Thelan's Critical Care Nursing : Diagnosis and Management

by Urden, Stacy & Lough

• ISBN13: 9780323032483
• ISBN10: 0323032486
• Edition: 5th
• Format: Hardcover
• Copyright: 2005-11-11
• Publisher: Mosby

Summary

This classic resource for critical care nursing is now a full-color text that provides a thorough examination of all the important aspects of critical care nursing with more appealing illustrations and design elements. Organized in ten units around alterations in body systems, this texts depth and scope will appeal to both novice and expert, while instructors praise its comprehensiveness and depend on its clinical relevance to inform their teaching and practice. Special Feature list located in the inside front and back covers provide a quick reference for finding this information. Clinical Applications promote student learning and critical thinking by illustrating the clinical course of a patient experiencing the history, clinical manifestations, treatment, and outcomes discussed. Data Collection feature incorporates information that should be included as part of the patients history. Nursing Diagnoses feature fosters critical thinking and decision making in a boxed menu of nursing diagnoses, complete with specific etiologic or related factors. Nursing Interventions Classification (NIC) feature lists the important nursing actions for a variety of nursing interventions that would be commonly incorporated in the management of a critically ill patient requiring a specific therapeutic management. Patient Education feature list the special topics that should be taught to the patient and family to prepare them for discharge. Pharmacologic Management Tables outline the common medications, along with any special considerations, used in treatment of the different disorders presented in the text. Full-color design and illustrations visually enhance the text. Evidence-Based Collaborative Practice feature highlights important research based articles on important topics like diabetic ketoacidosis, coronary artery disease and stable angina, and severe sepsis to help students understand the clinical significance of the problem. Patient Safety Alert feature highlights any safety issue for the learner that is specific and related to the chapter discussion as well as prepares the learner for important clinical situations. Collaborative Management boxes focus on the aspects of multidisciplinary care in the management of patients in the critical care setting. These are found in the nursing management sections, where appropriate, and are a numbered box. Pulmonary Disorders chapter now covers SARS. Neurologic Alterations chapters are restructured to three chapters in the unit. Organ Donation and Transplantation chapter now has important information on organ donation and procurement process.

Table of Contents

Unit I Foundations of Critical Care Nursing
Critical Care Nursing Practice	3	(11)
Overview	3	(1)
History of Critical Care	3	(1)
Contemporary Critical Care	4	(1)
Critical Care Nursing Roles	4	(1)
Critical Care Professional Organizations	5	(1)
Critical Care Nursing Standards	5	(1)
Evidence-Based Nursing Practice	5	(1)
Holistic Critical Care Nursing	6	(2)
Nursing's Unique Role in Health Care	8	(1)
Interdisciplinary Planning for Care	9	(3)
Regulatory Issues in Critical Care	12	(2)
Ethical Issues	14	(8)
Differences Between Morals and Ethics	14	(1)
Ethical Principles	14	(2)
Scarce Resources in Critical Care	16	(1)
Withholding and Withdrawing Treatment	17	(1)
Medical Futility	17	(1)
Ethics As a Foundation for Nursing Practice	17	(1)
Ethical Decision Making in Critical Care	18	(2)
Strategies for Promotion of Ethical Decision Making	20	(2)
