Photo Guide of Nursing Skills

by Smith, Sandra F.; Duell, Donna J., RN,MS; Martin, Barbara C.

• ISBN13: 9780838581742
• ISBN10: 0838581749
• Edition: 1st
• Format: Paperback
• Copyright: 2001-07-30
• Publisher: Prentice Hall

Summary

This heavily illustrated book provides a full color presentation of all basic and intermediate skills of nursing procedures. Its unique and easy-to-use format divides each procedure into logical stepscomplete with appropriate illustrations, descriptions, and rationales for each one. A focus on critical thinking looks at unexpected outcomes when performing skills, and encourages problem solving in a clinical context using alternative nursing actions.Chapter topics include legal and ethical protocol; documentation; infection control; personal hygiene; vital signs; wound care and dressings; oral, parenteral, and topical and mucous membrane medications; feeding and decompression tubes; urinary and bowel elimination; respiratory and cardiovascular procedures; cardiopulmonary emergencies; and intravenous medications.For individuals preparing for a career in nursing, or providing health care at home.

Table of Contents

Preface	xv
UNIT I. Introduction to nursing practice	1	(34)
Legal and Ethical Practice	3	(10)
Legal and Ethical Protocols	4	(1)
American Nurses Association Code for Nurses	4	(1)
Clients' Rights	5	(2)
Advance Directives	5	(1)
Living Will	5	(1)
Durable Power of Attorney for Health Care	5	(1)
Consent to Receive Health Services	6	(1)
Patient Right to Know Act	6	(1)
Legal Aspects	7	(6)
The Nurse Practice Act	7	(1)
Nurse Licensure	7	(1)
Standards of Clinical Nursing Practice	7	(1)
Liability and Legal Issues	8	(1)
Legal Issues and Drug Administration	8	(1)
Negligence and Malpractice	9	(4)
Documentation and Care Planning	13	(22)
Documentation	14	(13)
Charting Guidelines for Potential Legal Problems	15	(1)
The Charting Process	15	(1)
Charting and the Nursing Process	15	(1)
Documentation Systems	16	(11)
Care Planning	27	(8)
Types of Care Plans	27	(1)
Individualizing Care Plans	27	(2)
Critical Paths or Clinical Pathways	29	(6)
UNIT II. Medical Asepsis and Standard Precautions	35	(40)
Medical Asepsis	37	(12)
Handwashing	39	(3)
Donning and Removing Gloves	42	(7)
Infection Control	49	(26)
Standard Precautions	52	(9)
Standard Precautions (Tier One)	54	(1)
Beyond the Skill: Waterless Antiseptic Agents	55	(2)
Transmission-Based Precautions (Tier Two)	57	(4)
Isolation Practices	61	(14)
Protective Attire	61	(3)
Exit a Client's Room	64	(2)
Isolation Item Disposal	66	(3)
Beyond the Skill: Cleaning Washable Articles	69	(1)
Double Bag Equipment and Linen	69	(6)
UNIT III. Personal Care and Safety	75	(92)
Safe Client Environment	77	(28)
Client Environment	79	(11)
Provide a Comfortable Environment	80	(2)
Prevent Mechanical Injuries	82	(4)
Beyond the Skill: Preventing Injuries for High-Risk Clients	86	(1)
Prevent Thermal/Electrical Injuries	86	(3)
Prevent Latex Allergies	89	(1)
Health, Safety, and Disasters	90	(3)
Fire Safety	90	(1)
Disaster Preparedness	91	(1)
Radioactive Materials Safety	92	(1)
Restraints	93	(12)
Torso/Belt Restraint	94	(1)
Wrist Restraint	95	(1)
Vest Restraint	96	(2)
Beyond the Skill: Tying a Half-Bow Knot	98	(7)
Bathing and Bedmaking	105	(32)
Bathing	107	(12)
Bath for an Adult Client	108	(1)
Beyond the Skill: Making a Washcloth Mitt	109	(5)
Beyond the Skill: Morning and Evening Care	114	(1)
Back Care	115	(2)
Beyond the Skill: Alternate Methods for Bathing	117	(1)
Hydraulic Bathtub Chair	117	(2)
Bedmaking	119	(18)
Unoccupied Bed	120	(5)
