BOOK
Medical-Surgical Nursing in Canada - E-Book
Sharon L. Lewis | Shannon Ruff Dirksen | Margaret M. Heitkemper | Linda Bucher | Maureen A. Barry | Sandra Goldsworthy | Jana Lok | Jane Tyerman
(2018)
Additional Information
Book Details
Abstract
Learn how to become an exceptional caregiver in Canada’s evolving health care environment! Adapted by a team of 4 experienced Canadian nurse-educators and a slate of expert contributors from across the country, the 4th Canadian Edition of Medical-Surgical Nursing in Canada offers up-to-date coverage of the latest trends, hot topics, and clinical developments in the field. Completely revised and updated content explores patient care in various clinical settings and focuses on key topics such as patient safety, exam preparation, evidence-informed practice, prioritization, patient and caregiver teaching, culturally competent care, and the determinants of health. A variety of helpful boxes and tables make it easy for students to find essential information and the accessible writing style makes even the most complex concepts easy to grasp. Best of all — a complete collection of learning and study resources helps students learn more effectively and offers valuable, real-world preparation for clinical practice.
- Highly readable format offers a strong foundation in medical-surgical nursing.
- Content written and reviewed by leading experts in the field ensures that information is comprehensive, current, and clinically accurate.
- Revised Chapter 1 situates nursing practice in the unique Canadian context, discussing patient-centred care, interprofessional practice (including delegation and assignment), information-communication technologies, patient safety and quality improvement
- Culturally competent care chapter and special sections discuss culture as a determinant of health, Indigenous populations; health equity and health equality issues; and practical suggestions for developing cultural competence in nursing care
- Determinants of Health boxes focus on the Public Health Agency of Canada’s determinants of health, as they apply to particular disorders.
- UNIQUE! "Levels of Care" approach organizes nursing care in three levels: health promotion, acute intervention, and ambulatory and home care.
- Examination review questions at the end of each chapter reinforce key content while helping you prepare for examinations.
- Expanded chapter on genetics focuses on the practical application of genetics to nursing care of patients and includes current changes in Canadian clinical practice.
- Genetics in Clinical Practice boxes address key topics such as genetic testing, Alzheimer’s disease, sickle cell disease, and genetics-related ethical issues.
- Assessment Abnormalities tables alert readers to abnormalities frequently encountered in practice, as well as their possible etiologies
- More than 60 comprehensive nursing care plans on the Evolve website defining characteristics, expected outcomes, specific nursing interventions with rationales, evaluation criteria, and collaborative problems
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Endsheet 2 | IFC2 | ||
| Endsheet 3 | IFC3 | ||
| Endsheet 4 | IFC4 | ||
| Medical-Surgical Nursing in Canada | i | ||
| Copyright Page | ii | ||
| Table Of Contents | iii | ||
| About the Authors | xvii | ||
| Sharon L. Lewis, RN, PhD, FAAN | xvii | ||
| Linda Bucher, RN, PhD, CEN, CNE | xvii | ||
| Margaret McLean Heitkemper, RN, PhD, FAAN | xvii | ||
| Mariann M. Harding, RN, PhD, CNE | xvii | ||
| Maureen A. Barry, RN, MScN | xvii | ||
| Jana Lok, RN, MN, PhD, ENC(C) | xviii | ||
| Jane Tyerman, RN, MScN, PhD | xviii | ||
| Sandra Goldsworthy, RN, MSc, PhD, CNCC(C), CMSN(C) | xviii | ||
| Section Editors for the US 10th Edition | xviii | ||
| Jeffrey Kwong, DNP, MPH, ANP-BC, FAANP | xviii | ||
| Dottie Roberts, RN, EdD, MSN, MACI, RN, OCNS-C, CMSRN, CNE | xviii | ||
| Contributors | xix | ||
| Reviewers | xxiii | ||
| Dedication | xxv | ||
| Preface | xxvii | ||
| Organization | xxvii | ||
| Classic Features | xxvii | ||
| New Features | xxviii | ||
| A Word on Terminology | xxix | ||
| A Word on Laboratory Values | xxix | ||
| Learning Supplements for the Student | xxix | ||
| Teaching Supplements for Instructors | xxix | ||
| Acknowledgements | xxx | ||
| 1 Concepts in Nursing Practice | 1 | ||
| 1 Introduction to Medical-Surgical Nursing Practice in Canada | 2 | ||
| Learning Objectives | 2 | ||
| Key Terms | 2 | ||
| The Canadian Health Care Context | 2 | ||
| Complex Health Care Environments | 3 | ||
| Diverse Populations. | 3 | ||
| Determinants of Health. | 3 | ||
| Patient-Centred Care | 4 | ||
| Patient Safety and Quality Improvement. | 4 | ||
| Quality and Safety Education for Nurses (QSEN). | 5 | ||
| The Profession of Nursing in Canada | 5 | ||
| Standards of Practice. | 6 | ||
| Advanced Nursing Practice. | 6 | ||
| Teamwork and Interprofessional Collaboration | 7 | ||
| Interprofessional Teams. | 7 | ||
| Communication Among Health Care Team Members. | 7 | ||
| Delegation and Assignment. | 7 | ||
| Informatics and Technology | 9 | ||
| Nursing Informatics. | 9 | ||
| Electronic Health Records. | 10 | ||
| What Is Medical-Surgical Nursing? | 10 | ||
| Critical Thinking in Nursing | 10 | ||
| Evidence-Informed Practice | 11 | ||
| Steps in the Evidence-Informed Practice Process. | 12 | ||
| Step 1. | 12 | ||
| Step 2. | 12 | ||
| Step 3. | 12 | ||
| Step 4. | 12 | ||
| Step 5. | 12 | ||
| Step 6. | 12 | ||
| Implementation of Evidence-Informed Practice. | 12 | ||
| The Nursing Process | 13 | ||
| Phases of the Nursing Process | 13 | ||
| Interrelatedness of Phases | 13 | ||
| Assessment Phase | 13 | ||
| Data Collection. | 13 | ||
| Diagnosis Phase | 14 | ||
| Data Analysis and Problem Identification. | 14 | ||
| Nursing Diagnosis. | 14 | ||
| Diagnostic Process. | 14 | ||
| Identifying the Problem. | 14 | ||
| Etiology. | 14 | ||
| Signs and Symptoms. | 14 | ||
| Collaborative Problems. | 15 | ||
| Planning Phase | 15 | ||
| Priority Setting. | 15 | ||
| Identifying Outcomes. | 15 | ||
| Determining Interventions. | 15 | ||
| Implementation Phase. | 16 | ||
| Evaluation Phase. | 16 | ||
| Nursing Care Plans | 16 | ||
| Concept Maps | 16 | ||
| Clinical (Critical) Pathways | 16 | ||
| Documentation | 17 | ||
| Charting | 17 | ||
| Future Challenges of Nursing | 17 | ||
| Review Questions | 18 | ||
| References | 18 | ||
| Resources | 20 | ||
| 2 Cultural Competence and Health Equity in Nursing Care | 21 | ||
| Learning Objectives | 21 | ||
| Key Terms | 21 | ||
| The Need for Cultural Competence | 21 | ||
| Health Equity | 22 | ||
| Health Inequities Among Indigenous and Other Marginalized Populations | 22 | ||
| Health Literacy | 22 | ||
| Equity in Nursing Care | 23 | ||
| Culture as a Determinant of Health | 23 | ||
| Exploring the Concepts: Definitions and Meanings | 23 | ||
| Cultural Safety and Cultural Competence | 24 | ||
| “Culture” and Other Related Terms | 24 | ||
| Cultural Competence | 25 | ||
| Affective Domain | 26 | ||
| Behavioural Domain | 26 | ||
| Cross-Cultural Communication. | 26 | ||
| Verbal and Nonverbal Communication. | 26 | ||
| Culturally Competent Care | 28 | ||
| Communication Skills | 28 | ||
| Providing Effective Language Support. | 28 | ||
| Cognitive Domain | 29 | ||
| Generic Cultural Knowledge | 29 | ||
| Care, Cure, Caregivers, and Healing Systems. | 29 | ||
| Culturally Competent Care | 30 | ||
| Clock Time | 30 | ||
| Biology, Physiology, and Pharmacology. | 30 | ||
| Family Roles and Relationships. | 30 | ||
| Spirituality and Religion. | 31 | ||
| Migration and Settlement. | 31 | ||
| Dynamics of Difference | 32 | ||
| Environment and Equity | 32 | ||
| Understanding the Difference Between Equity and Equality | 32 | ||
| Nurse’s Self-Assessment | 32 | ||
| Culturally Competent Patient Assessment | 33 | ||
| Bridging Cultural Distances: The LEARN Model | 33 | ||
| Working in Diverse Teams | 33 | ||
| Conclusion | 34 | ||
| Review Questions | 34 | ||
| References | 35 | ||
| Resources | 36 | ||
| 3 Health History and Physical Examination | 37 | ||
| Learning Objectives | 37 | ||
| Key Terms | 37 | ||
| Data Collection | 37 | ||
| Interviewing Considerations | 38 | ||
| Teamwork and Collaboration | 38 | ||
| Data Organization | 38 | ||
| Culturally Competent Care | 39 | ||
| Assessment | 39 | ||
| Nursing History: Subjective Data | 39 | ||
| Biographical Data | 39 | ||
| Reason for Seeking Care | 39 | ||
| Current Health or History of Current Illness | 39 | ||
| Past Health History | 39 | ||
| Medications. | 39 | ||
| Allergies. | 40 | ||
| Surgery or Other Treatments. | 40 | ||
| Family History | 40 | ||
| Functional Health Assessment | 40 | ||
| Health Perception–Health Management. | 40 | ||
| Nutrition–Metabolic. | 40 | ||
| Elimination. | 41 | ||
| Activity–Exercise. | 41 | ||
| Sleep–Rest. | 41 | ||
| Cognitive–Perceptual. | 41 | ||
| Self-Perception–Self-Concept. | 41 | ||
| Role–Relationship. | 41 | ||
| Sexuality–Reproductive. | 41 | ||
| Coping–Stress Tolerance. | 41 | ||
| Value–Belief. | 41 | ||
| Physical Examination: Objective Data | 41 | ||
| General Survey | 41 | ||
| Physical Examination | 41 | ||
| Techniques. | 41 | ||
| Inspection. | 41 | ||
| Palpation. | 42 | ||
| Percussion. | 42 | ||
| Auscultation. | 42 | ||
| Equipment. | 42 | ||
| Organization of the Examination. | 42 | ||
| Recording Physical Examination. | 43 | ||
| Types of Assessment | 43 | ||
| Comprehensive Assessment | 43 | ||
| Focused Assessment | 43 | ||
| Emergency Assessment | 44 | ||
| Using Assessment Approaches | 44 | ||
| Problem Identification and Nursing Diagnoses | 47 | ||
| Review Questions | 47 | ||
| References | 47 | ||
| 4 Patient and Caregiver Teaching | 48 | ||
| Learning Objectives | 48 | ||
| Key Terms | 48 | ||
| Role of Patient and Caregiver Teaching | 48 | ||
| Teaching–Learning Process | 49 | ||
| Adult Learners | 49 | ||
| Adult Learning Principles. | 49 | ||
| Determinants of Learning. | 49 | ||
| Motivation of Adult Learners. | 49 | ||
| Nurse as Teacher | 50 | ||
| Required Competencies | 50 | ||
| Knowledge of Subject Matter. | 50 | ||
| Communication Skills. | 50 | ||
| Empathy. | 51 | ||
| Challenges to Nurse–Teacher Effectiveness. | 51 | ||
| Caregiver and Holistic Support | 51 | ||
| Process of Patient Teaching | 52 | ||
| Assessment | 52 | ||
| Physical Characteristics. | 52 | ||
| Psychological Characteristics. | 52 | ||
| Sociocultural Characteristics. | 53 | ||
| Socioeconomic Factors. | 53 | ||
| Literacy and Health Literacy. | 53 | ||
| Housing Arrangements and Living Location. | 54 | ||
| Culturally Competent Care | 54 | ||
| Learner Characteristics. | 55 | ||
| Learning Needs. | 55 | ||
| Readiness to Learn. | 55 | ||
| Learning Style. | 55 | ||
| Diagnosis | 55 | ||
| Planning | 55 | ||
| Selecting Teaching Strategies. | 55 | ||
| Patient Workshop. | 55 | ||
| Discussion. | 56 | ||
| Group Teaching. | 56 | ||
| Demonstration–Return Demonstration. | 57 | ||
| Role Play. | 57 | ||
| Use of Audiovisual Materials. | 57 | ||
| Use of the Internet. | 57 | ||
| Use of Printed Materials. | 57 | ||
| Games and Simulation. | 58 | ||
| Implementation | 58 | ||
| Evaluation | 58 | ||
| Continuity of Educational Care | 58 | ||
| Documentation of the Educational Process | 58 | ||
| The Standardized Teaching Plan | 59 | ||
| Review Questions | 59 | ||
| References | 60 | ||
| Resources | 61 | ||
| 5 Chronic Illness | 62 | ||
| Learning Objectives | 62 | ||
| Key Terms | 62 | ||
| The Epidemiology of Chronic Diseases | 63 | ||
| Health, Acute Illness, and Chronic Illness | 64 | ||
| Factors Contributing to Chronic Illness | 64 | ||
| Risk Factors for Chronic Illness | 65 | ||
| Prevention of Chronic Illness | 65 | ||
| The Role of Genetics | 65 | ||
| The Role of Aging | 65 | ||
| Disability in Chronic Illness | 66 | ||
| Psychosocial Dimensions of Chronic Illness | 66 | ||
| Illness Behaviour | 66 | ||
| Self-Efficacy | 67 | ||
| Health-Related Hardiness | 68 | ||
| Mood Disorders | 68 | ||
| Fatigue | 69 | ||
| Stigma | 69 | ||
| Quality of Life | 69 | ||
| Living With Chronic Illness | 69 | ||
| Chronic Illness and Caregiving | 70 | ||
| Conceptual Models of Chronic Illness | 70 | ||
| Illness Trajectory | 70 | ||
| Shifting Perspectives Model of Chronic Illness | 70 | ||
| Self-Management | 71 | ||
| The Emerging Paradigm of Chronic Care | 72 | ||
| Review Questions | 74 | ||
| References | 74 | ||
| Resources | 76 | ||
| 6 Community-Based Nursing and Home Care | 77 | ||
| Learning Objectives | 77 | ||
| Key Terms | 77 | ||
| The History of Home Health Nursing | 77 | ||
| Community Health Nursing Roles | 78 | ||
| A Health Care System Under Pressure | 78 | ||
| Changing Demographics | 78 | ||
| Health Human Resources. | 78 | ||
| Patient Safety. | 79 | ||
| Sustainability of the Health Care System | 79 | ||
| Primary Health Care. | 79 | ||
| Home Care | 79 | ||
| Definition and Importance of Home Care | 79 | ||
| Home Care Services | 80 | ||
| Quality and Accountability in Home Care | 80 | ||
| Funding and Utilization of Home Care Services | 80 | ||
| Home Health Care Team | 80 | ||
| Nursing Roles. | 80 | ||
| Home Health Care Patients | 81 | ||
| Home Health Nursing Practice | 81 | ||
| Overview. | 81 | ||
| Home Health Nursing and Family-Centred Care. | 82 | ||
| Culturally Competent Care | 82 | ||
| Home Health Nursing Practice | 82 | ||
| Home Health Nursing Practice Knowledge and Skills. | 82 | ||
| Trends in Home Health Nursing | 85 | ||
| New Nursing Graduates and Licensed Practical Nurses in Home Health Nursing. | 85 | ||
| Technology in Home Health Nursing Practice | 85 | ||
| Measurement of Nursing-Sensitive Outcomes | 85 | ||
| Summary | 86 | ||
| Review Questions | 86 | ||
| References | 87 | ||
| Resources | 89 | ||
| 7 Older Adults | 90 | ||
| Learning Objectives | 90 | ||
| Key Terms | 90 | ||
| Demographics of Aging | 90 | ||
| Attitudes Toward Aging | 91 | ||
| Biological Theories of Aging | 91 | ||
| Free Radical Theory | 91 | ||
| Cross-Link Theory | 91 | ||
| Immunological Theory | 91 | ||
| Age-Related Physiological Changes | 92 | ||
| Older Populations at High Risk | 92 | ||
| Older Women | 92 | ||
| Older Adults With Cognitive Impairments | 95 | ||
| Older Adults Living in Rural Settings | 95 | ||
| Older Adults Who Are Homeless | 96 | ||
| Frail Older Adults | 96 | ||
| Older Adults With Chronic Illness | 97 | ||
| Socially Isolated Older Adults | 97 | ||
| Culturally Competent Care | 97 | ||
| Older Adults | 97 | ||
| Social Support and the Older Adult | 98 | ||
| Caregivers | 98 | ||
| Elder Mistreatment and Abuse | 98 | ||
| Universal Health Care | 99 | ||
| Care Alternatives for Older Adults | 99 | ||
| Independent Living Options | 99 | ||
