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Summary Table of Contents

Comprehensive, logically-organized, and easy to read, this market-leading fundamentals text provides students with a solid base for their nursing education. Encompassing principles, concepts, and skills, it offers thorough coverage, a nursing process framework, an emphasis on critical thinking, and a focus on care in all settings. This new edition addresses a number of key issues, including evidence-based practice, safety concerns, and end-of-life care. To better meet the needs of beginning students, care plans have been expanded to more clearl... MOREy explain assessment findings leading to nursing diagnoses, as well as evaluation of outcomes. The 5-step nursing process provides a consistent framework for clinical chapters. The unique Critical Thinking Model visually demonstrates the application of the nursing process and critical thinking in each clinical chapter to help students understand the ongoing assimilation of knowledge and information that comprises critical thinking and its relationship to the nursing process. More than 65 skills, in a 2-column format, include rationales for each step and clearly explain both how and why nursing skills are performed. Procedural Guidelines boxes provide streamlined, step-by-step instructions for performing basic skills. The 3-tiered approach in implementation sections includes health promotion, acute care, and continuing care to address the diverse focus of today's care, as well as the various practice settings. Care Plans demonstrate the application of the 5-step nursing process to individual patient problems to help students understand how a plan is developed and how to evaluate care. Focus on Older Adults boxes, Research Highlight boxes, and Client Teaching boxes highlight key aspects of nursing care. The Caring in Nursing Practice chapter addresses the compassion nurses must incorporate with clinical competence to deliver comprehensive care. A CD-ROM companion, packaged with every text, includes a searchable audio glossary, Butterfield's Fluid and Electrolytes tutorial, NCLEX-style review questions, test taking tips, concept map situations, critical thinking model application, video clips, animations, and Spanish phrases. Unexpected Outcomes and Related Interventions for skills alert students to possible problems and help them determine the best nursing action. 18 Concept Maps more than any other fundamentals text visually demonstrate the association of multiple nursing diagnoses. Evidence-Based Practice Guidelines boxes review research that identifies best practices. The Care Plan format has been expanded to more clearly present assessment, defining characteristics, and evaluation of outcomes. Planning discussions include sections on Goals and Outcomes, Setting Priorities, and Continuity of Care to help beginning students plan and prioritize comprehensive client care. Safety Alerts provide information and techniques to ensure client and nurse safety. Cultural Aspects of Care boxes provide practical guidelines for how to meet the various cultural needs/preferences of clients and their communities. Rationales in care plans and procedures include references whenever possible to highlight evidence-based "best practice." NOC outcomes as well as NIC interventions are incorporated in Care Plans as appropriate. New 2002 CDC Hand Hygiene Guidelines are incorporated throughout. A new chapter on Nursing Today addresses emerging issues, including the nursing shortage. New coverage of bioterrorism has been added to the chapter on Safety. New content on end-of-life and palliative care has been added. The Spiritual Health chapter now offers expanded information to help students identify and meet their clients' spiritual needs. The Skin Integrity and Wound Care chapter has been revised

* The 5-step nursing process provides a consistent framework for clinical chapters. * The unique Critical Thinking Model visually demonstrates the application of the nursing process and critical thinking in each clinical chapter to help students understand the ongoing assimilation of knowledge and information that comprises critical thinking and its relationship to the nursing process. * More than 65 skills, in a 2-column format, include rationales for each step and clearly explain both how and why nursing skills are performed. * Procedural Guidelines boxes provide streamlined, step-by-step instructions for performing basic skills. * The 3-tiered approach in implementation sections includes health promotion, acute care, and continuing care to address the diverse focus of today's care, as well as the various practice settings. * Care Plans demonstrate the application of the 5-step nursing process to individual patient problems to help students underst

Unit I The Client and the Health Care Environment

Nursing Today

(25)

Historical Perspective Highlights

... MORE

(2)

Florence Nightingale

(1)

The Civil War to the Beginning of the Twentieth Century

(2)

Twentieth Century

(1)

Twenty-first Century

(1)

Societal Influences on Nursing

(1)

Demographic Changes

(1)

Women's Health Care Issues

(1)

Human Rights Movement

(1)

Medically Underserved

(1)

Threat of Bioterrorism

(1)

Needs of the Consumer

(1)

Cultural Diversity

(1)

Health Promotion and Wellness

(1)

Influence of Today's Health Care Delivery System

(1)

Rising Health Care Cost

(1)

Evidenced-Based Practice

(1)

Nursing and Biomedical Research

(1)

Nursing Shortage

(1)

Nursing as a Profession

(9)

Standards of Professional Performance

(5)

Standards of Care

(4)

Nursing Education

(1)

Professional Registered Nurse Education

(1)

Graduate Education

(1)

Continuing and In-Service Education

(1)

Nursing Practice

(1)

Nurse Practice Acts

(1)

Licensure and Certification

(1)

Science and Art of Nursing Practice

(1)

Professional Responsibilities and Roles

(4)

Autonomy and Accountability

(1)

Caregiver

(1)

Advocate

(1)

Educator

(1)

Communicator

(1)

Manager

(1)

Career Development

(3)

Professional Nursing Organizations

(1)

Future Trends in Nursing

(4)

Expansion of Employment Opportunities

(1)

Nursing's Public Perception

(1)

Nursing's Impact on Politics and Health Policy

(4)

Health Care Delivery System

(20)

Health Care Regulation and Competition

(2)

Nursing Implications

(1)

Levels of Health Care

(9)

Preventive and Primary Health Care Services

(2)

Secondary and Tertiary Care

(2)

Restorative Care

(2)

Continuing Care

(2)

Issues in Health Care Delivery

(4)

Competency

(1)

Evidence-Based Practice

(1)

Knowing Clients

(1)

Assistive Personnel

(1)

Quality Health Care

(1)

The Future of Health Care

(3)

Community-Based Nursing Practice

(14)

Community-Based Health Care

(1)

Achieving Healthy Populations and Communities

(1)

Community Health Nursing

(1)

Nursing Practice in Community Health

(1)

Community-Based Nursing

(6)

Vulnerable Populations

(5)

Competency in Community-Based Nursing

(1)

Case Manager

(1)

Collaborator

(1)

Educator

(1)

Counselor

(1)

Client Advocate

(1)

Change Agent

(1)

Community Assessment

(1)

