kozier & erb’s fundamentals of nursing

GloBAl EdITIoN

Concepts, Process, and PracticeTENTh EdITIoN

Audrey Berman • Shirlee J. Snyder • Geralyn Frandsen

Kozier & Erb’s Fundamentals of Nursing

Audrey Berman, PhD, RN

Professor

Dean, Nursing

Samuel Merritt University

Oakland, California

Shirlee J. Snyder, EdD, RN

Former Dean and Professor, Nursing

Nevada State College

Henderson, Nevada

Geralyn Frandsen, EdD, RN

Professor of Nursing

Maryville University

St. Louis, Missouri

TENTH EDITION

GLOBAL EDITION

FUNDAMENTALS OF NURSING

KOZIER & ERB’S

Concepts, Process, and Practice

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Kozier & Erb's Fundamentals of Nursing,eBook, Global Eition

Table of Contents

Front Cover

Brief Contents

Dedication

About the Authors

Acknowledgments

Thank You

Preface

Contents

Unit 1: The Nature of NursingChapter 1: Historical and Contemporary Nursing Practice

Introduction

Historical Perspectives

Womens Roles

Religion

War

Societal Attitudes

Nursing Leaders

Men in Nursing

Nursing Education

Types of Education Programs

Contemporary Nursing Practice

Definitions of Nursing

Recipients of Nursing

Scope of Nursing

Settings for Nursing

Nurse Practice Acts

Standards of Nursing Practice

Roles and Functions of the Nurse

Caregiver

Communicator

Teacher

Client Advocate

Counselor

Change Agent

Leader

Manager

Case Manager

Research Consumer

Expanded Career Roles

Table of Contents

Criteria of a Profession

Specialized Education

Body of Knowledge

Service Orientation

Ongoing Research

Code of Ethics

Autonomy

Professional Organization

Socialization to Nursing

Critical Values of Nursing

Factors Influencing Contemporary Nursing Practice

Health Care Reform

Quality and Safety in Health Care

Consumer Demands

Family Structure

Science and Technology

Information, Telehealth, and Telenursing

Legislation

Demography

The Current Nursing Shortage

Collective Bargaining

Nursing Associations

Nursing Organizations

American Nurses Association

National League for Nursing

International Council of Nurses

National Student Nurses Association

International Honor Society: Sigma Theta Tau

Chapter 2: Evidence-Based Practice and Research in NursingIntroduction

Evidence-Based Practice

Nursing Research

Approaches to Nursing Research

Overview of the Research Process

Research-Related Roles and Responsibilities for Nurses

Chapter 3: Nursing Theories and Conceptual FrameworksIntroduction

Introduction to Theories

Context for Theory Development in American Universities

Defining Terms

The Metaparadigm for Nursing

Role of Nursing Theory

In Education

In Research

In Clinical Practice

Table of Contents

Overview of Selected Nursing Theories

Nightingales Environmental Theory

Peplaus Interpersonal Relations Model

Hendersons Definition of Nursing

Rogers Science of Unitary Human Beings

Orems General Theory of Nursing

Kings Goal Attainment Theory

Neumans Systems Model

Roys Adaptation Model

Leiningers Cultural Care Diversity and Universality Theory

Watsons Human Caring Theory

Parses Humanbecoming Theory

Critique of Nursing Theory

Chapter 4: Legal Aspects of NursingIntroduction

General Legal Concepts

Functions of the Law in Nursing

Sources of Law

Types of Laws

Kinds of Legal Actions

The Civil Judicial Process

Nurses as Witnesses

Regulation of Nursing Practice

Nurse Practice Acts

Credentialing

Standards of Care

Contractual Arrangements in Nursing

Legal Roles of Nurses

Collective Bargaining

Selected Legal Aspects of Nursing Practice

Informed Consent

Delegation

Violence, Abuse, and Neglect

The Americans with Disabilities Act

Controlled Substances

The Impaired Nurse

Sexual Harassment

Abortions

Death and Related Issues

Areas of Potential Liability in Nursing

Crimes and Torts

Privacy of Clients Health Information

Social Media

Loss of Client Property

Unprofessional Conduct

Legal Protections in Nursing Practice

Table of Contents

Good Samaritan Acts

Professional Liability Insurance

Carrying Out a Physicians Orders

Providing Competent Nursing Care

Documentation

The Incident Report

Reporting Crimes, Torts, and Unsafe Practices

Legal Responsibilities of Students

Chapter 5: Values, Ethics, and AdvocacyIntroduction

Values

Values Transmission

Values Clarification

Ethics and Morality

Moral Development

Moral Frameworks

Moral Principles

Nursing Ethics

Nursing Codes of Ethics

Origins of Ethical Problems in Nursing

Making Ethical Decisions

Strategies to Enhance Ethical Decisions and Practice

Specific Ethical Issues

Acquired Immunodeficiency Syndrome (AIDS)

