Medical-Surgical Nursing Care / Edition 2

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The nature of nursing is …

Medical Surgical Nursing Care, 2e

Karen M. Burke, RN, MS

Priscilla LeMone, RN, DSN, FAAN

Elaine L. Mohn-Brown, EdD, RN

The nature of nursing embodies the ever-changing rewards and challenges for today’s practical and vocational nursing students. Streamlined yet thorough content provides easy access to need-to-know information and the essential skills needed to deliver safe and effective medical surgical nursing care. Extensive unit wrap-ups, critical thinking care maps, comprehensive reviews and much more, all ensure your success as a nursing student and as a nurse!

Features that promote success include:

· Critical thinking care maps and NCLEX-PN® exam preparation

· Documentation samples, pharmacology tables, a variety of special boxes related to client teaching and special populations

· Nursing care features such as priorities in nursing care, nursing care checklists and procedure checklists, clinical alerts, and nursing process care plans

Additional resources include:

· Student CD-ROM inside with an audio glossary, animations and videos, and NCLEX-PN® style review questions.

· Companion Website at with chapter-specific online resources, case studies, and additional NCLEX- PN® -style questions.

· Student workbook with chapter review activities and critical thinking case studies.

The nature of nursing — grow with it!

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Editorial Reviews

Doody's Review Service
Reviewer: Penny Wolfe Moore, RNC, PhD (Southwestern Adventist University)
Description: This medical/surgical nursing textbook for LVN/LPN students is organized around major medical diagnoses, but the content is very nursing focused. There are many excellent photographs and illustrations. The title does not indicate the primary audience, which may cause some confusion.
Purpose: The authors' objectives are not clearly stated but are self evident. "Understanding comes not through memorization, but through practice and integration of new material into your thinking. Medical-Surgical Nursing Care promotes understanding in several ways. The writing style is clear, with a focus on readability. Its content is streamlined but thorough, focusing on what you need to know and to be able to do." Writing a text in this manner is a challenge that the authors have met.
Audience: The authors' and I agree that the LVN/PN nursing student will be the primary user of this comprehensive textbook. The three authors, all of the "contributor team," and the entire reviewer panel are educators. This presents a potential problem. It would be well advised to include RNs and LVN/PNs in full time clinical practice. All the educators have many years of experience and represent various specialties.
Features: Nursing care organized around all the major medical diagnoses is covered. There are several features that make this a student-friendly book. Using a system of different colors and icons (the icons are boxes of variable colors without symbolic value) students are pointed to "Caring Tip", "Learning Outcomes" (primarily a discussion and description of level objectives), "MediaLink", "Client Teaching", "Nursing Care and Procedure", "Nutrition and Population Focus", "Assessment", and several others. Multiple choice questions are presented at the end of each chapter for a summary and test-taking practice. The photographs and illustrations are excellent.
Assessment: This comprehensive textbook designed for the LVN/PN nursing students is well organized and well written. The photographs and illustrations are some of the best I have seen. The use of colors and icons to direct and organize the student experience is good, but adding icons with symbolic value would be an improvement. The chapter objectives are very low level but since this is a basic text for the LVN/PN student, perhaps this is appropriate. The book comes with a student CD-ROM with exam questions, case studies and a link to the companion Web site. There are several supplements for faculty also.

3 Stars from Doody
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Product Details

  • ISBN-13: 9780131714724
  • Publisher: Prentice Hall
  • Publication date: 6/9/2006
  • Edition description: REV
  • Edition number: 2
  • Pages: 1608
  • Product dimensions: 8.62 (w) x 10.98 (h) x 1.94 (d)

Meet the Author

Karen M. Burke, RN, MS

Karen M. Burke is the Education Consultant for the Oregon State Board of Nursing. She obtained her initial nursing education at Emanuel Hospital School of Nursing in Portland, Oregon, later completing baccalaureate studies at Oregon Health & Sciences University, and a master’s degree at University of Portland. Ms. Burke has extensive clinical nursing experience in acute care and community-based settings, as well as more than 20 years of experience as a nurse educator and program administrator.