Changing Clients' Health

(3)

Theoretical Foundations of Nursing Practice

(13)

The Domain of Nursing Theory

(2)

Components of a Theory

(1)

Types of Theory

(1)

Theoretical Models

(1)

Relationship of Theory to the Nursing Process and Client Needs

(1)

Interdisciplinary Theories

(2)

Systems Theory

(2)

Basic Human Needs

(1)

Health-and-Wellness Models

(1)

Stress and Adaptation

(1)

Developmental Theories

(1)

Psychosocial Theories

(1)

Selected Nursing Theories

(3)

Nightingale's Theory

(1)

Peplau's Theory

(1)

Henderson's Theory

(1)

Abdellah's Theory

(1)

Johnson's Theory

(1)

Rogers' Theory

(1)

Orem's Theory

(1)

Neuman's Theory

(1)

Leininger's Theory

(1)

King's Theory

(1)

Roy's Theory

(1)

Watson's Theory

(1)

Benner and Wrubel's Theory

(1)

The Link Between Theory and Knowledge Development in Nursing

(4)

Nursing Research as a Basis for Practice

(16)

Historical Perspective

(1)

Scientific Research in Nursing

(1)

Knowledge Acquisition

(1)

Scientific Method

(1)

Nursing and the Scientific Approach

(3)

Nursing Research

(2)

Research Process

(2)

Conducting Nursing Research

(1)

Ethical Issues in Research

(1)

Rights of Human Subjects

(1)

Applying Research to Nursing Practice

(7)

Research Report Versus Clinical Article

(1)

Locating Research Studies

(1)

Identifying Clinical Nursing Problems

(1)

Research Utilization

(5)

Unit II Caring Throughout the Life Span

Health and Wellness

(17)

Healthy People Documents

(1)

Definition of Health

(1)

Models of Health and Illness

(3)

Health Belief Model

(1)

Health Promotion Model

(1)

Basic Human Needs Model

(1)

Holistic Health Models

(1)

Variables Influencing Health and Health Beliefs and Practices

(2)

Internal Variables

(1)

External Variables

(1)

Health Promotion, Wellness, and Illness Prevention

(1)

Levels of Preventive Care

(1)

Risk Factors

(2)

Genetic and Physiological Factors

(1)

Age

(2)

Environment

(1)

Lifestyle

(1)

Risk Factor Modification and Changing Health Behaviors

(1)

Illness

100

(2)

Acute Illness and Chronic Illness

101

(1)

Illness Behavior

101

(1)

Variables Influencing Illness and Illness Behavior

101

(1)

Impact of Illness on the Client and Family

102

(4)

Behavioral and Emotional Changes

102

(1)

Impact on Body Image

102

(1)

Impact on Self-Concept

103

(1)

Impact on Family Roles

103

(1)

Impact on Family Dynamics

103

(3)

Caring in Nursing Practice

106

(12)

Theoretical Views on Caring

108

(2)

Caring Is Primary

108

(1)

The Essence of Nursing and Health

108

(1)

Transpersonal Caring

108

(1)

Swanson's Theory of Caring

109

(1)

Summary of Theoretical Views

109

(1)

Clients' Perceptions of Caring

110

(1)

Ethic of Care

111

(1)

Caring in Nursing Practice

112

(2)

Providing Presence

112

(1)

Touch

112

(1)

Listening

113

(1)

Knowing the Client

113

(1)

Spiritual Caring

114

(1)

Family Care

114

(1)

The Challenge of Caring

114

(4)

Culture and Ethnicity

118

(21)

Population Diversity

119

(1)

Health Disparities

119

(1)

Understanding Cultural Concepts

119

(3)

Culturally Congruent Care

120

(2)

Cultural Conflicts

122

(1)

Cultural Context of Health and Caring

122

(2)

Cultural Healing Modalities and Healers

123

(1)

Culture-Bound Syndrome

124

(1)

Culture and Life Transitions

124

(4)

Pregnancy

125

(1)

Childbirth

125

(1)

Newborn

125

(1)

Postpartum Period

126

(1)

Grief and Loss

127

(1)

Cultural Assessment

128

(3)

Census Data

129

(1)

Asking Questions

129

(1)

Establishing Relationship

129

(2)

Selected Components of Cultural Assessment

131

(4)

Ethnic Heritage and Ethnohistory

131

(1)

Biocultural History

132

(1)

Social Organization

132

(1)

Religious and Spiritual Beliefs

132

(1)

Communication Patterns

133

(1)

Time Orientation

133

(1)

Caring Beliefs and Practices

134

(1)

Experience With Professional Health Care

134

(1)

Nursing Decisions

135

(4)

Caring for Families

139

(16)

The Family

140

(1)

Concept of Family

141

(1)

Definition: What Is a Family?

141

(1)

Current Trends and New Family Forms

141

(2)

Changing Economic Status

143

(1)

Homelessness

143

(1)

Family Violence

143

(1)

Human Immunodeficiency Virus

143

(1)

Theoretical Approaches: An Overview

143

(1)

Family Health System

144

(1)

Developmental Stages

144

(1)

Attributes of Families

144

(3)

Structure

144

(1)

Function

145

(1)

The Family and Health

146

(1)

Family Nursing

147

(1)

Family as Context

147

(1)

Family as Client

147

(1)

Family as System

147

(1)

Nursing Process for the Family

148

(7)

Assessing the Needs of the Family

148

(1)

Family-Focused Care

149

(1)

Challenges for Family Nursing

150

(1)

Implementing Family-Centered Care

150

(5)

Developmental Theories

155

(16)

Growth and Development

156

(2)

Major Factors Influencing Growth and Development

157

(1)

Developmental Theories

158

(1)

Four Areas of Theory Development

158

(1)

Biophysical Developmental Theories

158

(1)

Gesell's Theory of Development

158

(1)

Psychoanalytic/Psychosocial Theory

159

(5)

Sigmund Freud

159

(1)

Erik Erikson

160

(1)

Robert Havighurst

161

(1)

Roger Gould

162

(2)

Stella Chess and Alexander Thomas

164

(1)

Cognitive Developmental Theory

164

(2)

Jean Piaget's Theory of Cognitive Development

164

(2)

Moral Developmental Theory

166

(5)

Jean Piaget's Moral Developmental Theory

166

(1)

