Franklin

Clinical nursing skills : basic to advanced skills / Sandra F. Smith, Donna J. Duell, Barbara C. Martin.

Author/Creator:
Smith, Sandra Fucci.
Publication:
Upper Saddle River, N.J. : Prentice Hall Health, [2000]
Format/Description:
Book
xxxii, 1199 pages : illustrations (chiefly color), ; 29 cm + 1 CD-ROM (4 3/4 in.)
Edition:
Fifth edition.
Status/Location:
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Details

Subjects:
Nursing.
Medical subjects:
Nursing Process.
Summary:
This book targets new skills -- based on clinical standards of AANC, CDC, and the National Society for IV Nurses -- necessary for successful entry into clinical practice. It also focuses on practical information now an integral part of the Nurse Licensure Exam. Coverage includes over 560 basic to advanced skills that explore the abilities needed for nursing, step-by-step illustrations that demonstrate these skills, the effects of cultural diversity, 6-step physical assessment, OASIS requirements for home care, and management guidelines -- such as delegation of responsibilities and information/flow reporting. For nursing professionals interested in their field's latest issues and trends, and individuals considering making the profession of nursing their own.
Contents:
Chapter 1 Professional Nursing 1
Professional Role 2
Legal Aspects 4
Client's Rights 6
Clinical Practice 9
Medical Asepsis Principles 17
Protocol for Procedures 17
Management Guidelines 18
Delegation of Responsibilities 76
Information Flow 18
Chapter 2 Nursing Process and Critical Thinking 19
Critical Thinking 20
Nursing Process 20
Nurses Are Critical Thinkers 22
Nursing Diagnosis 25
Management Guidelines 27
Delegation of Responsibilities 27
Information Flow 27
Chapter 3 Client Care Plans and Management 29
Care Plans 30
Communication 36
Delegating Client Care 40
Student Clinical Planning 41
Management Guidelines 43
Delegation of Responsibilities 43
Information Flow 43
Chapter 4 Documentation and Reporting 45
Charting 46
Reporting 61
Documentation 61
Word Roots, Prefixes and Suffixes 64
Management Guidelines 66
Delegation of Responsibilities 66
Information Flow 66
Chapter 5 Communication and Nurse-Client Relationship 67
Communication 69
Therapeutic Communication Techniques 69
Blocks to Communication 71
Cultural Diversity Nursing 72
Relationship Therapy 72
Nursing Diagnoses 74
Unit 1 Therapeutic Communication 75
Introducing Yourself to a Client 76
Beginning a Client Interaction 76
Assisting a Client to Discuss Cultural Preferences 76
Assisting a Client to Describe Personal Experiences 77
Encouraging a Client to Express Needs, Feelings, and Thoughts 77
Using Communication to Increase a Client's Sense of Self-Worth 77
Critical Thinking Application 78
Unit 2 Nurse-Client Relationship 79
Initiating a Nurse-Client Relationship 80
Facilitating a Nurse-Client Relationship 80
Terminating a Nurse-Client Relationship 81
Critical Thinking Application 81
Gerontologic Considerations 82
Management Guidelines 82
Delegation of Responsibilities 82
Information Flow 82
Chapter 6 Alternative Treatment Methods and Stress Management 83
Stress 85
A New Paradigm for Health 90
Alternative Treatment Methods 91
Nursing Diagnoses 95
Unit 1 Stress and Adaptation 96
Determining the Effect of Stress 97
Determining Response Patterns 98
Managing Stress 98
Manipulating the Environment to Reduce Stress 98
Teaching Coping Strategies 99
Managing Stress Using a Holistic Model 99
Alleviating Stress Using Controlled Breathing 100
Alleviating Stress Using Body Relaxation 101
Alleviating Stress Using Meditation 101
Critical Thinking Application 102
Gerontologic Considerations 102
Management Guidelines 102
Delegation of Responsibilities 102
Information Flow 102
Chapter 7 Admission and Discharge 103
Admission, Transfer, and Discharge 105
Nursing Diagnoses 108
Unit 1 Admission and Transfer 109
Admitting a Client 109
Transferring a Client 112
Critical Thinking Application 113
Unit 2 Height and Weight 114
Obtaining Height and Weight 114
Critical Thinking Application 116
Unit 3 Discharge 117
Discharging a Client 117
Discharging a Client Against Medical Advice (AMA) 118
Critical Thinking Application 120
Gerontologic Considerations 120
Management Guidelines 121
Delegation of Responsibilities 121
Information Flow 121
Chapter 8 Safe Client Environment and Restraints 123
Orientation to the Client Environment 124
Characteristics that Influence Adaptation 125