As a nurse educator, Ms. Burke is known as a leader and an innovator. She led the faculty of an associate degree nursing program in developing an online program to deliver nursing education to a distant rural community. Ms. Burke is actively involved in nursing education in Oregon, participating in the development of an educational consortium of a public university and local community colleges to deliver a common baccalaureate degree nursing curriculum around the state. She also is actively involved in the Oregon Nursing Leadership Council Education Committee, helping identify strategies to recruit and retain nursing faculty, develop innovative clinical models, and provide policy guidelines for use by all nursing education programs in the state. In addition, Ms. Burke is working with nursing leaders and educators to identify and develop strategic plans to more effectively educate and use practical nurses (LPNs) in Oregon. As education consultant to the Board, she works directly with new and existing practical and registered nursing programs to promote and maintain current and high-quality nursing education for the citizens of Oregon.

Ms. Burke strongly values the nursing profession and believes in the importance of a strong education in the art and science of nursing for all students entering the profession. She believes that her diverse experience as a nursing student, clinical nurse, and nurse educator and administrator has prepared her well to relate to nursing students in diverse educational settings.

Ms. Burke and her husband Steve love to garden, travel, and spend time with their extended family. Ms. Burke also enjoys a passion for quilting, accumulating and gradually completing multiple UFOs (unfinished objects).

Priscilla LeMone, RN, DSN, FAAN

Priscilla LeMone has spent most of her career as a nurse educator, teaching medical-surgical nursing and pathophysiology at all levels from diploma to doctoral students. She has a diploma in nursing from Deaconess College of Nursing (St. Louis, Missouri), baccalaureate and master’s degrees from Southeast Missouri State University, and a doctorate in nursing from the University of Alabama-Birmingham. Dr. LeMone has retired from the Sinclair School of Nursing, University of Missouri-Columbia as Associate Professor Emeritus.

Dr. LeMone has received numerous awards for scholarship and teaching during her over 30 years as a nurse educator. She is most honored for receiving the Kemper Fellowship for Teaching Excellence from the University of Missouri-Columbia and the Unique Contribution Award from the North American Nursing Diagnosis Association, and for being selected as a Fellow in the American Academy of Nursing.

She believes that her education gave her solid and everlasting roots in nursing. Her work with students has given her the wings that allow her love of nursing and teaching to continue through the years.

Elaine L. Mohn-Brown, RN, EdD

Elaine L. Mohn-Brown received her Diploma in Nursing from Akron General Medical Center School of Nursing in Akron, Ohio. She has baccalaureate and master’s degrees in nursing and health education from Metropolitan State College and University of Northern Colorado, and an EdD in higher education administration from Brigham Young University. She has worked in critical care units in Ohio and Colorado.

Her first teaching position was as a practical nursing instructor at Larimer County Vocational-Technical Center in Colorado. For the past 26 years, she has been on the faculty of the ADN Program at Chemeketa Community College in Salem, Oregon. Through thought-provoking classroom presentations and hands-on acute care medical-surgical experiences, she has encouraged students to question and understand the rationale for their nursing care. She has implemented an extensive orientation program for novice nursing faculty at Chemeketa Community College and in 2005 developed Clinical Teaching in Oregon, a DVD to educate new clinical nursing faculty.

Dr. Mohn-Brown serves as a member of the Editorial Advisory Board for Nurse Educator and is a program evaluator for the Northwest Commission on Colleges and Universities. She has published nationally and conducts workshops at the national level.

Her love of nursing and teaching has taken her to numerous international and national conferences.

Linda Eby, RN, MN

Linda Eby received her baccalaureate and master’s degrees in nursing from Oregon Health and Sciences University. She has 31 years of experience in nursing. Her nursing practice has been in critical care, home health/hospice, and psychiatric mental health nursing. As a Clinical Nurse Specialist in clinical genetics, she coordinated the Prenatal Genetics Clinic at OHSU. She has conducted workshops on teaching diverse students of nursing. As secretary of the American Federation of Teachers-Oregon, she serves as an advocate for the rights of education employees and students.

Ms. Eby has been teaching nursing at the community college level for 20 years. Her current teaching areas are nursing fundamentals, diabetes care, transcultural nursing, and psychiatric mental health nursing. She is the coordinator of a Nursing Student Success Program, which serves students who speak English as a non-native language, immigrant students, and other nontraditional students.

