Medical-Surgical Nursing: Critical Thinking in Client Care / Edition 3

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Overview

Readers will love this book's organization and clear presentation of patient care, with its consistent format and multiple methodologies—narrative text, boxes, tables, graphics, photographs. It is built around functional health patterns, with a focus on developing decision-making skills through an abundance of case studies and examples. Includes new topics such as diseases specific to bioterrorism, information on diversity, and focused assessments with information specific to the older adult. Covers new concepts such as health promotion, home care with resources, and complementary therapies. Features "Applying the Nursing Process: A Case Study Approach to the Nursing Process," in which a Case Study is presented for each disease process and the reader is given an outline of the nursing process actions. Offers a comprehensive technology package to help prepare readers for the computerized NCLEX exam; includes a Companion Website and Study Wizard CD-ROM. The perfect reference for registered nurses and licensed practical nurses in acute and home care settings.

The book contains predominantly color illustrations, with some black-and-white illustrations.

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Editorial Reviews

Deborah K. Fultner
This book contains assessments, pathophysiology, nursing care and diagnoses, and patient teaching of numerous disease processes. It is divided into systems and easy to use. The purpose is to provide the nursing instructor, nursing student, and practicing medical-surgical nurse a guide to care for clients in today's changing healthcare system and across the continuum of care. The book targets nursing students, practicing nurses, and educators in medical surgical nursing. The book can be used in a variety of settings such as home health, ambulatory clinics, and managed care. The book has excellent illustrations that assist the learner in understanding the material. Unique features include critical thinking scenarios, clinical pathways, and application of research findings. The text provides care plans based on NANDA diagnoses, patient teaching, and discharge plans for the client in the acute setting. This is an excellent book for educators and students in all academic settings. It is an equally excellent text for today's practicing nurse. The authors address changes in the healthcare delivery system that affect the nurse in the acute care setting. They bring together nursing diagnoses, clinical pathways, and research findings to equip today's nurse to deliver quality care. Resources are relevant and current. The book makes an excellent textbook and reference.
Doody's Review Service
Reviewer: Deborah K. Fultner, MS, RNC, CS (Texas Christian University)
Description: This book contains assessments, pathophysiology, nursing care and diagnoses, and patient teaching of numerous disease processes. It is divided into systems and easy to use.
Purpose: The purpose is to provide the nursing instructor, nursing student, and practicing medical-surgical nurse a guide to care for clients in today's changing healthcare system and across the continuum of care.
Audience: The book targets nursing students, practicing nurses, and educators in medical surgical nursing. The book can be used in a variety of settings such as home health, ambulatory clinics, and managed care.
Features: The book has excellent illustrations that assist the learner in understanding the material. Unique features include critical thinking scenarios, clinical pathways, and application of research findings. The text provides care plans based on NANDA diagnoses, patient teaching, and discharge plans for the client in the acute setting.
Assessment: This is an excellent book for educators and students in all academic settings. It is an equally excellent text for today's practicing nurse. The authors address changes in the healthcare delivery system that affect the nurse in the acute care setting. They bring together nursing diagnoses, clinical pathways, and research findings to equip today's nurse to deliver quality care. Resources are relevant and current. The book makes an excellent textbook and reference.

4 Stars! from Doody
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Product Details

  • ISBN-13: 9780130990754
  • Publisher: Prentice Hall
  • Publication date: 7/28/2003
  • Edition description: Older Edition
  • Edition number: 3
  • Pages: 1760
  • Product dimensions: 8.83 (w) x 11.03 (h) x 2.24 (d)