| Community-Based Care for Older Adults | 100 | ||
| Adult Day Care Programs. | 100 | ||
| Home Health Care. | 100 | ||
| Long-Term Care Facilities | 100 | ||
| Legal and Ethical Issues | 100 | ||
| Nursing Management Older Adults | 101 | ||
| Nursing Assessment | 101 | ||
| Nursing Diagnoses | 101 | ||
| Planning | 102 | ||
| Nursing Implementation | 102 | ||
| Health Promotion. | 102 | ||
| Teaching Older Adults. | 102 | ||
| Acute Care Settings. | 102 | ||
| Geriatric Rehabilitation. | 103 | ||
| Assistive Devices. | 103 | ||
| Safety. | 103 | ||
| Medication Use. | 104 | ||
| Depression. | 105 | ||
| Sleep. | 105 | ||
| Behavioural Management. | 105 | ||
| Use of Restraints. | 106 | ||
| Evaluation. | 106 | ||
| Review Questions | 107 | ||
| References | 107 | ||
| Resources | 109 | ||
| 8 Stress and Stress Management | 110 | ||
| Learning Objectives | 110 | ||
| Key Terms | 110 | ||
| Definition of Stress | 110 | ||
| Work-Related Stress | 111 | ||
| Theories of Stress | 111 | ||
| General Adaptation Syndrome | 112 | ||
| Factors Affecting Response to Stress | 112 | ||
| Physiological Response to Stress | 113 | ||
| Nervous System | 113 | ||
| Cerebral Cortex. | 113 | ||
| Limbic System. | 113 | ||
| Reticular Formation. | 113 | ||
| Hypothalamus. | 113 | ||
| Endocrine System | 114 | ||
| Summary of Neuroendocrine System Stress Response | 114 | ||
| Immune System | 114 | ||
| Effects of Stress on Health | 115 | ||
| Coping | 116 | ||
| Relaxation Strategies | 117 | ||
| Relaxation Breathing | 117 | ||
| Meditation | 117 | ||
| Imagery | 118 | ||
| Music for Relaxation | 119 | ||
| Muscle Relaxation | 119 | ||
| Nursing Management Stress | 119 | ||
| Nursing Assessment | 119 | ||
| Demands. | 120 | ||
| Human Responses to Stress. | 120 | ||
| Coping. | 120 | ||
| Nursing Implementation | 120 | ||
| Review Questions | 122 | ||
| References | 122 | ||
| Resources | 123 | ||
| 9 Sleep and Sleep Disorders | 124 | ||
| Learning Objectives | 124 | ||
| Key Terms | 124 | ||
| Sleep | 124 | ||
| Physiological Sleep Mechanisms | 125 | ||
| Sleep–Wake Cycle | 125 | ||
| Wake Behaviour. | 125 | ||
| Sleep Behaviour. | 125 | ||
| Circadian Rhythms | 125 | ||
| Sleep Architecture | 126 | ||
| Non–Rapid Eye Movement Sleep. | 126 | ||
| Rapid Eye Movement Sleep. | 126 | ||
| Effects of Sleep Deprivation | 126 | ||
| Sleep Disturbances in the Hospital | 126 | ||
| Sleep Disorders | 128 | ||
| Insomnia | 128 | ||
| Etiology and Pathophysiology | 128 | ||
| Clinical Manifestations | 128 | ||
| Diagnostic Studies | 128 | ||
| Self-Report. | 128 | ||
| Actigraphy. | 128 | ||
| Polysomnography. | 128 | ||
| Collaborative Care | 129 | ||
| Cognitive–Behavioural Therapies. | 129 | ||
| Drug Therapy. | 129 | ||
| Benzodiazepines. | 129 | ||
| Benzodiazepine Receptor–like Agents. | 130 | ||
| Antidepressants. | 130 | ||
| Antihistamines. | 130 | ||
| Complementary and Alternative Therapies. | 130 | ||
| Herbal Supplements. | 130 | ||
| Acupuncture. | 130 | ||
| Other Therapeutic Sleep Aids. | 130 | ||
| Nursing Management Insomnia | 130 | ||
| Nursing Assessment | 130 | ||
| Nursing Diagnoses | 131 | ||
| Nursing Implementation | 131 | ||
| Narcolepsy | 132 | ||
| Etiology and Pathophysiology | 132 | ||
| Diagnostic Studies | 132 | ||
| Collaborative Care | 132 | ||
| Drug Therapy. | 132 | ||
| Behavioural Therapy. | 132 | ||
| Circadian Rhythm Sleep–Wake Disorders | 132 | ||
| Sleep-Disordered Breathing | 133 | ||
| Obstructive Sleep Apnea | 133 | ||
| Clinical Manifestations and Diagnostic Studies | 133 | ||
| Nursing and Collaborative Management Sleep Apnea | 134 | ||
| Surgical Interventions | 134 | ||
| Special Concerns for Hospitalization With Obstructive Sleep Apnea | 134 | ||
| Sleep Movement Disorders | 135 | ||
| Parasomnias | 135 | ||
| Rapid Eye Movement Parasomnias. | 135 | ||
| Non–Rapid Eye Movement Parasomnias. | 135 | ||
| Age-Related Considerations | 135 | ||
| Sleep | 135 | ||
| Special Sleep Needs of Nurses | 136 | ||
| Review Questions | 137 | ||
| References | 138 | ||
| Resources | 139 | ||
| 10 Pain | 140 | ||
| Learning Objectives | 140 | ||
| Key Terms | 140 | ||
| Pain | 140 | ||
| Magnitude of the Pain Problem | 140 | ||
| Definitions of Pain | 141 | ||
| Dimensions of Pain and the Pain Process | 142 | ||
| Physiological Dimension of Pain | 142 | ||
| Transduction. | 142 | ||
| Transmission. | 143 | ||
| Transmission to the Spinal Cord. | 143 | ||
| Dorsal Horn Processing. | 143 | ||
| Transmission to the Thalamus and the Cortex. | 144 | ||
| Perception. | 145 | ||
| Modulation. | 145 | ||
| Sensory-Discriminative, Motivational–Affective, Behavioural, Cognitive–Evaluative, and Sociocultural Dimensions of Pain | 145 | ||
| Causes and Types of Pain | 146 | ||
| Nociceptive Pain | 146 | ||
| Neuropathic Pain | 146 | ||
| Pain Assessment | 147 | ||
| Sensory-Discriminative Component | 147 | ||
| Pattern of Pain. | 147 | ||
| Area of Pain. | 147 | ||
| Intensity of Pain. | 147 | ||
| Nature of Pain. | 149 | ||
| Motivational–Affective, Behavioural, Cognitive–Evaluative, and Sociocultural Components | 149 | ||
| Advances in Pain Assessment Research | 149 | ||
| Pain Treatment | 150 | ||
| Basic Principles | 150 | ||
| Drug Therapy for Pain | 150 | ||
| Equianalgesic Dose. | 151 | ||
| Scheduling Analgesics. | 151 | ||
| Titration. | 151 | ||
| Analgesic Ladder. | 151 | ||
| Drug Therapy for Mild Pain. | 152 | ||
| Drug Therapy for Mild to Moderate Pain. | 153 | ||
| Drug Therapy for Moderate to Severe Pain. | 154 | ||
| Adjuvant Analgesic Therapy. | 155 | ||
| Antidepressants. | 155 | ||
| Antiseizure Drugs. | 155 | ||
| Corticosteroids. | 155 | ||
| Local Anaesthetics. | 155 | ||
| Administration Routes. | 155 | ||
| Oral. | 156 | ||
| Sublingual and Buccal. | 157 | ||
| Intranasal. | 157 | ||
| Rectal. | 157 | ||
| Transdermal. | 157 | ||
| Parenteral Routes. | 157 | ||
| Intraspinal Delivery. | 157 | ||
| Patient-Controlled Analgesia. | 158 | ||
| Surgical Therapy for Pain | 158 | ||
| Nerve Blocks. | 158 | ||
| Interventional Therapy | 158 | ||
| Therapeutic Nerve Blocks. | 158 | ||
| Neuroablative Techniques. | 158 | ||
| Neuroaugmentation. | 158 | ||
| Nonpharmacological Therapy for Pain | 158 | ||
| Physical Pain Relief Strategies | 158 | ||
| Massage. | 158 | ||
| Exercise. | 159 | ||
| Transcutaneous Electrical Nerve Stimulation. | 159 | ||
| Application of Heat. | 159 | ||
| Application of Cold. | 159 | ||
| Cognitive Techniques. | 160 | ||
| Distraction. | 160 | ||
| Relaxation Strategies. | 160 | ||
| Self-Management. | 160 | ||
| Nursing and Collaborative Management Pain | 160 | ||
| Effective Communication | 160 | ||
| Barriers to Effective Pain Management | 160 | ||
| Tolerance. | 161 | ||
| Physical Dependence. | 161 | ||
| Addiction. | 161 | ||
| Institutionalizing Pain Education and Management | 162 | ||
| Ethical Issues in Pain Management | 163 | ||
| Fear of Hastening Death by Administering Analgesics | 163 | ||
| Use of Placebos in Pain Assessment and Treatment | 163 | ||
| Age-Related Considerations | 163 | ||
| Pain | 163 | ||
| Special Populations | 163 | ||
| Cognitively Impaired Individuals | 163 | ||
| Patients With Substance use Problems | 164 | ||
| Review Questions | 164 | ||
| References | 165 | ||
| Resources | 167 | ||
| 11 Substance Use | 168 | ||
| Learning Objectives | 168 | ||
| Key Terms | 168 | ||
| Substance Use in Canada | 168 | ||
| Substance Use From a Continuum of Use Perspective | 169 | ||
| Neurophysiology of Substances of Abuse | 169 | ||
| Attitudes Toward People Experiencing Substance-Related Problems | 170 | ||
| The Harm-Reduction Perspective | 170 | ||
| Health Complications of Substance Use | 170 | ||
| Nursing Management Substance Use | 171 | ||
| Assessment | 171 | ||
| Nursing Diagnoses | 172 | ||
| Planning | 172 | ||
| Nursing Implementation | 172 | ||
| Urgent Care Situations. | 172 | ||
| Overdose. | 172 | ||
| Withdrawal. | 172 | ||
| Perioperative Care. | 172 | ||
| Acute Pain Management Considerations. | 174 | ||
| Stimulants and Stimulant Withdrawal | 175 | ||
| Nicotine | 175 | ||
| Characteristics | 175 | ||
| Physiological Effects of Use | 175 | ||
| Health Complications | 175 | ||
| Collaborative Care: Nursing Interventions for Tobacco Use Disorder | 176 | ||
| Tobacco Use Cessation. | 176 | ||
| Nicotine Replacement Therapy and Pharmacotherapeutic Interventions for Nicotine Dependence. | 176 | ||
| Cocaine and Other Stimulants | 177 | ||
| Characteristics | 177 | ||
| Effects of Use | 178 | ||
| Withdrawal | 178 | ||
| Complications | 178 | ||
| Collaborative Care | 178 | ||
| Caffeine | 178 | ||
| Characteristics | 178 | ||
| Effects of Use | 179 | ||
| Complications | 179 | ||
| Collaborative Care | 179 | ||
| Depressants | 179 | ||
| Alcohol | 179 | ||
| Characteristics | 179 | ||
| Effects of Use | 180 | ||
| Alcohol Intoxication | 180 | ||
| Acute Alcohol Intoxication. | 180 | ||
| Alcohol Withdrawal | 181 | ||
| Complications | 181 | ||
| Complications Associated With Chronic Alcoholism. | 184 | ||
| 2 Pathophysiological Mechanisms of Disease | 222 | ||
| 14 Inflammation and Wound Healing | 223 | ||
| Learning Objectives | 223 | ||
| Key Terms | 223 | ||
| Cell Injury | 223 | ||
| Cell Adaptation to Sublethal Injury | 223 | ||
| Hypertrophy. | 223 | ||
| Hyperplasia. | 224 | ||
| Atrophy. | 224 | ||
| Metaplasia. | 224 | ||
| Dysplasia. | 224 | ||
| Anaplasia. | 224 | ||
| Causes of Lethal Cell Injury | 224 | ||
| Cell Apoptosis and Necrosis | 224 | ||
| Defence Against Injury | 225 | ||
| Mononuclear Phagocyte System | 225 | ||
| Inflammatory Response | 225 | ||
| Vascular Response. | 225 | ||
| Cellular Response. | 226 | ||
| Neutrophils. | 226 | ||
| Monocytes. | 227 | ||
| Lymphocytes. | 227 | ||
| Eosinophils and Basophils. | 227 | ||
| Chemical Mediators. | 227 | ||
| Complement System. | 227 | ||
| Prostaglandins and Leukotrienes. | 228 | ||
| Exudate Formation. | 228 | ||
| Clinical Manifestations. | 228 | ||
| Fever. | 228 | ||
| Types of Inflammation. | 229 | ||
| Healing Process. | 229 | ||
| Regeneration. | 229 | ||
| Repair. | 229 | ||
| Primary Intention. | 229 | ||
| Initial (Inflammatory) Phase. | 230 | ||
| Granulation (Proliferative/Reconstructive) Phase. | 230 | ||
| Maturation Phase and Scar Contraction. | 230 | ||
| Secondary Intention. | 230 | ||
| Tertiary Intention. | 230 | ||
| Wound Classification. | 230 | ||
| Delay of Healing. | 231 | ||
| Complications of Healing. | 231 | ||
| Adhesions. | 231 | ||
| Contractures. | 231 | ||
| Dehiscence and Evisceration. | 231 | ||
| Excess Granulation Tissue. | 232 | ||
| Fistula Formation. | 232 | ||
| Infection. | 232 | ||
| Hemorrhage. | 232 | ||
| Formation of Hypertrophic Scars and Keloids. | 232 | ||
| Nursing Management Inflammation and Healing | 232 | ||
| Nursing Implementation | 232 | ||
| Health Promotion. | 232 | ||
| Acute Intervention | 233 | ||
| Observation and Vital Signs. | 233 | ||
| Fever. | 233 | ||
| RICE. | 234 | ||
| Rest. | 234 | ||
| Ice and Heat. | 234 | ||
| Compression and Immobilization. | 234 | ||
| Elevation. | 234 | ||
| Wound Management. | 234 | ||
| Red Wound. | 234 | ||
| Yellow Wound. | 235 | ||
| Black Wound. | 235 | ||
| Negative-Pressure Wound Therapy. | 235 | ||
| Hyperbaric Oxygen Therapy. | 236 | ||
| Electrical Stimulation. | 236 | ||
| Psychological Implications. | 237 | ||
| Ambulatory and Home Care. | 237 | ||
| Pressure Injuries | 237 | ||
| Causes and Pathophysiological Features | 237 | ||
| Clinical Manifestations | 237 | ||
| Nursing and Collaborative Management Pressure Injuries | 237 | ||
| Nursing Assessment | 241 | ||
| Nursing Diagnoses | 241 | ||
| Planning | 241 | ||
| Nursing Implementation | 241 | ||
| Health Promotion. | 241 | ||
| Acute Intervention. | 241 | ||
| Measuring the Wound. | 241 | ||
| Documentation. | 243 | ||
| Wound Irrigation. | 243 | ||
| Local Wound Care. | 244 | ||
| Ambulatory and Home Care. | 244 | ||
| Evaluation | 244 | ||
| Review Questions | 245 | ||
| References | 246 | ||
| Resources | 246 | ||
| 15 Genetics | 248 | ||
| Learning Objectives | 248 | ||
| Key Terms | 248 | ||
| Human Genome Project | 248 | ||
| Basic Principles of Genetics | 249 | ||
| Chromosomes, Genes, and DNA | 249 | ||
| How Proteins Are Made | 250 | ||
| Primary Categories of Genetic Conditions | 251 | ||
| Single-Gene Disorders | 251 | ||
| Autosomal Dominant. | 251 | ||
| Autosomal Recessive. | 251 | ||
| X-Linked. | 252 | ||
| Chromosomal Disorders | 252 | ||
| Multifactorial Inheritance | 253 | ||
| Genetics in Clinical Practice | 254 | ||
| Taking a Family History | 254 | ||
| Genetic Testing | 254 | ||
| Prenatal Diagnosis and Screening. | 254 | ||
| Amniocentesis. | 254 | ||
| Chorionic Villus Sampling. | 254 | ||
| Screening for Carriers of Genetic Disease. | 254 | ||
| Presymptomatic and Predisposition Testing. | 254 | ||
| Genetic Counselling | 255 | ||
| Gene Therapy | 256 | ||
| Methods of Gene Delivery. | 256 | ||
| Examples of Gene Therapy for Cancer. | 256 | ||
| Gene Editing: Using the CRISPR-Cas9 System in Gene Therapy. | 256 | ||
| Nursing Management Genetics | 257 | ||
| Review Questions | 258 | ||
| References | 259 | ||
| Resources | 259 | ||
| 16 Altered Immune Response and Transplantation | 260 | ||
| Learning Objectives | 260 | ||
| Key Terms | 260 | ||
| Normal Immune Response | 260 | ||
| Antigens | 260 | ||
| Types of Immunity | 261 | ||
| Innate Immunity. | 261 | ||
| Acquired Immunity. | 261 | ||
| Active Acquired Immunity. | 261 | ||
| Passive Acquired Immunity. | 261 | ||
| Lymphoid Organs | 261 | ||
| Cells Involved in Immune Response | 261 | ||
| Mononuclear Phagocytes. | 261 | ||
| Lymphocytes. | 262 | ||
| B Lymphocytes. | 262 | ||
| T Lymphocytes. | 262 | ||
| T Cytotoxic Cells. | 262 | ||
| T Helper Cells. | 263 | ||
| Natural Killer Cells. | 263 | ||
| Dendritic Cells. | 263 | ||
| Cytokines | 263 | ||
| Comparison of Humoral and Cell-Mediated Immunity | 264 | ||
| Humoral Immunity. | 265 | ||
| Cell-Mediated Immunity. | 266 | ||
| Age-Related Considerations | 266 | ||
| Effects of Aging on the Immune System | 266 | ||
| Altered Immune Response | 266 | ||
| Hypersensitivity Reactions | 266 | ||
| Type I: IgE-Mediated Reactions. | 266 | ||
| Anaphylaxis. | 268 | ||
| Atopic Reactions. | 268 | ||
| Type II: Cytotoxic and Cytolytic Reactions. | 269 | ||
| Hemolytic Transfusion Reactions. | 269 | ||
| Goodpasture’s Syndrome. | 269 | ||
| Type III: Immune-Complex Reactions. | 270 | ||
| Type IV: Delayed Hypersensitivity Reactions. | 270 | ||
| Contact Dermatitis. | 270 | ||
| Microbial Hypersensitivity Reactions. | 270 | ||
| Allergic Disorders | 270 | ||
| Assessment | 270 | ||
| Health History. | 270 | ||
| Physical Examination. | 270 | ||
| Diagnostic Studies | 271 | ||
| Skin Tests. | 271 | ||
