Fundamental Concepts and Skills for Nursing

7th Edition - November 22, 2024
Imprint: Saunders
Author: Patricia A. Williams
Language: English
Paperback ISBN:
9 7 8 - 0 - 4 4 3 - 2 4 5 2 3 - 7
eBook ISBN:
9 7 8 - 0 - 4 4 3 - 2 4 5 9 9 - 2
eBook ISBN:
9 7 8 - 0 - 4 4 3 - 2 4 5 9 8 - 5

Learn the basic concepts and fundamental skills that LPN/LVNs need in current practice! Fundamental Concepts and Skills for Nursing, 7th Edition, prepares you for nursing practice… Read more

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Learn the basic concepts and fundamental skills that LPN/LVNs need in current practice! Fundamental Concepts and Skills for Nursing, 7th Edition, prepares you for nursing practice in a variety of care settings, including hospitals, long-term care facilities, medical offices, clinics, surgery centers, and home care agencies. Illustrated, easy-to-read guidelines provide a thorough understanding of the nursing process and problem solving, addressing topics such as the physiologic and psychosocial needs of the patient, critical thinking and clinical judgment, communication, collaboration with the health care team, patient teaching, and cultural competence. Ideal for LPN/LVN programs with a concept-based curriculum, this text prepares you to pass the Next Generation NCLEX-PN® Exam and succeed in any care setting.

Title of Book
Cover image
Title page
Table of Contents
Copyright
Dedication
Contributors and Reviewers
Contributors
Reviewers
To the Instructor
Organization of the Text
Content
Special Features
LPN Threads
Teaching and Learning Package
For the Instructor
For the Student
To the Student
Reading and Review Tools
Chapter Features
Acknowledgments
Unit I. Introduction to Nursing and the Health Care System
1. Nursing and the Health Care System
Historical Overview
Nursing in England and Throughout Europe
Florence Nightingale
Nursing in North America
The Art and Science of Nursing
Evidence-Based Practice
Current Nursing Practice
Professional Behaviors
Communication
Assessment
Planning
Caring Interventions
Managing
Nursing Education Pathways
Practical Nursing
Registered Nursing
Advanced Practice Nursing
Delivery of Nursing Care
Delivery Care Systems
Practice Settings
Essentials Domains
Essentials Concepts
Today’s Health Care System
Health Maintenance Organizations
Preferred Provider Organizations
Cost Containment
The Patient Protection and Affordable Care Act
Key Points
Additional Learning Resources
Online Resources
Scenario A
Scenario B
Scenario C
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Chapter Outline
2. Concepts of Health, Illness, Stress, and Health Promotion
Health and Illness
Traditional Views of Health and Illness
Traditional Views
Stages of Illness
Transition Stage
Acceptance Stage
Convalescence Stage
Current Views of Health and Illness
Implications of Current Views
The Consumer Concept of Health and Illness
Health and Illness Behaviors
Cultural Influences on Concepts of Health and Illness
The Holistic Approach
Components of Holistic Care
Maslow’s Theory of Basic Needs
Physiologic Needs
Security and Belonging
Self-Esteem and Love
Self-Actualization
Homeostasis
Adaptation
General Adaptation Syndrome
The Effects of Stress
Coping With Stress
Defense Mechanisms
Physical Effects
Psychological Effects
Stress-Reduction Techniques
Health Promotion and Illness Prevention
Primary Prevention
Secondary Prevention
Tertiary Prevention
Key Points
Additional Learning Resources
Online Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Chapter Outline
3. Legal and Ethical Aspects of Nursing
Source of Law
Civil and Criminal Law
Laws Related to Nursing Practice and Licensure
Nurse Practice Act
Scope of Practice
Licensure
Student Nurses
Professional Accountability
Delegation
Standards of Care
Professional Discipline
Continuing Education
Laws and Guidelines Affecting Nursing Practice
Occupational Safety and Health Administration
What to Expect During Your Hospital Stay
Child Abuse Prevention and Treatment Act
Discrimination
Sexual Harassment
Good Samaritan Laws
Patient’s Rights
National Patient Safety Goals
Legal Documents
The Health Record
Health Insurance Portability and Accountability Act
Consents and Releases
Witnessing Wills or Other Legal Documents
Advance Directives
Violations of Law
Negligence and Malpractice
Common Legal Issues
Assault and Battery
Defamation
Invasion of Privacy
False Imprisonment
Decreasing Legal Risk
Nursing Competence
Incident or Occurrence Reports
Malpractice Insurance
1 Maintain Competence
2 Document Fully
3 Establish Rapport
4 Communicate Effectively
5 Take Care of Yourself
Ethics in Nursing
Codes of Ethics
Ethics Committees
Ethical Dilemmas
Key Points
Additional Learning Resources
Online Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
Chapter Outline
Unit II. The Nursing Process
4. The Nursing Process, Critical Thinking, and Clinical Judgment
The Nursing Process
Critical Thinking
Problem Solving and Decision-Making
Skills for Critical Thinking
Critical Thinking in Nursing: The Nursing Process and Clinical Judgment Measurement Model
Priority Setting and Work Organization
Application of Problem Solving, Clinical Reasoning, and Using the Clinical Judgment Measurement Model
Key Points
Additional Learning Resources
Online Resource
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
Chapter Outline
5. Assessment, Data Analysis/Problem Identification, and Planning
Assessment (Data Collection)
Functional
Dysfunctional
The Interview
Health Records Review
Physical Assessment
Initial Observation
Head
Vital Signs
Heart and Lung Assessment, Neurologic Check
Abdomen
Extremities
Tubes and Equipment Present
Pain Status
Assessment in Long-Term Care
Assessment in Home Health Care
Data Analysis/Problem Identification
Defining Characteristics
Prioritization of Problems
Problem Statements in Long-Term Care
Problem Statements in Home Health Care
Planning
Expected Outcomes (Goals)
Planning in Long-Term Care Facilities
Planning in Home Health Care
Interventions (Nursing Orders)
Documentation of the Plan
Key Points
Additional Learning Resources
Online Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
Scenario D
Chapter Outline
6. Implementation and Evaluation
Implementation
Priority Setting
Implementation
Standard F states
Evaluation
Standard C states
Standard D states
Considerations for Care Delivery
Interprofessional Care
Implementing Care
Implementation in Long-Term Care
Implementation in Home Health Care
At the Beginning of the Procedure
During the Procedure
At the End of the Procedure
Documentation of the Nursing Process
Evaluation
Evaluation in Long-Term Care
