Clinical Nursing Skills : Basic to Advanced Skills

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

• ISBN13: 9780838513897
• ISBN10: 0838513891
• Edition: 4th
• Format: Paperback
• Copyright: 1996-02-01
• Publisher: Appleton & Lange

Summary

The fourth edition of this popular text features over 550 basic, intermediate, and advanced skills. Step-by-step instructions for each skill are presented in vivid detail. Full-color photos and illustrations complement the text throughout. An updated overview of principles and concepts is included in each chapter, with assessment, planning, intervention, and evaluation objectives.

Table of Contents

Preface	xxiii	(2)
Acknowledgments	xxv
CHAPTER 1. PROFESSIONAL NURSING	1	(16)
Professional Role	2	(2)
American Nurses Association Code for Nurses	2	(1)
Assuming the Client Role	3	(1)
Assuming the Nursing Role	3	(1)
Legal Aspects	4	(2)
The Nurse Practice Act	4	(1)
Nurse Licensure	4	(1)
Standards of Nursing Practice	4	(1)
Liability and Legal Issues	5	(1)
Drugs and the Nurse	5	(1)
Negligence Malpractice	6	(1)
Client Rights	6	(2)
Consent to Receive Health Services	6	(1)
Clients `Rights	7	(1)
Advanced Directives	7	(1)
Clinical Practice	8	(3)
Guidelines for Clinical Practice	8	(1)
Providing Client Care	8	(1)
Client's Records	9	(1)
Client's Chart	9	(1)
Communicating with the Client	10	(1)
Basic Nursing Assessment	10	(1)
Medical Asepsis Principles	11	(1)
Hand Washing	12	(1)
Protocol for Procedures	12	(5)
CHAPTER 2. NURSING PROCESS	17	(8)
Nursing Process	18	(2)
Assessment	18	(1)
Nursing Diagnosis	18	(1)
Planning	19	(1)
Implementation	19	(1)
Evaluation	19	(1)
Critical Thinking	20	(1)
Assessment	20	(1)
Nursing Diagnosis	20	(1)
Planning	20	(1)
Implementation	20	(1)
Evaluation	21	(1)
Nursing Diagnosis	21	(4)
Diagnostic Statements	22	(3)
CHAPTER 3. CLIENT CARE MANAGEMENT	25	(12)
Care Plans	26	(5)
Format	26	(1)
Types	26	(1)
Individualizing Care Plans	26	(1)
Initiating the Plans	26	(1)
Client Problems or Needs	27	(1)
Nursing Diagnosis	28	(1)
Expected Outcomes or Goals	28	(1)
Interventions	29	(1)
Checkpoints and Deadlines	29	(1)
Short-and Long-Term Goals	29	(1)
Updating Care Plans	30	(1)
Activating Care Plans	30	(1)
Inactivating Care Plans	31	(1)
Communication	31	(4)
Documentation	31	(1)
Care Plans	31	(2)
Careplan Formats	33	(1)
Report	33	(1)
Care Conferences	34	(1)
Delegating Client Care	34	(1)
General Principles of Delegation	34	(1)
Client Acuity Systems	34	(1)
Evaluation	35	(1)
Student Clinical Planning	35	(2)
Preclinical Planning	35	(1)
Time Management	36	(1)
CHAPTER 4. DOCUMENTATION	37	(26)
Charting	38	(18)
Charting-A Method of Communication	38	(2)
The Charting Process	40	(1)
Charting for Potential Legal Problems	41	(1)
Charting and the Nursing Process	41	(1)
Charting Systems	41	(2)
Computer-Assisted Charting	53	(2)
Minimizing Legal Risks of Computer Charting	55	(1)
Reporting	56	(1)
Intrashift Reports	56	(1)
Intershift Reports	56	(1)
Physician Notification	56	(1)
Nurse Manager	57	(1)
Documentation	57	(6)
Unusual Occurrence, or Incident Report	57	(1)
Consent Forms	57	(6)
CHAPTER 5. COMMUNICATION AND THE NURSE-CLIENT RELATIONSHIP	63	(14)
Communication	65	(1)
Therapeutic Communication Techniques	66	(1)
Blocks to Communication	67	(1)
Relationship Therapy	68	(2)
Relationship Principles	69	(1)
Phases in Nurse-Client Relationship Therapy	69	(1)
Unit One Therapeutic Communication	70	(3)
Introducing Yourself to a Client	70	(1)
Beginning a Client Interaction	71	(1)
Assisting a Client to Describe Personal Experiences	71	(1)
Encouraging a Client to Express Needs, Feelings, and Thoughts	71	(1)
Using Communication to Increase the Client's Sense of Self-Worth	72	(1)
Unit Two Nurse-Client Relationship	73	(4)
Initiating a Nurse-Client Relationship	73	(1)
Facilitating a Nurse-Client Relationship	74	(1)
Terminating a Nurse-Client Relationship	74	(3)
CHAPTER 6. STRESS, HOLISTIC HEALTH, AND ALTERNATIVE TREATMENT METHODS	77	(18)
Stress	79	(5)
The Effect of Stress	80	(1)
Individual Responses to Stress	81	(1)
Stress and Disease	82	(2)
A New Paradigm for Health	84	(1)
A Holistic Approach to Health	84	(1)
Alternative Medicine	85	(4)
Alternative Treatment Methods	85	(4)
Unit One Stress and Adaptation	89	(6)
Determining the Effect of Stress	90	(1)
Determining Response Patterns	90	(1)
Managing Stress	91	(1)
Manipulating the Environment to Reduce Stress	91	(1)
Teaching Coping Strategies	91	(1)
Managing Stress Using a Holistic Model	92	(1)
Alleviating Stress Using Controlled Breathing	92	(1)
Alleviating Stress Using Body Relaxation	93	(1)
Alleviating Stress Using Meditation	93	(2)
CHAPTER 7. ADMISSION AND DISCHARGE	95	(20)
Admission, Transfer, and Discharge	97	(4)
Admission to the Hospital	97	(1)
Admission to the Nursing Unit	97	(3)
Transfer from Unit to Unit	100	(1)
Discharge from a Unit	100	(1)
Unit One Admission and Transfer	101	(6)
Admitting a Client	101	(4)
Transferring a Client	105	(2)
Unit Two Height and Weight	107	(3)
Obtaining Height and Weight	107	(3)
Unit Three Discharge	110	(5)
Discharging a Client	110	(1)
