Medical-Surgical Nursing in Canada: Assessment and Management of Clinical Problems

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Front Cover Brief Contents Title Page Copyright Page Table Of Contents About the Authors Sharon L. Lewis, RN, PhD, FAAN Linda Bucher, RN, PhD, CEN, CNE Margaret McLean Heitkemper, RN, PhD, FAAN Mariann M. Harding, RN, PhD, CNE Maureen A. Barry, RN, MScN Jana Lok, RN, MN, PhD, ENC(C) Jane Tyerman, RN, MScN, PhD Sandra Goldsworthy, RN, MSc, PhD, CNCC(C), CMSN(C) Section Editors for the US 10th Edition Jeffrey Kwong, DNP, MPH, ANP-BC, FAANP Dottie Roberts, RN, EdD, MSN, MACI, RN, OCNS-C, CMSRN, CNE Contributors Reviewers Dedication Preface Organization Classic Features New Features A Word on Terminology A Word on Laboratory Values Learning Supplements for the Student Teaching Supplements for Instructors Acknowledgements Section 1 - Concepts in Nursing Practice 1. Introduction to Medical-Surgical Nursing Practice in Canada Learning Objectives Key Terms The Canadian Health Care Context Complex Health Care Environments Diverse Populations. Determinants of Health. Patient-Centred Care Patient Safety and Quality Improvement. Quality and Safety Education for Nurses (QSEN). The Profession of Nursing in Canada Standards of Practice. Advanced Nursing Practice. Teamwork and Interprofessional Collaboration Interprofessional Teams. Communication Among Health Care Team Members. Delegation and Assignment. Informatics and Technology Nursing Informatics. Electronic Health Records. What Is Medical-Surgical Nursing? Critical Thinking in Nursing Evidence-Informed Practice Steps in the Evidence-Informed Practice Process. Step 1. Step 2. Step 3. Step 4. Step 5. Step 6. Implementation of Evidence-Informed Practice. The Nursing Process Phases of the Nursing Process Interrelatedness of Phases Assessment Phase Data Collection. Diagnosis Phase Data Analysis and Problem Identification. Nursing Diagnosis. Diagnostic Process. Identifying the Problem. Etiology. Signs and Symptoms. Collaborative Problems. Planning Phase Priority Setting. Identifying Outcomes. Determining Interventions. Implementation Phase. Evaluation Phase. Nursing Care Plans Concept Maps Clinical (Critical) Pathways Documentation Charting Future Challenges of Nursing Review Questions References Resources 2. Cultural Competence and Health Equity in Nursing Care Learning Objectives Key Terms The Need for Cultural Competence Health Equity Health Inequities Among Indigenous and Other Marginalized Populations Health Literacy Equity in Nursing Care Culture as a Determinant of Health Exploring the Concepts: Definitions and Meanings Cultural Safety and Cultural Competence “Culture” and Other Related Terms Cultural Competence Affective Domain Behavioural Domain Cross-Cultural Communication. Verbal and Nonverbal Communication. Culturally Competent Care Communication Skills Providing Effective Language Support. Cognitive Domain Generic Cultural Knowledge Care, Cure, Caregivers, and Healing Systems. Culturally Competent Care Clock Time Biology, Physiology, and Pharmacology. Family Roles and Relationships. Spirituality and Religion. Migration and Settlement. Dynamics of Difference Environment and Equity Understanding the Difference Between Equity and Equality Nurse’s Self-Assessment Culturally Competent Patient Assessment Bridging Cultural Distances: The LEARN Model Working in Diverse Teams Conclusion Review Questions References Resources 3. Health History and Physical Examination Learning Objectives Key Terms Data Collection Interviewing Considerations Teamwork and Collaboration Data Organization Culturally Competent Care Assessment Nursing History: Subjective Data Biographical Data Reason for Seeking Care Current Health or History of Current Illness Past Health History Medications. Allergies. Surgery or Other Treatments. Family History Functional Health Assessment Health Perception–Health Management. Nutrition–Metabolic. Elimination. Activity–Exercise. Sleep–Rest. Cognitive–Perceptual. Self-Perception–Self-Concept. Role–Relationship. Sexuality–Reproductive. Coping–Stress Tolerance. Value–Belief. Physical Examination: Objective Data General Survey Physical Examination Techniques. Inspection. Palpation. Percussion. Auscultation. Equipment. Organization of the Examination. Recording Physical Examination. Types of Assessment Comprehensive Assessment Focused Assessment Emergency Assessment Using Assessment Approaches Problem Identification and Nursing Diagnoses Review Questions References 4. Patient and Caregiver Teaching Learning Objectives Key Terms Role of Patient and Caregiver Teaching Teaching–Learning Process Adult Learners Adult Learning Principles. Determinants of Learning. Motivation of Adult Learners. Nurse as Teacher Required Competencies Knowledge of Subject Matter. Communication Skills. Empathy. Challenges to Nurse–Teacher Effectiveness. Caregiver and Holistic Support Process of Patient Teaching Assessment Physical Characteristics. Psychological Characteristics. Sociocultural Characteristics. Socioeconomic Factors. Literacy and Health Literacy. Housing Arrangements and Living Location. Culturally Competent Care Learner Characteristics. Learning Needs. Readiness to Learn. Learning Style. Diagnosis Planning Selecting Teaching Strategies. Patient Workshop. Discussion. Group Teaching. Demonstration–Return Demonstration. Role Play. Use of Audiovisual Materials. Use of the Internet. Use of Printed Materials. Games and Simulation. Implementation Evaluation Continuity of Educational Care Documentation of the Educational Process The Standardized Teaching Plan Review Questions References Resources 5. Chronic Illness Learning Objectives Key Terms The Epidemiology of Chronic Diseases Health, Acute Illness, and Chronic Illness Factors Contributing to Chronic Illness Risk Factors for Chronic Illness Prevention of Chronic Illness The Role of Genetics The Role of Aging Disability in Chronic Illness Psychosocial Dimensions of Chronic Illness Illness Behaviour Self-Efficacy Health-Related Hardiness Mood Disorders Fatigue Stigma Quality of Life Living With Chronic Illness Chronic Illness and Caregiving Conceptual Models of Chronic Illness Illness Trajectory Shifting Perspectives Model of Chronic Illness Self-Management The Emerging Paradigm of Chronic Care Review Questions References Resources 6. Community-Based Nursing and Home Care Learning Objectives Key Terms The History of Home Health Nursing Community Health Nursing Roles A Health Care System Under Pressure Changing Demographics Health Human Resources. Patient Safety. Sustainability of the Health Care System Primary Health Care. Home Care Definition and Importance of Home Care Home Care Services Quality and Accountability in Home Care Funding and Utilization of Home Care Services Home Health Care Team Nursing Roles. Home Health Care Patients Home Health Nursing Practice Overview. Home Health Nursing and Family-Centred Care. Culturally Competent Care Home Health Nursing Practice Home Health Nursing Practice Knowledge and Skills. Trends in Home Health Nursing New Nursing Graduates and Licensed Practical Nurses in Home Health Nursing. Technology in Home Health Nursing Practice Measurement of Nursing-Sensitive Outcomes Summary Review Questions References Resources 7. Older Adults Learning Objectives Key Terms Demographics of Aging Attitudes Toward Aging Biological Theories of Aging Free Radical Theory Cross-Link Theory Immunological Theory Age-Related Physiological Changes Older Populations at High Risk Older Women Older Adults With Cognitive Impairments Older Adults Living in Rural Settings Older Adults Who Are Homeless Frail Older Adults Older Adults With Chronic Illness Socially Isolated Older Adults Culturally Competent Care Older Adults Social Support and the Older Adult Caregivers Elder Mistreatment and Abuse Universal Health Care Care Alternatives for Older Adults Independent Living Options Community-Based Care for Older Adults Adult Day Care Programs. Home Health Care. Long-Term Care Facilities Legal and Ethical Issues Nursing Management Older Adults Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Teaching Older Adults. Acute Care Settings. Geriatric Rehabilitation. Assistive Devices. Safety. Medication Use. Depression. Sleep. Behavioural Management. Use of Restraints. Evaluation. Review Questions References Resources 8. Stress and Stress Management Learning Objectives Key Terms Definition of Stress Work-Related Stress Theories of Stress General Adaptation Syndrome Factors Affecting Response to Stress Physiological Response to Stress Nervous System Cerebral Cortex. Limbic System. Reticular Formation. Hypothalamus. Endocrine System Summary of Neuroendocrine System Stress Response Immune System Effects of Stress on Health Coping Relaxation Strategies Relaxation Breathing Meditation Imagery Music for Relaxation Muscle Relaxation Nursing Management Stress Nursing Assessment Demands. Human Responses to Stress. Coping. Nursing Implementation Review Questions References Resources 9. Sleep and Sleep Disorders Learning Objectives Key Terms Sleep Physiological Sleep Mechanisms Sleep–Wake Cycle Wake Behaviour. Sleep Behaviour. Circadian Rhythms Sleep Architecture Non–Rapid Eye Movement Sleep. Rapid Eye Movement Sleep. Effects of Sleep Deprivation Sleep Disturbances in the Hospital Sleep Disorders Insomnia Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Self-Report. Actigraphy. Polysomnography. Collaborative Care Cognitive–Behavioural Therapies. Drug Therapy. Benzodiazepines. Benzodiazepine Receptor–like Agents. Antidepressants. Antihistamines. Complementary and Alternative Therapies. Herbal Supplements. Acupuncture. Other Therapeutic Sleep Aids. Nursing Management Insomnia Nursing Assessment Nursing Diagnoses Nursing Implementation Narcolepsy Etiology and Pathophysiology Diagnostic Studies Collaborative Care Drug Therapy. Behavioural Therapy. Circadian Rhythm Sleep–Wake Disorders Sleep-Disordered Breathing Obstructive Sleep Apnea Clinical Manifestations and Diagnostic Studies Nursing and Collaborative Management Sleep Apnea Surgical Interventions Special Concerns for Hospitalization With Obstructive Sleep Apnea Sleep Movement Disorders Parasomnias Rapid Eye Movement Parasomnias. Non–Rapid Eye Movement Parasomnias. Age-Related Considerations Sleep Special Sleep Needs of Nurses Review Questions References Resources 10. Pain Learning Objectives Key Terms Pain Magnitude of the Pain Problem Definitions of Pain Dimensions of Pain and the Pain Process Physiological Dimension of Pain Transduction. Transmission. Transmission to the Spinal Cord. Dorsal Horn Processing. Transmission to the Thalamus and the Cortex. Perception. Modulation. Sensory-Discriminative, Motivational–Affective, Behavioural, Cognitive–Evaluative, and Sociocultural Dimensions of Pain Causes and Types of Pain Nociceptive Pain Neuropathic Pain Pain Assessment Sensory-Discriminative Component Pattern of Pain. Area of Pain. Intensity of Pain. Nature of Pain. Motivational–Affective, Behavioural, Cognitive–Evaluative, and Sociocultural Components Advances in Pain Assessment Research Pain Treatment Basic Principles Drug Therapy for Pain Equianalgesic Dose. Scheduling Analgesics. Titration. Analgesic Ladder. Drug Therapy for Mild Pain. Drug Therapy for Mild to Moderate Pain. Drug Therapy for Moderate to Severe Pain. Adjuvant Analgesic Therapy. Antidepressants. Antiseizure Drugs. Corticosteroids. Local Anaesthetics. Administration Routes. Oral. Sublingual and Buccal. Intranasal. Rectal. Transdermal. Parenteral Routes. Intraspinal Delivery. Patient-Controlled Analgesia. Surgical Therapy for Pain Nerve Blocks. Interventional Therapy Therapeutic Nerve Blocks. Neuroablative Techniques. Neuroaugmentation. Nonpharmacological Therapy for Pain Physical Pain Relief Strategies Massage. Exercise. Transcutaneous Electrical Nerve Stimulation. Application of Heat. Application of Cold. Cognitive Techniques. Distraction. Relaxation Strategies. Self-Management. Nursing and Collaborative Management Pain Effective Communication Barriers to Effective Pain Management Tolerance. Physical Dependence. Addiction. Institutionalizing Pain Education and Management Ethical Issues in Pain Management Fear of Hastening Death by Administering Analgesics Use of Placebos in Pain Assessment and Treatment Age-Related Considerations Pain Special Populations Cognitively Impaired Individuals Patients With Substance use Problems Review Questions References Resources 11. Substance Use Learning Objectives Key Terms Substance Use in Canada Substance Use From a Continuum of Use Perspective Neurophysiology of Substances of Abuse Attitudes Toward People Experiencing Substance-Related Problems The Harm-Reduction Perspective Health Complications of Substance Use Nursing Management Substance Use Assessment Nursing Diagnoses Planning Nursing Implementation Urgent Care Situations. Overdose. Withdrawal. Perioperative Care. Acute Pain Management Considerations. Stimulants and Stimulant Withdrawal Nicotine Characteristics Physiological Effects of Use Health Complications Collaborative Care: Nursing Interventions for Tobacco Use Disorder Tobacco Use Cessation. Nicotine Replacement Therapy and Pharmacotherapeutic Interventions for Nicotine Dependence. Cocaine and Other Stimulants Characteristics Effects of Use Withdrawal Complications Collaborative Care Caffeine Characteristics Effects of Use Complications Collaborative Care Depressants Alcohol Characteristics Effects of Use Alcohol Intoxication Acute Alcohol Intoxication. Alcohol Withdrawal Complications Complications Associated With Chronic Alcoholism. Collaborative Care Sedative–Hypnotics Characteristics Effects of Use Complications Withdrawal From Sedative–Hypnotics. Collaborative Care Opioids Characteristics Effects of Use Opioid Overdose Opioid Withdrawal Complications Collaborative Care Withdrawal Management. Methadone. Buprenorphine. Maintenance. Hallucinogens Characteristics Effects of Use Collaborative Care Inhalants Nursing Management Addictive Behaviours Nursing Assessment and Screening Nursing Diagnoses Planning Nursing Implementation Health Promotion. Motivational Interviewing: Engaging in a Supportive Dialogue With People With Problematic Substance Use. Age-Related Considerations Review Questions References Resources 12. Complementary and Alternative Therapies Learning Objectives Key Terms Alternative Medical Systems Traditional Chinese Medicine Acupuncture. Acupressure. Mind–Body Medicines Natural Products Herbal Therapies Clinical Applications of Herbal Therapy. Manipulative and Body-Based Practices Massage Therapy Clinical Applications of Massage Therapy. Massage Techniques. Hand-Mediated Biofield Energies Therapeutic Touch. Clinical Applications of Therapeutic Touch. Healing Touch. Clinical Applications of Healing Touch. Other Complementary and Alternative Medicine Practices Spiritual Therapies Prayer. Forms of Prayer. Clinical Applications of Prayer. Age-Related Considerations Complementary and Alternative Therapies Nursing Management Complementary and Alternative Therapies Assessment Serving as a Resource and Promoting Safety Providing Holistic Self-Care and Holistic Nursing Practice Serving as a Provider Participating in Research Review Questions References Resources 13. Palliative Care at the End of Life Learning Objectives Key Terms Hospice Palliative Care Integrated Hospice Palliative Care Approach End-of-Life Care Death Physical Manifestations of the End of Life Psychosocial Manifestations of the End of Life Grief and Bereavement Spiritual Needs Culturally Competent Care At the End of Life Legal and Ethical Issues Affecting End-of-Life Care Advance Care Planning and Advance Directives Resuscitation Physician-Assisted Dying Palliative Sedation Organ and Tissue Donation Nursing Management End of Life Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Psychosocial Care. Anxiety and Depression. Anger. Hopelessness and Powerlessness. Fear. Fear of Pain. Fear of Shortness of Breath. Fear of Loneliness and Abandonment. Fear of Meaninglessness. Communication. Physical Care. Postmortem Care. Special Needs of Caregivers in End-of-Life Care Special Needs of Family Caregivers Special Needs of Nurses Review Questions References Resources Section 2 - Pathophysiological Mechanisms of Disease 14. Inflammation and Wound Healing Learning Objectives Key Terms Cell Injury Cell Adaptation to Sublethal Injury Hypertrophy. Hyperplasia. Atrophy. Metaplasia. Dysplasia. Anaplasia. Causes of Lethal Cell Injury Cell Apoptosis and Necrosis Defence Against Injury Mononuclear Phagocyte System Inflammatory Response Vascular Response. Cellular Response. Neutrophils. Monocytes. Lymphocytes. Eosinophils and Basophils. Chemical Mediators. Complement System. Prostaglandins and Leukotrienes. Exudate Formation. Clinical Manifestations. Fever. Types of Inflammation. Healing Process. Regeneration. Repair. Primary Intention. Initial (Inflammatory) Phase. Granulation (Proliferative/Reconstructive) Phase. Maturation Phase and Scar Contraction. Secondary Intention. Tertiary Intention. Wound Classification. Delay of Healing. Complications of Healing. Adhesions. Contractures. Dehiscence and Evisceration. Excess Granulation Tissue. Fistula Formation. Infection. Hemorrhage. Formation of Hypertrophic Scars and Keloids. Nursing Management Inflammation and Healing Nursing Implementation Health Promotion. Acute Intervention Observation and Vital Signs. Fever. RICE. Rest. Ice and Heat. Compression and Immobilization. Elevation. Wound Management. Red Wound. Yellow Wound. Black Wound. Negative-Pressure Wound Therapy. Hyperbaric Oxygen Therapy. Electrical Stimulation. Psychological Implications. Ambulatory and Home Care. Pressure Injuries Causes and Pathophysiological Features Clinical Manifestations Nursing and