Evaluation in Home Health Care
Revision of the Nursing Care Plan
Quality Improvement
Constructing a Nursing Care Plan
Key Points
Additional Learning Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
Chapter Outline
Unit III. Communication in Nursing
7. Documentation of Nursing Care
Documentation and the Health Record
Purposes of Documentation
Documentation and the Nursing Process
The Health Record
Methods of Documentation (Charting)
Source-Oriented or Narrative Documentation
Problem-Oriented Medical Record Documentation (POMR)
Focus Documentation (F-DAR)
SOAP Documentation
Problem Identification, Interventions, and Evaluation Documentation (PIE Charting)
Charting by Exception
Electronic Documentation
Case Management System Documentation
The Documentation Process
Basic Principles of Documentation
Accuracy in Documentation
Objectivity in Documentation
Brevity and Completeness in Documentation
What to Document
General Documentation Guidelines
Key Points
Additional Learning Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Chapter Outline
8. Communication and the Nurse–Patient Relationship
The Communication Process
Factors Affecting Communication
Cultural Differences
Past Experience
Emotions, Mood, and Environment
Attitude, Perceptions, and Self-Concept
Communication Skills
Active Listening
Interpreting Nonverbal Messages
Obtaining Feedback
Focusing
Adjusting Style
Therapeutic Communication Techniques
Using Silence
Asking Open-Ended Questions
Restating
Clarifying
Using Touch
Using General Leads
Offering of Self
Encouraging Elaboration
Providing Patient Education
Looking at Alternatives
Summarizing
Blocks to Effective Communication
Changing the Subject
Offering False Reassurance
Giving Advice
Using Defensive Comments
Asking Prying or Probing Questions
Using Clichés
Listening Inattentively
Interviewing Skills
The Nurse–Patient Relationship
Empathy
Becoming Nonjudgmental
Maintaining Hope
Application of the Nursing Process/Clinical Judgment Measurement Model
Nurse–Patient Communication
Communicating With the Hearing-Impaired Patient
Communicating With an Aphasic Patient
Communicating With Older Adults
Communicating With Children
Communication Within the Health Care Team
End-of-Shift Report
Telephoning Primary Care Providers
Assignment Considerations and Delegating
Computer Communication
Communication in the Home and Community
Key Points
Additional Learning Resources
Online Resource
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
Chapter Outline
9. Patient Education and Health Promotion
Purposes of Patient Education
Goals of Patient Education
Modes of Learning
Assessment of Learning Needs
Priorities in Learning
Factors Affecting Learning
Readiness to Learn
Cultural Values and Expectations
Confidence and Ability
The Patient Education Plan
Resources for Patient Education
Implementing the Plan
Evaluation
Documentation
Coordination with Discharge Planning
Key Points
Additional Learning Resources
Online Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
Chapter Outline
10. Delegation, Leadership, and Management
Leadership and the Chain of Command
The Chain of Command
Leadership Styles
Keys to Effective Leadership
Effective Communication and Relationships
Professional Behaviors
Clinical Competence and Confidence
Organization
Delegation
Leadership Roles
Beginning Leadership Roles
Advanced Leadership Roles
Critical Thinking Questions
Management Skills for the Licensed Practical Nurse/Licensed Vocational Nurse
Time Management
Using the Computer or Tablet
Receiving new Orders
Taking Verbal Orders
Documenting for Reimbursement
Risk Management
Key Points
Additional Learning Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
Chapter Outline
Unit IV. Developmental, Psychosocial, and Cultural Considerations
11. Growth and Development: Infancy Through Adolescence
Overview of Structure and Function
Prenatal Development
What Happens in the Germinal Stage of Prenatal Development?
What Happens in the Embryonic Stage of Prenatal Development?
What Happens in the Fetal Stage of Prenatal Development?
What Causes Multiple Births?
Adolescent Development
How Does a Girl Mature Into a Woman?
How Does a Boy Mature Into a Man?
Theories and Principles of Growth and Development
Age Groups
Theories of Development
Principles of Growth and Development
Prenatal Development
Events in Prenatal Development
Maternal Influences
Infants
Nutrition
Appearance and Capabilities of Newborns
Physical Development
Motor Development
Cognitive Development
Psychosocial Development
Young Children
Physical Development
Motor Development
Cognitive Development
Psychosocial Development
Day Care and Early Education
Middle and Older Children
Physical Development
Cognitive Development
Psychosocial Development
Parenting
Child Abuse
Adolescents
Physical Development
Sexuality
Cognitive Development
Psychosocial Development
Tasks of Adolescence
Concerns in Adolescent Development
Pregnancy
Employment
Substance Abuse
Eating Disorders
Mental Health
Early Deaths
Key Points
Additional Learning Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Chapter Outline
12. Adulthood and the Family
Adulthood as Continuing Change
Theories of Development
Schaie’s Theory of Cognitive Development
Erikson’s Stages of Adult Psychosocial Development
Families
Types of Families
Historical Changes in Families
Divorce and Families
Young Adults
Physical Development
Health Concerns of Young Adults
Risky Behavior
Stress-Related Illness
Early Disease
Cognitive Development
Continuing Education
Careers and Work
Psychosocial Development
Developmental Tasks
Marriage
Parenting
Home Management
Developing a Social Group
Community Responsibility
Middle Adulthood
Physical Development
Health Concerns
Cognitive Development
Working Life
Lifelong Learning
Psychosocial Development
Marriage
Friendships
Parenting
Caring for Parents
Generativity
Key Points
Additional Learning Resources
Online Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Chapter Outline
13. Promoting Healthy Adaptation to Aging
Overview of Aging
Theories of Aging
Longevity
Demographics
Physical Changes
Health Concerns
Health Promotion Behaviors
Cognitive Aspects of Aging
Wisdom and Learning
Memory Issues
Employment and Retirement
Health Promotion Behaviors
Psychosocial Aspects of Aging
Life Review
Family Relationships
Social Activity
Living Arrangements
Health Promotion Behaviors
When a Parent Needs Help
Planning Ahead
Observing Changes
Resources for Families
Key Points
Additional Learning Resources
Online Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Chapter Outline
14. Cultural and Spiritual Aspects of Patient Care
Transcultural Care
What Is Culture?