Meet the Author

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. She is currently an Associate Professor and Director of Undergraduate Studies, Sinclair School of Nursing, University of Missouri-Columbia.
Dr. LeMone has had 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, 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.
A widow, Dr. LeMone lives with her dog and shares time with her two children and her granddaughter. When she has time, she enjoys growing flowers and reading fiction.
Karen Burke has practiced nursing in acute intensive and coronary care, in community-based settings, and in nursing education. As an educator, she has taught nursing skills, fundamentals, pathophysiology, and basic to advanced medical-surgical nursing. Ms. Burke has a diploma in nursing from Emanuel Hospital School of Nursing in Portland, Oregon, later completing baccalaureatestudies at Oregon Health & Science University, and a master's degree at University of Portland.
Ms. Burke has been part of the nursing faculty at Clatsop Community College in Astoria, Oregon, since the inception of the Associate Degree Nursing program in 1983, most recently serving as Director of Health Occupations and Nursing. In this role, she is known as a leader and an innovator. She led the nursing faculty in developing an online program to deliver basic nursing education to a distant rural community. This program continues, serving as a model for other community college nursing programs to reach out to geographically isolated communities. Ms. Burke is actively involved in nursing education and developing strategies to address the nursing shortage in Oregon. She is a member of the Oregon Council of Associate Degree Nursing Programs (OCAP) and the Oregon Nursing Leadership Council (ONLC), currently serving as chair of the ONLC Education Committee. She is coauthor of several other texts: Medical-Surgical Nursing Care, with Priscilla LeMone and Elaine Mohn-Brown; Fundamentals of Nursing: Concepts, Process, and Practice (6th edition), with Barbara Kozier, Glenora Erb, and Audrey Berman; and a clinical handbook to accompany this text.
Ms. Burke sees herself as a nurse first, then a nurse educator and educational administrator. She strongly values the nursing profession and the importance of providing a solid education in the, art and science of nursing for all students entering the profession.
When possible, Ms. Burke and her husband Steve spend time with their extended family and traveling. She enjoys a passion for quilting, and, when the weather allows, gardening.
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Table of Contents