Flat Bottom Sheet	125	(1)
Beyond the Skill: Mitered Corner	126	(1)
Surgical Bed	127	(2)
Pillowcase Change	129	(1)
Occupied Bed	130	(7)
Personal Hygiene	137	(30)
Skin Care	137	(7)
Monitor Skin Condition	139	(2)
Prevent Skin Breakdown	141	(2)
Beyond the Skill: Therapeutic Mattresses and Beds	143	(1)
Oral Care	144	(6)
Oral Evaluation	145	(1)
Beyond the Skill: Nurse-Client Teaching for Dental Health	146	(1)
Oral Hygiene	146	(2)
Beyond the Skill: Flossing	148	(1)
Denture Care	148	(1)
Oral Care for Unconscious Client	149	(1)
Hair Care	150	(5)
Hair Care	151	(1)
Beyond the Skill: Pediculosis	152	(1)
Braided Hair	153	(1)
Beards and Mustaches	153	(1)
Shaving	154	(1)
Foot Care	155	(2)
Foot Care	156	(1)
Perineal and Genital Care	157	(10)
Perineal Care for Females	158	(2)
Beyond the Skill: Alternative Method for Perineal Care	160	(1)
Perineal Care for Males	160	(7)
UNIT IV. Health Evaluation	167	(80)
Admission and Assessment	169	(40)
Admission of Client	172	(4)
Admission	173	(3)
Height and Weight	176	(3)
Height and Weight	177	(1)
Beyond the Skill: Alternative Methods for Weighing Clients	178	(1)
Admission Assessment	179	(21)
Examination Techniques	181	(1)
Assessment	182	(18)
Focus Assessment	200	(9)
Vital Signs	209	(38)
Temperature	211	(7)
Digital Thermometer	212	(2)
Electronic Thermometer	214	(2)
Tympanic Membrane Temperature	216	(2)
Pulse	218	(11)
Beyond the Skill: Pulse Characteristics	220	(1)
Radial Pulse	220	(1)
Beyond the Skill: Palpating the Pulse	221	(1)
Apical Pulse	221	(2)
Apical-Radial Pulse	223	(1)
Beyond the Skill: Experience is Important	223	(1)
Peripheral Pulse	224	(2)
Beyond the Skill: Understanding Physiology	226	(1)
Peripheral Pulse with Doppler	227	(2)
Respiration	229	(3)
Respiratory Rate	231	(1)
Blood Pressure	232	(15)
Blood Pressure	233	(4)
Beyond the Skill: Types of Manometers	237	(1)
Lower-Extremity Blood Pressure	238	(2)
Beyond the Skill: Alternate Methods for Blood Pressure	240	(7)
UNIT V. Skin and Tissue Integrity	247	(74)
Heat and Cold	249	(22)
Heat Therapy	252	(7)
Hot Moist Pack	253	(2)
Hot Sterile Moist Compress	255	(1)
Beyond the Skill: Sitz Bath	256	(1)
Aquathermic (Aqua K) Pad	257	(2)
Cold Therapy	259	(12)
Tepid Sponge Bath	260	(2)
Instant Cold Pack	262	(2)
Hypothermia Blanket	264	(7)
Wound Care and Dressings	271	(50)
Measures to Prevent Infection	273	(7)
Sterline Gloves	274	(2)
Liquid from Sterile Container	276	(1)
Dressing Change Preparation with Prepackaged Kit	277	(1)
Dressing Change Preparation with Individual Supplies	278	(2)
Dressing Change	280	(6)
Dry Sterile Dressing	281	(2)
Suture Removal	283	(1)
Staple Removal	284	(2)
Wound Care	286	(14)
Wound Assessment	287	(2)
Wound Cleaning	289	(2)
Beyond the Skill: Wound Irrigation	291	(1)
Wet-to-Damp Dressing	292	(4)
Open Wound Drainage System	296	(1)
Beyond the Skill: Drainage Pouches for Wounds	297	(1)
Closed Wound Drainage System	298	(2)
Vascular Insufficiency Wounds	300	(21)
Venous Dressing	301	(3)
Beyond the Skill: Assessing Ankle-Brachial Index (ABI)	304	(1)
Prevention of Pressure Ulcers	305	(3)
Beyond the Skill: Pressure Ulcers Staging and Treatment	308	(1)
Tegaderm Transparent Adhesive Film Dressing	309	(3)
Op-Site Transparent Adhesive Film Dressing	312	(1)
Beyond the Skill: Hydrocolloid Dressing	313	(8)
UNIT VI. Mobility	321	(92)
Body Mechanics and Positioning	323	(29)
Body Mechanics	325	(5)
Establish Body Alignment	326	(2)
Proper Body Alignment	328	(1)
Basic Principles of Body Mechanics	329	(1)
Body Positioning	330	(22)
Position Changes	331	(1)
Beyond the Skill: Position Changes	332	(1)
Move Client Up in Bed	332	(4)