Understanding Spirituality
Major Religions in the United States and Canada
Christianity
Roman Catholic
Eastern Orthodox
Islam
Judaism
Orthodox Judaism
Reform Judaism
Hinduism, Buddhism, and Taoism
Developing Cultural Congruence
Terminology for Cultural Congruence
Barriers to Cultural Congruence
Cultural Differences
Communication
View of Time
Personal Space
Family Organization and Structure
Nutritional Practices
Death and Dying
Healthcare Beliefs
Susceptibility to Disease
Nursing Process and Clinical Judgment Measurement Model in Transcultural Nursing
Assessment (Data Collection)
Data Analysis/Problem Identification
Planning
Implementation
Evaluation
Key Points
Additional Learning Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
Chapter Outline
15. Sexuality and Patient Care
Gender and Sexuality
Person-Centered Communication
Influences on Sexuality
Sexuality and Gender Across the Lifespan
Toddlerhood and Young Childhood
Grade School Age
Adolescence and Young Adulthood
Older Adulthood
Sexuality in Health Care
Collecting Sexual Data
Sexual Dysfunction
Partners
Practices
Protections From Sexually Transmitted Infections
Past History of Sexually Transmitted Infections
Pregnancy
Scenario
Problem Statement
Supporting Assessment Data
Applying Clinical Judgment
Key Points
Additional Learning Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
Chapter Outline
16. Loss, Grief, and End-of-Life Care
Nurses’ Attitudes Toward End-of-Life Care
Change, Loss, and Grief
Change
Loss
Grief
Stages of Grief
Death and Dying
End-of-Life Care Within the Health Care System
Hospice and Palliative Care
The Dying Process
Theories of Death and Dying and Emergence of Thanatology
Scenario
Problem Statement
Supporting Assessment Data
Applying Clinical Judgment
Nursing and the Dying Process
Application of the Nursing Process/Clinical Judgment Measurement Model
Assessment (Data Collection)
Use Analgesia Cautiously
Data Analysis/Problem Identification
Planning
Implementation
Common Problems of the Dying Patient and Nursing Management
Evaluation
Signs of Impending Death
Physical Signs
Psychosocial and Spiritual Aspects of Dying
Legal and Ethical Aspects of Life-and-Death Issues
Advance Directives
Euthanasia
Adequate Pain Control
Organ and Tissue Donation
Postmortem (After Death) Care
Supplies
Action (Rationale)
Assessment
Planning
Implementation
Evaluation
Documentation
Documentation Example
Critical Thinking Questions
Key Points
Additional Learning Resources
Online Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Chapter Outline
Unit V. Basic Nursing Skills
17. Infection Prevention and Control:: Protective Mechanisms and Asepsis
Infectious Agents
Bacteria
Prions
Protozoa
Viruses
Rickettsia
Fungi
Helminths
Other Infectious Agents
Process (Chain) of Infection
Causative Agent (Link One)
Reservoir (Link Two)
Portal of Exit (Link Three)
Mode of Transfer (Link Four)
Portal of Entry (Link Five)
Susceptible Host (Link Six)
Susceptibility of the Older Adult
Body Defenses Against Infection
Inflammatory Response
Immune Response
Asepsis and Control of Microorganisms
Medical Asepsis and Surgical Asepsis
Hand Hygiene
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Special Considerations
Hand Hygiene With Approved Alcohol-Based Hand Rub Agent
Special Considerations
Critical Thinking Questions
Standard Precautions
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Removing Personal Protective Equipment
Evaluation
Documentation
Documentation Example
Gown
Mask
Protective Eyewear
Head Cover
Shoe Covers
Gloves
Disposal of Sharps
Critical Thinking Questions
Action (Rationale)
Needle Stick Injuries
Biohazardous Waste
Cleaning and Disinfection
Scenario
Problem Statement
Supporting Assessment Data
Problem Statement
Supporting Assessment Data
Applying Clinical Judgment
Scenario
Problem Statement
Supporting Assessment Data
Problem Statement
Supporting Assessment Data
Sterilization
Applying Clinical Judgment
Sepsis in the Home Environment
Infection Control Surveillance
Key Points
Additional Learning Resources
Online Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
Scenario D
Chapter Outline
18. Infection Prevention and Control in the Hospital and Home
Infection
Stages of Infection
Health Care–Associated Infections
Infection Prevention and Control
Standard Precautions
Airborne Precautions
Droplet Precautions
Contact Precautions
Personal Protective Equipment
Application of the Nursing Process/Clinical Judgment Measurement Model
Assessment (Data Collection)
Data Analysis/Problem Identification
Planning
Implementation
Scenario
Problem Statement
Supporting Assessment Data
Problem Statement
Supporting Assessment Data
Problem Statement
Supporting Assessment Data
Applying Clinical Judgment
Scenario
Problem Statement
Supporting Assessment Data
Problem Statement
Supporting Assessment Data
Problem Statement
Supporting Assessment Data
General Guidelines for Isolation Precautions
Infection Prevention and Control in the Home
Protective Environment
Psychological Aspects of Isolation
Infection Prevention and Control for the Nurse
Surgical Asepsis
Applying Clinical Judgment
Airborne Precautions
Droplet Precautions
Contact Precautions
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Critical Thinking Questions
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Critical Thinking Questions
Evaluation
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Adding Supplies or Equipment to the Sterile Field
Evaluation
Documentation
Example
Special Considerations
Critical Thinking Questions
Action (Rationale)
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Gloving
Ungloving
Evaluation
Documentation
Critical Thinking Questions
Key Points
Additional Learning Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
Chapter Outline
19. Safely Lifting, Moving, and Positioning Patients
Overview of the Structure and Function of the Musculoskeletal System
Which Structures Are Involved in Positioning and Moving Patients?
What Are the Functions of Bones for Positioning and Moving Patients?
What Are the Functions of Muscles for Positioning and Moving Patients?
What Changes in the System Occur With Aging?
Principles of Body Movement for Nurses
Obtain Help Whenever Possible
Use Your Leg Muscles
Provide Stability for Movement
Use Smooth, Coordinated Movements
Keep Loads Close to the Body
Keep Loads Near the Center of Gravity
Pull and Pivot
Principles of Body Movement for Patients
Hazards of Improper Alignment and Positioning
Pressure Injuries
Application of the Nursing Process/Clinical Judgment Measurement Model
Assessment (Data Collection)
Data Analysis/Problem Identification
Planning
Implementation
Positioning
Common Positions and Their Variations
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Supine Position
Fowler and Semi-Fowler Positions
Side-Lying Position
Side-Lying Oblique Position
Modified Left Lateral Recumbent Position
Prone Position
Completing Care
Evaluation
Documentation
Documentation Example
Special Considerations
After Positioning a Patient, Check the Following Areas to Prevent Possible Problems
Supine Position
Fowler and Semi-Fowler Positions
Side-Lying Position
Modified Left Lateral Recumbent Position
Prone Position
Moving Patients Up in Bed
Critical Thinking Questions
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
For the Patient Who Can Assist
For the Patient Who Needs Assistance (1 or 2 Nurses)
For the Immobile Patient (1 Nurse)
For the Immobile Patient (2 Nurses With a Lift Sheet)
Completing Care
Evaluation
Documentation
Documentation Example
Therapeutic Exercise
Critical Thinking Questions
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Special Considerations
Lifting and Transferring
Transferring Devices
Critical Thinking Questions
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Transferring the Patient Back to the Bed (a Reversal of the Procedure)
Evaluation
Documentation
Documentation Example
Special Considerations
Critical Thinking Questions
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Critical Thinking Questions
Evaluation
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Ambulating the Patient
Breaking a Patient’s Fall
Assisting the Patient Back to Bed After Ambulating
Evaluation
Documentation
Documentation Example
Documentation Example
Special Considerations
Critical Thinking Questions
Scenario
Problem Statement
Supporting Assessment Data
Applying Clinical Judgment
Key Points
Additional Learning Resources
Online Resource
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
Chapter Outline
20. Assisting With Hygiene, Personal Care, Skin Care, and the Prevention of Pressure Injuries
Overview of the Structure and Function of the Integumentary System
What Is the Structure of the Skin?
What Are the Functions of the Skin and Its Structures?
What Changes in the System Occur With Aging?
