UNDERSTANDING Medical Surgical Nursing

UNIT ONE Understanding Health Care Issues 1 1 Critical Thinking and the Nursing Process 2 2 Evidence-Based Practice 5 3 Issues in Nursing Practice 8 4 Cultural Influences on Nursing Care 12 5 Complementary and Alte ...

UNIT ONE Understanding Health Care Issues 1 1 Critical Thinking and the Nursing Process 2 2 Evidence-Based Practice 5 3 Issues in Nursing Practice 8 4 Cultural Influences on Nursing Care 12 5 Complementary and Alternative Modalities 16 UNIT TWO Understanding Health and Illness 19 6 Nursing Care of Patients With Fluid, Electrolyte, and Acid-Base Imbalances 20 7 Nursing Care of Patients Receiving Intravenous Therapy 23 8 Nursing Care of Patients With Infections 26 9 Nursing Care of Patients in Shock 30 10 Nursing Care of Patients in Pain 34 11 Nursing Care of Patients With Cancer 37 12 Nursing Care of Patients Having Surgery 40 13 Nursing Care of Patients With Emergent Conditions and Disaster/Bioterrorism Response 45 UNIT THREE Understanding Life Span Influences on Health and Illness 49 14 Developmental Considerations in the Nursing Care of Adults 50 15 Nursing Care of Older Adult Patients 53 16 Nursing Care of Patients at Home 57 17 Nursing Care of Patients at the End of Life 60 UNIT FOUR Understanding the Immune System 63 18 Immune System Function, Assessment, and Therapeutic Measures 64 19 Nursing Care of Patients With Immune Disorders 68 20 Nursing Care of Patients With HIV Disease and AIDS 74 UNIT FIVE Understanding the Cardiovascular System 77 21 Cardiovascular System Function, Assessment, and Therapeutic Measures 78 22 Nursing Care of Patients With Hypertension 82 23 Nursing Care of Patients With Valvular, Inflammatory, and Infectious Cardiac or Venous Disorders 86 24 Nursing Care of Patients With Occlusive Cardiovascular Disorders 92 25 Nursing Care of Patients With Cardiac Dysrhythmias 96 26 Nursing Care of Patients With Heart Failure 102 UNIT SIX Understanding the Hematologic and Lymphatic Systems 107 27 Hematologic and Lymphatic System Function, Assessment, and Therapeutic Measures 108 28 Nursing Care of Patients With Hematologic and Lymphatic Disorders 112 UNIT SEVEN Understanding the Respiratory System 117 29 Respiratory System Function, Assessment, and Therapeutic Measures 118 30 Nursing Care of Patients With Upper Respiratory Tract Disorders 123 31 Nursing Care of Patients With Lower Respiratory Tract Disorders 126 UNIT EIGHT Understanding the Gastrointestinal, Hepatic, and Pancreatic Systems 131 32 Gastrointestinal, Hepatobiliary, and Pancreatic Systems Function, Assessment, and Therapeutic Measures 132 vii 4069_FM_i-viii 25/11/14 3:15 PM Page vii 33 Nursing Care of Patients With Upper Gastrointestinal Disorders 137 34 Nursing Care of Patients With Lower Gastrointestinal Disorders 141 35 Nursing Care of Patients With Liver, Pancreatic, and Gallbladder Disorders 144 UNIT NINE Understanding the Urinary System 149 36 Urinary System Function, Assessment, and Therapeutic Measures 150 37 Nursing Care of Patients With Disorders of the Urinary System 154 UNIT TEN Understanding the Endocrine System 159 38 Endocrine System Function and Assessment 160 39 Nursing Care of Patients With Endocrine Disorders 163 40 Nursing Care of Patients With Disorders of the Endocrine Pancreas 167 UNIT ELEVEN Understanding the Genitourinary and Reproductive System 171 41 Genitourinary and Reproductive System Function and Assessment 172 42 Nursing Care of Women With Reproductive System Disorders 177 43 Nursing Care of Male Patients With Genitourinary Disorders 180 44 Nursing Care of Patients With Sexually Transmitted Infections 183 UNIT TWELVE Understanding the Musculoskeletal System 187 45 Musculoskeletal Function and Assessment 188 46 Nursing Care of Patients With Musculoskeletal and Connective Tissue Disorders 192 UNIT THIRTEEN Understanding the Neurologic System 197 47 Neurologic System Function, Assessment, and Therapeutic Measures 198 48 Nursing Care of Patients With Central Nervous System Disorders 203 49 Nursing Care of Patients With Cerebrovascular Disorders 207 50 Nursing Care of Patients With Peripheral Nervous System Disorders 211 UNIT FOURTEEN Understanding the Sensory System 215 51 Sensory System Function, Assessment, and Therapeutic Measures: Vision and Hearing 216 52 Nursing Care of Patients With Sensory Disorders: Vision and Hearing 221 UNIT FIFTEEN Understanding the Integumentary System 225 53 Integumentary System Function, Assessment, and Therapeutic Measures 226 54 Nursing Care of Patients With Skin Disorders 229 55 Nursing Care of Patients With Burns 232 UNIT SIXTEEN Understanding Mental Health Care 235 56 Mental Health Function, Assessment, and