Preface
Contributors
Reviewers
About the Authors
Guide to Medical-Surgical Nursing
Special Features
Pt. 1 Medical-Surgical Nursing Practice 1
Unit 1 Dimensions of Medical-Surgical Nursing 3
Ch. 1 The Medical-Surgical Nurse 4
Ch. 2 The Adult Client in Health and Illness 19
Ch. 3 Community-Based and Home Care of the Adult Client 37
Unit 2 Alterations in Patterns of Health 53
Ch. 4 Nursing Care of Clients in Pain 54
Ch. 5 Nursing Care of Clients with Altered Fluid, Electrolyte, or Acid-Base Balance 76
Ch. 6 Nursing Care of Clients Experiencing Trauma and Shock 136
Ch. 7 Nursing Care of Clients Having Surgery 165
Ch. 8 Nursing Care of Clients with Infection 192
Ch. 9 Nursing Care of Clients with Altered Immunity 232
Ch. 10 Nursing Care of Clients with Cancer 270
Ch. 11 Nursing Care of Clients Experiencing Loss, Grief, and Death 315
Ch. 12 Nursing Care of Clients with Problems of Substance Abuse 331
Pt. 2 Nutrition and Metabolic Patterns 347
Unit 3 Responses to Altered Integumentary Structure and Function 349
Ch. 13 Assessing Clients with Integumentary Disorders 350
Ch. 14 Nursing Care of Clients with Integumentary Disorders 361
Ch. 15 Nursing Care of Clients with Burns 411
Unit 4 Responses to Altered Endocrine Function 436
Ch. 16 Assessing Clients with Endocrine Disorders 437
Ch. 17 Nursing Care of Clients with Endocrine Disorders 444
Ch. 18 Nursing Care of Clients with Diabetes Mellitus 472
Unit 5 Responses to Altered Nutrition 506
Ch. 19 Assessing Clients with Nutritional and Gastrointestinal Disorders 507
Ch. 20 Nursing Care of Clients with Nutritional Disorders 522
Ch. 21 Nursing Care of Clients with Upper Gastrointestinal Disorders 540
Ch. 22 Nursing Care of Clients with Gallbladder, Liver, and Pancreatic Disorders 573
Pt. 3 Elimination Patterns 609
Unit 6 Responses to Altered Bowel Elimination 611
Ch. 23 Assessing Clients with Bowel Elimination Disorders 612
Ch. 24 Nursing Care of Clients with Bowel Disorders 617
Unit 7 Responses to Altered Urinary Elimination 693
Ch. 25 Assessing Clients with Urinary System Disorders 694
Ch. 26 Nursing Care of Clients with Urinary Tract Disorders 704
Ch. 27 Nursing Care of Clients with Kidney Disorders 743
Pt. 4 Activity and Exercise Patterns 791
Unit 8 Responses to Altered Cardiac Function 793
Ch. 28 Assessing Clients with Cardiac Disorders 794
Ch. 29 Nursing Care of Clients with Coronary Heart Disease 804
Ch. 30 Nursing Care of Clients with Cardiac Disorders 869
Unit 9 Responses to Altered Peripheral Tissue Perfusion 917
Ch. 31 Assessing Clients with Hematologic, Peripheral Vascular, and Lymphatic Disorders 918
Ch. 32 Nursing Care of Clients with Hematologic Disorders 931
Ch. 33 Nursing Care of Clients with Peripheral Vascular and Lymphatic Disorders 980
Unit 10 Responses to Altered Respiratory Function 1029
Ch. 34 Assessing Clients with Respiratory Disorders 1030
Ch. 35 Nursing Care of Clients with Upper Respiratory Disorders 1041
Ch. 36 Nursing Care of Clients with Lower Respiratory Disorders 1076
Unit 11 Responses to Altered Musculoskeletal Function 1177
Ch. 37 Assessing Clients with Musculoskeletal Disorders 1178
Ch. 38 Nursing Care of Clients with Musculoskeletal Trauma 1190
Ch. 39 Nursing Care of Clients with Musculoskeletal Disorders 1222
Pt. 5 Cognitive and Perceptual Patterns 1287
Unit 12 Responses to Altered Neurologic Function 1289
Ch. 40 Assessing Clients with Neurologic Disorders 1290
Ch. 41 Nursing Care of Clients with Cerebrovascular and Spinal Cord Disorders 1306
Ch. 42 Nursing Care of Clients with Intracranial Disorders 1345
Ch. 43 Nursing Care of Clients with Neurologic Disorders 1397
Unit 13 Responses to Altered Visual and Auditory Function 1448
Ch. 44 Assessing Clients with Eye and Ear Disorders 1449
Ch. 45 Nursing Care of Clients with Eye and Ear Disorders 1464
Pt. 6 Sexuality and Reproductive Patterns 1509
Unit 14 Responses to Altered Sexual and Reproductive Function 1511
Ch. 46 Assessing Clients with Reproductive System Disorders 1512
Ch. 47 Nursing Care of Men with Reproductive System Disorders 1526
Ch. 48 Nursing Care of Women with Reproductive System Disorders 1552
Ch. 49 Nursing Care of Clients with Sexually Transmitted Infections 1598
App. A Standard Precautions 1618
App. B 2003-2004 NANDA-Approved Nursing Diagnoses 1620
App. C Evaluate Your Response and Test Yourself Answers 1621
Photographic and Art Credits 1632
Index
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Introduction

At no other time in recent history has there been a greater need for nurses. In fact, the need for new nurses is projected to be at or greater than 1 million by 2010. Registered nurses are the largest group of health care professionals in the United States, numbering over 2.6 million. However, various forces are in effect that may decrease their numbers or challenge their ability to meet client needs. As our currently employed nurses age and retire, the population will also become older. As the population ages, more people will develop chronic illnesses and disabilities that require skilled nursing care. This means that your knowledge and skills will be in demand to meet health care needs well into the future.

Students are expected to build on a knowledge foundation of basic sciences, social sciences, and fundamentals of nursing to synthesize and critically analyze new knowledge necessary to provide holistic care that addresses the individualized human responses to potential or actual alterations in health. The third edition of Medical-Surgical Nursing: Critical Thinking in Client Care has been completely revised to provide you with that knowledge and the skills needed to care for clients to promote health, facilitate recovery from illness and injury, and provide support when coping with disability or grieving.