Application of the Nursing Process/Clinical Judgment Measurement Model
Assessment (Data Collection)
Factors Affecting Hygiene
Skin and Pressure Injuries
Data Analysis/Problem Identification
Planning
Implementation
Bathing
Early Morning Care
AM Care or Morning Care
Afternoon Care
Hour-of-Sleep Care (Bedtime)
Supplies
For Perineal Care
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
For Prescription Female Perineal Care
Completing Care
Evaluation
Documentation
Documentation Example
Home Care Considerations
Critical Thinking Questions
Action (Rationale)
Scenario
Problem Statement
Supporting Assessment Data
Back Massage
Perineal Care
Mouth Care
Applying Clinical Judgment
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Hair Care
Critical Thinking Questions
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Nail Care
Critical Thinking Questions
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Eye Care
Critical Thinking Questions
Action (Rationale)
Shaving a Male Patient With a Safety Razor
Shaving a Male Patient With an Electric Razor
Ear Care
Evaluation
Key Points
Additional Learning Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
21. Patient Environment and Safety
Factors Affecting the Environment
Temperature
Ventilation
Humidity
Lighting
Odor Control
Noise Control
Interior Design
Neatness
Privacy
Patient Unit
Beds
Bed Positions
Bed Making
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Make the Bed on One Side
Make the Bed on the Other Side
Evaluation
Documentation
Documentation Example
Critical Thinking Questions
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Special Considerations
Home Care Considerations
Critical Thinking Questions
Safety
In the Home
Hazards
Falls
Burns
Smoking
Fire
Hazardous Materials
Biohazards
Bioterrorism and Other Terrorism Agents
Poison
Restraints and Supportive Devices
Legal Implications of Using Restraints and Supportive Devices
Alternatives to Restraints and Supportive Devices
Principles Related to the Use of Restraints and Supportive Devices
Documentation of the Use of Restraints and Supportive Devices
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
For the Security or Safety Belt
For a Chair With a Tabletop
For Extremity Immobilizers
For a Mitten or Hand Mitt
Evaluation
Documentation
Documentation Examples
Home Care Considerations
Critical Thinking Questions
Scenario
Problem Statement
Supporting Assessment Data
Applying Clinical Judgment
Key Points
Additional Learning Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
Scenario D
22. Measuring Vital Signs
Overview of Structure and Function Related to the Regulation of Vital Signs
How Is Body Heat Produced?
What Factors Affect Body Heat Production?
How Is Body Temperature Regulated?
How Does Fever Occur, and What Are Its Physiologic Effects?
What Physiologic Mechanisms Control the Pulse?
What Is Respiration?
What Are the Organs of Respiration?
How Is Respiration Controlled?
What Is Blood Pressure?
What Physiologic Factors Directly Affect Blood Pressure?
What Changes Occur in Vital Signs With Aging?
Measuring Body Temperature
Factors Influencing Temperature Readings
Problems of Temperature Regulation
Hyperthermia
Hypothermia
Taking Body Temperature
Taking an Oral Temperature
Taking a Rectal Temperature
Taking an Axillary Temperature
Glass Thermometers
Reading the Glass Thermometer
Electronic Thermometers
Tympanic Thermometers
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Special Considerations
Temporal Artery Skin Thermometer
Critical Thinking Questions
Disposable Thermometers
Supplies
Action (Rationale)
Assessment (Data Collection)
For a Tympanic Thermometer
Planning
Implementation
For a Temporal Artery Thermometer
Evaluation
Documentation
Documentation Example
Special Considerations
Critical Thinking Questions
Application of the Nursing Process/Clinical Judgment Measurement Model
Assessment (Data Collection)
Data Analysis/Problem Identification
Planning
Implementation
Evaluation
Scenario
Problem Statement
Supporting Assessment Data
Applying Clinical Judgment
Measuring the Pulse
Common Pulse Points
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Special Considerations
Critical Thinking Questions
Pulse Rate
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Special Considerations
Critical Thinking Questions
Pulse Characteristics
Application of the Nursing Process/Clinical Judgment Measurement Model
Measuring Respirations
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Critical Thinking Questions
Respiratory Patterns
Measuring Oxygen Saturation of the Blood
Measuring the Blood Pressure
Equipment Used for Measuring Blood Pressure
Korotkoff Sounds
Hypertension
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Special Considerations
Critical Thinking Questions
Hypotension
Application of the Nursing Process/Clinical Judgment Measurement Model
Pain, the Fifth Vital Sign
Automated Vital Sign Monitors
Documenting Vital Signs
Recording Temperature Measurements
Recording Pulse Measurements
Recording Respiration Measurements
Recording Blood Pressure Measurements
Evaluating Vital Sign Trends
Key Points
Temperature
Pulse
Respiration
Blood Pressure
Additional Learning Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
23. Assessing Health Status
Data Collection and Assessment
Application of the Nursing Process/Clinical Judgment Measurement Model
Assessment (Data Collection)
Data Collection
Psychosocial and Cultural Assessment
Social Data
Physical Data: Review of Systems
Head and Neck
Chest
Abdomen
Genitourinary
Extremities and Musculoskeletal
Endocrine
Physical Assessment
Physical Examination Techniques
Basic Physical Examination
Review of Body Systems
Potential Alcohol Abuse
For Children
For an Older Adult
For Spouse or Partner
Action (Rationale)
Action (Rationale)
Action (Rationale)
Action (Rationale)
Data Analysis/Problem Identification
Planning
Implementation
Rest and Activity Needs
Nutritional, Fluid, and Electrolyte Needs
Safety and Security
Hygiene and Grooming
Oxygenation and Circulation Needs
Psychosocial and Learning Needs
Elimination
Supplies
Assisting With a Physical Examination
Special Focused Examinations
Action (Rationale)
Special Considerations
Critical Thinking Questions
Initial Observation
Head
Vital Signs
Pain
Chest: General Heart and Lung Assessment
Abdomen
Extremities
Tubes and Equipment
Assessment of Needs
Supplies
Action (Rationale)
For the Comatose Patient
Critical Thinking Questions
Evaluation
Key Points
Additional Learning Resources
Online Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
Scenario D
24. Admitting, Transferring, and Discharging Patients
Types of Admissions
Routine Admissions
Emergency Admissions
Admission Process
Preadmission Procedures and Requirements
Authorization for Admission
Admitting Department Function
Laboratory Work and X-Ray Examinations
Day of Admission
Patient Orientation to the Nursing Unit
Initial Nursing Assessment (Data Collection)
Initiating the Health Record
Reactions to Admission
Plan of Care
Patient Transfer to Another Hospital Unit
Discharging the Patient
Discharge to a Long-Term Care or Rehabilitation Facility
Discharge Home
Home Health Care
Discharge Against Medical Advice
Death of a Patient
Providing Support for Significant Others
Pronouncement of Death
Autopsies
Key Points
Additional Learning Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Chapter Outline
25. Diagnostic Tests and Specimen Collection
Diagnostic Tests and Procedures
Application of the Nursing Process/Clinical Judgment Measurement Model
Assessment (Data Collection)
Data Analysis/Problem Identification
Planning
Implementation
Laboratory Tests
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Critical Thinking Questions
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Special Considerations
Critical Thinking Question
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Special Considerations
Ultrasonography
Critical Thinking Questions
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Stool Culture
Test for Ova and Parasites
Test for Occult Blood
Evaluation
Documentation
Documentation Example
Special Considerations
Radiology Procedures
Cardiopulmonary Studies and Procedures
Endoscopic Examinations
Aspirations
Electroencephalography
Other Diagnostic Tests
Critical Thinking Questions
Examinations of the Heart
Examinations of Pulmonary Function
Action (Rationale)
Action (Rationale)
Supplies
For Throat Culture
For Wound Culture
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
For Throat
For Wound (Aerobic Culture)
For Both Throat and Wound Cultures
Evaluation
Documentation
Documentation Example: Throat
Documentation Example: Wound
Special Considerations
Critical Thinking Questions
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Critical Thinking Questions
Evaluation
Key Points
Additional Learning Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Chapter Outline
Unit VI. Meeting Basic Physiologic Needs
26. Fluid, Electrolyte, and Acid–Base Balance
Composition of Body Fluids
Water
Electrolytes
Nonelectrolytes
Blood
Distribution of Body Fluids
Movement of Fluid and Electrolytes
Passive Transport
Active Transport
Fluid and Electrolyte Imbalances
Fluid Volume Deficit
Dehydration
Fluid Volume Overload
Edema
Electrolyte Imbalances
Sodium Imbalances
Potassium Imbalances
Calcium Imbalances
Magnesium Imbalances
Anion Imbalances
Acid–Base Balance
pH
Bicarbonate
Control Mechanisms
Acid–Base Imbalances
Respiratory Acidosis
Metabolic Acidosis
Effects of Acidosis
Respiratory Alkalosis
Metabolic Alkalosis
Effects of Alkalosis
Application of the Nursing Process/Clinical Judgment Measurement Model
Assessment (Data Collection)
Data Analysis/Problem Identification
Planning
Implementation
Recording Intake and Output
Scenario
Problem Statement
Supporting Assessment Data
Applying Clinical Judgment
Evaluation
Supplies
Nursing Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Critical Thinking Questions
Key Points
Additional Learning Resources
Online Resource
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
Scenario D
Chapter Outline
27. Concepts of Basic Nutrition and Cultural Considerations
Overview of the Structure and Function of the Gastrointestinal System
Which Structures Are Involved in the Gastrointestinal (Digestive) System?
