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Medical-Surgical Nursing Care / Edition 1

Medical-Surgical Nursing Care / Edition 1


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Product Details

ISBN-13: 9780130281623
Publisher: Pearson
Publication date: 09/20/2002
Edition description: Older Edition
Pages: 1100
Product dimensions: 8.70(w) x 11.10(h) x 1.50(d)

About 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.

Table of Contents


I. Introduction to Medical Surgical Nursing

1. The Medical-Surgical Nurse

2. The Adult Client in Health and illness

3. The Older Adult Client in Health and Illness *NEW CHAPTER*

4. Settings of Care (new title)

5. Guidelines for Client Assessment (new title)

6. Essential Nursing Pharmacology *NEW CHAPTER*


II. Foundations of Medical-Surgical Nursing

7. Caring for Clients with Altered Fluid, Electrolyte, or Acid-Base Balance

8. Caring for Clients in Pain

9. Caring for Clients Having Surgery

10. Caring for Clients with Inflammation and Infection

11. Caring for Clients with Altered Immunity

12. Caring for Clients with Cancer

13. Caring for Clients Experiencing Shock, Trauma, or Critical Illness

14. Loss, Grief, and End-of-Life Care


III. Disrupted Endocrine Function


15. The Endocrine System and Assessment *NEW CHAPTER*

16. Caring for Clients with Endocrine Disorders

17. Caring for Clients with Diabetes Mellitus


IV. Disrupted Gastrointestinal Function


18. The Gastrointestinal System and Assessment *NEW CHAPTER*

19. Caring for Clients with Nutritional and Upper GI Disorders

20. Caring for Clients with Bowel Disorders

21. Caring for Clients with Gallbladder, Liver, and Pancreatic Disorders


V. Disrupted Respiratory Function


22. The Respiratory System and Assessment *NEW CHAPTER*

23. Caring for Clients with Upper Respiratory Disorders

24. Caring for Clients with Lower Respiratory Disorders

VI. Disrupted Cardiovascular Function

25. The Cardiovascular System and Assessment *NEW CHAPTER*

26. Caring for Clients with Coronary Heart Disease

27. Caring for Clients with Cardiac Disorders

28. Caring for Clients with Peripheral Vascular Disorders

VII. Disrupted Hematologic and Lymphatic Function

29. The Hematologic and Lymphatic Systems and Assessment *NEW CHAPTER*

30. Caring for Clients with Hematologic and Lymphatic Disorders

VIII. Disrupted Urinary Function

31. The Urinary System and Assessment *NEW CHAPTER*

32. Caring for Clients with Renal and Urinary Tract Disorders

IX. Disrupted Reproductive Function

33. The Reproductive System and Assessment *NEW CHAPTER*

34. Caring for Male Clients with Reproductive System Disorders

35. Caring for Female Clients with Reproductive System Disorders

36. Caring for Clients with Sexually Transmitted Diseases (Change to current terminology)

X. Disrupted Neurologic Function

37. The Nervous System and Assessment *NEW CHAPTER*

38. Caring for Clients with Intracranial Disorders

39. Caring for Clients with Degenerative Neurologic and Spinal Cord Disorders

40. Caring for Clients with Eye and Ear Disorders

XI. Disrupted Musculoskeletal Function

41. The Musculoskeletal System and Assessment *NEW CHAPTER*

42. Caring for Clients with Musculoskeletal Trauma

43. Caring for Clients with Musculoskeletal Disorders

XII. Disrupted Integumentary Function

44. The Integumentary System and Assessment *NEW CHAPTER*

45. Caring for Clients with Skin Disorders

46. Caring for Clients with Burns

XIII. Disrupted Mental Health Function

47. Mental Health and Assessment *NEW CHAPTER*

48. Caring for Clients with Psychotic Disorders *NEW CHAPTER*

49. Caring for Clients with Mood Disorders *NEW CHAPTER*

50. Caring for Clients with Anxiety Disorders *NEW CHAPTER*

51. Caring for Clients with Personality Disorders *NEW CHAPTER*

52. Caring for Clients with Substance Abuse or Dependency


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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