Medical-Surgical Nursing : An Integrated Approach

by White,Lois

• ISBN13: 9780766825666
• ISBN10: 0766825663
• Edition: 2nd
• Format: Hardcover
• Copyright: 2001-08-09
• Publisher: Cengage Learning

Summary

Medical Surgical Nursing: An Integrated Approach is designed for students in practical/vocational nursing programs. All aspects of this nursing field are examined, from how and where the health care delivery system is set up, to the nurse's role in care related to IV therapy and diagnostic testing, to legal and ethical responsibilities, communication and cultural diversity. This revised edition also includes new chapters covering alternative therapies, loss grief and death, mental illness and responding to emergencies. Case studies, critical thinking questions and exercises developing care plans encourage students to think beyond the classroom. Full color illustrations, cross-referencing between chapters, and suggested resources are among the many features that will appeal to students. ? Diagnostic tests are listed alphabetically in chart form making important information about the test, normal values and nursing responsibilities easy to find ? Chapter end critical thinking questions help students apply chapter content ? "Web Flash" box suggests Internet sites students can consult for additional information ? Text includes a glossary, a list of abbreviations and acronyms, a listing of the latest NANDA nursing diagnoses and Standard Precautions

Table of Contents

Reviewers	p. xiii
Contributors	p. xiv
Preface	p. xvi
How to Use this Text	p. xix
Foundations of Nursing
Factors Affecting Nursing Care	p. 2
The Health Care Delivery System	p. 3
Types of Health Care Services	p. 3
Health Care Delivery System	p. 4
Health Care Team	p. 8
Economics of Health Care	p. 10
Factors Influencing Health Care	p. 13
Challenges within the Health Care System	p. 14
Nursing's Response to Health Care Challenges	p. 16
Trends and Issues	p. 18
Critical Thinking	p. 21
Critical Thinking	p. 21
Skills of Critical Thinking	p. 23
Standards for Critical Thinking	p. 25
Reasoning and Problem-Solving	p. 27
Traits of a Disciplined Thinker	p. 30
Critical Thinking and the Nursing Process	p. 31
Legal Responsibilities	p. 33
Basic Legal Concepts	p. 34
Nursing Practice and the Law	p. 36
Nurse-Client Relationship	p. 37
Informed Consent	p. 41
Advance Directives	p. 43
Incident Reports	p. 45
Professional Liability	p. 48
Impaired Nurse	p. 48
Ethical Responsibilities	p. 53
Concept of Ethics	p. 54
Ethical Principles	p. 54
Ethical Theories	p. 57
Ethics and Values	p. 57
Ethical Codes	p. 59
The Client's Rights	p. 59
Ethical Dilemmas	p. 62
Ethical Decision Making	p. 63
Ethics and Nursing	p. 63
Holistic Nursing Care	p. 67
Communication	p. 69
Process of Communication	p. 69
Methods of Communication	p. 71
Influences on Communication	p. 72
Congruency of Messages	p. 73
Listening/Observing	p. 74
Therapeutic Communication	p. 74
Psychosocial Aspects of Communication	p. 78
Nurse-Client Communication	p. 81
Communicating with the Health Care Team	p. 84
Communicating with Yourself	p. 86
Cultural Diversity and Nursing	p. 89
Culture	p. 89
Cultural Influences on Health Care Beliefs and Practices	p. 92
Cultural and Racial Influences on Client Care	p. 96
Cultural Aspects and the Nursing Process	p. 102