What Are the Functions of the Organs of the Gastrointestinal System?
What Changes in the Digestive System Occur with Aging?
Dietary Guidelines
USDA MyPlate and the 2020–2025 Dietary Guidelines for Americans
Infant, Child, and Adolescent Health
Educational and Community-Based Programs
Nutrition and Healthy Eating
Protein
Functions of Protein
Food Sources of Protein
Essential Amino Acids
Nonessential Amino Acids
Dietary Reference Intakes of Protein
Protein Deficiency
Protein Excess
Vegetarian Diets
Carbohydrates
Functions of Carbohydrates
Simple Carbohydrates
Complex Carbohydrates (Starches)
Recommendations for Intake
Fiber
Fats (Lipids)
Functions of Fat
Food Sources of Fat
Vitamins, Minerals, and Water
Vitamins
Minerals
Water
Factors That Influence Nutrition
Age
Illness
Emotional Status
Economic Status
Religion
Culture
Food Safety
Cultural Influences on Nutrition
African American
Hispanic American
Asian American
Middle Eastern American
Nutrition Counseling
Nutritional Needs Throughout the Life Span
Infants
Toddlers and Preschool Children
School-Age Children
Adolescents
Adults
Older Adults
Application of the Nursing Process/Clinical Judgment Measurement Model
Assessment (Data Collection)
Data Analysis/Problem Identification
Planning
Implementation
Patient and Family Education
Evaluation
Scenario
Problem Statement
Supporting Assessment Data
Problem Statement
Supporting Assessment Data
Problem Statement
Supporting Assessment Data
Applying Clinical Judgment
Key Points
Additional Learning Resources
Online Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
Scenario D
Chapter Outline
28. Nutritional Therapy and Assisted Feeding
Nutritional Therapy Fundamentals
The Goals of Nutritional Therapy
The Postoperative Patient
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
The Visually Impaired Patient
Evaluation
Documentation
Documentation Example
Critical Thinking Questions
Health Issues Related to Nutrition
Feeding and Eating Disorders
Anorexia Nervosa
Obesity
Pregnancy
Substance Use Disorders
Disease Processes That Benefit From Nutritional Therapy
Cardiovascular Disease
Diabetes Mellitus
Scenario
Problem Statement
Supporting Assessment Data
Problem Statement
Supporting Assessment Data
Applying Clinical Judgment
HIV/AIDS
Assisted Feeding
Nasogastric and Enteral Tubes
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Special Considerations
Critical Thinking Questions
Percutaneous Endoscopic Gastrostomy or Jejunostomy Tubes
Feeding Tubes and Pumps
Action (Rationale)
Action (Rationale)
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Critical Thinking Questions
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
For Intermittent Feedings
For Continuous Tube Feeding
For Both Intermittent and Continuous Tube Feeding
Evaluation
Documentation
Documentation Example
Critical Thinking Questions
Total Parenteral Nutrition
Application of the Nursing Process/Clinical Judgment Measurement Model
Assessment (Data Collection)
Data Analysis/Problem Identification
Planning
Implementation
Evaluation
Documentation
Key Points
Additional Learning Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
Scenario D
Chapter Outline
29. Assisting With Respiration and Oxygen Delivery
Overview of the Structure and Function of the Respiratory System
Which Structures Are Involved in Respiration?
What Are the Functions of Respiratory Structures?
What Changes Occur With Aging That Affect Respiration?
Hypoxemia
Obstruction of the Airway
Restricted Movement of the Thoracic Cage or the Pleura
Decreased Neuromuscular Function
Disturbances in Diffusion of Gases
Environmental Causes
Symptoms of Hypoxia
Pulse Oximetry
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Special Considerations
Critical Thinking Questions
Airway Obstruction and Respiratory Arrest
Clearing Respiratory Secretions
The Effective Cough
Action (Rationale)
For a Conscious Person
For an Unconscious Person
For the Conscious Infant
For the Unconscious Infant
Special Considerations
Critical Thinking Questions
Action (Rationale)
Special Considerations
Critical Thinking Questions
Deep Breathing
Effective Coughing
Postural Drainage
Oxygen Administration
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Special Considerations
Critical Thinking Questions
Cannula
Masks
Artificial Airways
Nasopharyngeal Suctioning
Tracheobronchial Suctioning
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Critical Thinking Questions
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Suctioning With a Sleeved Catheter
Evaluation
Documentation
Documentation Example
Special Considerations
Critical Thinking Questions
Tracheostomy
Chest Drainage Tubes
Action (Rationale)
Application of the Nursing Process/Clinical Judgment Measurement Model
Assessment (Data Collection)
Data Analysis/Problem Identification
Planning
Scenario
Problem Statement
Supporting Assessment Data
Applying Clinical Judgment
Implementation
Tracheostomy Care
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Special Considerations
Chest Tube Care
Nebulizer Treatments
Patient Education
Critical Thinking Questions
Evaluation
Documentation
Key Points
Additional Learning Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Chapter Outline
30. Promoting Urinary Elimination
Overview of Structure and Function of the Urinary System
Which Structures Are Involved in Urinary Elimination?