Abortion

Organ and Tissue Transplantation

End-of-Life Issues

Allocation of Scarce Health Resources

Management of Personal Health Information

Advocacy

The Advocates Role

Unit 2: Contemporary Health CareChapter 6: Health Care Delivery Systems

Introduction

Types of Health Care Agencies and Services

Primary Prevention: Health Promotion and Illness Prevention

Secondary Prevention: Diagnosis and Treatment

Tertiary Prevention: Rehabilitation, Health Restoration, and Palliative Care

Types of Health Care Services

Public Health

Physicians Offices

Ambulatory Care Centers

Occupational Health Clinics

Hospitals

Subacute Care Facilities

Table of Contents

Extended (Long-Term) Care Facilities

Retirement and Assisted Living Centers

Rehabilitation Centers

Home Health Care Agencies

Day Care Centers

Rural Care

Hospice Services

Crisis Centers

Mutual Support and Self-Help Groups

Providers of Health Care

Nurse

Alternative (Complementary) Care Provider

Case Manager

Dentist

Dietitian or Nutritionist

Emergency Medical Personnel

Occupational Therapist

Paramedical Technologist

Pharmacist

Physical Therapist

Physician

Physician Assistant

Podiatrist

Respiratory Therapist

Social Worker

Spiritual Support Personnel

Unlicensed Assistive Personnel

Factors Affecting Health Care Delivery

Increasing Number of Older Adults

Advances in Technology

Economics

Womens Health

Uneven Distribution of Services

Access to Health Insurance

The Homeless and the Poor

Health Insurance Portability and Accountability Act

Demographic Changes

Frameworks for Care

Managed Care

Case Management

Differentiated Practice

Case Method

Functional Method

Team Nursing

Primary Nursing

Financing Health Care

Payment Sources in the United States

Table of Contents

Insurance Plans

Chapter 7: Community Nursing and Care ContinuityIntroduction

The Movement of Health Care to the Community

Primary Health Care and Primary Care

Community-Based Health Care

Community Health

Community-Based Frameworks

Community-Based Settings

Community-Based Nursing

Competencies Required for Community-Based Care

Collaborative Health Care

Continuity of Care

Care Across the Life Span

Discharge Planning

Preparing Clients to Go Home

Medication Reconciliation

Home Health Care Teaching

Referrals

Chapter 8: Home CareIntroduction

Home Health Nursing

Unique Aspects of Home Health Nursing

The Home Health Care System

Referral Process

Home Health Agencies

Private Duty Agencies

Durable Medical Equipment Companies

Reimbursement

Roles of the Home Health Nurse

Advocate

Caregiver

Educator

Case Manager or Coordinator

Perspectives of Home Care Clients

Selected Dimensions of Home Health Nursing

Client Safety

Nurse Safety

Infection Prevention

Caregiver Support

The Practice of Nursing in the Home

Establishing Health Issues

Planning and Delivering Care

Resources for Home Health Nursing

The Future of Home Health Care

Table of Contents

Chapter 9: Electronic Health Records and Information TechnologyIntroduction

General Concepts

Computer Systems

Management Information Systems

Hospital Information Systems

Technology in Nursing Education

Teaching and Learning

Testing

Student and Course Record Management

Technology in Nursing Practice

Documentation of Client Status and Medical Record Keeping

Electronic Access to Client Data

Practice Management

Specific Applications of Computers in Nursing Practice

Technology in Nursing Administration

Human Resources

Medical Records Management

Facilities Management

Budget and Finance

Quality Assurance and Utilization Review

Accreditation

Technology in Nursing Research

Problem Identification

Literature Review

Research Design

Data Collection and Analysis

Research Dissemination

Research Grants

Unit 3: The Nursing ProcessChapter 10: Critical Thinking and Clinical Reasoning

Introduction

Purpose of Critical Thinking

Techniques in Critical Thinking

Applying Critical Thinking to Nursing Practice

Problem Solving

Attitudes That Foster Critical Thinking

Independence

Fair-Mindedness

Insight into Egocentricity

Intellectual Humility

Intellectual Courage to Challenge the Status Quo and Rituals

Integrity

Perseverance

Confidence

Table of Contents

Curiosity

Components of Clinical Reasoning

Setting Priorities

Developing Rationales

Learning How to Act

Clinical Reasoning-in-Transition

Responding to Changes in the Clients Condition

Reflection

Integration of Critical Thinking and Clinical Reasoning

Concept Mapping

Concept Mapping and Enhancing Critical Thinking and Clinical Reasoning

Chapter 11: AssessingIntroduction

Overview of the Nursing Process

Phases of the Nursing Process

Characteristics of the Nursing Process

Assessing

Collecting Data

Types of Data

Sources of Data

Data Collection Methods

Organizing Data

Conceptual Models/Frameworks

Wellness Models

Nonnursing Models

Validating Data

Documenting Data

Chapter 12: DiagnosingIntroduction

Nanda Nursing Diagnoses

Definitions

Status of the Nursing Diagnoses

Components of a NANDA Nursing Diagnosis

Differentiating Nursing Diagnoses from Medical Diagnoses

