Fundamental Skills and Concepts in Patient Care, Revised Reprint

by Timby, Barbara Kuhn

• ISBN13: 9780781737012
• ISBN10: 078173701X
• Edition: 7th
• Format: Paperback
• Copyright: 2002-06-17
• Publisher: LWW

Summary

This popular text has been reprinted in color to add visual appeal while maintaining the same content and presentation. Straightforward and easy to understand, Fundamental Skills and Concepts in Patient Care, Seventh Edition features a well-integrated blend of material and step-by-step procedures. The full color now enhances the material and adds increased visual appeal. Designed specifically for LPN/LVN students, this introductory textbook covers various techniques, procedures, and basic nursing concepts. A Brandon-Hill Recommended Title.

Author Biography

Barbara Kuhn Timby, RN,C, BSN, MA Nursing Professor Glen Oaks Community College Centreville, Michigan

Table of Contents

SECTION I Fundamental Nursing Concepts	1	(2)
UNIT I EXPLORING CONTEMPORARY NURSING	3	(30)
Nursing Foundations	5	(16)
Nursing Origins	5	(1)
The Nightingale Reformation	6	(1)
The Crimean War	6	(1)
Nightingale's Contributions	7	(1)
Establishing Nursing in the United States	7	(1)
U.S. Nursing Schools	7	(1)
Expanding Horizons of Practice	8	(1)
Contemporary Nursing	8	(1)
Combining Nursing Art With Science	8	(1)
Integrating Nursing Theory	9	(1)
Definitions of Nursing	9	(1)
The Educational Ladder	9	(4)
Practical/Vocational Nursing	11	(1)
Registered Nursing	11	(1)
Hospital-Based Diploma Programs	12	(1)
Associate Degree Programs	12	(1)
Baccalaureate Programs	13	(1)
Graduate Nursing Programs	13	(1)
Continuing Education	13	(1)
Future Trends	13	(2)
Unique Nursing Skills	15	(6)
Assessment Skills	15	(1)
Caring Skills	15	(1)
Counseling Skills	15	(1)
Comforting Skills	15	(6)
Nursing Process	21	(12)
The Nursing Process	21	(1)
Characteristics of the Nursing Process	22	(1)
Assessment	22	(3)
Types of Data	22	(1)
Sources for Data	23	(1)
Types of Assessments	23	(1)
Organizing Data	23	(2)
Diagnosis	25	(1)
Nursing Diagnoses	25	(1)
Diagnostic Statements	25	(1)
Collaborative Problems	26	(1)
Planning	26	(2)
Setting Priorities	26	(1)
Establishing Goals	26	(2)
Selecting Nursing Interventions	28	(1)
Documenting the Plan of Care	28	(1)
Communicating the Plan	28	(1)
Implementation	28	(2)
Documentation	28	(2)
Evaluation	30	(1)
Using the Nursing Process	30	(3)
UNIT II INTEGRATING BASIC CONCEPTS	33	(46)
Laws and Ethics	35	(12)
Laws	35	(5)
Constitutional Law	35	(1)
Statutory Laws	35	(1)
Administrative Laws	36	(1)
Common Law	37	(1)
Criminal Laws	37	(1)
Civil Laws	37	(3)
Professional Liability	40	(1)
Liability Insurance	41	(1)
Reducing Liability	41	(1)
Malpractice Litigation	41	(1)
Ethics	41	(6)
Codes of Ethics	41	(2)
Solving Ethical Dilemmas	43	(1)
Common Ethics Issues	44	(3)
Health and Illness	47	(8)
Health	47	(1)
Health Values and Beliefs	47	(1)
Wellness	48	(1)
Holism	48	(1)
Illness	49	(1)
Morbidity and Mortality	49	(1)
Acute, Chronic, and Terminal Illnesses	49	(1)
Primary and Secondary Illnesses	50	(1)
Remission and Exacerbation	50	(1)
