Health and Physical Assessment in Nursing

by D'Amico, Donita; Barbarito, Colleen

• ISBN13: 9780130493736
• ISBN10: 0130493732
• Edition: 2nd
• Format: Hardcover
• Copyright: 2012-01-01
• Publisher: Prentice Hall

Summary

Undergraduate nursingin physical and health assessment,the text begins with introductory concepts, such as overall health assessment, conducting a health interview and health history, as well as documentation. The second half is organized by body systems, and each chapter reviews anatomy and physiology, teaches students how to conduct an interview, and walks students through the examination for that body system.With our three step approach, we will help students prepare for success. Learn the techniques Demonstrate your skills Practice and test yourselfThisis a program that combines thetext and mediain order tocreateanintegrated teaching and learning system. Media is a driving force in this course,possibly more than any other nursing course. With our program,the difference is,the media is chapter specific.

Table of Contents

Preface	viii
UNIT I INTRODUCTION TO HEALTH ASSESSMENT	1	(94)
Health Assessment	1	(21)
Healthy People 2010	2	(1)
Health	3	(1)
Definitions of Health	3	(1)
Models of Health	3	(1)
Health Assessment	4	(7)
The Interview	4	(1)
The Health History	4	(1)
The Focused Interview	4	(1)
Physical Assessment	5	(1)
Documentation	5	(3)
Interpretation of Findings	8	(3)
Nursing Process	11	(2)
Assessment	11	(1)
Diagnosis	11	(2)
Planning	13	(1)
Implementation	13	(1)
Evaluation	13	(1)
Critical Thinking	13	(4)
Collection of Information	14	(1)
Analysis of the Situation	15	(1)
Generation of Alternatives	16	(1)
Selection of Alternatives	16	(1)
Evaluation	16	(1)
Role of the Professional Nurse	17	(4)
Teacher	17	(2)
Caregiver	19	(1)
Advanced Practice Roles	19	(2)
Application Through Critical Thinking	21	(1)
Case Study	21	(1)
Critical Thinking Questions	21	(1)
Wellness and Health Promotion	22	(24)
Wellness	23	(2)
Wellness Theories	23	(2)
Health Promotion	25	(3)
Definition	25	(1)
Perspectives on Health Promotion	25	(3)
Healthy People 2010	28	(9)
Leading Health Indicators	29	(8)
Health Promotion and the Nursing Process	37	(7)
Assessment	37	(7)
Plan Development	44	(1)
Roles of the Professional Nurse	44	(1)
Application Through Critical Thinking	44	(1)
Case Study	44	(2)
Critical Thinking Questions	45	(1)
Health Assessment Across the Life Span	46	(23)
Principles of Growth and Development	47	(1)
Theories of Development	48	(1)
Cognitive Theory	48	(1)
Psychoanalytic Theory	48	(1)
Psychosocial Theory	49	(1)
Stages of Development	49	(17)
Infants	49	(3)
Toddlers	52	(2)
Preschool Children	54	(2)
School-Age Children	56	(2)
Adolescents	58	(3)
Young Adults	61	(1)
Middle-Aged Adults	61	(2)
Older Adults	63	(3)
Growth and Development in Health Assessment	66	(1)
Factors That Influence Growth and Development	66	(2)
Nutrition	66	(1)
Family	66	(1)
Culture	67	(1)
Socioeconomic Status	67	(1)
Application Through Critical Thinking	68	(1)
Case Study	68	(1)
Critical Thinking Questions	68	(1)
Cultural Considerations	69	(11)
Cultural Competence	70	(1)
Culture	70	(1)
Terms Related to Culture	71	(2)
Race	72	(1)
Ethnicity	72	(1)
Diversity	72	(1)
Assimilation	72	(1)
Cultural Phenomena That Impact Healthcare	73	(5)
Communication	74	(3)
Temporal Relationships	77	(1)
Family Patterns	77	(1)
Dietary Patterns	77	(1)
Health Beliefs and Health Practices	77	(1)
Culture in Comprehensive Health Assessment	78	(1)
Application Through Critical Thinking	79	(1)
Case Study	79	(1)
Critical Thinking Questions	79	(1)
Psychosocial Assessment	80	(15)
Psychosocial Health	81	(1)
Factors That Influence Psychosocial Health	81	(5)
Internal Factors	81	(1)
External Factors	82	(1)
Additional Factors in Psychosocial Health	83	(3)
The Nursing Process in Psychosocial Assessment	86	(7)
Assessment	86	(7)
Organizing the Data	93	(1)
Application Through Critical Thinking	93	(1)
Case Study	93	(2)
Critical Thinking Questions	93	(2)
UNIT II INTRODUCTION TO PHYSICAL ASSESSMENT	95	(87)
Techniques and Equipment	95	(13)
Basic Techniques of Physical Assessment	96	(4)
Inspection	96	(1)
Palpation	97	(1)
Percussion	98	(2)
Auscultation	100	(1)
Equipment	100	(5)
Stethoscope	100	(3)
Doppler Ultrasonic Stethoscope	103	(1)
Ophthalmoscope	103	(1)
Otoscope	104	(1)
Professional Responsibilities	105	(2)
Cues	105	(1)
Critical Thinking	105	(1)
Providing a Safe and Comfortable Environment	105	(1)
Standard Precautions	106	(1)
Application Through Critical Thinking	107	(1)