Physical and Biological Dimensions 126
Sociocultural Dimensions 130
A Sale Environment 131
Nursing Diagnoses 133
Unit 1 A Safe Environment 134
Preventing Mechanical Injuries 135
Preventing Thermal/Electrical Injuries 135
Providing Safety for Clients During a Fire 136
Providing Safety for Clients Receiving Radioactive Materials 137
Critical Thinking Application 138
Unit 2 Restraints 139
Applying Torso/Belt Restraint 139
Using Wrist Restraints 140
Using Mitt Restraints 141
Using Elbow Restraints 141
Applying a Chest Restraint 142
Applying Mummy Restraints 143
Critical Thinking Application 144
Gerontologic Considerations 145
Management Guidelines 146
Delegation of Responsibilities 146
Information Flow 146
Chapter 9 Bathing and Bedmaking 147
General Terminology 149
Basic Health Care 150
Nursing Diagnoses 151
Unit 1 Bedmaking 152
Folding a Mitered Corner 153
Changing a Pillowcase 153
Making an Unoccupied Bed 153
Making a Surgical Bed 156
Changing an Occupied Bed 156
Critical Thinking Application 159
Unit 2 Bath Care 160
Folding a Washcloth Mitt 161
Providing Morning Care 161
Bathing an Adult Client 162
Bathing an Infant 164
Bathing in a Hydraulic Bathtub Chair 165
Bathing the Critically Ill 166
Critical Thinking Application 167
Unit 3 Skin Integrity 168
Monitoring Skin Condition 168
Preventing Skin Breakdown 169
Critical Thinking Application 171
Unit 4 Evening Care 172
Providing Evening Care 173
Providing Back Care 173
Critical Thinking Application 175
Gerontologic Considerations 175
Management Guidelines 176
Delegation of Responsibilities 176
Information Flow 176
Chapter 10 Personal Hygiene 177
Hygienic Care 179
Nursing Diagnoses 180
Unit 1 Oral Hygiene 181
Providing Oral Hygiene 182
Flossing Client's Teeth 183
Providing Denture Care 183
Providing Oral Care for Unconscious Clients 184
Critical Thinking Application 185
Unit 2 Hair Care 186
Providing Hair Care 187
Shampooing Hair 187
Braiding Hair 189
Providing Hair Care for Beards and Mustaches 189
Shaving a Client 190
Critical Thinking Application 190
Unit 3 Pediculosis 191
Removing Lice 191
Critical Thinking Application 192
Unit 4 Foot Care 193
Providing Foot Care 193
Providing Nail Care 194
Critical Thinking Application 195
Unit 5 Bedpan, Urinal, and Commode 196
Using a Bedpan and Urinal 196
Assisting Client to Commode 197
Critical Thinking Application 198
Unit 6 Perineal and Genital Care 199
Draping a Female Client 199
Providing Female Perineal Care 200
Administering a Vaginal Irrigation 201
Providing Male Perineal Care 201
Critical Thinking Application 202
Unit 7 Eye and Ear Care 203
Providing Routine Eye Care 203
Providing Eye Care for Comatose Client 204
Removing and Cleaning an Artificial Eye 204
Removing and Cleaning Hard Contact Lenses 205
Removing and Cleaning Soft Contact Lenses 205
Cleaning and Checking a Hearing Aid 206
Critical Thinking Application 206
Gerontologic Considerations 207
Management Guidelines 207
Delegation of Responsibilities 207
Information Flow 207
Chapter 11 Vital Signs 209
Vital Signs 211
Temperature 212
Pulse 213
Respiration 214
Blood Pressure 215
Nursing Diagnoses 217
Unit 1 Temperature 218
Taking an Oral Temperature 219
Taking a Rectal Temperature 220
Taking an Axillary Temperature 220
Using an Electronic Thermometer 221
Using an Infrared Thermometer for Tympanic Temperature 222
Using a Chemical Strip Tape 223
Critical Thinking Application 224
Unit 2 Pulse Rate 225
Taking a Radial Pulse 226
Taking an Apical Pulse 227
Taking an Apical-Radial Pulse 228
Taking a Peripheral Pulse 229
Monitoring Peripheral Pulses with Doppler Ultrasound Stethoscope 229
Critical Thinking Application 231
Unit 3 Respirations 232
Obtaining the Respiratory Rate 232
Critical Thinking Application 233
Unit 4 Blood Pressure 235
Taking a Blood Pressure 235
Palpating Systolic Arterial Blood Pressure 238
Measuring Leg Blood Pressure 239
Measuring Blood Pressure by Flush Method in Small Infant 239
Using a Continuous Noninvasive Monitoring Device 240
Critical Thinking Application 241
Gerontologic Considerations 242
Management Guidelines 243
Delegation of Responsibilities 243
Information Flow 243
Chapter
12 Body Mechanics and Positioning 245
Musculoskeletal System 247
System Alterations 247
Body Mechanics 248
Nursing Diagnoses 248
Unit 1 Proper Body Mechanics 249
Establishing Body Alignment 249
Maintaining Proper Body Alignment 250
Using Coordinated Movements 251