Discharging a Client against Medical Advice (AMA)	111	(4)
CHAPTER 8. SAFE CLIENT ENVIRONMENT	115	(24)
Orientation to the Client Environment	116	(1)
Maintaining Homeostasis	116	(1)
Characteristics that Influence Adaptation	117	(1)
Age	117	(1)
Level of Consciousness	117	(1)
States of Illness	118	(1)
Physical and Biologic Dimensions	118	(4)
Adequate Space	118	(1)
Natural and Artificial Light	119	(1)
Humidity and Temperature	119	(1)
Ventilation	119	(1)
Comfortable Sound Levels	119	(1)
Furniture and Clean Surfaces	120	(1)
Food and Water	121	(1)
Waste Disposal	121	(1)
Sociocultural Dimensions	122	(1)
Organization of Time	122	(1)
Privacy	122	(1)
Individualized Care	123	(1)
Information and Teaching	123	(1)
Unit One A Safe Environment	123	(9)
A Safe Environment	124	(1)
Safety Precautions	124	(1)
Guidelines for the Use of Restraints	125	(3)
Preventing Mechanical Injuries	128	(1)
Preventing Thermal Injuries	128	(1)
Providing Safety for Clients during a Fire	129	(1)
Providing Safety for Clients Receiving Radioactive Material	130	(2)
Unit Two Restraints	132	(7)
Using Wrist Restraints	132	(1)
Using Mitt Restraints	133	(1)
Using Elbow Restraints	134	(1)
Applying a Safety Belt	134	(1)
Applying a Chest Restraints	135	(1)
Applying Mummy Restraints	136	(3)
CHAPTER 9. BATHING AND BEDMAKING	139	(32)
Basic Health Care	142	(3)
Types of Beds	142	(1)
Bathing	142	(1)
Skin Problems	143	(2)
Unit One Bedmaking	145	(8)
Folding a Mitered Corner	145	(1)
Changing a Pillowcase	146	(1)
Making and Unoccupied Bed	146	(2)
Making a Surgical Bed	148	(1)
Changing an Occupied Bed	149	(4)
Unit Two Bath Care	153	(9)
Folding a Washcloth Mitt	154	(1)
Providing Morning Care	154	(1)
Bathing an Adult Client	155	(3)
Bathing an Infant	158	(1)
Bathing with a Hydraulic Bathtub Chair	159	(1)
Bathing the Critically III	160	(2)
Unit Three Skin Integrity	162	(4)
Monitoring Skin Condition	162	(1)
Preventing Skin Breakdown	163	(3)
Unit Four Evening Care	166	(5)
Providing Evening Care	166	(1)
Providing Back Care	167	(4)
CHAPTER 10. PERSONAL HYGIENE	171	(32)
Hygienic Care	173	(2)
Oral Hygiene	173	(1)
Hair Care	173	(1)
Foot Care	174	(1)
Perineal and Genital Care	174	(1)
Unit One Oral Hygiene	175	(6)
Providing Oral Hygiene	175
Flossing Client's Teeth	177	(1)
Providing Denture Care	177	(1)
Providing Oral Care for Unconscious Clients	178	(3)
Unit Two Hair Care	181	(5)
Providing Hair Care	182	(1)
for Routine Hair Care	182	(1)
for Tangled Hair	182	(1)
for Coarse or Curly Hair	182	(1)
Shampooing Hair	182	(1)
for Client in a Chair	182	(1)
for Client on a Gurney	183	(1)
for Client on Bed Rest	183	(1)
Braiding Hair	183	(1)
Providing Hair Care for Breads and Mustaches	184	(1)
Shaving a Client	184	(2)
Unit Three Pediculosis	186	(2)
Removing Lice	186	(2)
Unit Four Foot Care	188	(3)
Providing Foot Care	188	(1)
Providing Nail Care	189	(2)
Unit Five Bedpan and Urinal	191	(3)
Using Bedpan and Urinal	191	(1)
Assisting Client to Commode	191	(3)
Unit Six Perineal and Genital Care	194	(4)
Draping a Female Client	194	(1)
Providing Female Perineal Care	195	(1)
Administering a Vaginal Irrigation	196	(1)
Providing Male Perineal Care	196	(2)
Unit Seven Eye and Ear Care	198	(5)
Providing Routine Eye Care	198	(1)
Providing Eye Care for Comatose Client	199	(1)
Providing Eye Care for Client with Glasses	199	(1)
Providing Eye Care for Client with Artificial Eye	199	(1)
Providing Eye Care for Client with Hard Contact Lenses	200	(1)
Providing Eye Care for Client with Soft Contact Lenses	201	(1)
Providing Ear Care for Client with Hearing Aid	201	(2)
CHAPTER 11. VITAL SIGNS	203	(36)
Vital Signs	205	(1)
Temperature	206	(1)
Regulatory Mechanisms	206	(1)
Measuring Body Temperature	207	(1)
Pulse	207	(1)
Circulatory System Control	207	(1)
Heart Rate and Rhythm	207	(1)
Evaluating Pulse Quality	208	(1)
Respiration	208	(1)
Evaluation Respiratory Rate	208	(1)
Blood Pressure	209	(3)
Unit One Temperature	212	(6)
Taking an Oral Temperature	213	(1)
Taking a Rectal Temperature	214	(1)
Taking an Axillary Temperature	214	(1)
Using an Electronic Thermometer	215	(1)
Using an Infrared Thermometer for Ear Canal Temperature	216	(1)
Using a Chemical Strip Tape	216	(2)
Unit Two Pulse Rate	218	(8)
Taking a Radial Pulse	218	(2)
Taking an Apical Pulse	220	(1)
Taking an Apical-Radial Pulse	221	(1)
Taking a Peripheral Pulse	221	(1)
Monitoring Peripheral Pulses with Doppler Ultrasound Stethoscope	222	(4)
Unit Three Respirations	226	(3)
Obtaining the Respiratory Rate	226	(3)
Unit Four Blood Pressure	229	(10)
Taking a Blood Pressure	229	(3)
Palpating Systolic Arterial Blood Pressure	232	(1)
Measuring Leg Blood Pressure	232	(1)
Measuring Blood Pressure by Flush Method in Small Infant	233	(1)
Using a Continuous Noninvasive Monitoring Device	234	(5)
CHAPTER 12. BODY MECHANICS AND POSITIONING	239	(22)
Musculoskeletal System	241	(2)
Skeletal Muscles	241	(1)
Joints	241	(1)
Bones	241	(1)
System Alterations	241	(1)
Nursing Measures	242	(1)
Body Mechanics	242	(1)
Unit One Proper Body Mechanics	243	(5)
Establishing Body Alignment	243	(1)