| Procedure. | 271 | ||
| Results. | 271 | ||
| Precautions. | 271 | ||
| Collaborative Care | 271 | ||
| Anaphylaxis. | 271 | ||
| Chronic Allergies. | 272 | ||
| Allergen Recognition and Control. | 272 | ||
| Drug Therapy. | 272 | ||
| Antihistamines. | 272 | ||
| Sympathomimetic or Decongestant Drugs. | 272 | ||
| Corticosteroids. | 273 | ||
| Antipruritic Drugs. | 273 | ||
| Mast Cell–Stabilizing Drugs. | 273 | ||
| Leukotriene Receptor Antagonists. | 273 | ||
| Immunotherapy. | 273 | ||
| Mechanism of Action. | 273 | ||
| Method of Administration. | 273 | ||
| Subcutaneous Immunotherapy. | 273 | ||
| Sublingual Immunotherapy. | 273 | ||
| Nursing Management Immunotherapy | 273 | ||
| Latex Allergies | 273 | ||
| Types of Latex Allergies. | 274 | ||
| Latex-Food Syndrome. | 274 | ||
| Nursing and Collaborative Management Latex Allergies | 274 | ||
| Multiple Chemical Sensitivities | 274 | ||
| Autoimmunity | 274 | ||
| Autoimmune Diseases | 275 | ||
| Apheresis | 275 | ||
| Plasmapheresis. | 275 | ||
| Immunodeficiency Disorders | 276 | ||
| Primary Immunodeficiency Disorders | 276 | ||
| Secondary Immunodeficiency Disorders | 276 | ||
| Human Leukocyte Antigen System | 277 | ||
| Human Leukocyte Antigen and Disease Associations. | 277 | ||
| Organ Transplantation | 277 | ||
| Tissue Typing | 278 | ||
| HLA Typing. | 278 | ||
| Panel of Reactive Antibodies. | 278 | ||
| Crossmatch. | 278 | ||
| Transplant Rejection | 279 | ||
| Hyperacute Rejection. | 279 | ||
| Acute Rejection. | 279 | ||
| Chronic Rejection. | 279 | ||
| Immuno-Suppressive Therapy | 279 | ||
| Calcineurin Inhibitors | 279 | ||
| Mycophenolate Mofetil (CellCept) | 281 | ||
| Sirolimus (Rapamune) | 281 | ||
| Monoclonal Antibodies | 281 | ||
| Polyclonal Antibodies | 281 | ||
| Graft-Versus-Host Disease | 281 | ||
| Alternative Strategies | 281 | ||
| Transplantation of Organs From Deceased Donor | 282 | ||
| Xenotransplantation | 282 | ||
| Ex Vivo Transplantation | 282 | ||
| Stem Cell Transplantation | 282 | ||
| New Technologies in Immunology | 283 | ||
| Hybridoma Technology: Monoclonal Antibodies | 283 | ||
| Review Questions | 284 | ||
| References | 285 | ||
| Resources | 286 | ||
| 17 Infection and Human Immunodeficiency Virus Infection | 287 | ||
| Learning Objectives | 287 | ||
| Key Terms | 287 | ||
| Infections | 287 | ||
| Causes of Infections | 287 | ||
| Emerging Infections | 289 | ||
| Re-Emerging Infections | 290 | ||
| Resistant Organisms | 290 | ||
| Health Care–Associated Infections | 291 | ||
| Age-Related Considerations | 291 | ||
| Infection in Older Adults | 291 | ||
| Infection Prevention and Control | 291 | ||
| Infection Precautions | 291 | ||
| Preventing Occupational Infections in Health Care Workers | 293 | ||
| Human Immunodeficiency Virus Infection | 293 | ||
| Significance of the Problem | 294 | ||
| Transmission of Human Immunodeficiency Virus | 294 | ||
| Sexual Transmission | 295 | ||
| Contact With Blood and Blood Products | 295 | ||
| Perinatal Transmission | 295 | ||
| Pathophysiology | 295 | ||
| Clinical Manifestations and Complications | 297 | ||
| Acute Infection | 297 | ||
| Chronic Infection | 297 | ||
| Early Chronic Infection. | 297 | ||
| Intermediate Chronic Infection. | 297 | ||
| Late Chronic Infection or Acquired Immune Deficiency Syndrome. | 298 | ||
| Diagnostic Studies | 298 | ||
| Diagnosis of Human Immunodeficiency Virus Infection | 298 | ||
| Laboratory Studies in Human Immunodeficiency Virus Infection | 298 | ||
| Collaborative Care | 301 | ||
| Drug Therapy for Human Immunodeficiency Virus Infection | 301 | ||
| Preventing Transmission of Human Immunodeficiency Virus | 302 | ||
| Drug Therapy for Opportunistic Diseases | 303 | ||
| Vaccination | 304 | ||
| Nursing Management Human Immunodeficiency Virus Infection | 304 | ||
| Nursing Assessment | 304 | ||
| Nursing Diagnoses | 304 | ||
| Planning | 304 | ||
| Nursing Implementation | 305 | ||
| Health Promotion. | 305 | ||
| Prevention of Human Immunodeficiency Virus Infection. | 306 | ||
| Decreasing Risks Related to Sexual Intercourse. | 307 | ||
| Decreasing Risks Related to Substance Misuse. | 307 | ||
| Decreasing Risks of Perinatal Transmission. | 308 | ||
| Decreasing Risks at Work. | 308 | ||
| Human Immunodeficiency Virus Testing and Counselling. | 308 | ||
| Acute Intervention | 308 | ||
| Early Intervention. | 308 | ||
| Initial Response to a Diagnosis of Human Immunodeficiency Virus Infection. | 308 | ||
| Antiretroviral Therapy. | 308 | ||
| When to Start Antiretroviral Therapy. | 309 | ||
| Adherence. | 309 | ||
| Health Promotion. | 310 | ||
| Acute Exacerbations. | 310 | ||
| Ongoing Care. | 311 | ||
| Disease and Drug Adverse Effects. | 311 | ||
| End-of-Life Care. | 311 | ||
| Evaluation | 312 | ||
| Review Questions | 313 | ||
| References | 313 | ||
| Resources | 315 | ||
| 18 Cancer | 316 | ||
| Learning Objectives | 316 | ||
| Key Terms | 316 | ||
| Definition and Incidence | 316 | ||
| Progress Made in Cancer Prevention: Modifiable Risk Factors | 317 | ||
| Biological Processes of Cancer | 317 | ||
| Defects in Cellular Proliferation | 317 | ||
| Defects in Cellular Differentiation | 319 | ||
| Development of Cancer | 319 | ||
| Initiation. | 320 | ||
| Chemical Carcinogens. | 320 | ||
| Radiation. | 320 | ||
| Viral and Bacterial Carcinogens. | 320 | ||
| Genetic Susceptibility. | 321 | ||
| Promotion. | 321 | ||
| Progression. | 321 | ||
| Role of the Immune System | 322 | ||
| Mechanisms of Escape From Immunological Surveillance. | 323 | ||
| Oncofetal Antigens. | 323 | ||
| Classification of Cancer | 324 | ||
| Anatomical Site Classification | 324 | ||
| Histological Analysis Classification | 324 | ||
| Classifying Extent of Disease | 324 | ||
| Clinical Staging. | 324 | ||
| TNM Classification System. | 324 | ||
| Prevention and Detection of Cancer | 325 | ||
| Diagnosis of Cancer | 325 | ||
| Biopsy. | 326 | ||
| Collaborative Care | 326 | ||
| Goals and Modalities | 326 | ||
| Clinical Trials | 327 | ||
| Surgical Therapy | 327 | ||
| Cure and Control | 327 | ||
| Supportive and Palliative Surgical Procedures | 328 | ||
| Rehabilitative Management | 328 | ||
| Chemotherapy | 328 | ||
| Effect on Cells | 329 | ||
| Classification of Chemotherapeutic Drugs | 329 | ||
| Preparation and Administration of Chemotherapeutic Agents | 329 | ||
| Methods of Administration | 329 | ||
| Infusion Pumps. | 331 | ||
| Regional Administration of Chemotherapeutic Agents. | 331 | ||
| Intra-Arterial Chemotherapy. | 331 | ||
| Intraperitoneal Chemotherapy. | 331 | ||
| Intrathecal or Intraventricular Chemotherapy. | 331 | ||
| Intravesical Bladder Chemotherapy. | 332 | ||
| Effects of Chemotherapy on Normal Tissues | 332 | ||
| Treatment Plan | 332 | ||
| Radiation Therapy | 333 | ||
| Effects of Radiation | 333 | ||
| Cellular Death and Tissue Reactions. | 333 | ||
| Simulation and Treatment | 333 | ||
| External Radiation. | 333 | ||
| Internal Radiation. | 333 | ||
| Measurement of Radiation | 334 | ||
| Goals of Radiation Therapy | 334 | ||
| Nursing Management Radiation Therapy and Chemotherapy | 335 | ||
| Nursing Implementation | 335 | ||
| Fatigue. | 335 | ||
| Anorexia. | 335 | ||
| Bone Marrow Suppression. | 335 | ||
| Skin Reactions. | 338 | ||
| Oral, Oropharyngeal, and Esophageal Reactions. | 339 | ||
| Pulmonary Effects. | 339 | ||
| Gastro-intestinal Effects. | 339 | ||
| Reproductive Effects. | 340 | ||
| Late Effects of Radiation Treatment and Chemotherapy | 340 | ||
| Biological and Targeted Therapy | 340 | ||
| Hematopoietic Growth Factors | 343 | ||
| Colony-Stimulating Factors. | 343 | ||
| Erythropoietin. | 343 | ||
| Toxic and Adverse Effects of Biological Agents | 343 | ||
| Nursing Management Biological Therapy | 343 | ||
| Bone Marrow and Stem Cell Transplantation | 343 | ||
| Types of Bone Marrow Transplants | 344 | ||
| Procedures | 344 | ||
| Harvest Procedures. | 344 | ||
| Preparative Regimens. | 344 | ||
| Complications. | 344 | ||
| Peripheral Stem Cell Transplantation | 344 | ||
| Cord Blood Stem Cells | 345 | ||
| Gene Therapy | 345 | ||
| Complications Resulting From Cancer | 345 | ||
| Nutritional Problems | 345 | ||
| Malnutrition. | 345 | ||
| Altered Taste Sensation. | 345 | ||
| Infection | 345 | ||
| Oncological Emergencies | 345 | ||
| Obstructive Emergencies. | 345 | ||
| Superior Vena Cava Syndrome. | 345 | ||
| Spinal Cord Compression. | 345 | ||
| Third Space Syndrome. | 346 | ||
| Intestinal Obstruction. | 346 | ||
| Metabolic Emergencies. | 346 | ||
| Syndrome of Inappropriate Antidiuretic Hormone. | 346 | ||
| Hypercalcemia. | 346 | ||
| Tumour Lysis Syndrome. | 346 | ||
| Septic Shock and Disseminated Intravascular Coagulation. | 346 | ||
| Infiltrative Emergencies. | 346 | ||
| Cardiac Tamponade. | 346 | ||
| Carotid Artery Rupture. | 346 | ||
| Management of Cancer Pain | 346 | ||
| Psychosocial Care | 347 | ||
| Age-Related Considerations | 348 | ||
| Cancer | 348 | ||
| Review Questions | 348 | ||
| References | 349 | ||
| Resources | 350 | ||
| 19 Fluid, Electrolyte, and Acid–Base Imbalances | 352 | ||
| Learning Objectives | 352 | ||
| Key Terms | 352 | ||
| Homeostasis | 352 | ||
| Water Content of the Body | 353 | ||
| Body Fluid Compartments | 353 | ||
| Calculation of Fluid Gain or Loss | 353 | ||
| Electrolytes | 353 | ||
| Measurement of Electrolytes | 353 | ||
| Electrolyte Composition of Fluid Compartments | 354 | ||
| Mechanisms Controlling Fluid and Electrolyte Movement | 354 | ||
| Diffusion | 354 | ||
| Facilitated Diffusion | 354 | ||
| Active Transport | 354 | ||
| Osmosis | 354 | ||
| Measurement of Osmolality. | 355 | ||
| Osmotic Movement of Fluids. | 355 | ||
| Hydrostatic Pressure | 355 | ||
| Oncotic Pressure | 356 | ||
| Fluid Movement in Capillaries | 356 | ||
| Fluid Shifts | 356 | ||
| Shifts of Plasma to Interstitial Fluid. | 356 | ||
| Elevation of Venous Hydrostatic Pressure. | 356 | ||
| Decrease in Plasma Oncotic Pressure. | 356 | ||
| Elevation of Interstitial Oncotic Pressure. | 356 | ||
| Shifts of Interstitial Fluid to Plasma. | 356 | ||
| Fluid Movement Between Extracellular Fluid and Intracellular Fluid | 356 | ||
| Fluid Spacing | 357 | ||
| Regulation of Water Balance | 357 | ||
| Hypothalamic Regulation | 357 | ||
| Pituitary Regulation | 357 | ||
| Adrenal Cortical Regulation | 357 | ||
| Renal Regulation | 358 | ||
| Cardiac Regulation | 358 | ||
| Gastro-intestinal Regulation | 358 | ||
| Insensible Water Loss | 358 | ||
| Age-Related Considerations | 358 | ||
| Fluid and Electrolytes | 358 | ||
| Fluid and Electrolyte Imbalances | 359 | ||
| Sodium and Extracellular Fluid Volume Imbalances | 359 | ||
| Hypernatremia. | 359 | ||
| Collaborative Care. | 360 | ||
| Hyponatremia. | 360 | ||
| 3 Perioperative Care | 383 | ||
| 20 Nursing Management | 384 | ||
| Learning Objectives | 384 | ||
| Key Terms | 384 | ||
| Surgical Settings | 384 | ||
| Surgical Wait Times | 385 | ||
| Elective Inpatient Surgery | 385 | ||
| Ambulatory Surgery. | 385 | ||
| Preoperative Admission Assessment | 385 | ||
| Day-of-Surgery Assessment | 385 | ||
| Subjective Data | 386 | ||
| Psychosocial Assessment. | 386 | ||
| Anxiety. | 386 | ||
| Common Fears. | 386 | ||
| Coping With Surgery. | 387 | ||
| Health History. | 387 | ||
| Medications. | 387 | ||
| Allergies. | 388 | ||
| Review of Systems. | 388 | ||
| Nervous System. | 389 | ||
| Cardiovascular System. | 389 | ||
| Respiratory System. | 389 | ||
| Urinary System. | 389 | ||
| Integumentary System. | 389 | ||
| Musculo-Skeletal System. | 389 | ||
| Endocrine System. | 389 | ||
| Immune System. | 390 | ||
| Fluid and Electrolyte Status. | 390 | ||
| Nutritional Status. | 390 | ||
| Nursing Assessment: Patient About to Undergo Surgery. | 390 | ||
| Objective Data | 390 | ||
| Physical Examination. | 390 | ||
| Laboratory and Diagnostic Testing. | 390 | ||
| Nursing Management Patient About to Undergo Surgery | 392 | ||
| Preoperative Education | 392 | ||
| General Surgery Information. | 392 | ||
| Ambulatory Surgery Information. | 392 | ||
| Legal Preparation for Surgery | 394 | ||
| Consent for Surgery. | 394 | ||
| Voluntary Consent. | 395 | ||
| Capacity to Consent. | 395 | ||
| Life-Threatening Situations. | 395 | ||
| Properly Informing the Patient. | 395 | ||
| Day-of-Surgery Preparation | 395 | ||
| Nursing Role | 395 | ||
| Preoperative Medications. | 396 | ||
| Transportation to the Operating Room | 396 | ||
| Culturally Competent Care | 398 | ||
| Patient About to Undergo Surgery | 398 | ||
| Age-Related Considerations | 398 | ||
| Older-Adult Patient About to Undergo Surgery | 398 | ||
| Review Questions | 399 | ||
| References | 400 | ||
| Resources | 400 | ||
| 21 Nursing Management | 401 | ||
| Learning Objectives | 401 | ||
| Key Terms | 401 | ||
| Physical Environment | 401 | ||
| Department Layout | 401 | ||
| Preoperative Holding Area | 402 | ||
| Operating Room | 402 | ||
| Surgical Team | 402 | ||
| Registered Nurse | 402 | ||
| Circulating Role. | 403 | ||
| Practical Nurse | 404 | ||
| Scrub Role. | 404 | ||
| Surgeon and Assistant | 404 | ||
| Registered Nurse First Assistant | 404 | ||
| Anaesthesiologist | 404 | ||
| Advanced Nursing Practice Roles | 405 | ||
| Registered Nurse Anaesthesia Assistant. | 405 | ||
| Nursing Management Patient Before Surgery | 405 | ||
| Psychosocial Assessment | 405 | ||
| Physical Assessment | 405 | ||
| Chart Review | 405 | ||
| Admitting the Patient | 405 | ||
| Nursing Management Intraoperative Care | 406 | ||
| Room Preparation | 406 | ||
| Transferring the Patient. | 406 | ||
| Scrubbing, Gowning, and Gloving. | 406 | ||
| Basic Aseptic Technique | 406 | ||
| Assisting the Anaesthesiologist | 407 | ||
| Positioning the Patient | 408 | ||
| Preparing the Surgical Site | 409 | ||
| Safety Considerations | 409 | ||
| Classification of Anaesthesia | 409 | ||
| General Anaesthesia | 410 | ||
| Intravenous Induction Agents. | 410 | ||
| IV Drugs and General Anaesthesia. | 410 | ||
| Opioids. | 410 | ||
| Benzodiazepines. | 410 | ||
| Neuro-Muscular Blocking Drugs. | 412 | ||
| Antiemetics. | 412 | ||
| Local Anaesthesia | 412 | ||
| Methods of Administration. | 412 | ||
| Spinal and Epidural Anaesthesia (Neuraxial Blocks). | 413 | ||
| Procedural (Conscious) Sedation | 413 | ||
| Patient After Surgery | 414 | ||
| Age-Related Considerations | 415 | ||
| Patient During Surgery | 415 | ||
| Exceptional Clinical Events in the Operating Room | 415 | ||
| Anaphylactic Reactions | 415 | ||
| Malignant Hyperthermia | 415 | ||
| Major Blood Loss | 415 | ||
| New and Future Considerations | 415 | ||
| Review Questions | 416 | ||
| References | 416 | ||
| Resources | 417 | ||
| 22 Nursing Management | 418 | ||
| Learning Objectives | 418 | ||