What Are the Functions of Urinary Structures for Elimination?
What Factors Can Interfere With Urinary Elimination?
What Changes in the System Occur With Aging?
Normal Urinary Elimination
Factors Affecting Normal Urination
Characteristics of Normal Urine
Color
Clarity
Odor
Specific Gravity
pH
Alterations in Urinary Elimination
Cranberry Products to Prevent Bladder Infections
Application of the Nursing Process/Clinical Judgment Measurement Model
Assessment (Data Collection)
Urine Specimen Collection
For the Female Patient
For the Male Patient
For the Patient at Home
Action (Rationale)
Data Analysis/Problem Identification
Planning
Cultural Awareness for Toileting Preferences
Implementation
Risk for Falls
Supplies
Nursing Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
For the Helpless Patient
Evaluation
Documentation
Documentation Example
Special Considerations
Assisting With Use of Urinal
Helping a Patient Urinate
External Female Catheter System
Types of Urinary Catheters
Performing Catheterization
Critical Thinking Questions
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Special Considerations
Critical Thinking Questions
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Special Considerations
Critical Thinking Questions
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Special Considerations
The Nurse’s Role in Preventing Catheter-Associated Urinary Tract Infections
The Suprapubic Catheter
Intermittent Self-Catheterization
Bladder Irrigation or Instillation
Critical Thinking Questions
Removal of an Indwelling Catheter
Action (Rationale)
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Variation: Open System Irrigation
Special Considerations
Assisting the Patient Who Is Incontinent
Urinary Diversion Care
Critical Thinking Questions
Action (Rationale)
Evaluation
Documentation
Key Points
Additional Learning Resources
Online Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
Scenario D
31. Promoting Bowel Elimination
Overview of the Structure and Function of the Intestinal System
Which Structures of the Intestinal System Are Involved in Waste Elimination?
What Are the Functions of the Intestines?
What Effect Does Aging Have on the Intestinal Tract?
Characteristics of Stool
Normal Characteristics of Stool
Abnormal Characteristics of Stool
Bowel Elimination Problems
Hypoactive Bowel and Constipation
Hyperactive Bowel and Diarrhea
Medications Used for Constipation
Stool Softeners
Bulk-Forming Laxatives
Irritant or Stimulant Laxatives
Saline Laxatives
Laxatives for Chronic Constipation
Medications Used for Diarrhea (Antidiarrheals)
Fecal Incontinence
Application of the Nursing Process/Clinical Judgment Measurement Model
Assessment (Data Collection)
History
Physical Assessment
Data Analysis/Problem Identification
Planning
Scenario
Problem Statement
Supporting Assessment Data
Applying Clinical Judgment
Implementation
Evaluation
Documentation
Interventions for Constipation, Flatus, Fecal Impaction, or Fecal Incontinence
Rectal Suppositories
Enemas
Types of Enemas
Amount and Temperature of Solution
Recommended Position
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
For Large-Volume Enema
For Disposable or Oil-Retention Enema
For Both Types of Enema
Evaluation
Documentation
Documentation Example
Critical Thinking Questions
Rectal Tube
Fecal Impaction
Action (Rationale)
Bowel Training for Incontinence
Bowel Ostomy
Uses of Bowel Ostomies
Action (Rationale)
Ileostomy
Colostomy
To Control Diarrhea, Increase Intake of
To Soften the Consistency of the Stool, Increase Intake of
These Foods May Increase Stool or Urine Odor
These Foods May Decrease Stool Odor
These Foods Increase Flatus
Avoid These Foods Because They May Cause Obstruction
Ostomy Care
Skin Care
Applying an Ostomy Appliance
Irrigating a Colostomy
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Special Considerations
Critical Thinking Questions
Action (Rationale)
Key Points
Additional Learning Resources
Online Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
Scenario D
Chapter Outline
32. Pain, Comfort, and Sleep
Pain and Discomfort
Theories of Pain
Gate Control Theory
Endorphins
Types of Pain
Acute Pain
Persistent Pain
Phantom Pain
Nociceptive Pain
Neuropathic Pain
Cancer Pain
Application of the Nursing Process/Clinical Judgment Measurement Model
Assessment (Data Collection)
Perception of Pain
Pain Scales
Data Analysis/Problem Identification
Planning
Implementation
Nonpharmacologic Methods of Pain Control
Scenario
Problem Statement
Supporting Assessment Data
Applying Clinical Judgment
Supplies
Action (Rationale)
Assessment
Planning
Implementation
Evaluation
Documentation
Documentation Example
Medical Methods of Pain Control
Critical Thinking Questions
Preparation
Read the Imagery Script
After the Imagery Experience
Fentanyl Danger for Children
Evaluation
Sleep
Supplies
Action (Rationale)
Assessment
Planning
Implementation
Evaluation
Documentation
Documentation Example
Critical Thinking Questions
Action (Rationale)
Functions of Sleep
Stages of Sleep
Normal Sleep Requirements
Factors Affecting Sleep
Sleep Disorders
Insomnia
Restless Legs Syndrome
Sleep Apnea
Snoring
Narcolepsy
Application of the Nursing Process/Clinical Judgment Measurement Model
Assessment (Data Collection)
Data Analysis/Problem Identification
Planning
Implementation
Evaluation
Key Points
Additional Learning Resources
Online Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
Scenario D
Chapter Outline
33. Integrative Health Approaches
Integrative Health Approaches
Mind and Body Practices
Acupuncture
Yoga
Chiropractic
Massage Therapy
Relaxation Therapy
Imagery
Meditation
Biofeedback
Biofield Therapies
Reiki
Therapeutic Touch
Hypnotherapy
Music, Art, and Dance Therapy
Humor
Prayer
Natural Products
Herbal Therapy and Dietary Supplements
Aromatherapy
Other Integrative Interventions
Homeopathic Medicine
Naturopathic Medicine
Traditional Chinese Medicine
Ayurveda
Shamanism
Folk Medicine
Native Medicine
The Nurse’s Role in Integrative Health Approaches
Key Points
Additional Learning Resources
Online Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
Chapter Outline
Unit VII. Medication Administration
34. Pharmacology and Preparation for Drug Administration
Pharmacology
Classification of Drugs
Legal Control of Drugs
Drug Standards
Basic Concepts of Pharmacology
Drug Action and Pharmacokinetics
Drug Response and Pharmacodynamics
Drug and Food Incompatibilities
Medication Administration and Safety
Considerations for Infants and Children
When Preparing to Administer Medications
At the Time of Medication Administration to the Patient
Working With the Patient for Error Prevention
Considerations for the Older Adult
Considerations for Home Care
Problems of Nonadherence
Application of the Nursing Process/Clinical Judgment Measurement Model
Assessment (Data Collection)
Data Analysis/Problem Identification
Planning
Scenario
Problem Statement
Supporting Assessment Data
Problem Statement
Supporting Assessment Data
Applying Clinical Judgment
Implementation
Calculating the Drug Dosage to Be Given
Practicing the Six Rights
Volume Equivalents
Weight Equivalents
Evaluation
Key Points
Additional Learning Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
Scenario D
Chapter Outline
35. Administering Oral, Topical, and Inhalant Medications
Nursing Responsibilities in Medication Administration
Medication Orders
Types of Orders