Therapeutic Measures 236 57 Nursing Care of Patients With Mental Health Disorders 239 viii Contents 4069_FM_i-viii 25/11/14 3:15 PM Page viii Understanding Health Care Issues Critical Thinking ❑ Critical thinking traits ❑ Knowledge base ❑ Critical thinking skills ❑ Problem solving ❑ Role of the LPN/LVN ❑ Nursing process ❑ Data collection ❑ Documentation of data ❑ Nursing diagnosis ❑ Planning care ❑ Prioritizing care ❑ Identifying interventions ❑ Implementation ❑ Evaluation Evidence-Based Practice ❑ Evidence-based practice ❑ Use of evidence-based practice ❑ Identifying evidence ❑ Evidence-based practice process ❑ Six steps of evidencebased practice ❑ Evidence-based practice, quality and safety ❑ Quality and Safety Education for Nurses (QSEN) project ❑ Joint Commission’s 2014 National Patient Safety Goals Issues ❑ Health care delivery ❑ Economic issues ❑ Nursing/health team ❑ Leadership in nursing practice ❑ Career opportunities ❑ Ethics and values ❑ Ethical obligations and nursing ❑ Nursing code of ethics ❑ Building blocks of ethics ❑ Ethical theories ❑ Ethical decision making ❑ Legal concepts ❑ HIPAA ❑ Nursing liability and the law Cultural Influences ❑ Cultural diversity ❑ Communication ❑ Space ❑ Time orientation ❑ Social organization ❑ Environmental control ❑ Health care providers ❑ Biological variations ❑ Death and dying ❑ Cultural groups ❑ Culturally competent care Alternative/Complementary ❑ Alternative versus complementary therapies ❑ Allopathic/Western medicine ❑ Ayurveda ❑ Chinese medicine ❑ Chiropractic ❑ Homeopathy ❑ Naturopathy ❑ American Indian medicine ❑ Osteopathy ❑ Herbal therapy ❑ Relaxation therapies ❑ Massage therapy ❑ Aquatherapy ❑ Heat and cold ❑ Safety/effectiveness ❑ Role of LPN/LVN unit ONE CHECKLIST FOR LEARNING SUCCESS 4069_Ch01_001-004 24/11/14 3:44 PM Page 1 2 Critical Thinking and the Nursing Process 1 VOCABULARY Define the following terms and use them in sentences. Nursing process Definition: Sentence: Critical thinking Definition: Sentence: Assessment Definition: Sentence: Objective data Definition: Sentence: Subjective data Definition: Sentence: Nursing diagnosis Definition: Sentence: Evaluation Definition: Sentence: Vigilance Definition: Sentence: 4069_Ch01_001-004 24/11/14 3:44 PM Page 2 SUBJECTIVE AND OBJECTIVE DATA Identify the following data as subjective (symptom) or objective (sign). 1. Pain 2. Shortness of breath 3. Edema (swelling) 4. Capillary refill 2 seconds 5. Nausea 6. Vomiting 7. Dizziness 8. Cyanosis 9. Numbness 10. Indigestion 11. Pale 12. Serum potassium 3.6 mEq/L 13. Palpitations (feeling of racing heart) 14. Blood pressure 130/82 mm Hg 15. White blood cell count 7000/mm3 CRITICAL THINKING Sometimes cognitive maps are used to organize thinking. Look at samples in any of the Function and Assessment chapters under Aging Changes. Some of the workbook chapters will ask you to make a cognitive map, so here is an opportunity to practice. Consider a time when you have had a headache or other discomfort. Fill in the spaces with information related to the WHAT’S UP? questions. See Chapter 1 Answers for one patient’s responses. Once you have the questions answered, you could go even further and make links with possible interventions. There is no one right way to make a cognitive map—use your imagination! Chapter 1 Critical Thinking and the Nursing Process 3 Patient's perception Where is it? Useful other data Quality Severity Timing Aggravating and alleviating factors Headache Choose the best answer unless directed otherwise. 1. Which one of the following is a nursing diagnosis? 1. Peptic ulcer 2. Pneumonia 3. Ineffective airway clearance 4. Myocardial infarction 2. Which one of the following is a medical diagnosis? 1. Hiatal hernia 2. Impaired mobility 3. Powerlessness 4. Anxiety 3. An LPN wishes to learn why a patient’s lung sounds have crackles and questions the physician during morning rounds. Which critical thinking attitude is the nurse exhibiting? 1. Intellectual humility 2. Intellectual sense of justice 3. Intellectual empathy 4. Intellectual integrity REVIEW QUESTIONS—CONTENT REVIEW 4069_Ch01_001-004 24/11/14 3:44 PM Page 3 4. The LVN is caring for a patient with diabetes. In what order should the nurse carry out the nursing process? Place all steps in correct sequential order. 1. Implement plan of care 2. Assist with evaluation 3. Collect data 4. Assist with development of nursing diagnoses 5. Assist with planning of outcomes and interventions 5. Which of the following statements best defines critical thinking? 1. Orderly, goal-directed thinking 2. Clear thinking during critical situations 3. Constructive feedback about nursing actions 4. Critica