Collaborative Management Pressure Injuries Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Measuring the Wound. Documentation. Wound Irrigation. Local Wound Care. Ambulatory and Home Care. Evaluation Review Questions References Resources 15. Genetics Learning Objectives Key Terms Human Genome Project Basic Principles of Genetics Chromosomes, Genes, and DNA How Proteins Are Made Primary Categories of Genetic Conditions Single-Gene Disorders Autosomal Dominant. Autosomal Recessive. X-Linked. Chromosomal Disorders Multifactorial Inheritance Genetics in Clinical Practice Taking a Family History Genetic Testing Prenatal Diagnosis and Screening. Amniocentesis. Chorionic Villus Sampling. Screening for Carriers of Genetic Disease. Presymptomatic and Predisposition Testing. Genetic Counselling Gene Therapy Methods of Gene Delivery. Examples of Gene Therapy for Cancer. Gene Editing: Using the CRISPR-Cas9 System in Gene Therapy. Nursing Management Genetics Review Questions References Resources 16. Altered Immune Response and Transplantation Learning Objectives Key Terms Normal Immune Response Antigens Types of Immunity Innate Immunity. Acquired Immunity. Active Acquired Immunity. Passive Acquired Immunity. Lymphoid Organs Cells Involved in Immune Response Mononuclear Phagocytes. Lymphocytes. B Lymphocytes. T Lymphocytes. T Cytotoxic Cells. T Helper Cells. Natural Killer Cells. Dendritic Cells. Cytokines Comparison of Humoral and Cell-Mediated Immunity Humoral Immunity. Cell-Mediated Immunity. Age-Related Considerations Effects of Aging on the Immune System Altered Immune Response Hypersensitivity Reactions Type I: IgE-Mediated Reactions. Anaphylaxis. Atopic Reactions. Type II: Cytotoxic and Cytolytic Reactions. Hemolytic Transfusion Reactions. Goodpasture’s Syndrome. Type III: Immune-Complex Reactions. Type IV: Delayed Hypersensitivity Reactions. Contact Dermatitis. Microbial Hypersensitivity Reactions. Allergic Disorders Assessment Health History. Physical Examination. Diagnostic Studies Skin Tests. Procedure. Results. Precautions. Collaborative Care Anaphylaxis. Chronic Allergies. Allergen Recognition and Control. Drug Therapy. Antihistamines. Sympathomimetic or Decongestant Drugs. Corticosteroids. Antipruritic Drugs. Mast Cell–Stabilizing Drugs. Leukotriene Receptor Antagonists. Immunotherapy. Mechanism of Action. Method of Administration. Subcutaneous Immunotherapy. Sublingual Immunotherapy. Nursing Management Immunotherapy Latex Allergies Types of Latex Allergies. Latex-Food Syndrome. Nursing and Collaborative Management Latex Allergies Multiple Chemical Sensitivities Autoimmunity Autoimmune Diseases Apheresis Plasmapheresis. Immunodeficiency Disorders Primary Immunodeficiency Disorders Secondary Immunodeficiency Disorders Human Leukocyte Antigen System Human Leukocyte Antigen and Disease Associations. Organ Transplantation Tissue Typing HLA Typing. Panel of Reactive Antibodies. Crossmatch. Transplant Rejection Hyperacute Rejection. Acute Rejection. Chronic Rejection. Immuno-Suppressive Therapy Calcineurin Inhibitors Mycophenolate Mofetil (CellCept) Sirolimus (Rapamune) Monoclonal Antibodies Polyclonal Antibodies Graft-Versus-Host Disease Alternative Strategies Transplantation of Organs From Deceased Donor Xenotransplantation Ex Vivo Transplantation Stem Cell Transplantation New Technologies in Immunology Hybridoma Technology: Monoclonal Antibodies Review Questions References Resources 17. Infection and Human Immunodeficiency Virus Infection Learning Objectives Key Terms Infections Causes of Infections Emerging Infections Re-Emerging Infections Resistant Organisms Health Care–Associated Infections Age-Related Considerations Infection in Older Adults Infection Prevention and Control Infection Precautions Preventing Occupational Infections in Health Care Workers Human Immunodeficiency Virus Infection Significance of the Problem Transmission of Human Immunodeficiency Virus Sexual Transmission Contact With Blood and Blood Products Perinatal Transmission Pathophysiology Clinical Manifestations and Complications Acute Infection Chronic Infection Early Chronic Infection. Intermediate Chronic Infection. Late Chronic Infection or Acquired Immune Deficiency Syndrome. Diagnostic Studies Diagnosis of Human Immunodeficiency Virus Infection Laboratory Studies in Human Immunodeficiency Virus Infection Collaborative Care Drug Therapy for Human Immunodeficiency Virus Infection Preventing Transmission of Human Immunodeficiency Virus Drug Therapy for Opportunistic Diseases Vaccination Nursing Management Human Immunodeficiency Virus Infection Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Prevention of Human Immunodeficiency Virus Infection. Decreasing Risks Related to Sexual Intercourse. Decreasing Risks Related to Substance Misuse. Decreasing Risks of Perinatal Transmission. Decreasing Risks at Work. Human Immunodeficiency Virus Testing and Counselling. Acute Intervention Early Intervention. Initial Response to a Diagnosis of Human Immunodeficiency Virus Infection. Antiretroviral Therapy. When to Start Antiretroviral Therapy. Adherence. Health Promotion. Acute Exacerbations. Ongoing Care. Disease and Drug Adverse Effects. End-of-Life Care. Evaluation Review Questions References Resources 18. Cancer Learning Objectives Key Terms Definition and Incidence Progress Made in Cancer Prevention: Modifiable Risk Factors Biological Processes of Cancer Defects in Cellular Proliferation Defects in Cellular Differentiation Development of Cancer Initiation. Chemical Carcinogens. Radiation. Viral and Bacterial Carcinogens. Genetic Susceptibility. Promotion. Progression. Role of the Immune System Mechanisms of Escape From Immunological Surveillance. Oncofetal Antigens. Classification of Cancer Anatomical Site Classification Histological Analysis Classification Classifying Extent of Disease Clinical Staging. TNM Classification System. Prevention and Detection of Cancer Diagnosis of Cancer Biopsy. Collaborative Care Goals and Modalities Clinical Trials Surgical Therapy Cure and Control Supportive and Palliative Surgical Procedures Rehabilitative Management Chemotherapy Effect on Cells Classification of Chemotherapeutic Drugs Preparation and Administration of Chemotherapeutic Agents Methods of Administration Infusion Pumps. Regional Administration of Chemotherapeutic Agents. Intra-Arterial Chemotherapy. Intraperitoneal Chemotherapy. Intrathecal or Intraventricular Chemotherapy. Intravesical Bladder Chemotherapy. Effects of Chemotherapy on Normal Tissues Treatment Plan Radiation Therapy Effects of Radiation Cellular Death and Tissue Reactions. Simulation and Treatment External Radiation. Internal Radiation. Measurement of Radiation Goals of Radiation Therapy Nursing Management Radiation Therapy and Chemotherapy Nursing Implementation Fatigue. Anorexia. Bone Marrow Suppression. Skin Reactions. Oral, Oropharyngeal, and Esophageal Reactions. Pulmonary Effects. Gastro-intestinal Effects. Reproductive Effects. Late Effects of Radiation Treatment and Chemotherapy Biological and Targeted Therapy Hematopoietic Growth Factors Colony-Stimulating Factors. Erythropoietin. Toxic and Adverse Effects of Biological Agents Nursing Management Biological Therapy Bone Marrow and Stem Cell Transplantation Types of Bone Marrow Transplants Procedures Harvest Procedures. Preparative Regimens. Complications. Peripheral Stem Cell Transplantation Cord Blood Stem Cells Gene Therapy Complications Resulting From Cancer Nutritional Problems Malnutrition. Altered Taste Sensation. Infection Oncological Emergencies Obstructive Emergencies. Superior Vena Cava Syndrome. Spinal Cord Compression. Third Space Syndrome. Intestinal Obstruction. Metabolic Emergencies. Syndrome of Inappropriate Antidiuretic Hormone. Hypercalcemia. Tumour Lysis Syndrome. Septic Shock and Disseminated Intravascular Coagulation. Infiltrative Emergencies. Cardiac Tamponade. Carotid Artery Rupture. Management of Cancer Pain Psychosocial Care Age-Related Considerations Cancer Review Questions References Resources 19. Fluid, Electrolyte, and Acid–Base Imbalances Learning Objectives Key Terms Homeostasis Water Content of the Body Body Fluid Compartments Calculation of Fluid Gain or Loss Electrolytes Measurement of Electrolytes Electrolyte Composition of Fluid Compartments Mechanisms Controlling Fluid and Electrolyte Movement Diffusion Facilitated Diffusion Active Transport Osmosis Measurement of Osmolality. Osmotic Movement of Fluids. Hydrostatic Pressure Oncotic Pressure Fluid Movement in Capillaries Fluid Shifts Shifts of Plasma to Interstitial Fluid. Elevation of Venous Hydrostatic Pressure. Decrease in Plasma Oncotic Pressure. Elevation of Interstitial Oncotic Pressure. Shifts of Interstitial Fluid to Plasma. Fluid Movement Between Extracellular Fluid and Intracellular Fluid Fluid Spacing Regulation of Water Balance Hypothalamic Regulation Pituitary Regulation Adrenal Cortical Regulation Renal Regulation Cardiac Regulation Gastro-intestinal Regulation Insensible Water Loss Age-Related Considerations Fluid and Electrolytes Fluid and Electrolyte Imbalances Sodium and Extracellular Fluid Volume Imbalances Hypernatremia. Collaborative Care. Hyponatremia. Collaborative Care. Extracellular Fluid Volume Imbalances. Collaborative Care. Nursing Management Sodium and Volume Imbalances Nursing Diagnoses Nursing Implementation Intake and Output. Cardiovascular Changes. Respiratory Changes. Neurological Changes. Daily Weight Measurements. Skin Assessment and Care. Other Nursing Measures. Potassium Imbalances Hyperkalemia. Clinical Manifestations. Nursing and Collaborative Management Hyperkalemia Nursing Diagnoses Nursing Implementation Hypokalemia. Clinical Manifestations. Nursing and Collaborative Management Hypokalemia Nursing Diagnoses Nursing Implementation. Calcium Imbalances Hypercalcemia. Nursing and Collaborative Management Hypercalcemia Nursing Diagnoses Nursing Implementation Hypocalcemia. Nursing and Collaborative Management Hypocalcemia Nursing Diagnoses Nursing Implementation Phosphate Imbalances Hyperphosphatemia. Hypophosphatemia. Magnesium Imbalances Hypermagnesemia. Hypomagnesemia. Protein Imbalances Acid–Base Imbalances pH and Hydrogen Ion Concentration. Acid–Base Regulation. Buffer System. Respiratory System. Renal System. Alterations in Acid–Base Balance. Respiratory Acidosis. Respiratory Alkalosis. Metabolic Acidosis. Metabolic Alkalosis. Mixed Acid–Base Disorders. Clinical Manifestations. Blood Gas Values Assessment of Fluid, Electrolyte, and Acid–Base Imbalances Subjective Data Important Health Information Past Health History. Medications. Surgery or Other Treatments. Other Subjective Data. Objective Data Physical Examination. Laboratory Values. Oral Fluid and Electrolyte Replacement Intravenous Fluid and Electrolyte Replacement Solutions Hypotonic. Isotonic. Hypertonic. Intravenous Additives. Plasma Expanders. Central Venous Access Devices Centrally Inserted Catheters Peripherally Inserted Central Catheters Implanted Infusion Ports Complications Nursing Management Central Venous Access Devices Removal of Central Venous Access Devices Review Questions References Resources Section 3 - Perioperative Care 20. Nursing Management: Preoperative Care Learning Objectives Key Terms Surgical Settings Surgical Wait Times Elective Inpatient Surgery Ambulatory Surgery. Preoperative Admission Assessment Day-of-Surgery Assessment Subjective Data Psychosocial Assessment. Anxiety. Common Fears. Coping With Surgery. Health History. Medications. Allergies. Review of Systems. Nervous System. Cardiovascular System. Respiratory System. Urinary System. Integumentary System. Musculo-Skeletal System. Endocrine System. Immune System. Fluid and Electrolyte Status. Nutritional Status. Nursing Assessment: Patient About to Undergo Surgery. Objective Data Physical Examination. Laboratory and Diagnostic Testing. Nursing Management Patient About to Undergo Surgery Preoperative Education General Surgery Information. Ambulatory Surgery Information. Legal Preparation for Surgery Consent for Surgery. Voluntary Consent. Capacity to Consent. Life-Threatening Situations. Properly Informing the Patient. Day-of-Surgery Preparation Nursing Role Preoperative Medications. Transportation to the Operating Room Culturally Competent Care Patient About to Undergo Surgery Age-Related Considerations Older-Adult Patient About to Undergo Surgery Review Questions References Resources 21. Nursing Management: Intraoperative Care Learning Objectives Key Terms Physical Environment Department Layout Preoperative Holding Area Operating Room Surgical Team Registered Nurse Circulating Role. Practical Nurse Scrub Role. Surgeon and Assistant Registered Nurse First Assistant Anaesthesiologist Advanced Nursing Practice Roles Registered Nurse Anaesthesia Assistant. Nursing Management Patient Before Surgery Psychosocial Assessment Physical Assessment Chart Review Admitting the Patient Nursing Management Intraoperative Care Room Preparation Transferring the Patient. Scrubbing, Gowning, and Gloving. Basic Aseptic Technique Assisting the Anaesthesiologist Positioning the Patient Preparing the Surgical Site Safety Considerations Classification of Anaesthesia General Anaesthesia Intravenous Induction Agents. IV Drugs and General Anaesthesia. Opioids. Benzodiazepines. Neuro-Muscular Blocking Drugs. Antiemetics. Local Anaesthesia Methods of Administration. Spinal and Epidural Anaesthesia (Neuraxial Blocks). Procedural (Conscious) Sedation Patient After Surgery Age-Related Considerations Patient During Surgery Exceptional Clinical Events in the Operating Room Anaphylactic Reactions Malignant Hyperthermia Major Blood Loss New and Future Considerations Review Questions References Resources 22. Nursing Management: Postoperative Care Learning Objectives Key Terms Postoperative Care in the Postanaesthesia Care Unit Postanaesthesia Care Unit Admission Postanaesthesia Care Unit Progression Initial Assessment Potential Alterations in Respiratory Function Etiology Postanaesthesia Care Unit. Clinical Unit. Nursing Management Respiratory Complications Nursing Assessment Nursing Diagnoses Nursing Implementation Postanaesthesia Care Unit. Clinical Unit. Potential Alterations in Cardiovascular Function Etiology Postanaesthesia Care Unit. Clinical Unit. Nursing Management Cardiovascular Problems Nursing Assessment Nursing Diagnoses Nursing Implementation Postanaesthesia Care Unit. Clinical Unit. Potential Alterations in Neurological Function Etiology Postanaesthesia Care Unit. Nursing Management Neurological Complications Nursing Assessment Nursing Diagnoses Nursing Implementation Postanaesthesia Care Unit. Clinical Unit. Pain and Discomfort Etiology Postanaesthesia Care Unit. Clinical Unit. Nursing Management Pain Nursing Assessment Postanaesthesia Care Unit. Clinical Unit. Nursing Diagnoses Nursing Implementation Postanaesthesia Care Unit. Clinical Unit. Potential Alterations in Temperature Etiology Postanaesthesia Care Unit. Clinical Unit. Nursing Management Potential Temperature Complications Nursing Assessment Nursing Diagnoses Nursing Implementation Postanaesthesia Care Unit. Clinical Unit. Potential Gastro-Intestinal Problems Etiology Postanaesthesia Care Unit. Clinical Unit. Nursing Management Gastro-Intestinal Problems Nursing Assessment Nausea and Vomiting. Ileus Postoperative Ileus. Paralytic Ileus. Nursing Diagnoses Nursing Implementation Postanaesthesia Care Unit. Clinical Unit. Potential Alterations in Urinary Function Etiology Low Urine Output. Nursing Management Potential Urinary Problems Nursing Assessment Nursing Diagnoses Nursing Implementation Potential Alterations in the Integument Etiology Nursing Management Surgical Wounds Nursing Assessment Nursing Diagnoses Nursing Implementation Potential Alterations in Psychological Function Etiology Nursing Management Psychological Function Nursing Diagnoses Nursing Implementation Discharge From the Postanaesthesia Care Unit Care of the Postoperative Patient on the Clinical Unit Planning for Discharge and Follow-Up Care Ambulatory and Inpatient Surgery Discharge Ambulatory Surgery Discharge. Discharge From the Clinical Unit. Age-Related Considerations Patient After Surgery Review Questions References Resources Section 4 - Problems Related to Altered Sensory Input 23. Nursing Assessment: Visual and Auditory Systems Learning Objectives Key Terms The Visual System Structures and Functions Structures and Functions of Vision Eyeball. Refractive Media. Refractive Errors. Visual Pathways. External Structures and Functions Eyebrows, Eyelids, and Eyelashes. Internal Structures and Functions Age-Related Considerations The Visual System Assessment Subjective Data Past Health History. Medications. Surgery or Other Treatments. Self-Care History. Social and Occupational Health History. Coping Abilities. Objective Data Physical Examination. Assessing Functional Status Visual Acuity. Extraocular Muscle Functions. Pupil Function. Assessing Structures. Eyebrows, Eyelashes, and Eyelids. Conjunctiva and Sclera. Cornea. Iris. Retina and Optic Nerve. Focused Assessment. Special Assessment Techniques Colour Vision. Stereopsis. Intraocular Pressure. Diagnostic Studies The Auditory System Structures and Functions External Ear Middle Ear Inner Ear Transmission of Sound and Implications for Hearing Loss Age-Related Considerations The Auditory System Assessment Subjective Data Important Health History Current Health of Auditory System. Past Health History. Medications. Surgery or Other Treatments. Nutrition and Elimination. Activities of Daily Living and Exercise. Self-Care History. Coping Abilities. Objective Data Physical Examination. External Ear. External Auditory Canal and Tympanum. Focused Assessment. Diagnostic Studies Tests for Hearing Acuity Tuning-Fork Tests. Audiometry. Screening