Logroll Client	336	(1)
Trochanter Roll Placement	337	(1)
Beyond the Skill: Hand Rolls	338	(1)
Transfer from Bed to Gurney	339	(1)
Move to Gurney Using Transfer Board	340	(1)
Dangle Client at Bedside	341	(2)
Move Client from Bed to Chair	343	(2)
Safety Belt Transfer	345	(3)
Hoyer Lift Move	348	(4)
Exercise and Ambulation	352	(27)
Range of Motion	354	(8)
Range-of-Motion Exercises	355	(7)
Ambulation	362	(8)
Ambulation	363	(1)
Beyond the Skill: Prevent Client Injury	364	(1)
Ambulation with Walker	365	(2)
Ambulation with Cane	367	(3)
Crutch Walking	370	(9)
Beyond the Skill: Measuring for Crutches	371	(1)
Four-Point Gait	372	(7)
Orthopedic Measures	379	(34)
Bandages and Slings	381	(5)
Arm Sling Application	382	(1)
Figure Eight Bandage	383	(2)
Circular Bandage	385	(1)
Cast Care	386	(5)
Wet Cast Care	387	(1)
Beyond the Skill: Synthetic Cast Client Teaching	388	(1)
Assessment of Casted Extremity	388	(2)
Beyond the Skill: Amputee Care	390	(1)
Traction	391	(10)
Skin Traction Application	392	(1)
Balanced Skin Traction	393	(2)
Assessment of Skin Traction	395	(2)
Skeletal Traction Care	397	(2)
Beyond the Skill: Assessment of External Fixation Devices	399	(1)
Turning Wedge for Positioning	400	(1)
Halo Traction and Back Brace	401	(4)
Halo Traction	402	(1)
Beyond the Skill: Changing Halo Traction Vest Liner	403	(1)
Jewett-Taylor Back Brace	404	(1)
Continuous Passive Motion (PCE) Device	405	(8)
UNIT VII. Medication Administration	413	(66)
Nonparenteral Medications	415	(36)
Medication Administration	418	(7)
Medication Validation	419	(2)
Beyond the Skill: Computerized Access Systems	421	(1)
Narcotic Preparation	422	(1)
Client Validation	423	(2)
Oral Medications	425	(6)
Tablets and Capsules	426	(1)
Liquids	427	(1)
Crushed or Altered Tablets and Capsules	428	(2)
Nasogastric and Enteral Tube Medications	430	(1)
Topical Medications	431	(7)
Transdermal Medications	432	(1)
Beyond the Skill: Dermal Medications	433	(1)
Ophthalmic Drops	434	(1)
Ophthalmic Ointments	435	(1)
Otic Medications	436	(1)
Nasal Medications	437	(1)
Mucosal Medications	438	(13)
Sublingual Medications	439	(1)
Metered Dose Inhaler	439	(2)
MDI with Spacer	441	(1)
Nebulized Aerosols	442	(2)
Rectal Suppositories	444	(1)
Vaginal Suppositories	445	(6)
Parenteral Medications	451	(28)
Injection Preparation	453	(5)
Withdrawing Medication from a Vial	453	(2)
Withdrawing Medication from an Ampule	455	(1)
Beyond the Skill: Preparing a Prefilled Cartridge Syringe	456	(1)
Medications Combined in One Syringe	456	(2)
Intradermal Injections	458	(2)
Intradermal Injections	458	(2)
Subcutaneous Injections	460	(8)
Subcutaneous Injections	460	(2)
Heparin Injections	462	(2)
Insulin Injections	464	(2)
Finger-Stick Blood Glucose Testing	466	(1)
Beyond the Skill: Use of Glucose Meters	467	(1)
Intramuscular Injections	468	(11)
Intramuscular Injections	469	(4)
Z-Track Injections	473	(6)
UNIT VIII. Intravenous Therapy	479	(78)
Intravenous Fluids and Blood	481	(52)
Therapy Preparation	484	(7)
IV System Preparation	485	(4)
Beyond the Skill: Infusion Regulation Devices	489	(2)
IV Fluid Administration	491	(16)
Venipuncture	492	(7)
Beyond the Skill: IV Catheter Extension Tubing	499	(2)
Peripheral IV Fluid Infusion	501	(1)
Beyond the Skill: Intake and Output Measurement	502	(1)
Discontinuation of Peripheral IV	503	(1)
Phlebotomy	504	(3)
Central Venous Catheters	507	(12)
Central IV Fluid Infusion	508	(2)
Central Venous Catheter Access Cap Change	510	(1)
Central Venous Catheter Dressing	511	(5)
Blood Specimen from a Central Venous Catheter	516	(3)
Parenteral Nutrition	519	(3)