Differentiating Nursing Diagnoses from Collaborative Problems

The Diagnostic Process

Analyzing Data

Identifying Health Problems, Risks, and Strengths

Formulating Diagnostic Statements

Avoiding Errors in Diagnostic Reasoning

Ongoing Development of Nursing Diagnoses

Chapter 13: PlanningIntroduction

Types of Planning

Table of Contents

Initial Planning

Ongoing Planning

Discharge Planning

Developing Nursing Care Plans

Standardized Approaches to Care Planning

Formats for Nursing Care Plans

Multidisciplinary (Collaborative) Care Plans

Guidelines for Writing Nursing Care Plans

The Planning Process

Setting Priorities

Establishing Client Goals/Desired Outcomes

Selecting Nursing Interventions and Activities

Writing Individualized Nursing Interventions

Delegating Implementation

The Nursing Interventions Classification

Chapter 14: Implementing and EvaluatingIntroduction

Implementing

Relationship of Implementing to Other Nursing Process Phases

Implementing Skills

Process of Implementing

Evaluating

Relationship of Evaluating to Other Nursing Process Phases

Process of Evaluating Client Responses

Evaluating the Quality of Nursing Care

Chapter 15: Documenting and ReportingIntroduction

Ethical and Legal Considerations

Ensuring Confidentiality of Computer Records

Purposes of Client Records

Communication

Planning Client Care

Auditing Health Agencies

Research

Education

Reimbursement

Legal Documentation

Health Care Analysis

Documentation Systems

Source-Oriented Record

Problem-Oriented Medical Record

PIE

Focus Charting

Charting by Exception

Computerized Documentation

Case Management

Table of Contents

Documenting Nursing Activities

Admission Nursing Assessment

Nursing Care Plans

Kardexes

Flow Sheets

Progress Notes

Nursing Discharge/Referral Summaries

Long-Term Care Documentation

Home Care Documentation

General Guidelines for Recording

Date and Time

Timing

Legibility

Permanence

Accepted Terminology

Correct Spelling

Signature

Accuracy

Sequence

Appropriateness

Completeness

Conciseness

Legal Prudence

Reporting

Change-of-Shift Reports

Telephone Reports

Telephone Orders

Care Plan Conference

Nursing Rounds

Unit 4: Health Beliefs and PracticesChapter 16: Health Promotion

Introduction

Individual Health

Concept of Individuality

Concept of Holism

Concept of Homeostasis

Assessing the Health of Individuals

Applying Theoretical Frameworks

Needs Theories

Developmental Stage Theories

Healthy People 20420

Defining Health Promotion

Sites for Health Promotion Activities

Health Promotion Model

Individual Characteristics and Experiences

Table of Contents

Behavior-Specific Cognitions and Affect

Commitment to a Plan of Action

Immediate Competing Demands and Preferences

Behavioral Outcome

Stages of Health Behavior Change

Precontemplation Stage

Contemplation Stage

Preparation Stage

Action Stage

Maintenance Stage

Termination Stage

The Nurses Role in Health Promotion

The Nursing Process and Health Promotion

Nursing Management

Chapter 17: Health, Wellness, and IllnessIntroduction

Concepts of Health, Wellness, and Well-Being

Health

Wellness and Well-Being

Models of Health and Wellness

Clinical Model

Role Performance Model

Adaptive Model

Eudaimonistic Model

AgentHostEnvironment Model

HealthIllness Continua

Variables Influencing Health Status, Beliefs, and Practices

Internal Variables

External Variables

Health Belief Models

Health Locus of Control Model

Rosenstock and Beckers Health Belief Models

Health Care Adherence

Illness and Disease

Illness Behaviors

Effects of Illness

Chapter 18: Culturally Responsive Nursing CareIntroduction

Cultural Concepts

Health Disparities

Demographics

Immigration

Cultural Models of Nursing Care

American Association of Colleges of Nursing Competencies

Cultural Competence

Table of Contents

HEALTH Traditions Model

Providing Culturally Responsive Care

Health Beliefs and Practices

Family Patterns

Communication Style

Space Orientation

Time Orientation

Nutritional Patterns

Nursing Management

Chapter 19: Complementary and AlternativeHealing ModalitiesIntroduction

Basic Concepts

Holism

Humanism

Balance

Spirituality

Energy

Healing Environments

Healing Environments

Systematized Health Care Practices

Botanical Healing

Nutritional Therapy

Manual Healing Methods

MindBody Therapies

Spiritual Therapy

Miscellaneous Therapies

Unit 5: Life Span DevelopmentChapter 20: Concepts of Growth and Development

Introduction

Factors Influencing Growth and Development

Genetics

Temperament

Family

Nutrition

Environment

Health

Culture

Stages of Growth and Development

Growth and Development Theories

Biophysical Theory

Psychosocial Theories

Temperament Theories

Attachment Theory

Cognitive Theory

Behaviorist Theory

Table of Contents

Social Learning Theories

Ecologic Systems Theory

Theories of Moral Development

Theories of Spiritual Development

Applying Growth and Development Concepts to Nursing Practice

Chapter 21: Promoting Health from Conception Through AdolescenceIntroduction

Conception and Prenatal Development

Health Promotion

Neonates and Infants (Birth to 27 Year)