Legal Issues	22	(17)
Overview	23	(1)
Assessment Failures	23	(1)
Planning Failures	24	(1)
Implementation Failures	24	(3)
Evaluation Failures	27	(12)
Patient/Family Education	39	(19)
Challenges in Acute Care in Patient/Family Education	39	(1)
What Is Education?	39	(1)
Step 1: Assessment	40	(4)
Step 2: Education Plan of Care Development	44	(3)
Step 3: Implementation	47	(5)
Step 4: Outcome Evaluation	52	(1)
Step 5: Documentation	53	(1)
Factors That Affect the Teaching-Learning Process	54	(1)
Preparing the Patient/Family for Transfer	55	(3)
Psychosocial Alterations	58	(22)
Psychosocial Alterations, Coping Mechanisms, and Management	58	(1)
Holistic Nursing Practice	58	(1)
Effects of Stress on Mind/Body Interactions	59	(2)
Anxiety As a Response to Stress	61	(1)
Anxiety and Pain	61	(1)
Self-Concept	62	(1)
Powerlessness	63	(1)
Hopelessness	64	(1)
Spiritual Distress	65	(1)
Mental Status Changes Requiring Evaluation	65	(4)
Suicide	69	(1)
Coping	70	(1)
Coping Mechanisms	70	(2)
Coping Assessment	72	(1)
Enhancing the Coping Process	72	(2)
Care of Specific Populations	74	(6)
Sleep Alterations and Management	80	(14)
Normal Human Sleep	80	(3)
Chronobiology	83	(1)
Pharmacology	84	(1)
Abnormal Sleep	85	(9)
Nutrition Alterations and Management	94	(30)
Nutrient Metabolism	94	(2)
Implications of Undernutrition for the Sick or Stressed Patient	96	(1)
Assessing Nutritional Status	97	(4)
Nutrition and Cardiovascular Alterations	101	(3)
Nutrition and Neurologic Alterations	104	(1)
Nutrition and Renal Alterations	105	(2)
Nutrition and Gastrointestinal Alterations	107	(2)
Nutrition and Endocrine Alterations	109	(1)
Administering Nutrition Support	110	(9)
Evaluating Response to Nutrition Support	119	(5)
Pain and Pain Management	124	(28)
Importance of Pain Assessment	124	(1)
A Definition and Description of Pain	124	(1)
Physiology of Pain	125	(2)
Biologic Stress Response	127	(2)
A Framework for Pain Assessment	129	(1)
Pain Assessment	130	(4)
Patient Barriers to Pain Assessment and Management	134	(2)
Health Professional Barriers to Pain Assessment and Management	136	(1)
Organizational Barriers to Pain Assessment and Management	136	(1)
Pain Management	136	(1)
Pharmacologic Control of Pain	136	(6)
Delivery Methods	142	(3)
Nonpharmacologic Methods of Pain Management	145	(7)
Agitation and Sedation Management	152	(10)
Patient Agitation and Need for Sedation/Analgesia	152	(1)
Assessing Level of Sedation	152	(2)
Complications of Sedation	154	(1)
Selecting Medications for Sedation	155	(3)
Managing Drug Dependence and Withdrawal	158	(1)
Assessing for Delirium	158	(1)
Preventing Agitation and Delirium	159	(1)
Collaborative Management	160	(2)
End-of-Life Issues	162	(15)
End-of-Life Experience in Critical Care	162	(2)
Ethical/Legal Issues	164	(1)
Comfort Care	164	(1)
Prognostication	164	(1)
Communication and Decision Making	165	(1)
Culture and Religious Influences	165	(1)
Hospice	165	(1)
Withdrawal or Withholding of Treatment	165	(1)
Palliative Care	166	(1)
Symptom Management	166	(1)
Near Death Awareness	167	(1)
Withdrawal of Mechanical Ventilation	167	(1)
Professional Issues/Health Care Settings	168	(1)
Organ Donation	168	(1)
Family Care	169	(2)
Collaborative Care	171	(6)
Unit II Special Populations
The Pediatric Patient in the Adult Critical Care Unit	177	(28)
Respiratory System	177	(9)
Cardiovascular System	186	(7)
Nervous System	193	(3)
Gastrointestinal System/Fluids/Nutrition	196	(3)
Pain Management	199	(1)
Psychosocial Issues of the Child and Family	200	(5)
High-Risk and Critical Care in Obstetric Issues	205	(22)
Risks to Fetal Development	205	(1)
Physiologic Alterations in Pregnancy	205	(4)
Physiologic Changes During Labor and Delivery	209	(1)