Parenteral Nutrition and Lipid Infusion	520	(2)
Blood Transfusion	522	(11)
Blood Transfusion	523	(10)
Intravenous Medications	533	(24)
IV Medications	535	(9)
IV Piggyback (Secondary) Medication	536	(3)
IV Medication Using Volume Control Set	539	(2)
Beyond the Skill: Adding Medication to IV Fluid	541	(1)
IV Medication by Injection (IV Push)	542	(2)
Patient-Controlled Analgesia	544	(13)
PCA	547	(10)
UNIT IX. Gastrointestinal Therapy and Nutritional Support	557	(44)
Gastrointestinal Therapy	559	(20)
Gastrointestinal Tube Therapy	562	(17)
Large-Bore Nasogastric Tube Insertion	563	(5)
Beyond the Skill: Nasogastric Tube Placement	568	(1)
Enteral Decompression	569	(2)
Beyond the Skill: Salem Sump Tube Maintenance	571	(1)
Nasogastric Tube Irrigation	572	(2)
Nasoenteric Tube Removal	574	(5)
Nutritional Support	579	(22)
Small-Bore Nasoenteral Feeding	583	(3)
Small-Bore Feeding Tube Insertion	584	(2)
Enteral Feeding	586	(15)
Intermittent or Bolus Gastric Tube Feeding	589	(3)
Beyond the Skill: Gastrostomy or PEG Tube Site Care	592	(1)
Continuous Small-Bore Enteral Tube Feeding	593	(8)
UNIT X. Elimination	601	(78)
Urinary Elimination	603	(48)
Intake and Output	604	(7)
Measure and Record Intake	605	(2)
Measure and Record Output	607	(4)
Urine Studies	611	(5)
Obtain Urine Specimen Using Bedpan	611	(2)
Obtain Urine Specimen Using Commode	613	(1)
Measure Specific Gravity	614	(1)
Determine Urinary Ketone Bodies	615	(1)
Catheterization	616	(17)
Drape Client	617	(1)
Catheterization	618	(1)
Straight Catheter (Female)	619	(2)
Straight Catheter (Male)	621	(3)
Retention Catheter (Female)	624	(4)
Retention Catheter (Male)	628	(3)
Remove Retention Catheter	631	(2)
External Catheters	633	(3)
Condom Catheter	633	(2)
Attach Leg Bag to Catheter	635	(1)
Catheter and Bladder Irrigation and Instillation	636	(6)
Irrigate Catheter by Opening a Closed System	636	(2)
Irrigate Catheter Through a Closed System	638	(1)
Maintain Continuous Bladder Irrigations	639	(1)
Instill Medication into Bladder	640	(2)
Specimen Collection From a Closed System	642	(9)
Specimen Collection	642	(9)
Bowel Elimination	651	(28)
Rectal Tube	653	(2)
Enema Administration	655	(8)
Administer an Enema	657	(3)
Administer a Disposable Enema	660	(1)
Test for Occult Blood	661	(2)
Colostomy Irrigation	663	(4)
Fecal Ostomy Pouch	667	(12)
UNIT XI. Oxygenation and Circulation	679	(90)
Respiratory Skills	681	(40)
Preventive Measures	684	(9)
Deep Breathing and Coughing	685	(2)
Incentive Spirometry	687	(1)
Chest Physiotherapy (CPT)	687	(2)
Sputum Specimen Collection	689	(2)
Peak Flow Measurement	691	(2)
Oxygen Therapy	693	(8)
Oxygen Therapy	695	(2)
Bag-Valve-Mask Ventilation	697	(2)
Pulse Oximetry	699	(2)
Restorative Measures	701	(20)
Oropharyngeal Airway Tube Insertion	703	(2)
Tracheostomy Suctioning	705	(4)
Tracheostomy Care	709	(3)
Tracheal Tube Cuff Inflation	712	(1)
Tracheostomy Tube Cap Insertion	713	(1)
Chest Tube Drainage System	714	(7)
Cardiovascular Skills	721	(24)
Cardiac Monitoring	724	(12)
Continuous ECG Monitoring	726	(2)
Beyond the Skill: Continuous Cardiac Monitoring Lead Selection	728	(2)
ECG Rhythm Strip Analysis	730	(1)
Beyond the Skill: Recognition of Potentially Lethal Arrhythmias	731	(2)
Central Venous Pressure Measurement	733	(3)
Prevention of Venous Thrombosis	736	(9)
Graduated Compression Elastic Hose (T.E.D. Hose)	737	(2)
Pneumatic External Compression Device (Sequential Sleeves)	739	(6)
Cardiovascular and Pulmonary Emergencies	745	(24)
Basic Life Support	747	(22)
Cardiopulmonary Resuscitation (CPR)	749	(6)
Calling a Code	755	(3)