Audiometry. Pure-Tone Audiometry. Specialized Tests Test for Vestibular Function Review Questions References Resources 24. Nursing Management: Visual and Auditory Problems Learning Objectives Key Terms Visual Problems Correctable Refractive Errors Nonsurgical Corrections Corrective Glasses. Contact Lenses. Surgical Therapy Laser Surgery. Implantation. Uncorrectable Visual Impairment Levels of Visual Impairment Nursing Management Visual Impairment Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Optical Devices for Vision Enhancement. Nonoptical Methods for Vision Enhancement. Evaluation Age-Related Considerations Visual Impairment Eye Trauma Extraocular Disorders Inflammation and Infection Hordeolum. Chalazion. Blepharitis. Conjunctivitis. Bacterial Infections. Viral Infections. Chlamydial Infections. Allergic Conjunctivitis. Keratitis. Bacterial Infections. Viral Infections. Other Causes of Keratitis. Corneal Ulcer. Nursing Management Inflammation and Infection Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Evaluation Dry Eye Disorders Strabismus Corneal Disorders Corneal Scars and Opacities Keratoconus Intraocular Disorders Cataract Causes and Pathophysiological Processes. Clinical Manifestations. Diagnostic Studies. Collaborative Care. Nonsurgical Therapy. Surgical Therapy. Preoperative Phase. Intraoperative Phase. Postoperative Phase. Nursing Management Cataracts Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Evaluation Age-Related Considerations Retinopathy Retinal Detachment Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Collaborative Care Surgical Therapy Laser Photocoagulation and Cryopexy. Scleral Buckling. Intraocular Procedures. Postoperative Considerations in Scleral Buckling and Intraocular Procedures. Age-Related Macular Degeneration Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Collaborative Care Glaucoma Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Collaborative Care Chronic Open-Angle Glaucoma. Acute Angle-Closure Glaucoma. Nursing Management Glaucoma Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Evaluation Age-Related Considerations Intraocular Inflammation and Infection Enucleation Ocular Tumours Ocular Manifestations of Systemic Diseases Auditory Problems External Ear and Canal Trauma External Otitis Causes. Clinical Manifestations and Complications. Nursing and Collaborative Management External Otitis Cerumen and Foreign Bodies in the External Ear Canal Malignancy of the External Ear Middle Ear and Mastoid Acute Otitis Media Otitis Media With Effusion Chronic Otitis Media and Mastoiditis Etiology and Pathophysiology. Clinical Manifestations. Complications. Diagnostic Studies. Collaborative Care. Surgical Therapy. Nursing Management Chronic Otitis Media After Tympanoplasty Otosclerosis Collaborative Care. Nursing Management Otosclerosis Inner Ear Problems Ménière’s Disease Nursing and Collaborative Management Ménière’s Disease Benign Paroxysmal Positional Vertigo Acoustic Neuroma Hearing Loss and Deafness Types of Hearing Loss Conductive Hearing Loss. Sensorineural Hearing Loss. Mixed Hearing Loss. Central and Functional Hearing Loss. Classification of Hearing Loss. Clinical Manifestations. Nursing and Collaborative Management Hearing Loss and Deafness Health Promotion Environmental Noise Control. Immunizations. Ototoxic Substances. Assistive Devices and Techniques Hearing Aids. Speech Reading. Sign Language. Cochlear Implant. Assisted Listening Devices. Age-Related Considerations Hearing Loss Review Questions References Resources 25. Nursing Assessment: Integumentary System Learning Objectives Key Terms Structures and Functions of the Skin and Appendages Structures Epidermis. Dermis. Subcutaneous Tissue. Skin Appendages. Functions of the Integumentary System Age-Related Considerations Effects of Aging on the Integumentary System Assessment of the Integumentary System Subjective Data Past Medical History. Medications. Surgery or Other Treatments. Family History. Self-Care History. Nutritional History. Social, Environmental, and Occupational Health History. Cognitive–Perceptual. Coping Abilities. Objective Data Physical Examination. Inspection. Palpation. Assessment of Dark Skin Colour Diagnostic Studies of the Integumentary System Review Questions References 26. Nursing Management: Integumentary Problems Learning Objectives Key Terms Health Promotion Environmental Hazards Sun Exposure. Cold Exposure. Irritants and Allergens. Radiation. Rest and Sleep Exercise Hygiene Nutrition Self-Treatment Malignant Skin Neoplasms Risk Factors Nonmelanoma Skin Cancers Actinic Keratosis Basal Cell Carcinoma Squamous Cell Carcinoma Malignant Melanoma Clinical Manifestations Collaborative Care Atypical/Dysplastic Nevus Skin Infections and Infestations Bacterial Infections Viral Infections Fungal Infections Infestations and Insect Bites Allergic Dermatological Problems Benign Dermatological Problems Collaborative Care: Dermatological Problems Diagnostic Studies Collaborative Care Phototherapy. Radiation Therapy. Laser Technology. Drug Therapy. Antibiotics. Corticosteroids. Antihistamines. Topical Fluorouracil. Immuno-Modulators. Diagnostic and Surgical Therapy Skin Scraping. Electrodesiccation and Electrocoagulation. Curettage. Punch Biopsy. Cryosurgery. Excision. Nursing Management Dermatological Problems Ambulatory and Home Care Wet Dressings. Baths. Topical Medications. Control of Pruritus. Prevention of Spread. Prevention of Secondary Infections. Specific Skin Care. Psychological Effects of Chronic Dermatological Problems Physiological Effects of Chronic Dermatological Problems Cosmetic Procedures Body Art and Tattoos Elective Surgery Laser Surgery. Facelift. Liposuction. Nursing Management Cosmetic Surgery Preoperative Management Postoperative Management Skin Grafts Uses Types Review Questions References Resources 27. Nursing Management: Burns Learning Objectives Key Terms Types of Burn Injury Thermal Burns Chemical Burns Smoke and Inhalation Injury Electrical Burns Cold Thermal Injury Classification of Burn Injury Depth of Burn Extent of Burn Location of Burn Patient Risk Factors Phases of Burn Management Prehospital Care Emergent Phase Pathophysiological Changes Fluid and Electrolyte Shifts. Inflammation and Healing. Immunological Changes. Clinical Manifestations Complications Cardiovascular System. Respiratory System. Upper Airway Injury. Lower Airway Injury. Other Cardiopulmonary Problems. Urinary System. Nursing and Collaborative Management Emergent Phase Airway Management Fluid Therapy Wound Care Other Care Measures Drug Therapy Analgesics and Sedatives. Tetanus Immunization. Antimicrobial Agents. Venous Thrombo-Embolism Prophylaxis. Nutritional Therapy Acute Phase Pathophysiological Changes Clinical Manifestations Laboratory Values Sodium. Potassium. Complications Infection. Cardiovascular and Respiratory Systems. Neurological System. Musculo-Skeletal System. Gastro-Intestinal System. Endocrine System. Nursing and Collaborative Management Acute Phase Wound Care Excision and Grafting Cultured Epithelial Autografts. Artificial Skin. Pain Management Physiotherapy and Occupational Therapy Nutritional Therapy Psychosocial Care Rehabilitation Phase Pathophysiological Changes and Clinical Manifestations Complications Nursing and Collaborative Management Rehabilitation Phase Age-Related Considerations Burns Emotional Needs of the Patient and Caregivers Special Needs of the Nursing Staff Review Questions References Resources Section 5 - Problems of Oxygenation: Ventilation 28. Nursing Assessment: Respiratory System Learning Objectives Key Terms Structures and Functions of the Respiratory System Upper Respiratory Tract Lower Respiratory Tract Surfactant. Blood Supply. Chest Wall Physiology of Respiration Ventilation. Elastic Recoil and Compliance. Diffusion. Oxygen–Hemoglobin Dissociation Curve. Arterial Blood Gases. Mixed Venous Blood Gases. Oximetry. Oxygen Delivery. Control of Respiration Chemoreceptors. Mechanical Receptors. Respiratory Defence Mechanisms Filtration of Air. Mucociliary Clearance System. Cough Reflex. Reflex Bronchoconstriction. Alveolar Macrophages. Age-Related Considerations Effects of Aging on the Respiratory System Assessment of the Respiratory System Subjective Data Important Health Information Past Health History. Medications. Surgery or Other Treatments. Current Health History. Objective Data Physical Examination. Nose. Mouth and Pharynx. Neck. Thorax and Lungs. Inspection. Palpation. Percussion. Auscultation. Diagnostic Studies of the Respiratory System Blood Studies Oximetry Sputum Studies Skin Tests Tuberculin Skin Testing. Radiological Studies Chest Radiography. Computed Tomography. Magnetic Resonance Imaging. Ventilation–Perfusion Scan. Pulmonary Angiography. Positron Emission Tomography. Endoscopic Examinations Bronchoscopy. Mediastinoscopy. Lung Biopsy Thoracentesis Pulmonary Function Tests Exercise Testing Review Questions References Resources 29. Nursing Management: Upper Respiratory Problems Learning Objectives Key Terms Structural and Traumatic Disorders of the Nose Deviated Septum Nasal Fracture Rhinoplasty Collaborative Care Nursing Management Nasal Surgery Epistaxis Nursing and Collaborative Management Epistaxis Inflammation and Infection of the Nose and Paranasal Sinuses Allergic Rhinitis Clinical Manifestations Nursing and Collaborative Management Allergic Rhinitis Acute Viral Rhinitis Nursing and Collaborative Management Acute Viral Rhinitis Influenza Clinical Manifestations Nursing and Collaborative Management Influenza Sinusitis Clinical Manifestations Nursing and Collaborative Management Sinusitis Obstruction of the Nose and Paranasal Sinuses Polyps Foreign Bodies Problems Related to the Pharynx Acute Pharyngitis Clinical Manifestations Nursing and Collaborative Management Acute Pharyngitis Peritonsillar Abscess Problems Related to the Trachea and Larynx Airway Obstruction Tracheostomy Nursing Management Tracheostomy Providing Tracheostomy Care Swallowing Dysfunction Use of the Voice With a Tracheostomy Tube Decannulation Laryngeal Polyps Head and Neck Cancer Clinical Manifestations Diagnostic Studies Collaborative Care Nutritional Therapy. Nursing Management Head and Neck Cancer Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Radiation Therapy. Surgical Therapy. Voice Rehabilitation. Stoma Care. Depression. Sexuality. Ambulatory and Home Care. Evaluation Review Questions References Resources 30. Nursing Management: Lower Respiratory Problems Learning Objectives Key Terms Acute Bronchitis Pneumonia Etiology Factors Predisposing to Pneumonia. Acquisition of Organisms. Types of Pneumonia Community-Acquired Pneumonia. Hospital-Acquired Pneumonia. Fungal Pneumonia. Aspiration Pneumonia. Opportunistic Pneumonia. Pathophysiology Clinical Manifestations Complications Diagnostic Studies. Collaborative Care Pneumococcal Vaccine. Drug Therapy. Nutritional Therapy. Nursing Management Pneumonia Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Evaluation. Tuberculosis Etiology and Pathophysiology Clinical Manifestations Complications Miliary Tuberculosis. Pleural Effusion and Empyema. Tuberculosis Pneumonia. Other Organ Involvement. Diagnostic Studies Tuberculin Skin Testing. Chest Radiographic Study. Bacteriological Studies. Collaborative Care Drug Therapy Active Disease. Latent Tuberculosis Infection. Vaccine. Nursing Management Tuberculosis Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Evaluation Atypical Mycobacteria Pulmonary Fungal Infections Collaborative Care Bronchiectasis Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Collaborative Care Nursing Management Bronchiectasis Lung Abscess Etiology and Pathophysiology Clinical Manifestations and Complications Diagnostic Studies Nursing and Collaborative Management Lung Abscess Environmental Lung Diseases Clinical Manifestations Collaborative Care Lung Cancer Etiology Pathophysiology Paraneoplastic Syndrome. Clinical Manifestations Diagnostic Studies Staging. Screening for Lung Cancer. Collaborative Care Surgical Therapy. Radiation Therapy. Stereotactic Radiotherapy. Chemotherapy. Biological Therapy. Other Therapies Prophylactic Cranial Radiation. Bronchoscopic Laser Therapy. Phototherapy. Airway Stenting. Cryotherapy. Nursing Management Lung Cancer Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Evaluation Other Types of Lung Tumours Chest Trauma and Thoracic Injuries Pneumothorax Types of Pneumothorax Closed Pneumothorax. Open Pneumothorax. Tension Pneumothorax. Hemothorax. Chylothorax. Clinical Manifestations Collaborative Care Fractured Ribs Flail Chest Chest Tubes and Pleural Drainage Chest Tube Insertion Pleural Drainage Heimlich Valves. Small Chest Tubes. Nursing Management Chest Drainage Complications Chest Tube Removal Chest Surgery Preoperative Care Surgical Therapy Video-Assisted Thorascopic Surgery. Postoperative Care Restrictive Respiratory Disorders Pleural Effusion Types Clinical Manifestations Thoracentesis Collaborative Care Pleurisy Atelectasis Interstitial Lung Disease Idiopathic Pulmonary Fibrosis Sarcoidosis Vascular Lung Disorders Pulmonary Edema Pulmonary Embolism Etiology and Pathophysiology Clinical Manifestations Complications Diagnostic Studies Collaborative Care Drug Therapy. Surgical Therapy. Nursing Management Pulmonary Embolism Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Evaluation Pulmonary Hypertension Primary Pulmonary Hypertension Etiology and Pathophysiology Clinical Manifestations Collaborative Care Secondary Pulmonary Hypertension Cor Pulmonale Clinical Manifestations Collaborative Care Lung Transplantation Review Questions References Resources 31. Nursing Management: Obstructive Pulmonary Diseases Learning Objectives Key Terms Asthma Triggers of Asthma Attacks Allergens. Exercise. Respiratory Infections. Nose and Sinus Problems. Drugs and Food Additives. Gastro-esophageal Reflux Disease. Air Pollutants. Emotional Stress. Pathophysiology Clinical Manifestations Asthma Control and Severity Severe Acute Asthma and Life-Threatening Asthma. Diagnostic Studies for Asthma Collaborative Care General Management Approach. Acute Asthma Episode. Drug Therapy Anti-Inflammatory Drugs Corticosteroids. Antileukotrienes. Anti–Immunoglobulin E Antagonists. Bronchodilators. β2-Adrenergic Agonists. Anticholinergic Drugs. Methylxanthines. Patient Education Related to Drug Therapy. Nursing Management Asthma Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Asthma Education. Environmental Control. Self-Monitoring and Action Plans. Evaluation. Chronic Obstructive Pulmonary Disease Causes Cigarette Smoking. Occupational Chemicals and Dusts. Infection. Heredity. Aging. Pathophysiology Clinical Manifestations Classification of Chronic Obstructive Pulmonary Disease. Complications Cor Pulmonale. Acute Exacerbations of Chronic Obstructive Pulmonary Disease. Acute Respiratory Failure. Depression, Anxiety, and Panic. Clinical Assessment Collaborative Care Smoking Cessation. Drug Therapy. Oxygen Therapy. Indications for Use. Methods of Administration. Humidification. Complications Combustion. Carbon Dioxide Narcosis. Oxygen Toxicity. Absorption Atelectasis. Infection. Long-Term Oxygen Therapy at Home. Surgical Therapy. Pulmonary Rehabilitation Programs. Breathing Exercises. Effective Coughing. Nutritional Therapy. Age-Related Considerations Chronic Obstructive Pulmonary Disease Nursing Management Chronic Obstructive Pulmonary Disease Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Education. Exercise. Energy-Conserving Strategies. Sexual Activity. Sleep. Psychosocial Considerations. End-of-Life Issues. Evaluation Cystic Fibrosis Etiology and Pathophysiology Clinical Manifestations Complications Diagnostic Studies Collaborative Care Nursing Management Cystic Fibrosis Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Review Questions References Resources Section 6 - Problems of Oxygenation: Transport 32. Nursing Assessment: Hematological System Learning Objectives Key Terms Structures and Functions of the Hematological System Bone Marrow Blood Plasma. Blood Cells. Erythrocytes. Leukocytes. Granulocytes. Agranulocytes. Thrombocytes. Iron Metabolism Clotting Mechanisms Vascular Injury and Subendothelial Exposure. Platelet Plug Formation (Adhesion, Aggregation, Activation). Fibrin Clot Development. Clot Retraction and Dissolution. Spleen Lymph System Liver Age-Related Considerations Hematological System Assessment of the Hematological System Subjective Data Important Health Information Past Medical History. Medications. Surgery or Other Treatments. Approach to Obtaining a Hematological History Social and Occupational History. Self-Care History. Activities of Daily Living. Nutritional–Metabolic History. Elimination Pattern. Neurological History. Sleep History. Sexual–Reproductive History. Values and Beliefs. Objective Data Physical Examination. Lymph Node Assessment. Palpation of the Liver or the Spleen. Skin Assessment. Diagnostic Studies of the Hematological System Laboratory Studies Complete Blood Cell Count. Red Blood Cells. White Blood Cells. Platelet Count. Blood Typing and Rh Factor. Iron Metabolism. Radiological Studies Biopsy Bone Marrow Examination. Lymph Node Biopsy. Molecular Cytogenetics and Gene Analysis Review Questions References Resources 33. Nursing Management: Hematological Problems Learning Objectives Key Terms Anemia Definition and Classification Clinical Manifestations Integumentary Changes Cardiopulmonary Manifestations Nursing Management Anemia Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Age-Related Considerations Anemia Anemia Caused by Decreased Erythrocyte Production Iron-Deficiency Anemia Etiology Clinical Manifestations Diagnostic Studies Collaborative Care Drug Therapy. Nursing Management Iron-Deficiency Anemia Thalassemia Etiology