Lawrence Kohlberg's Moral Developmental Theory

166

(2)

Carol Gilligan

168

(3)

Conception Through Adolescence

171

(45)

Stages of Growth and Development

172

(1)

Selecting a Developmental Framework for Nursing

172

(1)

Conception

173

(3)

Intrauterine Life

173

(3)

Transition From Intrauterine to Extrauterine Life

176

(1)

Physical Changes

176

(1)

Psychosocial Changes

176

(1)

Health Risks

177

(1)

Newborn

177

(3)

Physical Changes

177

(2)

Cognitive Changes

179

(1)

Psychosocial Changes

179

(1)

Health Risks

179

(1)

Health Concerns

179

(1)

Infant

180

(9)

Physical Changes

180

(1)

Cognitive Changes

181

(1)

Psychosocial Changes

181

(1)

Health Risks

182

(1)

Health Concerns

182

(7)

Toddler

189

(4)

Physical Changes

189

(1)

Cognitive Changes

189

(1)

Psychosocial Changes

190

(1)

Health Risks

190

(2)

Health Concerns

192

(1)

Preschooler

193

(3)

Physical Changes

193

(1)

Cognitive Changes

193

(1)

Psychosocial Changes

194

(1)

Health Risks

194

(1)

Health Concerns

195

(1)

School-Age Children and Adolescents

196

(2)

School-Age Child

198

(6)

Physical Changes

198

(1)

Cognitive Changes

199

(1)

Psychosocial Changes

200

(1)

Health Risks

201

(2)

Health Concerns

203

(1)

Preadolescent

204

(1)

Adolescent

205

(11)

Physical Changes

205

(3)

Cognitive Changes

208

(1)

Psychosocial Changes

208

(2)

Health Risks

210

(2)

Health Concerns

212

(4)

Young to Middle Adult

216

(18)

Young Adult

218

(8)

Physical Changes

218

(1)

Cognitive Changes

218

(1)

Psychosocial Changes

218

(3)

Health Risks

221

(1)

Health Concerns

222

(4)

Middle Adult

226

(8)

Physical Changes

226

(2)

Cognitive Changes

228

(1)

Psychosocial Changes

228

(1)

Health Concerns

229

(5)

Older Adult

234

(26)

Variability Among Older Adults

236

(1)

Terminology

236

(1)

Myths and Stereotypes

236

(2)

Nurses' Attitudes Toward Older Adults

238

(1)

Theories of Aging

238

(1)

Developmental Tasks for Older Adults

239

(1)

Community-Based and Institutional Health Care Services

240

(1)

Assessing the Needs of Older Adults

241

(7)

Physiological Changes

241

(1)

Cognitive Changes

241

(5)

Psychosocial Changes

246

(2)

Addressing the Health Concerns of Older Adults

248

(7)

Health Promotion and Maintenance: Physiological Concerns

249

(4)

Health Promotion and Maintenance: Psychosocial Health Concerns

253

(2)

Older Adults and the Acute Care Setting

255

(1)

Older Adults and Restorative Care

256

(4)

Unit III Critical Thinking in Nursing Practice

Critical Thinking in Nursing Practice

260

(17)

Clinical Decisions in Nursing Practice

261

(1)

Critical Thinking Defined

262

(2)

Reflection

263

(1)

Language

263

(1)

Intuition

264

(1)

Thinking and Learning

264

(1)

Levels of Critical Thinking in Nursing

265

(1)

Basic Critical Thinking

265

(1)

Complex Critical Thinking

265

(1)

Commitment

265

(1)

Critical Thinking Competencies

265

(4)

Scientific Method

265

(1)

Problem Solving

266

(1)

Decision Making

266

(1)

Diagnostic Reasoning and Inference

267

(1)

Clinical Decision Making

267

(1)

Nursing Process as a Competency

268

(1)

Critical Thinking Model

269

(4)

Specific Knowledge Base

269

(1)

Experience

270

(1)

Attitudes for Critical Thinking

270

(2)

Standards for Critical Thinking

272

(1)

The Nursing Process Competency

273

(1)

Critical Thinking Competencies

273

(4)

Nursing Assessment

277

(22)

Nursing Process Overview

279

(1)

A Critical Thinking Approach to Assessment

279

(5)

Organization of Data Gathering

281

(1)

Data Collection

282

(2)

Types of Data

284

(1)

Sources of Data

284

(1)

Client

284

(1)

Family and Significant Others

284

(1)

Health Care Team Members

284

(1)

Medical Records

285

(1)

Other Records

285

(1)

Literature Review

285

(1)

Nurse's Experience

285

(1)

Methods of Data Collection

285

(7)

Interview

285

(4)

Nursing Health History

289

(2)

Documentation of History Findings

291

(1)

Physical Examination

291

(1)

Diagnostic and Laboratory Data

292

(1)

Formulating Nursing Judgments

292

(1)

Data Validation and Interpretation

292

(1)

Data Clustering

293

(1)

Data Documentation

293

(6)

Nursing Diagnosis

299

(18)

Evolution of Nursing Diagnosis

300

(3)

Critical Thinking and the Nursing Diagnostic Process

303

(3)

Diagnostic Process

303

(3)

Formulation of the Nursing Diagnosis

306

(1)

Components of a Nursing Diagnosis

306

(3)

Diagnostic Label

306

(1)

Related Factors

307

(1)

Definition

307

(1)

Risk Factors

307

(1)

Support of the Diagnostic Statement

307

(2)

Mind Mapping Nursing Diagnosis

309

(1)

Sources of Diagnostic Errors

309

(4)

Errors in Data Collection

309

(2)

Errors in Interpretation and Analysis of Data

311

(1)

Errors in Data Clustering

311

(1)

Errors in the Diagnostic Statement

311

(1)

Nursing Diagnosis and Other Health Care Problems

312

(1)

Nursing Diagnoses: Application to Care Planning

313

(4)

Advantages of Nursing Diagnoses

313

(1)

Limitations of Nursing Diagnoses

314

(3)

Planning Nursing Care

317

(22)

Establishing Priorities

318

(2)

Critical Thinking in Establishing Goals and Expected Outcomes

320

(4)

Goals of Care

320

(2)

Expected Outcomes

322

(1)

Combining Goal and Outcome Statements

322

(1)

Guidelines for Writing Goals and Expected Outcomes

323

(1)