Hereditary, Congenital, and Idiopathic Illnesses	50	(1)
Health Care System	50	(1)
Health Care Services	51	(1)
National Health Goals	51	(1)
Nursing Team	52	(1)
Management Patterns	52	(1)
Continuity of Health Care	53	(2)
Homeostasis, Adaptation, and Stress	55	(12)
Homeostasis	55	(1)
Holism	55	(1)
Physiologic Adaptation	56	(3)
Central Nervous System	56	(1)
Neurotransmitters	57	(1)
Autonomic Nervous System	58	(1)
Endocrine System	58	(1)
Stress	59	(2)
Nature of Stress	60	(1)
Stress Response	60	(1)
Stress-Related Disorders	61	(1)
Psychological Adaptation	61	(1)
Coping Mechanisms	61	(1)
Coping Strategies	61	(1)
Maladaptive Coping	62	(1)
Nursing Implications	62	(5)
Stress Reduction Techniques	62	(1)
Stress Management	63	(4)
Culture and Ethnicity	67	(12)
Culture	67	(1)
Race	68	(1)
Ethnicity	68	(1)
Stereotyping	69	(1)
Ethnocentrism	69	(1)
Anglo-American Culture	69	(1)
American Subcultures	69	(1)
Transcultural Nursing	70	(9)
Cultural Assessment	70	(5)
Culturally Sensitive Nursing	75	(4)
UNIT III FOSTERING COMMUNICATION	79	(36)
The Nurse-Patient Relationship	81	(8)
The Nurse-Patient Relationship	81	(2)
Underlying Principles	82	(1)
Phases of the Nurse-Patient Relationship	82	(1)
Barriers to a Therapeutic Relationship	83	(1)
Communication	83	(6)
Verbal Communication	83	(1)
Therapeutic Verbal Communication	84	(1)
Listening	84	(1)
Silence	85	(1)
Nonverbal Communication	86	(3)
Patient Teaching	89	(8)
Patient Teaching	89	(1)
Assessing the Learner	89	(4)
Learning Styles	90	(1)
Age and Developmental Differences	90	(1)
Capacity to Learn	91	(2)
Motivation	93	(1)
Learning Readiness	93	(1)
Learning Needs	93	(1)
Informal and Formal Teaching	93	(4)
Recording and Reporting	97	(18)
Medical Records	97	(3)
Uses	97	(3)
Patient Access to Records	100	(1)
Types of Patient Records	100	(1)
Methods of Charting	100	(3)
Narrative Charting	100	(1)
SOAP Charting	100	(1)
Focus Charting	100	(1)
PIE Charting	101	(1)
Charting by Exception	101	(1)
Computerized Charting	102	(1)
Documenting Information	103	(3)
Using Abbreviations	103	(1)
Indicating Documentation Time	103	(3)
Communication for Continuity and Collaboration	106	(9)
Written Forms of Communication	107	(1)
Interpersonal Communication	108	(7)
SECTION II Fundamental Nursing Skills	115	(2)
UNIT IV PERFORMING ASSESSMENT AND EVALUATION	117	(116)
Admission, Discharge, Transfer, and Referrals	119	(20)
The Admission Process	119	(5)
Medical Authorization	120	(1)
The Admitting Department	120	(1)
Nursing Admission Activities	120	(2)
Medical Admission Responsibilities	122	(1)
Common Responses to Admission	123	(1)
The Discharge Process	124	(1)
Obtaining Authorization for Medical Discharge	124	(1)
Providing Discharge Instructions	124	(1)
Notifying the Business Office	124	(1)
Discharging a Patient	125	(1)
Writing a Discharge Summary	125	(1)
Terminal Cleaning	125	(1)
Patient Transfer	125	(4)
Transfer Activities	125	(1)
Extended Care Facilities	126	(3)
Patient Referral	129	(3)
Home Health Care	129	(3)
Skill 10-1 Admitting a Patient	132	(3)
Skill 10-2 Discharging a Patient	135	(4)
Vital Signs	139	(40)
Body Temperature	140	(8)
