Fundamentals of Nursing

by Potter & Perry

• ISBN13: 9780323025867
• ISBN10: 0323025862
• Format: Hardcover
• Copyright: 2004-06-04
• Publisher: Mosby

Summary

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

Table of Contents

Unit I The Client and the Health Care Environment
Nursing Today	1	(25)
Historical Perspective Highlights	3	(2)
Florence Nightingale	3	(1)
The Civil War to the Beginning of the Twentieth Century	3	(2)
Twentieth Century	5	(1)
Twenty-first Century	5	(1)
Societal Influences on Nursing	5	(1)
Demographic Changes	5	(1)
Women's Health Care Issues	5	(1)
Human Rights Movement	6	(1)
Medically Underserved	6	(1)
Threat of Bioterrorism	6	(1)
Needs of the Consumer	6	(1)
Cultural Diversity	6	(1)
Health Promotion and Wellness	6	(1)
Influence of Today's Health Care Delivery System	6	(1)
Rising Health Care Cost	7	(1)
Evidenced-Based Practice	7	(1)
Nursing and Biomedical Research	7	(1)
Nursing Shortage	7	(1)
Nursing as a Profession	7	(9)
Standards of Professional Performance	7	(5)
Standards of Care	12	(4)
Nursing Education	16	(1)
Professional Registered Nurse Education	16	(1)
Graduate Education	16	(1)
Continuing and In-Service Education	17	(1)
Nursing Practice	17	(1)
Nurse Practice Acts	17	(1)
Licensure and Certification	17	(1)
Science and Art of Nursing Practice	18	(1)
Professional Responsibilities and Roles	18	(4)
Autonomy and Accountability	18	(1)
Caregiver	18	(1)
Advocate	18	(1)
Educator	19	(1)
Communicator	19	(1)
Manager	19	(1)
Career Development	19	(3)
Professional Nursing Organizations	22	(1)
Future Trends in Nursing	22	(4)
Expansion of Employment Opportunities	22	(1)
Nursing's Public Perception	22	(1)
Nursing's Impact on Politics and Health Policy	22	(4)
Health Care Delivery System	26	(20)
Health Care Regulation and Competition	28	(2)
Nursing Implications	29	(1)
Levels of Health Care	30	(9)
Preventive and Primary Health Care Services	31	(2)
Secondary and Tertiary Care	33	(2)
Restorative Care	35	(2)
Continuing Care	37	(2)
Issues in Health Care Delivery	39	(4)
Competency	39	(1)
Evidence-Based Practice	40	(1)
Knowing Clients	41	(1)
Assistive Personnel	41	(1)
Quality Health Care	42	(1)
The Future of Health Care	43	(3)
Community-Based Nursing Practice	46	(14)
Community-Based Health Care	47	(1)
Achieving Healthy Populations and Communities	48	(1)
Community Health Nursing	48	(1)
Nursing Practice in Community Health	49	(1)
Community-Based Nursing	49	(6)
Vulnerable Populations	50	(5)
Competency in Community-Based Nursing	55	(1)
Case Manager	55	(1)
Collaborator	55	(1)
Educator	55	(1)
Counselor	56	(1)
Client Advocate	56	(1)
Change Agent	56	(1)
Community Assessment	56	(1)
Changing Clients' Health	57	(3)
Theoretical Foundations of Nursing Practice	60	(13)
The Domain of Nursing Theory	62	(2)
Components of a Theory	62	(1)
Types of Theory	63	(1)
Theoretical Models	64	(1)
Relationship of Theory to the Nursing Process and Client Needs	64	(1)
Interdisciplinary Theories	64	(2)
Systems Theory	64	(2)
Basic Human Needs	66	(1)
Health-and-Wellness Models	66	(1)
Stress and Adaptation	66	(1)
Developmental Theories	66	(1)
Psychosocial Theories	66	(1)
Selected Nursing Theories	66	(3)
Nightingale's Theory	66	(1)
Peplau's Theory	67	(1)
Henderson's Theory	68	(1)
Abdellah's Theory	68	(1)
Johnson's Theory	68	(1)
Rogers' Theory	68	(1)
Orem's Theory	68	(1)
Neuman's Theory	68	(1)
Leininger's Theory	69	(1)
King's Theory	69	(1)
Roy's Theory	69	(1)
Watson's Theory	69	(1)
Benner and Wrubel's Theory	69	(1)
The Link Between Theory and Knowledge Development in Nursing	69	(4)
Nursing Research as a Basis for Practice	73	(16)
Historical Perspective	74	(1)
Scientific Research in Nursing	75	(1)
Knowledge Acquisition	75	(1)
Scientific Method	76	(1)
Nursing and the Scientific Approach	76	(3)
Nursing Research	77	(2)
Research Process	79	(2)
Conducting Nursing Research	81	(1)
Ethical Issues in Research	81	(1)
Rights of Human Subjects	81	(1)
Applying Research to Nursing Practice	82	(7)
Research Report Versus Clinical Article	83	(1)
Locating Research Studies	84	(1)
Identifying Clinical Nursing Problems	84	(1)
Research Utilization	84	(5)
Unit II Caring Throughout the Life Span
Health and Wellness	89	(17)
Healthy People Documents	90	(1)
Definition of Health	91	(1)
Models of Health and Illness	91	(3)
Health Belief Model	91	(1)
Health Promotion Model	92	(1)
Basic Human Needs Model	93	(1)
Holistic Health Models	93	(1)
Variables Influencing Health and Health Beliefs and Practices	94	(2)
Internal Variables	95	(1)
External Variables	95	(1)
Health Promotion, Wellness, and Illness Prevention	96	(1)
Levels of Preventive Care	97	(1)
Risk Factors	97	(2)
Genetic and Physiological Factors	97	(1)
Age	97	(2)
Environment	99	(1)