| Key Terms | 418 | ||
| Postoperative Care in the Postanaesthesia Care Unit | 418 | ||
| Postanaesthesia Care Unit Admission | 418 | ||
| Postanaesthesia Care Unit Progression | 418 | ||
| Initial Assessment | 419 | ||
| Potential Alterations in Respiratory Function | 420 | ||
| Etiology | 420 | ||
| Postanaesthesia Care Unit. | 420 | ||
| Clinical Unit. | 420 | ||
| Nursing Management Respiratory Complications | 423 | ||
| Nursing Assessment | 423 | ||
| Nursing Diagnoses | 423 | ||
| Nursing Implementation | 423 | ||
| Postanaesthesia Care Unit. | 423 | ||
| Clinical Unit. | 423 | ||
| Potential Alterations in Cardiovascular Function | 424 | ||
| Etiology | 424 | ||
| Postanaesthesia Care Unit. | 424 | ||
| Clinical Unit. | 424 | ||
| Nursing Management Cardiovascular Problems | 424 | ||
| Nursing Assessment | 424 | ||
| Nursing Diagnoses | 425 | ||
| Nursing Implementation | 425 | ||
| 4 Problems Related to Altered Sensory Input | 438 | ||
| 23 Nursing Assessment | 439 | ||
| Learning Objectives | 439 | ||
| Key Terms | 439 | ||
| The Visual System | 439 | ||
| Structures and Functions | 439 | ||
| Structures and Functions of Vision | 439 | ||
| Eyeball. | 439 | ||
| Refractive Media. | 439 | ||
| Refractive Errors. | 440 | ||
| Visual Pathways. | 440 | ||
| External Structures and Functions | 440 | ||
| Eyebrows, Eyelids, and Eyelashes. | 440 | ||
| Internal Structures and Functions | 441 | ||
| Age-Related Considerations | 442 | ||
| The Visual System | 442 | ||
| Assessment | 442 | ||
| Subjective Data | 442 | ||
| Past Health History. | 442 | ||
| Medications. | 442 | ||
| Surgery or Other Treatments. | 442 | ||
| Self-Care History. | 443 | ||
| Social and Occupational Health History. | 444 | ||
| Coping Abilities. | 444 | ||
| Objective Data | 445 | ||
| Physical Examination. | 445 | ||
| Assessing Functional Status | 445 | ||
| Visual Acuity. | 445 | ||
| Extraocular Muscle Functions. | 448 | ||
| Pupil Function. | 448 | ||
| Assessing Structures. | 448 | ||
| Eyebrows, Eyelashes, and Eyelids. | 448 | ||
| Conjunctiva and Sclera. | 448 | ||
| Cornea. | 448 | ||
| Iris. | 449 | ||
| Retina and Optic Nerve. | 449 | ||
| Focused Assessment. | 449 | ||
| Special Assessment Techniques | 449 | ||
| Colour Vision. | 449 | ||
| Stereopsis. | 449 | ||
| Intraocular Pressure. | 449 | ||
| Diagnostic Studies | 449 | ||
| The Auditory System | 450 | ||
| Structures and Functions | 450 | ||
| External Ear | 450 | ||
| Middle Ear | 451 | ||
| Inner Ear | 451 | ||
| Transmission of Sound and Implications for Hearing Loss | 451 | ||
| Age-Related Considerations | 452 | ||
| The Auditory System | 452 | ||
| Assessment | 452 | ||
| Subjective Data | 452 | ||
| Important Health History | 452 | ||
| Current Health of Auditory System. | 452 | ||
| Past Health History. | 452 | ||
| Medications. | 453 | ||
| Surgery or Other Treatments. | 453 | ||
| Nutrition and Elimination. | 453 | ||
| Activities of Daily Living and Exercise. | 454 | ||
| Self-Care History. | 454 | ||
| Coping Abilities. | 454 | ||
| Objective Data | 454 | ||
| Physical Examination. | 454 | ||
| External Ear. | 454 | ||
| External Auditory Canal and Tympanum. | 455 | ||
| Focused Assessment. | 455 | ||
| Diagnostic Studies | 456 | ||
| Tests for Hearing Acuity | 456 | ||
| Tuning-Fork Tests. | 456 | ||
| Audiometry. | 456 | ||
| Screening Audiometry. | 457 | ||
| Pure-Tone Audiometry. | 458 | ||
| Specialized Tests | 458 | ||
| Test for Vestibular Function | 458 | ||
| Review Questions | 458 | ||
| References | 458 | ||
| Resources | 459 | ||
| 24 Nursing Management | 460 | ||
| Learning Objectives | 460 | ||
| Key Terms | 460 | ||
| Visual Problems | 460 | ||
| Correctable Refractive Errors | 461 | ||
| Nonsurgical Corrections | 461 | ||
| Corrective Glasses. | 461 | ||
| Contact Lenses. | 461 | ||
| Surgical Therapy | 461 | ||
| Laser Surgery. | 462 | ||
| Implantation. | 462 | ||
| Uncorrectable Visual Impairment | 462 | ||
| Levels of Visual Impairment | 462 | ||
| Nursing Management Visual Impairment | 462 | ||
| Nursing Assessment | 462 | ||
| Nursing Diagnoses | 463 | ||
| Planning | 463 | ||
| Nursing Implementation | 463 | ||
| Health Promotion. | 463 | ||
| Acute Intervention. | 463 | ||
| Ambulatory and Home Care. | 464 | ||
| Optical Devices for Vision Enhancement. | 464 | ||
| Nonoptical Methods for Vision Enhancement. | 464 | ||
| Evaluation | 464 | ||
| Age-Related Considerations | 464 | ||
| Visual Impairment | 464 | ||
| Eye Trauma | 464 | ||
| Extraocular Disorders | 464 | ||
| Inflammation and Infection | 464 | ||
| Hordeolum. | 464 | ||
| Chalazion. | 465 | ||
| Blepharitis. | 465 | ||
| Conjunctivitis. | 465 | ||
| 5 Problems of Oxygenation: Ventilation | 555 | ||
| 28 Nursing Assessment | 556 | ||
| Learning Objectives | 556 | ||
| Key Terms | 556 | ||
| Structures and Functions of the Respiratory System | 556 | ||
| Upper Respiratory Tract | 556 | ||
| Lower Respiratory Tract | 557 | ||
| Surfactant. | 558 | ||
| Blood Supply. | 559 | ||
| Chest Wall | 559 | ||
| Physiology of Respiration | 559 | ||
| Ventilation. | 559 | ||
| Elastic Recoil and Compliance. | 559 | ||
| Diffusion. | 559 | ||
| Oxygen–Hemoglobin Dissociation Curve. | 559 | ||
| Arterial Blood Gases. | 560 | ||
| Mixed Venous Blood Gases. | 560 | ||
| Oximetry. | 561 | ||
| Oxygen Delivery. | 561 | ||
| Control of Respiration | 562 | ||
| Chemoreceptors. | 562 | ||
| Mechanical Receptors. | 562 | ||
| Respiratory Defence Mechanisms | 562 | ||
| Filtration of Air. | 562 | ||
| Mucociliary Clearance System. | 563 | ||
| Cough Reflex. | 563 | ||
| Reflex Bronchoconstriction. | 563 | ||
| Alveolar Macrophages. | 563 | ||
| Age-Related Considerations | 563 | ||
| Effects of Aging on the Respiratory System | 563 | ||
| Assessment of the Respiratory System | 563 | ||
| Subjective Data | 564 | ||
| Important Health Information | 564 | ||
| Past Health History. | 564 | ||
| Medications. | 565 | ||
| Surgery or Other Treatments. | 565 | ||
| Current Health History. | 565 | ||
| Objective Data | 566 | ||
| Physical Examination. | 566 | ||
| Nose. | 566 | ||
| Mouth and Pharynx. | 566 | ||
| Neck. | 566 | ||
| Thorax and Lungs. | 566 | ||
| Inspection. | 566 | ||
| Palpation. | 567 | ||
| Percussion. | 567 | ||
| Auscultation. | 567 | ||
| Diagnostic Studies of the Respiratory System | 569 | ||
| Blood Studies | 569 | ||
| Oximetry | 569 | ||
| Sputum Studies | 569 | ||
| Skin Tests | 570 | ||
| Tuberculin Skin Testing. | 570 | ||
| Radiological Studies | 571 | ||
| Chest Radiography. | 571 | ||
| Computed Tomography. | 571 | ||
| Magnetic Resonance Imaging. | 574 | ||
| Ventilation–Perfusion Scan. | 574 | ||
| Pulmonary Angiography. | 574 | ||
| Positron Emission Tomography. | 574 | ||
| Endoscopic Examinations | 574 | ||
| Bronchoscopy. | 574 | ||
| Mediastinoscopy. | 575 | ||
| Lung Biopsy | 575 | ||
| Thoracentesis | 575 | ||
| Pulmonary Function Tests | 575 | ||
| Exercise Testing | 577 | ||
| Review Questions | 577 | ||
| References | 578 | ||
| Resources | 578 | ||
| 29 Nursing Management | 579 | ||
| Learning Objectives | 579 | ||
| Key Terms | 579 | ||
| Structural and Traumatic Disorders of the Nose | 579 | ||
| Deviated Septum | 579 | ||
| Nasal Fracture | 579 | ||
| Rhinoplasty | 580 | ||
| Collaborative Care | 580 | ||
| Nursing Management Nasal Surgery | 580 | ||
| Epistaxis | 580 | ||
| Nursing and Collaborative Management Epistaxis | 580 | ||
| Inflammation and Infection of the Nose and Paranasal Sinuses | 581 | ||
| Allergic Rhinitis | 581 | ||
| Clinical Manifestations | 581 | ||
| Nursing and Collaborative Management Allergic Rhinitis | 581 | ||
| Acute Viral Rhinitis | 581 | ||
| Nursing and Collaborative Management Acute Viral Rhinitis | 583 | ||
| Influenza | 584 | ||
| Clinical Manifestations | 584 | ||
| Nursing and Collaborative Management Influenza | 585 | ||
| Sinusitis | 585 | ||
| Clinical Manifestations | 586 | ||
| Nursing and Collaborative Management Sinusitis | 586 | ||
| Obstruction of the Nose and Paranasal Sinuses | 587 | ||
| Polyps | 587 | ||
| Foreign Bodies | 587 | ||
| Problems Related to the Pharynx | 587 | ||
| Acute Pharyngitis | 587 | ||
| Clinical Manifestations | 587 | ||
| Nursing and Collaborative Management Acute Pharyngitis | 587 | ||
| Peritonsillar Abscess | 587 | ||
| Problems Related to the Trachea and Larynx | 587 | ||
| Airway Obstruction | 587 | ||
| Tracheostomy | 587 | ||
| Nursing Management Tracheostomy | 588 | ||
| Providing Tracheostomy Care | 588 | ||
| Swallowing Dysfunction | 590 | ||
| Use of the Voice With a Tracheostomy Tube | 591 | ||
| Decannulation | 593 | ||
| Laryngeal Polyps | 593 | ||
| Head and Neck Cancer | 593 | ||
| Clinical Manifestations | 593 | ||
| Diagnostic Studies | 593 | ||
| Collaborative Care | 593 | ||
| Nutritional Therapy. | 594 | ||
| Nursing Management Head and Neck Cancer | 595 | ||
| Nursing Assessment | 595 | ||
| Nursing Diagnoses | 595 | ||
| Planning | 595 | ||
| Nursing Implementation | 595 | ||
| Health Promotion. | 595 | ||
| Acute Intervention. | 595 | ||
| Radiation Therapy. | 596 | ||
| Surgical Therapy. | 596 | ||
| Voice Rehabilitation. | 596 | ||
| Stoma Care. | 597 | ||
| Depression. | 597 | ||
| Sexuality. | 597 | ||
| Ambulatory and Home Care. | 598 | ||
| Evaluation | 598 | ||
| Review Questions | 598 | ||
| References | 599 | ||
| Resources | 599 | ||
| 30 Nursing Management | 600 | ||
| Learning Objectives | 600 | ||
| Key Terms | 600 | ||
| Acute Bronchitis | 601 | ||
| Pneumonia | 601 | ||
| Etiology | 601 | ||
| Factors Predisposing to Pneumonia. | 601 | ||
| Acquisition of Organisms. | 601 | ||
| Types of Pneumonia | 601 | ||
| Community-Acquired Pneumonia. | 601 | ||
| Hospital-Acquired Pneumonia. | 602 | ||
| Fungal Pneumonia. | 602 | ||
| Aspiration Pneumonia. | 602 | ||
| Opportunistic Pneumonia. | 603 | ||
| Pathophysiology | 603 | ||
| Clinical Manifestations | 603 | ||
| Complications | 604 | ||
| Diagnostic Studies. | 604 | ||
| Collaborative Care | 604 | ||
| Pneumococcal Vaccine. | 605 | ||
| Drug Therapy. | 605 | ||
| Nutritional Therapy. | 605 | ||
| Nursing Management Pneumonia | 605 | ||
| Nursing Assessment | 605 | ||
| Nursing Diagnoses | 605 | ||
| Planning | 605 | ||
| Nursing Implementation | 605 | ||
| Health Promotion. | 605 | ||
| Acute Intervention. | 606 | ||
| Ambulatory and Home Care. | 606 | ||
| Evaluation. | 606 | ||
| Tuberculosis | 607 | ||
| Etiology and Pathophysiology | 607 | ||
| Clinical Manifestations | 607 | ||
| Complications | 608 | ||
| Miliary Tuberculosis. | 608 | ||
| Pleural Effusion and Empyema. | 608 | ||
| Tuberculosis Pneumonia. | 608 | ||
| Other Organ Involvement. | 608 | ||
| Diagnostic Studies | 608 | ||
| Tuberculin Skin Testing. | 608 | ||
| Chest Radiographic Study. | 608 | ||
| Bacteriological Studies. | 608 | ||
| Collaborative Care | 608 | ||
| Drug Therapy | 608 | ||
| Active Disease. | 608 | ||
| Latent Tuberculosis Infection. | 610 | ||
| Vaccine. | 610 | ||
| Nursing Management Tuberculosis | 610 | ||
| Nursing Assessment | 610 | ||
| Nursing Diagnoses | 610 | ||
| Planning | 610 | ||
| Nursing Implementation | 610 | ||
| Health Promotion. | 610 | ||
| Acute Intervention. | 610 | ||
| Ambulatory and Home Care. | 611 | ||
| Evaluation | 611 | ||
| Atypical Mycobacteria | 611 | ||
| Pulmonary Fungal Infections | 612 | ||
| Collaborative Care | 612 | ||
| Bronchiectasis | 612 | ||
| Etiology and Pathophysiology | 612 | ||
| Clinical Manifestations | 613 | ||
| Diagnostic Studies | 613 | ||
| Collaborative Care | 613 | ||
| Nursing Management Bronchiectasis | 613 | ||
| Lung Abscess | 614 | ||
| Etiology and Pathophysiology | 614 | ||
| Clinical Manifestations and Complications | 614 | ||
| Diagnostic Studies | 614 | ||
| Nursing and Collaborative Management Lung Abscess | 614 | ||
| Environmental Lung Diseases | 615 | ||
| Clinical Manifestations | 615 | ||
| Collaborative Care | 615 | ||
| Lung Cancer | 615 | ||
| Etiology | 615 | ||
| Pathophysiology | 617 | ||
| Paraneoplastic Syndrome. | 617 | ||
| Clinical Manifestations | 617 | ||
| Diagnostic Studies | 618 | ||
| Staging. | 618 | ||
| Screening for Lung Cancer. | 619 | ||
| Collaborative Care | 619 | ||
| Surgical Therapy. | 619 | ||
| Radiation Therapy. | 620 | ||
| Stereotactic Radiotherapy. | 620 | ||
| Chemotherapy. | 620 | ||
| Biological Therapy. | 620 | ||
| Other Therapies | 620 | ||
| Prophylactic Cranial Radiation. | 620 | ||
| Bronchoscopic Laser Therapy. | 620 | ||
| Phototherapy. | 620 | ||
| Airway Stenting. | 620 | ||
| Cryotherapy. | 620 | ||
| Nursing Management Lung Cancer | 620 | ||
| Nursing Assessment | 620 | ||
| Nursing Diagnoses | 621 | ||
| Planning | 621 | ||
| Nursing Implementation | 621 | ||
| Health Promotion. | 621 | ||
| Acute Intervention. | 622 | ||
| Ambulatory and Home Care. | 622 | ||
| Evaluation | 622 | ||
| Other Types of Lung Tumours | 622 | ||
| Chest Trauma and Thoracic Injuries | 623 | ||
| Pneumothorax | 623 | ||
| Types of Pneumothorax | 624 | ||
| Closed Pneumothorax. | 624 | ||
| Open Pneumothorax. | 624 | ||
| Tension Pneumothorax. | 624 | ||
| Hemothorax. | 625 | ||
| Chylothorax. | 625 | ||
| Clinical Manifestations | 625 | ||
| Collaborative Care | 625 | ||
| Fractured Ribs | 625 | ||
| Flail Chest | 625 | ||
| Chest Tubes and Pleural Drainage | 626 | ||
| Chest Tube Insertion | 626 | ||
| Pleural Drainage | 626 | ||
| Heimlich Valves. | 627 | ||
| Small Chest Tubes. | 628 | ||
| Nursing Management Chest Drainage | 628 | ||
| Complications | 628 | ||
| Chest Tube Removal | 628 | ||
| Chest Surgery | 628 | ||
| Preoperative Care | 628 | ||
| Surgical Therapy | 630 | ||
| Video-Assisted Thorascopic Surgery. | 630 | ||
| Postoperative Care | 631 | ||
| Restrictive Respiratory Disorders | 631 | ||
| Pleural Effusion | 631 | ||
| Types | 631 | ||
| Clinical Manifestations | 631 | ||
| Thoracentesis | 632 | ||
| Collaborative Care | 632 | ||
| Pleurisy | 633 | ||
| Atelectasis | 633 | ||
| Interstitial Lung Disease | 633 | ||
| Idiopathic Pulmonary Fibrosis | 633 | ||
| Sarcoidosis | 634 | ||
| Vascular Lung Disorders | 634 | ||
| Pulmonary Edema | 634 | ||
| Pulmonary Embolism | 634 | ||
| Etiology and Pathophysiology | 634 | ||
| Clinical Manifestations | 635 | ||
| Complications | 635 | ||
| Diagnostic Studies | 635 | ||
| Collaborative Care | 636 | ||
| Drug Therapy. | 636 | ||
| Surgical Therapy. | 636 | ||
| Nursing Management Pulmonary Embolism | 636 | ||
| Nursing Implementation | 636 | ||
| Health Promotion. | 636 | ||
| Acute Intervention. | 636 | ||
| Ambulatory and Home Care. | 636 | ||
| Evaluation | 636 | ||
| Pulmonary Hypertension | 636 | ||
| Primary Pulmonary Hypertension | 637 | ||
| Etiology and Pathophysiology | 637 | ||
| Clinical Manifestations | 637 | ||