Temperature Measurement	140	(1)
Normal Body Temperature	140	(2)
Assessment Sites	142	(1)
Thermometers	143	(3)
Elevated Body Temperature	146	(1)
Subnormal Body Temperature	147	(1)
Pulse	148	(3)
Pulse Rate	148	(1)
Pulse Rhythm	149	(1)
Pulse Volume	149	(1)
Assessment Sites	149	(2)
Respiration	151	(1)
Respiratory Rate	151	(1)
Breathing Patterns and Abnormal Characteristics	151	(1)
Blood Pressure	152	(6)
Factors Affecting Blood Pressure	152	(1)
Pressure Measurements	153	(1)
Assessment Sites	153	(1)
Equipment for Measuring Blood Pressure	153	(1)
Measuring Blood Pressure	154	(2)
Alternative Assessment Techniques	156	(1)
Abnormal Blood Pressure Measurements	157	(1)
Documenting Vital Signs	158	(1)
Nursing Implications	158	(4)
Skill 11-1 Assessing Body Temperature	162	(8)
Skill 11-2 Assessing the Radial Pulse	170	(2)
Skill 11-3 Assessing the Respiratory Rate	172	(2)
Skill 11-4 Assessing Blood Pressure	174	(5)
Physical Assessment	179	(26)
Overview of Physical Assessment	179	(2)
Purposes	180	(1)
Techniques	180	(1)
Equipment	181	(1)
Environment	181	(1)
Performing a Physical Assessment	181	(3)
General Data	182	(1)
Weight and Height	182	(1)
Draping and Positioning	183	(1)
Approaches for Data Collection	183	(1)
Data Collection	184	(14)
Head and Neck	184	(5)
Chest and Spine	189	(6)
Extremities	195	(1)
Abdomen	196	(1)
The Genitalia	197	(1)
Anus and Rectum	198	(1)
Nursing Implications	198	(3)
Skill 12-1 Performing a Physical Assessment	201	(4)
Special Examinations and Tests	205	(28)
Examinations and Tests	205	(6)
General Nursing Responsibilities	206	(2)
Arranging the Examination Area	208	(3)
Common Diagnostic Examinations	211	(4)
Pelvic Examination	211	(1)
Radiography	211	(2)
Endoscopic Examinations	213	(1)
Radionuclide Imaging	214	(1)
Ultrasonography	214	(1)
Electrical Graphic Recordings	214	(1)
Diagnostic Tests	215	(4)
Assisting with a Paracentesis	215	(1)
Assisting with a Lumbar Puncture	216	(1)
Collecting a Specimen for a Throat Culture	217	(2)
Measuring Capillary Blood Glucose	219	(1)
Nursing Implications	219	(3)
Skill 13-1 Assisting with a Pelvic Examination	222	(3)
Skill 13-2 Assisting with a Sigmoidoscopy	225	(3)
Skill 13-3 Using a Glucometer	228	(5)
UNIT V ASSISTING WITH BASIC NEEDS	233	(206)
Nutrition	235	(24)
Overview of Nutrition	236	(4)
Human Nutritional Needs	236	(4)
Nutritional Standards	240	(1)
Nutritional Patterns and Practices	240	(3)
Eating Habits	240	(3)
Nutritional Status Assessment	243	(2)
Subjective Data	243	(1)
Objective Data	243	(2)
Management of Problems Interfering with Nutrition	245	(3)
Obesity	245	(1)
Emaciation	246	(1)
Anorexia	246	(1)
Nausea	247	(1)
Vomiting	247	(1)
Stomach Gas	248	(1)
Management of Patient Nutrition	248	(5)
Common Hospital Diets	248	(1)
Meal Trays	248	(1)
Feeding Assistance	249	(4)
Skill 14-1 Serving and Removing Meal Trays	253	(1)
Skill 14-2 Feeding a Patient	254	(5)
Fluid and Chemical Balance	259	(46)
Body Fluid	260	(3)
Water	260	(1)
Electrolytes	260	(1)
Nonelectrolytes	261	(1)
Blood	261	(1)
Fluid and Electrolyte Distribution Mechanisms	261	(1)
Fluid Regulation	262	(1)
Fluid Volume Assessment	263	(3)