Clinical Manifestations Collaborative Care Megaloblastic Anemias Etiology Pernicious Anemia. Other Causes of Cobalamin Deficiency. Clinical Manifestations Diagnostic Studies Collaborative Care Folic Acid Deficiency Nursing Management Megaloblastic Anemia Anemia of Chronic Disease Aplastic Anemia Etiology Clinical Manifestations Diagnostic Studies Nursing and Collaborative Management Aplastic Anemia Anemia Caused by Blood Loss Acute Blood Loss Clinical Manifestations Diagnostic Studies Collaborative Care Nursing Management Acute Blood Loss Chronic Blood Loss Anemia Caused by Increased Erythrocyte Destruction Sickle Cell Disease Etiology and Pathophysiology Types of Sickle Cell Disease. Sickling Episodes. Clinical Manifestations Complications Diagnostic Studies Nursing and Collaborative Management Sickle Cell Disease Acquired Hemolytic Anemia Hemochromatosis Polycythemia Etiology and Pathophysiology Clinical Manifestations and Complications Diagnostic Studies Collaborative Care Nursing Management Polycythemia Vera Problems of Hemostasis Thrombo-Cytopenia Etiology and Pathophysiology Immune Thrombo-Cytopenic Purpura. Thrombotic Thrombo-Cytopenic Purpura. Heparin-Induced Thrombo-Cytopenia and Thrombosis Syndrome. Clinical Manifestations. Diagnostic Studies Collaborative Care Immune Thrombo-Cytopenic Purpura. Thrombotic Thrombo-Cytopenic Purpura. Heparin-Induced Thrombo-Cytopenia and Thrombosis Syndrome. Acquired Thrombo-Cytopenia From Decreased Platelet Production. Nursing Management Thrombo-Cytopenia Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Evaluation. Hemophilia and von Willebrand Disease Clinical Manifestations and Complications Diagnostic Studies Collaborative Care Nursing Management Hemophilia Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Evaluation Disseminated Intravascular Coagulation Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Collaborative Care Nursing Management Disseminated Intravascular Coagulation Nursing Diagnoses Nursing Implementation Neutropenia Clinical Manifestations Diagnostic Studies Nursing and Collaborative Management Neutropenia Age-Related Considerations Thrombo-Cytopenia and Neutropenia Myelodysplastic Syndrome Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Nursing and Collaborative Management Myelodysplastic Syndrome Leukemia Etiology and Pathophysiology Classification Acute Myelogenous Leukemia. Acute Lymphocytic Leukemia. Chronic Myelogenous Leukemia. Chronic Lymphocytic Leukemia. Other Leukemias. Clinical Manifestations Diagnostic Studies Collaborative Care Drug Therapy Regimens. Hematopoietic Stem Cell Transplantation. Nursing Management Leukemia Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Acute Intervention. Ambulatory and Home Care. Evaluation Lymphomas Hodgkin’s Lymphoma Etiology and Pathophysiology Clinical Manifestations Diagnostic and Staging Studies Nursing and Collaborative Management Hodgkin’s Lymphoma Non-Hodgkin’s Lymphoma Etiology and Pathophysiology Clinical Manifestations Diagnostic and Staging Studies Nursing and Collaborative Management Non-Hodgkin’s Lymphoma Multiple Myeloma Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Collaborative Care Nursing Management Multiple Myeloma Disorders of the Spleen Blood Component Therapy Administration Procedure Blood Transfusion Reactions Acute Transfusion Reactions Acute Hemolytic Reactions. Febrile Reactions. Allergic Reactions. Circulatory Overload. Sepsis. Transfusion-Related Acute Lung Injury. Massive Blood Transfusion Reaction. Delayed Transfusion Reactions. Infection. Autotransfusion Review Questions References Resources Section 7 - Problems of Oxygenation: Perfusion 34. Nursing Assessment: Cardiovascular System Learning Objectives Key Terms Structures and Functions of the Cardiovascular System Heart Structure. Blood Flow Through the Heart. Cardiac Valves. Blood Supply to the Myocardium. Conduction System. Electrocardiography. Mechanical System. Factors Affecting Cardiac Output. Cardiac Reserve. Vascular System Blood Vessels. Arteries and Arterioles. Capillaries. Veins and Venules. Regulation of the Cardiovascular System Autonomic Nervous System. Effect on the Heart. Effect on the Blood Vessels. Baroreceptors. Chemoreceptors. Blood Pressure Measurement of Arterial Blood Pressure. Pulse Pressure and Mean Arterial Pressure. Age-Related Considerations Effects of Aging on the Cardiovascular System Assessment of the Cardiovascular System Subjective Data Important Health Information History of Current Illness. Past Health History. Medications. Surgery or Other Treatments. Objective Data Physical Examination Vital Signs. Peripheral Vascular System Inspection. Palpation. Auscultation. Thorax Inspection and Palpation. Percussion. Auscultation. Diagnostic Studies of the Cardiovascular System Noninvasive Studies Chest Radiography. Electrocardiography. Ambulatory Electrocardiographic Monitoring. Transtelephonic Event Recorders. Exercise or Stress Testing. Echocardiography. Nuclear Cardiology. Cardiovascular Magnetic Resonance Imaging. Cardiac Computed Tomography. Blood Studies. Cardiac Biomarkers. C-Reactive Protein. Homocysteine. Cardiac Natriuretic Peptide Markers. Serum Lipids. Lipoprotein-Associated Phospholipase A2. Invasive Studies Cardiac Catheterization and Coronary Angiography. Intracoronary Ultrasonography. Fractional Flow Reserve. Hemodynamic Monitoring. Review Questions References Resources 35. Nursing Management: Hypertension Learning Objectives Key Terms Normal Regulation of Blood Pressure Sympathetic Nervous System Baroreceptors. Vascular Endothelium Renal System Endocrine System Hypertension Subtypes of Hypertension Etiology Primary Hypertension. Secondary Hypertension. Pathophysiology of Primary Hypertension Genes. Sodium and Water Retention. Altered Renin–Angiotensin–Aldosterone Mechanism. Stress and Increased Sympathetic Nervous System Activity. Insulin Resistance and Hyperinsulinemia. Endothelial Cell Dysfunction. Obesity. Clinical Manifestations Complications Hypertensive Heart Disease Coronary Artery Disease. Left Ventricular Hypertrophy. Heart Failure. Cerebro-vascular Disease. Peripheral Arterial Disease. Nephrosclerosis. Retinal Damage. Diagnostic Studies Ambulatory Blood Pressure Monitoring. Collaborative Care Risk Stratification. Lifestyle Modifications. Nutritional Therapy. Weight Reduction. Modification in Alcohol Consumption. Physical Activity. Avoidance of Tobacco Products. Stress Management. Drug Therapy. Patient Teaching Related to Drug Therapy. Resistant Hypertension. Nursing Management Primary Hypertension Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Individual Patient Evaluation. Screening Programs. Cardiovascular Risk Factor Modification. Ambulatory and Home Care. Physical Activity. Home Blood Pressure Monitoring. Patient Adherence. Evaluation Age-Related Considerations Hypertension Hypertensive Crisis Clinical Manifestations Nursing and Collaborative Management Hypertensive Crisis Review Questions References Resources 36. Nursing Management: Coronary Artery Disease and Acute Coronary Syndrome Learning Objectives Key Terms Coronary Artery Disease Etiology and Pathophysiology Developmental Stages Fatty Streak. Fibrous Plaque. Complicated Lesion. Collateral Circulation Risk Factors for Coronary Artery Disease Nonmodifiable Risk Factors Age, Sex, and Ethnicity. Major Modifiable Risk Factors Elevated Serum Lipid Levels. Hypertension. Tobacco Use. Physical Inactivity. Obesity. Modifiable Contributing Risk Factors Diabetes Mellitus. Metabolic Syndrome. Psychological States. Homocysteine. Substance Use. Health Promotion Identification of High-Risk People. Management of High-Risk People. Physical Activity. Health Education in Schools. Nutritional Therapy. Cholesterol-Lowering Drug Therapy Drugs That Restrict Lipoprotein Production. Drugs That Increase Lipoprotein Removal. Drugs That Decrease Cholesterol Absorption. Antiplatelet Therapy Chronic Stable Angina Prinzmetal’s Angina Collaborative Management Drug Therapy Short-Acting Nitrates. Sublingual Nitroglycerin. Long-Acting Nitrates. Transdermal Controlled-Release Nitrates. β-Adrenergic Blockers. Calcium Channel Blockers. Angiotensin-Converting Enzyme Inhibitors. Diagnostic Studies Acute Coronary Syndrome Etiology and Pathophysiology Manifestations of Acute Coronary Syndrome Unstable Angina Myocardial Infarction Clinical Manifestations of Myocardial Infarction Pain. Sympathetic Nervous System Stimulation. Cardiovascular Manifestations. Nausea and Vomiting. Fever. Healing Process Complications of Myocardial Infarction Dysrhythmias. Heart Failure. Cardiogenic Shock. Papillary Muscle Dysfunction. Ventricular Aneurysm. Pericarditis. Dressler’s Syndrome. Diagnostic Studies Unstable Angina and Myocardial Infarction Electrocardiographic Findings. Serum Cardiac Markers. Coronary Angiography. Other Measures Collaborative Care Emergent Percutaneous Coronary Intervention Fibrinolytic Therapy Indications and Contraindications. Procedure. Drug Therapy Intravenous Nitroglycerin. Morphine Sulphate. β-Adrenergic Blockers. Angiotensin-Converting Enzyme Inhibitors. Antidysrhythmia Medications. Cholesterol-Lowering Drugs. Stool Softeners. Nutritional Therapy Coronary Surgical Revascularization Coronary Artery Bypass Graft Surgery. Minimally Invasive Direct Coronary Artery Bypass. Off-Pump Coronary Artery Bypass. Robot-Assisted Cardiothoracic Surgery. Transmyocardial Laser Revascularization. Nursing Management Chronic Stable Angina and Acute Coronary Syndrome Nursing Assessment Nursing Diagnoses Planning Nursing Implementation: Chronic Stable Angina Health Promotion. Acute Intervention. Ambulatory and Home Care. Nursing Implementation: Acute Coronary Syndrome Acute Intervention. Pain. Monitoring. Rest and Comfort. Anxiety. Emotional and Behavioural Reactions. Coronary Revascularization. Ambulatory and Home Care. Patient Teaching. Physical Activity. Resumption of Sexual Activity. Evaluation Sudden Cardiac Death Etiology and Pathophysiology Nursing and Collaborative Management Sudden Cardiac Death Review Questions References Resources 37. Nursing Management: Heart Failure Learning Objectives Key Terms Heart Failure Etiology and Pathophysiology Pathology of Ventricular Failure. Heart Failure With Reduced Ejection Fraction. Heart Failure With Preserved Ejection Fraction. Mixed Heart Failure. Compensatory Mechanisms. Sympathetic Nervous System Activation. Neuro-hormonal Responses. Ventricular Dilation. Ventricular Hypertrophy. Counter-Regulatory Mechanisms. Types of Heart Failure Left-Sided Heart Failure. Right-Sided Heart Failure. Clinical Manifestations of Heart Failure Clinical Manifestations of Chronic Heart Failure Fatigue. Dyspnea. Paroxysmal Nocturnal Dyspnea. Tachycardia. Edema. Nocturia. Skin Changes. Behavioural Changes. Chest Pain. Weight Changes. Complications of Heart Failure Pleural Effusion. Dysrhythmias. Left Ventricular Thrombus. Hepatomegaly. Renal Failure. Classification of Heart Failure Diagnostic Studies Nursing and Collaborative Management Acute Decompensated Heart Failure Decreasing Intravascular Volume Decreasing Venous Return Decreasing Afterload Improving Gas Exchange and Oxygenation Improving Cardiac Function Reducing Anxiety Collaborative Care: Chronic Heart Failure Referral to Multidisciplinary Clinics or Specialist Care for Heart Failure Nonpharmacological Therapies Oxygen. Self-Management Teaching. Exercise and Activity. Devices Cardiac Resynchronization Therapy. Implantable Cardioverter–Defibrillator. Mechanical Circulatory Support. Cardiac Transplantation Advance Care Planning and Goals of Care Drug Therapy: Chronic Heart Failure Diuretics Angiotensin-Converting Enzyme Inhibitors Neprilysin Inhibitors β-Adrenergic Blockers Mineralocorticoid Receptor Antagonists Inotropic Drugs Sympathomimetic Agents. Phosphodiesterase Inhibitors. Vasodilator Drugs. Nutritional Therapy: Chronic Heart Failure General Principles Nursing Management Chronic Heart Failure Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Evaluation Cardiac Transplantation Mechanical Cardiac Support Devices Review Questions References Resources 38. Nursing Management: Dysrhythmias Learning Objectives Key Terms Rhythm Identification and Treatment Conduction System Nervous Control of the Heart Electrocardiographic Monitoring Telemetry Monitoring. Assessment of Cardiac Rhythm Electrophysiological Mechanisms of Dysrhythmias Evaluation of Dysrhythmias Types of Dysrhythmias Sinus Bradycardia. Clinical Associations. Electrocardiographic Characteristics. Clinical Significance. Treatment. Sinus Tachycardia. Clinical Associations. Electrocardiographic Characteristics. Clinical Significance. Treatment. Premature Atrial Contraction. Clinical Associations. Electrocardiographic Characteristics. Clinical Significance. Treatment. Paroxysmal Supraventricular Tachycardia. Clinical Associations. Electrocardiographic Characteristics. Clinical Significance. Treatment. Atrial Flutter. Clinical Associations. Electrocardiographic Characteristics. Clinical Significance. Treatment. Atrial Fibrillation. Clinical Associations. Electrocardiographic Characteristics. Clinical Significance. Treatment. Junctional Dysrhythmias. Clinical Associations. Electrocardiographic Characteristics. Clinical Significance. Treatment. First-Degree Atrioventricular Block. Clinical Associations. Electrocardiographic Characteristics. Clinical Significance. Treatment. Second-Degree Atrioventricular Block, Type I. Clinical Associations. Electrocardiographic Characteristics. Clinical Significance. Treatment. Second-Degree Atrioventricular Block, Type II. Clinical Associations. Electrocardiographic Characteristics. Clinical Significance. Treatment. Third-Degree Atrioventricular Block. Clinical Associations. Electrocardiographic Characteristics. Clinical Significance. Treatment. Premature Ventricular Contractions. Clinical Associations. Electrocardiographic Characteristics. Clinical Significance. Treatment. Ventricular Tachycardia. Clinical Associations. Electrocardiographic Characteristics. Clinical Significance. Treatment. Ventricular Fibrillation. Clinical Associations. Electrocardiographic Characteristics. Clinical Significance. Treatment. Asystole. Clinical Associations. Clinical Significance. Treatment. Pulseless Electrical Activity. Sudden Cardiac Death. Antidysrhythmia Drugs Defibrillation Synchronized Cardioversion. Implantable Cardioverter–Defibrillator. Pacemakers Temporary Pacemaker. Patient Monitoring. Radiofrequency Ablation Therapy Electrocardiographic Changes Associated With Acute Coronary Syndrome Ischemia Injury and Infarction Patient Monitoring Syncope Review Questions References Resources 39. Nursing Management: Inflammatory and Structural Heart Disorders Learning Objectives Key Terms Inflammatory Disorders of the Heart Infective Endocarditis Classification Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Collaborative Care Prophylactic Treatment. Drug Therapy. Nursing Management Infective Endocarditis Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Ambulatory and Home Care. Evaluation Acute Pericarditis Etiology and Pathophysiology Clinical Manifestations Complications Diagnostic Studies Collaborative Care Nursing Management Acute Pericarditis Chronic Constrictive Pericarditis Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Nursing and Collaborative Management Chronic Constrictive Pericarditis Myocarditis Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Collaborative Care Nursing Management Myocarditis Rheumatic Fever and Heart Disease Etiology and Pathophysiology Cardiac Lesions and Valvular Deformities. Extracardiac Lesions. Clinical Manifestations Major Criteria. Minor Criteria. Complications Diagnostic Studies Collaborative Care Nursing Management Rheumatic Fever and Heart Disease Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Evaluation Valvular Heart Disease Mitral Valve Stenosis Etiology and Pathophysiology Clinical Manifestations Mitral Valve Regurgitation Etiology and Pathophysiology Clinical Manifestations Mitral Valve Prolapse Etiology and Pathophysiology Clinical Manifestations Aortic Valve Stenosis Etiology and Pathophysiology Clinical Manifestations Aortic Valve Regurgitation Etiology and Pathophysiology Clinical Manifestations Tricuspid and Pulmonic Valve Disease Etiology and Pathophysiology Diagnostic Studies for Valvular Heart Disease Collaborative Care of Valvular Heart Disease Conservative Therapy. Percutaneous Aortic Valve Replacement. Percutaneous Transluminal Balloon Valvuloplasty. Surgical Therapy. Prosthetic Valves. Nursing Management Valvular Disorders Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention and Ambulatory and Home Care. Evaluation Cardiomyopathy Dilated Cardiomyopathy Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Nursing and Collaborative Management Dilated Cardiomyopathy Hypertrophic Cardiomyopathy Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Nursing and Collaborative Management Hypertrophic Cardiomyopathy Restrictive Cardiomyopathy Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Nursing and Collaborative Management Restrictive Cardiomyopathy Review Questions References Resources 40. Nursing Management: Vascular Disorders Learning Objectives Key Terms Peripheral Artery Disease Etiology and Pathophysiology of Peripheral Artery Disease Peripheral Artery Disease of the Lower Extremities Clinical Manifestations Complications Diagnostic Studies Collaborative Care Risk Factor Modification. Drug Therapy. Exercise Therapy. Nutritional Therapy. Complementary and Alternative Therapies. Care of the Leg With Critical Limb Ischemia. Interventional Radiological Catheter-Based Procedures. Surgical Therapy. Nursing Management Lower Extremity Peripheral Artery Disease Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Evaluation