Critical Thinking in Designing Nursing Interventions

324

(3)

Types of Interventions

324

(1)

Selection of Interventions

325

(2)

Planning Nursing Care

327

(8)

Purpose of Care Plans

327

(1)

Student Care Plans

328

(1)

Institutional Care Plans

329

(2)

Concept Maps

331

(4)

Consulting Other Health Care Professionals

335

(4)

When to Consult

336

(1)

How to Consult

336

(3)

Implementing Nursing Care

339

(15)

Types of Nursing Interventions

341

(1)

Protocols and Standing Orders

341

(1)

Critical Thinking in Implementation

342

(2)

Implementation Process

344

(3)

Reassessing the Client

344

(1)

Reviewing and Revising the Existing Nursing Care Plan

344

(1)

Organizing Resources and Care Delivery

344

(2)

Anticipating and Preventing Complications

346

(1)

Implementation Skills

346

(1)

Direct Care

347

(2)

Activities of Daily Living

347

(1)

Instrumental Activities of Daily Living

347

(1)

Physical Care Techniques

347

(1)

Counseling

347

(1)

Teaching

347

(2)

Controlling for Adverse Reactions

349

(1)

Preventive Measures

349

(1)

Indirect Care

349

(1)

Communicating Nursing Interventions

349

(1)

Delegating, Supervising, and Evaluating the Work of Other Staff Members

350

(1)

Achieving Client Goals

350

(4)

Evaluation

354

(16)

Critical Thinking and Evaluation

356

(1)

The Evaluation Process

357

(6)

Identifying Criteria and Standards

357

(4)

Collecting Evaluative Measures

361

(1)

Interpreting and Summarizing Findings

361

(1)

Documenting Findings

362

(1)

Care Plan Revision and Critical Thinking

363

(2)

Discontinuing a Care Plan

363

(1)

Modifying a Care Plan

363

(2)

Quality Improvement

365

(5)

Outcomes Management

366

(4)

Managing Client Care

370

(18)

Building a Nursing Team

371

(5)

Nursing Care Delivery Models

372

(1)

Decentralized Decision Making

373

(3)

Leadership Skills for Nursing Students

376

(4)

Clinical Care Coordination

376

(4)

Quality Management

380

(8)

Quality in Nursing Practice

381

(7)

Unit IV Professional Standards in Nursing Practice

Ethics and Values

388

(17)

Ethics

389

(4)

Basic Terms

389

(2)

Professional Nursing

391

(2)

Values

393

(1)

Value Formation

393

(1)

Values Clarification

393

(1)

Bioethics

394

(3)

Philosophical Constructions

395

(1)

Consensus in Bioethics

396

(1)

Nursing Point of View

397

(1)

How to Process an Ethical Dilemma

397

(2)

Institutional Resources

399

(1)

Issues in Bioethics

400

(5)

Quality of Life

400

(1)

Genetic Screening

400

(1)

Futile Care

401

(1)

Allocation of Scarce Resources: Medical Technologies

401

(1)

Allocation of Scarce Resources: The Nursing Shortage

401

(4)

Legal Implications in Nursing Practice

405

(18)

Legal Limits of Nursing

406

(2)

Sources of Law

406

(1)

Standards of Care

407

(1)

Federal Statutory Issues in Nursing Practice

408

(3)

Americans With Disabilities Act

408

(1)

Emergency Medical Treatment and Active Labor Act

409

(1)

Mental Health Parity Act

409

(1)

Advance Directives

409

(1)

Uniform Anatomical Gift Act

410

(1)

Health Insurance Portability and Accountability Act

411

(1)

Restraints

411

(1)

State Statutory Issues in Nursing Practice

411

(2)

Licensure

411

(1)

Good Samaritan Laws

411

(1)

Public Health Laws

412

(1)

The Uniform Determination of Death Act

412

(1)

Physician-Assisted Suicide

412

(1)

Civil and Common Law Issues in Nursing Practice

413

(6)

Torts

413

(1)

Intentional Torts

413

(1)

Unintentional Torts

414

(1)

Consent

414

(3)

Abortion Issues

417

(1)

Student Nurses

418

(1)

Malpractice Insurance

418

(1)

Abandonment and Assignment Issues

418

(1)

Risk Management

419

(4)

Professional Involvement

419

(4)

Communication

423

(25)

Communication and Nursing Practice

424

(2)

Communication and Interpersonal Relationships

425

(1)

Developing Communication Skills

425

(1)

Levels of Communication

426

(1)

Intrapersonal Communication

427

(1)

Interpersonal Communication

427

(1)

Transpersonal Communication

427

(1)

Small-Group Communication

427

(1)

Public Communication

427

(1)

Basic Elements of the Communication Process

427

(2)

Referent

428

(1)

Sender and Receiver

428

(1)

Messages

428

(1)

Channels

428

(1)

Feedback

428

(1)

Interpersonal Variables

428

(1)

Environment

429

(1)

Forms of Communication

429

(4)

Verbal Communication

429

(1)

Nonverbal Communication

429

(2)

Symbolic Communication

431

(1)

Metacommunication

431

(1)

Professional Nursing Relationships

431

(1)

Nurse-Client Helping Relationships

431

(1)

Nurse-Family Relationships

432

(1)

Nurse-Health Team Relationships

433

(1)

Nurse-Community Relationships

433

(1)

Elements of Professional Communication

433

(1)

Courtesy

433

(1)

Use of Names

433

(1)

Privacy and Confidentiality

433

(1)

Trustworthiness

433

(1)

Autonomy and Responsibility

434

(1)

Assertiveness

434

(1)

Communication Within the Nursing Process

434

(14)

Assessment

434

(2)

Nursing Diagnosis

436

(1)

Planning

436

(1)

Implementation

437

(7)

Evaluation

444

(4)

Client Education

448

(28)

Standards for Client Education

450

(1)

Purposes of Client Education

450

(1)

Maintenance and Promotion of Health and Illness Prevention

450

(1)

Restoration of Health

451

(1)

Coping With Impaired Functioning

451

(1)

Teaching and Learning

451

(3)

Role of the Nurse in Teaching and Learning

452

(1)

Teaching as Communication

453

(1)

Domains of Learning

454

(2)

Cognitive Learning

454

(1)

Affective Learning

455

(1)

Psychomotor Learning

455

(1)