Intake and Output	263	(3)
Common Fluid Imbalances	266	(1)
Hypovolemia	266	(1)
Hypervolemia	266	(1)
Third-Spacing	267	(1)
Intravenous Fluid Administration	267	(11)
Types of Solutions	268	(2)
Preparation for Administration	270	(2)
Infusion Techniques	272	(1)
Venipuncture	273	(1)
Infusion Monitoring and Maintenance	274	(3)
Discontinuation of an Intravenous Infusion	277	(1)
Insertion of an Intermittent Venous Access Device	277	(1)
Blood Administration	278	(1)
Blood Collection and Storage	278	(1)
Blood Safety	278	(1)
Blood Compatibility	278	(1)
Blood Transfusion	278	(1)
Transfusion Reactions	279	(1)
Parenteral Nutrition	279	(3)
Peripheral Parenteral Nutrition	279	(1)
Total Parenteral Nutrition	279	(2)
Lipid Emulsions	281	(1)
Nursing Implications	282	(3)
Skill 15-1 Recording Intake and Output	285	(3)
Skill 15-2 Preparing Intravenous Solutions	288	(3)
Skill 15-3 Starting an Intravenous Infusion	291	(4)
Skill 15-4 Changing IV Solution Containers	295	(2)
Skill 15-5 Changing IV Tubing	297	(1)
Skill 15-6 Inserting a Medication Lock	298	(3)
Skill 15-7 Administering a Blood Transfusion	301	(4)
Hygiene	305	(30)
The Integumentary System	306	(1)
Skin	306	(1)
Mucous Membranes	306	(1)
Hair	306	(1)
Nails	307	(1)
Teeth	307	(1)
Hygiene Practices	307	(8)
Bathing	307	(4)
Shaving	311	(1)
Oral Hygiene	312	(1)
Hair Care	313	(1)
Nail Care	314	(1)
Visual and Hearing Devices	315	(2)
Eyeglasses	315	(1)
Contact Lenses	315	(1)
Artificial Eyes	316	(1)
Hearing Aids	316	(1)
Nursing Implications	317	(4)
Skill 16-1 Providing a Tub Bath or Shower	321	(2)
Skill 16-2 Administering Perineal Care	323	(3)
Skill 16-3 Giving a Bed Bath	326	(3)
Skill 16-4 Giving Oral Care to Unconscious Patients	329	(3)
Skill 16-5 Shampooing Hair	332	(3)
Comfort, Rest, and Sleep	335	(28)
The Patient Environment	336	(3)
Patient Rooms	336	(1)
Room Furnishings	337	(2)
Sleep and Rest	339	(3)
Functions of Sleep	339	(1)
Sleep Phases	339	(1)
Sleep Requirements	339	(1)
Factors Affecting Sleep	339	(3)
Sleep Assessment	342	(1)
Questionnaires	342	(1)
Sleep Diary	342	(1)
Nocturnal Polysomnography	342	(1)
Multiple Sleep Latency Test	343	(1)
Sleep Disorders	343	(2)
Insomnia	343	(1)
Hypersomnias	344	(1)
Sleep-Wake Cycle Disturbances	344	(1)
Parasomnias	345	(1)
Nursing Implications	345	(5)
Progressive Relaxation	345	(1)
Back Massage	346	(4)
Skill 17-1 Making an Unoccupied Bed	350	(5)
Skill 17-2 Making an Occupied Bed	355	(3)
Skill 17-3 Giving a Back Massage	358	(5)
Safety	363	(20)
Age-Related Safety Factors	363	(1)
Infants and Toddlers	363	(1)
School-Aged Children and Adolescents	364	(1)
Adults	364	(1)
Environmental Hazards	364	(8)
Latex Sensitization	364	(2)
Burns	366	(2)
Asphyxiation	368	(1)
Electrical Shock	369	(1)
Poisoning	369	(1)
Falls	370	(2)
Restraints	372	(2)
Legislation	372	(1)
Accreditation Standards	372	(1)
Restraint Alternatives	373	(1)
Use of Restraints	373	(1)
Nursing Implications	374	(3)
Skill 18-1 Using Physical Restraints	377	(6)
Pain Management	383	(24)
Pain	384	(2)
Pain Transmission	384	(1)
Pain Perception	384	(1)
Pain Theories	384	(1)
Types of Pain	385	(1)