Automated External Defibrillation (AED)	758	(2)
Abdominal Thrust (Heimlich) Maneuver	760	(9)
Appendix A: Converting Dosage Systems and Calculating Dosages	769	(2)
Appendix B: Calculations of Solutions	771	(2)
Appendix C: Abbreviations, Symbols, and Conversion Tables for Equivalents	773	(2)
Glossary	775	(12)
Bibliography	787	(6)
Answers to Self-Check Evaluations	793	(18)
Index	811

Excerpts

Photo Guide of Nursing Skillshas been designed to present nursing skills in a unique format: step-by-step photographs of essential skills that student nurses learn as part of their professional education. Mastery of this content is critical, since much of the time that nurses spend with clients is devoted to skill performance. There is no easier way to learn and master a skill than to visualize it as a step-by-step sequential process. This format enables the student to see, rather than just read about, each skill.The authors have separated the skills into units containing chapters that progress from basic to intermediate level of difficulty. Each chapter includes introductory material providing the theoretical foundation necessary to understand the skill components; step-by-step photos and/or line drawings depicting each skill; clinical notes and safety alerts--additional information necessary for skill mastery; and Beyond the Skill material as an adjunct to the skill itself.Key features include: More than 1300 full-color photos and line drawings, with minimal accompanying text, illustrate over 300 step-by-step procedures. This book, including essential basic to intermediate level skills, will serve as a useful supplement to any textbook that addresses fundamental concepts of nursing. Text material that includes quick-reference clinical content, safety alerts, charts and tables, and Beyond the Skill adjunct material to supplement the individual steps for each skill. A Critical Thinking Focus section at the end of each unit. Exercises focus on nursing competencies to assist learners in integrating knowledge, judgment, and skill. A section on unexpected outcomes and alternative nursing actions assists students in analyzing outcomes and contributes to rational problem solving and decision making. A self-check evaluation section is included at the end of each chapter. Clear, logical, and straightforward page layout and presentation of material. This allows the student to learn the steps of skill performance with minimal reliance on the text copy.Photo Guide of Nursing Skillsis a heavily illustrated, full-color presentation of necessary basic and intermediate skills for students enrolled in all types of nursing programs. This book provides a useful supplement to any text that focuses on basic nursing concepts, and will especially assist those individuals who learn most efficiently through visual cues rather than by verbal means.The three authors, after completing the fifth edition ofClinical Nursing Skills,realized that a different type of skills textbook would fill a gap at the fundamental level of nursing education. As a result of many long hours of discussion, they elected to present essential skills in an illustrated format with a step-by-step approach for students who learn more easily through visualization. Thus, the creation of this photo guide.The authors wish to thank all those who helped and contributed to this textbook, including Ron May, the photographer; Karen Hoxeng, the project concept director; the various editors and proofreaders; the indexer; and the reviewers of the text.