Basic Learning Principles

456

(4)

Motivation to Learn

456

(2)

Ability to Learn

458

(1)

Learning Environment

459

(1)

Integrating the Nursing and Teaching Processes

460

(16)

Assessment

460

(2)

Nursing Diagnosis

462

(1)

Planning

463

(3)

Implementation

466

(6)

Evaluation

472

(4)

Documentation

476

(24)

Confidentiality

478

(1)

Standards

478

(1)

Multidisciplinary Communication Within the Health Care Team

479

(1)

Purposes of Records

479

(2)

Communication

479

(1)

Legal Documentation

480

(1)

Financial Billing

480

(1)

Education

481

(1)

Research

481

(1)

Auditing-Monitoring

481

(1)

Guidelines for Quality Documentation and Reporting

481

(2)

Factual

481

(1)

Accurate

481

(1)

Complete

482

(1)

Current

482

(1)

Organized

483

(1)

Methods of Recording

483

(4)

Narrative Documentation

483

(1)

Problem-Oriented Medical Record

483

(1)

Source Records

484

(1)

Charting by Exception

484

(1)

Case Management Plan and Critical Pathways

485

(2)

Common Record-Keeping Forms

487

(7)

Admission Nursing History Forms

487

(1)

Flow Sheets and Graphic Records

487

(1)

Client Care Summary or Kardex

487

(5)

Acuity Records

492

(1)

Standardized Care Plans

492

(1)

Discharge Summary Forms

492

(2)

Home Care Documentation

494

(1)

Long-Term Health Care Documentation

494

(1)

Computerized Documentation

494

(1)

Reporting

495

(5)

Change-of-Shift Reports

496

(1)

Telephone Reports

497

(1)

Telephone or Verbal Orders

497

(1)

Transfer Reports

497

(1)

Incident Reports

497

(3)

Unit V Psychosocial Basis for Nursing Practice

Self-Concept

500

(22)

Scientific Knowledge Base

501

(1)

Nursing Knowledge Base

502

(8)

Development of Self-Concept

502

(1)

Components and Interrelated Terms of Self-Concept

503

(2)

Stressors Affecting Self-Concept

505

(3)

Family Effect on Self-Concept Development

508

(1)

The Nurse's Effect on the Client's Self-Concept

509

(1)

Critical Thinking

510

(1)

Self-Concept and the Nursing Process

510

(12)

Assessment

510

(2)

Nursing Diagnosis

512

(1)

Planning

513

(3)

Implementation

516

(2)

Evaluation

518

(4)

Sexuality

522

(21)

Scientific Knowledge Base

524

(3)

Sexual Development

524

(1)

Sexual Response Cycle

525

(1)

Sexual Orientation

525

(1)

Contraception

526

(1)

Sexually Transmitted Diseases

526

(1)

Nursing Knowledge Base

527

(4)

Sociocultural Dimensions of Sexuality

527

(1)

Decisional Issues

528

(1)

Alterations in Sexual Health

529

(2)

Critical Thinking

531

(1)

Sexuality and the Nursing Process

531

(12)

Assessment

531

(3)

Nursing Diagnosis

534

(1)

Planning

535

(3)

Implementation

538

(2)

Evaluation

540

(3)

Spiritual Health

543

(24)

Scientific Knowledge Base

545

(1)

Nursing Knowledge Base

545

(4)

Framework of Systemic Organization

545

(1)

Traditional Concepts in Spiritual Health

546

(1)

Spiritual Problems

547

(2)

Critical Thinking

549

(1)

Nursing Process

549

(18)

Assessment

550

(4)

Nursing Diagnosis

554

(2)

Planning

556

(3)

Implementation

559

(4)

Evaluation

563

(4)

The Experience of Loss, Death, and Grief

567

(28)

Scientific Knowledge Base

568

(4)

Loss

568

(2)

Grief

570

(2)

Nursing Knowledge Base

572

(3)

Factors Influencing Loss and Grief

572

(1)

Coping With Grief and Loss

573

(2)

Critical Thinking

575

(1)

The Nursing Process and Grief

575

(20)

Assessment

575

(4)

Nursing Diagnosis

579

(1)

Planning

580

(3)

Implementation

583

(8)

Evaluation

591

(4)

Stress and Coping

595

(22)

Scientific Knowledge Base

596

(5)

Medulla Oblongata

597

(1)

Reticular Formation

597

(1)

Pituitary Gland

597

(1)

General Adaptation Syndrome

597

(2)

Types of Stress

599

(2)

Nursing Knowledge Base

601

(2)

Nursing Theory and the Role of Stress

601

(1)

Situational, Maturational, and Sociocultural Factors

601

(2)

Critical Thinking

603

(1)

Nursing Process

603

(14)

Assessment

603

(2)

Nursing Diagnosis

605

(1)

Planning

606

(2)

Implementation

608

(5)

Evaluation

613

(4)

Unit VI Scientific Basis for Nursing Practice

Vital Signs

617

(54)

Guidelines for Measuring Vital Signs

619

(1)

Body Temperature

620

(17)

Physiology

620

(2)

Factors Affecting Body Temperature

622

(3)

Nursing Process and Thermoregulation

625

(1)

Assessment

625

(1)

Measuring Body Temperature

626

(7)

Nursing Diagnosis

633

(1)

Planning

634

(1)

Implementation

634

(3)

Evaluation

637

(1)

Pulse

637

(8)

Physiology and Regulation

637

(1)

Assessment of Pulse

637

(1)

Character of the Pulse

638

(1)

Assessing the Radial and Apical Pulses

639

(6)

Nursing Process and Pulse Determination

645

(1)

Respiration

645

(5)

Physiological Control

645

(1)

Mechanics of Breathing

645

(1)

Assessment of Ventilation

645

(2)

Assessing Respirations

647

(2)

Assessment of Diffusion and Perfusion

649

(1)

Nursing Process and Respiratory Vital Signs

650

(1)

Blood Pressure

650

(16)

Measuring Oxygen Saturation (Pulse Oximetry)

651

(2)

Physiology of Arterial Blood Pressure

653

(1)

Factors Influencing Blood Pressure

654

(1)

Hypertension

655

(1)

Hypotension

656

(1)

Measurement of Blood Pressure

656

(1)

Measuring Blood Pressure

657

(8)