Case Study	107	(1)
Critical Thinking Questions	107	(1)
General Survey	108	(15)
Components of the General Survey	109	(2)
Physical Appearance	109	(1)
Mental Status	109	(1)
Mobility	110	(1)
Behavior of the Client	110	(1)
Age-Related Considerations	110	(1)
Measuring Height and Weight	111	(2)
Height	111	(1)
Weight	111	(1)
Age-Related Considerations	112	(1)
Measuring Vital Signs	113	(6)
Measuring Body Temperature	113	(1)
Measuring the Pulse Rate	114	(2)
Measuring Respiratory Rate	116	(1)
Measuring Blood Pressure	116	(2)
Age-Related Considerations	118	(1)
Pain---The Fifth Vital Sign	119	(1)
Pain Assessment	119	(1)
The Functional Assessment as Part of the General Survey	120	(2)
Functional Assessment Defined	120	(1)
Functional Assessment During the General Survey	120	(1)
Critical Thinking	120	(2)
Application Through Critical Thinking	122	(1)
Case Study	122	(1)
Critical Thinking Questions	122	(1)
Pain Assessment	123	(12)
Definition of Pain	124	(1)
Physiology of Pain	124	(3)
Theories of Pain	124	(1)
Nervous System	125	(2)
Nature of Pain	127	(1)
Types of Pain	127	(1)
Concepts Associated with Pain	128	(1)
Factors Influencing Pain	128	(2)
Developmental Considerations	128	(1)
Psychosocial Considerations	129	(1)
Environmental Considerations	130	(1)
Assessment	130	(2)
Pain History	131	(1)
Focused Interview	131	(1)
Physiological Responses	132	(1)
Assessment Tools	132	(1)
Unidimensional Tools	132	(1)
Multidimensional Tools	133	(1)
Application Through Critical Thinking	133	(1)
Case Study	133	(2)
Critical Thinking Questions	133	(1)
Applying Nursing Diagnoses	133	(2)
Nutritional Assessment	135	(21)
Defining Nutritional Health	136	(1)
Nutritional Assessment	137	(14)
Nutritional History	138	(1)
Physical Assessment	139	(10)
Biochemical Assessment---Laboratory Measurements	149	(1)
Cultural Considerations for the Nutritional Assessment	149	(1)
Nutritional Assessment Across the Life Span	149	(2)
Nutritional Screening and Assessment Tools	151	(2)
Food Guide Pyramid	151	(1)
Other Assessment Tools	152	(1)
Health Promotion	153	(1)
Application Through Critical Thinking	154	(1)
Case Study	154	(2)
Complete Documentation	155	(1)
Critical Thinking Questions	155	(1)
Applying Nursing Diagnoses	155	(1)
The Health History	156	(26)
Communication Skills	157	(3)
Interactional Skills	157	(3)
Barriers to Effective Client Interaction	160	(1)
False Reassurance	160	(1)
Interrupting or Changing the Subject	160	(1)
Passing Judgment	160	(1)
Cross-Examination	160	(1)
Technical Terms	160	(1)
Sensitive Issues	160	(1)
The Influence of Culture on Nurse-Client Interactions	161	(1)
Diversity	161	(1)
Body Language	161	(1)
Communicating with Language Differences	162	(1)
Professional Characteristics to Enhance the Nurse-Client Interaction	162	(1)
Positive Regard	162	(1)
Empathy	163	(1)
Genuineness	163	(1)
Concreteness	163	(1)
The Health History Interview	163	(3)
Sources of Information	163	(1)
Phases of the Health Assessment Interview	164	(2)
The Health History	166	(9)
Components of the Health History	167	(8)
Documentation	175	(5)
Nursing Considerations	180	(1)
Application Through Critical Thinking	180	(1)
Case Study	180	(2)
Critical Thinking Questions	181	(1)
UNIT III PHYSICAL ASSESSMENT	182	(600)
Skin, Hair, and Nails	182	(52)
Anatomy and Physiology Review	183	(2)
Skin and Glands	183	(1)
Subcutaneous Tissue	184	(1)
Cutaneous Glands	184	(1)
Oil Glands	184	(1)
Hair	185	(1)
Nails	185	(1)
Special Considerations	185	(6)
Developmental Considerations	185	(3)
Psychosocial Considerations	188	(1)
Cultural and Environmental Considerations	188	(3)
Gathering the Data	191	(1)
Focused Interview	191	(1)
Skin	192	(5)
Questions Related to Illness or Infection	192	(1)
Questions Related to Symptoms or Behaviors	193	(2)
Questions Related to Age	195	(1)
Questions Related to the Environment	196	(1)
Hair	197	(1)
Nails	198	(2)
Physical Assessment	200	(9)
Assessment Techniques and Findings	200	(1)
Survey	200	(1)
Inspection of the Skin	201	(1)
Palpation of the Skin	202	(3)
Inspection of the Scalp and Hair	205	(2)
Assessment of the Nails	207	(2)
Abnormal Findings	209	(1)
Vascular Lesions	209	(3)
Hemangioma	209	(1)
Port-Wine Stain	209	(1)
Spider Angioma	210	(1)
Venous Lake	210	(1)
Petechiae	210	(1)
Purpura	211	(1)
Ecchymosis	211	(1)
Hematoma	212	(1)
Primary Lesions	212	(2)
Macule, Patch	212	(1)
Papule, Plaque	212	(1)
Nodule, Tumor	213	(1)
Vesicle, Bulla	213	(1)
Wheal	213	(1)
Pustule	214	(1)
Cyst	214	(1)
Secondary Lesions	214	(3)
Atrophy	214	(1)