Maintaining Proper Body Alignment	244	(1)
Using Coordinated Movements	245	(1)
Using Basic Priciples	245	(3)
Unit Two Moving and Turning Clients	248	(13)
Turning to Side-Lying Position	250	(1)
Turning to a Prone Position	250	(1)
Moving the Client Up in Bed	251	(1)
Moving the Client with Assistance	252	(1)
Preparing to Move the Client from Bed	253	(1)
Dangling at the Bedside	253	(2)
Moving from Bed to Chair	255	(1)
Using a Hoyer Lift	256	(1)
Logrolling the Client	257	(1)
Using a Footboard	258	(1)
Placing a Trochanter Roll	259	(2)
CHAPTER 13 EXERCISE AND AMBULATION	261	(28)
Rehabilitation Concepts	263	(1)
Musculoskeletal System	263	(1)
Muscle Function	263	(1)
Joint Movements	264	(1)
Joints	264	(1)
Exercise	264	(1)
Ambulation	265	(1)
Crutches	266	(1)
Unit One Range of Motion	267	(7)
Performing Passive Range of Motion	267	(4)
Using Continuous Passive Motion Machine	271	(1)
Teaching Active Range of Motion	272	(2)
Unit Two Ambulation	274	(6)
Ambulating with Two Assistants	274	(1)
Ambulating with One Assistant	275	(2)
Ambulating with a Walker	277	(1)
Ambulating with a Cane	277	(3)
Unit Three Crutch Walking	280	(9)
Teaching Muscle-Strengthening Exercises	280	(1)
Measuring Client for Crutches	281	(1)
Teaching Crutch Walking: Four-Point Gait	282	(1)
Teaching Crutch Walking: Three-Point Gait	282	(1)
Teaching Crutch Walking: Two-Point Gait	283	(1)
Teaching Swing-To Gait and Swing-Through Gait	284	(1)
Teaching Upstairs and Downstairs Ambulation with Crutches	284	(5)
CHAPTER 14. BASIC PHYSICAL ASSESSMENT	289	(34)
Assessment Techniques	290	(1)
Equipment	290	(1)
Health History	290	(1)
Neurologic Assessment	291	(6)
Assessment of the Head and Neck	297	(4)
Assessment of the Skin	301	(3)
Assessment of the Chest: Lungs, Breast and Heart	304	(7)
Assessment of the Abdomen and Genitourinary Tract	311	(4)
Mental-Spiritual Assessment	315	(1)
Mental Status Assessment	315	(8)
CHAPTER 15. INFECTION CONTROL	323	(30)
Infection Control	326	(1)
Chain of Infection	326	(1)
Barriers to Infection	327	(1)
The Body's Natural Defenses	327	(1)
Conditions Predisposing to Infection	327	(2)
Surgical Wounds	328	(1)
Antibacterial Immune Mechanisms	328	(1)
Respiratory Tract	328	(1)
Genitourinary Tract	328	(1)
Invasive Devices	328	(1)
Venipuncture Sites	329	(1)
Total Parenteral Nutritional Therapy	329	(1)
Implanted Prosthetic Devices	329	(1)
Isolation Procedures	329	(5)
Isolation Fundamentals	333	(1)
Standard Precautions	333	(1)
Acquired Immunedeficiency Syndrome	334	(1)
Epidemiology and Modes of Transmission	334	(1)
Definitions	334	(1)
Other Infectious Diseases	334	(3)
Tuberculosis	334	(1)
Hepatitis B	335	(2)
Unit One Basic Medical Asepis	337	(4)
Handwashing (Medical Asepsis)	337	(2)
Cleaning Washable Articles	339	(1)
Donning and Removing Clean Gloves	339	(2)
Unit Two Isolation	341	(7)
Preparing for Isolation	341	(1)
Putting On and Removing a Gown	342	(2)
Using a Mask	344	(1)
Assessing Vital Signs	344	(1)
Removing Items from Isolation Room	345	(1)
Removing a Specimen from Isolation Room	346	(1)
Transporting Isolation Client Outside the Room	346	(1)
Removing Soiled Large Equipment from Isolation Room	346	(2)
Unit Three Standard Precautions	348	(5)
Caring for Isolation Clients	348	(5)
CHAPTER 16. MEDICATION ADMINISTRATION	353	(62)
Therapeutic Agents	355	(1)
Drug Metabolism	355	(1)
Routes for Absorption	355	(1)
Transportation	355	(1)
Biotransformation	356	(1)
Excretion	356	(1)
Factors That Affect Drug Metabolism	356	(1)
Drug Administration	356	(3)
Source and Naming of Drugs	356	(1)
Safety Procedures	356	(1)
Documenting the Medication	357	(2)
Unit One Drug Administration	359	(8)
Preparing for Drug Administration	359	(2)
Converting Medications	361	(1)
Calculating Dosages	361	(1)
Using Unit Dose System	361	(3)
Using Narcotic Control System	364	(3)
Unit Two Oral Medications	367	(4)
Preparing Oral Medications	367	(1)
Administering Oral Medications to Adults	368	(1)
Administering Oral Medications to Children	369	(2)
Unit Three Sublingual Medications	371	(2)
Administering Sublingual Medications	371	(2)
Unit Four Parenteral Medications	373	(19)
Preparing Injections	374	(3)
Administering Intradermal Injections	377	(1)
Administering Subcutaneous (Sub Q) Injections	378	(2)
Preparing Insulin Injections	380	(1)
for One Insulin Solution	380	(2)
for Two Insulin Solutions	382	(1)
Teaching Use of Insulin Pump	383	(1)
Administering Sub Q Heparin	384	(1)
Administering Intramuscular (IM) Injections	385	(4)
Using Z-Track Method	389	(3)
Unit Five Topical Medications	392	(4)
Applying Dermal Ointments and Slaves	392	(1)
Applying Ointment to Burns	393	(1)
Applying Transdermal Medications	393	(3)
Unit Six Eye Medications	396	(3)
Instilling Eye Drops	396	(1)
Administering Eye Ointment	397	(2)
Unit Seven Ear Medications	399	(2)
Administering Ear Medications	399	(2)
Unit Eight Respiratory Medications	401	(4)
Administering Respiratory Medications	401	(1)
Instilling Nose Drops	402	(1)
Administering Metered-Dose Inhaled Drugs	403	(1)
Using Spacer for Aerosol Therapy	404	(1)
Unit Nine Suppository Medications	405	(3)