Physical Development

Psychosocial Development

Cognitive Development

Moral Development

Health Risks

Health Assessment and Promotion

Toddlers (27 to 29 Years)




Moral Development

Spiritual Development

Health Risks


Preschoolers (30 and 31 Years)




Moral Development


Health Risks


School-Age Children (32 to 38 Years)




Moral Development


Health Risks


Adolescents (38 to 44 Years)




Moral Development


Table of Contents

Health Risks


Chapter 22: Promoting Health in Young and Middle-Aged AdultsIntroduction

Young Adults (46 to 66 Years)




Moral Development


Health Risks


Middle-Aged Adults (66 to 91 Years)




Moral Development


Health Risks


Chapter 23: Promoting Health in Older AdultsIntroduction

Characteristics of Older Adults in the United States

Demographics

Socioeconomic

Ethnicity

Health

Attitudes Toward Aging

Ageism

Myths and Stereotypes

Gerontological Nursing

Development

Roles

Care Settings for Older Adults

Acute Care Facilities

Long-Term Care Facilities

Hospice

Rehabilitation

Community

Physiological Aging

Integument

Neuromuscular

Sensory-Perceptual

Pulmonary

Cardiovascular

Gastrointestinal

Table of Contents

Urinary

Genitals

Psychosocial Aging

Retirement

Economic Change

Grandparenting

Relocation

Maintaining Independence and Self-Esteem

Facing Death and Grieving

Cognitive Abilities and Aging

Perception

Cognitive Agility

Memory

Learning

Moral Reasoning

Spirituality and Aging

Health Problems

Injuries

Chronic Disabling Illness

Drug Abuse and Misuse

Alcoholism

Dementia

Mistreatment of Older Adults


Chapter 24: Promoting Family HealthIntroduction

Family Health

Functions of the Family

Types of Families in Todays Society

Applying Theoretical Frameworks to Families

Systems Theory

Structural Functional Theory

Nursing Management

Unit 6: Integral Aspects of NursingChapter 25: Caring

Introduction

Professionalization of Caring

Caring as Helping the Other Grow

Nursing Theories on Caring

Culture Care Diversity and Universality (Leininger)

Theory of Bureaucratic Caring (Ray)

Caring, the Human Mode of Being (Roach)

Nursing as Caring (Boykin and Schoenhofer)

Theory of Human Care (Watson)

Theory of Caring (Swanson)