Erosion	215	(1)
Lichenification	215	(1)
Scales	215	(1)
Crust	216	(1)
Ulcer	216	(1)
Fissure	216	(1)
Scar	217	(1)
Keloid	217	(1)
Configurations and Shapes of Lesions	217	(3)
Annular	217	(1)
Confluent	218	(1)
Discrete	218	(1)
Grouped	218	(1)
Gyrate	219	(1)
Target	219	(1)
Linear	219	(1)
Polycyclic	220	(1)
Zosteriform	220	(1)
Common Skin Lesions	220	(4)
Tinea	220	(1)
Measles (Rubeola)	221	(1)
German Measles (Rubella)	221	(1)
Chickenpox (Varicella)	221	(1)
Herpes Simplex	222	(1)
Herpes Zoster	222	(1)
Psoriasis	222	(1)
Contact Dermatitis	223	(1)
Eczema	223	(1)
Impetigo	223	(1)
Malignant Skin Lesions	224	(1)
Basal Cell Carcinoma	224	(1)
Squamous Cell Carcinoma	224	(1)
Malignant Melanoma	224	(1)
Kaposi's Sarcoma	225	(1)
Abnormalities of the Hair	225	(2)
Seborrheic Dermatitis	225	(1)
Tinea Capitis	225	(1)
Alopecia Areata	226	(1)
Folliculitis	226	(1)
Furuncle/Abscess	226	(1)
Hirsutism	227	(1)
Abnormalities of the Nails	227	(2)
Spoon Nails	227	(1)
Paronychia	227	(1)
Beau's Line	228	(1)
Splinter Hemorrhage	228	(1)
Clubbing	228	(1)
Onycholysis	228	(1)
Health Promotion	229	(2)
Application Through Critical Thinking	231	(1)
Case Study	231	(3)
Complete Documentation	231	(1)
Critical Thinking Questions	231	(1)
Applying Nursing Diagnoses	231	(1)
Prepare Teaching Plan	232	(2)
Head, Neck, and Related Lymphatics	234	(29)
Anatomy and Physiology Review	235	(5)
Head	235	(1)
Neck	236	(3)
Lymphatics	239	(1)
Special Considerations	240	(1)
Developmental Considerations	240	(1)
Psychosocial Considerations	241	(1)
Cultural and Environmental Considerations	241	(1)
Gathering the Data	241	(1)
Focused Interview	241	(5)
General Questions	242	(1)
Questions Related to Illness, Infection, or Injury	243	(1)
Questions Related to Symptoms or Behaviors	243	(1)
Questions Related to Age	244	(1)
Questions Related to the Environment	245	(1)
Physical Assessment	246	(7)
Assessment Techniques and Findings	246	(1)
The Head	247	(2)
The Neck	249	(4)
Abnormal Findings	253	(1)
Headaches	253	(1)
Classic Migraine	253	(1)
Cluster Headache	254	(1)
Tension Headache	254	(1)
Abnormalities of the Skull and Face	254	(4)
Hydrocephalus	254	(1)
Craniosynostosis	254	(1)
Acromegaly	255	(1)
Bell's Palsy	255	(1)
Cushing's Syndrome	255	(1)
Down Syndrome	256	(1)
Parkinson's Disease	256	(1)
Brain Attack	257	(1)
Fetal Alcohol Syndrome	257	(1)
Torticollis	257	(1)
Thyroid Abnormalities	258	(1)
Hyperthyroidism	258	(1)
Hypothyroidism	258	(1)
Thyroiditis	258	(1)
Health Promotion	259	(1)
Application Through Critical Thinking	260	(1)
Case Study	260	(3)
Complete Documentation	260	(1)
Critical Thinking Questions	261	(1)
Applying Nursing Diagnoses	261	(1)
Prepare Teaching Plan	261	(2)
Eye	263	(41)
Anatomy and Physiology Review	264	(2)
Eye	264	(1)
Refraction of the Eye	265	(1)
Visual Pathways	265	(1)
Accessory Structures of the Eye	266	(1)
Special Considerations	266	(3)
Developmental Considerations	266	(3)
Psychosocial Considerations	269	(1)
Cultural and Environmental Considerations	269	(1)
Gathering the Data	269	(1)
Focused Interview	269	(7)
General Questions	270	(1)
Questions Related to Illness or Infection	270	(1)
Questions Related to Symptoms or Behaviors	271	(2)
Questions Related to Age	273	(1)
Questions Related to the Environment	274	(2)
Physical Assessment	276	(13)
Assessment Techniques and Findings	276	(1)
Testing Visual Acuity	276	(2)
Testing Visual Fields by Confrontation	278	(1)
Testing the Six Cardinal Fields of Gaze	279	(1)
Assessment of Corneal Light Reflex	280	(1)
Perform the Cover Test	281	(1)
Inspection of the Pupils	281	(1)
Evaluation of Pupillary Response	281	(1)
Testing for Accommodation of Pupil Response	282	(1)
Testing of the Corneal Reflex	282	(1)
Inspection of the External Eye	283	(1)
Palpation of the Eye	283	(1)
Examination of the Conjunctiva and Sclera Under the Lower Eyelid	284	(1)
Inspection of the Fundus with the Ophthalmoscope	285	(4)
Abnormal Findings	289	(4)
Visual Acuity	289	(1)
Visual Fields	290	(1)
Cardinal Fields of Gaze	291	(2)
Abnormal Pupillary Response	293	(1)
Adie's Pupil	293	(1)
Argyll Robertson Pupils	293	(1)
Anisocoria	293	(1)
Cranial Nerve III Damage	293	(1)
Horner's Syndrome	293	(1)
Mydriasis	294	(1)
Miosis	294	(1)
Monocular Blindness	294	(1)
Abnormalities of the Structures of the External Eye	294	(4)
Acute Glaucoma	294	(1)
Basal Cell Carcinoma	295	(1)
Blepharitis	295	(1)
Cataract	295	(1)
Chalazion	296	(1)
Conjunctivitis	296	(1)
Ectropion	296	(1)
Entropion	297	(1)
Hordeolum (Style)	297	(1)
Iritis	297	(1)