Sample Nursing Care Plan: The Family with Ineffective Coping	p. 105
Wellness Concepts	p. 111
Health	p. 111
Wellness	p. 112
Health Promotion	p. 113
Illness Prevention	p. 114
Factors Affecting Health	p. 117
Guidelines for Healthy Living	p. 122
Alternative/Complementary Therapies	p. 125
Historical Influences on Contemporary Practices	p. 126
Modern Trends	p. 127
Alternative/Complementary Interventions	p. 128
Nursing and Alternative/Complementary Approaches	p. 140
Loss, Grief, and Death	p. 145
Loss	p. 146
Grief	p. 146
Death	p. 153
Sample Nursing Care Plan: The Client with a Terminal Illness/Cancer of the Lung	p. 164
Areas of Medical-Surgical Nursing Care
Basic Concepts of Medical-Surgical Nursing	p. 170
Fluid, Electrolyte, and Acid-Base Balance	p. 171
Homeostasis	p. 172
Chemical Organization	p. 172
Water	p. 175
Gases	p. 175
Acids, Bases, Salts, and pH	p. 176
Buffers	p. 176
Substance Movement	p. 177
Fluid and Electrolyte Balance	p. 179
Disturbance in Electrolyte Balance	p. 182
Acid-Base Balance	p. 184
Disturbances in Acid-Base Balance	p. 185
Nursing Process	p. 187
Sample Nursing Care Plan: The Client with Excess Fluid Volume	p. 193
IV Therapy	p. 197
Parenteral Fluids	p. 197
Equipment	p. 199
Preparing an Intravenous Solution	p. 200
Initiating IV Therapy	p. 201
Administering IV Therapy	p. 202
Managing IV Therapy	p. 203
Intravenous Drug Therapy	p. 204
Documentation	p. 206
Blood Transfusion	p. 206
Sample Nursing Care Plan	p. 208
Health Assessment	p. 211
Health History	p. 213
Physical Examination	p. 215
Head-to-Toe Assessment	p. 216
Diagnostic Tests	p. 231
Diagnostic Testing	p. 232
Laboratory Tests	p. 235
Radiological Studies	p. 258
Ultrasonography	p. 264
Magnetic Resonance Imaging	p. 265
Radioactive Studies	p. 265
Electrodiagnostic Studies	p. 266
Endoscopy	p. 268
Aspiration/Biopsy	p. 268
Other Tests	p. 273
Pain Management	p. 281
Definitions of Pain	p. 282
Nature of Pain	p. 282
Common Myths about Pain	p. 283
Types of Pain	p. 283
Purpose of Pain	p. 285
Physiology of Pain	p. 285
Factors Affecting the Pain Experience	p. 288
JCAHO Standards	p. 288
Nursing Process	p. 288
Sample Nursing Care Plan: The Client with Chronic Pain	p. 302
Anesthesia	p. 307
Preanesthetic Preparation	p. 308
Sedation	p. 309
Regional Anesthesia	p. 310
General Anesthesia	p. 313
Postoperative Pain Management	p. 316
Nursing Care of the Surgical Client	p. 321
Preoperative Phase	p. 322
Intraoperative Phase	p. 332
Postoperative Phase	p. 339
Ambulatory Surgery	p. 353
Elderly Clients Undergoing Surgery	p. 354
Nursing Care of the Oncology Client	p. 359
Incidence	p. 359
Pathophysiology	p. 360
Risk Factors	p. 361
Detection	p. 362
Common Diagnostic Tests	p. 363
Staging of Tumors	p. 363
Grading of Tumors	p. 363
Treatment Modalities	p. 364
Symptom Management	p. 369
Medical Emergencies	p. 373
Hypercalcemia	p. 373
Spinal Cord Compression	p. 374
Superior Vena Cava Syndrome	p. 374
Cardiac Tamponade	p. 374
Psychosocial Alterations	p. 374
Sample Nursing Care Plan: The Client with Lung Cancer	p. 377
Oxygenation and Perfusion	p. 382
Nursing Care of the Client: Respiratory System	p. 383
Anatomy and Physiology Review	p. 384
Assessment	p. 387
Common Diagnostic Tests	p. 389
Infectious/Inflammatory Disorders	p. 389
Infectious/Inflammatory Disorders of the Upper Respiratory Tract	p. 389
Pneumonia	p. 391