The kaleidoscope cover image is a strong reflection of health care today. The meditative aspect of focusing on the images in the kaleidoscope calms and helps to integrate the mind, spirit, and body. As with nursing care, healing benefits are discovered through various complementary and alternative therapy methods. Nursing care, like thekaleidoscope, is the integration of mind-body-spirit.

GOALS FOR THIS TEXTBOOK

Although the information has been totally updated, we continue to believe that students learn best within a nursing model of care with consistent organization and understandable text. From the first edition, we have held fast to our vision that this textbook will:

  • Provide the most current information possible about the art and science of nursing.
  • Provide clear explanations of the pathophysiologic processes of human illnesses and injury, integrating that information as a vital component of treatment and nursing care.
  • Emphasize the nurse's role as an essential member of the health care team.
  • Prioritize nursing diagnoses and interventions specific to altered responses to illness.
  • Provide case studies for each major illness or injury so students can envision the client as a person requiring care.
  • Foster critical thinking and decision-making skills in clinical practice.

NEW TO THIS EDITION

The third edition of this textbook includes new content on cultural diversity that is integrated throughout the narrative as well as incorporated into the following feature boxes: Focus on Diversity, Nursing Care of the Older Adult, Meeting Individualized Needs, Nursing Research, and Multisystem Effects. Additionally, new content covers health promotion, gerontology, complementary and alternative therapies, genetics, and diseases specific to bioterrorism. The new health-promotion heads can be found in the nursing care section in every disorder chapter. Complementary and alternative therapies are integrated throughout the textbook where appropriate. Genetics as a risk factor or that increases incidence of a disease is included with the disorders, such as Huntington's chorea, Von Willebrand's disease, sickle cell disease, and hemophilia. Diseases are included if more prevalent as the result of inheritance (such as diabetes). Genetic counseling is included in nursing care as appropriate. Information about infections that may be caused by bioterrorism is included in Chapter 8. Based on reviewer feedback, two new chapters have been added: Chapter 12 concerns care of clients with substance abuse and Chapter 39 deals with care of clients with musculoskeletal disorders (two separate chapters in the previous edition). This combined chapter is more consistent and easier for students to follow.

ORGANIZATION

The book has six major parts, organized by functional health patterns. Each part opens with a concept map illustrating the relationship of each functional health pattern to possible nursing diagnoses. The parts are then divided into units based on alterations in human structure and function. Each unit with a focus on altered health states opens with an assessment chapter that provides a review of normal anatomy and physiology, questions for a health history, and assessment techniques with possible abnormal findings. Students will find a detailed health history questionnaire, using functional health patterns as a guide, on the Companion Website. Also on the .CD, students will find a comprehensive review of anatomy and physiology complete with animations, three-dimensional structures, and exercises. This draws upon the student's prerequisite knowledge, and serves to reinforce basic principles of anatomy and physiology as applied to physical assessment.

Following the assessment chapter in each unit, information about major conditions and diseases follows a consistent chapter format. Key components of the clinical chapters include following:

PATHOPHYSIOLOGY. The discussion of each major illness or condition begins with an overview of pathophysiology, followed by manifestations and complications. In the new edition, we have increased coverage of pathophysiology and highlighted it as a section within the disease. A new feature, Focus on Diversity, is included with some disorders to demonstrate, for example, how race, age, and gender affect differences in incidence, prevalence, and mortality.

COLLABORATIVE CARE. Collaborative care considers the treatment of the illness or condition by the health care team. Information in this section includes, as appropriate, diagnostic tests, medications, surgery and treatments, fluid management, dietary management, and complementary therapies.