Periorbital Edema	298	(1)
Ptosis	298	(1)
Abnormalities of the Fundus	298	(1)
Diabetic Retinopathy	298	(1)
Hypertensive Retinopathy	298	(1)
Macular Degeneration	299	(1)
Health Promotion	299	(2)
Application Through Critical Thinking	301	(1)
Case Study	301	(3)
Complete Documentation	301	(1)
Critical Thinking Questions	302	(1)
Applying Nursing Diagnoses	303
Prepare Teaching Plan	302	(2)
Ears, Nose, Mouth, and Throat	304	(44)
Anatomy and Physiology Review	305	(5)
Ear	305	(1)
Nose and Sinuses	306	(1)
Mouth	307	(3)
Throat	310	(1)
Special Considerations	310	(2)
Developmental Considerations	311	(1)
Psychosocial Considerations	311	(1)
Cultural and Environmental Considerations	312	(1)
Gathering The Data	312	(1)
Focused Interview	312	(7)
General Questions	313	(1)
Questions Related to Illness or Infection	313	(1)
Questions Related to Symptoms or Behaviors	314	(1)
Questions Related to the Environment	314	(1)
Questions Related to Age	315	(1)
Nose and Sinuses	316	(1)
Mouth and Throat	317	(2)
Physical Assessment	319	(14)
Assessment Techniques and Findings	319	(1)
Ear	320	(6)
Nose and Sinuses	326	(4)
Mouth and Throat	330	(3)
Abnormal Findings	333	(1)
Ear	333	(2)
Hemotympanum	333	(1)
Otitis Externa	333	(1)
Otitis Media	334	(1)
Perforation of the Tympanic Membrane	334	(1)
Scarred Tympanic Membrane	334	(1)
Tophi	335	(1)
Tympanostomy Tubes	335	(1)
Nose and Sinuses	335	(4)
Epistaxis	335	(1)
Rhinitis	336	(1)
Sinusitis	337	(1)
Deviated Septum	337	(1)
Nasal Polyps	338	(1)
Perforated Septum	338	(1)
Mouth and Throat	339	(4)
Ankyloglossia	339	(1)
Aphthous Ulcers	339	(1)
Black Hairy Tongue	340	(1)
Gingival Hyperplasia	340	(1)
Gingivitis	340	(1)
Tonsillitis	341	(1)
Smooth Tongue	341	(1)
Herpes Simplex	341	(1)
Carcinoma	342	(1)
Leukoplakia	342	(1)
Health Promotion	343	(1)
Application Through Critical Thinking	344	(1)
Case Study	344	(4)
Complete Documentation	345	(1)
Critical Thinking Questions	345	(1)
Applying Nursing Diagnoses	345	(1)
Prepare Teaching Plan	345	(3)
Respiratory System	348	(49)
Anatomy and Physiology Review	349	(4)
Lower Respiratory Tract	350	(2)
Respiratory Process	352	(1)
Landmarks	353	(6)
Special Considerations	359	(2)
Developmental Considerations	359	(1)
Psychosocial Considerations	360	(1)
Cultural and Environmental Considerations	360	(1)
Gathering the Data	361	(1)
Focused Interview	361	(8)
General Questions	362	(1)
Questions Related to Illness or Infection	363	(1)
Questions Related to Symptoms or Behaviors	363	(3)
Questions Related to Age	366	(1)
Questions Related to the Environment	367	(2)
Physical Assessment	369	(19)
Assessment Techniques and Findings	369	(1)
Survey	370	(1)
Inspection of the Anterior Thorax	370	(1)
Inspection of the Posterior Thorax	371	(1)
Palpation of the Posterior Thorax	372	(2)
Percussion of the Posterior Thorax	374	(2)
Auscultation of the Posterior Thorax	376	(3)
Assessment of Voice Sounds	379	(1)
Assessment of the Anterior Thorax	379	(1)
Palpation of the Anterior Thorax	379	(3)
Percussion of the Anterior Thorax	382	(1)
Auscultation of the Anterior Thorax	383	(5)
Abnormal Findings	388	(1)
Respiratory Disorders	388	(4)
Asthma	388	(1)
Atelectasis	388	(1)
Chronic Bronchitis	389	(1)
Emphysema	389	(1)
Lobar Pneumonia	390	(1)
Pleural Effusion	390	(1)
Pneumothorax	391	(1)
Congestive Heart Failure	391	(1)
Health Promotion	392	(2)
Application Through Critical Thinking	394	(1)
Case Study	394	(3)
Complete Documentation	395	(1)
Critical Thinking Questions	395	(1)
Applying Nursing Diagnoses	395	(1)
Prepare Teaching Plan	395	(2)
Breasts and Axillae	397	(28)
Anatomy and Physiology Review	398	(3)
Breasts	398	(1)
Axillae and Lymph Nodes	399	(2)
Muscles of the Chest Wall	401	(1)
Special Considerations	401	(2)
Developmental Considerations	401	(1)
Psychosocial Considerations	402	(1)
Cultural and Environmental Considerations	402	(1)
Gathering the Data	403	(1)
Focused Interview	403	(5)
General Questions	404	(1)
Questions Related to Illness or Infection	404	(1)
Questions Related to Symptoms or Behaviors	404	(1)
Questions Related to Age	405	(1)
Questions Related to the Environment	406	(2)
Physical Assessment	408	(9)
Assessment Techniques and Findings	408	(1)
Inspection of the Breast	408	(4)
Palpation of the Breast	412	(3)
Examination of the Axillae	415	(1)
Inspection of the Male Breast	416	(1)
Palpation of the Male Breast and Axillae	416	(1)
Abnormal Findings	417	(3)
Benign Breast Disease	417	(1)
Fibroadenoma	418	(1)
Intraductal Papilloma	418	(1)
Mammary Duct Ectasia	418	(1)