Using Basic Principles 252
Critical Thinking Application 254
Unit 2 Moving and Turning Clients 255
Turning to Side-Lying Position 257
Turning to a Prone Position 257
Moving the Client Up in Bed 258
Moving the Client with Assistance 258
Transferring Client from Bed to Gurney 259
Dangling at the Bedside 260
Moving from Bed to Chair 261
Using a Hoyer Lift 262
Logrolling the Client 263
Using a Footboard 264
Placing a Trochanter Roll 265
Critical Thinking Application 266
Gerontologic Considerations 266
Management Guidelines 267
Delegation of Responsibilities 267
Information Flow 267
Chapter 13 Exercise and Ambulation 269
Rehabilitation Concepts 271
Musculoskeletal System 271
Joints 271
Ambulation 272
Crutches 273
Nursing Diagnoses 274
Unit 1 Range of Motion 275
Performing Passive Range of Motion 275
Using Continuous Passive Motion Machine 279
Teaching Active Range of Motion 280
Critical Thinking Application 280
Unit 2 Ambulation 281
Minimizing Orthostatic Hypotension 282
Ambulating with Two Assistants 282
Ambulating with One Assistant 283
Ambulating with a Walker 284
Ambulating with a Cane 285
Critical Thinking Application 286
Unit 3 Crutch Walking 287
Teaching Muscle-Strengthening Exercises 287
Measuring Client for Crutches 288
Teaching Crutch Walking: Four-Point Gait 289
Teaching Crutch Walking: Three-Point Gait 289
Teaching Crutch Walking: Two-Point Gait 290
Teaching Swing-To Gait and Swing-Through Gait 290
Teaching Upstairs and Downstairs Ambulation with Crutches 291
Critical Thinking Application 292
Gerontologic Considerations 293
Management Guidelines 294
Delegation of Responsibilities 294
Information Flow 294
Chapter 14 Physical Assessment 295
Assessment 296
Health History 296
Nurses' Role 296
Examination Techniques 297
Focus Assessment 298
Neurologic Assessment 300
Assessment of the Head and Neck 307
Assessment of the Skin 311
Assessment of the Chest: Lungs, Breasts, and Heart 314
Assessment of the Abdomen and Genitourinary Tract 321
Mental-Spiritual Assessment 325
Mental Status Assessment 326
Gerontologic Considerations 330
Management Guidelines 332
Delegation of Responsibilities 332
Information Flow 332
Chapter 15 Infection Control 333
Infection Control 336
Barriers to Infection 337
Conditions Predisposing to Infection 337
Standard Precautions 339
Acquired Immunodeficiency Syndrome 342
Healthcare Workers' Exposure to HIV 343
Health Care Worker Protection Act 343
Other Infectious Diseases 344
Nursing Diagnoses 345
Unit 1 Basic Medical Asepsis 346
Handwashing (Medical Asepsis) 346
Cleaning Washable Articles 348
Donning and Removing Clean Gloves 348
Critical Thinking Application 349
Unit 2 Standard Precautions 350
Donning Protective Gear Utilizing Standard Precautions 351
Exiting a Client's Room Utilizing Standard Precautions 352
Critical Thinking Application 353
Unit 3 Isolation 357
Preparing for Isolation 357
Putting On and Removing a Gown 358
Using a Mask 360
Assessing Vital Signs 360
Removing Items from Isolation Room 361
Utilizing Double-Bagging for Isolation 361
Removing a Specimen from Isolation Room 362
Transporting Isolation Client Outside the Room 362
Removing Soiled Large Equipment from Isolation Room 363
Critical Thinking Application 364
Gerontologic Considerations 364
Management Guidelines 364
Delegation of Responsibilities 364
Information Flow 364
Chapter 16 Medication Administration 365
Therapeutic Agents (Drugs) 367
Biologic Processes of Drug Metabolism 367
Drug Administration 368
Nursing Diagnoses 369
Unit 1 Medication Biodynamics 370
Preparing Medications 370
Converting Dosage Systems 372
Calculating Dosages 372
Preparing for Medication Administration 373
Using the Narcotic Control System 375
Critical Thinking Application 376
Unit 2 Oral Administration 377
Preparing Oral Medications 377
Administering Oral Medications to Adults 378
Administering Oral Medications to Children 379
Critical Thinking Application 380
Unit 3 Parenteral Administration 381
Preparing Injections 381
Administering Intradermal Injections 385
Administering Subcutaneous (Sub Q) Injections 386
Preparing Insulin Injections 388
Teaching Use of Insulin Pump 391
Administering Sub Q Heparin 393
Administering Intramuscular (IM) Injections 394
Using Z-Track Method 398
Critical Thinking Application 399
Unit 4 Topical Administration 401
Applying Dermal Ointments 402
Applying Ointment to Burns 402
Applying Transdermal Medications 403
Instilling Ophthalmic Drops 404