| Collaborative Care | 637 | ||
| Secondary Pulmonary Hypertension | 638 | ||
| Cor Pulmonale | 638 | ||
| Clinical Manifestations | 638 | ||
| Collaborative Care | 638 | ||
| Lung Transplantation | 638 | ||
| Review Questions | 640 | ||
| References | 641 | ||
| Resources | 642 | ||
| 31 Nursing Management | 643 | ||
| Learning Objectives | 643 | ||
| Key Terms | 643 | ||
| Asthma | 643 | ||
| Triggers of Asthma Attacks | 644 | ||
| Allergens. | 644 | ||
| Exercise. | 644 | ||
| Respiratory Infections. | 645 | ||
| Nose and Sinus Problems. | 645 | ||
| Drugs and Food Additives. | 645 | ||
| Gastro-esophageal Reflux Disease. | 646 | ||
| Air Pollutants. | 646 | ||
| Emotional Stress. | 646 | ||
| Pathophysiology | 646 | ||
| Clinical Manifestations | 647 | ||
| Asthma Control and Severity | 647 | ||
| Severe Acute Asthma and Life-Threatening Asthma. | 649 | ||
| Diagnostic Studies for Asthma | 649 | ||
| Collaborative Care | 650 | ||
| General Management Approach. | 651 | ||
| Acute Asthma Episode. | 651 | ||
| Drug Therapy | 653 | ||
| Anti-Inflammatory Drugs | 653 | ||
| Corticosteroids. | 653 | ||
| Antileukotrienes. | 656 | ||
| Anti–Immunoglobulin E Antagonists. | 657 | ||
| Bronchodilators. | 657 | ||
| β2-Adrenergic Agonists. | 657 | ||
| Anticholinergic Drugs. | 657 | ||
| Methylxanthines. | 657 | ||
| Patient Education Related to Drug Therapy. | 658 | ||
| Nursing Management Asthma | 659 | ||
| Nursing Assessment | 659 | ||
| Nursing Diagnoses | 659 | ||
| Planning | 660 | ||
| Nursing Implementation | 660 | ||
| Asthma Education. | 660 | ||
| Environmental Control. | 660 | ||
| Self-Monitoring and Action Plans. | 662 | ||
| Evaluation. | 664 | ||
| Chronic Obstructive Pulmonary Disease | 664 | ||
| Causes | 664 | ||
| Cigarette Smoking. | 664 | ||
| Occupational Chemicals and Dusts. | 665 | ||
| Infection. | 665 | ||
| Heredity. | 665 | ||
| Aging. | 665 | ||
| Pathophysiology | 666 | ||
| Clinical Manifestations | 667 | ||
| Classification of Chronic Obstructive Pulmonary Disease. | 668 | ||
| Complications | 668 | ||
| Cor Pulmonale. | 668 | ||
| Acute Exacerbations of Chronic Obstructive Pulmonary Disease. | 669 | ||
| Acute Respiratory Failure. | 670 | ||
| Depression, Anxiety, and Panic. | 670 | ||
| Clinical Assessment | 670 | ||
| Collaborative Care | 671 | ||
| Smoking Cessation. | 671 | ||
| Drug Therapy. | 671 | ||
| Oxygen Therapy. | 672 | ||
| Indications for Use. | 672 | ||
| Methods of Administration. | 672 | ||
| Humidification. | 674 | ||
| Complications | 674 | ||
| Combustion. | 674 | ||
| Carbon Dioxide Narcosis. | 674 | ||
| Oxygen Toxicity. | 676 | ||
| Absorption Atelectasis. | 676 | ||
| Infection. | 676 | ||
| Long-Term Oxygen Therapy at Home. | 676 | ||
| Surgical Therapy. | 677 | ||
| Pulmonary Rehabilitation Programs. | 678 | ||
| Breathing Exercises. | 678 | ||
| Effective Coughing. | 679 | ||
| Nutritional Therapy. | 679 | ||
| Age-Related Considerations | 679 | ||
| Chronic Obstructive Pulmonary Disease | 679 | ||
| Nursing Management Chronic Obstructive Pulmonary Disease | 680 | ||
| Nursing Assessment | 680 | ||
| Nursing Diagnoses | 680 | ||
| Planning | 680 | ||
| Nursing Implementation | 680 | ||
| Health Promotion. | 680 | ||
| Education. | 682 | ||
| Exercise. | 682 | ||
| Energy-Conserving Strategies. | 684 | ||
| Sexual Activity. | 684 | ||
| Sleep. | 684 | ||
| Psychosocial Considerations. | 684 | ||
| End-of-Life Issues. | 685 | ||
| Evaluation | 685 | ||
| Cystic Fibrosis | 685 | ||
| Etiology and Pathophysiology | 685 | ||
| Clinical Manifestations | 686 | ||
| Complications | 686 | ||
| Diagnostic Studies | 686 | ||
| Collaborative Care | 687 | ||
| Nursing Management Cystic Fibrosis | 689 | ||
| Nursing Assessment | 689 | ||
| Nursing Diagnoses | 689 | ||
| Planning | 689 | ||
| Nursing Implementation | 689 | ||
| Review Questions | 691 | ||
| References | 691 | ||
| Resources | 693 | ||
| 6 Problems of Oxygenation: Transport | 694 | ||
| 32 Nursing Assessment | 695 | ||
| Learning Objectives | 695 | ||
| Key Terms | 695 | ||
| Structures and Functions of the Hematological System | 695 | ||
| Bone Marrow | 695 | ||
| Blood | 696 | ||
| Plasma. | 696 | ||
| Blood Cells. | 696 | ||
| Erythrocytes. | 696 | ||
| Leukocytes. | 697 | ||
| Granulocytes. | 698 | ||
| Agranulocytes. | 698 | ||
| Thrombocytes. | 698 | ||
| Iron Metabolism | 698 | ||
| Clotting Mechanisms | 699 | ||
| Vascular Injury and Subendothelial Exposure. | 699 | ||
| Platelet Plug Formation (Adhesion, Aggregation, Activation). | 699 | ||
| Fibrin Clot Development. | 699 | ||
| Clot Retraction and Dissolution. | 699 | ||
| Spleen | 700 | ||
| Lymph System | 701 | ||
| Liver | 701 | ||
| Age-Related Considerations | 701 | ||
| Hematological System | 701 | ||
| Assessment of the Hematological System | 702 | ||
| Subjective Data | 702 | ||
| Important Health Information | 702 | ||
| Past Medical History. | 702 | ||
| Medications. | 703 | ||
| Surgery or Other Treatments. | 703 | ||
| Approach to Obtaining a Hematological History | 703 | ||
| Social and Occupational History. | 703 | ||
| Self-Care History. | 703 | ||
| Activities of Daily Living. | 703 | ||
| Nutritional–Metabolic History. | 703 | ||
| Elimination Pattern. | 704 | ||
| Neurological History. | 704 | ||
| Sleep History. | 704 | ||
| Sexual–Reproductive History. | 704 | ||
| Values and Beliefs. | 704 | ||
| Objective Data | 704 | ||
| Physical Examination. | 704 | ||
| Lymph Node Assessment. | 704 | ||
| Palpation of the Liver or the Spleen. | 705 | ||
| Skin Assessment. | 705 | ||
| Diagnostic Studies of the Hematological System | 705 | ||
| Laboratory Studies | 707 | ||
| Complete Blood Cell Count. | 707 | ||
| Red Blood Cells. | 707 | ||
| White Blood Cells. | 708 | ||
| Platelet Count. | 708 | ||
| Blood Typing and Rh Factor. | 708 | ||
| Iron Metabolism. | 709 | ||
| Radiological Studies | 711 | ||
| Biopsy | 711 | ||
| Bone Marrow Examination. | 711 | ||
| Lymph Node Biopsy. | 711 | ||
| Molecular Cytogenetics and Gene Analysis | 711 | ||
| Review Questions | 713 | ||
| References | 713 | ||
| Resources | 713 | ||
| 33 Nursing Management | 714 | ||
| Learning Objectives | 714 | ||
| Key Terms | 714 | ||
| Anemia | 715 | ||
| Definition and Classification | 715 | ||
| Clinical Manifestations | 715 | ||
| Integumentary Changes | 715 | ||
| Cardiopulmonary Manifestations | 715 | ||
| Nursing Management Anemia | 716 | ||
| Nursing Assessment | 716 | ||
| Nursing Diagnoses | 716 | ||
| Planning | 716 | ||
| Nursing Implementation | 716 | ||
| Age-Related Considerations | 716 | ||
| Anemia | 716 | ||
| Anemia Caused by Decreased Erythrocyte Production | 717 | ||
| Iron-Deficiency Anemia | 717 | ||
| Etiology | 717 | ||
| Clinical Manifestations | 718 | ||
| Diagnostic Studies | 718 | ||
| Collaborative Care | 719 | ||
| Drug Therapy. | 719 | ||
| Nursing Management Iron-Deficiency Anemia | 720 | ||
| Thalassemia | 720 | ||
| Etiology | 720 | ||
| Clinical Manifestations | 720 | ||
| Collaborative Care | 720 | ||
| Megaloblastic Anemias | 721 | ||
| Etiology | 721 | ||
| Pernicious Anemia. | 721 | ||
| Other Causes of Cobalamin Deficiency. | 721 | ||
| Clinical Manifestations | 721 | ||
| Diagnostic Studies | 721 | ||
| Collaborative Care | 722 | ||
| Folic Acid Deficiency | 722 | ||
| Nursing Management Megaloblastic Anemia | 722 | ||
| Anemia of Chronic Disease | 722 | ||
| Aplastic Anemia | 722 | ||
| Etiology | 722 | ||
| 7 Problems of Oxygenation: Perfusion | 765 | ||
| 34 Nursing Assessment | 766 | ||
| Learning Objectives | 766 | ||
| Key Terms | 766 | ||
| Structures and Functions of the Cardiovascular System | 766 | ||
| Heart | 766 | ||
| Structure. | 766 | ||
| Blood Flow Through the Heart. | 767 | ||
| Cardiac Valves. | 767 | ||
| Blood Supply to the Myocardium. | 767 | ||
| Conduction System. | 767 | ||
| Electrocardiography. | 767 | ||
| Mechanical System. | 769 | ||
| Factors Affecting Cardiac Output. | 769 | ||
| Cardiac Reserve. | 769 | ||
| Vascular System | 769 | ||
| Blood Vessels. | 769 | ||
| Arteries and Arterioles. | 769 | ||
| Capillaries. | 769 | ||
| Veins and Venules. | 769 | ||
| Regulation of the Cardiovascular System | 770 | ||
| Autonomic Nervous System. | 770 | ||
| Effect on the Heart. | 770 | ||
| Effect on the Blood Vessels. | 770 | ||
| Baroreceptors. | 770 | ||
| Chemoreceptors. | 770 | ||
| Blood Pressure | 770 | ||
| Measurement of Arterial Blood Pressure. | 770 | ||
| Pulse Pressure and Mean Arterial Pressure. | 770 | ||
| Age-Related Considerations | 770 | ||
| Effects of Aging on the Cardiovascular System | 770 | ||
| Assessment of the Cardiovascular System | 771 | ||
| Subjective Data | 771 | ||
| Important Health Information | 771 | ||
| History of Current Illness. | 771 | ||
| Past Health History. | 771 | ||
| Medications. | 771 | ||
| Surgery or Other Treatments. | 772 | ||
| Objective Data | 772 | ||
| Physical Examination | 772 | ||
| Vital Signs. | 772 | ||
| Peripheral Vascular System | 772 | ||
| Inspection. | 772 | ||
| Palpation. | 772 | ||
| Auscultation. | 772 | ||
| Thorax | 774 | ||
| Inspection and Palpation. | 774 | ||
| Percussion. | 776 | ||
| Auscultation. | 776 | ||
| Diagnostic Studies of the Cardiovascular System | 777 | ||
| Noninvasive Studies | 777 | ||
| Chest Radiography. | 777 | ||
| Electrocardiography. | 777 | ||
| Ambulatory Electrocardiographic Monitoring. | 777 | ||
| Transtelephonic Event Recorders. | 783 | ||
| Exercise or Stress Testing. | 783 | ||
| Echocardiography. | 783 | ||
| Nuclear Cardiology. | 784 | ||
| Cardiovascular Magnetic Resonance Imaging. | 784 | ||
| Cardiac Computed Tomography. | 784 | ||
| Blood Studies. | 784 | ||
| Cardiac Biomarkers. | 784 | ||
| C-Reactive Protein. | 785 | ||
| Homocysteine. | 785 | ||
| Cardiac Natriuretic Peptide Markers. | 785 | ||
| Serum Lipids. | 785 | ||
| Lipoprotein-Associated Phospholipase A2. | 785 | ||
| Invasive Studies | 785 | ||
| Cardiac Catheterization and Coronary Angiography. | 785 | ||
| Intracoronary Ultrasonography. | 786 | ||
| Fractional Flow Reserve. | 786 | ||
| Hemodynamic Monitoring. | 786 | ||
| Review Questions | 787 | ||
| References | 787 | ||
| Resources | 788 | ||
| 35 Nursing Management | 789 | ||
| Learning Objectives | 789 | ||
| Key Terms | 789 | ||
| Normal Regulation of Blood Pressure | 789 | ||
| Sympathetic Nervous System | 790 | ||
| Baroreceptors. | 790 | ||
| Vascular Endothelium | 790 | ||
| Renal System | 791 | ||
| Endocrine System | 791 | ||
| Hypertension | 791 | ||
| Subtypes of Hypertension | 792 | ||
| Etiology | 793 | ||
| Primary Hypertension. | 793 | ||
| Secondary Hypertension. | 793 | ||
| Pathophysiology of Primary Hypertension | 794 | ||
| Genes. | 794 | ||
| Sodium and Water Retention. | 794 | ||
| Altered Renin–Angiotensin–Aldosterone Mechanism. | 794 | ||
| Stress and Increased Sympathetic Nervous System Activity. | 794 | ||
| Insulin Resistance and Hyperinsulinemia. | 794 | ||
| Endothelial Cell Dysfunction. | 795 | ||
| Obesity. | 795 | ||
| Clinical Manifestations | 795 | ||
| Complications | 795 | ||
| Hypertensive Heart Disease | 795 | ||
| Coronary Artery Disease. | 795 | ||
| Left Ventricular Hypertrophy. | 796 | ||
| Heart Failure. | 796 | ||
| Cerebro-vascular Disease. | 796 | ||
| Peripheral Arterial Disease. | 796 | ||
| Nephrosclerosis. | 797 | ||
| Retinal Damage. | 797 | ||
| Diagnostic Studies | 797 | ||
| Ambulatory Blood Pressure Monitoring. | 797 | ||
| Collaborative Care | 798 | ||
| Risk Stratification. | 798 | ||
| Lifestyle Modifications. | 798 | ||
| Nutritional Therapy. | 798 | ||
| Weight Reduction. | 799 | ||
| Modification in Alcohol Consumption. | 799 | ||
| Physical Activity. | 799 | ||
| Avoidance of Tobacco Products. | 800 | ||
| Stress Management. | 800 | ||
| Drug Therapy. | 800 | ||
| Patient Teaching Related to Drug Therapy. | 804 | ||
| Resistant Hypertension. | 804 | ||
| Nursing Management Primary Hypertension | 805 | ||
| Nursing Assessment | 805 | ||
| Nursing Diagnoses | 805 | ||
| Planning | 805 | ||
| Nursing Implementation | 805 | ||
| Health Promotion. | 805 | ||
| Individual Patient Evaluation. | 805 | ||
| Screening Programs. | 806 | ||
| Cardiovascular Risk Factor Modification. | 806 | ||
| Ambulatory and Home Care. | 807 | ||
| Physical Activity. | 807 | ||
| Home Blood Pressure Monitoring. | 808 | ||
| Patient Adherence. | 808 | ||
| Evaluation | 808 | ||
| Age-Related Considerations | 808 | ||
| Hypertension | 808 | ||
| Hypertensive Crisis | 809 | ||
| Clinical Manifestations | 809 | ||
| Nursing and Collaborative Management Hypertensive Crisis | 809 | ||
| Review Questions | 810 | ||
| References | 811 | ||
| Resources | 811 | ||
| 36 Nursing Management | 813 | ||
| Learning Objectives | 813 | ||
| Key Terms | 813 | ||
| Coronary Artery Disease | 813 | ||
| Etiology and Pathophysiology | 814 | ||
| Developmental Stages | 814 | ||
| Fatty Streak. | 814 | ||
| Fibrous Plaque. | 814 | ||
| Complicated Lesion. | 815 | ||
| Collateral Circulation | 815 | ||
| Risk Factors for Coronary Artery Disease | 815 | ||
| Nonmodifiable Risk Factors | 815 | ||
| Age, Sex, and Ethnicity. | 815 | ||
| Major Modifiable Risk Factors | 815 | ||
| Elevated Serum Lipid Levels. | 815 | ||
| Hypertension. | 816 | ||
| Tobacco Use. | 816 | ||
| Physical Inactivity. | 817 | ||
| Obesity. | 817 | ||
| Modifiable Contributing Risk Factors | 817 | ||
| Diabetes Mellitus. | 817 | ||
| Metabolic Syndrome. | 817 | ||
| Psychological States. | 817 | ||
| Homocysteine. | 818 | ||
| Substance Use. | 818 | ||
| Health Promotion | 818 | ||
| Identification of High-Risk People. | 818 | ||
| Management of High-Risk People. | 818 | ||
| Physical Activity. | 819 | ||
| Health Education in Schools. | 819 | ||
| Nutritional Therapy. | 819 | ||
| Cholesterol-Lowering Drug Therapy | 819 | ||
| Drugs That Restrict Lipoprotein Production. | 820 | ||
| Drugs That Increase Lipoprotein Removal. | 820 | ||
| Drugs That Decrease Cholesterol Absorption. | 820 | ||
| Antiplatelet Therapy | 820 | ||
| Chronic Stable Angina | 820 | ||
| Prinzmetal’s Angina | 824 | ||
| Collaborative Management | 824 | ||
| Drug Therapy | 824 | ||
| Short-Acting Nitrates. | 824 | ||
| Sublingual Nitroglycerin. | 825 | ||
| Long-Acting Nitrates. | 825 | ||
| Transdermal Controlled-Release Nitrates. | 825 | ||
| β-Adrenergic Blockers. | 827 | ||
| Calcium Channel Blockers. | 827 | ||
| Angiotensin-Converting Enzyme Inhibitors. | 827 | ||
| Diagnostic Studies | 827 | ||
| Acute Coronary Syndrome | 827 | ||
| Etiology and Pathophysiology | 827 | ||
| Manifestations of Acute Coronary Syndrome | 827 | ||
| Unstable Angina | 827 | ||
| Myocardial Infarction | 828 | ||
| Clinical Manifestations of Myocardial Infarction | 828 | ||
| Pain. | 828 | ||
| Sympathetic Nervous System Stimulation. | 828 | ||