Tuberculosis	p. 394
Sample Nursing Care Plan: The Client with Tuberculosis	p. 399
Pleurisy/Pleural Effusion	p. 402
Acute Respiratory Tract Disorders	p. 404
Atelectasis	p. 404
Pulmonary Embolism	p. 407
Pulmonary Edema	p. 408
Adult Respiratory Distress Syndrome	p. 410
Acute Respiratory Failure	p. 411
Chronic Respiratory Tract Disorders	p. 412
Chronic Obstructive Pulmonary Disease	p. 412
Asthma	p. 412
Chronic Bronchitis	p. 414
Emphysema	p. 416
Bronchiectasis	p. 419
Chest Trauma	p. 421
Pneumothorax/Hemothorax	p. 421
Neoplasm of the Respiratory Tract	p. 423
Benign Neoplasms	p. 423
Lung Cancer	p. 423
Laryngeal Cancer	p. 425
Disorders of the Nose	p. 426
Epistaxis	p. 426
Nursing Care of the Client: Cardiovascular System	p. 431
Anatomy and Physiology Review	p. 432
Health History	p. 434
Assessment	p. 435
Common Diagnostic Tests	p. 437
Cardiac Rhythm/Dysrhythmia	p. 437
Normal Sinus Rhythm	p. 437
Dysrhythmias	p. 438
Bradycardia	p. 438
Tachycardia	p. 438
Atrial Dysrhythmias	p. 438
Ventricular Dysrhythmias	p. 440
Atrioventricular Blocks	p. 442
Inflammatory Disorders	p. 443
Rheumatic Heart Disease	p. 443
Infective Endocarditis	p. 444
Myocarditis	p. 444
Pericarditis	p. 445
Valvular Heart Diseases	p. 445
Stenosis and Insufficiency	p. 446
Mitral Valve Prolapse	p. 446
Occlusive Disorders	p. 449
Arteriosclerosis	p. 449
Angina Pectoris	p. 449
Myocardial Infarction	p. 452
Congestive Heart Failure	p. 455
Cor Pulmonale	p. 458
Cardiac Transplantation	p. 458
Peripheral Vascular Disorders	p. 459
Venous Thrombosis/Thrombophlebitis	p. 459
Varicose Veins	p. 462
Buerger's Disease (Thromboangiitis Obliterans)	p. 463
Raynaud's Disease/Phenomenon	p. 463
Aneurysm	p. 465
Hypertension	p. 467
Sample Nursing Care Plan: The Client with Hypertension	p. 471
Nursing Care of the Client: Hematologic and Lymphatic Systems	p. 477
Anatomy and Physiology Review	p. 478
Assessment	p. 481
Common Diagnostic Tests	p. 483
Red Blood Cell Disorders: Anemias and Polycythemia	p. 483
Iron Deficiency Anemia	p. 483
Hypoplastic (Aplastic) Anemia	p. 484
Pernicious Anemia	p. 484
Acquired Hemolytic Anemia	p. 485
Sickle Cell Anemia (Inherited Hemolytic Anemia)	p. 485
Sample Nursing Care Plan: The Client with Sickle Cell Anemia	p. 487
Polycythemia	p. 490
White Blood Cell Disorders	p. 491
Leukemia	p. 491
Acute Leukemia	p. 492
Chronic Leukemia	p. 492
Agranulocytosis	p. 494
Coagulation Disorders	p. 496
Disseminated Intravascular Coagulation	p. 496
Hemophilia	p. 497
Thrombocytopenia	p. 498
Lymph Disorders	p. 499
Hodgkin's Disease	p. 500
Non-Hodgkin's Lymphoma	p. 501
Plamsa Cell Disorder	p. 502
Multiple Myeloma	p. 502
Body Defenses	p. 506
Nursing Care of the Client: Integumentary System	p. 507
Anatomy and Physiology Review	p. 508
Assessment	p. 510
Common Diagnostic Tests	p. 515
Wounds	p. 515
Burns	p. 520
Neoplasms: Malignant	p. 527
Basal Cell Carcinoma	p. 527
Squamous Cell Carcinoma	p. 527
Malignant Melanoma	p. 528
Mycosis Fungoides	p. 528
Neoplasms: Nonmalignant	p. 529
Infectious Disorders of the Skin	p. 529
Sample Nursing Care Plan: The Client with Scabies	p. 532
Inflammatory Disorders of the Skin	p. 536
Dermatitis	p. 536
Eczema	p. 536
Contact Dermatitis	p. 536
Exfoliative Dermatitis	p. 537
Psoriasis	p. 537
Ulcers	p. 539
Stasis Ulcers	p. 539
Pressure Ulcers	p. 541
Alopecia	p. 544
Nursing Care of the Client: Immune System	p. 547