Nursing Process and Blood Pressure Determination

665

(1)

Health Promotion and Vital Signs

666

(1)

Recording Vital Signs

666

(5)

Health Assessment and Physical Examination

671

(101)

Purposes of Physical Examination

673

(1)

Gathering a Health History

673

(1)

Developing Nursing Diagnoses and a Care Plan

673

(1)

Managing Client Problems

674

(1)

Evaluating Nursing Care

674

(1)

Cultural Sensitivity

674

(1)

Integration of Physical Assessment With Nursing Care

674

(1)

Skills of Physical Assessment

674

(4)

Inspection

674

(1)

Palpation

675

(1)

Percussion

676

(1)

Auscultation

677

(1)

Olfaction

678

(1)

Preparation for Examination

678

(4)

Infection Control

679

(1)

Environment

679

(1)

Equipment

679

(1)

Physical Preparation of the Client

679

(1)

Psychological Preparation of the Client

680

(1)

Assessment of Age-Groups

680

(2)

Organization of the Examination

682

(1)

General Survey

682

(5)

General Appearance and Behavior

682

(3)

Vital Signs

685

(1)

Height, Weight, and Circumference

685

(2)

Skin, Hair, and Nails

687

(9)

Skin

687

(5)

Hair and Scalp

692

(2)

Nails

694

(2)

Head and Neck

696

(20)

Head

696

(1)

Eyes

697

(6)

Ears

703

(4)

Nose and Sinuses

707

(2)

Mouth and Pharynx

709

(3)

Neck

712

(4)

Thorax and Lungs

716

(6)

Posterior Thorax

717

(4)

Lateral Thorax

721

(1)

Anterior Thorax

721

(1)

Heart

722

(5)

Inspection and Palpation

724

(1)

Auscultation

725

(2)

Vascular System

727

(8)

Blood Pressure

727

(1)

Carotid Arteries

727

(2)

Jugular Veins

729

(1)

Peripheral Arteries and Veins

730

(4)

Lymphatic System

734

(1)

Breasts

735

(6)

Female Breasts

735

(6)

Male Breasts

741

(1)

Abdomen

741

(5)

Inspection

742

(1)

Auscultation

743

(1)

Percussion

744

(1)

Palpation

744

(2)

Female Genitalia and Reproductive Tract

746

(4)

Preparation of the Client

746

(1)

External Genitalia

746

(3)

Speculum Examination of Internal Genitalia

749

(1)

Male Genitalia

750

(3)

Sexual Maturity

750

(1)

Penis

751

(2)

Scrotum

753

(1)

Inguinal Ring and Canal

753

(1)

Rectum and Anus

753

(2)

Inspection

753

(1)

Digital Palpation

753

(2)

Musculoskeletal System

755

(3)

General Inspection

755

(2)

Palpation

757

(1)

Range of Joint Motion

757

(1)

Muscle Tone and Strength

758

(1)

Neurological System

758

(9)

Mental and Emotional Status

761

(2)

Intellectual Function

763

(1)

Cranial Nerve Function

764

(1)

Sensory Function

764

(1)

Motor Function

765

(2)

Reflexes

767

(1)

After the Examination

767

(5)

Infection Control

772

(49)

Nature of Infection

773

(4)

Chain of Infection

774

(3)

The Infectious Process

777

(3)

Defenses Against Infection

777

(2)

Nosocomial Infections

779

(1)

The Nursing Process in Infection Control

780

(41)

Assessment

780

(3)

Nursing Diagnosis

783

(1)

Planning

784

(1)

Implementation

784

(6)

Hand Hygiene

790

(16)

Preparation of a Sterile Field

806

(2)

Surgical Hand Hygiene: Preparing for Gowning

808

(3)

Applying a Sterile Gown and Performing closed Gloving

811

(3)

Open Gloving

814

(2)

Evaluation

816

(5)

Medication Administration

821

(89)

Scientific Knowledge Base

823

(14)

Pharmacological Concepts

823

(1)

Medication Legislation and Standards

823

(2)

Pharmacokinetics as the Basis of Medication Actions

825

(4)

Types of Medication Action

829

(1)

Medication Interactions

829

(1)

Medication Dose Responses

830

(1)

Routes of Administration

830

(4)

Systems of Medication Measurement

834

(1)

Clinical Calculations

835

(2)

Administering Medications

837

(3)

Prescriber's Role

837

(1)

Types of Orders

838

(1)

Pharmacist's Role

839

(1)

Distribution Systems

839

(1)

Nurse's Role

840

(1)

Critical Thinking

840

(3)

Experience

840

(1)

Attitudes

840

(1)

Standards

841

(2)

Nursing Process and Medication Administration

843

(7)

Assessment

843

(2)

Nursing Diagnosis

845

(1)

Planning

845

(1)

Implementation

845

(4)

Evaluation

849

(1)

Medication Administration

850

(60)

Oral Administration

850

(1)

Administering Oral Medications

851

(4)

Topical Medication Applications

855

(2)

Administering Nasal Instillations

857

(2)

Administering Ophthalmic Medications

859

(5)

Administering Vaginal Medications

864

(2)

Administering Rectal Suppositories

866

(1)

Administering Medications by Inhalation

867

(1)

Using Metered-Dose or Dry Powder Inhalers

868

(3)

Administering Medications by Irrigation

871

(1)

Administering Parenteral Medications

871

(4)

Preparing Injections

875

(5)

Administering Injections

880

(1)

Administering Injections

881

(13)

Adding Medications to Intravenous Fluid Containers

894

(3)

Administering Medications by Intravenous Bolus

897

(4)

Administering Intravenous Medications by Piggyback, Intermittent Intravenous Infusion Sets, and Miniinfusion Pumps

901

(9)

Complementary and Alternative Therapies

910

(19)

Complementary or Alternative Medicine Therapies in Health Care

912

(2)

Nursing-Accessible Therapies

914

(5)

Relaxation Therapy

916

(2)

Meditation and Breathing

918

(1)

Imagery

918

(1)

Training-Specific Therapies

919

(4)

Biofeedback

919

(1)

Therapeutic Touch

920

(1)

Chiropractic Therapy

921

(1)

Traditional Chinese Medication

921

(1)

Acupuncture

922

(1)

Herbal Therapies

922

(1)

Nursing Role in Complementary and Alternative Therapies

923

(6)