NURSING CARE. Because the prevention of illness is a critical factor in health care today, this section begins with health-promotion information. A brief section on assessment provides a focused health history interview and physical examination guides, as well as information about assessment of the older adult. Nursing care is discussed within a context of priority nursing diagnoses and interventions, with rationales provided for each intervention. As care is increasingly provided in the home, nursing care is followed by a list of topics and resources for teaching about home care. Lastly, for each major disorder or condition, a narrative Nursing Care Plan is provided. Each plan begins with a brief case study, followed by the steps of the nursing process in action. Critical thinking questions specific to the care plan conclude this part, with a section called Evaluate Your Response that provides additional guidance for critical thinking. Suggested guidelines are found in Appendix C.

CHAPTER REVIEW. This new section at the end of each chapter concludes with five multiple-choice review questions, to reinforce comprehension of the chapter content. The student will also find the section entitled EXPLORE MediaLink, which encourages students to use the CD-ROM and the Companion Website to apply what they have learned from the textbook in case studies, to practice NCLEX questions, and to use additional resources such as animation tutorials and more.

HALLMARK FEATURES

Thoughtful attention was given to existing features that students and faculty liked in the previous edition. We give them more emphasis in the new edition.

  • Manifestations boxes reinforce understanding of the effects of illness or injury, and guide assessments and interventions.
  • Pathophysiology Illustrated and Multisystem Effects features provide visual illustrations of the causes and consequences of pathophysiology.
  • Nursing Implications boxes provide students with nursing implications that they need to be aware of when their client is undergoing a particular diagnostic test. These boxes address nursing care and client/family teaching.
  • Meeting Individualized Needs boxes contain information specific to altered health, age, gender, race, and culture.
  • Procedure boxes describe common or important procedures in detail.
  • Nursing Care of the Client boxes describe nursing care for various medical or surgical procedures.

NEW FEATURES

In addition to the hallmark features that have made this textbook so popular with students and faculty, we provide new items that help students learn the concepts in this textbook, apply them in clinical settings, and hone their clinical judgment skills. These include the following:

  • MediaLink, at the beginning of each chapter, lists specific content, animations, anatomy and physiology review, NCLEX review questions, tools, and other interactive exercises that appear on the accompanying student CD-ROM and the Companion Website. Special Medial-ink tabs appear throughout the chapter in the margins, encouraging the students to use the media supplements for specific activities, applications, and resources. The purpose of the MediaLink feature is to further enhance the student experience, build on knowledge gained from the textbook, prepare students for NCLEX, and foster critical thinking.
  • Medication Administration boxes provide examples of drugs commonly prescribed for specific illnesses, followed by nursing responsibilities and client/family teaching. The medication boxes reflect the role of nurses, who administer medications.
  • Focus on Diversity boxes list incidence, prevalence, etiology, and more for a particular disorder as effected by race or ethnicity.
  • Nursing Care of the Older Adult boxes are found throughout the text, as well as in the assessment sections for disorders. As the population continues to age, this is critical information for nursing care in any setting, and provides guidelines for assessing and teaching in home care for the elderly.
  • Nursing Care Plans throughout the text help students approach care from a nursing process perspective. The care plan is followed by critical thinking questions for students to apply their knowledge to a plan of care for a specific client. Suggested responses to the critical thinking questions can be found in Appendix C. Additional care plan activities can be found on the Companion Website. These activities provide students with client scenarios so they can write comprehensive care plans and email them to instructors as homework assignments.
  • NANDA, NIC, and NOC charts illustrate the most up-to-date information on nursing language, and demonstrate how these items are related for specific disorders.
  • Nursing Research: Evidence-Based Practice boxes are included to show how nursing research is used to provide rationales for nursing care.
  • Practice Alerts are integrated into nursing care purposefully to help students consider all aspects of nursing even though they may be focusing on only one aspect of client needs.
  • End of Chapter Review Section provides students with an opportunity to evaluate their comprehension of the chapter. The student-friendly section includes:
  • Test Yourself—Review questions at the end of every chapter.
  • EXPLORE MediaLink—at the end of every chapter, encourages students to use the CD-ROM and Companion Website to apply their knowledge of the chapter through additional case studies, practice NCLEX questions, A&P review, animation tutorials, and additional resources.
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