Pain Assessment	386	(2)
Assessment Tools	387	(1)
Assessment Standards	387	(1)
Pain Management	388	(7)
Drug Therapy	389	(3)
Surgical Approaches	392	(1)
Nondrug/Nonsurgical Interventions	392	(3)
Nursing Implications	395	(4)
Addiction	396	(1)
Placebos	396	(3)
Skill 19-1 Preparing a Patient-Controlled Analgesia (PCA) Infuser	399	(4)
Skill 19-2 Operating a Transcutaneous Electrical Nerve Stimulation (TENS) Unit	403	(4)
Oxygenation	407	(32)
Anatomy and Physiology of Breathing	408	(1)
Mechanics of Ventilation	408	(1)
Assessing Oxygenation	408	(3)
Physical Assessment	408	(1)
Arterial Blood Gases	408	(3)
Pulse Oximetry	411	(1)
Promoting Oxygenation	411	(3)
Positioning	411	(1)
Breathing Techniques	412	(2)
Oxygen Therapy	414	(10)
Oxygen Sources	414	(1)
Equipment Used in Oxygen Administration	415	(1)
Common Delivery Devices	416	(6)
Additional Delivery Devices	422	(1)
Oxygen Hazards	423	(1)
Related Oxygenation Techniques	424	(1)
Water-Seal Chest Tube Drainage	424	(1)
Hyperbaric Oxygen Therapy	424	(1)
Nursing Implications	424	(3)
Skill 20-1 Using a Pulse Oximeter	427	(2)
Skill 20-2 Administering Oxygen	429	(3)
Skill 20-3 Maintaining a Water-Seal Chest Tube Drainage System	432	(7)
UNIT VI PREVENTING INFECTION	439	(42)
Asepsis	441	(26)
Microorganisms	441	(2)
Types of Microoraganisms	442	(1)
Survival of Microorganisms	443	(1)
Chain of Infection	443	(2)
Infectious Agents	443	(1)
Reservoir	444	(1)
Exit Route	444	(1)
Mode of Transmission	444	(1)
Port of Entry	444	(1)
Susceptible Host	445	(1)
Asepsis	445	(6)
Medical Asepsis	445	(6)
Surgical Asepsis	451	(4)
Sterilization	451	(1)
Principles of Surgical Asepsis	452	(3)
Nursing Implications	455	(4)
Skill 21-1 Handwashing	459	(3)
Skill 21-2 Donning Sterile Gloves	462	(5)
Infection Control	467	(14)
Infection	467	(1)
Infection Control Precautions	468	(3)
Standard Precautions	468	(1)
Transmission-Based Precautions	469	(2)
Infection Control Measures	471	(3)
Patient Care Environment	471	(1)
Personal Protective Equipment	471	(2)
Disposing of Contaminated Linen, Equipment, and Supplies	473	(1)
Discarding Biodegradable Trash	473	(1)
Removing Reusable Items	474	(1)
Delivering Laboratory Specimens	474	(1)
Transporting Patients	474	(1)
Psychological Implications	474	(1)
Promoting Social Interaction	474	(1)
Combatting Sensory Deprivation	474	(1)
Nursing Implications	475	(3)
Skill 22-1 Removing Personal Protective Equipment	478	(3)
UNIT VII ASSISTING THE INACTIVE PATIENT	481	(86)
Body Mechanics, Positioning, and Moving	483	(24)
Maintaining Good Posture	484	(1)
Standing	484	(1)
Sitting	485	(1)
Lying Down	485	(1)
Body Mechanics	485	(1)
Ergonomics	486	(1)
Positioning Patients	486	(4)
Common Positions	487	(1)
Positioning Devices	488	(2)
Turning and Moving Patients	490	(1)
Protective Devices	490	(3)
Siderails	490	(1)
Mattress Overlays	490	(1)
Cradle	491	(1)
Specialty Beds	492	(1)
Transferring Patients	493	(2)
Transfer Devices	493	(1)
Patient Transfer	494	(1)
Nursing Implications	495	(3)
Skill 23-1 Turning and Moving a Patient	498	(4)
Skill 23-2 Transferring Patients	502	(5)
Therapeutic Exercise	507	(20)