Lifestyle	99	(1)
Risk Factor Modification and Changing Health Behaviors	99	(1)
Illness	100	(2)
Acute Illness and Chronic Illness	101	(1)
Illness Behavior	101	(1)
Variables Influencing Illness and Illness Behavior	101	(1)
Impact of Illness on the Client and Family	102	(4)
Behavioral and Emotional Changes	102	(1)
Impact on Body Image	102	(1)
Impact on Self-Concept	103	(1)
Impact on Family Roles	103	(1)
Impact on Family Dynamics	103	(3)
Caring in Nursing Practice	106	(12)
Theoretical Views on Caring	108	(2)
Caring Is Primary	108	(1)
The Essence of Nursing and Health	108	(1)
Transpersonal Caring	108	(1)
Swanson's Theory of Caring	109	(1)
Summary of Theoretical Views	109	(1)
Clients' Perceptions of Caring	110	(1)
Ethic of Care	111	(1)
Caring in Nursing Practice	112	(2)
Providing Presence	112	(1)
Touch	112	(1)
Listening	113	(1)
Knowing the Client	113	(1)
Spiritual Caring	114	(1)
Family Care	114	(1)
The Challenge of Caring	114	(4)
Culture and Ethnicity	118	(21)
Population Diversity	119	(1)
Health Disparities	119	(1)
Understanding Cultural Concepts	119	(3)
Culturally Congruent Care	120	(2)
Cultural Conflicts	122	(1)
Cultural Context of Health and Caring	122	(2)
Cultural Healing Modalities and Healers	123	(1)
Culture-Bound Syndrome	124	(1)
Culture and Life Transitions	124	(4)
Pregnancy	125	(1)
Childbirth	125	(1)
Newborn	125	(1)
Postpartum Period	126	(1)
Grief and Loss	127	(1)
Cultural Assessment	128	(3)
Census Data	129	(1)
Asking Questions	129	(1)
Establishing Relationship	129	(2)
Selected Components of Cultural Assessment	131	(4)
Ethnic Heritage and Ethnohistory	131	(1)
Biocultural History	132	(1)
Social Organization	132	(1)
Religious and Spiritual Beliefs	132	(1)
Communication Patterns	133	(1)
Time Orientation	133	(1)
Caring Beliefs and Practices	134	(1)
Experience With Professional Health Care	134	(1)
Nursing Decisions	135	(4)
Caring for Families	139	(16)
The Family	140	(1)
Concept of Family	141	(1)
Definition: What Is a Family?	141	(1)
Current Trends and New Family Forms	141	(2)
Changing Economic Status	143	(1)
Homelessness	143	(1)
Family Violence	143	(1)
Human Immunodeficiency Virus	143	(1)
Theoretical Approaches: An Overview	143	(1)
Family Health System	144	(1)
Developmental Stages	144	(1)
Attributes of Families	144	(3)
Structure	144	(1)
Function	145	(1)
The Family and Health	146	(1)
Family Nursing	147	(1)
Family as Context	147	(1)
Family as Client	147	(1)
Family as System	147	(1)
Nursing Process for the Family	148	(7)
Assessing the Needs of the Family	148	(1)
Family-Focused Care	149	(1)
Challenges for Family Nursing	150	(1)
Implementing Family-Centered Care	150	(5)
Developmental Theories	155	(16)
Growth and Development	156	(2)
Major Factors Influencing Growth and Development	157	(1)
Developmental Theories	158	(1)
Four Areas of Theory Development	158	(1)
Biophysical Developmental Theories	158	(1)
Gesell's Theory of Development	158	(1)
Psychoanalytic/Psychosocial Theory	159	(5)
Sigmund Freud	159	(1)
Erik Erikson	160	(1)
Robert Havighurst	161	(1)
Roger Gould	162	(2)
Stella Chess and Alexander Thomas	164	(1)
Cognitive Developmental Theory	164	(2)
Jean Piaget's Theory of Cognitive Development	164	(2)
Moral Developmental Theory	166	(5)
Jean Piaget's Moral Developmental Theory	166	(1)
Lawrence Kohlberg's Moral Developmental Theory	166	(2)
Carol Gilligan	168	(3)
Conception Through Adolescence	171	(45)
Stages of Growth and Development	172	(1)
Selecting a Developmental Framework for Nursing	172	(1)
Conception	173	(3)
Intrauterine Life	173	(3)
Transition From Intrauterine to Extrauterine Life	176	(1)
Physical Changes	176	(1)
Psychosocial Changes	176	(1)
Health Risks	177	(1)
Newborn	177	(3)
Physical Changes	177	(2)
Cognitive Changes	179	(1)
Psychosocial Changes	179	(1)
Health Risks	179	(1)
Health Concerns	179	(1)
Infant	180	(9)
Physical Changes	180	(1)
Cognitive Changes	181	(1)
Psychosocial Changes	181	(1)
Health Risks	182	(1)
Health Concerns	182	(7)
Toddler	189	(4)
Physical Changes	189	(1)
Cognitive Changes	189	(1)
Psychosocial Changes	190	(1)
Health Risks	190	(2)
Health Concerns	192	(1)
Preschooler	193	(3)
Physical Changes	193	(1)
Cognitive Changes	193	(1)
Psychosocial Changes	194	(1)
Health Risks	194	(1)
Health Concerns	195	(1)
School-Age Children and Adolescents	196	(2)
School-Age Child	198	(6)
Physical Changes	198	(1)
Cognitive Changes	199	(1)
Psychosocial Changes	200	(1)
Health Risks	201	(2)
Health Concerns	203	(1)
Preadolescent	204	(1)
Adolescent	205	(11)
Physical Changes	205	(3)
Cognitive Changes	208	(1)
Psychosocial Changes	208	(2)
Health Risks	210	(2)
Health Concerns	212	(4)
Young to Middle Adult	216	(18)
Young Adult	218	(8)
Physical Changes	218	(1)
Cognitive Changes	218	(1)