Inserting Rectal Suppositories	405	(1)
Inserting Vaginal Suppositories	406	(2)
Unit Ten Irrigations	408	(4)
Irrigating the Eye	408	(1)
Irrigating the Ear	409	(1)
Irrigating the Throat	409	(2)
Drug Supplement	411	(1)
Appendix 16-1. Abbreviations and Symbols of Orders, Prescriptions and Labels	412	(1)
Appendix 16-2. Conversion Tables	412	(3)
CHAPTER 17. PAIN MANAGEMENT	415	(24)
Coping with Pain	417	(3)
Theories of Pain	418	(1)
The Discovery of Endorphins	419	(1)
The Pain Experience	419	(1)
Pain Pathways	420	(1)
Noninvasive Pain Relief	420	(2)
The Nurse's Role	420	(2)
Techniques for Pain Control	422	(1)
Patient-Controlled Analgesia (PCA)	422	(1)
Epidural Pain Control	422	(1)
Direct IV Pain Control	422	(1)
Unit One Pain Relief	423	(6)
Alleviating Pain through Touch	424	(1)
Using Relaxation Techniques	424	(1)
Using Transcutaneous Electric Nerve Stimulation (TENS)	424	(2)
Administering Epidural Narcotic Analgesia	426	(1)
for Bolus Injection	426	(1)
for Continuous Injection	427	(2)
Unit Two Patient-Controlled Analgesia (PCA)	429	(10)
Qualifying Client for PCA	429	(1)
Administering PCA	430	(3)
Changing Dose Volume	433	(1)
Changing Lockout Interval	433	(1)
Changing 4-Hour Limit	433	(1)
Terminating a PCA Infusion	434	(1)
Teaching PCA to a Client	434	(5)
CHAPTER 18. NUTRITIONAL MANAGEMENT	439	(28)
Essential Nutrients	441	(2)
Carbohydrates	441	(1)
Fats	442	(1)
Proteins	442	(1)
Water	443	(1)
Vitamins	443	(1)
Minerals	443	(1)
Assimilation of Nutrients	443	(1)
Gastrointestinal Tract	444	(1)
The Accessory Organs	444	(1)
Normal and Therapeutic Nutrition	444	(4)
Nutritional Problems in the Hospital	445	(1)
Therapeutic Management	446	(2)
Unit One Nutrition Maintenance	448	(3)
Serving a Food Tray	448	(1)
Feeding a Client	449	(2)
Unit Two Therapeutic Diets	451	(6)
Providing Therapeutic Diets	451	(1)
Carbohydrate Control	451	(1)
Protein Control	451	(1)
Fat Control	452	(1)
Renal Disease	452	(1)
Vitamin Control	453	(1)
Mineral Control	453	(1)
Fiber Control	454	(1)
Bland Food Diets	454	(1)
Calorie Control	454	(1)
Pre- and Postoperative Diets	454	(1)
Mechanical Soft Diet	455	(1)
Pureed Diet	455	(2)
Unit Three Nutrients via Tube Feeding	457	(10)
Inserting a Nasogastric Tube	458	(2)
Irrigating a Nasogastric Tube	460	(1)
Collecting a Gastric Specimen from a Nasogastric Tube	461	(1)
Removing a Nasogastric Tube	461	(1)
Giving an Intermittent Nasogastric Feeding	461	(1)
Feeding via Continuous Nasogastric Method	462	(1)
Giving a Gastrostomy Feeding	463	(1)
Inserting a Small-Bore Feeding Tube (KEOFEED, DUBBHOFF, MOSS)	464	(3)
CHAPTER 19. SPECIMEN COLLECTION	467	(30)
Laboratory Tests	469	(3)
Nursing Responsibility	469	(1)
Urine Tests	469	(1)
Blood Tests	470	(1)
Cultures	470	(2)
Unit One Urine Specimens	472	(3)
Collecting Midstream Urine	472	(1)
Collecting 24-Hour Urine Specimen	473	(2)
Unit Two Infant Urine Specimen	475	(2)
Collecting a Specimen from an Infant	475	(2)
Unit Three Stool Specimens	477	(5)
Collecting Adult Stool Specimen	477	(1)
Collecting Stool to Test for Parasties	478	(1)
Collecting Infant Stool Specimen	478	(1)
Testing for Occult Blood	479	(1)
Gamma Fe-Cult Plus	479	(1)
Hemoccult	479	(1)
Collecting Stool for Bacterial Culture	480	(1)
Testing for Pinworms	480	(2)
Unit Four Venous Blood Specimens	482	(8)
Withdrawing Blood	482	(1)
Using Vacutainer System	483	(1)
Collecting a Specimen for Culture	484	(1)
Obtaining Blood Specimen for Glucose Testing	485	(1)
Measuring Blood Glucose Using Chemstrip	486	(1)
Measuring Blood Glucose Using Accu-Check or Glucometer	486	(1)
Accu-Chek Machine	487	(1)
Glucometer Machine	487	(1)
Measuring Blood Glucose Using Lifescan One-Touch II	487	(3)
Unit Five Sputum Collection	490	(3)
Obtaining Sputum Specimen	490	(1)
Using Suction Trap	491	(1)
Collecting Specimen by Transtracheal Aspiration	491	(2)
Unit Six Throat and Wound Specimens for Culture	493	(4)
Obtaining a Throat Specimen	493	(1)
Obtaining Aerobic Culture	494	(1)
Obtaining Anaerobic Culture	495	(2)
CHAPTER 20. DIAGNOSTIC TESTS	497	(30)
Preparation	499	(3)
Contrast Media Studies	499	(1)
Ultrasound Studies	500	(1)
Nuclear Imaging Studies	500	(1)
Magnetic Resonance Imaging (MRI)	500	(1)
Assisting the Physician during Tests	500	(2)
Unit One Contrast Media Studies	502	(6)
Preparing for Contrast Media Studies	503	(1)
Procedure for Oral Cholecystogram	503	(1)
Procedure for Intravenous Cholangiogram	504	(1)
Procedure for Intravenous Pyelogram	504	(1)
Procedure for Myelogram	504	(1)
Procedure for Arteriogram	505	(1)
Procedure for Computerized Axial Tomography (CAT Scan)	505	(1)
Procedure for Cardiac Catheterization	506	(2)
Unit Two Nuclear Imaging	508	(4)
Preparing for Nuclear Scan	509	(1)
Procedure for Bone Scan	509	(1)
Procedure for Lung Scan	509	(1)
Procedure for Brain Scan	509	(1)
Procedure for Nuclear Cardiography	510	(1)
Procedure for Adrenal Scan	510	(1)
Procedure for Thyroid Scan	510	(1)
Teaching for Nuclear Scan	510	(2)
Unit Three Barium Studies	512	(3)
Preparing for Barium Studies	512	(1)
Procedure for Barium Enema	513	(1)