Anatomy and Physiology Review	p. 548
Assessment	p. 550
Common Diagnostic Tests	p. 550
Hypersensitive Immune Response	p. 550
Allergies	p. 550
Anaphylactic Reaction	p. 552
Transfusion Reactions	p. 554
Transplant Rejection	p. 555
Latex Allergy	p. 556
Autoimmune Diseases	p. 556
Rheumatoid Arthritis	p. 556
Systematic Lupus Erythematosus	p. 559
Myasthenia Gravis	p. 562
Sample Nursing Care Plan: The Client with Myasthenia Gravis	p. 563
Nursing Care of the Client: HIV and AIDS	p. 569
Demographics of AIDS in the United States	p. 571
Modes of Transmission	p. 572
Common Diagnostic Tests	p. 573
Pulmonary Opportunistic Infections	p. 573
Pneumocystis Carinii Pneumonia	p. 573
Histoplasmosis	p. 574
Tuberculosis	p. 574
Gastrointestinal Opportunistic Infections	p. 575
Mycobacterium Avium Complex	p. 575
Cytomegalovirus	p. 575
Cryptosporidiosis	p. 576
Hepatitis	p. 576
HIV-Wasting Syndrome	p. 576
Oral Opportunistic Infections	p. 577
Oral and Esophageal Candidiasis	p. 577
Oral Hairy Leukoplakia	p. 578
Gynecological Opportunistic Infections	p. 578
Vaginal Candidiasis	p. 578
Cervical Intraepithelial Neoplasia	p. 579
Central Nervous System Opportunistic Infections	p. 579
AIDS Dementia Complex	p. 579
Toxoplasmosis	p. 580
Cryptococcosis	p. 580
Opportunistic Malignancies	p. 581
Kaposi's Sarcoma	p. 581
Sample Nursing Care Plan: The Client with Kaposi's Sarcoma	p. 581
Non-Hodgkin's Lymphoma	p. 583
Control, Mobility, Coordination, and Regulation	p. 586
Nursing Care of the Client: Musculoskeletal System	p. 587
Anatomy and Physiology Review	p. 588
Assessment	p. 590
Common Diagnostic Tests	p. 591
Musculoskeletal Trauma	p. 591
Strain	p. 591
Sprain	p. 591
Dislocation	p. 592
Fracture	p. 592
Compartment Syndrome	p. 593
Inflammatory Disorders	p. 598
Rheumatoid Arthritis	p. 598
Bursitis	p. 598
Polymyositis	p. 598
Osteomyelitis	p. 599
Degenerative Disorders	p. 600
Osteoporosis	p. 600
Degenerative Joint Disease (Osteoarthritis)	p. 602
Total Joint Arthroplasty	p. 603
Total hip Replacement	p. 603
Total Knee Replacement	p. 604
Musculoskeletal Disorders	p. 605
Amputations	p. 605
Sample Nursing Care Plan: The Client with a Below the Knee Amputation	p. 607
Temporomandibular Joint Disease/Disorder	p. 608
Carpal Tunnel Syndrome	p. 609
Systematic Disorders with Musculoskeletal Manifestations	p. 610
Gout	p. 610
Lyme Disease	p. 610
Nursing Care of the Client: Neurological System	p. 613
Anatomy and Physiology Review	p. 614
Neurological Nursing Assessment	p. 618
Common Diagnostic Tests	p. 624
Head Injury	p. 624
Scalp	p. 624
Skull	p. 624
Brain	p. 625
Brain Tumor	p. 629
Cerebrovascular Accident/Transient Ischemic Attacks	p. 630
Epilepsy/Seizure Disorder	p. 633
Herniated Intervertebral Disk	p. 635
Spinal Cord Injury	p. 637
Parkinson's Disease	p. 642
Multiple Sclerosis	p. 646
Sample Nursing Care Plan: The Client with Multiple Sclerosis	p. 648
Amyothrophic Lateral Sclerosis (Lou Gehrig's Disease)	p. 651
Alzheimer's Disease	p. 652
Guillian Barre Syndrome (Polyradiculoneuropathy)	p. 655
Headache	p. 657
Primary Headaches	p. 657
Secondary Headaches	p. 657
Trigeminal Neuralgia (Tic Duoloureux)	p. 659
Encephalitis, Meningitis	p. 660
Huntington's Disease or Chorea	p. 660
Gilles de la Tourette's Syndrome	p. 661
Nursing Care of the Client: Sensory System	p. 665