Carcinoma of the Breast	419	(1)
Abnormalities of the Male Breast	419	(1)
Health Promotion	420	(3)
Application Through Critical Thinking	423	(1)
Case Study	423	(2)
Complete Documentation	423	(1)
Critical Thinking Questions	423	(1)
Applying Nursing Diagnoses	423	(1)
Prepare Teaching Plan	423	(2)
Cardiovascular System	425	(51)
Anatomy and Physiology Review	426	(14)
Pericardium	426	(1)
Heart	426	(2)
Valves	428	(1)
Heart Sounds	429	(2)
Additional Heart Sounds	431	(1)
Coronary Arteries	431	(3)
Cardiac Veins	434	(1)
Cardiac Conduction System	434	(2)
Pulmonary Circulation	436	(1)
Systemic Circulation	436	(1)
Landmarks for Cardiovascular Assessment	436	(1)
Cardiac Cycle	437	(2)
Measurements of Cardiac Function	439	(1)
Special Considerations	440	(3)
Developmental Considerations	440	(2)
Psychosocial Considerations	442	(1)
Cultural and Environmental Considerations	442	(1)
Gathering the Data	443	(1)
Focused Interview	444	(7)
Questions Related to Illness	445	(1)
Questions Related to Symptoms or Behaviors	445	(2)
Questions Related to Age	447	(2)
Questions Related to the Environment	449	(2)
Physical Assessment	451	(12)
Assessment Techniques and Findings	451	(1)
Inspection	451	(6)
Palpation	457	(2)
Percussion	459	(1)
Auscultation	460	(3)
Abnormal Findings	463	(1)
Diseases of the Myocardium and Pumping Capacity of the Heart	463	(1)
Myocardial Ischemia	463	(1)
Myocardial Infarction	463	(1)
Congestive Heart Disease	463	(1)
Ventricular Hypertrophy	463	(1)
Valvular Disease	464	(3)
Valvular Heart Disease	464	(1)
Mitral Stenosis	464	(1)
Aortic Stenosis	464	(1)
Mitral Regurgitation	465	(1)
Pulmonic Stenosis	465	(1)
Tricuspid Stenosis	466	(1)
Mitral Valve Prolapse	466	(1)
Aortic Regurgitation	467	(1)
Septal Defects	467	(1)
Ventricular Septal Defect	467	(1)
Atrial Septal Defect	468	(1)
Congenital Heart Disease	468	(2)
Coarctation of the Aorta	468	(1)
Patent Ductus Arteriosus	469	(1)
Tetralogy of Fallot	469	(1)
Electrical Rhythm Disturbances	470	(1)
Ventricle Tachycardia	470	(1)
Ventricular Fibrillation	470	(1)
Heart Block	470	(1)
Atrial Flutter	471	(1)
Atrial Fibrillation	471	(1)
Health Promotion	471	(2)
Application Through Critical Thinking	473	(1)
Case Study	473	(3)
Complete Documentation	474	(1)
Critical Thinking Questions	474	(1)
Applying Nursing Diagnoses	474	(1)
Prepare Teaching Plan	474	(2)
Peripheral Vascular System	476	(34)
Anatomy and Physiology Review	477	(2)
Arteries	477	(1)
Veins	478	(1)
Capillaries	478	(1)
Lymphatic System	478	(1)
Special Considerations	479	(2)
Developmental Considerations	479	(2)
Psychosocial Considerations	481	(1)
Cultural and Environmental Considerations	481	(1)
Gathering the Data	481	(1)
Focused Interview	481	(4)
General Questions	482	(1)
Questions Related to Illness	482	(1)
Questions Related to Symptoms or Behaviors	482	(2)
Questions Related to Age	484	(1)
Questions Related to the Environment	484	(1)
Physical Assessment	485	(16)
Assessment Techniques and Findings	485	(1)
Blood Pressure	486	(2)
Carotid Arteries	488	(1)
Arms	489	(3)
Legs	492	(9)
Abnormal Findings	501	(4)
Arterial Insufficiency	502	(1)
Arterial Aneurysm	502	(1)
Venous Insufficiency	503	(1)
Varicose Veins	503	(1)
Raynaud's Disease	504	(1)
Deep Vein Thrombosis	504	(1)
Lymphedema	504	(1)
Health Promotion	505	(1)
Application Through Critical Thinking	506	(1)
Case Study	506	(4)
Complete Documentation	507	(1)
Critical Thinking Questions	507	(1)
Applying Nursing Diagnoses	507	(1)
Prepare Teaching Plan	507	(3)
Abdomen	510	(44)
Anatomy and Physiology Review	511	(5)
Abdomen	511	(1)
Alimentary Canal	511	(2)
Accessory Digestive Organs	513	(1)
Other Related Structures	513	(1)
Landmarks	514	(2)
Special Considerations	516	(3)
Developmental Considerations	516	(3)
Psychosocial Considerations	519	(1)
Cultural and Environmental Considerations	519	(1)
Gathering the Data	519	(1)
Focused Interview	519	(9)
General Questions	520	(1)
Questions Related to Illness or Infection	521	(1)
Questions Related to Symptoms or Behaviors	522	(2)
Questions Related to Age	524	(2)
Questions Related to the Environment	526	(2)
Physical Assessment	528	(14)
Assessment Techniques and Findings	528	(1)
Survey	529	(1)
Inspection of the Abdomen	529	(2)
Auscultation of the Abdomen	531	(2)
Percussion of the Abdomen	533	(2)
Percussion of the Liver	535	(1)
Percussion of the Spleen	536	(1)
Percussion of the Gastric Bubble	537	(1)
Palpation of the Abdomen	537	(2)
Palpation of the Liver	539	(1)
Palpation of the Spleen	539	(1)
Additional Procedures	540	(2)