Procedure for Upper Gastrointestinal Study	513	(2)
Unit Four Diagnostic Procedures	515	(12)
Assisting with Lumbar Puncture	516	(1)
Assisting with Liver Biopsy	517	(1)
Assisting with Thoracentesis	518	(1)
Assisting with Paracentesis	519	(1)
Assisting with Bone Marrow Aspiration	520	(1)
Assisting with Vaginal Examination and Papanicolaou (Pap) Smear	520	(1)
Assisting with Proctoscopy	520	(1)
Assisting with Fiberoptic Colonoscopy	521	(1)
Assisting with Gastroscopy-Endoscopy	522	(1)
Assisting with Cystoscopy	522	(1)
Assisting with Bronchoscopy	523	(1)
Assisting with Amniocentesis	524	(1)
Assisting with Magnetic Resonance Imaging (MRI)	524	(3)
CHAPTER 21. URINARY ELIMINATION	527	(64)
Urinary System	529	(2)
Urine Production	529	(1)
Micturation	530	(1)
Alterations in Urinary Elimination	531	(1)
Alterations Related to Fluids	531	(1)
Alterations Related to Obstructions	531	(1)
Alterations Related to Secretion of the Antidiuretic Hormone (ADH)	531	(1)
Alterations Related to Changes in Blood Volume	531	(1)
Nursing Interventions	531	(2)
Unit One Intake and Output	533	(3)
Measuring Intake and Output	533	(3)
Unit Two Urine Studies	536	(6)
Monitoring Specific Gravity with Urinometer	536	(1)
Monitoring Specific Gravity with Spectrometer	537	(1)
Determining Urine Glucose with Tape	537	(1)
Measuring Urine Glucose	538	(1)
Measuring Urine Ketone Bodies	539	(3)
Unit Three Catheterization	542	(13)
Draping a Female Client	543	(1)
Inserting a Straight Catheter (Female)	543	(2)
Inserting a Straight Catheter (Male)	545	(1)
Inserting a Retention Catheter (Female)	546	(4)
Inserting a Retention Catheter (Male)	550	(1)
Providing Catheter Care	551	(1)
Removing a Retention Catheter	552	(3)
Unit Four External Catheter System	555	(3)
Applying a Condom Catheter	555	(1)
Attaching Catheter to Leg Bag	556	(2)
Unit Five Suprapubic Catheter Care	558	(3)
Providing Suprapubic Catheter Care	558	(3)
Unit Six Bladder Irrigation and Instillation	561	(6)
Irrigating by Opening a Closed System	561	(2)
Irrigating a Closed System	563	(1)
Instilling Medications	563	(1)
Maintaining Continuous Irrigation	564	(3)
Unit Seven Specimens from Closed Systems	567	(2)
Collecting Specimen from a Closed System	567	(2)
Unit Eight Urinary Diversion	569	(6)
Applying a Urinary Diversion Pouch	569	(3)
Obtaining Specimen from an Ileal Conduit	572	(1)
Emptying Continent Ileostomy	573	(2)
Unit Nine Peritoneal Dialysis	575	(6)
Assisting with Catheter Insertion	576	(1)
Managing Peritoneal Dialysis	576	(1)
Maintaining Peritoneal Dialysis	577	(1)
Providing Cathether Site Care	578	(3)
Unit Ten Hemodialysis	581	(10)
Initiating Hemodialysis	582	(2)
Managing Hemodialysis	584	(1)
Terminating Hemodialysis	585	(1)
Maintaining Central Venous Dual-Lumen Catheters	586	(2)
Flushing Permanent Dual-Lumen Catheter with Heparin	588	(3)
CHAPTER 22. BOWEL ELIMINATION	591	(40)
Anatomy and Physiology	593	(1)
Defecation	594	(1)
Alteration in Elimination	595	(4)
Changes in Motility	595	(1)
Obstruction of the Lumen of the Bowel	595	(1)
Circulatory Deficiencies	596	(1)
Surgically Induced Alterations in the Structure of the Bowel	596	(3)
Unit One Rectal Tube Insertion	599	(3)
Inserting a Rectal Tube	599	(3)
Unit Two Bowel Evacuation	602	(4)
Removing a Fecal Impaction	602	(1)
Providing Digital Stimulation	603	(1)
Developing a Regular Bowel Routine	604	(1)
Administering a Suppository	604	(2)
Unit Three Enema Administration	606	(7)
Administering an Enema	606	(3)
Administering an Enema to a Child	609	(1)
Administering a Disposable Enema (Fleet's)	610	(1)
Administering a Retention Enema	610	(1)
Administering a Harris Flush Enema	611	(2)
Unit Four Colostomy Irrigations	613	(6)
Performing a Colostomy Irrigation	613	(3)
Performing Irrigation in Bed	616	(3)
Unit Five Fecal Ostomy Pouch Application	619	(6)
Applying a Fecal Ostomy Pouch	619	(6)
Unit Six Intestinal Tube Insertion	625	(6)
Assisting in Intestinal Tube Insertion	625	(2)
Removing an Intestinal Tube	627	(4)
CHAPTER 23. HEAT AND COLD THERAPY	631	(26)
Temperature Control	633	(2)
Adjustment Control	633	(2)
Conditions That Affect Adaptive Processes	634	(1)
Therapeutic-Effects of Heat	635	(1)
Therapeutic Effects of Cold	635	(2)
Unit One Moist Heat	637	(5)
Applying Hot Moist Pack	637	(1)
Applying Hot Sterile Moist Compress	638	(2)
Providing a Sitz Bath	640	(2)
Unit Two Warm Dry Heat	642	(5)
Using a Commercial Heat Pack	642	(1)
Using a Heat Cradle	643	(1)
Using the Infant Radiant Warmer	643	(1)
Applying an Aquathermic Pad	644	(3)
Unit Three Cold Applications	647	(4)
Providing a Tepid Bath	647	(1)
Using Ice Application	648	(1)
Using Instant Cold Pack	649	(2)
Unit Four Hypothermia Blanket	651	(6)
Using a Cooling Blanket	651	(6)
CHAPTER 24. WOUND CARE AND DRESSINGS	657	(40)
Wound Healing	659	(1)
Inflammatory Phase	659	(1)
Proliferative, or Granulation, Phase	659	(1)
Motivation, or Would-Remodeling, Phase	659	(1)
Types of Wound Healing	660	(1)
Primary Intention	660	(1)
Secondary Intention	660	(1)
Tertiary Intention	660	(1)
Major Factors Affecting Wound Healing	660	(1)