Sensation, Perception, and Cognition	p. 666
Anatomy and Physiology Review	p. 666
Assessment	p. 668
Common Diagnostic Tests	p. 671
Sensory, Perceptual, and Cognitive Alterations	p. 672
Sensory Deficit	p. 672
Sensory Deprivation	p. 672
Sensory Overload	p. 672
Disorders of the Ear	p. 673
Impaired Hearing	p. 673
Types of Hearing Loss	p. 673
Behaviors Indicating Hearing Loss	p. 673
Hearing Aids/Assistive Devices	p. 673
Meniere's Disease	p. 675
Otosclerosis	p. 677
Acoustic Neuroma	p. 678
Otitis Media	p. 679
Otitis Externa	p. 680
Mastioditis	p. 680
Disorders of the Eye	p. 680
Cataracts	p. 680
Glaucoma	p. 682
Retinal Detachment	p. 683
Infections	p. 685
Keratitis	p. 685
Stye	p. 685
Chalazion	p. 685
Conjunctivitis (Pink Eye)	p. 685
Refractive Errors	p. 685
Injury	p. 686
Foreign Bodies	p. 687
Chemical Burns	p. 687
Impaired Vision	p. 687
Macular Degeneration	p. 687
Sample Nursing Care Plan: The Client with Macular Degeneration	p. 688
Other Senses	p. 690
Taste	p. 690
Smell	p. 690
Touch	p. 691
Nursing Care of the Client: Endocrine System	p. 693
Anatomy and Physiology Review	p. 694
Common Diagnostic Tests	p. 696
Diabetes Mellitus	p. 696
Diagnosis and Classification	p. 697
Pituitary Disorders	p. 711
Hyperpituitarism	p. 711
Gigantism	p. 711
Acromegaly	p. 711
Syndrome of Inappropriate Antidiuretic Hormone	p. 713
Pituitary Tumors	p. 713
Hypopituitarism	p. 714
Simmonds' Disease	p. 715
Diabetes Insipidus	p. 715
Thyroid Disorders	p. 716
Hyperthyroidism	p. 716
Sample Nursing Care Plan: The Client with Hyperthryoidism	p. 720
Hypothyroidism	p. 722
Cretinism	p. 722
Myxedema	p. 722
Hashimoto's Thyroiditis	p. 724
Thyroid Tumors	p. 724
Cancer of the Thyroid	p. 724
Goiter	p. 725
Parathyroid Disorders	p. 725
Hyperparathyroidism	p. 725
Hypoparathyroidism	p. 726
Adrenal Disorders	p. 728
Cushing's Disease/Syndrome (Adrenal Hyperfunction)	p. 728
Addison's Disease (Adrenal Hypofunction)	p. 730
Pheochromocytoma	p. 731
Digestion and Elimination	p. 736
Nursing Care of the Client: Gastrointestinal System	p. 737
Anatomy and Physiology Review	p. 738
Assessment	p. 740
Common Diagnostic Tests	p. 741
Disorders of the Gastrointestinal Tract	p. 741
Stomatitis	p. 741
Esophageal Varices	p. 742
Gastroesophageal Reflux Disease	p. 744
Gastritis	p. 745
Ulcers	p. 746
Appendicitis	p. 749
Diverticulosis and Diverticulitis	p. 750
Stomal/Ostomy Management	p. 750
Discharge Teaching of the Ostomy Client	p. 751
Sample Nursing Care Plan: The Client with Diverticulitis	p. 753
Inflammatory Bowel Disease	p. 755
Intestinal Obstruction	p. 757
Hernias	p. 759
Peritonitis	p. 760
Hemorrhoids	p. 761
Constipation	p. 762
Disorders of the Accessory Organs	p. 763
Cirrhosis	p. 763
Hepatitis	p. 765
Pancreatitis	p. 767
Cholecystitis and Cholelithiasis	p. 769
Neoplasms of the Gastrointestinal System	p. 770
Oral Cancer	p. 770
Colorectal Cancer	p. 771
Liver Cancer	p. 773
Nursing Care of the Client: Urinary System	p. 775
Anatomy and Physiology Review	p. 776
Assessment	p. 777
Common Diagnostic Tests	p. 777
Altered Urinary Elimination Patterns	p. 778
Urinary Retention	p. 778
Urinary Incontinence	p. 778
Stress Incontinence	p. 778
Urge Incontinence	p. 779
Overflow Incontinence	p. 779
Total Incontinence	p. 779
Nocturnal Enuresis	p. 779
Infectious Disorders	p. 779
Cystitis	p. 779
Pyelonephritis	p. 781
Acute Glomerulonephritis	p. 782