Psychosocial Changes	218	(3)
Health Risks	221	(1)
Health Concerns	222	(4)
Middle Adult	226	(8)
Physical Changes	226	(2)
Cognitive Changes	228	(1)
Psychosocial Changes	228	(1)
Health Concerns	229	(5)
Older Adult	234	(26)
Variability Among Older Adults	236	(1)
Terminology	236	(1)
Myths and Stereotypes	236	(2)
Nurses' Attitudes Toward Older Adults	238	(1)
Theories of Aging	238	(1)
Developmental Tasks for Older Adults	239	(1)
Community-Based and Institutional Health Care Services	240	(1)
Assessing the Needs of Older Adults	241	(7)
Physiological Changes	241	(1)
Cognitive Changes	241	(5)
Psychosocial Changes	246	(2)
Addressing the Health Concerns of Older Adults	248	(7)
Health Promotion and Maintenance: Physiological Concerns	249	(4)
Health Promotion and Maintenance: Psychosocial Health Concerns	253	(2)
Older Adults and the Acute Care Setting	255	(1)
Older Adults and Restorative Care	256	(4)
Unit III Critical Thinking in Nursing Practice
Critical Thinking in Nursing Practice	260	(17)
Clinical Decisions in Nursing Practice	261	(1)
Critical Thinking Defined	262	(2)
Reflection	263	(1)
Language	263	(1)
Intuition	264	(1)
Thinking and Learning	264	(1)
Levels of Critical Thinking in Nursing	265	(1)
Basic Critical Thinking	265	(1)
Complex Critical Thinking	265	(1)
Commitment	265	(1)
Critical Thinking Competencies	265	(4)
Scientific Method	265	(1)
Problem Solving	266	(1)
Decision Making	266	(1)
Diagnostic Reasoning and Inference	267	(1)
Clinical Decision Making	267	(1)
Nursing Process as a Competency	268	(1)
Critical Thinking Model	269	(4)
Specific Knowledge Base	269	(1)
Experience	270	(1)
Attitudes for Critical Thinking	270	(2)
Standards for Critical Thinking	272	(1)
The Nursing Process Competency	273	(1)
Critical Thinking Competencies	273	(4)
Nursing Assessment	277	(22)
Nursing Process Overview	279	(1)
A Critical Thinking Approach to Assessment	279	(5)
Organization of Data Gathering	281	(1)
Data Collection	282	(2)
Types of Data	284	(1)
Sources of Data	284	(1)
Client	284	(1)
Family and Significant Others	284	(1)
Health Care Team Members	284	(1)
Medical Records	285	(1)
Other Records	285	(1)
Literature Review	285	(1)
Nurse's Experience	285	(1)
Methods of Data Collection	285	(7)
Interview	285	(4)
Nursing Health History	289	(2)
Documentation of History Findings	291	(1)
Physical Examination	291	(1)
Diagnostic and Laboratory Data	292	(1)
Formulating Nursing Judgments	292	(1)
Data Validation and Interpretation	292	(1)
Data Clustering	293	(1)
Data Documentation	293	(6)
Nursing Diagnosis	299	(18)
Evolution of Nursing Diagnosis	300	(3)
Critical Thinking and the Nursing Diagnostic Process	303	(3)
Diagnostic Process	303	(3)
Formulation of the Nursing Diagnosis	306	(1)
Components of a Nursing Diagnosis	306	(3)
Diagnostic Label	306	(1)
Related Factors	307	(1)
Definition	307	(1)
Risk Factors	307	(1)
Support of the Diagnostic Statement	307	(2)
Mind Mapping Nursing Diagnosis	309	(1)
Sources of Diagnostic Errors	309	(4)
Errors in Data Collection	309	(2)
Errors in Interpretation and Analysis of Data	311	(1)
Errors in Data Clustering	311	(1)
Errors in the Diagnostic Statement	311	(1)
Nursing Diagnosis and Other Health Care Problems	312	(1)
Nursing Diagnoses: Application to Care Planning	313	(4)
Advantages of Nursing Diagnoses	313	(1)
Limitations of Nursing Diagnoses	314	(3)
Planning Nursing Care	317	(22)
Establishing Priorities	318	(2)
Critical Thinking in Establishing Goals and Expected Outcomes	320	(4)
Goals of Care	320	(2)
Expected Outcomes	322	(1)
Combining Goal and Outcome Statements	322	(1)
Guidelines for Writing Goals and Expected Outcomes	323	(1)
Critical Thinking in Designing Nursing Interventions	324	(3)
Types of Interventions	324	(1)
Selection of Interventions	325	(2)
Planning Nursing Care	327	(8)
Purpose of Care Plans	327	(1)
Student Care Plans	328	(1)
Institutional Care Plans	329	(2)
Concept Maps	331	(4)
Consulting Other Health Care Professionals	335	(4)
When to Consult	336	(1)
How to Consult	336	(3)
Implementing Nursing Care	339	(15)
Types of Nursing Interventions	341	(1)
Protocols and Standing Orders	341	(1)
Critical Thinking in Implementation	342	(2)
Implementation Process	344	(3)
Reassessing the Client	344	(1)
Reviewing and Revising the Existing Nursing Care Plan	344	(1)
Organizing Resources and Care Delivery	344	(2)
Anticipating and Preventing Complications	346	(1)
Implementation Skills	346	(1)
Direct Care	347	(2)
Activities of Daily Living	347	(1)
Instrumental Activities of Daily Living	347	(1)
Physical Care Techniques	347	(1)
Counseling	347	(1)
Teaching	347	(2)
Controlling for Adverse Reactions	349	(1)
Preventive Measures	349	(1)
Indirect Care	349	(1)
Communicating Nursing Interventions	349	(1)