Acute Arterial Ischemic Disorders Etiology and Pathophysiology Clinical Manifestations Collaborative Care Thromboangiitis Obliterans Raynaud’s Phenomenon Aortic Aneurysms Etiology and Pathophysiology Classification Clinical Manifestations Complications Diagnostic Studies Collaborative Care Surgical Therapy. Endovascular Graft Procedure. Complications. Nursing Management Aortic Aneurysms and Aortoiliac Disease Nursing Assessment Planning Nursing Implementation Health Promotion. Acute Intervention. Graft Patency. Cardiovascular Status. Infection. Gastrointestinal Status. Neurological Status. Peripheral Perfusion Status. Renal Perfusion Status. Ambulatory and Home Care. Evaluation Aortic Dissection Etiology and Pathophysiology Clinical Manifestations Complications Diagnostic Studies Collaborative Care Conservative Therapy. Endovascular Dissection Repair. Surgical Therapy. Nursing Management Aortic Dissection Venous Disorders Phlebitis Venous Thrombo-embolism Etiology Venous Stasis. Endothelial Damage. Hypercoagulability of Blood. Pathophysiology Superficial Vein Thrombosis Clinical Manifestations. Collaborative Care. Venous Thrombo-embolism Clinical Manifestations. Complications. Diagnostic Studies. Collaborative Care Prevention and Prophylaxis. Drug Therapy. Vitamin K Antagonists. Thrombin Inhibitors: Indirect. Thrombin Inhibitors: Direct. Factor Xa Inhibitors. Anticoagulation Therapy for VTE Prophylaxis. Anticoagulation Therapy for Venous Thrombo-embolism Treatment. Thrombolytic Therapy for Venous Thrombo-embolism. Surgical Therapy. Nursing Management Venous Thrombo-embolism Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Acute Intervention. Ambulatory and Home Care. Evaluation Varicose Veins Etiology and Pathophysiology Clinical Manifestations and Complications Diagnostic Studies and Collaborative Care Nursing Management Varicose Veins Chronic Venous Insufficiency and Venous Leg Ulcers Etiology and Pathophysiology Clinical Manifestations and Complications Collaborative Care Nursing Management Chronic Venous Insufficiency and Venous Leg Ulcers Review Questions References Resources Section 8 - Problems of Ingestion, Digestion, Absorption, and Elimination 41. Nursing Assessment: Gastro-Intestinal System Learning Objectives Key Terms Structures and Functions of the Gastro-Intestinal System Ingestion and Propulsion of Food Mouth. Pharynx. Esophagus. Digestion and Absorption Mouth. Stomach. Small Intestine. Physiology of Digestion. Elimination Large Intestine. Liver, Biliary Tract, and Pancreas Liver. Biliary Tract. Bilirubin Metabolism. Pancreas. Age-Related Considerations Effects of Aging on the Gastro-Intestinal System Assessment of the Gastro-Intestinal System Subjective Data Important Health Information Past Health History. Medications. Surgery or Other Treatments. Objective Data Physical Examination Mouth Inspection. Palpation. Abdomen. Inspection. Auscultation. Percussion. Palpation. Rectum and Anus. Diagnostic Studies of the Gastro-Intestinal System Radiological Studies Upper Gastro-Intestinal Series. Lower Gastro-Intestinal Series. Abdominal Ultrasonography. Endoscopy Endoscopic Ultrasonography. Capsule Endoscopy. Liver Biopsy Liver Function Studies Review Questions References Resources 42. Nursing Management: Nutritional Problems Learning Objectives Key Terms Nutritional Problems Normal Nutrition Major Nutrients Vegetarian Diet Culturally Competent Care Malnutrition Etiology of Malnutrition Socioeconomic Factors. Physical Illnesses. Use of Probiotics. Incomplete Diets. Drug–Nutrient Interactions. Eating Disorders. Anorexia Nervosa. Bulimia Nervosa. Pathophysiology of Starvation Impact of Inflammation. Clinical Manifestations Nursing Management High-Risk Nutritional Status Nursing Assessment Assessment of Nutritional Intake. The 24-Hour Recall. The Food Frequency Questionnaire. The Food Diary. Direct Observation. Anthropometric Measurements. Laboratory Studies. Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Care. Ambulatory and Home Care. Evaluation Age-Related Considerations Malnutrition Dysphagia Specialized Nutrition Support Oral Nutrition Enteral Nutrition Orogastric, Nasogastric, and Nasointestinal Tubes. Gastrostomy and Jejunostomy Tubes. Tube Feedings and Safety. Patient Position. Aspiration Risk. Tube Position. Site Care. Tube Patency. Misconnection. Age-Related Considerations Enteral Feeds Parenteral Nutrition Composition. Calories. Protein. Electrolytes. Trace Elements and Vitamins. Methods of Administration. Central Parenteral Nutrition. Peripheral Parenteral Nutrition. Comparison of Central and Peripheral Parenteral Nutrition. Complications. Nursing Management Parenteral Nutrition Home Nutrition Support Review Questions References Resources 43. Nursing Management: Obesity Learning Objectives Key Terms Obesity Classifications of Body Weight and Obesity Epidemiology of Obesity Etiology and Pathophysiology Genetic–Biological Basis. Environmental Factors. Psychosocial Factors. Health Risks Associated With Obesity Metabolic Syndrome Etiology and Pathophysiology Nursing and Collaborative Management Metabolic Syndrome Cardiovascular Problems. Respiratory Problems. Diabetes Mellitus. Musculo-Skeletal Problems. Gastro-Intestinal and Liver Problems. Cancer. Psychosocial Issues. Nursing and Conservative Collaborative Management Patients With Obesity Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Nutritional Therapy. Physical Activity. Behaviour Modification. Support Groups. Drug Therapy Nutrient Absorption–Blocking Drugs Collaborative Surgical Therapy Restrictive Surgeries Vertical Banded Gastroplasty. Adjustable Gastric Banding. Malabsorptive Surgery Biliopancreatic Diversion. Biliopancreatic Diversion With Duodenal Switch. Combination of Restrictive and Malabsorptive Surgery Roux-en-Y Surgical Procedure. Cosmetic Surgeries to Reduce Fatty Tissue and Skin Folds Lipectomy. Liposuction. Nursing Management Patient With Obesity Undergoing Surgery Nursing Implementation Perioperative Care. Preoperative Care. Special Considerations for Bariatric Surgery. Postoperative Care. Special Considerations for Bariatric Surgery. Ambulatory and Home Care Special Considerations for Bariatric Surgery. Evaluation Age-Related Considerations Obesity in Older Adults Review Questions References Resources 44. Nursing Management: Upper Gastro-Intestinal Problems Learning Objectives Key Terms Nausea and Vomiting Etiology and Pathophysiology Clinical Manifestations Collaborative Care Drug Therapy. Nutritional Therapy. Nursing Management Nausea and Vomiting Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Acute Intervention. Ambulatory and Home Care. Evaluation Age-Related Considerations Nausea and Vomiting Foodborne Illness Escherichia coli O157:H7 Poisoning Oral Inflammations and Infections Oral Cancer Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Collaborative Care Surgical Therapy. Nonsurgical Therapy. Nutritional Therapy. Nursing Management Oral Cancer Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Evaluation Esophageal Disorders Gastro-esophageal Reflux Disease Etiology and Pathophysiology Clinical Manifestations Complications Diagnostic Studies Collaborative Care Lifestyle Modifications. Nutritional Therapy. Drug Therapy. Surgical Therapy. Endoscopic Therapy. Nursing Management Gastro-esophageal Reflux Disease Hiatal Hernia Types Etiology and Pathophysiology Clinical Manifestations Complications Diagnostic Studies Nursing and Collaborative Management Hiatal Hernia Conservative Therapy Surgical Therapy Age-Related Considerations Gastro-esophageal Reflux Disease and Hiatal Hernia Esophageal Cancer Etiology and Pathophysiology Clinical Manifestations Complications Diagnostic Studies Collaborative Care Nutritional Therapy. Nursing Management Esophageal Cancer Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention Preoperative Care. Postoperative Care. Ambulatory and Home Care. Evaluation Other Esophageal Disorders Eosinophilic Esophagitis Esophageal Diverticula Esophageal Strictures Achalasia Esophageal Varices Disorders of the Stomach and Upper Small Intestine Gastritis Types Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Nursing and Collaborative Management Gastritis Acute Gastritis Chronic Gastritis Gastric Cancer Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Collaborative Care Surgical Therapy. Adjuvant Therapy. Nursing Management Gastric Cancer Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention Preoperative Care. Postoperative Care. Ambulatory and Home Care. Evaluation Upper Gastro-intestinal Bleeding Etiology and Pathophysiology Esophageal Origin. Stomach and Duodenal Origin. Emergency Assessment and Management Diagnostic Studies Collaborative Care Endoscopic Therapy. Surgical Therapy. Drug Therapy. Nursing Management Upper Gastro-intestinal Bleeding Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Evaluation Peptic Ulcer Disease Types Etiology and Pathophysiology Gastric Ulcers. Duodenal Ulcers. Stress-Related Mucosal Disease. Clinical Manifestations Complications Hemorrhage. Perforation. Gastric Outlet Obstruction. Diagnostic Studies Collaborative Care: Conservative Therapy Drug Therapy. Histamine-2 Receptor Blockers. Proton Pump Inhibitors. Antibiotic Therapy. Antacids. Anticholinergic Drugs. Cytoprotective Drug Therapy. Other Drugs. Nutritional Therapy. Therapy Related to Complications of Peptic Ulcer Disease Acute Exacerbation. Perforation. Gastric Outlet Obstruction. Nursing Management Peptic Ulcer Disease Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Hemorrhage. Perforation. Gastric Outlet Obstruction. Ambulatory and Home Care. Evaluation Collaborative Therapy: Surgical Therapy for Peptic Ulcer Disease Postoperative Complications. Dumping Syndrome. Postprandial Hypoglycemia. Bile Reflux Gastritis. Nutritional Therapy. Nursing Management Surgical Therapy for Peptic Ulcer Disease Preoperative Care Postoperative Care Age-Related Considerations Peptic Ulcer Disease Review Questions References Resources 45. Nursing Management: Lower Gastro-Intestinal Problems Learning Objectives Key Terms Diarrhea Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Collaborative Care Nursing Management Acute Infectious Diarrhea Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Fecal Incontinence Etiology and Pathophysiology Diagnostic Studies and Collaborative Care Nursing Management Fecal Incontinence Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Constipation Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies and Collaborative Care Nutritional Therapy. Nursing Management Constipation Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Acute Abdominal Pain Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies and Collaborative Management Nursing Management Acute Abdominal Pain Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Acute Intervention Preoperative Care. Postoperative Care. Care of Nasogastric and Nasointestinal Tubes. Ambulatory and Home Care. Evaluation Abdominal Trauma Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Nursing and Collaborative Management Abdominal Trauma Chronic Abdominal Pain Irritable Bowel Syndrome Inflammatory Disorders Appendicitis Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies and Collaborative Care Nursing Management Appendicitis Peritonitis Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Collaborative Care Nursing Management Peritonitis Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Gastro-enteritis Nursing Management Gastro-enteritis Inflammatory Bowel Disease Ulcerative Colitis Etiology and Pathophysiology Clinical Manifestations Complications Diagnostic Studies Collaborative Care Drug Therapy. Surgical Therapy. Total Proctocolectomy With Permanent Ileostomy. Total Proctocolectomy With Ileoanal Reservoir. Postoperative Care. Nutritional Therapy. Nursing Management Ulcerative Colitis Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Evaluation Crohn’s Disease Etiology and Pathophysiology Clinical Manifestations Complications Diagnostic Studies Collaborative Care Drug Therapy. Nutritional Therapy. Surgical Therapy. Nursing Management Crohn’s Disease Age-Related Considerations Inflammatory Bowel Disease Malabsorption Syndrome Celiac Disease Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies and Collaborative Care Lactase Deficiency Clinical Manifestations Nursing and Collaborative Management Lactase Deficiency Short-Bowel Syndrome Clinical Manifestations Collaborative Care Intestinal Obstruction Types of Intestinal Obstruction Mechanical. Nonmechanical. Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Collaborative Care Nursing Management Intestinal Obstruction Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Polyps of the Large Intestine Types of Polyps Diagnostic Studies and Collaborative Care Colorectal Cancer Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Collaborative Care Surgical Therapy. Chemotherapy and Radiation Therapy. Nursing Management Colorectal Cancer Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention Preoperative Care. Postoperative Care. Ambulatory and Home Care. Evaluation Ostomy Surgery Types Surgical Therapy End Stoma. Loop Stoma. Double-Barrelled Stoma. Ileoanal Reservoir. Nursing Management Ostomy Surgery Preoperative Care Colostomy Care Colostomy Irrigations. Ileostomy Care Adaptation to an Ostomy Sexual Dysfunction After Ostomy Surgery Diverticulosis and Diverticulitis Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Nursing and Collaborative Management Diverticulosis and Diverticulitis Hernias Types Clinical Manifestations Nursing and Collaborative Management Hernias Anorectal Problems Hemorrhoids Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies and Collaborative Care Nursing Management Hemorrhoids Anal Fissure Anorectal Abscess Anal Fistula Anal Cancer Pilonidal Sinus Review Questions References Resources 46. Nursing Management: Liver, Pancreas, and Biliary Tract Problems Learning Objectives Key Terms Jaundice Prehepatic Jaundice Hepatic Jaundice Posthepatic (Cholestatic) Jaundice Disorders of the Liver Viral Hepatitis Pathophysiological Features Liver. Systemic Effects. Clinical Manifestations Acute Phase. Chronic Phase. Complications Diagnostic Studies Viral Serological Tests. Serum Liver Enzymes. Liver Function Tests. Hepatitis A Hepatitis A Virus (HAV). Clinical Manifestations. Hepatitis B Hepatitis B Virus (HBV). Acute Hepatitis B. Chronic Hepatitis B. Drug Therapy. Interferon. Nucleoside and Nucleotide Analogues. Hepatitis C Hepatitis C Virus (HCV). Diagnostic Tests. Drug Therapy Acute Hepatitis C. Chronic Hepatitis C. Hepatitis D Hepatitis E Nursing Management Viral Hepatitis Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Hepatitis A. Hepatitis B. Hepatitis C. Acute Intervention Jaundice. Rest. Ambulatory and Home Care. Evaluation Control of Viral Hepatitis in Health Care Providers Hepatitis A. Hepatitis B. Hepatitis C. Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis Causes Clinical Manifestations and Diagnostic Studies Collaborative Care Alcohol and Drug-Induced Hepatitis Alcohol Hepatitis Drug-Induced Liver Injury (DILI) Autoimmune and Genetic Liver Diseases Autoimmune Hepatitis Wilson’s Disease Hereditary Hemochromatosis Primary Biliary Cholangitis Primary Sclerosing Cholangitis Cirrhosis of the Liver Etiology Clinical Manifestations Manifestations of Advanced Cirrhosis. Jaundice. Skin Lesions. Hematological Problems. Endocrine Disturbances. Peripheral Neuropathy. Complications Portal Hypertension and Esophageal and Gastric Varices. Peripheral Edema and Ascites. Hepatic Encephalopathy. Hepato-Renal Syndrome. Diagnostic Studies Liver Biopsy. Noninvasive Fibrosis Markers. Collaborative Care in Advanced Cirrhosis of the Liver Ascites. Esophageal and Gastric Varices. Long-Term Management. Shunting Procedures. Hepatic Encephalopathy. Drug Therapy. Nutritional Therapy. Nursing Management Cirrhosis Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Bleeding Esophageal Varices. Hepatic Encephalopathy. Ambulatory and Home Care. Evaluation Acute Liver Failure Clinical Manifestations and Diagnostic Studies Nursing and Collaborative Management Acute Liver Failure Liver Cancer Clinical Manifestations and Diagnostic Studies Nursing and Collaborative Management Liver Cancer Liver Transplantation Age-Related Considerations Liver Disease in Older Adults Disorders of the Pancreas Acute Pancreatitis Etiology and Pathophysiology Clinical Manifestations Complications Diagnostic Studies Collaborative Care Conservative Therapy. Surgical Therapy. Drug Therapy. Nutritional Therapy. Nursing Management Acute Pancreatitis Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Evaluation Chronic Pancreatitis Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Collaborative Care Nursing Management Chronic Pancreatitis Pancreatic Cancer Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Collaborative Care Nursing Management Pancreatic Cancer Disorders of the Biliary Tract Cholelithiasis and Cholecystitis Etiology and Pathophysiology Cholelithiasis. Cholecystitis. Clinical Manifestations Complications Diagnostic Studies Collaborative Care Conservative Therapy Cholelithiasis. Cholecystitis. Surgical Therapy. Transhepatic Biliary Catheter. Drug Therapy. Nutritional Therapy. Nursing Management Gallbladder Disease Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Postoperative Care. Ambulatory and Home Care. Evaluation Gallbladder Cancer Review Questions References Resources Section 9 - Problems of Urinary Function 47. Nursing Assessment: Urinary System Learning Objectives Key Terms Structures and Functions of the Urinary System Kidneys Macrostructure. Microstructure. Blood Supply. Physiology of Urine Formation. Glomerular Function. Tubular Function. Other Functions of the Kidney. Production