Table of Contents

Types of Knowledge in Nursing

Empirical Knowing: The Science of Nursing

Personal Knowing: The Therapeutic Use of Self

Ethical Knowing: The Moral Component

Aesthetic Knowing: The Art of Nursing

Developing Ways of Knowing

Caring Encounters

Knowing the Client

Nursing Presence

Empowering the Client

Compassion

Competence

Maintaining Caring Practice

Caring for Self

Reflection on Practice

Chapter 26: CommunicatingIntroduction

Communicating

The Communication Process

Modes of Communication

Factors Influencing the Communication Process

Therapeutic Communication

Barriers to Communication

The Helping Relationship

Phases of the Helping Relationship

Developing Helping Relationships

Group Communication

Group Dynamics

Types of Health Care Groups

Communication and the Nursing Process

Nursing Management

Communication Among Health Professionals

Disruptive Behaviors

Responding to Disruptive Behaviors

Nurse and Physician Communication

Chapter 27: TeachingIntroduction

Teaching

Teaching Clients and Their Families

Teaching in the Community

Teaching Health Personnel

Learning

Learning Domains

Learning Theories

Factors Affecting Learning

Table of Contents

The Internet and Health Information

Online Health Information

Older Adults and Use of the Internet

Implications

Nurse as Educator

Nursing Management

Chapter 28: Leading, Managing, and DelegatingIntroduction

The Nurse as Leader and Manager

Leadership

Leadership Theory

Effective Leadership

Management

Levels of Management

Management Functions

Principles of Management

Skills and Competencies of Nurse Managers

The Nurse as Delegator

Change

Types of Change

The Nurses Role in Change

Unit 7: Assessing HealthChapter 29: Vital Signs

Introduction

Body Temperature

Regulation of Body Temperature

Factors Affecting Body Temperature

Alterations in Body Temperature

Assessing Body Temperature

SKILL 29-1: Assessing Body Temperature

Pulse

Factors Affecting the Pulse

Pulse Sites

Assessing the Pulse

SKILL 29-2: Assessing a Peripheral Pulse

Apical Pulse Assessment

SKILL 29-3: Assessing an Apical Pulse

SKILL 29-4: Assessing an Apical-Radial Pulse

Respirations

Mechanics and Regulation of Breathing

Assessing Respirations

Factors Affecting Respirations

SKILL 29-5: Assessing Respirations

Blood Pressure

Table of Contents

Determinants of Blood Pressure

Factors Affecting Blood Pressure

Hypertension

Hypotension

Assessing Blood Pressure

Common Errors in Assessing Blood Pressure

SKILL 29-6: Assessing Blood Pressure

Oxygen Saturation

Factors Affecting Oxygen Saturation Readings

SKILL 29-7: Measuring Oxygen Saturation

Chapter 30: Health AssessmentIntroduction

Physical Health Assessment

Preparing the Client

Preparing the Environment

Positioning

Draping

Instrumentation

Methods of Examining

General Survey

Appearance and Mental Status

SKILL 30-1: Assessing Appearance and Mental Status

Vital Signs

Height and Weight

Integument

Skin

SKILL 30-2: Assessing the Skin

Hair

Nails

SKILL 30-3: Assessing the Hair

SKILL 30-4: Assessing the Nails

Head

Skull and Face

SKILL 30-5: Assessing the Skull and Face

Eyes and Vision

SKILL 30-6: Assessing the Eye Structures and Visual Acuity

Ears and Hearing

SKILL 30-7: Assessing the Ears and Hearing

Nose and Sinuses

SKILL 30-8: Assessing the Nose and Sinuses

Mouth and Oropharynx

SKILL 30-9: Assessing the Mouth and Oropharynx

Neck

Thorax and Lungs

Chest Landmarks

Table of Contents

SKILL 30-10: Assessing the Neck

Chest Shape and Size

Breath Sounds

SKILL 30-11: Assessing the Thorax and Lungs

Cardiovascular and Peripheral Vascular Systems

Heart

Central Vessels

SKILL 30-12: Assessing the Heart and Central Vessels

Peripheral Vascular System

SKILL 30-13: Assessing the Peripheral Vascular System

Breasts and Axillae

SKILL 30-14: Assessing the Breasts and Axillae

Abdomen

SKILL 30-15: Assessing the Abdomen

Musculoskeletal System

SKILL 30-16: Assessing the Musculoskeletal System

Neurologic System

Mental Status

Level of Consciousness

Cranial Nerves

Reflexes

Motor Function

Sensory Function

SKILL 30-17: Assessing the Neurologic System

Female Genitals and Inguinal Area

SKILL 30-18: Assessing the Female Genitals and Inguinal Area

Male Genitals and Inguinal Area

SKILL 30-19: Assessing the Male Genitals and Inguinal Area

Anus

Skill 3020 Assessing the Anus

Unit 8: Integral Components of Client CareChapter 31: Asepsis

Introduction

Types of Microorganisms That Cause Infections

Types of Infections

Nosocomial and Health CareAssociated Infections

Chain of Infection

Etiologic Agent

Reservoir

Portal of Exit from Reservoir

Method of Transmission

Portal of Entry to the Susceptible Host

Susceptible Host

Body Defenses Against Infection

Table of Contents

Nonspecific Defenses

Specific Defenses

Factors Increasing Susceptibility to Infection

Nursing Management

SKILL 31-1: Performing Hand Hygiene

SKILL 31-2: Applying and Removing Personal Protective Equipment (Gloves, Gown,

Mask, Eyewear)

SKILL 31-3: Establishing and Maintaining a Sterile Field

SKILL 31-4: Applying and Removing Sterile Gloves (Open Method)

SKILL 31-5: Applying a Sterile Gown and Gloves (Closed Method)