Delegating, Supervising, and Evaluating the Work of Other Staff Members	350	(1)
Achieving Client Goals	350	(4)
Evaluation	354	(16)
Critical Thinking and Evaluation	356	(1)
The Evaluation Process	357	(6)
Identifying Criteria and Standards	357	(4)
Collecting Evaluative Measures	361	(1)
Interpreting and Summarizing Findings	361	(1)
Documenting Findings	362	(1)
Care Plan Revision and Critical Thinking	363	(2)
Discontinuing a Care Plan	363	(1)
Modifying a Care Plan	363	(2)
Quality Improvement	365	(5)
Outcomes Management	366	(4)
Managing Client Care	370	(18)
Building a Nursing Team	371	(5)
Nursing Care Delivery Models	372	(1)
Decentralized Decision Making	373	(3)
Leadership Skills for Nursing Students	376	(4)
Clinical Care Coordination	376	(4)
Quality Management	380	(8)
Quality in Nursing Practice	381	(7)
Unit IV Professional Standards in Nursing Practice
Ethics and Values	388	(17)
Ethics	389	(4)
Basic Terms	389	(2)
Professional Nursing	391	(2)
Values	393	(1)
Value Formation	393	(1)
Values Clarification	393	(1)
Bioethics	394	(3)
Philosophical Constructions	395	(1)
Consensus in Bioethics	396	(1)
Nursing Point of View	397	(1)
How to Process an Ethical Dilemma	397	(2)
Institutional Resources	399	(1)
Issues in Bioethics	400	(5)
Quality of Life	400	(1)
Genetic Screening	400	(1)
Futile Care	401	(1)
Allocation of Scarce Resources: Medical Technologies	401	(1)
Allocation of Scarce Resources: The Nursing Shortage	401	(4)
Legal Implications in Nursing Practice	405	(18)
Legal Limits of Nursing	406	(2)
Sources of Law	406	(1)
Standards of Care	407	(1)
Federal Statutory Issues in Nursing Practice	408	(3)
Americans With Disabilities Act	408	(1)
Emergency Medical Treatment and Active Labor Act	409	(1)
Mental Health Parity Act	409	(1)
Advance Directives	409	(1)
Uniform Anatomical Gift Act	410	(1)
Health Insurance Portability and Accountability Act	411	(1)
Restraints	411	(1)
State Statutory Issues in Nursing Practice	411	(2)
Licensure	411	(1)
Good Samaritan Laws	411	(1)
Public Health Laws	412	(1)
The Uniform Determination of Death Act	412	(1)
Physician-Assisted Suicide	412	(1)
Civil and Common Law Issues in Nursing Practice	413	(6)
Torts	413	(1)
Intentional Torts	413	(1)
Unintentional Torts	414	(1)
Consent	414	(3)
Abortion Issues	417	(1)
Student Nurses	418	(1)
Malpractice Insurance	418	(1)
Abandonment and Assignment Issues	418	(1)
Risk Management	419	(4)
Professional Involvement	419	(4)
Communication	423	(25)
Communication and Nursing Practice	424	(2)
Communication and Interpersonal Relationships	425	(1)
Developing Communication Skills	425	(1)
Levels of Communication	426	(1)
Intrapersonal Communication	427	(1)
Interpersonal Communication	427	(1)
Transpersonal Communication	427	(1)
Small-Group Communication	427	(1)
Public Communication	427	(1)
Basic Elements of the Communication Process	427	(2)
Referent	428	(1)
Sender and Receiver	428	(1)
Messages	428	(1)
Channels	428	(1)
Feedback	428	(1)
Interpersonal Variables	428	(1)
Environment	429	(1)
Forms of Communication	429	(4)
Verbal Communication	429	(1)
Nonverbal Communication	429	(2)
Symbolic Communication	431	(1)
Metacommunication	431	(1)
Professional Nursing Relationships	431	(1)
Nurse-Client Helping Relationships	431	(1)
Nurse-Family Relationships	432	(1)
Nurse-Health Team Relationships	433	(1)
Nurse-Community Relationships	433	(1)
Elements of Professional Communication	433	(1)
Courtesy	433	(1)
Use of Names	433	(1)
Privacy and Confidentiality	433	(1)
Trustworthiness	433	(1)
Autonomy and Responsibility	434	(1)
Assertiveness	434	(1)
Communication Within the Nursing Process	434	(14)
Assessment	434	(2)
Nursing Diagnosis	436	(1)
Planning	436	(1)
Implementation	437	(7)
Evaluation	444	(4)
Client Education	448	(28)
Standards for Client Education	450	(1)
Purposes of Client Education	450	(1)
Maintenance and Promotion of Health and Illness Prevention	450	(1)
Restoration of Health	451	(1)
Coping With Impaired Functioning	451	(1)
Teaching and Learning	451	(3)
Role of the Nurse in Teaching and Learning	452	(1)
Teaching as Communication	453	(1)
Domains of Learning	454	(2)
Cognitive Learning	454	(1)
Affective Learning	455	(1)
Psychomotor Learning	455	(1)
Basic Learning Principles	456	(4)
Motivation to Learn	456	(2)
Ability to Learn	458	(1)
Learning Environment	459	(1)
Integrating the Nursing and Teaching Processes	460	(16)
Assessment	460	(2)
Nursing Diagnosis	462	(1)
Planning	463	(3)
Implementation	466	(6)
Evaluation	472	(4)
Documentation	476	(24)
Confidentiality	478	(1)
Standards	478	(1)
Multidisciplinary Communication Within the Health Care Team	479	(1)
Purposes of Records	479	(2)
Communication	479	(1)
Legal Documentation	480	(1)
Financial Billing	480	(1)
Education	481	(1)