Nutrition	660	(1)
General Physical Health	660	(1)
Medications	660	(1)
Goals of Wound Care	660	(1)
Wound Infections	661	(1)
Complications Associated with Wound Healing	661	(1)
Wound Specimens for Culture	661	(1)
Pressure Ulcers	661	(2)
Unit One Measures to Prevent Infection	663	(6)
Completing a Surgical Hand Scrub	663	(1)
Using Sterile Gloves	664	(1)
Pouring from a Sterile Container	665	(1)
Preparing a Sterile Field	666	(1)
Preparing a Sterile Field Using Prepackaged Supplies	667	(2)
Unit Two Dressing Change	669	(5)
Changing a Dry Sterile Dressing	669	(2)
Removing Sutures	671	(1)
Removing Staples	671	(3)
Unit Three Wound Care	674	(12)
Changing a Wound Dressing	675	(2)
Changing a Dressing for Peripheral Vascular Wound	677	(2)
Caring for a Wound with a Drain	679	(2)
Applying an Abdominal Binder	681	(1)
Maintaining Wound Drainage System	682	(1)
Irrigating Wounds	683	(3)
Unit Four Wet-to-Damp Dressings	686	(3)
Applying Wet-to-Damp Dressings	686	(3)
Unit Five Pressure Ulcers	689	(8)
Applying Transparent Adhesive Film Dressing	691	(4)
Using Hydrocolloid Dressing	695	(2)
CHAPTER 25. RESPIRATORY CARE	697	(66)
The Respiratory System	699	(1)
The Respiratory Cycle	700	(1)
Alterations in Respiration	700	(1)
Alterations in Ventilation	700	(1)
Alterations in Diffusion	701	(1)
Alterations in Perfusion	701	(1)
Assessment of Respiratory Function	701	(2)
Nursing Interventions	701	(2)
Unit One Deep Breathing Exercises	703	(4)
Instructing Clients to Deep Breathe	703	(1)
Instructing Clients to Cough	704	(1)
Teaching Diaphragmatic Breathing	705	(1)
Using Incentive Spirometers	705	(2)
Unit Two Chest Physiotherapy (CPT)	707	(5)
Preparing Client for CPT	707	(1)
Performing Percussion	708	(1)
Performing Vibration	709	(1)
Performing Postural Drainage	710	(2)
Unit Three Oxygen Therapy	712	(10)
Monitoring Clients Receiving Oxygen Therapy	712	(2)
Using an Oxygen Cylinder	714	(1)
Using Pulse Oximetry	715	(1)
Using an Oxygen Analyzer	716	(1)
Using a Nasal Cannula	716	(1)
Using an Oxygen Face Mask	717	(1)
Using a Pediatric Oxygen Mask	718	(1)
Using a Pediatric Oxygen Tent	719	(1)
Using an Oxygen Hood	719	(3)
Unit Four Suctioning	722	(7)
Suctioning Using Separate Catheter and Glove	722	(2)
Suctioning Using Catheter and Sleeve	724	(1)
Suctioning with In-line Catheter	725	(1)
Suctioning Infants with Bulb Syringe	726	(3)
Unit Five Intermittent Positive Pressure Breathing (IPPB)	729	(5)
Setting up the Puritan-Bennett PR 2	729	(1)
Administering a Nebulized Treatment	730	(1)
Administering Medication by Nebulization	731	(3)
Unit Six Tracheostomy Care	734	(12)
Cleaning the Inner Cannula	735	(2)
Changing Trach Ties	737	(1)
Performing Tracheostomy Suctioning	738	(3)
Using a Manual Resuscitator	741	(1)
Plugging a Tracheostomy	742	(1)
Deflating a Tracheal Cuff	743	(1)
Inflating a Tracheal Cuff	743	(3)
Unit Seven Water-Seal Drainage Systems	746	(9)
Maintaining a Three-Bottle System	746	(2)
Setting Up and Maintaining Disposable Water-Seal System	748	(3)
Assisting with Removal of Chest Tubes	751	(1)
Obtaining Chest Drainage Specimen	752	(1)
Administering Blood Through Autotransfusion Using the Pleur-evac ATS	752	(3)
Unit Eight Intubation	755	(4)
Inserting an Oropharyngeal Airway	755	(1)
Inserting a Nasopharyngeal Airway	756	(1)
Assisting with Endotracheal Intubation	756	(1)
Measuring Cuff Pressure	757	(1)
Providing Care for Client with an Endotracheal Tube	757	(2)
Unit Nine Tracheostomy Intubation	759	(4)
Assisting with Tracheostomy Intubation	759	(4)
CHAPTER 26. CIRCULATORY MAINTENANCE	763	(30)
The Circulatory System	765	(1)
Electrical Conduction	766	(1)
Alterations in Circulation	766	(2)
Hemorrhage	767	(1)
Shock	767	(1)
Pump Failure	767	(1)
Ischemia	768	(1)
Thrombosis and Embolism	768	(1)
Altered Circulation	768	(2)
Assessment	768	(1)
Planning and Intervention	769	(1)
Unit One Control of Bleeding	770	(3)
Using Digital Pressure	770	(1)
Using Pressure Dressing	771	(2)
Unit Two Circulatory Maintenance	773	(5)
Applying Elastic Hosiery	775	(1)
Applying Sequential Compression Devices	775	(3)
Unit Three Electrocardiogram (ECG) Monitoring	778	(6)
Monitoring the ECG	778	(2)
Interpreting an ECG Strip	780	(4)
Unit Four Emergency Life Support Measures	784	(9)
Administering Basic Life Support to an Adult	784	(4)
Administering CPR to a Child	788	(1)
Administering the Heimlich Maneuver for Conscious Client	789	(1)
Administering the Heimlich Maneuver for Unconscious Client	789	(1)
Providing Care Following Code	790	(3)
CHAPTER 27. INTRAVENOUS THERAPY	793	(48)
Fluids and Electrolytes	795	(3)
Fluids	795	(1)
Electrolytes	796	(1)
Alterations	796	(2)
Unit One Intravenous Therapy	798	(10)
Preparing IV System	798	(3)
Preparing IV Site	801	(2)
Inserting a Winged-Tip Needle	803	(1)
Inserting an Over-the-Needle Catheter	804	(4)
Unit Two IV Management	808	(12)
Regulating IV Flow Rate	808	(2)
Using an IV Controller	810	(1)
Using an IV Pump	811	(1)
Using a Syringe Pump	812	(2)
Managing IV Site	814	(1)
Changing IV Dressing	815	(1)
Changing Gown for Client with IV	816	(1)
Discontinuing an IV	817	(3)