Chapter 32: SafetyIntroduction

Factors Affecting Safety

Age and Development

Lifestyle

Mobility and Health Status

Sensory-Perceptual Alterations

Cognitive Awareness

Emotional State

Ability to Communicate

Safety Awareness

Environmental Factors

Nursing Management

SKILL 32-1: Using a Bed or Chair Exit Safety Monitoring Device

SKILL 32-2: Implementing Seizure Precautions

SKILL 32-3: Applying Restraints

Chapter 33: HygieneIntroduction

Hygienic Care

Skin

Nursing Management

SKILL 33-1: Bathing an Adult Client

SKILL 33-2: Providing Perineal-Genital Care

Feet

Developmental Variations

Nursing Management

SKILL 33-3: Providing Foot Care

Nails

Nursing Management

Mouth


Nursing Management

SKILL 33-4: Brushing and Flossing the Teeth

Table of Contents

SKILL 33-5: Providing Special Oral Care for the Unconscious Client

Hair


Nursing Management

SKILL 33-6: Providing Hair Care

Eyes

Nursing Management

Ears

Cleaning the Ears

Care of Hearing Aids

SKILL 33-7: Removing, Cleaning, and Inserting a Hearing Aid

Nose

Supporting a Hygienic Environment

Environment

Hospital Beds

Mattresses

Side Rails

Footboard or Footboot

Intravenous Rods

Making Beds

Unoccupied Bed

SKILL 33-8: Changing an Unoccupied Bed

Changing an Occupied Bed

SKILL 33-9: Changing an Occupied Bed

Chapter 34: Diagnostic TestingIntroduction

Diagnostic Testing Phases

Pretest

Intratest

Post-Test

Nursing Diagnoses

Blood Tests

Complete Blood Count

Serum Electrolytes

Serum Osmolality

Drug Monitoring

Arterial Blood Gases

Blood Chemistry

Metabolic Screening

Capillary Blood Glucose

SKILL 34-1: Obtaining a Capillary Blood Specimen to Measure Blood Glucose

Specimen Collection and Testing

Stool Specimens

Urine Specimens

SKILL 34-2: Collecting a Urine Specimen for Culture and Sensitivity by Clean

Table of Contents

CatchSputum Specimens

Throat Culture

Visualization Procedures

Clients with Gastrointestinal Alterations

Clients with Urinary Alterations

Clients with Cardiopulmonary Alterations

Computed Tomography

Magnetic Resonance Imaging

Nuclear Imaging Studies

Aspiration/Biopsy

Lumbar Puncture

Abdominal Paracentesis

Thoracentesis

Bone Marrow Biopsy

Liver Biopsy

Chapter 35: MedicationsIntroduction

Drug Standards

Legal Aspects of Drug Administration

Effects of Drugs

Drug Misuse

Actions of Drugs on the Body

Pharmacodynamics

Pharmacokinetics

Factors Affecting Medication Action

Developmental Factors

Gender

Cultural, Ethnic, and Genetic Factors

Diet

Environment

Psychological Factors

Illness and Disease

Time of Administration

Routes of Administration

Oral

Sublingual

Buccal

Parenteral

Topical

Medication Orders

Types of Medication Orders

Essential Parts of a Medication Order

Communicating a Medication Order

Systems of Measurement

Table of Contents

Metric System

Apothecaries System

Household System

Converting Units of Weight and Measure

Methods of Calculating Dosages

Administering Medications Safely

Medication Administration Errors

Medication Reconciliation

Medication Dispensing Systems

Process of Administering Medications

Developmental Considerations

Oral Medications

SKILL 35-1: Administering Oral Medications

Nasogastric and Gastrostomy Medications

Parenteral Medications

Equipment

Preparing Injectable Medications

SKILL 35-2: Preparing Medications from Ampules

SKILL 35-3: Preparing Medications from Vials

SKILL 35-4: Mixing Medications Using One Syringe

Intradermal Injections

Subcutaneous Injections

SKILL 35-5: Administering an Intradermal Injection for Skin Tests

SKILL 35-6: Administering a Subcutaneous Injection

Intramuscular Injections

SKILL 35-7: Administering an Intramuscular Injection

Intravenous Medications

SKILL 35-8: Adding Medications to Intravenous Fluid Containers

SKILL 35-9: Administering Intravenous Medications Using IV Push

Topical Medications

SKILL 35-10: Administering Ophthalmic Instillations

SKILL 35-11: Administering Otic Instillations

SKILL 35-12: Administering Vaginal Instillations

Inhaled Medications

Irrigations

Chapter 36: Skin Integrity and Wound CareIntroduction

Skin Integrity

Types of Wounds

Pressure Ulcers

Etiology of Pressure Ulcers

Risk Factors

Stages of Pressure Ulcers

Wound Healing

Table of Contents

Types of Wound Healing

Phases of Wound Healing

Types of Wound Exudate

Complications of Wound Healing

Factors Affecting Wound Healing

Nursing Management

SKILL 36-1: Obtaining a Wound Drainage Specimen for Culture

SKILL 36-2: Irrigating a Wound

Supporting and Immobilizing Wounds

Bandages