Regularly Scheduled or Routine Medication Orders
Dosage of Medications
Routes of Oral and Topical Medication Administration
Medication Administration and Technology
Medication Administration Record
Medication Administration Systems
Unit-Dose System
Prescription System
Preparation of Oral Controlled Substances From a Dispenser
Topical Drugs
Application of the Nursing Process/Clinical Judgment Measurement Model
Assessment (Data Collection)
Data Analysis/Problem Identification
Planning
Implementation
Oral Medication
Older Adults
Scenario
Problem Statement
Supporting Assessment Data
Eye and Ear Medications
Applying Clinical Judgment
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Special Considerations
Nasal Medications
Critical Thinking Questions
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Eye Drop Application
Eye Ointment Application
For Eye Drops and Ointment
Evaluation
Documentation
Special Considerations
Inhalation Medications
Vaginal Medications
Rectal Medications
Topical Skin Medications
Administering Medications via Feeding Tube
Critical Thinking Questions
Action (Rationale)
For Irrigation with a Vaginal Douche
For Insertion of a Vaginal Suppository
For Instillation of Vaginal Cream or Foam
Action (Rationale)
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
To Apply Lotion
To Apply Cream or Ointment
To Apply Antianginal Ointment
Evaluation
Documentation
Documentation Example
Critical Thinking Questions
Evaluation
Documentation
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Critical Thinking Questions
Medication Errors
Key Points
Additional Learning Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
Scenario D
Scenario E
Chapter Outline
36. Administering Intradermal, Subcutaneous, and Intramuscular Injections
Principles of Parenteral Injections
Routes for Parenteral Medication
Intradermal Route
Subcutaneous Route
Intramuscular Route
Injection Equipment
Types of Syringes
Measurement Scales
Needle Gauge and Length
Preventing Needle Sticks
Syringe and Needle Selection
Preparing the Syringe for Use
Parenteral Solutions
Using a Medication Ampule
Action (Rationale)
Removing Protective Wrapping
Using a Medication Vial
Reconstitution of a Drug
Compatibility of Medications
Application of the Nursing Process/Clinical Judgment Measurement Model
Assessment (Data Collection)
Action (Rationale)
Data Analysis/Problem Identification
Action (Rationale)
Planning
Implementation
Intradermal Injections
Subcutaneous Injections
Intramuscular Injections
Action (Rationale)
Priming the Pen
Injection, Disposal, and Storage
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Critical Thinking Questions
Positive Reaction
Negative Reaction
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Special Considerations
Anaphylactic Shock
Critical Thinking Questions
Scenario
Problem Statement
Supporting Assessment Data
Applying Clinical Judgment
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Examples
Special Considerations
Critical Thinking Questions
Evaluation
Documentation
Action (Rationale)
Key Points
Additional Learning Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
Scenario D
Chapter Outline
37. Administering Intravenous Solutions and Medications
Intravenous Therapy and the Role of the Nurse
Licensed Practical Nurse/Licensed Vocational Nurse’s Role in Intravenous Therapy
Types of Intravenous Solutions
Scenario
Problem Statement
Supporting Assessment Data
Applying Clinical Judgment
Equipment for Intravenous Administration
Administration Sets
Primary Intravenous Set
Secondary, or Piggyback, Intravenous Set
Parallel, or Y, Intravenous Set
Controlled-Volume Intravenous Set
Intermittent Intravenous Device (Saline or PRN Lock)
Filters
Infusion Pumps and Controllers
Venous Access Devices
Intravenous Needles and Catheters
Central Venous Catheters and Peripherally Inserted Central Catheters
Infusion Port
Complications of Intravenous Therapy
Infiltration
Extravasation
Phlebitis
Bloodstream Infection
Other Complications
Application of the Nursing Process/Clinical Judgment Measurement Model
Assessment (Data Collection)
Data Analysis/Problem Identification
Planning
Calculation of Flow Rates
Implementation
Initiating Intravenous Therapy
Supplies
Supplies for Saline or PRN Lock (if needed)
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Preparing the IV Infusion
Placing the IV Catheter and Starting the Infusion
Evaluation
Documentation
Documentation Example
Special Considerations
Managing Intravenous Therapy
Critical Thinking Questions
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Administering Intravenous Medications
Critical Thinking Questions
Action (Rationale)
Action (Rationale)
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Special Considerations
Critical Thinking Questions
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Flushing the Saline or PRN Lock
Administering the Intravenous Medication
Evaluation
Documentation
Critical Thinking Questions
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Administering Heparin Infusions
Administering Antineoplastic Medications
Discontinuing an Intravenous Infusion
Administering Blood and Blood Products
Critical Thinking Question
Action (Rationale)
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Special Considerations
Total Parenteral Nutrition
Critical Thinking Questions
Evaluation
Documentation
Key Points
Additional Learning Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
Scenario D
Chapter Outline
Unit VIII. Care of the Surgical and Immobile Patient
38. Care of the Surgical Patient
Reasons for Surgery
Patients at Higher Risk for Surgical Complications
Perioperative Nursing
Enhancements to Surgical Technique
Laser Surgery
Fiberoptic Surgery
Robotic Surgery
Anesthesia
General Anesthesia
Regional Anesthesia
Conscious Sedation Anesthesia
Local Anesthesia
Preoperative Procedures
Informed Consent Before Surgery
Physical Examination
Application of the Nursing Process/Clinical Judgment Measurement Model
Preoperative Care
Assessment (Data Collection)
Data Analysis/Problem Identification
Planning
Implementation
Patient Education for Postoperative Exercises
NPO Status
Elimination
Expected Tubes and Equipment
Rest and Sedation
Pain Control
Skin Preparation
Immediate Preoperative Care
Preparation of the Patient Unit
Deep Breathing
Huff Coughing
Using an Incentive Spirometer
Evaluation
Scenario
Problem Statement
Supporting Assessment Data
Problem Statement
Supporting Assessment Data
Problem Statement
Supporting Assessment Data
Problem Statement
Supporting Assessment Data
Problem Statement
Supporting Assessment Data
Problem Statement
Supporting Assessment Data
Applying Clinical Judgment
Intraoperative Care
Role of the Scrub Person and Circulating Nurse
Postanesthesia Immediate Care
Postanesthesia Care Unit (PACU)
Postanesthesia Care in the Same-Day Surgery Unit
Major Functions of the Circulating Nurse
Major Functions of the Scrub Person
Postoperative Care
Assessment (Data Collection)
Data Analysis/Problem Identification
Planning
Implementation
Protect the Patient From Injury
Promote Respiratory Function
Promote Circulation
Maintain Fluid Balance
Promote Gastrointestinal Function
Promote Comfort
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Special Considerations
Promote Rest and Activity
Prevent Infection
Monitor for Complications of Surgery
Critical Thinking Questions
Evaluation