| Cardiovascular Manifestations. | 828 | ||
| Nausea and Vomiting. | 828 | ||
| Fever. | 829 | ||
| Healing Process | 829 | ||
| Complications of Myocardial Infarction | 829 | ||
| Dysrhythmias. | 829 | ||
| Heart Failure. | 829 | ||
| Cardiogenic Shock. | 829 | ||
| Papillary Muscle Dysfunction. | 829 | ||
| Ventricular Aneurysm. | 829 | ||
| Pericarditis. | 829 | ||
| Dressler’s Syndrome. | 830 | ||
| Diagnostic Studies | 830 | ||
| Unstable Angina and Myocardial Infarction | 830 | ||
| Electrocardiographic Findings. | 830 | ||
| Serum Cardiac Markers. | 830 | ||
| Coronary Angiography. | 830 | ||
| Other Measures | 830 | ||
| Collaborative Care | 831 | ||
| Emergent Percutaneous Coronary Intervention | 831 | ||
| Fibrinolytic Therapy | 832 | ||
| Indications and Contraindications. | 832 | ||
| Procedure. | 832 | ||
| Drug Therapy | 833 | ||
| Intravenous Nitroglycerin. | 833 | ||
| Morphine Sulphate. | 833 | ||
| β-Adrenergic Blockers. | 833 | ||
| Angiotensin-Converting Enzyme Inhibitors. | 833 | ||
| Antidysrhythmia Medications. | 833 | ||
| Cholesterol-Lowering Drugs. | 833 | ||
| Stool Softeners. | 833 | ||
| Nutritional Therapy | 833 | ||
| Coronary Surgical Revascularization | 833 | ||
| Coronary Artery Bypass Graft Surgery. | 833 | ||
| Minimally Invasive Direct Coronary Artery Bypass. | 834 | ||
| Off-Pump Coronary Artery Bypass. | 834 | ||
| Robot-Assisted Cardiothoracic Surgery. | 834 | ||
| Transmyocardial Laser Revascularization. | 834 | ||
| Nursing Management Chronic Stable Angina and Acute Coronary Syndrome | 834 | ||
| Nursing Assessment | 834 | ||
| Nursing Diagnoses | 834 | ||
| Planning | 834 | ||
| Nursing Implementation: Chronic Stable Angina | 834 | ||
| Health Promotion. | 834 | ||
| Acute Intervention. | 834 | ||
| Ambulatory and Home Care. | 835 | ||
| Nursing Implementation: Acute Coronary Syndrome | 835 | ||
| Acute Intervention. | 835 | ||
| Pain. | 835 | ||
| Monitoring. | 835 | ||
| Rest and Comfort. | 837 | ||
| Anxiety. | 837 | ||
| Emotional and Behavioural Reactions. | 838 | ||
| Coronary Revascularization. | 838 | ||
| Ambulatory and Home Care. | 839 | ||
| Patient Teaching. | 839 | ||
| Physical Activity. | 840 | ||
| Resumption of Sexual Activity. | 840 | ||
| Evaluation | 841 | ||
| Sudden Cardiac Death | 841 | ||
| Etiology and Pathophysiology | 841 | ||
| Nursing and Collaborative Management Sudden Cardiac Death | 841 | ||
| Review Questions | 842 | ||
| References | 843 | ||
| Resources | 844 | ||
| 37 Nursing Management | 845 | ||
| Learning Objectives | 845 | ||
| Key Terms | 845 | ||
| Heart Failure | 845 | ||
| Etiology and Pathophysiology | 845 | ||
| Pathology of Ventricular Failure. | 846 | ||
| Heart Failure With Reduced Ejection Fraction. | 846 | ||
| Heart Failure With Preserved Ejection Fraction. | 846 | ||
| Mixed Heart Failure. | 846 | ||
| Compensatory Mechanisms. | 846 | ||
| Sympathetic Nervous System Activation. | 846 | ||
| Neuro-hormonal Responses. | 847 | ||
| Ventricular Dilation. | 847 | ||
| Ventricular Hypertrophy. | 847 | ||
| Counter-Regulatory Mechanisms. | 847 | ||
| Types of Heart Failure | 848 | ||
| Left-Sided Heart Failure. | 848 | ||
| Right-Sided Heart Failure. | 848 | ||
| Clinical Manifestations of Heart Failure | 848 | ||
| Clinical Manifestations of Chronic Heart Failure | 849 | ||
| Fatigue. | 849 | ||
| Dyspnea. | 849 | ||
| Paroxysmal Nocturnal Dyspnea. | 849 | ||
| Tachycardia. | 850 | ||
| Edema. | 850 | ||
| Nocturia. | 850 | ||
| Skin Changes. | 850 | ||
| Behavioural Changes. | 850 | ||
| Chest Pain. | 850 | ||
| Weight Changes. | 850 | ||
| Complications of Heart Failure | 850 | ||
| Pleural Effusion. | 850 | ||
| Dysrhythmias. | 850 | ||
| Left Ventricular Thrombus. | 851 | ||
| Hepatomegaly. | 851 | ||
| Renal Failure. | 851 | ||
| Classification of Heart Failure | 851 | ||
| Diagnostic Studies | 851 | ||
| Nursing and Collaborative Management Acute Decompensated Heart Failure | 851 | ||
| Decreasing Intravascular Volume | 851 | ||
| Decreasing Venous Return | 851 | ||
| Decreasing Afterload | 852 | ||
| Improving Gas Exchange and Oxygenation | 852 | ||
| Improving Cardiac Function | 852 | ||
| Reducing Anxiety | 853 | ||
| Collaborative Care: Chronic Heart Failure | 853 | ||
| Referral to Multidisciplinary Clinics or Specialist Care for Heart Failure | 853 | ||
| Nonpharmacological Therapies | 853 | ||
| Oxygen. | 853 | ||
| Self-Management Teaching. | 853 | ||
| Exercise and Activity. | 853 | ||
| Devices | 853 | ||
| Cardiac Resynchronization Therapy. | 853 | ||
| Implantable Cardioverter–Defibrillator. | 853 | ||
| Mechanical Circulatory Support. | 853 | ||
| Cardiac Transplantation | 854 | ||
| Advance Care Planning and Goals of Care | 854 | ||
| Drug Therapy: Chronic Heart Failure | 854 | ||
| Diuretics | 854 | ||
| Angiotensin-Converting Enzyme Inhibitors | 854 | ||
| Neprilysin Inhibitors | 855 | ||
| β-Adrenergic Blockers | 856 | ||
| Mineralocorticoid Receptor Antagonists | 856 | ||
| Inotropic Drugs | 856 | ||
| Sympathomimetic Agents. | 856 | ||
| Phosphodiesterase Inhibitors. | 856 | ||
| Vasodilator Drugs. | 856 | ||
| Nutritional Therapy: Chronic Heart Failure | 856 | ||
| General Principles | 857 | ||
| Nursing Management Chronic Heart Failure | 858 | ||
| Nursing Assessment | 858 | ||
| Nursing Diagnoses | 858 | ||
| Planning | 858 | ||
| Nursing Implementation | 859 | ||
| Health Promotion. | 859 | ||
| Acute Intervention. | 859 | ||
| Ambulatory and Home Care. | 859 | ||
| Evaluation | 861 | ||
| Cardiac Transplantation | 861 | ||
| Mechanical Cardiac Support Devices | 863 | ||
| Review Questions | 864 | ||
| References | 865 | ||
| Resources | 865 | ||
| 38 Nursing Management | 866 | ||
| Learning Objectives | 866 | ||
| Key Terms | 866 | ||
| Rhythm Identification and Treatment | 866 | ||
| Conduction System | 866 | ||
| Nervous Control of the Heart | 867 | ||
| Electrocardiographic Monitoring | 867 | ||
| Telemetry Monitoring. | 869 | ||
| Assessment of Cardiac Rhythm | 870 | ||
| Electrophysiological Mechanisms of Dysrhythmias | 870 | ||
| Evaluation of Dysrhythmias | 871 | ||
| Types of Dysrhythmias | 872 | ||
| Sinus Bradycardia. | 872 | ||
| 8 Problems of Ingestion, Digestion, Absorption, and Elimination | 947 | ||
| 41 Nursing Assessment | 948 | ||
| Learning Objectives | 948 | ||
| Key Terms | 948 | ||
| Structures and Functions of the Gastro-Intestinal System | 948 | ||
| Ingestion and Propulsion of Food | 949 | ||
| 9 Problems of Urinary Function | 1140 | ||
| 47 Nursing Assessment | 1141 | ||
| Learning Objectives | 1141 | ||
| Key Terms | 1141 | ||
| Structures and Functions of the Urinary System | 1141 | ||
| Kidneys | 1141 | ||
| Macrostructure. | 1141 | ||
| Microstructure. | 1142 | ||
| Blood Supply. | 1142 | ||
| Physiology of Urine Formation. | 1143 | ||
| Glomerular Function. | 1143 | ||
| Tubular Function. | 1143 | ||
| Other Functions of the Kidney. | 1145 | ||
| Production of Erythropoietin. | 1145 | ||
| Activation of Vitamin D. | 1145 | ||
| Production and Secretion of Renin. | 1145 | ||
| Ureters | 1145 | ||
| Bladder | 1147 | ||
| Urethra | 1148 | ||
| Urethro-Vesical Unit Function | 1148 | ||
| Age-Related Considerations | 1148 | ||
| Effects of Aging on the Urinary System | 1148 | ||
| Assessment of the Urinary System | 1149 | ||
| Subjective Data | 1149 | ||
| Important Health Information | 1149 | ||
| Past Health History. | 1149 | ||
| Medications. | 1149 | ||
| Surgery and Other Treatments. | 1149 | ||
| Key Questions. | 1149 | ||
| Health History. | 1149 | ||
| Nutritional Assessment. | 1151 | ||
| Elimination Assessment. | 1151 | ||
| Activity Assessment. | 1151 | ||
| Pain Assessment. | 1152 | ||
| Self-Concept Assessment. | 1152 | ||
| Relationship and Sexuality Assessment. | 1152 | ||
| Objective Data | 1152 | ||
| Physical Examination | 1152 | ||
| Inspection. | 1152 | ||
| Palpation. | 1152 | ||
| Percussion. | 1152 | ||
| Auscultation. | 1152 | ||
| Diagnostic Studies | 1153 | ||
| Analysis of Urine | 1154 | ||
| Urinalysis. | 1154 | ||
| Composite Urine Collections. | 1154 | ||
| Creatinine Clearance. | 1157 | ||
| Urine Cytology. | 1158 | ||
| Radiological Studies | 1158 | ||
| Kidney, Ureter, and Bladder Radiography. | 1158 | ||
| Intravenous Pyelography. | 1158 | ||
| Retrograde Pyelography. | 1159 | ||
| Antegrade Pyelography. | 1159 | ||
| Renal Ultrasonography. | 1159 | ||
| Computed Tomography. | 1159 | ||
| Renal Arteriography. | 1159 | ||
| Cystography. | 1159 | ||
| Urethrography. | 1159 | ||
| Loopography. | 1160 | ||
| Renal Radionuclide Imaging. | 1160 | ||
| Renal Biopsy. | 1160 | ||
| Endoscopy | 1160 | ||
| Cystoscopy. | 1160 | ||
| Urodynamics Testing | 1161 | ||
| Urinary Flow Study. | 1161 | ||
| Cystometrography. | 1161 | ||
| Sphincter Electromyography. | 1161 | ||
| Voiding Pressure Flow Study. | 1161 | ||
| Video-Urodynamics Testing. | 1161 | ||
| Radionuclide Cystography. | 1161 | ||
| Whitaker Test. | 1161 | ||
| Review Questions | 1161 | ||
| References | 1162 | ||
| Resources | 1162 | ||
| 48 Nursing Management | 1163 | ||
| Learning Objectives | 1163 | ||
| Key Terms | 1163 | ||
| Infectious and Inflammatory Disorders of the Urinary System | 1163 | ||
| Urinary Tract Infection | 1163 | ||
| Classification | 1164 | ||
| Etiology and Pathophysiology | 1164 | ||
| Clinical Manifestations | 1165 | ||
| Diagnostic Studies | 1165 | ||
| Collaborative Care and Drug Therapy | 1166 | ||
| Nursing Management Urinary Tract Infection | 1166 | ||
| Nursing Assessment | 1166 | ||
| Nursing Diagnoses | 1166 | ||
| Planning | 1167 | ||
| Nursing Implementation | 1167 | ||
| Health Promotion. | 1167 | ||
| Acute Intervention. | 1167 | ||
| Ambulatory and Home Care. | 1167 | ||
| Evaluation | 1168 | ||
| Acute Pyelonephritis | 1168 | ||
| Etiology and Pathophysiology | 1168 | ||
| Clinical Manifestations and Diagnostic Studies | 1168 | ||
| Collaborative Care and Drug Therapy | 1169 | ||
| Nursing Management Acute Pyelonephritis | 1169 | ||
| Nursing Assessment | 1169 | ||
| Nursing Diagnoses | 1169 | ||
| Planning | 1169 | ||
| Nursing Implementation | 1169 | ||
| Health Promotion. | 1169 | ||
| Acute Intervention and Home Care. | 1169 | ||
| Evaluation | 1169 | ||
| Chronic Pyelonephritis | 1169 | ||
| Urethritis | 1170 | ||
| Urethral Diverticula | 1170 | ||
| Interstitial Cystitis | 1170 | ||
| Collaborative Care and Drug Therapy | 1171 | ||
| Nursing Management Interstitial Cystitis | 1171 | ||
| Renal Tuberculosis | 1172 | ||
| Immunological Disorders of the Kidney | 1172 | ||
| Glomerulo-Nephritis | 1172 | ||
| Clinical Manifestations | 1172 | ||
| Acute Poststreptococcal Glomerulo-Nephritis | 1172 | ||
| Clinical Manifestations and Complications | 1172 | ||
| Diagnostic Studies | 1172 | ||
| Nursing and Collaborative Management Acute Poststreptococcal Glomerulo-Nephritis | 1173 | ||
| Goodpasture’s Syndrome | 1173 | ||
| Nursing and Collaborative Management Goodpasture’s Syndrome | 1173 | ||
| Rapidly Progressive Glomerulo-Nephritis | 1173 | ||
| Chronic Glomerulo-Nephritis | 1173 | ||
| Nephrotic Syndrome | 1174 | ||
| Etiology and Clinical Manifestations | 1174 | ||
| Collaborative Care | 1174 | ||
| Nursing Management Nephrotic Syndrome | 1174 | ||
| Obstructive Uropathies | 1174 | ||
| Urinary Tract Calculi | 1175 | ||
| Etiology and Pathophysiology | 1176 | ||
| Types | 1176 | ||
| Clinical Manifestations | 1177 | ||
| Diagnostic Studies | 1177 | ||
| Collaborative Care | 1177 | ||
| Endo-Urological Procedures. | 1178 | ||
| Lithotripsy. | 1178 | ||
| Surgical Therapy. | 1179 | ||
| Nutritional Therapy. | 1179 | ||
| Nursing Management Renal Calculi | 1179 | ||
| Nursing Assessment | 1179 | ||
| Nursing Diagnoses | 1179 | ||
| Planning | 1179 | ||
| Nursing Implementation | 1179 | ||
| Evaluation | 1180 | ||
| Strictures | 1180 | ||
| Ureteral Strictures | 1180 | ||
| Urethral Stricture | 1180 | ||
| Renal Trauma | 1181 | ||
| Renal Vascular Problems | 1181 | ||
| Nephrosclerosis | 1181 | ||
| Renal Artery Stenosis | 1181 | ||
| Renal Vein Thrombosis | 1181 | ||
| Hereditary Renal Diseases | 1182 | ||
| Polycystic Kidney Disease | 1182 | ||
| Clinical Manifestations | 1182 | ||
| Collaborative Care | 1182 | ||
| Medullary Cystic Disease | 1183 | ||
| Alport Syndrome | 1183 | ||
| Renal Involvement in Metabolic and Connective Tissue Diseases | 1183 | ||
| Urinary Tract Tumours | 1183 | ||
| Kidney Cancer | 1183 | ||
| Bladder Cancer | 1184 | ||
| Clinical Manifestations and Diagnostic Studies | 1184 | ||
| Nursing and Collaborative Management Bladder Cancer | 1185 | ||
| Surgical Therapy | 1185 | ||
| Radiation Therapy and Chemotherapy | 1185 | ||
| Intravesical Therapy | 1185 | ||
| Urinary Incontinence and Retention | 1186 | ||
| Nursing Management Urinary Incontinence | 1186 | ||
| Diagnostic Studies | 1186 | ||
| Collaborative Care: Urinary Incontinence | 1188 | ||
| Drug Therapy. | 1189 | ||
| 10 Problems Related to Regulatory and Reproductive Mechanisms | 1234 | ||
| 50 Nursing Assessment | 1235 | ||
| Learning Objectives | 1235 | ||
| Key Terms | 1235 | ||
| Structures and Functions of the Endocrine System | 1235 | ||
| Glands | 1235 | ||
| Hormones | 1236 | ||
| Classifications and Functions. | 1236 | ||
| Hormone Transport. | 1236 | ||
| Targets and Receptors. | 1236 | ||
| Protein Hormone Receptors. | 1236 | ||
| Steroid Hormone Receptors. | 1236 | ||
| Regulation of Hormonal Secretion. | 1236 | ||
| Simple Feedback. | 1236 | ||
| Nervous System Control. | 1238 | ||
| Rhythms. | 1238 | ||
| Hypothalamus | 1239 | ||
| Pituitary Gland | 1239 | ||
| Anterior Pituitary Gland. | 1239 | ||
| Tropic Hormones. | 1239 | ||
| Growth Hormone. | 1239 | ||
| Prolactin. | 1239 | ||
| Posterior Pituitary Gland. | 1239 | ||
| Antidiuretic Hormone. | 1240 | ||
| Oxytocin. | 1240 | ||
| Pineal Gland. | 1240 | ||
| Thyroid Gland | 1240 | ||
| Thyroxine and Triiodothyronine. | 1241 | ||
| Calcitonin. | 1241 | ||
| Parathyroid Glands | 1241 | ||
| Parathyroid Hormone. | 1241 | ||
| Adrenal Glands | 1241 | ||
| Adrenal Medulla. | 1241 | ||
| Adrenal Cortex. | 1242 | ||
| Cortisol. | 1242 | ||
| Aldosterone. | 1242 | ||
| Adrenal Androgens. | 1242 | ||
| Pancreas | 1242 | ||
| Glucagon. | 1242 | ||
| Insulin. | 1242 | ||
| Age-Related Considerations | 1243 | ||
| The Endocrine System | 1243 | ||
| Assessment of the Endocrine System | 1243 | ||
| Subjective Data | 1243 | ||
| Important Health Information | 1243 | ||
| Past Health History. | 1243 | ||
| Family History. | 1243 | ||
| Medications. | 1243 | ||
| Surgery and Other Treatments. | 1245 | ||
| Objective Data | 1245 | ||
| Physical Examination. | 1245 | ||
| Vital Signs. | 1245 | ||
| Height and Weight. | 1245 | ||
| Mental–Emotional Status. | 1246 | ||
| Integument. | 1246 | ||