Research	481	(1)
Auditing-Monitoring	481	(1)
Guidelines for Quality Documentation and Reporting	481	(2)
Factual	481	(1)
Accurate	481	(1)
Complete	482	(1)
Current	482	(1)
Organized	483	(1)
Methods of Recording	483	(4)
Narrative Documentation	483	(1)
Problem-Oriented Medical Record	483	(1)
Source Records	484	(1)
Charting by Exception	484	(1)
Case Management Plan and Critical Pathways	485	(2)
Common Record-Keeping Forms	487	(7)
Admission Nursing History Forms	487	(1)
Flow Sheets and Graphic Records	487	(1)
Client Care Summary or Kardex	487	(5)
Acuity Records	492	(1)
Standardized Care Plans	492	(1)
Discharge Summary Forms	492	(2)
Home Care Documentation	494	(1)
Long-Term Health Care Documentation	494	(1)
Computerized Documentation	494	(1)
Reporting	495	(5)
Change-of-Shift Reports	496	(1)
Telephone Reports	497	(1)
Telephone or Verbal Orders	497	(1)
Transfer Reports	497	(1)
Incident Reports	497	(3)
Unit V Psychosocial Basis for Nursing Practice
Self-Concept	500	(22)
Scientific Knowledge Base	501	(1)
Nursing Knowledge Base	502	(8)
Development of Self-Concept	502	(1)
Components and Interrelated Terms of Self-Concept	503	(2)
Stressors Affecting Self-Concept	505	(3)
Family Effect on Self-Concept Development	508	(1)
The Nurse's Effect on the Client's Self-Concept	509	(1)
Critical Thinking	510	(1)
Self-Concept and the Nursing Process	510	(12)
Assessment	510	(2)
Nursing Diagnosis	512	(1)
Planning	513	(3)
Implementation	516	(2)
Evaluation	518	(4)
Sexuality	522	(21)
Scientific Knowledge Base	524	(3)
Sexual Development	524	(1)
Sexual Response Cycle	525	(1)
Sexual Orientation	525	(1)
Contraception	526	(1)
Sexually Transmitted Diseases	526	(1)
Nursing Knowledge Base	527	(4)
Sociocultural Dimensions of Sexuality	527	(1)
Decisional Issues	528	(1)
Alterations in Sexual Health	529	(2)
Critical Thinking	531	(1)
Sexuality and the Nursing Process	531	(12)
Assessment	531	(3)
Nursing Diagnosis	534	(1)
Planning	535	(3)
Implementation	538	(2)
Evaluation	540	(3)
Spiritual Health	543	(24)
Scientific Knowledge Base	545	(1)
Nursing Knowledge Base	545	(4)
Framework of Systemic Organization	545	(1)
Traditional Concepts in Spiritual Health	546	(1)
Spiritual Problems	547	(2)
Critical Thinking	549	(1)
Nursing Process	549	(18)
Assessment	550	(4)
Nursing Diagnosis	554	(2)
Planning	556	(3)
Implementation	559	(4)
Evaluation	563	(4)
The Experience of Loss, Death, and Grief	567	(28)
Scientific Knowledge Base	568	(4)
Loss	568	(2)
Grief	570	(2)
Nursing Knowledge Base	572	(3)
Factors Influencing Loss and Grief	572	(1)
Coping With Grief and Loss	573	(2)
Critical Thinking	575	(1)
The Nursing Process and Grief	575	(20)
Assessment	575	(4)
Nursing Diagnosis	579	(1)
Planning	580	(3)
Implementation	583	(8)
Evaluation	591	(4)
Stress and Coping	595	(22)
Scientific Knowledge Base	596	(5)
Medulla Oblongata	597	(1)
Reticular Formation	597	(1)
Pituitary Gland	597	(1)
General Adaptation Syndrome	597	(2)
Types of Stress	599	(2)
Nursing Knowledge Base	601	(2)
Nursing Theory and the Role of Stress	601	(1)
Situational, Maturational, and Sociocultural Factors	601	(2)
Critical Thinking	603	(1)
Nursing Process	603	(14)
Assessment	603	(2)
Nursing Diagnosis	605	(1)
Planning	606	(2)
Implementation	608	(5)
Evaluation	613	(4)
Unit VI Scientific Basis for Nursing Practice
Vital Signs	617	(54)
Guidelines for Measuring Vital Signs	619	(1)
Body Temperature	620	(17)
Physiology	620	(2)
Factors Affecting Body Temperature	622	(3)
Nursing Process and Thermoregulation	625	(1)
Assessment	625	(1)
Measuring Body Temperature	626	(7)
Nursing Diagnosis	633	(1)
Planning	634	(1)
Implementation	634	(3)
Evaluation	637	(1)
Pulse	637	(8)
Physiology and Regulation	637	(1)
Assessment of Pulse	637	(1)
Character of the Pulse	638	(1)
Assessing the Radial and Apical Pulses	639	(6)
Nursing Process and Pulse Determination	645	(1)
Respiration	645	(5)
Physiological Control	645	(1)
Mechanics of Breathing	645	(1)
Assessment of Ventilation	645	(2)
Assessing Respirations	647	(2)
Assessment of Diffusion and Perfusion	649	(1)
Nursing Process and Respiratory Vital Signs	650	(1)
Blood Pressure	650	(16)
Measuring Oxygen Saturation (Pulse Oximetry)	651	(2)
Physiology of Arterial Blood Pressure	653	(1)
Factors Influencing Blood Pressure	654	(1)
Hypertension	655	(1)
Hypotension	656	(1)
Measurement of Blood Pressure	656	(1)
Measuring Blood Pressure	657	(8)
Nursing Process and Blood Pressure Determination	665	(1)
Health Promotion and Vital Signs	666	(1)
Recording Vital Signs	666	(5)
Health Assessment and Physical Examination	671	(101)
Purposes of Physical Examination	673	(1)
Gathering a Health History	673	(1)
Developing Nursing Diagnoses and a Care Plan	673	(1)
Managing Client Problems	674	(1)