Key Points
Additional Learning Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
Chapter Outline
39. Providing Wound Care and TreatingPressure Injuries
Wound Healing
Types of Wounds and the Healing Process
Phases of Wound Healing
Factors Affecting Wound Healing
Age
Nutrition
Lifestyle
Medications
Infection
Chronic Illness and Chronic Wounds
Complications of Wound Healing
Hemorrhage
Infection
Dehiscence and Evisceration
Treatment of Wounds
Wound Closure
Drains and Drainage Devices
Debridement
Dressings
Transparent Film Dressings
Hydrocolloid or Hydrocellular Dressing
Securing Dressings
Action (Rationale)
Binders
Negative Pressure Wound Therapy
Treatment of Pressure Injuries or Vascular Ulcers
Application of the Nursing Process/Clinical Judgment Measurement Model
Assessment (Data Collection)
Data Analysis/Problem Identification
Planning
Implementation
Wound Cleansing and Dressing Changing
Hydrocolloid and Hydrocellular Dressings
Wound Irrigation, Debridement, and Packing
Scenario
Problem Statement
Supporting Assessment Data
Applying Clinical Judgment
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Critical Thinking Questions
Action (Rationale)
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Special Considerations
Critical Thinking Questions
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Special Considerations
Patient Education for Wound Care
Suture and Staple Removal
Critical Thinking Questions
Action (Rationale)
For Sutures
For Staples
For Sutures and Staples
Eye, Ear, and Vaginal Irrigations
Action (Rationale)
Eye Irrigation
Ear Irrigation
Hot and Cold Applications
Heat
Cold
Evaluation
Key Points
Additional Learning Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
Chapter Outline
40. Promoting Musculoskeletal Function
Effects of Immobilization
Systemic Effect of Immobilization
Value the Perspectives and Expertise of All Health Team Members
Psychosocial Effects of Immobilization
Intraprofessional and Interprofessional Collaboration
Types of Immobilization
Splints
Traction
Manual Traction
Skin Traction
Skeletal Traction
Casts
Internal Fixators
External Fixators
Devices Used to Prevent Problems of Immobility
Specialty Beds and Mattresses
Air Fluidized Beds
Low Air Loss Mattresses
Continuous Lateral Rotation Beds and Mattresses
Pressure Relief Devices
Continuous Passive Motion Machine
Therapeutic Exercise
Action (Rationale)
Application of the Nursing Process/Clinical Judgment Measurement Model
Assessment (Data Collection)
Data Analysis/Problem Identification
Planning
Implementation
Scenario
Problem Statement
Supporting Assessment Data
Problem Statement
Supporting Assessment Data
Problem Statement
Supporting Assessment Data
Problem Statement
Supporting Assessment Data
Applying Clinical Judgment
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Special Considerations
Bandages Used to Support, Apply Pressure, or Immobilize
Critical Thinking Questions
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Special Considerations
Immobilizing and Supporting With a Sling
Using a Mechanical Lift to Transfer the Patient Who Is Immobile
Assisting With Aids to Mobilization
Critical Thinking Questions
Action (Rationale)
Action (Rationale)
Supplies
Action (Rationale)
Assessment (Data Collection)
Planning
Implementation
Evaluation
Documentation
Documentation Example
Special Considerations
Rehabilitation
Critical Thinking Questions
Evaluation
Documentation
Key Points
Additional Learning Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activities
Scenario A
Scenario B
Scenario C
Chapter Outline
Unit IX. Caring for Older Adults
41. Common Physical Care Problems of theOlder Adult
Getting Older
Immobility
Nursing Interventions to Promote Mobility
Preventing Falls
Alteration in Elimination
Urinary Incontinence
Nursing Interventions for Urinary Incontinence
Constipation and Fecal Impaction
Nursing Interventions for Constipation and Fecal Impaction
Alteration in Nutrition
Nutritional Guidelines
Nursing Interventions for Nutritional Support
Sensory Deficits
Vision Deficits
Nursing Interventions for the Visually Impaired
Hearing Deficit
Nursing Interventions for the Hearing Impaired
Sexuality
Polypharmacy
Age-Related Factors
Nursing Interventions for Polypharmacy
Scenario
Problem Statement
Supporting Assessment Data
Applying Clinical Judgment
Key Points
Additional Learning Resources
Online Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activity
Chapter Outline
42. Common Psychosocial Care Problems of the Older Adult
Cognitive Functioning in Older Adults
Changes in Cognitive Functioning in Older Adults
Assessment of Cognitive Changes in Older Adults
Common Cognitive Disorders in Older Adults
Confusion
Delirium
Dementia
Specific Interventions for Confusion and Disorientation
Alzheimer Disease
Treatment and Nursing Interventions for Alzheimer Disease
Preclinical Alzheimer Disease
Mild Cognitive Impairment (MCI) Caused By Alzheimer Disease
Dementia Caused By Alzheimer Disease
Safety for the Cognitively Impaired Older Adult
Home and Transportation Adjustments
Behaviors Associated with Cognitive Disorders
Agitation, Hostility, and Paranoia
Wandering
Sundown Syndrome
Eating Problems
Depression, Alcohol Use Disorder, and Suicide
Assessments for Depression, Alcohol Use Disorder, and Suicide
Mood Scale (Short Form)
Physical Assessment
Psychosocial Assessment
Interventions for Depression, Alcohol Use Disorder, and Suicide Prevention
Crimes Against Older Adults
Elder Abuse
Scams and White Collar Crime
Future Issues of Concern to Older Adults
Planning for the Future
Key Points
Additional Learning Resources
Online Resources
Review Questions for the Next Generation NCLEX Examination
Clinical Judgment Activity
Chapter Outline
Appendix A. Standard Steps for All Nursing Procedures
At the Beginning of the Procedure
Step A: Perform the Task According to Protocol
Step B: Check the Order, Collect the Equipment and Supplies, and Perform Hand Hygiene
Step C: Identify and Prepare the Patient; Introduce Yourself
Step D: Provide Privacy and Institute Safety Precautions; Arrange the Supplies and Equipment
During the Procedure
Step E: Use Standard Precautions and Aseptic Technique as Appropriate
At the end of the Procedure
Step X: Remove Gloves and Other Protective Equipment
Step Y: Restore the Unit; Collect the Used Equipment; Dispose of, Clean, or Store Items in the Proper Places
Step Z: Document and Report the Procedure
Appendix B. Standards of Practice and Educational Competencies of Graduates of Practical/Vocational Nursing Programs
Appendix C. American Nurses Association Code of Ethics for Nurses
Appendix D. Standard Precautions
Recommendations
IV. Standard Precautions
IV.A. Hand Hygiene
IV.B. Personal Protective Equipment
IV.C. Respiratory Hygiene/Cough Etiquette
IV.D. Patient Placement
IV.E. Patient-Care Equipment and Instruments/Devices
IV.F. Care of the Environment
IV.G. Textiles and Laundry
IV.H. Safe Injection Practices
IV.I. Infection Control Practices for Special Lumbar Puncture Procedures
IV.J. Worker Safety
Appendix E. Most Common Laboratory Test Values
References
Glossary
Index
Priority Problem List

Life Sciences

Physical Sciences & Engineering

Social Sciences & Humanities

Health

Fundamental Concepts and Skills for Nursing

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Patricia A. Williams

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