Ms. Eby loves and respects the profession of nursing even more now than she did 31 years ago. Fortunately, she has two wonderful daughters and two good dogs to provide balance in her life.

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Table of Contents

Ch. 1 The medical - surgical nurse 3
Ch. 2 The adult client in health and illness 15
Ch. 3 The older adult client in health and illness 30
Ch. 4 Settings of care 43
Ch. 5 Guidelines for client assessment 57
Ch. 6 Essential nursing pharmacology 75
Ch. 7 Caring for clients with altered fluid, electrolyte, or acid-base balance 91
Ch. 8 Caring for clients in pain 137
Ch. 9 Caring for clients having surgery 161
Ch. 10 Caring for clients with inflammation and infection 192
Ch. 11 Caring for clients with altered immunity 220
Ch. 12 Caring for clients with cancer 252
Ch. 13 Caring for clients experiencing shock, trauma, or critical illness 284
Ch. 14 Loss, grief, and end-of-life care 306
Ch. 15 The endocrine system and assessment 325
Ch. 16 Caring for clients with endocrine disorders 335
Ch. 17 Caring for clients with diabetes mellitus 357
Ch. 18 The gastrointestinal system and assessment 385
Ch. 19 Caring for clients with nutritional and upper gastrointestinal disorders 398
Ch. 20 Caring for clients with bowel disorders 432
Ch. 21 Caring for clients with gallbladder, liver, and pancreatic disorders 470
Ch. 22 The respiratory system and assessment 501
Ch. 23 Caring for clients with upper respiratory disorders 513
Ch. 24 Caring for clients with lower respiratory disorders 537
Ch. 25 The cardiovascular system and assessment 593
Ch. 26 Caring for clients with coronary heart disease and dysrhythmias 606
Ch. 27 Caring for clients with cardiac disorders 641
Ch. 28 Caring for clients with peripheral vascular disorders 668
Ch. 29 The hematologic and lymphatic systems and assessment 701
Ch. 30 Caring for clients with hematologic and lymphatic disorders 712
Ch. 31 The urinary system and assessment 745
Ch. 32 Caring for clients with renal and urinary tract disorders 757
Ch. 33 The reproductive system and assessment 803
Ch. 34 Caring for male clients with reproductive system disorders 816
Ch. 35 Caring for female clients with reproductive system disorders 838
Ch. 36 Caring for clients with sexually transmitted infections 876
Ch. 37 The nervous system and assessment 895
Ch. 38 Caring for clients with intracranial disorders 911
Ch. 39 Caring for clients with degenerative neurologic and spinal cord disorders 945
Ch. 40 Caring for clients with eye and ear disorders 973
Ch. 41 The musculoskeletal system and assessment 1005
Ch. 42 Caring for clients with musculoskeletal trauma 1018
Ch. 43 Caring for clients with musculoskeletal disorders 1045
Ch. 44 The integumentary system and assessment 1081
Ch. 45 Caring for clients with skin disorders 1090
Ch. 46 Caring for clients with burns 1114
Ch. 47 Mental health and assessment 1135
Ch. 48 Caring for clients with psychotic disorders 1146
Ch. 49 Caring for clients with mood disorders 1164
Ch. 50 Caring for clients with anxiety disorders 1188
Ch. 51 Caring for clients with personality disorders 1206
Ch. 52 Caring for clients with substance abuse or dependency 1222
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The need for nurses is greater than ever before. There are no short-term solutions to this problem: as currently practicing nurses age and retire, so does the population as a whole, further increasing the need for health care services. Today, more than ever before, we need you, the nursing student, to succeed in your studies. Today, more than ever before, we need you, the nursing student, to enter the nursing profession. Today, more than ever before, we need you, the nursing student, to see nursing as a career, not just a job.

This hook is dedicated to your success as a student and as a practicing nurse. We believe a strong foundation in understanding the common diseases and disorders that affect adult clients is necessary to provide effective nursing care. We believe that understanding the basis for nursing care activities is vital to providing individualized care for clients. We believe that client teaching is a vital nursing role at all levels and in all settings. Medical-Surgical Nursing Care provides a strong foundation for caring through its emphasis on pathophysiology, nursing care, and client teaching.