Fitness Assessment	507	(3)
Body Composition	508	(1)
Vital Signs	508	(1)
Fitness Tests	508	(2)
Exercise Prescriptions	510	(1)
Target Heart Rate	510	(1)
Metabolic Energy Equivalent	510	(1)
Types of Exercise	510	(3)
Fitness Exercise	510	(1)
Therapeutic Exercise	511	(2)
Nursing Implications	513	(3)
Skill 24-1 Performing Range-of-Motion (ROM) Exercises	516	(7)
Skill 24-2 Using a Continuous Passive Motion (CPM) Machine	523	(4)
Mechanical Immobilization	527	(20)
Mechanical Immobilization	527	(1)
Mechanical Immobilizing Devices	528	(9)
Splints	528	(2)
Slings	530	(1)
Braces	531	(1)
Casts	531	(3)
Traction	534	(3)
External Fixators	537	(1)
Nursing Implications	537	(3)
Skill 25-1 Applying an Arm Sling	540	(3)
Skill 25-2 Assisting with a Cast Application	543	(2)
Skill 25-3 Providing Pin Site Care	545	(2)
Ambulatory Aids	547	(20)
Preparing for Ambulation	547	(2)
Isometric Exercises	547	(1)
Upper Arm Strengthening	548	(1)
Dangling	548	(1)
Using a Tilt Table	549	(1)
Assistive Devices	549	(1)
Ambulatory Aids	550	(2)
Canes	550	(1)
Walkers	550	(1)
Crutches	551	(1)
Crutch-Walking Gaits	551	(1)
Prosthetic Limbs	552	(2)
Temporary Prosthetic Limb	553	(1)
Permanent Prosthetic Components	553	(1)
Patient Care	554	(1)
Ambulation with a Limb Prosthesis	554	(1)
Nursing Implications	554	(3)
Skill 26-1 Measuring for Crutches, Canes, and Walkers	557	(3)
Skill 26-2 Assisting with Crutch-Walking	560	(4)
Skill 26-3 Applying a Leg Prosthesis	564	(3)
UNIT VIII THE SURGICAL PATIENT	567	(82)
Perioperative Care	569	(22)
Preoperative Period	570	(6)
Inpatient Surgery	570	(1)
Outpatient Surgery	570	(1)
Informed Consent	571	(1)
Preoperative Blood Donation	571	(1)
Immediate Preoperative Care	571	(5)
Intraoperative Period	576	(1)
Receiving Room	576	(1)
Operating Room	576	(1)
Surgical Waiting Area	576	(1)
Postoperative Period	576	(3)
Immediate Postoperative Care	577	(1)
Continuing Postoperative Care	578	(1)
Nursing Implications	579	(4)
Skill 27-1 Applying Antiembolism Stockings	583	(2)
Skill 27-2 Performing Presurgical Skin Preparation	585	(2)
Skill 27-3 Applying a Pneumatic Compression Device	587	(4)
Wound Care	591	(26)
Wounds	592	(1)
Wound Repair	592	(1)
Inflammation	592	(1)
Proliferation	592	(1)
Remodeling	592	(1)
Wound Healing	593	(1)
Wound Management	593	(9)
Dressings	594	(1)
Drains	595	(1)
Sutures and Staples	596	(1)
Bandages and Binders	596	(1)
Debridement	597	(3)
Heat and Cold Applications	600	(2)
Pressure Ulcers	602	(3)
Stages of Pressure Ulcers	602	(1)
Prevention of Pressure Ulcers	603	(2)
Nursing Implications	605	(3)
Skill 28-1 Changing a Gauze Dressing	608	(3)
Skill 28-2 Irrigating a Wound	611	(2)
Skill 28-3 Providing a Sitz Bath	613	(4)
Gastrointestinal Intubation	617	(32)
Intubation	618	(1)
Types of Tubes	618	(2)
Orogastric Tube	618	(1)
Nasogastric Tubes	618	(1)
Nasointestinal Tubes	619	(1)
Transabdominal Tubes	620	(1)
Nasogastric Tube Management	620	(3)
Insertion	621	(1)
Use and Maintenance	622	(1)
Removal	623	(1)
Nasointestinal Tube Management	623	(2)
Insertion	623	(2)
Checking Tube Placement	625	(1)
Transabdominal Tube Management	625	(1)