Evaluating Nursing Care	674	(1)
Cultural Sensitivity	674	(1)
Integration of Physical Assessment With Nursing Care	674	(1)
Skills of Physical Assessment	674	(4)
Inspection	674	(1)
Palpation	675	(1)
Percussion	676	(1)
Auscultation	677	(1)
Olfaction	678	(1)
Preparation for Examination	678	(4)
Infection Control	679	(1)
Environment	679	(1)
Equipment	679	(1)
Physical Preparation of the Client	679	(1)
Psychological Preparation of the Client	680	(1)
Assessment of Age-Groups	680	(2)
Organization of the Examination	682	(1)
General Survey	682	(5)
General Appearance and Behavior	682	(3)
Vital Signs	685	(1)
Height, Weight, and Circumference	685	(2)
Skin, Hair, and Nails	687	(9)
Skin	687	(5)
Hair and Scalp	692	(2)
Nails	694	(2)
Head and Neck	696	(20)
Head	696	(1)
Eyes	697	(6)
Ears	703	(4)
Nose and Sinuses	707	(2)
Mouth and Pharynx	709	(3)
Neck	712	(4)
Thorax and Lungs	716	(6)
Posterior Thorax	717	(4)
Lateral Thorax	721	(1)
Anterior Thorax	721	(1)
Heart	722	(5)
Inspection and Palpation	724	(1)
Auscultation	725	(2)
Vascular System	727	(8)
Blood Pressure	727	(1)
Carotid Arteries	727	(2)
Jugular Veins	729	(1)
Peripheral Arteries and Veins	730	(4)
Lymphatic System	734	(1)
Breasts	735	(6)
Female Breasts	735	(6)
Male Breasts	741	(1)
Abdomen	741	(5)
Inspection	742	(1)
Auscultation	743	(1)
Percussion	744	(1)
Palpation	744	(2)
Female Genitalia and Reproductive Tract	746	(4)
Preparation of the Client	746	(1)
External Genitalia	746	(3)
Speculum Examination of Internal Genitalia	749	(1)
Male Genitalia	750	(3)
Sexual Maturity	750	(1)
Penis	751	(2)
Scrotum	753	(1)
Inguinal Ring and Canal	753	(1)
Rectum and Anus	753	(2)
Inspection	753	(1)
Digital Palpation	753	(2)
Musculoskeletal System	755	(3)
General Inspection	755	(2)
Palpation	757	(1)
Range of Joint Motion	757	(1)
Muscle Tone and Strength	758	(1)
Neurological System	758	(9)
Mental and Emotional Status	761	(2)
Intellectual Function	763	(1)
Cranial Nerve Function	764	(1)
Sensory Function	764	(1)
Motor Function	765	(2)
Reflexes	767	(1)
After the Examination	767	(5)
Infection Control	772	(49)
Nature of Infection	773	(4)
Chain of Infection	774	(3)
The Infectious Process	777	(3)
Defenses Against Infection	777	(2)
Nosocomial Infections	779	(1)
The Nursing Process in Infection Control	780	(41)
Assessment	780	(3)
Nursing Diagnosis	783	(1)
Planning	784	(1)
Implementation	784	(6)
Hand Hygiene	790	(16)
Preparation of a Sterile Field	806	(2)
Surgical Hand Hygiene: Preparing for Gowning	808	(3)
Applying a Sterile Gown and Performing closed Gloving	811	(3)
Open Gloving	814	(2)
Evaluation	816	(5)
Medication Administration	821	(89)
Scientific Knowledge Base	823	(14)
Pharmacological Concepts	823	(1)
Medication Legislation and Standards	823	(2)
Pharmacokinetics as the Basis of Medication Actions	825	(4)
Types of Medication Action	829	(1)
Medication Interactions	829	(1)
Medication Dose Responses	830	(1)
Routes of Administration	830	(4)
Systems of Medication Measurement	834	(1)
Clinical Calculations	835	(2)
Administering Medications	837	(3)
Prescriber's Role	837	(1)
Types of Orders	838	(1)
Pharmacist's Role	839	(1)
Distribution Systems	839	(1)
Nurse's Role	840	(1)
Critical Thinking	840	(3)
Experience	840	(1)
Attitudes	840	(1)
Standards	841	(2)
Nursing Process and Medication Administration	843	(7)
Assessment	843	(2)
Nursing Diagnosis	845	(1)
Planning	845	(1)
Implementation	845	(4)
Evaluation	849	(1)
Medication Administration	850	(60)
Oral Administration	850	(1)
Administering Oral Medications	851	(4)
Topical Medication Applications	855	(2)
Administering Nasal Instillations	857	(2)
Administering Ophthalmic Medications	859	(5)
Administering Vaginal Medications	864	(2)
Administering Rectal Suppositories	866	(1)
Administering Medications by Inhalation	867	(1)
Using Metered-Dose or Dry Powder Inhalers	868	(3)
Administering Medications by Irrigation	871	(1)
Administering Parenteral Medications	871	(4)
Preparing Injections	875	(5)
Administering Injections	880	(1)
Administering Injections	881	(13)
Adding Medications to Intravenous Fluid Containers	894	(3)
Administering Medications by Intravenous Bolus	897	(4)
Administering Intravenous Medications by Piggyback, Intermittent Intravenous Infusion Sets, and Miniinfusion Pumps	901	(9)
Complementary and Alternative Therapies	910	(19)
Complementary or Alternative Medicine Therapies in Health Care	912	(2)
Nursing-Accessible Therapies	914	(5)
Relaxation Therapy	916	(2)
Meditation and Breathing	918	(1)
Imagery	918	(1)
Training-Specific Therapies	919	(4)
Biofeedback	919	(1)
Therapeutic Touch	920	(1)
Chiropractic Therapy	921	(1)
Traditional Chinese Medication	921	(1)
Acupuncture	922	(1)
Herbal Therapies	922	(1)