Basic Turns for Roller Bandages

Circular Turns

Spiral Turns

Spiral Reverse Turns

Recurrent Turns

Figure-Eight Turns

Binders

Arm Sling

Straight Abdominal Binder

Heat and Cold Applications

Local Effects of Heat

Local Effects of Cold

Systemic Effects of Heat and Cold

Thermal Tolerance

Adaptation of Thermal Receptors

Rebound Phenomenon

Applying Heat and Cold

Hot Water Bag

Aquathermia Pad

Hot and Cold Packs

Electric Heating Pads

Ice Bags, Ice Gloves, and Ice Collars

Compresses

Soaks

Sitz Baths

Cooling Sponge Baths

Chapter 37: Perioperative NursingIntroduction

Types of Surgery

Purpose

Degree of Urgency

Degree of Risk

Preoperative Phase

Preoperative Consent

Nursing Management

SKILL 37-1: Teaching Moving, Leg Exercises, Deep Breathing, and Coughing

Table of Contents

SKILL 37-2: Applying Antiemboli Stockings

Intraoperative Phase

Types of Anesthesia

Nursing Management

Postoperative Phase

Immediate Postanesthetic Phase

Preparing for Ongoing Care of the Postoperative Client

Nursing Management

SKILL 37-3: Managing Gastrointestinal Suction

SKILL 37-4: Cleaning a Sutured Wound and Changing a Dressing on a Wound with a

Drain

Unit 9: Promoting Psychosocial HealthChapter 38: Sensory Perception

Introduction

Components of the Sensory Experience

Arousal Mechanism

Factors Affecting Sensory Function

Developmental Stage

Culture

Stress

Medications and Illness

Lifestyle and Personality

Sensory Alterations

Sensory Deprivation

Sensory Overload

Sensory Deficits

Nursing Management

Chapter 39: Self-ConceptIntroduction

Self-Concept

Formation of Self-Concept

Components of Self-Concept

Personal Identity

Body Image

Role Performance

Self-Esteem

Factors that Affect Self-Concept

Stage of Development

Family and Culture

Stressors

Resources

History of Success and Failure

Illness

Nursing Management

Table of Contents

Chapter 40: SexualityIntroduction

Development of Sexuality

Birth to 12 Years

Adolescence

Young and Middle Adulthood

Older Adulthood

Sexual Health

Components of Sexual Health

Varieties of Sexuality

Sexual Orientation

Gender Identity

Erotic Preferences

Factors Influencing Sexuality

Family

Culture

Religion

Personal Expectations and Ethics

Sexual Response Cycle

Altered Sexual Function

Past and Current Factors

Sexual Desire Disorders

Sexual Arousal Disorders

Orgasmic Disorders

Sexual Pain Disorders

Problems with Satisfaction

Nursing Management

Chapter 41: SpiritualityIntroduction

Spirituality and Related Concepts Described

Spiritual Care or Spiritual Nursing Care?

Spiritual Needs, Spiritual Distress, Spiritual Health, and Religious Coping


Religious Practices that Nurses Should Know

Holy Days

Sacred Texts

Sacred Symbols

Prayer and Meditation

Beliefs Affecting Diet

Beliefs About Illness and Healing

Beliefs About Dress and Modesty

Beliefs Related to Birth

Beliefs Related to Death

Spiritual Health and the Nursing Process

Nursing Management

Table of Contents

Spiritual Self-Awareness for the Nurse

Chapter 42: Stress and CopingIntroduction

Concept of Stress

Sources of Stress

Effects of Stress

Models of Stress

Stimulus-Based Models

Response-Based Models

Transaction-Based Models

Indicators of Stress

Physiological Indicators

Psychological Indicators

Cognitive Indicators

Coping

Nursing Management

Chapter 43: Loss, Grieving, and DeathIntroduction

Loss and Grief

Types and Sources of Loss

Grief, Bereavement, and Mourning

Stages of Grieving

Manifestations of Grief

Factors Influencing the Loss and Grief Responses

Nursing Management

Dying and Death

Responses to Dying and Death

Definitions and Signs of Death

Death-Related Religious and Cultural Practices

Nursing Management

Unit 10: Promoting Physiological HealthChapter 44: Activity and Exercise

Introduction

Normal Movement

Alignment and Posture

Joint Mobility

Balance

Coordinated Movement

Factors Affecting Body Alignment and Activity

Growth and Development

Nutrition

Personal Values and Attitudes

External Factors

Prescribed Limitations

Table of Contents

Exercise

Types of Exercise

Benefits of Exercise

Effects of Immobility

Musculoskeletal System

Cardiovascular System

Respiratory System

Metabolic System

Urinary System

Gastrointestinal System

Integumentary System

Psychoneurologic System

Nursing Management

SKILL 44-1: Moving a Client Up in Bed

SKILL 44-2: Turning a Client to the Lateral or Prone Position in Bed

SKILL 44-3: Logrolling a Client

SKILL 44-4: Assisting a Client to Sit on the Side of the Bed (Dangling)