Administering Ophthalmic Ointment 405
Administering Otic Medications 406
Critical Thinking Application 407
Unit 5 Mucous Membrane Applications 408
Administering Sublingual/Buccal Medications 409
Administering Respiratory Medications 409
Instilling Nose Drops 409
Administering Metered-Dose Inhaled (MDI) Medications 410
Using a Spacer with MDI 411
Critical Thinking Application 412
Unit 6 Suppository Administration 413
Administering Rectal Suppositories 413
Administering Vaginal Suppositories 414
Critical Thinking Application 415
Unit 7 Irrigations 416
Irrigating the Eye 416
Irrigating the Ear 417
Irrigating the Throat 417
Critical Thinking Application 418
Gerontologic Considerations 418
Management Guidelines 419
Delegation of Responsibilities 419
Information Flow 419
Chapter 17 Pain Medication 423
Coping with Pain 425
Noninvasive Pain Relief 428
Techniques for Pain Control 429
Nursing Diagnoses 431
Unit 1 Pain Relief 432
Alleviating Pain through Touch 433
Using Relaxation Techniques 433
Using Transcutaneous Electric Nerve Stimulation (TENS) 433
Administering Epidural Narcotic Analgesia 435
Critical Thinking Application 437
Unit 2 Patient-Controlled Analgesia (PCA) 439
Qualifying the Client for PCA 440
Administering PCA 440
Changing Dose Volume 443
Changing Lockout Interval 443
Changing 4-Hour Limit 444
Terminating a PCA Infusion 444
Teaching PCA to a Client 444
Critical Thinking Application 446
Gerontologic Considerations 447
Management Guidelines 448
Delegation of Responsibilities 448
Information Flow 448
Chapter 18 Nutritional Management 449
Essential Nutrients 451
Assimilation of Nutrients 453
Normal and Therapeutic Nutrition 454
Nursing Diagnoses 457
Unit 1 Nutrition Maintenance 458
Serving a Food Tray 459
Feeding a Client 459
Critical Thinking Application 460
Unit 2 Therapeutic Diets 461
Providing Therapeutic Diets 461
Critical Thinking Application 465
Unit 3 Nutrients via Tube Feeding 466
Inserting a Nasogastric Tube 467
Irrigating a Nasogastric Tube 470
Collecting a Gastric Specimen from a Nasogastric Tube 471
Removing a Nasogastric Tube 471
Giving an Intermittent Nasogastric Feeding 472
Feeding via Continuous Nasogastric Method 473
Giving a Gastrostomy Feeding 475
Inserting a Small-Bore Feeding Tube (Keofeed, Dubbhoff, Moss) 476
Critical Thinking Application 477
Gerontologic Considerations 478
Management Guidelines 479
Delegation of Responsibilities 479
Information Flow 479
Chapter 19 Specimen Collection 481
Laboratory Tests 483
Nursing Diagnoses 485
Unit 1 Urine Specimens 486
Collecting Midstream Urine 486
Collecting 24-Hour Urine Specimen 487
Critical Thinking Application 488
Unit 2 Infant Urine Specimen 489
Collecting a Specimen from an Infant 489
Critical Thinking Application 490
Unit 3 Stool Specimens 491
Collecting Adult Stool Specimen 491
Collecting Stool for Parasites 492
Collecting Infant Stool Specimen 492
Testing for Occult Blood
Collecting Stool for Bacterial Culture 494
Testing for Pinworms 494
Critical Thinking Application 498
Unit 4 Blood Specimens 496
Withdrawing Venous Blood 497
Using Vacutainer System 498

Withdrawing Arterial Blood 498
Collecting a Specimen for Culture 499
Obtaining Blood Specimen for Glucose Testing (Capillary Puncture) 500
Measuring Blood Glucose Using Chemstrip 501
Measuring Blood Glucose Using Accu-Chek or Glucometer 502
Measuring Blood Glucose Using Lifescan One-Touch II 503
Critical Thinking Application 504
Unit 5 Sputum Collection 506
Obtaining Sputum Specimen 506
Using Suction Trap 507
Collecting Specimen by Transtracheal Aspiration 507
Critical Thinking Application 508
Unit 6 Throat and Wound Specimens for Culture 509
Obtaining a Throat Specimen 509
Obtaining Specimen for Aerobic Culture 510
Obtaining Specimen for Anaerobic Culture 511
Critical Thinking Application 512
Gerontologic Considerations 512
Management Guidelines 513
Delegation of Responsibilities 513
Information Flow 513
Chapter 20 Diagnostic Tests 515
Preparation 517
Nursing Diagnoses 519
Unit 1 Contrast Media Studies 520
Preparing for Contrast Media Studies 520
Critical Thinking Application 525
Unit 2 Nuclear Imaging 528
Preparing for Nuclear Scan 527
Teaching for Nuclear Scan 529
Critical Thinking Application 530
Unit 3 Barium Studies 531
Preparing for Barium Studies 531
Critical Thinking Application 533
Unit 4 Diagnostic Procedures 534
Assisting with Lumbar Puncture 535
Assisting with Liver Biopsy 536
