Special Considerations | 1137 | ||
| Teaching | 1137 | ||
| Pediatric | 1137 | ||
| Gerontological | 1138 | ||
| Skill 44.7 Managing Feeding Tubes in the Home | 1138 | ||
| Delegation and Collaboration | 1138 | ||
| Equipment | 1138 | ||
| Step/\tRationale | 1138 | ||
| Recording and Reporting | 1141 | ||
| Special Considerations | 1141 | ||
| Teaching | 1141 | ||
| Pediatric | 1141 | ||
| Gerontological | 1141 | ||
| Skill 44.8 Managing Parenteral Nutrition in the Home | 1141 | ||
| Delegation and Collaboration | 1142 | ||
| Equipment | 1142 | ||
| Step/\tRationale | 1142 | ||
| Recording and Reporting | 1145 | ||
| Special Considerations | 1145 | ||
| Teaching | 1145 | ||
| Pediatric | 1145 | ||
| Gerontological | 1145 | ||
| Clinical Debrief | 1145 | ||
| Review Questions | 1145 | ||
| References | 1145 | ||
| Appendixes | 1147 | ||
| Appendix A | 1147 | ||
| NANDA Definitions From Nursing Diagnoses: Definitions and Classification 2015-2017, 10th Edition. | 1147 | ||
| Appendix B | 1153 | ||
| Terminology/Combining Forms: Prefixes and Suffixes | 1153 | ||
| Common Prefixes | 1153 | ||
| Common Suffixes | 1154 | ||
| Index | 1156 | ||
| A | 1156 | ||
| B | 1157 | ||
| C | 1159 | ||
| D | 1161 | ||
| E | 1162 | ||
| F | 1164 | ||
| G | 1164 | ||
| H | 1165 | ||
| I | 1166 | ||
| J | 1168 | ||
| K | 1168 | ||
| L | 1168 | ||
| M | 1168 | ||
| N | 1170 | ||
| O | 1171 | ||
| P | 1172 | ||
| Q | 1176 | ||
| R | 1176 | ||
| S | 1176 | ||
| T | 1178 | ||
| U | 1179 | ||
| V | 1180 | ||
| W | 1180 | ||
| Y | 1180 | ||
| Z | 1180 | ||
| Index of Skills and Procedural Guidelines | 1182 |