Unit Three Intake and Output	820	(5)
Monitoring Intake and Output	820	(3)
Monitoring IV Intake	823	(2)
Unit Four IV Medication Administration	825	(7)
Adding Medication to IV Solution	825	(1)
Using a Secondary or Partial-Fill Additive Bag (IV Piggyback)	826	(1)
Using a Volume Control Set	827	(2)
Using a Peripheral Saline Lock	829	(1)
Administering Medications through IV Line Y-Site	829	(3)
Unit Five Blood Transfusions	832	(9)
Administering Blood through a Y-Set	832	(2)
Administering Blood through a Straight Line	834	(2)
Monitoring for Potential Complications	836	(1)
Administering Blood Components	836	(5)
CHAPTER 28. VASCULAR ACCESS DEVICES	841	(42)
Vascular Access Devices	843	(1)
Total Parenteral Nutrition	843	(1)
Peripheral Insertion of a Central Venous Catheter (PICC)	844	(1)
Unit One Untunneled Central Venous Catheters	845	(7)
Assisting with Central Venous Catheterization	845	(1)
Changing a Central Venous Catheter Dressing	846	(2)
Measuring and Monitoring CVP	848	(4)
Unit Two Total Parenteral Nutrition	852	(8)
Assisting with Catheter Insertion	853	(2)
Maintaining Central Vein Infusions	855	(1)
Changing Parenteral Hyperalimentation Dressing and Tubing	856	(2)
Maintaining Hyperalimentation for Children	858	(2)
Unit Three Intralipid Therapy	860	(3)
Infusing IV Lipids	860	(3)
Unit Four Tunneled Vascular Access Devices (VADs)	863	(9)
Maintaining the Hickman or Broviac CV Catheter	863	(1)
Changing the Hickman or Broviac CV Catheter Dressing	864	(1)
Drawing Blood from a CV Catheter	865	(1)
Maintaining the Groshong CV Catheter	866	(2)
Changing the Groshong CV Catheter	868	(1)
Drawing Blood from the Groshong CV Catheter	868	(4)
Unit Five Implanted Subcutaneous Infusion Port	872	(6)
Accessing and Flushing an Implanted Infusion Port Using a Huber Needle	872	(2)
Administering IV Drugs via an Implanted Infusion Port	874	(1)
Administering Solutions or Drugs via Continuous Infusion	874	(1)
Drawing Blood from an Implanted Port	875	(3)
Unit Six Peripherally Inserted Central Cathether (PICC)	878	(5)
Maintaining the PICC	879	(1)
Changing the PICC Dressing	879	(2)
Drawing Blood from the PICC	881	(2)
CHAPTER 29. ORTHOPEDIC MEASURES	883	(44)
Restoring Function	885	(1)
Fractures	885	(1)
Types of Fracture	886	(3)
Traction	886	(1)
Special Beds	887	(2)
Unit One Bandage Application	889	(4)
Applying a Sling	889	(1)
Applying a Circular Bandage	890	(1)
Applying a Spiral Bandage	890	(1)
Applying a Figure-Eight Bandage	891	(2)
Unit Two Splinting a Fracture	893	(2)
Applying a Splint	893	(1)
Applying an Air Splint	894	(1)
Unit Three Cast Care	895	(4)
Caring for a Wet Cast	896	(1)
Assessing a Casted Extremity	896	(1)
Instructing in Care of a Synthetic Cast	897	(2)
Unit Four Traction	899	(6)
Monitoring Skin Traction	899	(3)
Monitoring Skeletal Traction	902	(3)
Unit Five Halo Traction and Back Brace	905	(3)
Placing a Jewett-Taylor Back Brace	905	(1)
Monitoring Halo Traction	906	(2)
Unit Six Clients with Amputated Limbs	908	(3)
Positioning and Exercising	908	(1)
Applying a Shrink Bandage	909	(2)
Unit Seven Nelson Bed	911	(5)
Using a Nelson Bed	911	(1)
Moving to Chair Position	912	(1)
Moving to Contour Position	913	(1)
Tilting Bed to Vertical Position	913	(1)
Tilting Bed to Trendelenburg's Position	914	(2)
Unit Eight Stryker Frame	916	(5)
Using a Stryker Wedge Turning Frame	916	(1)
Turning from Supine to Prone	917	(1)
Using a Stryker Parallel Frame	918	(1)
Assisting Client with Bedpan	918	(1)
Attaching Fixed Traction	919	(1)
Attaching Skeletal Traction	919	(2)
Unit Nine CircOlectric Bed	921	(6)
Preparing to Operate Bed	921	(1)
Placing Ambulatory Client on Bed	922	(1)
Placing Nonambulatory Client on Bed	922	(1)
Turning from Supine to Prone	922	(2)
Assisting with Bedpan	924	(3)
CHAPTER 30. OPERATIVE CARE	927	(32)
Nurse's Role	929	(1)
Perioperative Stages	929	(1)
Preoperative Anxiety	929	(3)
Unit One Stress in Preoperative Clients	932	(4)
Preventing Anxiety and Stress	932	(1)
Reducing Anxiety and Stress	933	(1)
Assisting the Client Who Uses Denial	934	(2)
Unit Two Preoperative Teaching	936	(8)
Providing Surgical Information	937	(1)
for the Preoperative Client	937	(1)
for the Intraoperative Client	937	(1)
for the Postoperative Client	937	(1)
Providing Client Teaching	937	(1)
Providing Family Teaching	938	(1)
Providing Teaching for Laser Therapy	938	(2)
Providing Teaching for Lithotripsy	940	(1)
Instructing in Deep Breathing Exercises	940	(1)
Instructing in Coughing Exercises	941	(1)
Providing Instruction to Turn in Bed	942	(1)
Instructing in Leg Exercises	942	(2)
Unit Three Preoperative Care	944	(7)
Obtaining Baseline Data	945	(1)
Preparing the Surgical Site	945	(2)
Preparing the Client for Surgery	947	(2)
Administering Preoperative Medications	949	(2)
Unit Four Recovery Room Care and Discharge	951	(4)
Providing Recovery Room Care	951	(2)
Discharging Client from Recovery Room	953	(2)
Unit Five Postoperative Care	955	(4)
Providing Postoperative Care	955	(1)
Administering Postoperative Medications	956	(3)
CHAPTER 31. CLIENT EDUCATION AND DISCHARGE PLANNING	959	(18)