of Erythropoietin. Activation of Vitamin D. Production and Secretion of Renin. Ureters Bladder Urethra Urethro-Vesical Unit Function Age-Related Considerations Effects of Aging on the Urinary System Assessment of the Urinary System Subjective Data Important Health Information Past Health History. Medications. Surgery and Other Treatments. Key Questions. Health History. Nutritional Assessment. Elimination Assessment. Activity Assessment. Pain Assessment. Self-Concept Assessment. Relationship and Sexuality Assessment. Objective Data Physical Examination Inspection. Palpation. Percussion. Auscultation. Diagnostic Studies Analysis of Urine Urinalysis. Composite Urine Collections. Creatinine Clearance. Urine Cytology. Radiological Studies Kidney, Ureter, and Bladder Radiography. Intravenous Pyelography. Retrograde Pyelography. Antegrade Pyelography. Renal Ultrasonography. Computed Tomography. Renal Arteriography. Cystography. Urethrography. Loopography. Renal Radionuclide Imaging. Renal Biopsy. Endoscopy Cystoscopy. Urodynamics Testing Urinary Flow Study. Cystometrography. Sphincter Electromyography. Voiding Pressure Flow Study. Video-Urodynamics Testing. Radionuclide Cystography. Whitaker Test. Review Questions References Resources 48. Nursing Management: Renal and Urological Problems Learning Objectives Key Terms Infectious and Inflammatory Disorders of the Urinary System Urinary Tract Infection Classification Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Collaborative Care and Drug Therapy Nursing Management Urinary Tract Infection Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Evaluation Acute Pyelonephritis Etiology and Pathophysiology Clinical Manifestations and Diagnostic Studies Collaborative Care and Drug Therapy Nursing Management Acute Pyelonephritis Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention and Home Care. Evaluation Chronic Pyelonephritis Urethritis Urethral Diverticula Interstitial Cystitis Collaborative Care and Drug Therapy Nursing Management Interstitial Cystitis Renal Tuberculosis Immunological Disorders of the Kidney Glomerulo-Nephritis Clinical Manifestations Acute Poststreptococcal Glomerulo-Nephritis Clinical Manifestations and Complications Diagnostic Studies Nursing and Collaborative Management Acute Poststreptococcal Glomerulo-Nephritis Goodpasture’s Syndrome Nursing and Collaborative Management Goodpasture’s Syndrome Rapidly Progressive Glomerulo-Nephritis Chronic Glomerulo-Nephritis Nephrotic Syndrome Etiology and Clinical Manifestations Collaborative Care Nursing Management Nephrotic Syndrome Obstructive Uropathies Urinary Tract Calculi Etiology and Pathophysiology Types Clinical Manifestations Diagnostic Studies Collaborative Care Endo-Urological Procedures. Lithotripsy. Surgical Therapy. Nutritional Therapy. Nursing Management Renal Calculi Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Evaluation Strictures Ureteral Strictures Urethral Stricture Renal Trauma Renal Vascular Problems Nephrosclerosis Renal Artery Stenosis Renal Vein Thrombosis Hereditary Renal Diseases Polycystic Kidney Disease Clinical Manifestations Collaborative Care Medullary Cystic Disease Alport Syndrome Renal Involvement in Metabolic and Connective Tissue Diseases Urinary Tract Tumours Kidney Cancer Bladder Cancer Clinical Manifestations and Diagnostic Studies Nursing and Collaborative Management Bladder Cancer Surgical Therapy Radiation Therapy and Chemotherapy Intravesical Therapy Urinary Incontinence and Retention Nursing Management Urinary Incontinence Diagnostic Studies Collaborative Care: Urinary Incontinence Drug Therapy. Surgical Therapy. Collaborative Care: Urinary Retention Drug Therapy. Surgical Therapy. Nursing Management Urinary Retention Instrumentation Urethral Catheterization Ureteral Catheters Suprapubic Catheters Nephrostomy Tubes Intermittent Catheterization Surgery of the Urinary Tract Renal and Ureteral Surgery Preoperative Management Postoperative Management Urine Output. Respiratory Status. Abdominal Distension. Laparoscopic Nephrectomy Urinary Diversion Incontinent Urinary Diversion Continent Urinary Diversions Orthotopic Bladder Substitution Nursing Management Urinary Diversion Preoperative Management Postoperative Management Review Questions References Resources 49. Nursing Management: Acute Kidney Injury and Chronic Kidney Disease Learning Objectives Key Terms Acute Kidney Injury Etiology and Pathophysiology Clinical Manifestations Initiation Phase. Maintenance Phase. Urinary Changes. Fluid Volume Excess. Metabolic Acidosis. Sodium Balance. Potassium Excess. Hematological Disorders. Calcium Deficit and Phosphate Excess. Waste Product Accumulation. Neurological Disorders. Recovery Phase. Diagnostic Studies. Collaborative Care Nutritional Therapy. Nursing Management Acute Kidney Injury Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Evaluation Age-Related Considerations Acute Kidney Injury Chronic Kidney Disease Clinical Manifestations Urinary System. Metabolic Disturbances Waste Product Accumulation. Altered Carbohydrate Metabolism. Elevated Triglycerides. Electrolyte and Acid–Base Imbalances Potassium. Sodium. Calcium and Phosphate. Magnesium. Metabolic Acidosis. Hematological System Anemia. Bleeding Tendencies. Infection. Cardiovascular System. Respiratory System. Gastro-Intestinal System. Neurological System. Musculo-Skeletal System. Integumentary System. Reproductive System. Psychological Changes. Diagnostic Studies Collaborative Management: Chronic Kidney Disease Drug Therapy Hyperkalemia. Hypertension. Chronic Kidney Disease–Mineral and Bone Disorder. Anemia. Dyslipidemia. Complications of Drug Therapy. Nutritional Therapy Protein Restriction. Sodium and Fluid Restriction. Potassium Restriction. Phosphate Restriction. Nursing Management Chronic Kidney Disease Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Care Considerations for Chronic Kidney Disease in Stages 4 to 5. Ambulatory and Home Care. Evaluation Dialysis General Principles of Dialysis Peritoneal Dialysis Catheter Placement Dialysis Solutions and Cycles Peritoneal Dialysis Systems Automated Peritoneal Dialysis. Continuous Ambulatory Peritoneal Dialysis. Complications of Peritoneal Dialysis Exit-Site Infection. Peritonitis. Abdominal Pain. Outflow Problems. Hernias. Lower Back Problems. Bleeding. Pulmonary Complications. Protein Loss. Carbohydrate and Lipid Abnormalities. Effectiveness of and Adaptation to Chronic Peritoneal Dialysis Hemodialysis Vascular Access Sites for Hemodialysis Arteriovenous Fistulas and Grafts. Central Venous Catheters. Dialyzers Procedure Settings for Hemodialysis. Complications of Hemodialysis Hypotension. Muscle Cramps. Loss of Blood. Hepatitis. Sepsis. Disequilibrium Syndrome. Effectiveness of and Adaptation to Hemodialysis Continuous Renal Replacement Therapy Kidney Transplantation Ethical Issues Recipient Selection Histocompatibility Studies Donor Sources Living Donors. Deceased Donors. Surgical Procedure Living Donor. Kidney Transplant Recipient. Nursing Management Kidney Transplant Recipient Preoperative Care Postoperative Care Living Donor. Kidney Transplant Recipient. Immuno-suppressive Therapy Complications of Transplantation Rejection. Infection. Cardiovascular Disease. Malignancies. Recurrence of Original Renal Disease. Corticosteroid-Related Complications. Age-Related Considerations Chronic Kidney Disease Review Questions References Resources Section 10 - Problems Related to Regulatory and Reproductive Mechanisms 50. Nursing Assessment: Endocrine System Learning Objectives Key Terms Structures and Functions of the Endocrine System Glands Hormones Classifications and Functions. Hormone Transport. Targets and Receptors. Protein Hormone Receptors. Steroid Hormone Receptors. Regulation of Hormonal Secretion. Simple Feedback. Nervous System Control. Rhythms. Hypothalamus Pituitary Gland Anterior Pituitary Gland. Tropic Hormones. Growth Hormone. Prolactin. Posterior Pituitary Gland. Antidiuretic Hormone. Oxytocin. Pineal Gland. Thyroid Gland Thyroxine and Triiodothyronine. Calcitonin. Parathyroid Glands Parathyroid Hormone. Adrenal Glands Adrenal Medulla. Adrenal Cortex. Cortisol. Aldosterone. Adrenal Androgens. Pancreas Glucagon. Insulin. Age-Related Considerations The Endocrine System Assessment of the Endocrine System Subjective Data Important Health Information Past Health History. Family History. Medications. Surgery and Other Treatments. Objective Data Physical Examination. Vital Signs. Height and Weight. Mental–Emotional Status. Integument. Head. Neck. Thorax. Abdomen. Extremities. Genitalia. Diagnostic Studies of the Endocrine System Laboratory Studies Pituitary Studies. Thyroid Studies. Parathyroid Studies. Adrenal Studies. Pancreatic Studies. Review Questions References Resources 51. Nursing Management: Endocrine Problems Learning Objectives Key Terms Disorders of the Anterior Pituitary Gland Acromegaly Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Collaborative Care Surgical Therapy. Radiation Therapy. Drug Therapy. Nursing Management Acromegaly Nursing Assessment Nursing Implementation Excesses of Other Tropic Hormones Hypofunction of the Pituitary Gland Etiology and Pathophysiology Clinical Manifestations and Diagnostic Studies Nursing and Collaborative Management Hypopituitarism Disorders of the Posterior Pituitary Gland Syndrome of Inappropriate Antidiuretic Hormone Etiology and Pathophysiology Clinical Manifestations and Diagnostic Studies Collaborative Care Nursing Management Syndrome of Inappropriate Antidiuretic Hormone Diabetes Insipidus Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Collaborative Care Nursing Management Diabetes Insipidus Disorders of the Thyroid Gland Goitre Thyroid Nodules and Cancer Types of Thyroid Cancer Diagnostic Studies Nursing and Collaborative Care Thyroid Cancer Multiple Endocrine Neoplasia Thyroiditis Hyperthyroidism Etiology and Pathophysiology Graves’ Disease. Toxic Nodular Goitres. Clinical Manifestations Complications Diagnostic Studies Collaborative Care Drug Therapy. Antithyroid Drugs. Iodine. β-Adrenergic Blockers. Radioactive Iodine Therapy. Surgical Therapy. Nutritional Therapy. Nursing Management Hyperthyroidism Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Acute Intervention. Acute Thyrotoxicosis. Thyroid Surgery. Ambulatory and Home Care Postoperative Care. Evaluation Hypothyroidism Etiology and Pathophysiology Clinical Manifestations Complications Diagnostic Studies Collaborative Care Nursing Management Hypothyroidism Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Evaluation Disorders of the Parathyroid Glands Hyperparathyroidism Etiology and Pathophysiology Clinical Manifestations and Complications Diagnostic Studies Collaborative Care Surgical Therapy. Nonsurgical Therapy. Nursing Management Hyperparathyroidism Hypoparathyroidism Etiology and Pathophysiology Clinical Manifestations Nursing and Collaborative Management Hypoparathyroidism Disorders of the Adrenal Cortex Cushing’s Syndrome Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Collaborative Care Nursing Management Cushing’s Syndrome Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Preoperative Care. Postoperative Care. Ambulatory and Home Care. Evaluation Adrenocortical Insufficiency Etiology and Pathophysiology Clinical Manifestations Complications Diagnostic Studies Collaborative Care Nursing Management Addison’s Disease Nursing Implementation Acute Intervention. Ambulatory and Home Care. Corticosteroid Therapy Effects of Corticosteroid Therapy Complications Associated With Corticosteroid Therapy Nursing and Collaborative Management Corticosteroid Therapy Hyperaldosteronism Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Nursing and Collaborative Management Primary Hyperaldosteronism Disorders of the Adrenal Medulla Pheochromocytoma Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Nursing and Collaborative Management Pheochromocytoma Review Questions References Resources 52. Nursing Management: Diabetes Mellitus Learning Objectives Key Terms Diabetes Mellitus Etiology and Pathophysiology Normal Insulin Metabolism. Type 1 Diabetes Mellitus. Etiology and Pathophysiology. Onset of Disease. Prediabetes. Type 2 Diabetes Mellitus. Etiology and Pathophysiology. Onset of Disease. Gestational Diabetes. Secondary Diabetes. Clinical Manifestations Type 1 Diabetes Mellitus. Type 2 Diabetes Mellitus. Complications Diagnostic Studies. Collaborative Care Drug Therapy: Insulin Types of Insulin. Insulin Regimens. Mealtime Insulin (Bolus). Long- or Intermediate-Acting (Basal) Background Insulin. Combination Therapy. Storage of Insulin. Administration of Insulin. Injection. Alternate Delivery Methods. Problems With Insulin Therapy. Allergic Reactions. Lipodystrophy. Somogyi Effect and Dawn Phenomenon. Drug Therapy: Antihyperglycemic Agents Insulin Secretagogues. Meglitinides. Biguanides. α-Glucosidase Inhibitors. Thiazolidinediones. Dipeptidyl Peptidase-4 Inhibitors. Sodium-Glucose Cotransporter Type 2 (SGLT2) Inhibitors. Combination Therapy. Glucagon-Like Peptide (GLP)-1 Receptor Agonists (Incretin Mimetics). Other Drugs Affecting Blood Glucose Levels. Nutritional Therapy Type 1 Diabetes Mellitus. Type 2 Diabetes Mellitus. Food Composition. Alcohol. Healthy Eating Education. Exercise Monitoring Blood Glucose Bariatric Surgery Culturally Competent Care Diabetes Mellitus Nursing Management Diabetes Mellitus Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Stress of Acute Illness and Surgery. Ambulatory and Home Care. Insulin Therapy. Oral and Noninsulin Injectable Agents. Personal Hygiene. Medical Identification and Travel. Patient and Caregiver Teaching. Evaluation Acute Complications of Diabetes Mellitus Diabetic Ketoacidosis Etiology and Pathophysiology Clinical Manifestations Collaborative Care Hyperosmolar Hyperglycemic State Collaborative Care Nursing Management Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State Hypoglycemia Nursing and Collaborative Management Hypoglycemia Chronic Complications of Diabetes Mellitus Macrovascular Complications Microvascular Complications Diabetic Retinopathy Etiology and Pathophysiology Collaborative Care Nephropathy Neuropathy Etiology and Pathophysiology Classification Sensory Neuropathy. Autonomic Neuropathy. Complications of the Foot and the Lower Extremity Integumentary Complications Infection Age-Related Considerations Diabetes Mellitus Review Questions References Resources 53. Nursing Assessment: Reproductive System Learning Objectives Key Terms Structures and Functions of the Male and Female Reproductive Systems Male Reproductive System Testes. Ducts. Glands. External Genitalia. Female Reproductive System Pelvic Organs Ovaries. Fallopian Tubes. Uterus. Vagina. Pelvis. External Genitalia. Breasts. Neuroendocrine Regulation of the Reproductive System Menarche Menstrual Cycle Menopause Phases of the Sexual Response Male Sexual Response. Female Sexual Response. Age-Related Considerations The Reproductive System and Sexual Response Assessment of the Male and Female Reproductive Systems Subjective Data Important Health Information. Past Health History. Family History. Medications. Surgery or Other Treatments. Documenting a Health History Related to a Reproductive Problem. Menstrual History. Obstetrical History. Menopause. Nutritional History. Self-Care History. Elimination. Sexual Health History. Inclusive and Appropriate Health Care for Sexual and Gender Minority Communities. Objective Data Physical Examination: Male. Pubis. Penis. Scrotum and Testes. Inguinal Region and Spermatic Cord. Anus and Prostate. Physical Examination: Female. Breasts. External Genitalia. Internal Pelvic Examination. Diagnostic Studies of Reproductive Systems Urine Studies Pregnancy Testing. Hormone Studies. Blood Studies Hormone Studies. Tumour Markers. Serological Tests for Syphilis. Cultures and Smears Cytological Studies Radiological Studies Mammography. Ultrasonography. Review Questions References Resources 54. Nursing Management: Breast Disorders Learning Objectives Key Terms Assessment of Breast Disorders Diagnostic Studies Radiological Studies Biopsies Benign Breast Disorders Mastalgia Breast Infections Mastitis. Lactational Breast Abscess. Fibrocystic Changes Nursing and Collaborative Management Fibrocystic Changes Fibroadenoma Nursing and Collaborative Management Fibroadenoma Nipple Discharge Intraductal Papilloma. Duct Ectasia. Gynecomastia Senescent Gynecomastia. Age-Related Considerations Breast Changes Breast Cancer Etiology and Risk Factors Risk Factors for Women. Genetic Factors. Risk Factors for Men. Prophylactic Oophorectomy and Mastectomy. Pathophysiology Types of Breast Cancer Noninvasive Breast Cancer. Invasive (Infiltrating) Ductal Carcinoma. Inflammatory Breast Cancer. Paget’s Disease. Invasive (Infiltrating) Lobular Carcinoma. Clinical Manifestations Complications Diagnostic Studies Collaborative Care Surgical Therapy. Breast-Conserving Surgery. Axillary Node Dissection. Modified Radical Mastectomy. Postmastectomy Pain Syndrome. Adjuvant Therapy. Radiation Therapy. Primary Radiation Therapy. High-Dose Brachytherapy. Palliative Radiation Therapy. Systemic Therapy. Chemotherapy. Hormonal Therapy. Estrogen Receptor Blockers. Aromatase Inhibitors. Biological and Targeted Therapy. Follow-Up and Survivorship Care. Culturally Competent Care Breast Cancer Nursing Management Breast Cancer Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Acute Intervention. Psychological Care. Ambulatory and Home Care. Evaluation Mammoplasty Breast Reconstruction Indications. Types of Reconstruction Breast Implants and Tissue Expansion. Tissue Flap Procedures. Nipple–Areolar Reconstruction. Breast Augmentation Breast Reduction Nursing Management Breast Augmentation and Reduction Review Questions References