Nursing Role in Complementary and Alternative Therapies	923	(6)
Unit VII Basic Human Needs
Activity and Exercise	929	(30)
Scientific Knowledge Base	931	(3)
Overview of Body Mechanics, Exercise, and Activity	931	(1)
Regulation of Movement	932	(1)
Principles of Body Mechanics	933	(1)
Nursing Knowledge Base	934	(2)
Developmental Changes	934	(1)
Behavioral Aspects	935	(1)
Environmental Issues	935	(1)
Cultural and Ethnic Influences	936	(1)
Family and Social Support	936	(1)
Critical Thinking	936	(1)
Nursing Process	937	(22)
Assessment	937	(2)
Nursing Diagnosis	939	(1)
Planning	940	(1)
Implementation	941	(13)
Evaluation	954	(5)
Client Safety	959	(42)
Scientific Knowledge Base	960	(3)
Environmental Safety	960	(3)
Nursing Knowledge Base	963	(3)
Risks at Developmental Stages	963	(2)
Individual Risk Factors	965	(1)
Risks in the Health Care Agency	965	(1)
Critical Thinking	966	(2)
Safety and the Nursing Process	968	(33)
Assessment	968	(3)
Nursing Diagnosis	971	(1)
Planning	971	(2)
Implementation	973	(11)
Applying Restraints	984	(10)
Seizure Precautions	994	(3)
Evaluation	997	(4)
Hygiene	1001	(65)
Scientific Knowledge Base	1002	(3)
The Skin	1003	(1)
The Feet, Hands, and Nails	1004	(1)
The Oral Cavity	1004	(1)
The Hair	1004	(1)
The Eyes, Ears, and Nose	1004	(1)
Nursing Knowledge Base	1005	(2)
Social Practice	1005	(1)
Personal Preferences	1006	(1)
Body Image	1006	(1)
Socioeconomic Status	1006	(1)
Health Beliefs and Motivation	1006	(1)
Cultural Variables	1006	(1)
Physical Condition	1006	(1)
Critical Thinking	1007	(1)
Nursing Process	1008	(58)
Assessment	1008	(7)
Nursing Diagnosis	1015	(2)
Planning	1017	(1)
Implementation	1018	(5)
Bathing a Client	1023	(8)
Perineal Care	1031	(4)
Performing Nail and Foot Care	1035	(6)
Providing Oral Hygiene	1041	(3)
Performing Mouth Care for an Unconscious or Debilitated Client	1044	(12)
Making an Occupied Bed	1056	(5)
Evaluation	1061	(5)
Oxygenation	1066	(68)
Scientific Knowledge Base	1067	(13)
Cardiovascular Physiology	1067	(3)
Respiratory Physiology	1070	(2)
Factors Affecting Oxygenation	1072	(2)
Alterations in Cardiac Functioning	1074	(5)
Alterations in Respiratory Functioning	1079	(1)
Nursing Knowledge Base	1080	(2)
Developmental Factors	1080	(1)
Lifestyle Risk Factors	1080	(1)
Environmental Factors	1081	(1)
Critical Thinking	1082	(1)
Nursing Process	1082	(52)
Assessment	1082	(9)
Nursing Diagnosis	1091	(1)
Planning	1092	(1)
Implementation	1093	(8)
Suctioning	1101	(9)
Care of an Artificial Airway	1110	(8)
Care of Clients With Chest Tubes	1118	(5)
Applying a Nasal Cannula or Oxygen Mask	1123	(4)
Using Home Liquid Oxygen Equipment	1127	(3)
Evaluation	1130	(4)
Fluid, Electrolyte, and Acid-Base Balances	1134	(64)
Scientific Knowledge Base	1135	(11)
Distribution of Body Fluids	1136	(1)
Composition of Body Fluids	1136	(1)
Movement of Body Fluids	1136	(1)
Regulation of Body Fluids	1137	(2)
Regulation of Electrolytes	1139	(1)
Regulation of Acid-Base Balance	1140	(1)
Disturbances in Electrolyte, Fluid, and Acid-Base Balances	1141	(5)
Nursing Knowledge Base	1146	(1)
Critical Thinking	1146	(52)
Nursing Process	1146	(1)
Assessment	1146	(6)
Nursing Diagnosis	1152	(3)
Planning	1155	(2)
Implementation	1157	(5)
Initiating a Peripheral Intravenous Infusion	1162	(13)
Regulating Intravenous Flow Rate	1175	(7)
Maintenance of IV System	1182	(5)
Changing a Peripheral Intravenous Dressing	1187	(6)
Evaluation	1193	(5)
Sleep	1198	(30)
Scientific Knowledge Base	1200	(6)
Physiology of Sleep	1200	(1)
Functions of Sleep	1201	(1)
Physical Illness	1202	(1)
Sleep Disorders	1203	(3)
Nursing Knowledge Base	1206	(3)
Sleep and Rest	1206	(1)
Normal Sleep Requirements and Patterns	1206	(1)
Factors Affecting Sleep	1207	(2)
Critical Thinking	1209	(1)
Nursing Process	1210	(18)
Assessment	1210	(3)
Nursing Diagnosis	1213	(2)
Planning	1215	(2)
Implementation	1217	(6)
Evaluation	1223	(5)
Comfort	1228	(43)
Scientific Knowledge Base	1230	(4)
Nature of Pain	1230	(1)
Physiology of Pain	1230	(3)
Types of Pain	1233	(1)
Nursing Knowledge Base	1234	(5)
Knowledge, Attitudes, and Beliefs	1235	(1)
Factors Influencing Pain	1236	(3)
Critical Thinking	1239	(1)
Nursing Process and Pain	1239	(32)
Assessment	1240	(6)
Nursing Diagnosis	1246	(1)
Planning	1247	(1)
Implementation	1248	(16)
Evaluation	1264	(7)
Nutrition	1271	(51)
Scientific Knowledge Base	1273	(6)
Nutrients: The Biochemical Units of Nutrition	1273	(2)
Anatomy and Physiology of the Digestive System	1275	(3)
Dietary Guidelines	1278	(1)
Nursing Knowledge Base	1279	(6)
Nutrition During Human Growth and Development	1279	(6)
Alternative Food Patterns	1285	(1)
Critical Thinking	1285	(1)
Nursing Process and Nutrition	1286	(36)
Assessment	1286	(4)
Nursing Diagnosis	1290	(1)
Planning	1291	(4)