Assisting with Thoracentesis 537
Assisting with Paracentesis 538
Assisting with Bone Marrow Aspiration 539
Assisting with Vaginal Examination and Papanicolaou (Pap) Smear 539
Assisting with Proctoscopy 540
Assisting with Fiberoptic Colonoscopy 540
Assisting with Gastroscopy-Endoscopy 541
Assisting with Cystoscopy 542
Assisting with Bronchoscopy 542
Assisting with Amniocentesis 543
Assisting with Magnetic Resonance Imaging (MRI) 543
Critical Thinking Application 544
Gerontologic Considerations 545
Management Guidelines 546
Delegation of Responsibilities 546
Information Flow 546
Chapter 21 Urinary Elimination 547
Urinary System 549
Alterations in Urinary Elimination 551
Nursing Interventions 551
Nursing Diagnoses 552
Unit 1 Intake and Output 553
Measuring Intake and Output 553
Critical Thinking Application 555
Unit 2 Urine Studies 556
Monitoring Specific Gravity with Urinometer 556
Monitoring Specific Gravity with Spectrometer 557
Determining Urine Glucose with Tape 557
Measuring Urine Glucose 558
Measuring Urine Ketone Bodies 559
Critical Thinking Application 561
Unit 3 Catheterization 562
Draping a Female Client 563
Inserting a Straight Catheter (Female) 563
Inserting a Straight Catheter (Male) 565
Inserting a Retention Catheter (Female) 567
Inserting a Retention Catheter (Male) 570
Providing Catheter Care 571
Removing a Retention Catheter 572
Critical Thinking Application 573
Unit 4 External Catheter System 575
Applying a Condom Catheter 575
Attaching Catheter to Leg Bag 576
Critical Thinking Application 573
Unit 5 Suprapubic Catheter Care 578
Providing Suprapubic Catheter Care 578
Critical Thinking Application 580
Unit 6 Bladder Irrigation and Instillation 581
Irrigating by Opening a Closed System 581
Irrigating a Closed System 583
Instilling Medications 583
Maintaining Continuous Irrigation 584
Critical Thinking Application 585
Unit 7 Specimens from Closed Systems 587
Collecting Specimen from a Closed System 587
Critical Thinking Application 588
Unit 8 Urinary Diversion 589
Applying a Urinary Diversion Pouch 589
Obtaining Specimen from an Ileal Conduit 593
Emptying Continent Urinary Diversion 593
Critical Thinking Application 594
Unit 9 Peritoneal Dialysis 596
Assisting with Catheter Insertion 597
Managing Peritoneal Dialysis 597
Maintaining Peritoneal Dialysis 599
Providing Catheter Site Care 599
Administering CAPD 600
Critical Thinking Application 600
Unit 10 Hemodialysis 603
Initiating Hemodialysis 604
Managing Hemodialysis 607
Terminating Hemodialysis 607
Using Continuous Venovenous Hemofiltration (CVVH) 609
Maintaining Central Venous Dual-Lumen Catheter (DLC) 610
Flushing Permanent Dual-Lumen Catheter (PDLC) with Heparin 612
Critical Thinking Application 613
Gerontologic Considerations 615
Management Guidelines 615
Delegation of Responsibilities 615
Information Flow 616
Chapter 22 Bowel Elimination 617
Anatomy and Physiology 619
Defecation 620
Alteration in Elimination 621
Nursing Diagnoses 624
Unit 1 Rectal Tube Insertion 625
Inserting a Rectal Tube 625
Critical Thinking Application 627
Unit 2 Bowel Evacuation 628
Removing a Fecal Impaction 629
Providing Digital Stimulation 629
Developing a Regular Bowel Routine 630
Administering a Suppository 631
Critical Thinking Application 632
Unit 3 Enema Administration 633
Administering an Enema 634
Administering an Enema to a Child 635
Administering a Disposable Enema (Fleet's) 636
Administering a Retention Enema 637
Administering a Harris Flush Enema 637
Critical Thinking Application 638
Unit 4 Colostomy Irrigation 640
Performing a Colostomy Irrigation 640
Performing Irrigation in Bed 643
Critical Thinking Application 644
Unit 5 Fecal Ostomy Pouch Application 647
Applying a Fecal Ostomy Pouch 647
Critical Thinking Application 651
Unit 6 Intestinal Tube Insertion 653
Assisting in Intestinal Tube Insertion 653
Removing an Intestinal Tube 656
Critical Thinking Application 656
Gerontologic Considerations 657
Management Guidelines 657
Delegation of Responsibilities 657
Information Flow 657
Chapter 23 Heat and Cold Therapy 659
Temperature Control 661
Therapeutic Effects of Heat 663
Therapeutic Effects of Cold 663
Nursing Diagnoses 664
Unit 1 Moist Heat 665
Applying Hot Moist Pack to Skin 665
Applying Hot Sterile Moist Compress 666
Providing a Sitz Bath 668
Critical Thinking Application 669
Unit 2 Warm Dry Heat 670
Using a Commercial Heat Pack 670
Using a Heat Cradle 671
Using the Infant Radiant Warmer 671