Resources 55. Nursing Management: Sexually Transmitted Infections Learning Objectives Key Terms Sexually Transmitted Infections Factors Affecting Incidence of Sexually Transmitted Infection Bacterial Infections Gonorrhea Etiology and Pathophysiology Clinical Manifestations Men. Women. General. Complications Eye Infections in Newborns. Diagnostic Studies Collaborative Care Drug Therapy. Syphilis Etiology and Pathophysiology Clinical Manifestations Complications Diagnostic Studies Collaborative Care Drug Therapy. Chlamydial Infections Etiology and Pathophysiology Clinical Manifestations and Complications Diagnostic Studies and Collaborative Care Drug Therapy. Viral Infections Genital Herpes Etiology and Pathophysiology Clinical Manifestations Complications Herpes Simplex Virus Infection During Pregnancy. Diagnostic Studies and Collaborative Care Drug Therapy. Genital Human Papilloma Virus Infections Clinical Manifestations and Complications Diagnostic Studies and Collaborative Care Human Papilloma Virus Immunization Nursing Management Sexually Transmitted Infections Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Measures to Prevent Infection. Screening Programs. Case Finding. Educational and Research Programs. Harm Reduction. Acute Intervention Psychological Support. Follow-Up. Hygiene Measures. Sexual Activity. Ambulatory and Home Care. Evaluation Review Questions References Resources 56. Nursing Management: Female Reproductive Problems Learning Objectives Key Terms Infertility Etiology and Pathophysiology Diagnostic Studies Ovulatory Studies. Tubal Patency Studies. Postcoital Studies. Nursing and Collaborative Management Infertility Abortion Spontaneous Abortion Induced Abortion Problems Related to Menstruation Premenstrual Syndrome Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies and Collaborative Care Drug Therapy. Dysmenorrhea Etiology and Pathophysiology Clinical Manifestations Nursing and Collaborative Management Dysmenorrhea Abnormal Vaginal Bleeding Types of Irregular Bleeding Oligomenorrhea and Amenorrhea. Menorrhagia. Metrorrhagia. Diagnostic Studies and Collaborative Care Surgical Therapy. Nursing Management Abnormal Vaginal Bleeding Ectopic Pregnancy Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Nursing and Collaborative Management Ectopic Pregnancy Perimenopause and Postmenopause Clinical Manifestations Collaborative Care Drug Therapy. Nonhormonal Therapy. Nutritional Therapy. Culturally Competent Care Menopause Nursing Management Perimenopause and Postmenopause Conditions of Vulva, Vagina, and Cervix Etiology and Pathophysiology Clinical Manifestations Collaborative Care Nursing Management Conditions of Vulva, Vagina, and Cervix Pelvic Inflammatory Disease Etiology and Pathophysiology Clinical Manifestations Complications Collaborative Care Nursing Management Pelvic Inflammatory Disease Chronic Pelvic Pain Endometriosis Etiology and Pathophysiology Clinical Manifestations Collaborative Care Drug Therapy. Surgical Therapy. Nursing Management Endometriosis Benign Tumours of the Female Reproductive System Leiomyomas Etiology and Pathophysiology Clinical Manifestations Collaborative Care Cervical Polyps Benign Ovarian Tumours Polycystic Ovary Syndrome Cancer of the Female Reproductive System Cervical Cancer Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Collaborative Care Endometrial or Uterine Cancer Etiology and Pathophysiology Clinical Manifestations Collaborative Care Ovarian Cancer Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Collaborative Care Vaginal Cancer Vulvar Cancer Surgical Procedures: Female Reproductive System Radiation Therapy: Cancers of the Female Reproductive System External Radiation Therapy Internal Radiation Therapy (Brachytherapy) Nursing Management Cancers of the Female Reproductive System Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention Related to Surgery. Hysterectomy. Salpingectomy and Oophorectomy. Vulvectomy. Pelvic Exenteration. Acute Intervention With Radiation Therapy. Evaluation Problems With Pelvic Support Uterine Prolapse Cystocele and Rectocele Nursing Management Problems With Pelvic Support Fistula Nursing Management Fistulas Review Questions References Resources 57. Nursing Management: Male Reproductive Problems Learning Objectives Key Terms Problems of the Prostate Gland Benign Prostatic Hyperplasia Etiology and Pathophysiology Clinical Manifestations Complications Diagnostic Studies Collaborative Care Drug Therapy. 5α-Reductase Inhibitors. α-Adrenergic Receptor Blockers. Erectogenic Drugs. Herbal Therapy. Minimally Invasive Therapy. Transurethral Microwave Thermotherapy. Transurethral Needle Ablation. Laser Prostatectomy. Intraprostatic Urethral Stents. Invasive Therapy (Surgery). Transurethral Resection of the Prostate. Transurethral Incision of the Prostate. Prostatectomy. Nursing Management Benign Prostatic Hyperplasia Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Preoperative Care. Postoperative Care. Ambulatory and Home Care. Evaluation Prostate Cancer Etiology and Pathophysiology Clinical Manifestations and Complications Diagnostic Studies Collaborative Care Conservative Therapy. Surgical Therapy Radical Prostatectomy. Nerve-Sparing Procedure. Cryosurgery. Radiation Therapy. External Beam Irradiation. Brachytherapy. Drug Therapy. Androgen Deprivation Therapy. Androgen Synthesis Inhibitors. Androgen Receptor Blockers. Orchiectomy. Chemotherapy. Radiotherapy. Culturally Competent Care Prostate Cancer Nursing Management Prostate Cancer Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Evaluation Prostatitis Etiology and Pathophysiology Clinical Manifestations and Complications Diagnostic Studies Nursing and Collaborative Management Prostatitis Problems of the Penis Congenital Problems Problems of the Prepuce Problems of Erectile Mechanism Cancer of the Penis Problems of the Scrotum and Testes Inflammatory and Infectious Problems Skin Problems Epididymitis Orchitis Congenital Problems Acquired Problems Hydrocele Spermatocele Varicocele Testicular Torsion Testicular Cancer Etiology and Pathophysiology Clinical Manifestations and Complications Diagnostic Studies Nursing and Collaborative Management Testicular Cancer Testicular Self-Examination Collaborative Care Sexual Functioning Vasectomy Erectile Dysfunction Etiology and Pathophysiology Clinical Manifestations and Complications Diagnostic Studies Collaborative Care Erectogenic Drugs. Vacuum Constriction Devices. Vasoactive Drugs. Penile Implants. Sexual Counselling. Nursing Management Erectile Dysfunction Andropause Infertility Review Questions References Resources Section 11 - Problems Related to Movement and Coordination 58. Nursing Assessment: Nervous System Learning Objectives Key Terms Structures and Functions of the Nervous System Cells of the Nervous System Neurons. Glial Cells. Neurogenesis Nerve Impulse Synapse. Neurotransmitters. Central Nervous System Spinal Cord. Ascending Tracts. Descending Tracts. Lower Motor Neurons. Upper Motor Neurons. Reflex Arc. Brain. Cerebrum. Brain Stem. Cerebellum. Ventricles and Cerebro-Spinal Fluid. Cerebro-Spinal Fluid. Peripheral Nervous System Spinal Nerves. Cranial Nerves. Autonomic Nervous System. Cerebral Circulation Blood–Brain Barrier. Protective Structures Meninges. Skull. Vertebral Column. Age-Related Considerations Effects of Aging on the Nervous System Assessment of the Nervous System Subjective Data Important Health Information Past Health History. Medications. Surgery or Other Treatments. Health Status. General Health Practices. Nutritional Problems. Bowel and Bladder Problems. Motor Problems. Sleep Problems. Cognition and Sensory Problems. Emotional Problems. Relationship Problems. Sexual Problems. Objective Data Physical Examination. Mental Status. Function of Cranial Nerves. Olfactory Nerve. Optic Nerve. Oculomotor, Trochlear, and Abducens Nerves. Trigeminal Nerve. Facial Nerve. Vestibulo-cochlear Nerve. Glossopharyngeal and Vagus Nerves. Spinal Accessory Nerve. Hypoglossal Nerve. Motor Function. Sensory Function. Light Touch. Pain and Temperature. Vibration Sense. Position Sense. Cortical Sensory Functions. Reflex Function. Diagnostic Studies of the Nervous System Cerebro-Spinal Fluid Analysis. Lumbar Puncture. Radiological Studies Cerebral Angiography. Computed Tomography. Magnetic Resonance Imaging. Positron Emission Tomography. Electrographic Studies Electroencephalography. Electromyography and Nerve Conduction Studies. Evoked Potentials. Combined Doppler and Ultrasound (Duplex) Studies Carotid Duplex. Transcranial Doppler Sonography. Review Questions References Resources 59. Nursing Management: Acute Intracranial Problems Learning Objectives Key Terms Intracranial Pressure Regulation and Maintenance of Intracranial Pressure Normal Intracranial Pressure. Normal Compensatory Adaptations. Cerebral Blood Flow Autoregulation of Cerebral Blood Flow. Other Factors Affecting Cerebral Blood Flow. Pressure Changes. Increased Intracranial Pressure Mechanisms of Increased Intracranial Pressure Cerebral Edema Vasogenic Cerebral Edema. Cytotoxic Cerebral Edema. Interstitial Cerebral Edema. Clinical Manifestations Change in Level of Consciousness. Changes in Vital Signs. Ocular Signs. Decrease in Motor Function. Headache. Vomiting. Complications Diagnostic Studies Neuromonitoring Measurement of Intracranial Pressure. Cerebro-Spinal Fluid Drainage. Cerebral Oxygenation Monitoring. Collaborative Care Drug Therapy. Nutritional Therapy. Supportive Therapy. Nursing Management Increased Intracranial Pressure Nursing Assessment Glasgow Coma Scale. Neurological Assessment. Nursing Diagnoses Planning Nursing Implementation Acute Intervention Respiratory Function. Fluid and Electrolyte Balance. Monitoring Intracranial Pressure. Body Position. Protection From Injury. Psychological Considerations. Evaluation Head Injury Types of Head Injuries Scalp Lacerations. Skull Fractures. Head Trauma. Diffuse Injury. Diffuse Axonal Injury. Focal Injury. Complications Epidural Hematoma. Subdural Hematoma. Intraparenchymal Hematoma. Traumatic Subarachnoid Hemorrhage. Diagnostic Studies and Collaborative Care Nursing Management Head Injury Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Evaluation Brain Tumours Types Clinical Manifestations Complications Diagnostic Studies Collaborative Care Drug Therapy. Surgical Therapy. Ventricular Shunts. Radiation Therapy and Radiosurgery. Chemotherapy and Targeted Therapy. Other Therapies. Nursing Management Brain Tumours Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Evaluation Cranial Surgery Types Stereotactic Surgery. Craniotomy. Nursing Management Cranial Surgery Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Acute Intervention. Ambulatory and Home Care. Evaluation Inflammatory Conditions of the Brain Bacterial Meningitis Etiology and Pathophysiology Clinical Manifestations Complications Diagnostic Studies Collaborative Care Nursing Management Bacterial Meningitis Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Evaluation Viral Meningitis Encephalitis Etiology and Pathophysiology Clinical Manifestations and Diagnostic Studies Nursing and Collaborative Management Viral Encephalitis Rabies Brain Abscess Review Questions References Resources 60. Nursing Management: Stroke Learning Objectives Key Terms Pathophysiology of a Stroke Anatomy of Cerebral Circulation Regulation of Cerebral Blood Flow Atherosclerosis Risk Factors for Stroke Nonmodifiable Risk Factors Modifiable Risk Factors Types of Stroke Ischemic Stroke Transient Ischemic Attack. Thrombotic Stroke. Embolic Stroke. Hemorrhagic Stroke Intracerebral Hemorrhage. Subarachnoid Hemorrhage. Clinical Manifestations of Stroke Motor Function. Communication. Affect. Intellectual Function. Spatial–Perceptual Alterations. Elimination. Diagnostic Studies Collaborative Care Prevention Therapy. Drug Therapy. Surgical Therapy. Collaborative Acute Care for Ischemic Stroke. Drug Therapy for Ischemic Stroke. Surgical Therapy for Ischemic Stroke. Collaborative Acute Care for Hemorrhagic Stroke Drug Therapy. Surgical Therapy. Rehabilitation Care. Nursing Management Stroke Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention for All Stroke Patients. Respiratory System. Neurological System. Cardiovascular System. Musculo-Skeletal System. Integumentary System. Gastro-Intestinal System. Urinary System. Nutrition. Communication. Sensory–Perceptual Alterations. Coping. Ambulatory and Home Care: Stroke Recovery. Musculo-Skeletal Function. Nutritional Therapy. Bowel Function. Bladder Function. Sensory–Perceptual Function. Affect. Coping. Sexual Function. Community Reintegration. Age-Related Considerations Stroke Review Questions References Resources 61. Nursing Management: Chronic Neurological Problems Learning Objectives Key Terms Headache Migraine Headache Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Tension-Type Headache Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Cluster Headache Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Other Types of Headaches Collaborative Care for Headaches Drug Therapy Migraine Headache. Tension-type Headache. Cluster Headache. Other Headaches. Nursing Management Headaches Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Evaluation Chronic Neurological Disorders Seizure Disorders and Epilepsy Etiology and Pathophysiology Clinical Manifestations Generalized Seizures. Tonic–Clonic Seizures. Typical Absence Seizures. Atypical Absence Seizures. Other Types of Generalized Seizures. Focal Seizures. Focal Aware Seizures. Focal Impaired Awareness Seizures. Complications Physical. Psychosocial. Diagnostic Studies Collaborative Care Drug Therapy. Surgical Therapy. Alternate Therapies. Nursing Management Seizure Disorders and Epilepsy Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Evaluation Multiple Sclerosis Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Collaborative Care Drug Therapy. Alternate Therapies. Nutritional Therapy. Nursing Management Multiple Sclerosis Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Evaluation Parkinson’s Disease Etiology and Pathophysiology Clinical Manifestations Tremor. Rigidity. Bradykinesia. Complications Diagnostic Studies Collaborative Care Drug Therapy. Surgical Therapy. Nutritional Therapy. Nursing Management Parkinson’s Disease Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Evaluation Myasthenia Gravis Etiology and Pathophysiology Clinical Manifestations and Complications Diagnostic Studies Collaborative Care Drug Therapy. Surgical Therapy. Other Therapies. Nursing Management Myasthenia Gravis Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Evaluation Restless Legs Syndrome Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Nursing and Collaborative Management Restless Legs Syndrome Amyotrophic Lateral Sclerosis Huntington’s Disease Normal Pressure Hydrocephalus Review Questions References Resources 62. Nursing Management: Delirium, Alzheimer’s Disease, and Other Dementias Learning Objectives Key Terms Delirium Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Nursing and Collaborative Management Delirium Drug Therapy Dementia Etiology and Pathophysiology Alzheimer’s Disease. Vascular Dementia. Dementia With Lewy Bodies. Frontotemporal Dementia. Clinical Manifestations Behavioural and Psychological Symptoms of Dementia. Diagnostic Studies Related Assessments. Risk Modification Collaborative Care Drug Therapy. Nursing Management Dementia Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Behavioural Changes. Safety. Pain Management. Eating and Swallowing Difficulties. Oral Care. Infection Prevention. Skin Care. Elimination Problems. Caregiver Support. Legal Matters and Personal Care Planning. Evaluation Review Questions References Resources 63. Nursing Management: Peripheral Nerve and Spinal Cord Problems Learning Objectives Key Terms Cranial Nerve Disorders Trigeminal Neuralgia Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Collaborative Care Drug Therapy. Conservative Therapy. Surgical Therapy. Nursing Management Trigeminal Neuralgia Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Evaluation Bell’s Palsy Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Collaborative Care Drug Therapy. Nursing Management Bell’s Palsy Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Evaluation Polyneuropathies Guillain-Barré Syndrome Etiology and Pathophysiology Clinical Manifestations Complications. Diagnostic Studies Collaborative Care Nutritional Therapy. Nursing Management Guillain-Barré Syndrome Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Evaluation Botulism Etiology and Pathophysiology Clinical Manifestations Drug Therapy Tetanus Etiology and Pathophysiology Clinical Manifestations Drug Therapy. Nursing Management Tetanus Neuro-Syphilis Spinal Cord Problems Spinal Cord Injury Etiology and Pathophysiology Initial Injury. Spinal and Neurogenic Shock. Classification of Spinal Cord Injury. Mechanisms of Injury. Level of Injury. Degree of Injury. Central Cord Syndrome. Anterior Cord Syndrome. Brown-Séquard Syndrome. Posterior Cord Syndrome. Conus Medullaris Syndrome and Cauda Equina Syndrome. American Spinal Injury Association Impairment Scale. Clinical Manifestations Respiratory System. Cardiovascular System. Urinary System. Gastro-Intestinal System. Integumentary System. Thermoregulation. Metabolic Needs. Peripheral Vascular Problems. Diagnostic Studies Collaborative Care Nonoperative Stabilization. Surgical Therapy. Drug Therapy. Nursing Management Spinal Cord Injury Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Immobilization. Respiratory Dysfunction. Cardiovascular Instability. Fluid and Nutritional Maintenance. Bladder and Bowel Management. Temperature Control. Stress Ulcers. Sensory Deprivation. Reflexes. Autonomic Dysreflexia. Rehabilitation and Home Care. Respiratory Rehabilitation. Neurogenic Bladder. Neurogenic Bowel. Neurogenic Skin. Sexuality. Grief and Depression. Evaluation Age-Related Considerations Spinal Cord Injury Spinal Cord Injury Research in Canada Spinal Cord Tumours Etiology and Pathophysiology Clinical Manifestations Nursing and Collaborative Management Spinal Cord Tumours Postpolio Syndrome Etiology and Pathophysiology Clinical Manifestations and Diagnostic Studies Nursing and Collaborative Management Postpolio Syndrome Review Questions References Resources 64. Nursing Assessment: Musculo-Skeletal System Learning Objectives Key Terms Structures and Functions of the Musculo-skeletal System Bone Function. Microscopic Structure. Gross Structure. Types. Joints Cartilage Muscle Types. Structure. Contractions. Neuro-muscular Junction. Energy Source. Ligaments and Tendons Fasciae Bursae Age-Related Considerations The Musculo-skeletal System Assessment of the Musculo-skeletal System Subjective Data Important Health Information. Past Health History. Medications. Surgery or Other Treatments. Objective Data Physical Examination. Inspection. Palpation. Motion. Muscle Strength Testing. Measurement. Other. Diagnostic Studies of the Musculo-skeletal System Radiography Magnetic Resonance Imaging Arthroscopy Arthrocentesis and Synovial Fluid Analysis Muscle Enzymes Serological Studies Review Questions References Resources 65. Nursing Management: Musculo-Skeletal Trauma and Orthopaedic Surgery Learning Objectives Key Terms Soft Tissue Injuries Sprains and Strains Nursing Management Sprains and Strains Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Dislocation and Subluxation Nursing and Collaborative Management Dislocation Repetitive Strain Injury Carpal Tunnel Syndrome Nursing and Collaborative Management Carpal Tunnel Syndrome Rotator Cuff Injury Meniscus Injury Nursing and Collaborative Management Meniscus Injury Anterior Cruciate Ligament Injury Nursing and Collaborative Management ACL Injury Bursitis Fractures Classification Clinical Manifestations Fracture Healing Collaborative Care Fracture Reduction Closed Reduction. Open Reduction. Traction. Fracture Immobilization. Casts. Upper Extremity Injuries. Vertebral Injuries. Lower Extremity Injuries. External Fixation. Internal Fixation. Electrical Bone Growth Stimulation. Drug Therapy. Nutritional Therapy. Nursing Management Fractures Nursing Assessment Neuro-vascular Assessment. Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Preoperative Management. Postoperative Management. Other Measures. Traction. Ambulatory and Home Care Cast Care. Psychosocial Problems. Ambulation. Assistive Devices. Counselling and Referrals. Evaluation Complications of Fractures Infection Collaborative Care. Compartment Syndrome Clinical Manifestations. Collaborative Care. Venous Thrombo-Embolism Fat Embolism Syndrome Clinical Manifestations. Collaborative Care. Types of Fractures Colles Fracture Fracture of the Humerus Fracture of the Pelvis Fracture of the Hip Clinical Manifestations Collaborative Care Nursing Management Hip Fracture Nursing Implementation Preoperative Management. Postoperative Management. Ambulatory and Home Care. Evaluation Age-Related Considerations Hip Fracture Femoral Shaft Fracture Fracture of the Tibia Stable Vertebral Fractures Facial Fractures Mandible Fracture Nursing Management Mandibular Fracture Nursing Implementation Preoperative Management. Postoperative Management. Amputation Clinical Indications Diagnostic Studies Collaborative Care Nursing Management Amputation Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Preoperative Management. Postoperative Management. Ambulatory and Home Care. Special Considerations in Upper-Limb Amputation. Evaluation Age-Related Considerations Amputation Common Joint Surgical Procedures Types of Joint Surgeries Synovectomy Osteotomy Debridement Arthroplasty Hip Arthroplasty. Hip Resurfacing. Knee Arthroplasty. Finger Joint Arthroplasty. Elbow and Shoulder Arthroplasty. Ankle Arthroplasty. Arthrodesis Complications of Joint Surgery Collaborative Care Preoperative Management. Postoperative Management. Nursing Management Joint Surgery Review Questions References Resources 66. Nursing Management: Musculo-Skeletal Problems Learning Objectives Key Terms Osteomyelitis Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Collaborative Care Nursing Management Osteomyelitis Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Evaluation Bone Tumours Clinical Manifestations Diagnostic Studies Benign Tumours Osteochondroma Osteoclastoma Malignant Bone Tumours Osteosarcoma Ewing Sarcoma Family of Tumours Metastatic Bone Cancer Nursing Management Bone Cancer Low Back Pain Etiology and Pathophysiology Acute Low Back Pain Collaborative Care Chronic Low Back Pain Spinal Stenosis Nursing and Collaborative Management Chronic Low Back Pain Nursing Management Nonspecific Low Back Pain Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Evaluation Intervertebral Disc Disease Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Collaborative Care Surgical Therapy. Nursing Management Spinal Surgery Neck Pain Foot Disorders Nursing Management Foot Disorders Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Age-Related Considerations Foot Problems Metabolic Bone Diseases Osteoporosis Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Nursing and Collaborative Management Osteoporosis Drug Therapy Paget’s Disease Age-Related Considerations Metabolic Bone Diseases Review Questions References Resources 67. Nursing Management: Arthritis and Connective Tissue Diseases Learning Objectives Key Terms Arthritis Osteoarthritis Etiology and Pathophysiology Clinical Manifestations Systemic. Joints. Deformity. Diagnostic Studies Collaborative Care Rest and Joint Protection. Heat and Cold Applications. Nutritional Therapy and Exercise. Complementary and Alternative Therapies. Drug Therapy. Surgical Therapy. Nursing Management Osteoarthritis Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Evaluation Rheumatoid Arthritis Etiology and Pathophysiology Genetic Factors. Clinical Manifestations Joints. Extra-Articular Manifestations. Diagnostic Studies Collaborative Care Drug Therapy Disease-Modifying Antirheumatic Drugs. Biological and Targeted Therapies. Other Drug Therapy. Nutritional Therapy. Surgical Therapy. Nursing Management Rheumatoid Arthritis Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care Rest. Joint Protection. Heat and Cold Therapy and Exercise. Psychological Support. Age-Related Considerations Arthritis Gout Etiology and Pathophysiology Clinical Manifestations and Complications Diagnostic Studies Collaborative Care Drug Therapy. Nutritional Therapy. Nursing Management Gout Lyme Disease Septic Arthritis Spondyloarthropathies Ankylosing Spondylitis Etiology and Pathophysiology Clinical Manifestations and Complications Diagnostic Studies Collaborative Care Nursing Management Ankylosing Spondylitis Psoriatic Arthritis Reactive Arthritis Other Connective Tissue Disorders Systemic Lupus Erythematosus Etiology and Pathophysiology Clinical Manifestations and Complications Dermatological Manifestations. Musculo-Skeletal Problems. Cardiopulmonary Problems. Renal Problems. Nervous System Problems. Hematological Problems. Infection. Diagnostic Studies Collaborative Care Drug Therapy. Nursing Management Systemic Lupus Erythematosus Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Ambulatory and Home Care. Lupus and Pregnancy. Psychosocial Issues. Evaluation Scleroderma Etiology and Pathophysiology Clinical Manifestations Raynaud’s Phenomenon. Skin and Joint Changes. Internal Organ Involvement. Diagnostic Studies Collaborative Care Drug Therapy. Nursing Management Scleroderma Polymyositis and Dermatomyositis Etiology and Pathophysiology Clinical Manifestations and Complications Muscular. Dermal. Other Manifestations. Diagnostic Studies Nursing and Collaborative Management Polymyositis and Dermatomyositis Mixed (Overlapping) Forms of Connective Tissue Disease Sjögren Syndrome Soft-Tissue Rheumatic Syndromes Myofascial Pain Syndrome Fibromyalgia Etiology and Pathophysiology Clinical Manifestations and Complications Diagnostic Studies Collaborative Care Nursing Management Fibromyalgia Systemic Exertion Intolerance Disease Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Nursing and Collaborative Management SEID Review Questions References Resources Section 12 - Nursing Care in Specialized Settings 68. Nursing Management: Critical Care Environment Learning Objectives Key Terms Critical Care Nursing Critical Care Units Critical Care Nurse Critical Care Patient Common Problems of Critical Care Patients. Nutrition. Anxiety. Pain. Impaired Communication. Sensory-Perceptual Problems. Sleep Problems. Issues Related to Caregivers. Culturally Competent Care Critical Care Patients Hemodynamic Monitoring Hemodynamic Terminology Cardiac Output and Cardiac Index. Preload. Afterload. Vascular Resistance. Contractility. Principles of Invasive Pressure Monitoring Types of Invasive Pressure Monitoring Arterial Blood Pressure. Measurements. Complications. Arterial Pressure–Based Cardiac Output. Measurements. Pulmonary Artery Flow-Directed Catheter. Pulmonary Artery Catheter Insertion. Central Venous or Right Atrial Pressure Measurement. Noninvasive Hemodynamic Monitoring: Impedance Cardiography. Venous Oxygen Saturation. Noninvasive Arterial Oxygenation Monitoring. Nursing Management Hemodynamic Monitoring Circulatory Assist Devices Intra-Aortic Balloon Pump Effects of Counter-Pulsation. Complications With IABP Therapy. Ventricular Assist Devices Implantable Artificial Heart Nursing Management Circulatory Assist Devices Artificial Airways Endotracheal Tubes Endotracheal Intubation Procedure Nursing Management Artificial Airway Maintaining Correct Tube Placement Maintaining Proper Cuff Inflation Monitoring Oxygenation and Ventilation Maintaining Tube Patency Providing Oral Care and Maintaining Skin Integrity Fostering Comfort and Communication Complications of Endotracheal Intubation Mechanical Ventilation Types of Mechanical Ventilation Negative-Pressure Ventilation. Positive-Pressure Ventilation. Volume Ventilation. Pressure Ventilation. Settings of Mechanical Ventilators Modes of Volume Ventilation Assist-Control Ventilation. Synchronized Intermittent Mandatory Ventilation. Modes of Pressure Ventilation Pressure-Support Ventilation. Pressure-Control Inverse Ratio Ventilation. Airway Pressure Release Ventilation. Other Modes. Other Ventilatory Manoeuvres Positive End-Expiratory Pressure. Continuous Positive Airway Pressure. Bilevel Positive Airway Pressure. High-Frequency Oscillatory Ventilation. Nitric Oxide. Prone Positioning. Extracorporeal Membrane Oxygenation. Complications of Positive-Pressure Ventilation Cardiovascular System. Pulmonary System. Barotrauma. Volutrauma. Alveolar Hypoventilation. Alveolar Hyperventilation. Ventilator-Associated Pneumonia. Sodium and Water Imbalance. Neurological System. Gastro-Intestinal System. Musculo-Skeletal System. Psychosocial Needs. Machine Disconnection or Malfunction. Weaning From Positive-Pressure Ventilation and Extubation Chronic Mechanical Ventilation Nursing Management Mechanical Ventilation Other Critical Care Content Review Questions References Resources 69. Nursing Management: Shock, Systemic Inflammatory Response Syndrome, and Multiple-Organ Dysfunction Syndrome Learning Objectives Key Terms Shock Classification of Shock Shock Caused by Low Blood Flow Cardiogenic Shock. Hypovolemic Shock. Distributive Shock: Shock Caused by Maldistribution of Blood Flow Neurogenic Shock. Anaphylactic Shock. Septic Shock. Stages of Shock Compensatory Stage. Progressive Stage. Refractory Stage. Diagnostic Studies Collaborative Care: General Measures Oxygen and Ventilation. Fluid Resuscitation. Drug Therapy. Sympathomimetic Drugs. Vasodilator Drugs. Nutritional Therapy. Collaborative Care: Specific Measures Cardiogenic Shock. Hypovolemic Shock. Septic Shock. Neurogenic Shock. Anaphylactic Shock. Nursing Management Shock Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health Promotion. Acute Intervention. Neurological Status. Cardiovascular Status. Respiratory Status. Renal Status. Body Temperature and Skin Changes. Gastro-Intestinal Status. Personal Hygiene. Emotional Support and Comfort. Ambulatory and Home Care. Evaluation Systemic Inflammatory Response Syndrome and Multiple-Organ Dysfunction Syndrome Etiology and Pathophysiology Organ and Metabolic Dysfunction. Clinical Manifestations Nursing and Collaborative Management SIRS and MODS Prevention and Treatment of Infection Maintenance of Tissue Oxygenation Nutritional and Metabolic Needs Support of Failing Organs Review Questions References Resources 70. Nursing Management: Respiratory Failure and Acute Respiratory Distress Syndrome Learning Objectives Key Terms Acute Respiratory Failure Etiology and Pathophysiology Hypoxemic Respiratory Failure. Ventilation–Perfusion Mismatch. Shunt. Diffusion Limitation. Alveolar Hypoventilation. Interrelationship of Mechanisms. Hypercapnic Respiratory Failure. Airways and Alveoli. Central Nervous System. Chest Wall. Neuro-muscular Conditions. Tissue Oxygen Needs. Clinical Manifestations Consequences of Hypoxemia and Hypoxia. Specific Clinical Manifestations. Diagnostic Studies Nursing and Collaborative Management Acute Respiratory Failure Nursing Assessment Nursing Diagnoses Planning Prevention Respiratory Therapy Oxygen Therapy. Mobilization of Secretions. Effective Coughing and Positioning. Hydration and Humidification. Chest Physiotherapy. Airway Suctioning. Positive-Pressure Ventilation. Drug Therapy Relief of Bronchospasm. Reduction of Airway Inflammation. Reduction of Pulmonary Congestion. Treatment of Pulmonary Infections. Reduction of Severe Anxiety, Pain, and Agitation. Medical Supportive Therapy Treating the Underlying Cause. Maintaining Adequate Cardiac Output. Maintaining Adequate Hemoglobin Concentration. Nutritional Therapy Evaluation Age-Related Considerations Respiratory Failure Acute Respiratory Distress Syndrome Etiology and Pathophysiology Injury or Exudative Phase. Reparative or Proliferative Phase. Fibrotic Phase. Clinical Progression Clinical Manifestations Complications Hospital-Acquired Pneumonia. Barotrauma. Volutrauma. Stress Ulcers. Renal Failure. Nursing and Collaborative Management Acute Respiratory Distress Syndrome Nursing Assessment Nursing Diagnoses Planning Respiratory Therapy Oxygen Administration. Mechanical Ventilation. Positioning Strategies. Medical Supportive Therapy Maintenance of Cardiac Output and Tissue Perfusion. Maintenance of Nutrition and Fluid Balance. Evaluation Severe Acute Respiratory Syndrome Review Questions References Resources 71. Nursing Management: Emergency Care Situations Learning Objectives Key Terms Care of the Emergency Patient Primary Survey A = Airway With Cervical Spine Stabilization or Immobilization B = Breathing C = Circulation D = Disability Secondary Survey E = Exposure and Environmental Control F = Full Set of Vital Signs/Five Interventions/Facilitating Family Presence G = Giving Comfort Measures H = History and Head-to-Toe Assessment Head, Neck, and Face. Chest. Abdomen and Flanks. Pelvis and Perineum. Extremities. I = Inspect the Posterior Surfaces Intervention and Evaluation Mandatory Reporting of Gunshot and Stab Wounds Reporting of Abuse of Children Death in the Emergency Department Organ and Tissue Donation Emergency Department Wait Times. Age-Related Considerations Emergency Care Environmental Emergencies Heat-Related Emergencies Heat Cramps Heat Exhaustion Heatstroke Collaborative Care. Cold-Related Emergencies Frostbite Hypothermia Collaborative Care. Submersion Injuries Collaborative Care Bites and Stings Hymenopteran Stings Spider Bites (Arachnid) Black Widow Spiders. Tick Bites Animal and Human Bites Collaborative Care. Poisonings Violence Domestic Violence Elder Abuse. Sexual Assault Clinical Manifestations Physical. Psychological. Collaborative Care Nursing Management Sexual Assault Review Questions References Resources 72. Emergency Management and Disaster Planning Learning Objectives Key Terms Emergency Management and Disaster Planning Individual, Local–Municipal, Provincial–Territorial, and Federal and First Nations Responsibilities Disaster Response in First Nations Communities Emergency/Disaster Management Mitigation Preparedness Health Care Emergency Operations Plans. Internal and External Disasters. Contents of Health Care Emergency Operations Plans. Testing of Emergency Plans. Response The Incident Management System. Triage. Triage in Disaster Situations. Disaster Triage in the Hospital Setting. Recovery and Rehabilitation Critical Incident Stress Management. The Role of Nursing Leadership in Disaster Preparedness and Response Natural and Human-Made or Induced Disasters Natural Disasters Human-Made or Human-Induced Disasters Terrorism. Chemical–Biological–Radiological–Nuclear–Explosive Events. Biological Agents of Terrorism. Chemical Agents of Terrorism. Radiological and Nuclear Agents of Terrorism. Explosive Agents of Terrorism. Epidemics and Pandemics Severe Acute Respiratory Syndrome Outbreak Management Outbreak Management Strategies. Pandemic Planning Ethical Issues During a Disaster or Pandemic. Vulnerable Individuals and Populations. Disaster Nursing Review Questions References Resources Appendices Appendix A Nursing Diagnoses Appendix B Laboratory Values Glossary A B C D E F G H I J K L M O P Q R S T U V W Index A B C D E F G H I J K L M N O P Q R S T U V W X Y Z Special Features Back Matter Situation–Background–Assessment–Recommendation (SBAR) Sample I-SBAR-R Report From a Nurse to a Physician About a Critical Situation Identification Situation Background Assessment Recommendations Repeat Back