SKILL 44-5: Transferring Between Bed and Chair

SKILL 44-6: Transferring Between Bed and Stretcher

SKILL 44-7: Assisting a Client to Ambulate

Chapter 45: SleepIntroduction

Physiology of Sleep

Circadian Rhythms

Types of Sleep

Sleep Cycles

Functions of Sleep

Normal Sleep Patterns and Requirements

Newborns

Infants

Toddlers

Preschoolers

School-Age Children

Adolescents

Adults

Older Adults

Factors Affecting Sleep

Illness

Environment

Lifestyle

Emotional Stress

Stimulants and Alcohol

Diet

Smoking

Motivation

Table of Contents

Medications

Common Sleep Disorders

Insomnia

Excessive Daytime Sleepiness

Parasomnias

Nursing Management

Chapter 46: Pain ManagementIntroduction

The Nature of Pain

Types of Pain

Concepts Associated with Pain

Physiology of Pain

Nociception

Gate Control Theory

Responses to Pain

Factors Affecting the Pain Experience

Ethnic and Cultural Values

Developmental Stage

Environment and Support People

Previous Pain Experiences

Meaning of Pain

Nursing Management

SKILL 46-1: Providing a Back Massage

Chapter 47: NutritionIntroduction

Essential Nutrients

Carbohydrates

Proteins

Lipids

Micronutrients

Energy Balance

Energy Intake

Energy Output

Body Weight and Bodymass Standards

Factors Affecting Nutrition

Development

Sex

Ethnicity and Culture

Beliefs About Food

Personal Preferences

Religious Practices

Lifestyle

Economics

Medications and Therapy

Health

Table of Contents

Alcohol Consumption

Advertising


Nutritional Variations Throughout the Life Cycle

Neonate to 1 Year

Toddler

Preschooler

School-Age Child

Adolescent

Young Adult

Middle-Aged Adult

Older Adults

Standards for a Healthy Diet

Dietary Guidelines for Americans

Recommended Dietary Intake

Vegetarian Diets

Altered Nutrition

Nursing Management

SKILL 47-1: Inserting a Nasogastric Tube

SKILL 47-2: Administering a Tube Feeding

SKILL 47-3: Administering a Gastrostomy or Jejunostomy Feeding

SKILL 47-4: Removing a Nasogastric Tube

Chapter 48: Urinary EliminationIntroduction

Physiology of Urinary Elimination

Kidneys

Ureters

Bladder

Urethra

Pelvic Floor

Urination

Factors Affecting Voiding

Developmental Factors

Psychosocial Factors

Fluid and Food Intake

Medications

Muscle Tone

Pathologic Conditions

Surgical and Diagnostic Procedures

Altered Urine Production

Polyuria

Oliguria and Anuria

Altered Urinary Elimination

Frequency and Nocturia

Urgency

Table of Contents

Dysuria

Enuresis

Urinary Incontinence

Urinary Retention

Nursing Management

SKILL 48-1: Applying an External Urinary Device

SKILL 48-2: Performing Urinary Catheterization

SKILL 48-3: Performing Bladder Irrigation

Chapter 49: Fecal EliminationIntroduction

Physiology of Defecation

Large Intestine

Rectum and Anal Canal

Defecation

Feces

Factors that Affect Defecation

Development

Diet

Fluid Intake and Output

Activity


Defecation Habits

Medications

Diagnostic Procedures

Anesthesia and Surgery

Pathologic Conditions

Pain

Fecal Elimination Problems

Constipation

Diarrhea

Bowel Incontinence

Flatulence

Bowel Diversion Ostomies

Permanence

Anatomic Location

Surgical Construction of the Stoma

Nursing Management

SKILL 49-1: Administering an Enema

SKILL 49-2: Changing a Bowel Diversion Ostomy Appliance

Chapter 50: OxygenationIntroduction

Structure and Processes of the Respiratory System

Structure of the Respiratory System

Pulmonary Ventilation

Alveolar Gas Exchange

Table of Contents

Transport of Oxygen and Carbon Dioxide

Systemic Diffusion

Respiratory Regulation

Factors Affecting Respiratory Function

Age

Environment

Lifestyle

Health Status

Medications

Stress

Alterations in Respiratory Function

Conditions Affecting the Airway

Conditions Affecting Movement of Air

Conditions Affecting Diffusion

Conditions Affecting Transport

Nursing Management

SKILL 50-1: Administering Oxygen by Cannula, Face Mask, or Face Tent

SKILL 50-2: Oropharyngeal, Nasopharyngeal, and Nasotracheal Suctioning

SKILL 50-3: Suctioning a Tracheostomy or Endotracheal Tube

SKILL 50-4: Providing Tracheostomy Care

Chapter 51: CirculationIntroduction

Physiology of the Cardiovascular System

The Heart

Blood Vessels

Blood

Lifespan Considerations

Factors Affecting Cardiovascular Function

Risk Factors

Alterations in Cardiovascular Function

Decreased Cardiac Output

Impaired Tissue Perfusion

Blood Alterations

Nursing Management

SKILL 51-1: Applying Sequential Compression Devices

Chapter 52: Fluid, Electrolyte, and AcidBase BalanceIntroduction

Body Fluids and Electrolytes

Distribution of Body Fluids

Composition of Body Fluid

Movement of Body Fluids and Electrolytes

Regulating Body Fluids

Regulating Electrolytes

AcidBase Balance

Table of Contents

Regulation of AcidBase Balance

Factors Affecting Body Fluid, Electrolytes, and AcidBase Balance

Age

Sex and Body Size

Environmental Temperature

Lifestyle

Disturbances in Fluid Volume, Electrolyte, and AcidBase Balances

Fluid Imbalances

Electrolyte Imbalances

AcidBase Imbalances

Nursing Management

SKILL 52-1: Starting an Intravenous Infusion

SKILL 52-2: Monitoring an Intravenous Infusion

SKILL 52-3: Changing an Intravenous Container and Tubing

SKILL 52-4: Discontinuing an Intravenous Infusion

SKILL 52-5: Changing an Intravenous Catheter to an Intermittent Infusion Lock

SKILL 52-6 Initiating, Maintaining, and Terminating a Blood Transfusion Using a

Y-Set

AppendixAppendix A: Answers to Test Your Knowledge

Appendix B: Single Measurement Scales Used in NOC

Appendix C: NANDA-Approved Nursing Diagnoses 20152017

Glossary

Index

Back Cover

kozier & erb’s fundamentals of nursing

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