Tube Feedings	626	(3)
Benefits and Risks	626	(1)
Formula Considerations	626	(1)
Tube-Feeding Schedules	627	(1)
Patient Assessment	628	(1)
Nursing Management	628	(1)
Intestinal Decompression	629	(2)
Tube Insertion	631	(1)
Removal	631	(1)
Nursing Implications	631	(3)
Skill 29-1 Inserting a Nasogastric Tube	634	(4)
Skill 29-2 Irrigating a Nasogastric Tube	638	(2)
Skill 29-3 Removing a Nasogastric Tube	640	(2)
Skill 29-4 Administering Tube Feedings	642	(7)
UNIT IX PROMOTING ELIMINATION	649	(58)
Urinary Elimination	651	(32)
Urinary Elimination	652	(1)
Characteristics of Urine	652	(2)
Urine Specimen Collection	652	(2)
Abnormal Urine Characteristics	654	(1)
Abnormal Urinary Elimination Patterns	654	(1)
Anuria	654	(1)
Oliguria	654	(1)
Polyuria	654	(1)
Nocturia	654	(1)
Dysuria	654	(1)
Incontinence	654	(1)
Assisting Patients With Urinary Elimination	654	(1)
Commode	655	(1)
Urinal	655	(1)
Using a Bedpan	655	(1)
Managing Incontinence	655	(2)
Continence Training	655	(2)
Catheterization	657	(4)
Types of Catheters	657	(2)
Inserting a Catheter	659	(1)
Connecting a Closed Drainage System	659	(1)
Providing Catheter Care	659	(1)
Catheter Irrigation	660	(1)
Indwelling Catheter Removal	661	(1)
Urinary Diversions	661	(1)
Nursing Implications	662	(3)
Skill 30-1 Placing and Removing a Bedpan	665	(2)
Skill 30-2 Applying a Condom Catheter	667	(2)
Skill 30-3 Inserting a Foley Catheter in a Female Patient	669	(4)
Skill 30-4 Inserting a Foley Catheter in a Male Patient	673	(5)
Skill 30-5 Irrigating a Foley Catheter	678	(5)
Bowel Elimination	683	(24)
Bowel Elimination	683	(1)
Defecation	683	(1)
Assessment of Bowel Elimination	684	(1)
Elimination Patterns	684	(1)
Stool Characteristics	684	(1)
Common Alterations in Bowel Elimination	685	(2)
Constipation	685	(1)
Fecal Impaction	686	(1)
Flatulence	687	(1)
Diarrhea	687	(1)
Fecal Incontinence	687	(1)
Measures to Promote Bowel Elimination	687	(2)
Inserting a Rectal Suppository	687	(1)
Administering an Enema	688	(1)
Ostomy Care	689	(2)
Providing Peristomal Care	689	(1)
Applying an Ostomy Appliance	689	(1)
Draining a Continent Ileostomy	690	(1)
Irrigating a Colostomy	691	(1)
Nursing Implications	691	(3)
Skill 31-1 Inserting a Rectal Tube	694	(1)
Skill 31-2 Inserting a Rectal Suppository	695	(2)
Skill 31-3 Administering a Cleansing Enema	697	(3)
Skill 31-4 Changing an Ostomy Appliance	700	(2)
Skill 31-5 Irrigating a Colostomy	702	(5)
UNIT X MEDICATION ADMINISTRATION	707	(70)
Oral Medications	709	(16)
Medication Orders	710	(1)
Components of a Medication Order	710	(1)
Verbal Orders	711	(1)
Documentation in the Medication Administration Record	711	(1)
Methods of Supplying Medications	711	(2)
Storing Medications	713	(1)
Accounting for Narcotics	713	(1)
Medication Administration	713	(3)
Applying The Five Rights	713	(1)
Calculating Dosages	713	(1)
Administering Oral Medications	714	(1)
Administering Oral Medications by Enteral Tube	715	(1)
Documentation	715	(1)
Medication Errors	716	(1)
Nursing Implications	716	(3)
Skill 32-1 Administering Oral Medications	719	(2)
Skill 32-2 Administering Medications Through an Enteral Tube	721	(4)