Abnormal Findings	542	(1)
Abnormal Abdominal Sounds	542	(1)
Abdominal Pain	543	(1)
Abdominal Distention	544	(2)
Obesity	544	(1)
Gaseous Distention	545	(1)
Tumor	545	(1)
Ascites	546	(1)
Abdominal Hernias	546	(2)
Umbilical Hernia	547	(1)
Ventral (Incisional) Hernias	547	(1)
Hiatal Hernia	547	(1)
Alterations of the Gastrointestinal Tract	548	(1)
Nutritional Problems	548	(1)
Eating Disorders	548	(1)
Cancers	548	(1)
Inflammatory Processes	549	(1)
Health Promotion	549	(2)
Application Through Critical Thinking	551	(1)
Case Study	551	(3)
Complete Documentation	552	(1)
Critical Thinking Questions	552	(1)
Applying Nursing Diagnoses	552	(1)
Prepare Teaching Plan	552	(2)
Urinary System	554	(28)
Anatomy and Physiology Review	555	(2)
Kidneys	555	(2)
Renal Arteries	557	(1)
Ureters	557	(1)
Urinary Bladder	557	(1)
Urethra	557	(1)
Landmarks	557	(1)
Special Considerations	557	(4)
Developmental Considerations	557	(3)
Psychosocial Considerations	560	(1)
Cultural and Environmental Considerations	560	(1)
Gathering the Data	561	(1)
Focused Interview	561	(7)
General Questions	561	(1)
Questions Related to Illness or Infection	562	(1)
Questions Related to Symptoms or Behaviors	563	(3)
Questions Related to Age	566	(1)
Questions Related to the Environment	567	(1)
Physical Assessment	568	(9)
Assessment Techniques and Findings	568	(1)
General Survey	569	(2)
The Kidneys and Flanks	571	(2)
The Left Kidney	573	(2)
The Right Kidney	575	(1)
The Urinary Bladder	575	(2)
Abnormal Findings	577	(1)
Bladder Cancer	577	(1)
Glomerulonephritis	577	(1)
Renal Calculi	577	(1)
Renal Tumor	577	(1)
Renal Failure	577	(1)
Urinary Tract Infection	577	(1)
Changes in Urinary Elimination	577	(1)
Health Promotion	578	(2)
Application Through Critical Thinking	580	(1)
Case Study	580	(2)
Complete Documentation	580	(1)
Critical Thinking Questions	580	(1)
Applying Nursing Diagnoses	580	(1)
Prepare Teaching Plan	580	(2)
Male Reproductive System	582	(42)
Anatomy and Physiology Review	583	(3)
Male Reproductive System	583	(2)
Duct System	585	(1)
Accessory Glands	585	(1)
Penis	586	(1)
Inguinal Areas	586	(1)
Perianal Area	586	(1)
Special Considerations	586	(4)
Developmental Considerations	586	(2)
Psychosocial Considerations	588	(1)
Cultural and Environmental Considerations	589	(1)
Gathering the Data	590	(1)
Focused Interview	590	(8)
General Questions	591	(2)
Questions Related to Illness or Infection	593	(1)
Questions Related to Symptoms or Behaviors	593	(3)
Questions Related to Age	596	(1)
Questions Related to Environment	597	(1)
Physical Assessment	598	(12)
Assessment Techniques and Findings	598	(1)
Inspection	599	(4)
Palpation	603	(7)
Abnormal Findings	610	(1)
Abnormalities of the Penis	610	(2)
Hypospadias	610	(1)
Peyronie's Disease	610	(1)
Carcinoma	611	(1)
Genital Warts	611	(1)
Syphilitic Chancre	611	(1)
Genital Herpes	612	(1)
Abnormal Findings in the Scrotum	612	(4)
Hydrocele	612	(1)
Scrotal Hernia	613	(1)
Testicular Tumor	613	(1)
Orchitis	613	(1)
Epididymitis	614	(1)
Torsion of the Spermatic Cord	614	(1)
Small Testes	614	(1)
Cryptorchidism	615	(1)
Scrotal Edema	615	(1)
Abnormalities of the Perianal Area	616	(3)
Pilonidal Cyst	616	(1)
Anal Fissure	616	(1)
Hemorrhoids	617	(1)
Prolapse of the Rectum	618	(1)
Perianal Perirectal Abscess	618	(1)
Health Promotion	619	(1)
Application Through Critical Thinking	620	(1)
Case Study	620	(4)
Complete Documentation	621	(1)
Critical Thinking Questions	621	(1)
Applying Nursing Diagnoses	622	(1)
Prepare Teaching Plan	622	(2)
Female Reproductive System	624	(42)
Anatomy and Physiology Review	625	(3)
External Genitalia	625	(1)
Internal Reproductive Organs	626	(2)
Special Considerations	628	(2)
Developmental Considerations	628	(1)
Psychosocial Considerations	629	(1)
Cultural and Environmental Considerations	630	(1)
Gathering the Data	630	(1)
Focused Interview	631	(9)
General Questions	631	(2)
Questions Related to Illness or Infection	633	(1)
Questions Related to Symptoms or Behaviors	634	(3)
Questions Related to Age	637	(1)
Questions Related to Environment	638	(2)
Physical Assessment	640	(15)
Assessment Techniques and Findings	640	(1)
Inspection	640	(4)
Palpation	644	(1)
Inspection with a Speculum	645	(2)
Obtaining the Pap Smear and Gonorrhea Culture	647	(2)
Bimanual Palpation	649	(6)
Abnormal Findings	655	(1)
External Genitalia	655	(1)
Pediculosis Pubis	655	(1)
Herpes Simplex	655	(1)
Syphilitic Lesion	656	(1)
Human Papillomavirus (HPV)	656	(1)
Abscess of Bartholin's Gland	656	(1)
Cervix	656	(1)
Cyanosis	656	(1)