Implementation	1295	(5)
Inserting a Small-Bore Nasoenteric Tube for Enteral Feedings	1300	(5)
Administering Enteral Feedings via Nasoenteric Tubes	1305	(4)
Administering Enteral Feedings via Gastrostomy or Jejunostomy Tube	1309	(8)
Evaluation	1317	(5)
Urinary Elimination	1322	(51)
Scientific Knowledge Base	1323	(7)
Kidneys	1323	(1)
Ureters	1324	(1)
Bladder	1325	(1)
Urethra	1325	(1)
Act of Urination	1325	(5)
Nursing Knowledge Base	1330	(1)
Infection Control and Hygiene	1330	(1)
Growth and Development	1330	(1)
Psychosocial Considerations	1330	(1)
Critical Thinking	1331	(1)
Nursing Process and Alterations in Urinary Function	1331	(42)
Assessment	1331	(5)
Collecting Midstream (Clean-Voided) Urine Specimen	1336	(4)
Nursing Diagnosis	1340	(1)
Planning	1340	(3)
Implementation	1343	(8)
Inserting a Straight or an Indwelling Catheter	1351	(8)
Indwelling Catheter Care	1359	(3)
Closed and Open Catheter Irrigation	1362	(7)
Evaluation	1369	(4)
Bowel Elimination	1373	(47)
Scientific Knowledge Base	1374	(2)
Mouth	1374	(1)
Esophagus	1375	(1)
Stomach	1375	(1)
Small Intestine	1375	(1)
Large Intestine	1375	(1)
Anus	1376	(1)
Defecation	1376	(1)
Nursing Knowledge Base	1376	(5)
Factors Affecting Bowel Elimination	1376	(3)
Common Bowel Elimination Problems	1379	(1)
Bowel Diversions	1380	(1)
Critical Thinking	1381	(1)
Nursing Process and Bowel Elimination	1381	(39)
Assessment	1381	(6)
Nursing Diagnosis	1387	(1)
Planning	1387	(5)
Implementation	1392	(7)
Administering a Cleansing Enema	1399	(4)
Inserting and Maintaining a Nasogastric Tube	1403	(8)
Pouching an Ostomy	1411	(5)
Evaluation	1416	(4)
Unit VIII Clients With Special Needs
Mobility and Immobility	1420	(62)
Scientific Knowledge Base	1421	(6)
Physiology and Principles of Body Mechanics	1421	(1)
Regulation of Movement	1422	(3)
Pathological Influences on Mobility	1425	(2)
Nursing Knowledge Base	1427	(5)
Mobility-Immobility	1427	(5)
Critical Thinking	1432	(1)
Nursing Process for Impaired Body Alignment and Mobility	1433	(49)
Assessment	1433	(10)
Nursing Diagnosis	1443	(1)
Planning	1444	(3)
Implementation	1447	(11)
Moving and Positioning Clients in Bed	1458	(10)
Using Safe and Effective Transfer Techniques	1468	(11)
Evaluation	1479	(3)
Skin Integrity and Wound Care	1482	(83)
Scientific Knowledge Base	1483	(11)
Skin	1483	(1)
Pressure Ulcers	1484	(3)
Classification of Pressure Ulcers	1487	(1)
Wound Classifications	1487	(7)
Nursing Knowledge Base	1494	(6)
Prediction and Prevention of Pressure Ulcers	1494	(2)
Factors Influencing Pressure Ulcer Formation and Wound Healing	1496	(4)
Critical Thinking	1500	(1)
Nursing Process	1501	(64)
Assessment	1501	(3)
Assessment for Risk of Pressure Ulcer Development	1504	(5)
Nursing Diagnosis	1509	(1)
Planning	1509	(4)
Implementation	1513	(6)
Treating Pressure Ulcers	1519	(10)
Applying Dry and Wet-To-Dry Moist Dressings	1529	(9)
Implementation of Vacuum Assisted Wound Closure	1538	(6)
Performing Wound Irrigation	1544	(6)
Applying an Abdominal or Breast Binder	1550	(2)
Applying an Elastic Bandage	1552	(5)
Applying a Warm, Moist Compress to an Open Wound	1557	(3)
Evaluation	1560	(5)
Sensory Alterations	1565	(28)
Scientific Knowledge Base	1567	(2)
Normal Sensation	1567	(1)
Sensory Alterations	1568	(1)
Nursing Knowledge Base	1569	(2)
Factors Affecting Sensory Function	1569	(2)
Critical Thinking	1571	(1)
Nursing Process	1571	(22)
Assessment	1571	(5)
Nursing Diagnosis	1576	(1)
Planning	1577	(3)
Implementation	1580	(9)
Evaluation	1589	(4)
Care of Surgical Clients	1593	(52)
History of Surgical Nursing	1595	(1)
Ambulatory Surgery	1595	(1)
Scientific Knowledge Base	1595	(1)
Classification of Surgery	1595	(1)
Nursing Knowledge Base	1595	(2)
Critical Thinking	1597	(1)
The Nursing Process in the Preoperative Surgical Phase	1598	(26)
Assessment	1598	(9)
Nursing Diagnosis	1607	(1)
Planning	1607	(3)
Implementation	1610	(8)
Demonstrating Postoperative Exercises	1618	(4)
Evaluation	1622	(2)
Transport to the Operating Room	1624	(1)
Intraoperative Surgical Phase	1625	(1)
Preoperative (Holding) Area	1625	(1)
Admission to the Operating Room	1626	(1)
The Nursing Process in the Intraoperative Surgical Phase	1626	(2)
Assessment	1626	(1)
Nursing Diagnosis	1626	(1)
Planning	1626	(1)
Implementation	1626	(2)
Evaluation	1628	(1)
Postoperative Surgical Phase	1628	(3)
Immediate Postoperative Recovery	1628	(1)
Discharge From the Postanesthesia Care Unit	1629	(2)
Recovery in Ambulatory Surgery	1631	(1)
Postoperative Convalescence	1631	(1)
The Nursing Process in Postoperative Care	1631	(14)
Assessment	1631	(3)
Nursing Diagnosis	1634	(1)
Planning	1634	(1)
Implementation	1635	(6)
Evaluation	1641	(4)
Review Question Answers	1645	(3)
Review Question Rationales	1648