Topical and Inhalant Medications	725	(12)
Topical Route	725	(4)
Cutaneous Applications	725	(2)
Ophthalmic Applications	727	(1)
Otic Applications	727	(1)
Nasal Applications	728	(1)
Sublingual and Buccal Applications	728	(1)
Vaginal Applications	728	(1)
Rectal Applications	729	(1)
Inhalant Route	729	(1)
Inhalers	729	(1)
Nursing Implications	730	(3)
Skill 33-1 Instilling Eye Medications	733	(2)
Skill 33-2 Administering Nasal Medications	735	(2)
Parenteral Medications	737	(20)
Parenteral Administration Equipment	737	(1)
Syringes	738	(1)
Needles	738	(1)
Modified Injection Equipment	738	(1)
Drug Preparation	738	(3)
Ampules	738	(1)
Vials	739	(1)
Prefilled Cartridges	740	(1)
Combining Medications in One Syringe	740	(1)
Injection Routes	741	(6)
Intradermal Injections	741	(1)
Subcutaneous Injections	741	(3)
Intramuscular Injections	744	(3)
Reducing Injection Discomfort	747	(1)
Nursing Implications	747	(3)
Skill 34-1 Administering Intradermal Injections	750	(2)
Skill 34-2 Administering Subcutaneous Injections	752	(2)
Skill 34-3 Administering Intramuscular Injections	754	(3)
Intravenous Medications	757	(20)
Intravenous Medication Administration	757	(4)
Continuous Administration	758	(1)
Intermittent Administration	758	(3)
Central Venous Catheters	761	(2)
Percutaneous Catheters	761	(1)
Tunneled Catheters	761	(1)
Implanted catheters	761	(1)
Medication Administration Using a CVC	762	(1)
Nursing Implications	763	(3)
Skill 35-1 Administering Intravenous Medication by Continuous Infusion	766	(3)
Skill 35-2 Administering an Intermittent Secondary Infusion	769	(3)
Skill 35-3 Using a Volume-Control Set	772	(5)
UNIT XI INTERVENING IN EMERGENCY SITUATIONS	777	(30)
Airway Management	779	(16)
The Airway	779	(1)
Airway Management	780	(2)
Liquefying Secretions	780	(1)
Mobilizing Secretions	781	(1)
Suctioning Secretions	782	(1)
Artificial Airways	782	(2)
Oral Airway	782	(1)
Tracheostomy	783	(1)
Nursing Implications	784	(3)
Skill 36-1 Suctioning the Airway	787	(3)
Skill 36-2 Providing Tracheostomy Care	790	(5)
Resuscitation	795	(12)
Airway Obstruction	795	(1)
Identifying Signs of Airway Obstruction	795	(1)
Relieving an Obstruction	796	(1)
Cardiopulmonary Resuscitation	796	(3)
Performing an Initial Assessment	796	(1)
Obtaining Assistance	796	(1)
Performing ABCs	797	(1)
Assessing Effectiveness	798	(1)
Discontinuing Resuscitation	798	(1)
Nursing Implications	799	(3)
Skill 37-1 Relieving an Airway Obstruction	802	(2)
Skill 37-2 Performing Basic Cardiopulmonary Resuscitation	804	(3)
UNIT XII CARING FOR THE TERMINALLY ILL	807	(16)
Death and Dying	809	(14)
Terminal Illness and Care	809	(6)
Stages of Dying	809	(1)
Promoting Acceptance	810	(2)
Providing Terminal Care	812	(1)
Approaching Death	813	(2)
Confirming Death	815	(1)
Performing Postmortem Care	815	(1)
Grieving	815	(2)
Pathologic Grief	817	(1)
Resolution of Grief	817	(1)
Nursing Implications	817	(3)
Skill 38-1 Performing Postmortem Care	820	(3)
Glossary of Key Terms	823	(16)
Appendix A Common Abbreviations	839	(2)
Appendix B NANDA-Approved Nursing Diagnoses	841	(4)
Index	845