Applying an Aquathermic Pad 672
Critical Thinking Application 673
Unit 3 Cold Applications 675
Providing a Tepid Bath 675
Using Ice Application 676
Using Instant Cold Pack 677
Critical Thinking Application 677
Unit 4 Hypothermia Blanket 679
Using a Cooling Blanket 679
Critical Thinking Application 682
Gerontologic Considerations 684
Management Guidelines 684
Delegation of Responsibilities 684
Information Flow 684
Chapter 24 Wound Care and Dressings 685
Wound Healing 687
Wound Classification 687
Types of Wound Healing 688
Major Factors Affecting Wound Healing 688
Goals of Wound Care 689
Wound Infections 689
Wounds Caused by Vascular Insufficiency 690
Nursing Diagnoses 691
Unit 1 Measures to Prevent Infection 692
Completing a Surgical Hand Scrub 692
Donning Sterile Gloves 693
Pouring from a Sterile Container 695
Preparing a Sterile Field 695
Preparing a Sterile Field Using Prepackaged Supplies 697
Critical Thinking Application 697
Unit 2 Dressing Change 698
Changing a Dry Sterile Dressing 698
Removing Sutures 700
Removing Staples 701
Critical Thinking Application 702
Unit 3 Wound Care 703
Assessing a Wound 704
Changing a Wound Dressing 705
Changing a Dressing for a Venous Ulcer 707
Assessing Ankle-Brachial Index (ABI) 710
Caring for a Wound with a Drain 710
Applying an Abdominal Binder 712
Maintaining Wound Drainage System 712
Irrigating Wounds 714
Critical Thinking Application 715
Unit 4 Wet-to-Damp Dressings 717
Applying Wet-to-Damp Dressings 717
Critical Thinking Application 719
Unit 5 Pressure Ulcers 720
Preventing Pressure Ulcers 722
Applying Transparent Adhesive Film Dressing 723
Using Hydrocolloid Dressing 725
Critical Thinking Application 728
Gerontologic Considerations 728
Management Guidelines 729
Delegation of Responsibilities 729
Information Flow 729
Chapter 25 Respiratory Care 731
The Respiratory System 733
The Respiratory Cycle 733
Assessment of Respiratory Function 735
Nursing Diagnoses 736
Unit 1 Respiratory Maintenance Measures 737
Instructing Client to Deep Breathe 737

Instructing Client to Cottgh 738
Teaching Diaphragmatic Breathing 739
Teaching Use of an Incentive Spirometer (IS) 739
Using a Mask and Bag Resuscitator 740
Critical Thinking Application 741
Unit 2 Chest Physiotherapy (CPT) 742
Preparing Client for CPT 742
Performing Postural Drainage 743
Performing Percussion 744
Performing Vibration 744
Critical Thinking Application 745
Unit 3 Oxygen Administration 746
Monitoring Clients Receiving Oxygen 746
Using Pulse Oximetry 747
Using an Oxygen Analyzer 748
Using an Oxygen Cylinder 749
Using Nasal Cannulae 749
Using an Oxygen Face Mask 750
Using a Pediatric Oxygen Mask 751
Using a Pediatric Oxygen Tent 753
Using an Oxygen Hood 753
Critical Thinking Application 754
Unit 4 Intermittent Positive Pressure Breathing (IPPB) 756
Setting Up a Positive Pressure Device 756
Administering a Nebulized Treatment by IPPB 757
Administering Medication by Nonpressurized Nebulization
Aerosol (NPA) 758
Critical Thinking Application 759
Unit 5 Artificial Airways (Intubation) 760
Inserting an Oropharyngeal Airway 760
Inserting a Nasopharyngeal Airway (Nasal Trumpet) 761
Assisting with Endotracheal Intubation 762
Monitoring Tracheal Tube Cuff Pressure 763
Providing Care for Client with Endotracheal Tube 763
Extubation 763
Critical Thinking Application 764
Unit 6 Suctioning 766
Suctioning Using Separate Catheter and Glove 766
Suctioning Using Catheter and Sleeve 768
Suctioning with a Closed Suction System 769
Critical Thinking Application 771
Unit 7 Tracheostomy Care 773
Assisting with Tracheostomy Intubation 774
Inflating a Tracheal Tube Cuff 775
Cleaning the Inner Cannula and Ostomy 775
Changing Tracheostomy Tube Ties 777
Performing Tracheostomy Suctioning 779
Capping a Tracheostomy Tube 781
Critical Thinking Application 782
Unit 8 Chest Drainage Systems 784
Maintaining a Three-Bottle System 784
Setting Up and Maintaining a Disposable Water-Seal Suction System 786
Assisting with Removal of Chest Tubes 788
Administering Blood Through Autotransfusion Using Pleur-Evac ATS 789
Critical Thinking Application 790
Gerontologic Considerations 791
Management Guidelines 792
Delegation of Responsibilities 792
Information Flow 792
Chapter 26 Circuiatory Maintenance 795
The Circulatory System 797
Electrical Conduction 798
Alterations in Circulation 799
Altered Circulation 800
Nursing Diagnoses 801
Unit 1 Control of Bleeding 802