Carcinoma	656	(1)
Erosion	657	(1)
Polyp	657	(1)
Diethylstilbestrol (DES) Syndrome	657	(1)
Internal Reproductive Organs	657	(2)
Myomas/Fibroids	657	(1)
Ovarian Cancer	658	(1)
Ovarian Cysts	658	(1)
Inflammatory Processes	659	(2)
Atrophic Vaginitis	659	(1)
Candidiasis	659	(1)
Chlamydia	660	(1)
Gonorrhea	660	(1)
Trichomoniasis	660	(1)
Health Promotion	661	(2)
Application Through Critical Thinking	663	(1)
Case Study	663	(3)
Complete Documentation	663	(1)
Critical Thinking Questions	664	(1)
Applying Nursing Diagnoses	664	(1)
Prepare Teaching Plan	664	(2)
Musculoskeletal System	666	(64)
Anatomy and Physiology Review	667	(13)
Bones	667	(1)
Skeletal Muscles	667	(1)
Joints	667	(13)
Special Considerations	680	(3)
Developmental Considerations	680	(2)
Psychosocial Considerations	682	(1)
Cultural and Environmental Considerations	682	(1)
Gathering the Data	683	(1)
Focused Interview	683	(6)
General Questions	684	(1)
Questions Related to Illness, Infection, or Injury	684	(1)
Questions Related to Symptoms or Behaviors	685	(1)
Questions Related to Age	686	(1)
Questions Related to the Environment	687	(2)
Physical Assessment	689	(27)
Assessment Techniques and Findings	689	(1)
Survey	689	(1)
Assessment of the Joints	690	(1)
The Shoulders	691	(4)
Elbows	695	(3)
Wrists and Hands	698	(5)
Hips	703	(3)
Knees	706	(3)
Ankles and Feet	709	(2)
Spine	711	(5)
Abnormal Findings	716	(1)
Abnormalities of the Spine	717	(1)
Kyphosis	717	(1)
Scoliosis	717	(1)
Lordosis	718	(1)
Joint Disorders	718	(6)
Head and Neck	718	(1)
Shoulder	718	(1)
Elbow	719	(1)
Wrist and Hand	719	(3)
Knee	722	(1)
Foot	722	(2)
Health Promotion	724	(3)
Application Through Critical Thinking	727	(1)
Case Study	727	(3)
Complete Documentation	727	(1)
Critical Thinking Questions	727	(1)
Applying Nursing Diagnoses	727	(1)
Prepare Teaching Plan	728	(2)
Neurologic System	730	(52)
Anatomy and Physiology Review	731	(2)
Central Nervous System	731	(2)
Reflexes	733	(1)
Peripheral Nervous System	733	(1)
Special Considerations	733	(4)
Developmental Considerations	734	(2)
Psychosocial Considerations	736	(1)
Cultural and Environmental Considerations	736	(1)
Gathering the Data	737	(1)
Focused Interview	737	(6)
General Questions	738	(1)
Questions Related to Illness, Infection, or Injury	738	(1)
Questions Related to Symptoms or Behaviors	739	(1)
Questions Related to Age	740	(2)
Questions Related to the Environment	742	(1)
Physical Assessment	743	(31)
Assessment Techniques and Findings	743	(1)
Mental Status	744	(3)
Cranial Nerves	747	(10)
Motor Function	757	(4)
Sensory Function	761	(5)
Reflexes	766	(6)
Carotid Auscultation	772	(1)
Meningeal Assessment	772	(1)
Use of the Glasgow Coma Scale	773	(1)
Abnormal Findings	774	(1)
Seizures	775	(1)
Spinal Cord Injuries	775	(1)
Infections of the Neurologic System	775	(1)
Meningitis	775	(1)
Myelitis	775	(1)
Brain Abscess	775	(1)
Lyme Disease	775	(1)
Degenerative Neurologic Disorders	776	(1)
Alzheimer's Disease	776	(1)
Amyotrophic Lateral Sclerosis	776	(1)
Huntington's Disease	776	(1)
Multiple Sclerosis	776	(1)
Myasthenia Gravis	776	(1)
Parkinson's Disease	776	(1)
Health Promotion	777	(1)
Application Through Critical Thinking	778	(1)
Case Study	778	(4)
Complete Documentation	779	(1)
Critical Thinking Questions	779	(1)
Applying Nursing Diagnoses	779	(1)
Prepare Teaching Plan	779	(3)
UNIT IV PHYSICAL ASSESSMENT ACROSS THE LIFE SPAN	782
Assessment of Infants, Children, and Adolescents	782	(39)
Childhood Developmental Stages	783	(1)
Nutritional Assessment	783	(3)
Nutritional History	784	(1)
Physical Assessment	784	(1)
Laboratory Measurements	785	(1)
Physical Variants in Childhood	786	(9)
Integument	786	(1)
Head, Eyes, Ears, Nose, and Throat	786	(3)
Vital Signs	789	(1)
Respiratory System	789	(1)
Cardiovascular System	790	(1)
Breasts	791	(1)
Abdomen	792	(1)
Genitourinary and Reproductive Systems	792	(1)
Musculoskeletal System	792	(1)
Neurologic System	793	(2)
Special Considerations	795	(1)
Psychosocial Considerations	795	(1)
Cultural Considerations	795	(1)
Gathering the Data	796	(1)
Focused Interview	797	(3)
Questions About the Birth History	797	(1)
Questions Related to Illness or Infection	798	(1)
Questions Related to Well Children and Health Promotion	799	(1)
Physical Assessment	800	(14)
Assessment Techniques and Findings	800	(1)
General Survey	801	(1)
Growth and Development	801	(2)
Skin, Hair, and Nails	803	(1)
Head and Neck	803	(1)
Eyes and Vision	804	(1)
Ears and Hearing	805	(1)
Nose and Sinuses	806	(1)
Mouth and Throat	806	(1)