| Head. | 1246 | ||
| Neck. | 1246 | ||
| Thorax. | 1246 | ||
| Abdomen. | 1247 | ||
| Extremities. | 1247 | ||
| Genitalia. | 1247 | ||
| Diagnostic Studies of the Endocrine System | 1247 | ||
| Laboratory Studies | 1247 | ||
| Pituitary Studies. | 1247 | ||
| Thyroid Studies. | 1247 | ||
| Parathyroid Studies. | 1253 | ||
| Adrenal Studies. | 1254 | ||
| Pancreatic Studies. | 1254 | ||
| Review Questions | 1254 | ||
| References | 1255 | ||
| Resources | 1255 | ||
| 51 Nursing Management | 1256 | ||
| Learning Objectives | 1256 | ||
| Key Terms | 1256 | ||
| Disorders of the Anterior Pituitary Gland | 1256 | ||
| Acromegaly | 1256 | ||
| Etiology and Pathophysiology | 1256 | ||
| Clinical Manifestations | 1256 | ||
| Diagnostic Studies | 1257 | ||
| Collaborative Care | 1257 | ||
| Surgical Therapy. | 1257 | ||
| Radiation Therapy. | 1257 | ||
| Drug Therapy. | 1258 | ||
| Nursing Management Acromegaly | 1258 | ||
| Nursing Assessment | 1258 | ||
| Nursing Implementation | 1258 | ||
| Excesses of Other Tropic Hormones | 1258 | ||
| Hypofunction of the Pituitary Gland | 1259 | ||
| Etiology and Pathophysiology | 1259 | ||
| Clinical Manifestations and Diagnostic Studies | 1259 | ||
| Nursing and Collaborative Management Hypopituitarism | 1259 | ||
| Disorders of the Posterior Pituitary Gland | 1260 | ||
| Syndrome of Inappropriate Antidiuretic Hormone | 1260 | ||
| Etiology and Pathophysiology | 1260 | ||
| Clinical Manifestations and Diagnostic Studies | 1260 | ||
| Collaborative Care | 1260 | ||
| Nursing Management Syndrome of Inappropriate Antidiuretic Hormone | 1261 | ||
| Diabetes Insipidus | 1261 | ||
| Etiology and Pathophysiology | 1261 | ||
| Clinical Manifestations | 1261 | ||
| Diagnostic Studies | 1262 | ||
| Collaborative Care | 1262 | ||
| Nursing Management Diabetes Insipidus | 1262 | ||
| Disorders of the Thyroid Gland | 1263 | ||
| Goitre | 1263 | ||
| Thyroid Nodules and Cancer | 1263 | ||
| Types of Thyroid Cancer | 1264 | ||
| Diagnostic Studies | 1264 | ||
| Nursing and Collaborative Care Thyroid Cancer | 1264 | ||
| Multiple Endocrine Neoplasia | 1264 | ||
| Thyroiditis | 1264 | ||
| Hyperthyroidism | 1265 | ||
| Etiology and Pathophysiology | 1265 | ||
| Graves’ Disease. | 1265 | ||
| Toxic Nodular Goitres. | 1265 | ||
| Clinical Manifestations | 1265 | ||
| Complications | 1266 | ||
| Diagnostic Studies | 1266 | ||
| Collaborative Care | 1267 | ||
| Drug Therapy. | 1267 | ||
| Antithyroid Drugs. | 1267 | ||
| Iodine. | 1267 | ||
| β-Adrenergic Blockers. | 1267 | ||
| Radioactive Iodine Therapy. | 1267 | ||
| Surgical Therapy. | 1267 | ||
| Nutritional Therapy. | 1268 | ||
| Nursing Management Hyperthyroidism | 1268 | ||
| Nursing Assessment | 1268 | ||
| Nursing Diagnoses | 1268 | ||
| Planning | 1268 | ||
| Nursing Implementation | 1268 | ||
| Acute Intervention. | 1268 | ||
| Acute Thyrotoxicosis. | 1268 | ||
| Thyroid Surgery. | 1269 | ||
| Ambulatory and Home Care | 1269 | ||
| Postoperative Care. | 1269 | ||
| Evaluation | 1270 | ||
| Hypothyroidism | 1270 | ||
| Etiology and Pathophysiology | 1270 | ||
| Clinical Manifestations | 1270 | ||
| Complications | 1271 | ||
| Diagnostic Studies | 1271 | ||
| Collaborative Care | 1271 | ||
| Nursing Management Hypothyroidism | 1271 | ||
| Nursing Assessment | 1271 | ||
| Nursing Diagnoses | 1271 | ||
| Planning | 1271 | ||
| Nursing Implementation | 1271 | ||
| Health Promotion. | 1271 | ||
| Acute Intervention. | 1271 | ||
| Ambulatory and Home Care. | 1272 | ||
| Evaluation | 1272 | ||
| Disorders of the Parathyroid Glands | 1272 | ||
| Hyperparathyroidism | 1272 | ||
| Etiology and Pathophysiology | 1272 | ||
| Clinical Manifestations and Complications | 1273 | ||
| Diagnostic Studies | 1274 | ||
| Collaborative Care | 1274 | ||
| Surgical Therapy. | 1274 | ||
| Nonsurgical Therapy. | 1274 | ||
| Nursing Management Hyperparathyroidism | 1274 | ||
| Hypoparathyroidism | 1274 | ||
| Etiology and Pathophysiology | 1274 | ||
| 11 Problems Related to Movement and Coordination | 1447 | ||
| 58 Nursing Assessment | 1448 | ||
| Learning Objectives | 1448 | ||
| Key Terms | 1448 | ||
| Structures and Functions of the Nervous System | 1448 | ||
| Cells of the Nervous System | 1448 | ||
| Neurons. | 1448 | ||
| Glial Cells. | 1449 | ||
| Neurogenesis | 1449 | ||
| Nerve Impulse | 1449 | ||
| Synapse. | 1450 | ||
| Neurotransmitters. | 1450 | ||
| Central Nervous System | 1450 | ||
| Spinal Cord. | 1450 | ||
| Ascending Tracts. | 1451 | ||
| Descending Tracts. | 1451 | ||
| Lower Motor Neurons. | 1451 | ||
| Upper Motor Neurons. | 1452 | ||
| Reflex Arc. | 1452 | ||
| Brain. | 1452 | ||
| Cerebrum. | 1452 | ||
| Brain Stem. | 1452 | ||
| Cerebellum. | 1453 | ||
| Ventricles and Cerebro-Spinal Fluid. | 1453 | ||
| Cerebro-Spinal Fluid. | 1453 | ||
| Peripheral Nervous System | 1455 | ||
| Spinal Nerves. | 1455 | ||
| Cranial Nerves. | 1456 | ||
| Autonomic Nervous System. | 1456 | ||
| Cerebral Circulation | 1456 | ||
| Blood–Brain Barrier. | 1459 | ||
| Protective Structures | 1459 | ||
| Meninges. | 1459 | ||
| Skull. | 1459 | ||
| Vertebral Column. | 1459 | ||
| Age-Related Considerations | 1460 | ||
| Effects of Aging on the Nervous System | 1460 | ||
| Assessment of the Nervous System | 1461 | ||
| Subjective Data | 1461 | ||
| Important Health Information | 1461 | ||
| Past Health History. | 1461 | ||
| Medications. | 1461 | ||
| Surgery or Other Treatments. | 1461 | ||
| Health Status. | 1461 | ||
| General Health Practices. | 1461 | ||
| Nutritional Problems. | 1461 | ||
| Bowel and Bladder Problems. | 1462 | ||
| Motor Problems. | 1463 | ||
| Sleep Problems. | 1463 | ||
| Cognition and Sensory Problems. | 1463 | ||
| Emotional Problems. | 1463 | ||
| Relationship Problems. | 1463 | ||
| Sexual Problems. | 1463 | ||
| Objective Data | 1463 | ||
| Physical Examination. | 1463 | ||
| Mental Status. | 1463 | ||
| Function of Cranial Nerves. | 1464 | ||
| Olfactory Nerve. | 1464 | ||
| Optic Nerve. | 1464 | ||
| Oculomotor, Trochlear, and Abducens Nerves. | 1464 | ||
| Trigeminal Nerve. | 1465 | ||
| Facial Nerve. | 1465 | ||
| Vestibulo-cochlear Nerve. | 1465 | ||
| Glossopharyngeal and Vagus Nerves. | 1465 | ||
| Spinal Accessory Nerve. | 1465 | ||
| Hypoglossal Nerve. | 1465 | ||
| Motor Function. | 1465 | ||
| Sensory Function. | 1466 | ||
| Light Touch. | 1466 | ||
| Pain and Temperature. | 1466 | ||
| Vibration Sense. | 1466 | ||
| Position Sense. | 1466 | ||
| Cortical Sensory Functions. | 1466 | ||
| Reflex Function. | 1466 | ||
| Diagnostic Studies of the Nervous System | 1467 | ||
| Cerebro-Spinal Fluid Analysis. | 1467 | ||
| Lumbar Puncture. | 1467 | ||
| Radiological Studies | 1468 | ||
| Cerebral Angiography. | 1468 | ||
| Computed Tomography. | 1469 | ||
| Magnetic Resonance Imaging. | 1469 | ||
| Positron Emission Tomography. | 1471 | ||
| Electrographic Studies | 1472 | ||
| Electroencephalography. | 1472 | ||
| Electromyography and Nerve Conduction Studies. | 1472 | ||
| Evoked Potentials. | 1472 | ||
| Combined Doppler and Ultrasound (Duplex) Studies | 1472 | ||
| Carotid Duplex. | 1472 | ||
| Transcranial Doppler Sonography. | 1472 | ||
| Review Questions | 1472 | ||
| References | 1473 | ||
| Resources | 1473 | ||
| 59 Nursing Management | 1474 | ||
| Learning Objectives | 1474 | ||
| Key Terms | 1474 | ||
| Intracranial Pressure | 1474 | ||
| Regulation and Maintenance of Intracranial Pressure | 1475 | ||
| Normal Intracranial Pressure. | 1475 | ||
| Normal Compensatory Adaptations. | 1475 | ||
| Cerebral Blood Flow | 1475 | ||
| Autoregulation of Cerebral Blood Flow. | 1475 | ||
| Other Factors Affecting Cerebral Blood Flow. | 1475 | ||
| Pressure Changes. | 1476 | ||
| Increased Intracranial Pressure | 1476 | ||
| Mechanisms of Increased Intracranial Pressure | 1476 | ||
| Cerebral Edema | 1476 | ||
| Vasogenic Cerebral Edema. | 1477 | ||
| Cytotoxic Cerebral Edema. | 1477 | ||
| Interstitial Cerebral Edema. | 1478 | ||
| Clinical Manifestations | 1478 | ||
| Change in Level of Consciousness. | 1478 | ||
| Changes in Vital Signs. | 1478 | ||
| Ocular Signs. | 1478 | ||
| Decrease in Motor Function. | 1479 | ||
| Headache. | 1479 | ||
| Vomiting. | 1479 | ||
| Complications | 1479 | ||
| Diagnostic Studies | 1479 | ||
| Neuromonitoring | 1480 | ||
| Measurement of Intracranial Pressure. | 1480 | ||
| Cerebro-Spinal Fluid Drainage. | 1481 | ||
| Cerebral Oxygenation Monitoring. | 1482 | ||
| Collaborative Care | 1482 | ||
| Drug Therapy. | 1482 | ||
| Nutritional Therapy. | 1483 | ||
| Supportive Therapy. | 1483 | ||
| Nursing Management Increased Intracranial Pressure | 1483 | ||
| Nursing Assessment | 1483 | ||
| Glasgow Coma Scale. | 1483 | ||
| Neurological Assessment. | 1483 | ||
| Nursing Diagnoses | 1484 | ||
| Planning | 1485 | ||
| Nursing Implementation | 1485 | ||
| Acute Intervention | 1485 | ||
| Respiratory Function. | 1485 | ||
| Fluid and Electrolyte Balance. | 1485 | ||
| Monitoring Intracranial Pressure. | 1486 | ||
| Body Position. | 1486 | ||
| Protection From Injury. | 1486 | ||
| Psychological Considerations. | 1486 | ||
| Evaluation | 1486 | ||
| Head Injury | 1486 | ||
| Types of Head Injuries | 1487 | ||
| Scalp Lacerations. | 1487 | ||
| Skull Fractures. | 1487 | ||
| Head Trauma. | 1488 | ||
| Diffuse Injury. | 1488 | ||
| Diffuse Axonal Injury. | 1488 | ||
| Focal Injury. | 1488 | ||
| Complications | 1489 | ||
| Epidural Hematoma. | 1489 | ||
| Subdural Hematoma. | 1489 | ||
| Intraparenchymal Hematoma. | 1490 | ||
| Traumatic Subarachnoid Hemorrhage. | 1490 | ||
| Diagnostic Studies and Collaborative Care | 1490 | ||
| Nursing Management Head Injury | 1491 | ||
| Nursing Assessment | 1491 | ||
| Nursing Diagnoses | 1491 | ||
| Planning | 1491 | ||
| Nursing Implementation | 1491 | ||
| Health Promotion. | 1491 | ||
| Acute Intervention. | 1492 | ||
| Ambulatory and Home Care. | 1492 | ||
| Evaluation | 1493 | ||
| Brain Tumours | 1493 | ||
| Types | 1493 | ||
| Clinical Manifestations | 1493 | ||
| Complications | 1494 | ||
| Diagnostic Studies | 1494 | ||
| Collaborative Care | 1495 | ||
| Drug Therapy. | 1495 | ||
| Surgical Therapy. | 1495 | ||
| Ventricular Shunts. | 1495 | ||
| Radiation Therapy and Radiosurgery. | 1495 | ||
| Chemotherapy and Targeted Therapy. | 1495 | ||
| Other Therapies. | 1495 | ||
| Nursing Management Brain Tumours | 1495 | ||
| Nursing Assessment | 1495 | ||
| Nursing Diagnoses | 1496 | ||
| Planning | 1496 | ||
| Nursing Implementation | 1496 | ||
| Evaluation | 1496 | ||
| Cranial Surgery | 1496 | ||
| Types | 1496 | ||
| Stereotactic Surgery. | 1496 | ||
| Craniotomy. | 1498 | ||
| Nursing Management Cranial Surgery | 1498 | ||
| Nursing Assessment | 1498 | ||
| Nursing Diagnoses | 1498 | ||
| Planning | 1498 | ||
| Nursing Implementation | 1498 | ||
| Acute Intervention. | 1498 | ||
| Ambulatory and Home Care. | 1498 | ||
| Evaluation | 1499 | ||
| Inflammatory Conditions of the Brain | 1499 | ||
| Bacterial Meningitis | 1500 | ||
| Etiology and Pathophysiology | 1500 | ||
| Clinical Manifestations | 1500 | ||
| Complications | 1500 | ||
| Diagnostic Studies | 1501 | ||
| Collaborative Care | 1501 | ||
| Nursing Management Bacterial Meningitis | 1501 | ||
| Nursing Assessment | 1501 | ||
| Nursing Diagnoses | 1501 | ||
| Planning | 1501 | ||
| Nursing Implementation | 1501 | ||
| Health Promotion. | 1501 | ||
| Acute Intervention. | 1502 | ||
| Ambulatory and Home Care. | 1502 | ||
| Evaluation | 1502 | ||
| Viral Meningitis | 1502 | ||
| Encephalitis | 1502 | ||
| Etiology and Pathophysiology | 1502 | ||
| Clinical Manifestations and Diagnostic Studies | 1503 | ||
| Nursing and Collaborative Management Viral Encephalitis | 1503 | ||
| Rabies | 1503 | ||
| Brain Abscess | 1503 | ||
| Review Questions | 1504 | ||
| References | 1505 | ||
| Resources | 1506 | ||
| 60 Nursing Management | 1507 | ||
| Learning Objectives | 1507 | ||
| Key Terms | 1507 | ||
| Pathophysiology of a Stroke | 1508 | ||
| Anatomy of Cerebral Circulation | 1508 | ||
| Regulation of Cerebral Blood Flow | 1508 | ||
| Atherosclerosis | 1508 | ||
| Risk Factors for Stroke | 1509 | ||
| Nonmodifiable Risk Factors | 1509 | ||
| Modifiable Risk Factors | 1509 | ||
| Types of Stroke | 1510 | ||
| Ischemic Stroke | 1510 | ||
| Transient Ischemic Attack. | 1510 | ||
| Thrombotic Stroke. | 1511 | ||
| Embolic Stroke. | 1511 | ||
| Hemorrhagic Stroke | 1511 | ||
| Intracerebral Hemorrhage. | 1511 | ||
| Subarachnoid Hemorrhage. | 1512 | ||
| Clinical Manifestations of Stroke | 1512 | ||
| Motor Function. | 1512 | ||
| Communication. | 1513 | ||
| Affect. | 1513 | ||
| Intellectual Function. | 1513 | ||
| Spatial–Perceptual Alterations. | 1513 | ||
| Elimination. | 1514 | ||
| Diagnostic Studies | 1514 | ||
| Collaborative Care | 1514 | ||
| Prevention Therapy. | 1514 | ||
| Drug Therapy. | 1514 | ||
| Surgical Therapy. | 1515 | ||
| Collaborative Acute Care for Ischemic Stroke. | 1515 | ||
| Drug Therapy for Ischemic Stroke. | 1517 | ||
| Surgical Therapy for Ischemic Stroke. | 1517 | ||
| Collaborative Acute Care for Hemorrhagic Stroke | 1517 | ||
| Drug Therapy. | 1517 | ||
| Surgical Therapy. | 1517 | ||
| Rehabilitation Care. | 1518 | ||
| Nursing Management Stroke | 1518 | ||
| Nursing Assessment | 1518 | ||
| Nursing Diagnoses | 1519 | ||
| Planning | 1520 | ||
| Nursing Implementation | 1520 | ||
| Health Promotion. | 1520 | ||
| Acute Intervention for All Stroke Patients. | 1523 | ||
| Respiratory System. | 1523 | ||
| Neurological System. | 1523 | ||
| Cardiovascular System. | 1523 | ||
| Musculo-Skeletal System. | 1524 | ||
| Integumentary System. | 1524 | ||
| Gastro-Intestinal System. | 1524 | ||
| Urinary System. | 1524 | ||
| Nutrition. | 1525 | ||
| Communication. | 1525 | ||
| Sensory–Perceptual Alterations. | 1525 | ||
| Coping. | 1526 | ||
| Ambulatory and Home Care: Stroke Recovery. | 1526 | ||
| Musculo-Skeletal Function. | 1527 | ||
| Nutritional Therapy. | 1527 | ||
| Bowel Function. | 1527 | ||
| Bladder Function. | 1528 | ||
| Sensory–Perceptual Function. | 1528 | ||
| Affect. | 1529 | ||
| Coping. | 1529 | ||
| Sexual Function. | 1529 | ||
| Community Reintegration. | 1529 | ||
| Age-Related Considerations | 1529 | ||
| Stroke | 1529 | ||
| Review Questions | 1530 | ||
| References | 1531 | ||
| Resources | 1532 | ||
| 61 Nursing Management | 1534 | ||
| Learning Objectives | 1534 | ||
| Key Terms | 1534 | ||
| Headache | 1534 | ||
| Migraine Headache | 1534 | ||
| 12 Nursing Care in Specialized Settings | 1726 | ||
| 68 Nursing Management | 1727 | ||
| Learning Objectives | 1727 | ||
| Key Terms | 1727 | ||
| Critical Care Nursing | 1727 | ||
| Critical Care Units | 1727 | ||
| Critical Care Nurse | 1728 | ||
| Critical Care Patient | 1729 | ||