Cardiac Disease	210	(3)
Hypertensive Disease	213	(3)
Obstetric Disseminated Intravascular Coagulation	216	(1)
Pulmonary Dysfunction	217	(2)
Trauma	219	(4)
Neurologic Dysfunction	223	(4)
Gerontologic Alterations and Management	227	(22)
Cardiovascular System	227	(4)
Pulmonary System	231	(2)
Renal System	233	(1)
Gastrointestinal System	234	(1)
Central Nervous System	235	(2)
Immune System	237	(1)
Changes in Pharmacokinetics and Pharmacodynamics	238	(1)
Physical Examination and Diagnostic Procedures	239	(10)
Perianesthesia Management	249	(30)
Selection of Anesthesia	249	(1)
General Anesthesia	249	(1)
Anesthetic Agents	250	(5)
Perianesthesia Assessment and Care	255	(7)
Management of Postanesthesia Problems and Emergencies	262	(17)
Unit III Cardiovascular Alterations
Cardiovascular Anatomy and Physiology	279	(23)
Anatomy	279	(12)
Physiology	291	(11)
Cardiovascular Clinical Assessment	302	(17)
History	302	(1)
Physical Examination	302	(17)
Cardiovascular Diagnostic Procedures	319	(108)
Laboratory Assessment	319	(9)
Diagnostic Procedures	328	(99)
Cardiovascular Disorders	427	(76)
Coronary Artery Disease	427	(12)
Myocardial Infarction	439	(16)
Sudden Cardiac Death	455	(4)
Heart Failure	459	(9)
Cardiomyopathy	468	(3)
Pulmonary Hypertension	471	(2)
Endocarditis	473	(3)
Valvular Heart Disease	476	(5)
Atherosclerotic Diseases of the Aorta	481	(4)
Peripheral Arterial Disease	485	(3)
Carotid Artery Disease	488	(3)
Venous Thromboembolism	491	(3)
Hypertensive Emergency	494	(9)
Cardiovascular Therapeutic Management	503	(64)
Temporary Pacemakers	503	(10)
Permanent Pacemakers	513	(2)
Implantable Cardioverter Defibrillator	515	(2)
Fibrinolytic Therapy	517	(6)
Catheter Interventions for Coronary Artery Disease	523	(8)
Balloon Valvotomy	531	(1)
Cardiac Surgery	532	(12)
Mechanical Circulatory Assist Devices	544	(6)
Vascular Surgery	550	(2)
Effects of Cardiovascular Drugs	552	(15)
Unit IV Pulmonary Alterations
Pulmonary Anatomy and Physiology	567	(20)
Thorax	567	(3)
Conducting Airways	570	(3)
Respiratory Airways	573	(2)
Pulmonary Blood and Lymph Supply	575	(2)
Ventilation	577	(4)
Respiration	581	(1)
Ventilation/Perfusion Relationships	582	(1)
Gas Transport	582	(5)
Pulmonary Clinical Assessment	587	(17)
History	587	(1)
Physical Examination	587	(8)
Assessment Findings of Common Disorders	595	(9)
Pulmonary Diagnostic Procedures	604	(13)
Laboratory Studies	604	(6)
Diagnostic Procedures	610	(4)
Bedside Monitoring	614	(3)
Pulmonary Disorders	617	(40)
Acute Respiratory Failure	617	(5)
Acute Lung Injury	622	(6)
Pneumonia	628	(4)
Aspiration Pneumonitis	632	(3)
Pulmonary Embolism	635	(3)
Status Asthmaticus	638	(2)
Air Leak Disorders	640	(4)
Thoracic Surgery	644	(4)
Long-Term Mechanical Ventilator Dependence	648	(9)
Pulmonary Therapeutic Management	657	(34)
Oxygen Therapy	657	(3)
Artificial Airways	660	(10)
Invasive Mechanical Ventilation	670	(10)
Noninvasive Mechanical Ventilation	680	(2)
Position Therapy	682	(2)
Pharmacology	684	(7)
Unit V Neurologic Alterations
Neurologic Anatomy and Physiology	691	(29)
Divisions of the Nervous System	691	(1)
Microstructure of the Nervous System	691	(6)
Central Nervous System	697	(23)
Neurologic Clinical Assessment and Diagnostic Procedures	720	(25)
Clinical Assessment	720	(11)
Diagnostic Procedures	731	(7)
Laboratory Studies	738	(1)
Bedside Monitoring	738	(7)
Neurologic Disorders and Therapeutic Management	745	(42)
Coma	745	(3)
Stroke	748	(18)
Guillain-Barre Syndrome	766	(2)
Craniotomy	768	(6)
Intracranial Hypertension	774	(7)
Pharmacologic Agents	781	(6)
Unit VI Renal Alterations
Renal Anatomy and Physiology	787	(14)
Macroscopic Anatomy	787	(1)
Vascular Anatomy	787	(1)
Microscopic Structure and Function	788	(2)