Unit VII Basic Human Needs

Activity and Exercise

929

(30)

Scientific Knowledge Base

931

(3)

Overview of Body Mechanics, Exercise, and Activity

931

(1)

Regulation of Movement

932

(1)

Principles of Body Mechanics

933

(1)

Nursing Knowledge Base

934

(2)

Developmental Changes

934

(1)

Behavioral Aspects

935

(1)

Environmental Issues

935

(1)

Cultural and Ethnic Influences

936

(1)

Family and Social Support

936

(1)

Critical Thinking

936

(1)

Nursing Process

937

(22)

Assessment

937

(2)

Nursing Diagnosis

939

(1)

Planning

940

(1)

Implementation

941

(13)

Evaluation

954

(5)

Client Safety

959

(42)

Scientific Knowledge Base

960

(3)

Environmental Safety

960

(3)

Nursing Knowledge Base

963

(3)

Risks at Developmental Stages

963

(2)

Individual Risk Factors

965

(1)

Risks in the Health Care Agency

965

(1)

Critical Thinking

966

(2)

Safety and the Nursing Process

968

(33)

Assessment

968

(3)

Nursing Diagnosis

971

(1)

Planning

971

(2)

Implementation

973

(11)

Applying Restraints

984

(10)

Seizure Precautions

994

(3)

Evaluation

997

(4)

Hygiene

1001

(65)

Scientific Knowledge Base

1002

(3)

The Skin

1003

(1)

The Feet, Hands, and Nails

1004

(1)

The Oral Cavity

1004

(1)

The Hair

1004

(1)

The Eyes, Ears, and Nose

1004

(1)

Nursing Knowledge Base

1005

(2)

Social Practice

1005

(1)

Personal Preferences

1006

(1)

Body Image

1006

(1)

Socioeconomic Status

1006

(1)

Health Beliefs and Motivation

1006

(1)

Cultural Variables

1006

(1)

Physical Condition

1006

(1)

Critical Thinking

1007

(1)

Nursing Process

1008

(58)

Assessment

1008

(7)

Nursing Diagnosis

1015

(2)

Planning

1017

(1)

Implementation

1018

(5)

Bathing a Client

1023

(8)

Perineal Care

1031

(4)

Performing Nail and Foot Care

1035

(6)

Providing Oral Hygiene

1041

(3)

Performing Mouth Care for an Unconscious or Debilitated Client

1044

(12)

Making an Occupied Bed

1056

(5)

Evaluation

1061

(5)

Oxygenation

1066

(68)

Scientific Knowledge Base

1067

(13)

Cardiovascular Physiology

1067

(3)

Respiratory Physiology

1070

(2)

Factors Affecting Oxygenation

1072

(2)

Alterations in Cardiac Functioning

1074

(5)

Alterations in Respiratory Functioning

1079

(1)

Nursing Knowledge Base

1080

(2)

Developmental Factors

1080

(1)

Lifestyle Risk Factors

1080

(1)

Environmental Factors

1081

(1)

Critical Thinking

1082

(1)

Nursing Process

1082

(52)

Assessment

1082

(9)

Nursing Diagnosis

1091

(1)

Planning

1092

(1)

Implementation

1093

(8)

Suctioning

1101

(9)

Care of an Artificial Airway

1110

(8)

Care of Clients With Chest Tubes

1118

(5)

Applying a Nasal Cannula or Oxygen Mask

1123

(4)

Using Home Liquid Oxygen Equipment

1127

(3)

Evaluation

1130

(4)

Fluid, Electrolyte, and Acid-Base Balances

1134

(64)

Scientific Knowledge Base

1135

(11)

Distribution of Body Fluids

1136

(1)

Composition of Body Fluids

1136

(1)

Movement of Body Fluids

1136

(1)

Regulation of Body Fluids

1137

(2)

Regulation of Electrolytes

1139

(1)

Regulation of Acid-Base Balance

1140

(1)

Disturbances in Electrolyte, Fluid, and Acid-Base Balances

1141

(5)

Nursing Knowledge Base

1146

(1)

Critical Thinking

1146

(52)

Nursing Process

1146

(1)

Assessment

1146

(6)

Nursing Diagnosis

1152

(3)

Planning

1155

(2)

Implementation

1157

(5)

Initiating a Peripheral Intravenous Infusion

1162

(13)

Regulating Intravenous Flow Rate

1175

(7)

Maintenance of IV System

1182

(5)

Changing a Peripheral Intravenous Dressing

1187

(6)

Evaluation

1193

(5)

Sleep

1198

(30)

Scientific Knowledge Base

1200

(6)

Physiology of Sleep

1200

(1)

Functions of Sleep

1201

(1)

Physical Illness

1202

(1)

Sleep Disorders

1203

(3)

Nursing Knowledge Base

1206

(3)

Sleep and Rest

1206

(1)

Normal Sleep Requirements and Patterns

1206

(1)

Factors Affecting Sleep

1207

(2)

Critical Thinking

1209

(1)

Nursing Process

1210

(18)

Assessment

1210

(3)

Nursing Diagnosis

1213

(2)

Planning

1215

(2)

Implementation

1217

(6)

Evaluation

1223

(5)

Comfort

1228

(43)

Scientific Knowledge Base

1230

(4)

Nature of Pain

1230

(1)

Physiology of Pain

1230

(3)

Types of Pain

1233

(1)

Nursing Knowledge Base

1234

(5)

Knowledge, Attitudes, and Beliefs

1235

(1)

Factors Influencing Pain

1236

(3)

Critical Thinking

1239

(1)

Nursing Process and Pain

1239

(32)

Assessment

1240

(6)

Nursing Diagnosis

1246

(1)

Planning

1247

(1)

Implementation

1248

(16)

Evaluation

1264

(7)

Nutrition

1271

(51)

Scientific Knowledge Base

1273

(6)

Nutrients: The Biochemical Units of Nutrition

1273

(2)

Anatomy and Physiology of the Digestive System

1275

(3)

Dietary Guidelines

1278

(1)

Nursing Knowledge Base

1279

(6)

Nutrition During Human Growth and Development

1279

(6)

Alternative Food Patterns

1285

(1)

Critical Thinking

1285

(1)

Nursing Process and Nutrition

1286

(36)

Assessment

1286

(4)

Nursing Diagnosis

1290

(1)