Client Education	961	(1)
Readiness to Learn	961	(1)
Resistance to Change	961	(1)
Student Nurse's Role in Client Education	962	(1)
Discharge Planning	962	(3)
Unit One Client Education	965	(7)
Collecting Data	966	(1)
Determining Readiness to Learn	967	(1)
Identifying Learning Needs	967	(1)
Determining Appropriate Teaching Strategy	967	(1)
Selecting the Educational Setting	968	(1)
Implementing the Teaching Strategy	969	(1)
Developing an Evaluation Tool	970	(2)
Unit Two Discharge Planning	972	(5)
Preparing a Client for Discharge	972	(1)
Completing a Discharge Summary	973	(4)
CHAPTER 32. CARE OF THE DYING CLIENT	977	(14)
Loss and Grieving	978	(1)
Stages of Grief	978	(1)
Stages of Dying	979	(2)
Unit One The Grief Process	981	(3)
Understanding Grief	982	(1)
Assisting with Grief	982	(2)
Unit Two The Dying Client	984	(4)
Assisting the Dying Client	985	(3)
Unit Three Postmortem Care	988	(3)
Providing Postmortem Care	988	(3)
CHAPTER 33. ADVANCED SKILLS IN NURSING PRACTICE	991	(50)
Advanced Skills in Nursing Practice	993	(2)
Unit One Cardiac Emergencies	995	(8)
Using the Emergency Cart	996	(1)
Contents of Typical Emergency Cart	996	(2)
Performing Defibrillation	998	(2)
Assisting with Synchronized Elective Cardioversion	1000	(3)
Unit Two Pacemaker Management	1003	(6)
Pacemaker	1003	(1)
Transvenous	1003	(1)
Transthoracic	1004	(1)
Assisting with Pacemaker Insertion	1004	(2)
Maintaining Temporary Pacemaker Function	1006	(1)
Providing Client Teaching	1007	(2)
Unit Three Arterial Lines	1009	(9)
Arterial Line Monitoring	1009	(1)
Blood Gas Analysis	1010	(1)
Performing Allen's Test	1011	(1)
Assisting with Arterial Line Insertion	1012	(1)
Maintaining Arterial Line Function	1013	(1)
Withdrawing Arterial Blood Samples	1014	(2)
Removing Arterial Line	1016	(2)
Unit Four Hemodynamic Monitoring Using a Pulmonary Artery Catheter	1018	(9)
Assisting Physician with Insertion	1020	(3)
Obtaining Pressure Readings	1023	(1)
Obtaining Cardiac Output Measurements	1024	(1)
Balancing the Transducer	1024	(1)
Calibrating the Monitor and Transducer	1025	(1)
Balancing and Calibrating the Oscilloscope	1025	(2)
Unit Five Mechanical Ventilation	1027	(10)
Ventilation and Gas Exchange Alterations	1027	(2)
Caring for Clients on Ventilators	1029	(2)
Providing Positive End-Expiratory Pressure (PEEP)	1031	(1)
Providing Continuous Positive Airway Pressure (CPAP)	1032	(5)
Unit Six Ventilator Weaning Process	1037	(4)
Weaning Long-Term Ventilated Client (T-Tube Trial)	1037	(4)
CHAPTER 34. HOME CARE MANAGEMENT	1041	(44)
Introduction	1042	(3)
Home Care Definition	1042	(1)
Home Health Team	1043	(1)
Referral to Home Care	1043	(1)
Transition from Hospital to Home	1044	(1)
Client Teaching	1044	(1)
Adapting Care to the Home Setting	1044	(1)
Admission to Home Care	1045	(1)
Plan of Treatment	1045	(1)
Documentation	1045	(1)
Unit One Admission to Home Care	1045	(7)
Identifying Eligibility for Medicare Reimbursement	1049	(1)
Assessing Home for State Environment	1050	(2)
Unit Two Infection Control	1052	(6)
Preparing for Client Care	1052	(1)
Disposing of Waste Materials in the Home Setting	1053	(1)
Cleansing Thermometer	1054	(1)
Caring for an AIDS or HIV Client in the Home	1054	(1)
Cleansing Equipment in the Home Setting	1055	(1)
Teaching Preventive Measures in the Home	1055	(2)
Teaching Safer Practices to IV Drug Users	1057	(1)
Unit Three Body Mechanics	1058	(2)
Positioning Nonhospital Bed for Client Care	1059	(1)
Moving a Helpless Client Up in the Bed Without Assistance	1059	(1)
Unit Four Hygienic Care	1060	(5)
Bathing	1060	(1)
Skin Care	1060	(1)
Pressure Ulcer Care	1060	(1)
Hair Care	1060	(2)
Bathing Client in the Home	1062	(1)
Transferring Client to Tub or Shower	1062	(1)
Adapting Bedmaking to the Home	1063	(1)
Providing Pressure Ulcer Care	1063	(1)
Preparing Normal Saline	1063	(1)
Removing Lice	1064	(1)
Unit Five Medications	1065	(3)
Administering Medications	1066	(1)
Sterilizing Nondisposable Medications Equipment	1067	(1)
Unit Six Total Parenteral Nutrition	1068	(3)
Nutrition	1068	(2)
Administering Total Parenteral Nutrition in the Home	1070	(1)
Discontinuing TPN Infusion	1070	(1)
Unit Seven Urinary Elimination	1071	(4)
Using Clean Technique for Intermittent Self-Catheterization	1072	(1)
for Female Client	1072	(1)
for Male Client	1073	(1)
Administering Chronic Ambulatory Peritoneal Dialysis (CAPD)	1073	(1)
Changing Dressing for CAPD Client	1074	(1)
Unit Eight Respiratory Care	1075	(6)
Caring for Oxygen Equipment	1077	(1)
Teaching Safety Measure for Oxygen Use	1077	(1)
Managing Ventilaltor Equipment	1077	(1)
Providing Catheter Care for Transtrachael Catheter	1078	(1)
for Heimlich Micro-Trach	1078	(1)
for Spofford Christopher Oxygen Optimizing Prosthesis (SCOOP) 1 Catheter	1079	(1)
for SCOOP 2 Catheter	1079	(1)
Teaching the Client Catheter Care	1079	(2)
Unit Nine Circulatory Care	1081	(4)
Monitoring Pacemaker at Home	1082	(1)
Checking with Pacemaker Clinic via Telephone	1083	(1)
Instructing Client in Use of Holter Monitor	1083	(2)
Bibliography	1085	(8)
Index	1093