Nervous System Innervation	790	(1)
Processes of Urine Formation	791	(1)
Functions of the Kidneys	792	(2)
Fluid Balance	794	(2)
Factors Controlling Fluid Balance	796	(1)
Electrolyte Balance	796	(5)
Renal Clinical Assessment and Diagnostic Procedures	801	(12)
History	801	(1)
Physical Examination	801	(4)
Additional Assessment Parameters	805	(2)
Laboratory Assessment	807	(4)
Radiologic Assessment	811	(1)
Kidney Biopsy	811	(2)
Renal Disorders and Therapeutic Management	813	(34)
Acute Renal Failure	813	(1)
Acute Tubular Necrosis	814	(2)
Assessment and Diagnosis	816	(2)
``At Risk'' Disease States and Acute Renal Failure	818	(10)
Renal Replacement Therapy---Dialysis	828	(19)
Unit VII Gastrointestinal Alterations
Gastrointestinal Anatomy and Physiology	847	(11)
Mouth	847	(1)
Esophagus	847	(1)
Stomach	848	(2)
Small Intestine	850	(2)
Large Intestine	852	(1)
Accessory Organs	853	(5)
Gastrointestinal Clinical Assessment and Diagnostic Procedures	858	(13)
Clinical Assessment	858	(1)
History	858	(1)
Physical Examination	858	(5)
Laboratory Studies	863	(1)
Diagnostic Procedures	864	(7)
Gastrointestinal Disorders and Therapeutic Management	871	(30)
Acute Gastrointestinal Hemorrhage	871	(6)
Acute Pancreatitis	877	(4)
Fulminant Hepatic Failure	881	(4)
Gastrointestinal Surgery	885	(4)
Therapeutic Management	889	(12)
Unit VIII Endocrine Alterations
Endocrine Anatomy and Physiology	901	(9)
Pancreas	901	(3)
Pituitary Gland and Hypothalamus	904	(3)
Thyroid Gland	907	(3)
Endocrine Assessment and Diagnostic Procedures	910	(8)
Pancreas	910	(2)
Pituitary Gland	912	(2)
Thyroid Gland	914	(4)
Endocrine Disorders and Therapeutic Management	918	(51)
Neuroendocrinology of Stress and Critical Illness	918	(9)
Diabetes Mellitus	927	(7)
Diabetic Ketoacidosis	934	(9)
Hyperglycemic Hyperosmolar State	943	(5)
Diabetes Insipidus	948	(5)
Syndrome of Inappropriate Secretion of Antidiuretic Hormone	953	(3)
Thyroid Storm	956	(5)
Myxedema Coma	961	(8)
Unit IX Multisystem Alterations
Trauma	969	(40)
Mechanisms of Injury	969	(1)
Phases of Trauma Care	970	(5)
Specific Trauma Injuries	975	(28)
Complications of Trauma	1003	(3)
Special Considerations	1006	(3)
Shock	1009	(23)
Shock Syndrome	1009	(3)
Hypovolemic Shock	1012	(2)
Cardiogenic Shock	1014	(3)
Anaphylactic Shock	1017	(4)
Neurogenic Shock	1021	(2)
Severe Sepsis and Septic Shock	1023	(9)
Systemic Inflammatory Response Syndrome and Multiple Organ Dysfunction Syndrome	1032	(15)
The Inflammatory Response	1032	(2)
Multiple Organ Dysfunction Syndrome	1034	(8)
Nursing Management of High-Risk Patients	1042	(2)
Experimental Approaches in SIRS and MODS	1044	(3)
Burns	1047	(29)
Anatomy and Functions of the Skin	1047	(1)
Pathophysiology and Etiology of Burn Injury	1048	(1)
Classification of Burn Injuries	1049	(3)
Initial Emergency Burn Management	1052	(4)
Special Management Considerations	1056	(3)
Burn Nursing Diagnoses and Management	1059	(14)
Rehabilitation Phase	1073	(3)
Organ Donation and Transplantation	1076	(52)
Introduction	1076	(1)
Organ Donation	1076	(10)
Recovery of Organs	1086	(4)
Immunology of Transplant Rejection	1090	(8)
Heart Transplantation	1098	(4)
Heart-Lung Transplantation	1102	(4)
Single-Lung and Double-Lung Transplantations	1106	(2)
Liver Transplantation	1108	(9)
Kidney Transplantation	1117	(3)
Pancreas Transplantation	1120	(8)
Hematologic Disorders and Oncologic Emergencies	1128	(73)
Overview of Coagulation and Fibrinolysis	1128	(1)
Disseminated Intravascular Coagulation	1129	(6)
Thrombocytopenia	1135	(1)
Heparin--Induced Thrombocytopenia	1136	(3)
Tumor Lysis Syndrome	1139	(2)
Hospital-Acquired Anemia of the Critically III	1141	(60)
Unit X Nursing Management Plans
Appendix	1201