Using Digital Pressure 802
Using Pressure Dressing 803
Critical Thinking Application 804
Unit 2 Circulatory Maintenance 805
Applying Elastic Hosiery 805
Applying Sequential Compression Devices 807
Critical Thinking Application 809
Unit 3 Electrocardiogram (ECG) Monitoring 810
Monitoring the ECG 811
Interpreting an ECG Strip 812
Recording a 12-Lead ECG 815
Monitoring Clients on Telemetry 817
Critical Thinking Application 819
Unit 4 Emergency Life-Support Measures 821
Administering Basic Life-Support to an Adult 821
Administering CPR to a Child 825
Administering the Heimlich Maneuver for Conscious Client 826
Administering the Heimlich Maneuver for Unconscious Client 827
Calling a Code 828
Using an Emergency "Crash" Cart 829
Performing Emergency Defibrillation 830
Providing Care Following Code 830
Critical Thinking Application 830
Unit 5 Pacemaker Management 831
Assisting with Pacemaker Insertion 831
Maintaining Pacemaker Function 833
Providing Client Teaching 833
Critical Thinking Application 835
Gerontologic Considerations 836
Management Guidelines 836
Delegation of Responsibilities 836
Information Flow 837
Chapter 27 Intravenous Therapy Management 839
Fluids and Electrolyte Balance 841
Fluid and Electrolyte Imbalance 842
Nursing Diagnoses 843
Unit 1 Initiating Intravenous Therapy 844
Preparing the Infusion System 844
Preparing the Venipuncture Site 847
Inserting a Winged Needle 848
Inserting an Over-the-Needle Catheter 850
Critical Thinking Application 853
Unit 2 Intravenous Management 854
Regulating Infusion Flow Rate 854
Using an Electronic Flow-Control Device 856
Using a Syringe Pump 856
Managing the IV Site 858
Changing Gown for Client with IV 859
Discontinuing an IV 860
Critical Thinking Application 861
Unit 3 Intake and Output 863
Monitoring Intake and Output 863
Monitoring IV Intake 866
Critical Thinking Application 866
Unit 4 IV Medication Administration 868
Adding Medication to IV Solution 868
Using a Secondary ("Piggyback") Bag 869
Using a Volume Control Set 870
Using a Peripheral Saline Lock 872
Administering Medications by IV Line Injection "Push" 872
Critical Thinking Application 874
Unit 5 Blood Transfusions 875
Administering Blood through a Y-Set 875
Administering Blood through a Straight Line 877
Administering Blood Components 878
Monitoring for Potential Complications 878
Critical Thinking Application 881
Gerontologic Considerations 882
Management Guidelines 882
Delegation of Responsibilities 882
Information Flow 883
Chapter 28 Central Venous Access Devices 885
Central Vascular Access Devices 887
Nursing Diagnoses 888
Unit 1 Percutaneous Central Venous Catheters 889
Assisting with Percutaneous Central Venous Catheterization 889
Changing a Central Venous Catheter Dressing 890
Drawing Blood from a Central Venous Catheter 892
Measuring and Monitoring Central Venous Pressure (CVP) 894
Critical Thinking Application 897
Unit 2 Total Parenteral Nutrition 898
Assisting with Catheter Insertion 898
Maintaining Hyperalimentation Infusions (TPN) 901
Changing Hyperalimentation (TPN) Dressing and Tubing 901
Maintaining Hyperalimentation for Children 903
Critical Thinking Application 904
Unit 3 Lipid Emulsion Therapy 905
Infusing IV Lipids 905
Critical Thinking Application 907
Unit 4 Tunneled Central Venous Access Devices (CVADs) 908
Maintaining the Hickman or Broviac CV Catheter 908
Changing the Hickman or Broviac CV Catheter Dressing 909
Maintaining the CV Catheter with Groshong Valve 910
Drawing Blood from the CV Catheter with Groshong Valve 911
Critical Thinking Application 912
Unit 5 Implanted Subcutaneous CV Infusion Port 914
Accessing and Flushing an Implanted Venous Access Port Using a Huber Needle 914
Administering Drugs via an Implanted Venous Access Port 916
Administering Infusions via an Implanted Venous Access Port 916
Drawing Blood from an Implanted Venous Access Port 918
Critical Thinking Application 919
Unit 6 Peripherally Inserted Central Catheter (PICC) 920
Maintaining the PICC 920
Changing the PICC Dressing 921
Drawing Blood from the PICC 922
Removing the PICC 923
Critical Thinking Application 923
Gerontologic Considerations 924
Management Guidelines 924
Delegation of Responsibilities 924
Information Flow 925
Chapter 29 Orthopedic Measures 927
Restoring Function 929
Nursing Diagnoses 932
Unit 1 Bandage Application 933
Applying a Sling 933
Applying a Circular Bandage 934
Applying a Spiral Bandage 935