Planning

1291

(4)

Implementation

1295

(5)

Inserting a Small-Bore Nasoenteric Tube for Enteral Feedings

1300

(5)

Administering Enteral Feedings via Nasoenteric Tubes

1305

(4)

Administering Enteral Feedings via Gastrostomy or Jejunostomy Tube

1309

(8)

Evaluation

1317

(5)

Urinary Elimination

1322

(51)

Scientific Knowledge Base

1323

(7)

Kidneys

1323

(1)

Ureters

1324

(1)

Bladder

1325

(1)

Urethra

1325

(1)

Act of Urination

1325

(5)

Nursing Knowledge Base

1330

(1)

Infection Control and Hygiene

1330

(1)

Growth and Development

1330

(1)

Psychosocial Considerations

1330

(1)

Critical Thinking

1331

(1)

Nursing Process and Alterations in Urinary Function

1331

(42)

Assessment

1331

(5)

Collecting Midstream (Clean-Voided) Urine Specimen

1336

(4)

Nursing Diagnosis

1340

(1)

Planning

1340

(3)

Implementation

1343

(8)

Inserting a Straight or an Indwelling Catheter

1351

(8)

Indwelling Catheter Care

1359

(3)

Closed and Open Catheter Irrigation

1362

(7)

Evaluation

1369

(4)

Bowel Elimination

1373

(47)

Scientific Knowledge Base

1374

(2)

Mouth

1374

(1)

Esophagus

1375

(1)

Stomach

1375

(1)

Small Intestine

1375

(1)

Large Intestine

1375

(1)

Anus

1376

(1)

Defecation

1376

(1)

Nursing Knowledge Base

1376

(5)

Factors Affecting Bowel Elimination

1376

(3)

Common Bowel Elimination Problems

1379

(1)

Bowel Diversions

1380

(1)

Critical Thinking

1381

(1)

Nursing Process and Bowel Elimination

1381

(39)

Assessment

1381

(6)

Nursing Diagnosis

1387

(1)

Planning

1387

(5)

Implementation

1392

(7)

Administering a Cleansing Enema

1399

(4)

Inserting and Maintaining a Nasogastric Tube

1403

(8)

Pouching an Ostomy

1411

(5)

Evaluation

1416

(4)

Unit VIII Clients With Special Needs

Mobility and Immobility

1420

(62)

Scientific Knowledge Base

1421

(6)

Physiology and Principles of Body Mechanics

1421

(1)

Regulation of Movement

1422

(3)

Pathological Influences on Mobility

1425

(2)

Nursing Knowledge Base

1427

(5)

Mobility-Immobility

1427

(5)

Critical Thinking

1432

(1)

Nursing Process for Impaired Body Alignment and Mobility

1433

(49)

Assessment

1433

(10)

Nursing Diagnosis

1443

(1)

Planning

1444

(3)

Implementation

1447

(11)

Moving and Positioning Clients in Bed

1458

(10)

Using Safe and Effective Transfer Techniques

1468

(11)

Evaluation

1479

(3)

Skin Integrity and Wound Care

1482

(83)

Scientific Knowledge Base

1483

(11)

Skin

1483

(1)

Pressure Ulcers

1484

(3)

Classification of Pressure Ulcers

1487

(1)

Wound Classifications

1487

(7)

Nursing Knowledge Base

1494

(6)

Prediction and Prevention of Pressure Ulcers

1494

(2)

Factors Influencing Pressure Ulcer Formation and Wound Healing

1496

(4)

Critical Thinking

1500

(1)

Nursing Process

1501

(64)

Assessment

1501

(3)

Assessment for Risk of Pressure Ulcer Development

1504

(5)

Nursing Diagnosis

1509

(1)

Planning

1509

(4)

Implementation

1513

(6)

Treating Pressure Ulcers

1519

(10)

Applying Dry and Wet-To-Dry Moist Dressings

1529

(9)

Implementation of Vacuum Assisted Wound Closure

1538

(6)

Performing Wound Irrigation

1544

(6)

Applying an Abdominal or Breast Binder

1550

(2)

Applying an Elastic Bandage

1552

(5)

Applying a Warm, Moist Compress to an Open Wound

1557

(3)

Evaluation

1560

(5)

Sensory Alterations

1565

(28)

Scientific Knowledge Base

1567

(2)

Normal Sensation

1567

(1)

Sensory Alterations

1568

(1)

Nursing Knowledge Base

1569

(2)

Factors Affecting Sensory Function

1569

(2)

Critical Thinking

1571

(1)

Nursing Process

1571

(22)

Assessment

1571

(5)

Nursing Diagnosis

1576

(1)

Planning

1577

(3)

Implementation

1580

(9)

Evaluation

1589

(4)

Care of Surgical Clients

1593

(52)

History of Surgical Nursing

1595

(1)

Ambulatory Surgery

1595

(1)

Scientific Knowledge Base

1595

(1)

Classification of Surgery

1595

(1)

Nursing Knowledge Base

1595

(2)

Critical Thinking

1597

(1)

The Nursing Process in the Preoperative Surgical Phase

1598

(26)

Assessment

1598

(9)

Nursing Diagnosis

1607

(1)

Planning

1607

(3)

Implementation

1610

(8)

Demonstrating Postoperative Exercises

1618

(4)

Evaluation

1622

(2)

Transport to the Operating Room

1624

(1)

Intraoperative Surgical Phase

1625

(1)

Preoperative (Holding) Area

1625

(1)

Admission to the Operating Room

1626

(1)

The Nursing Process in the Intraoperative Surgical Phase

1626

(2)

Assessment

1626

(1)

Nursing Diagnosis

1626

(1)

Planning

1626

(1)

Implementation

1626

(2)

Evaluation

1628

(1)

Postoperative Surgical Phase

1628

(3)

Immediate Postoperative Recovery

1628

(1)

Discharge From the Postanesthesia Care Unit

1629

(2)

Recovery in Ambulatory Surgery

1631

(1)

Postoperative Convalescence

1631

(1)

The Nursing Process in Postoperative Care

1631

(14)

Assessment

1631

(3)

Nursing Diagnosis

1634

(1)

Planning

1634

(1)

Implementation

1635

(6)

Evaluation

1641

(4)

Review Question Answers

1645

(3)

Review Question Rationales

1648

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Fundamentals of Nursing

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