Chest and Lungs	806	(1)
Cardiovascular	807	(1)
Abdomen	807	(1)
Genitalia	808	(2)
Musculoskeletal	810	(3)
Neurologic	813	(1)
Abnormal Findings	814	(2)
Otitis Media	814	(1)
Allergic Rhinitis	814	(1)
Asthma	814	(1)
Acne Vulgaris	815	(1)
Scalp Ringworm (Tinea Capitis)	815	(1)
Acute Gastroenteritis	815	(1)
Health Promotion	816	(2)
Application Through Critical Thinking	818	(1)
Case Study	818	(3)
Complete Documentation	818	(1)
Critical Thinking Questions	818	(1)
Applying Nursing Diagnoses	818	(1)
Prepare Teaching Plan	819	(2)
The Pregnant Female	821	(53)
Nutritional Assessment	822	(2)
Physical Assessment	822	(1)
Laboratory Measurements	823	(1)
Anatomy and Physiology Review	824	(9)
The Placenta	824	(1)
Fetal Development	825	(1)
Reproductive System Changes	825	(2)
Changes in Breasts	827	(1)
Respiratory System Changes	828	(1)
Cardiovascular and Hematologic System Changes	828	(1)
Integumentary System Changes	829	(1)
Changes in the Ear, Nose, Throat, and Mouth	830	(1)
Gastrointestinal System Changes	830	(1)
Urinary System Changes	830	(1)
Musculoskeletal Changes	831	(1)
Neurologic System Changes	831	(1)
Endocrine System Changes	832	(1)
Cultural Variations	833	(1)
Laboratory Tests in Pregnancy	833	(1)
The Postpartum Female	833	(4)
Anatomy and Physiology Review	833	(1)
The BUBBLESHE Head-to-Toe Postpartum Assessment	833	(4)
Gathering the Data	837	(1)
Focused Interview	837	(13)
Confirmation of Pregnancy	838	(1)
Demographics	838	(1)
Menstrual History	839	(1)
Obstetrical and Gynecological History	840	(1)
Reaction to Pregnancy	840	(1)
Past Obstetrical History	840	(1)
Past Gynecological History	841	(1)
Past Medical History and Family History	842	(2)
Genetic Information	844	(2)
Lifestyle and Social Health Practices	846	(1)
Nutrition and Exercise History	846	(2)
Environmental Exposure	848	(2)
Physical Assessment	850	(16)
General Survey	851	(1)
Skin, Hair, and Nails	851	(1)
Head and Neck	852	(1)
Eyes, Ears, Nose, Mouth, and Throat	852	(1)
Thorax and Lungs	852	(1)
The Heart	852	(1)
Breasts and Axillae	853	(1)
Extremities	853	(1)
Neurologic System	853	(1)
Abdomen and Fetal Assessment	853	(5)
External Genitalia	858	(2)
Inspection of Vagina and Cervix	860	(1)
Palpation of Pelvis	860	(3)
Palpation of Cervix, Uterus, Adnexa, and Vagina	863	(2)
Anus and Rectum	865	(1)
Abnormal Findings	866	(2)
Common Complications in Pregnancy	866	(1)
Common Complications in the Postpartum Period	867	(1)
Health Promotion	868	(3)
Application Through Critical Thinking	871	(1)
Case Study	871	(3)
Complete Documentation	871	(1)
Critical Thinking Questions	871	(1)
Applying Nursing Diagnoses	871	(1)
Prepare Teaching Plan	871	(3)
Assessing the Older Adult	874
Theories of Aging	875	(1)
Anatomy and Physiology Review with Changes of Aging	876	(5)
Integumentary System	876	(1)
Mouth, Nose, and Throat	876	(1)
Eyes	876	(1)
Ears	877	(1)
Respiratory System	877	(1)
Cardiovascular System	877	(1)
Gastrointestinal System	877	(2)
Genitourinary System	879	(1)
Endocrine System	880	(1)
Musculoskeletal System	880	(1)
Neurologic System	881	(1)
Gathering the Data	881	(1)
Guidelines for Interviewing Older Adults	881	(1)
Focused Interview	882	(5)
Questions for the Client	882	(3)
Questions for Family Members or Caregivers	885	(2)
Physical Assessment	887	(13)
Assessment Techniques and Findings	887	(1)
General Survey	887	(2)
Integumentary System	889	(1)
Head and Neck	890	(2)
Eye	892	(1)
Ear	893	(1)
Respiratory System	893	(1)
Breasts	894	(1)
Cardiovascular System	895	(1)
Abdomen	895	(1)
Genitourinary System	896	(1)
Musculoskeletal System	897	(1)
Neurologic System	898	(2)
Abnormal Findings	900	(1)
Skin Lesions	900	(1)
Insulin Resistance Syndrome	900	(1)
Diabetes Mellitus	900	(1)
Drug and Alcohol Abuse	901	(1)
Health Promotion	901	(2)
Application Through Critical Thinking	903	(1)
Case Study	903
Complete Documentation	904	(1)
Critical Thinking Questions	904	(1)
Applying Nursing Diagnoses	904	(1)
Prepare Teaching Plan	905
Appendix A 2005--2006 North American Nursing Diagnosis Association (NANDA) Approved Nursing Diagnoses	1	(1)
Appendix B Standard Precautions for Blood and Bodily Fluid Exposure	1	(1)
Appendix C Standard Precautions for Infection Control	1	(1)
Appendix D Blood Pressure Standards for Girls Ages I to 17 Years	1	(1)
Appendix E Blood Pressure Standards for Boys Ages 1 to 17 Years	1	(1)
Appendix F Denver Developmental Screening	1	(1)
Appendix G Mini Nutritional Assessment	1	(1)
Glossary	1	(1)
References	1	(1)
Credits	1	(1)
Index	1