Understanding comes not through memorization, but through practice and integration of new material into your thinking. Medical-Surgical Nursing Care promotes understanding in several ways. The writing style is clear, with a focus on readability. Its content is streamlined but thorough, focusing on what you need to know and to be able to do.


Medical-Surgical Nursing Care is organized to promote learning. Part One, Medical-Surgical Nursing Practice, focuses on concepts, issues, and nursing care applicable to caringfor adults in many different situations and settings. Parts Two through Seven focus on diseases and disorders affecting adults. These disorders are organized by functional health patterns (for example, nutritional-metabolic, activity-exercise) and by affected body systems under each functional health pattern (for example, common skin problems, bowel disorders, cardiac disorders).

Each chapter begins with a Caring Tip that provides words of wisdom from the lived experience of a practicing nursing or nurse educator. You will be able to use these tips as you move into and through your career in nursing. Learning Outcomes help focus and define your learning as you read and study the material.

The structure and function of the affected body system is reviewed at the beginning of the chapter. Disorders affecting that body system are presented in a consistent format: the disorder is defined; its Pathophysiology, signs and symptoms, and complications are explained; and Collaborative Care (including diagnostic tests, pharmacology, surgery, and other treatments) for the disorder is outlined. Nursing Care related to the disorder is presented in a nursing process format. When a disorder is major, very complex, or very common, all of the Nursing Process steps are provided. When it is not, the text provides an abbreviated, more focused discussion, similar to the focused assessment nurses perform. Because teaching is a vital nursing role, discussion of each disorder concludes with Discharge Considerations and teaching for the client and family.

Case Studies following many major disorders bring the disorders to life. Clients rarely arrive in a health care setting as a pure medical diagnosis. As humans, clients bring all their roles and responsibilities as individuals, spouses, parents, children, workers, students, friends, and volunteers. They arrive as unique individuals influenced by their ethnicity, culture, and background. They arrive with psychosocial issues such as fear, guilt, or difficulty meeting financial responsibilities. They often arrive with other diseases and disorders complicating the current problem. The case studies in this text emphasize the holistic aspects of nursing care.

Critical Thinking Questions conclude each case study. These questions allow you to practice your new found learning and to expand your thinking beyond the immediate focus of the disease or disorder presented. Additional Critical Thinking Self-Check Questions are provided on the CD-ROM throughout nursing care chapters. They provide more case scenarios for you to use to test your knowledge and thinking skills. These self-check questions focus on the nursing roles of collecting assessment data and implementing nursing care. Each case is matched with hints to guide your critical thinking. They will help you learn to individualize your nursing care.

Each chapter concludes with features to reinforce and enhance your learning. Key Terms by Topic list the boldfaced key terms in the text by the topic under which they were defined. Key Points provide a summary of chapter content with reminders that you can use throughout your nursing career. For Further Study is a handy listing of cross-references within the chapter and the topics to which they apply. An interactive Critical Thinking Care Map provides a brief case study, assessment data, and a nursing diagnosis for a specific client. We then ask you, the student, to sort the data and sample interventions, evaluate the results, and chart your findings. Finally, NCLEX-PN Review Questions and a Test-Taking Tip help you review the chapter material and practice your test-taking skills.


Throughout each chapter, you will find consistent features to facilitate and reinforce your learning.

  • To avoid interrupting your reading by reaching for your medical dictionary, Key Terms are presented in boldface type. They are defined in the text and the glossary at the end of the book. Other important or unfamiliar terms are italicized and defined in the text.
  • Clinical Alerts within the text emphasize information critical to providing effective, safe clinical nursing care.
  • Cultural Care Strategies, including nursing implications and self-reflection questions, prepare students to deliver culturally sensitive adult nursing care.
  • Color-coded boxes organize highlighted information for quick retrieval: red Data Collection boxes for manifestations and risk factors of a disorder; blue Nursing Care boxes for nursing care related to specific tests or procedures; orange boxes highlighting Client Teaching; and green boxes focusing on specific Population Groups and Nutrition information.
  • Nursing Care Checklists quickly summarize nursing care activities for particular procedures or surgeries.
  • Procedure Checklists review key steps in performing previously learned nursing care procedures and provide Sample Documentation.
  • Pharmacology Tables highlight nursing implications and client teaching for drugs used to treat particular disorders.
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