| Common Problems of Critical Care Patients. | 1729 | ||
| Nutrition. | 1729 | ||
| Anxiety. | 1729 | ||
| Pain. | 1729 | ||
| Impaired Communication. | 1730 | ||
| Sensory-Perceptual Problems. | 1730 | ||
| Sleep Problems. | 1730 | ||
| Issues Related to Caregivers. | 1730 | ||
| Culturally Competent Care | 1731 | ||
| Critical Care Patients | 1731 | ||
| Hemodynamic Monitoring | 1731 | ||
| Hemodynamic Terminology | 1731 | ||
| Cardiac Output and Cardiac Index. | 1731 | ||
| Preload. | 1731 | ||
| Afterload. | 1732 | ||
| Vascular Resistance. | 1733 | ||
| Contractility. | 1733 | ||
| Principles of Invasive Pressure Monitoring | 1733 | ||
| Types of Invasive Pressure Monitoring | 1733 | ||
| Arterial Blood Pressure. | 1733 | ||
| Measurements. | 1734 | ||
| Complications. | 1735 | ||
| Arterial Pressure–Based Cardiac Output. | 1735 | ||
| Measurements. | 1735 | ||
| Pulmonary Artery Flow-Directed Catheter. | 1735 | ||
| Pulmonary Artery Catheter Insertion. | 1737 | ||
| Central Venous or Right Atrial Pressure Measurement. | 1737 | ||
| Noninvasive Hemodynamic Monitoring: Impedance Cardiography. | 1737 | ||
| Venous Oxygen Saturation. | 1738 | ||
| Noninvasive Arterial Oxygenation Monitoring. | 1738 | ||
| Nursing Management Hemodynamic Monitoring | 1738 | ||
| Circulatory Assist Devices | 1739 | ||
| Intra-Aortic Balloon Pump | 1739 | ||
| Effects of Counter-Pulsation. | 1739 | ||
| Complications With IABP Therapy. | 1740 | ||
| Ventricular Assist Devices | 1741 | ||
| Implantable Artificial Heart | 1741 | ||
| Nursing Management Circulatory Assist Devices | 1741 | ||
| Artificial Airways | 1742 | ||
| Endotracheal Tubes | 1742 | ||
| Endotracheal Intubation Procedure | 1743 | ||
| Nursing Management Artificial Airway | 1743 | ||
| Maintaining Correct Tube Placement | 1744 | ||
| Maintaining Proper Cuff Inflation | 1744 | ||
| Monitoring Oxygenation and Ventilation | 1744 | ||
| Maintaining Tube Patency | 1744 | ||
| Providing Oral Care and Maintaining Skin Integrity | 1745 | ||
| Fostering Comfort and Communication | 1746 | ||
| Complications of Endotracheal Intubation | 1746 | ||
| Mechanical Ventilation | 1747 | ||
| Types of Mechanical Ventilation | 1747 | ||
| Negative-Pressure Ventilation. | 1747 | ||
| Positive-Pressure Ventilation. | 1747 | ||
| Volume Ventilation. | 1747 | ||
| Pressure Ventilation. | 1747 | ||
| Settings of Mechanical Ventilators | 1747 | ||
| Modes of Volume Ventilation | 1747 | ||
| Assist-Control Ventilation. | 1748 | ||
| Synchronized Intermittent Mandatory Ventilation. | 1749 | ||
| Modes of Pressure Ventilation | 1749 | ||
| Pressure-Support Ventilation. | 1749 | ||
| Pressure-Control Inverse Ratio Ventilation. | 1749 | ||
| Airway Pressure Release Ventilation. | 1749 | ||
| Other Modes. | 1749 | ||
| Other Ventilatory Manoeuvres | 1749 | ||
| Positive End-Expiratory Pressure. | 1749 | ||
| Continuous Positive Airway Pressure. | 1750 | ||
| Bilevel Positive Airway Pressure. | 1750 | ||
| High-Frequency Oscillatory Ventilation. | 1750 | ||
| Nitric Oxide. | 1750 | ||
| Prone Positioning. | 1750 | ||
| Extracorporeal Membrane Oxygenation. | 1750 | ||
| Complications of Positive-Pressure Ventilation | 1750 | ||
| Cardiovascular System. | 1750 | ||
| Pulmonary System. | 1750 | ||
| Barotrauma. | 1750 | ||
| Volutrauma. | 1751 | ||
| Alveolar Hypoventilation. | 1751 | ||
| Alveolar Hyperventilation. | 1751 | ||
| Ventilator-Associated Pneumonia. | 1751 | ||
| Sodium and Water Imbalance. | 1751 | ||
| Neurological System. | 1752 | ||
| Gastro-Intestinal System. | 1752 | ||
| Musculo-Skeletal System. | 1752 | ||
| Psychosocial Needs. | 1752 | ||
| Machine Disconnection or Malfunction. | 1753 | ||
| Weaning From Positive-Pressure Ventilation and Extubation | 1753 | ||
| Chronic Mechanical Ventilation | 1755 | ||
| Nursing Management Mechanical Ventilation | 1755 | ||
| Other Critical Care Content | 1755 | ||
| Review Questions | 1756 | ||
| References | 1757 | ||
| Resources | 1758 | ||
| 69 Nursing Management | 1759 | ||
| Learning Objectives | 1759 | ||
| Key Terms | 1759 | ||
| Shock | 1759 | ||
| Classification of Shock | 1759 | ||
| Shock Caused by Low Blood Flow | 1760 | ||
| Cardiogenic Shock. | 1760 | ||
| Hypovolemic Shock. | 1760 | ||
| Distributive Shock: Shock Caused by Maldistribution of Blood Flow | 1763 | ||
| Neurogenic Shock. | 1763 | ||
| Anaphylactic Shock. | 1764 | ||
| Septic Shock. | 1764 | ||
| Stages of Shock | 1765 | ||
| Compensatory Stage. | 1766 | ||
| Progressive Stage. | 1766 | ||
| Refractory Stage. | 1768 | ||
| Diagnostic Studies | 1768 | ||
| Collaborative Care: General Measures | 1769 | ||
| Oxygen and Ventilation. | 1769 | ||
| Fluid Resuscitation. | 1770 | ||
| Drug Therapy. | 1771 | ||
| Sympathomimetic Drugs. | 1771 | ||
| Vasodilator Drugs. | 1771 | ||
| Nutritional Therapy. | 1773 | ||
| Collaborative Care: Specific Measures | 1773 | ||
| Cardiogenic Shock. | 1773 | ||
| Hypovolemic Shock. | 1773 | ||
| Septic Shock. | 1773 | ||
| Neurogenic Shock. | 1774 | ||
| Anaphylactic Shock. | 1775 | ||
| Nursing Management Shock | 1775 | ||
| Nursing Assessment | 1775 | ||
| Nursing Diagnoses | 1775 | ||
| Planning | 1775 | ||
| Nursing Implementation | 1775 | ||
| Health Promotion. | 1775 | ||
| Acute Intervention. | 1776 | ||
| Neurological Status. | 1776 | ||
| Cardiovascular Status. | 1776 | ||
| Respiratory Status. | 1776 | ||
| Renal Status. | 1776 | ||
| Body Temperature and Skin Changes. | 1776 | ||
| Gastro-Intestinal Status. | 1777 | ||
| Personal Hygiene. | 1777 | ||
| Emotional Support and Comfort. | 1777 | ||
| Ambulatory and Home Care. | 1777 | ||
| Evaluation | 1777 | ||
| Systemic Inflammatory Response Syndrome and Multiple-Organ Dysfunction Syndrome | 1777 | ||
| Etiology and Pathophysiology | 1777 | ||
| Organ and Metabolic Dysfunction. | 1777 | ||
| Clinical Manifestations | 1778 | ||
| Nursing and Collaborative Management SIRS and MODS | 1778 | ||
| Prevention and Treatment of Infection | 1778 | ||
| Maintenance of Tissue Oxygenation | 1779 | ||
| Nutritional and Metabolic Needs | 1780 | ||
| Support of Failing Organs | 1780 | ||
| Review Questions | 1781 | ||
| References | 1781 | ||
| Resources | 1781 | ||
| 70 Nursing Management | 1782 | ||
| Learning Objectives | 1782 | ||
| Key Terms | 1782 | ||
| Acute Respiratory Failure | 1782 | ||
| Etiology and Pathophysiology | 1784 | ||
| Hypoxemic Respiratory Failure. | 1784 | ||
| Ventilation–Perfusion Mismatch. | 1784 | ||
| Shunt. | 1785 | ||
| Diffusion Limitation. | 1785 | ||
| Alveolar Hypoventilation. | 1785 | ||
| Interrelationship of Mechanisms. | 1785 | ||
| Hypercapnic Respiratory Failure. | 1785 | ||
| Airways and Alveoli. | 1786 | ||
| Central Nervous System. | 1786 | ||
| Chest Wall. | 1786 | ||
| Neuro-muscular Conditions. | 1787 | ||
| Tissue Oxygen Needs. | 1787 | ||
| Clinical Manifestations | 1787 | ||
| Consequences of Hypoxemia and Hypoxia. | 1788 | ||
| Specific Clinical Manifestations. | 1788 | ||
| Diagnostic Studies | 1788 | ||
| Nursing and Collaborative Management Acute Respiratory Failure | 1789 | ||
| Nursing Assessment | 1789 | ||
| Nursing Diagnoses | 1789 | ||
| Planning | 1790 | ||
| Prevention | 1790 | ||
| Respiratory Therapy | 1790 | ||
| Oxygen Therapy. | 1790 | ||
| Mobilization of Secretions. | 1790 | ||
| Effective Coughing and Positioning. | 1790 | ||
| Hydration and Humidification. | 1791 | ||
| Chest Physiotherapy. | 1791 | ||
| Airway Suctioning. | 1791 | ||
| Positive-Pressure Ventilation. | 1791 | ||
| Drug Therapy | 1792 | ||
| Relief of Bronchospasm. | 1792 | ||
| Reduction of Airway Inflammation. | 1792 | ||
| Reduction of Pulmonary Congestion. | 1792 | ||
| Treatment of Pulmonary Infections. | 1792 | ||
| Reduction of Severe Anxiety, Pain, and Agitation. | 1792 | ||
| Medical Supportive Therapy | 1793 | ||
| Treating the Underlying Cause. | 1793 | ||
| Maintaining Adequate Cardiac Output. | 1793 | ||
| Maintaining Adequate Hemoglobin Concentration. | 1793 | ||
| Nutritional Therapy | 1793 | ||
| Evaluation | 1793 | ||
| Age-Related Considerations | 1793 | ||
| Respiratory Failure | 1793 | ||
| Acute Respiratory Distress Syndrome | 1794 | ||
| Etiology and Pathophysiology | 1794 | ||
| Injury or Exudative Phase. | 1795 | ||
| Reparative or Proliferative Phase. | 1796 | ||
| Fibrotic Phase. | 1796 | ||
| Clinical Progression | 1796 | ||
| Clinical Manifestations | 1796 | ||
| Complications | 1797 | ||
| Hospital-Acquired Pneumonia. | 1797 | ||
| Barotrauma. | 1797 | ||
| Volutrauma. | 1797 | ||
| Stress Ulcers. | 1797 | ||
| Renal Failure. | 1797 | ||
| Nursing and Collaborative Management Acute Respiratory Distress Syndrome | 1798 | ||
| Nursing Assessment | 1798 | ||
| Nursing Diagnoses | 1798 | ||
| Planning | 1798 | ||
| Respiratory Therapy | 1798 | ||
| Oxygen Administration. | 1798 | ||
| Mechanical Ventilation. | 1798 | ||
| Positioning Strategies. | 1798 | ||
| Medical Supportive Therapy | 1799 | ||
| Maintenance of Cardiac Output and Tissue Perfusion. | 1799 | ||
| Maintenance of Nutrition and Fluid Balance. | 1799 | ||
| Evaluation | 1799 | ||
| Severe Acute Respiratory Syndrome | 1799 | ||
| Review Questions | 1800 | ||
| References | 1801 | ||
| Resources | 1802 | ||
| 71 Nursing Management | 1803 | ||
| Learning Objectives | 1803 | ||
| Key Terms | 1803 | ||
| Care of the Emergency Patient | 1804 | ||
| Primary Survey | 1804 | ||
| A = Airway With Cervical Spine Stabilization or Immobilization | 1804 | ||
| B = Breathing | 1806 | ||
| C = Circulation | 1806 | ||
| D = Disability | 1806 | ||
| Secondary Survey | 1806 | ||
| E = Exposure and Environmental Control | 1806 | ||
| F = Full Set of Vital Signs/Five Interventions/Facilitating Family Presence | 1806 | ||
| G = Giving Comfort Measures | 1808 | ||
| H = History and Head-to-Toe Assessment | 1808 | ||
| Head, Neck, and Face. | 1808 | ||
| Chest. | 1808 | ||
| Abdomen and Flanks. | 1808 | ||
| Pelvis and Perineum. | 1808 | ||
| Extremities. | 1809 | ||
| I = Inspect the Posterior Surfaces | 1809 | ||
| Intervention and Evaluation | 1809 | ||
| Mandatory Reporting of Gunshot and Stab Wounds | 1809 | ||
| Reporting of Abuse of Children | 1809 | ||
| Death in the Emergency Department | 1810 | ||
| Organ and Tissue Donation | 1810 | ||
| Emergency Department Wait Times. | 1810 | ||
| Age-Related Considerations | 1810 | ||
| Emergency Care | 1810 | ||
| Environmental Emergencies | 1811 | ||
| Heat-Related Emergencies | 1811 | ||
| Heat Cramps | 1811 | ||
| Heat Exhaustion | 1811 | ||
| Heatstroke | 1812 | ||
| Collaborative Care. | 1812 | ||
| Cold-Related Emergencies | 1813 | ||
| Frostbite | 1813 | ||
| Hypothermia | 1813 | ||
| Collaborative Care. | 1814 | ||
| Submersion Injuries | 1814 | ||
| Collaborative Care | 1815 | ||
| Bites and Stings | 1816 | ||
| Hymenopteran Stings | 1816 | ||
| Spider Bites (Arachnid) | 1816 | ||
| Black Widow Spiders. | 1816 | ||
| Tick Bites | 1817 | ||
| Animal and Human Bites | 1817 | ||
| Collaborative Care. | 1817 | ||
| Poisonings | 1818 | ||
| Violence | 1819 | ||
| Domestic Violence | 1819 | ||
| Elder Abuse. | 1820 | ||
| Sexual Assault | 1820 | ||
| Clinical Manifestations | 1820 | ||
| Physical. | 1820 | ||
| Psychological. | 1820 | ||
| Collaborative Care | 1820 | ||
| Nursing Management Sexual Assault | 1820 | ||
| Review Questions | 1823 | ||
| References | 1823 | ||
| Resources | 1825 | ||
| 72 Emergency Management and Disaster Planning | 1826 | ||
| Learning Objectives | 1826 | ||
| Key Terms | 1826 | ||
| Emergency Management and Disaster Planning | 1827 | ||
| Individual, Local–Municipal, Provincial–Territorial, and Federal and First Nations Responsibilities | 1827 | ||
| Disaster Response in First Nations Communities | 1828 | ||
| Emergency/Disaster Management | 1828 | ||
| Mitigation | 1829 | ||
| Preparedness | 1829 | ||
| Health Care Emergency Operations Plans. | 1829 | ||
| Internal and External Disasters. | 1829 | ||
| Contents of Health Care Emergency Operations Plans. | 1830 | ||
| Testing of Emergency Plans. | 1831 | ||
| Response | 1831 | ||
| The Incident Management System. | 1832 | ||
| Triage. | 1833 | ||
| Triage in Disaster Situations. | 1833 | ||
| Disaster Triage in the Hospital Setting. | 1834 | ||
| Recovery and Rehabilitation | 1834 | ||
| Critical Incident Stress Management. | 1834 | ||
| The Role of Nursing Leadership in Disaster Preparedness and Response | 1835 | ||
| Natural and Human-Made or Induced Disasters | 1835 | ||
| Natural Disasters | 1835 | ||
| Human-Made or Human-Induced Disasters | 1835 | ||
| Terrorism. | 1835 | ||
| Chemical–Biological–Radiological–Nuclear–Explosive Events. | 1835 | ||
| Biological Agents of Terrorism. | 1837 | ||
| Chemical Agents of Terrorism. | 1837 | ||
| Radiological and Nuclear Agents of Terrorism. | 1839 | ||
| Explosive Agents of Terrorism. | 1840 | ||
| Epidemics and Pandemics | 1840 | ||
| Severe Acute Respiratory Syndrome | 1840 | ||
| Outbreak Management | 1840 | ||
| Outbreak Management Strategies. | 1840 | ||
| Pandemic Planning | 1841 | ||
| Ethical Issues During a Disaster or Pandemic. | 1842 | ||
| Vulnerable Individuals and Populations. | 1843 | ||
| Disaster Nursing | 1843 | ||
| Review Questions | 1844 | ||
| References | 1845 | ||
| Resources | 1846 | ||
| Appendices | 1848 | ||
| Appendix A Nursing Diagnoses | 1848 | ||
| Appendix B Laboratory Values | 1852 | ||
| Glossary | 1863 | ||
| A | 1863 | ||
| B | 1865 | ||
| C | 1865 | ||
| D | 1867 | ||
| E | 1868 | ||
| F | 1869 | ||
| G | 1870 | ||
| H | 1870 | ||
| I | 1872 | ||
| J | 1873 | ||
| K | 1873 | ||
| L | 1873 | ||
| M | 1873 | ||
| O | 1875 | ||
| P | 1876 | ||
| Q | 1878 | ||
| R | 1878 | ||
| S | 1878 | ||
| T | 1880 | ||
| U | 1881 | ||
| V | 1881 | ||
| W | 1882 | ||
| Index | 1883 | ||
| A | 1883 | ||
| B | 1887 | ||
| C | 1889 | ||
| D | 1894 | ||
| E | 1896 | ||
| F | 1898 | ||
| G | 1899 | ||
| H | 1900 | ||
| I | 1903 | ||
| J | 1905 | ||
| K | 1905 | ||
| L | 1906 | ||
| M | 1907 | ||
| N | 1909 | ||
| O | 1910 | ||
| P | 1912 | ||
| Q | 1916 | ||
| R | 1916 | ||
| S | 1918 | ||
| T | 1922 | ||
| U | 1924 | ||
| V | 1924 | ||
| W | 1925 | ||
| X | 1926 | ||
| Y | 1926 | ||
| Z | 1926 | ||
| Special Features | 1927 | ||
| Endsheet 5 | IBC1 | ||
| Endsheet 6 | IBC2 | ||
| Endsheet 7 | IBC3 | ||
| Situation–Background–Assessment–Recommendation (SBAR) or Identification-Situation–Background–Assessment–Recommendation-Read Back (I-SBAR-R) Technique | IBC3 | ||
| The Identification–Situation–Background–Assessment–Recommendation–Read Back (I–SBAR–R) Technique | IBC3 | ||
| Sample I-SBAR-R Report From a Nurse to a Physician About a Critical Situation | IBC3 | ||
| Identification | IBC3 | ||
| Situation | IBC3 | ||
| Background | IBC3 | ||
| Assessment | IBC3 | ||
| Recommendations | IBC3 | ||
| Repeat Back | IBC3 |