Chronic Glomerulonephritis	p. 785
Obstructive Disorders	p. 786
Urolithiasis	p. 786
Urinary Bladder Tumors	p. 789
Renal Tumors	p. 791
Polycystic Kidney	p. 792
Renal Failure	p. 793
Acute Renal Failure	p. 793
Postrenal ARF	p. 793
Prerenal ARF	p. 793
Intrarenal ARF	p. 793
Sample Nursing Care Plan: The Client with Acute Renal Failure	p. 796
Chronic Renal Failure (End-Stage Renal Disease)	p. 797
Dialysis	p. 800
Kidney Transplantation	p. 802
Reproductive and Sexual Disorders	p. 806
Nursing Care of the Client: Female Reproductive System	p. 807
Anatomy and Physiology Review	p. 808
Common Diagnostic Tests	p. 809
Inflammatory Disorders	p. 809
Pelvic Inflammatory Disease	p. 809
Endometriosis	p. 812
Vaginitis	p. 813
Toxic Shock Syndrome	p. 814
Benign Neoplasms	p. 816
Fibrocystic Breast Disease	p. 816
Fibroid Tumors	p. 818
Malignant Neoplasms	p. 819
Breast Cancer	p. 819
Sample Nursing Care Plan: The Client with Breast Cancer	p. 824
Cervical Cancer	p. 826
Endometrial Cancer	p. 829
Ovarian Cancer	p. 830
Menstrual Disorders	p. 832
Dysmenorrhea	p. 832
Amenorrhea	p. 833
Other Disorders	p. 833
Premenstrual Syndrome	p. 834
Complications of Menopause	p. 835
Structural Disorders	p. 837
Cystocele, Urethrocele, Rectocele, Prolapsed Uterus	p. 837
Infertility	p. 839
Contraception	p. 841
Natural Method	p. 841
Barrier and Spermicide Methods	p. 842
Hormonal Methods	p. 842
Intrauterine Device Method	p. 842
Sterilization Method	p. 843
Nursing Care of the Client: Male Reproductive System	p. 847
Anatomy and Physiology Review	p. 848
Common Diagnostic Tests	p. 848
Inflammatory Disorders	p. 849
Epididymitis/Orchitis/Prostatitis	p. 849
Benign Prostatic Hyperplasia	p. 851
Malignant Neoplasms	p. 854
Breast Cancer	p. 854
Prostate Cancer	p. 855
Testicular Cancer	p. 857
Penile Cancer	p. 859
Structural Disorders	p. 860
Functional Disorders and Concerns	p. 861
Impotence	p. 861
Sample Nursing Care Plan: The Client Experiencing Impotence	p. 863
Infertility	p. 864
Contraception	p. 864
Nursing Care of the Client: Sexually Transmitted Diseases	p. 867
Anatomy and Physiology Review	p. 868
Common Diagnostic Tests	p. 870
Chlamydia	p. 870
Gonorrhea	p. 870
Syphilis	p. 871
Genital Herpes	p. 872
Cytomegalovirus	p. 873
Genital Warts	p. 874
AIDS	p. 874
Trichomoniasis	p. 875
Hepatitis B	p. 875
Sample Nursing Care Plan: The Client with Genital Herpes	p. 876
Physical and Mental Integrity	p. 882
Nursing Care of the Client: Mental Illness	p. 883
Mental Health and Illness	p. 884
Relationship Development	p. 884
The Client Experiencing a Crisis	p. 886
The Client Who is Anxious	p. 886
Mild Anxiety	p. 886
Moderate Anxiety	p. 886
Severe Anxiety	p. 887
Panic Anxiety	p. 887
The Client with Generalized Anxiety Disorder	p. 887
The Client with Panic Disorder	p. 887
The Client with Post-Traumatic Stress Disorder	p. 887
The Client Who is Depressed	p. 890
Mild Depression	p. 891
Moderate Depression	p. 891
Severe Depression	p. 891
The Client with Major Depressive Disorder	p. 891
The Client with Dysthymic Disorder	p. 891
The Client Who is Potentially Violent	p. 895
The Client Who is Homicial	p. 896
The Client Who is Suicidal	p. 896
The Client with Suicidal Ideations	p. 896
The Client Who is Actively Suicidal	p. 896
Sample Nursing Care Plan: The Suicidal Client with Major Depression	p. 900
The Client Who is Psychotic	p. 903
The Client with Schizophrenia	p. 903
The Client with Bipolar Disorder	p. 907
The Client Requiring Special Consideration	p. 910
The Client with Attention Deficit/Hyperactivity Disorder	p. 910
Predominantly Hyperactive-Impulsive Type	p. 910
Predominantly Inattentive Type	p. 910
Combined Type	p. 910
The Client Experiencing Neglect and/or Abuse	p. 913
Elder Abuse and Neglect	p. 913
Domestic Violence	p. 913
Rape	p. 913
The Client with an Eating Disorder	p. 915
Nursing Care of the Client: Substance Abuse	p. 919
Historical Perspectives	p. 920
Factors Related to Substance Abuse	p. 921
Prevention	p. 922
Diagnostic Testing	p. 922
Treatment/Recovery	p. 923
Substance Use Patterns	p. 923
CNS Depressants	p. 923
Alcohol	p. 923
Benzodiazepines and Other Sedative-Hypnotics	p. 928
Cannabis	p. 928
CNS Stimulants	p. 929
Cocaine	p. 929
Amphetamines	p. 930
Caffeine	p. 931
Nicotine	p. 931
Methylphenidate Hydrochloride (Ritalin)	p. 932
Hallucinogens	p. 932
Lysergic Acid Diethylamide	p. 932
Phencyclidine	p. 933
Opioids	p. 934
Inhalants	p. 936
Anabolic Steroids	p. 936
Codependency	p. 938
The Impaired Nurse	p. 939
Special Areas of Medical-Surgical Nursing	p. 942
Nursing Care of the Older Client	p. 943
Gerontological Nursing	p. 944
Theories of Aging	p. 945
Myths and Realities of Aging	p. 945
Health and Aging	p. 948
Physiologic Changes Associated with Aging	p. 952
Sample Nursing Care Plan: The Client with Alzheimer's Disease (AD)	p. 965
Financing Elder Care in the 21st Century	p. 969
Rehabilitation, Home Health, Long-Term Care, and Hospice	p. 973
Legal and Ethical Responsibilities	p. 974
Sources of Reimbursement	p. 975
Licensure, Certification, and Accreditation	p. 976
Rehabilitation	p. 977
Home Health Care	p. 979
Long-Term Care	p. 980
Hospice	p. 981
Sample Nursing Care Plan: The Client Requiring Rehabilitative Care	p. 982
Integration of Body Systems	p. 988
Nursing Care of the Client: Responding to Emergencies	p. 989
Approaches to Emergency Care	p. 990
Shock	p. 992
Cardiopulmonary Emergencies	p. 993
Neurological/Neurosurgical Emergencies	p. 995
Abdominal Emergencies	p. 996
Genitourinary Emergencies	p. 997
Ocular Emergencies	p. 999
Musculoskeletal Emergencies	p. 1000
Soft-Tissue Emergencies	p. 1001
Sample Nursing Care Plan: The Client with a Soft-Tissue Injury	p. 1002
Poisoning and Overdoses	p. 1005
Environmental/Temperature Emergencies	p. 1006
Multiple-System Trauma	p. 1008
Legal Issues	p. 1008
Death in the Emergency Department	p. 1009
Critical Thinking on Multiple Systems	p. 1011
Systems Reviewed in Diabetes Mellitus Exercise	p. 1011
Critical Thinking Exercise with Diabetes Mellitus	p. 1011
Systems Reviewed in Cirrhosis Exercise	p. 1013
Critical Thinking Exercise with Cirrhosis	p. 1013
Systems Reviewed in Hypertension, Congestive Heart Failure, and Chronic Renal Failure Exercise	p. 1013
Critical Thinking Exercise with Hypertension, Congestive Heart Failure, and Chronic Renal Failure	p. 1014
Systems Reviewed in Parkinson Disease Exercise	p. 1014
Critical Thinking Exercise with Parkinson Disease	p. 1014
References/Suggested Readings and Resources	p. 1017
NANDA Nursing Diagnoses 2001-2002	p. 1051
Abbreviations, Acronyms, and Symbols	p. 1053
English/Spanish Words and Phrases	p. 1058
Glossary	p. 1064
Index	p. 1079
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