Applying a Figure-Eight Bandage 935
Critical Thinking Application 936
Unit 2 Splinting a Fracture 937
Applying a Splint 937
Critical Thinking Application 938
Unit 3 Cast Care 939
Caring for a Wet Cast 940
Assessing a Casted Extremity 940
Instructing in Care of a Synthetic Cast 941
Critical Thinking Application 942
Unit 4 Traction 943
Monitoring Skin Traction 943
Monitoring Skeletal Traction 946
Monitoring External Fixation Devices 948
Critical Thinking Application 949
Unit 5 Halo Traction and Back Brace 950
Placing a Jewett-Taylor Back Brace 950
Monitoring Halo Traction 951
Critical Thinking Application 952
Unit 6 Clients with Amputated Limbs 953
Positioning and Exercising 953
Applying a Compression Bandage 954
Critical Thinking Application 955
Unit 7 Clients with Joint Replacement 960
Providing Care for a Client with Hip Replacement 956
Providing Care for a Client with Knee Replacement 958
Critical Thinking Application 959
Unit 8 Nelson Bed 960
Using a Nelson Bed 960
Moving to Chair Position 961
Moving to Contour Position 962
Tilting Bed to Vertical
Position 962
Tilting Bed to Trendelenburg's Position 963
Critical Thinking Application 964
Unit 9 Stryker Frame 965
Using a Stryker Wedge Turning Frame 965
Turning from Supine to Prone 966
Using a Stryker Parallel Frame 968
Assisting Client with Bedpan 968
Attaching Fixed Traction 968
Attaching Skeletal Traction 969
Critical Thinking Application 970
Gerontologic Considerations 970
Management Guidelines 971
Delegation of Responsibilities 971
Information Flow 971
Chapter 30 Opfrative Care 973
The Surgical Experience 975
Nursing Diagnoses 978
Unit 1 Stress in Preoperative Clients 979
Preventing Anxiety and Stress 979
Reducing Anxiety and Stress 980
Assisting the Client Who Uses Denial 980
Critical Thinking Application 981
Unit 2 Preoperative Teaching 982
Providing Surgical Information 983
Providing Client Teaching 984
Providing Family Teaching 984
Providing Teaching for Laser Therapy 985
Providing Teaching for Lithotripsy 986
Instructing in Deep Breathing Exercises 987
Instructing in Coughing Exercises 987
Providing Instruction to Turn in Bed 988
Instructing in Leg Exercises 988
Critical Thinking Application 989
Unit 3 Preoperative Care 990
Obtaining Baseline Data 991
Preparing the Surgical Site 991
Preparing the Client for Surgery 993
Administering Preoperative Medications 995
Critical Thinking Application 996
Unit 4 Postanesthesia Room Care and Discharge 997
Providing Postanesthesia Room (PAR) Care 998
Discharging Client from Postanesthesia Room to Nursing Unit 999
Discharging Client from Postanesthesia Room to Home 1000
Critical Thinking Application 1001
Unit 5 Postoperative Care 1002
Providing Postoperative Care 1002
Administering Postoperative Medications 1003
Critical Thinking Application 1004
Gerontologic Considerations 1005
Management Guidelines 1006
Delegation of Responsibilities 1006
Information Flow 1006
Chapter 31 Client Education and Discharge Planning 1007
Client Education 1009
Discharge Planning 1010
Nursing Diagnoses 1012
Unit 1 Client Education 1013
Collecting Data 1014
Determining Readiness to Learn 1015
Identifying Learning Needs 1015
Determining Appropriate Teaching Strategy 1016
Selecting the Educational Setting 1016
Implementing the Teaching Strategy 1017
Developing an Evaluation Tool 1018
Critical Thinking Application 1018
Unit 2 Discharge Planning 1020
Preparing a Client for Discharge 1020
Completing a Discharge Summary 1021
Critical Thinking Application 1022
Gerontologic Considerations 1022
Management Guidelines 1023
Delegation of Responsibilities 1023
Information Flow 1024
Chapter 32 Care of the Dying Client 1027
Loss and Grieving 1028
Stages of Dying 1029
The Hospice Option 1030
Nursing Diagnoses 1031
Unit 1 The Grief Process 1032
Understanding Grief 1033
Assisting with Grief 1033
Clinical Thinking Application 1034
Unit 2 The Dying Client 1035
Assisting the Dying Client 1036
Clinical Thinking Application 1037
Unit 3 Postmortem Care 1038
Providing Postmortem Care 1038
Critical Thinking Application 1040
Gerontologic Considerations 1040
Management Guidelines 1040
Delegation of Responsibilities 1040
Information Flow 1041
Chapter 33 Advanced Nursing Skills 1043
Advanced Skills in Nursing Practice 1045
Unit 1 Cardiac Emergencies 1047
Using the Emergency Cart 1048
Checking Contents of the Emergency Cart 1048
Calling a Code 1050
Performing Defibrillation 1050
Assisting with Elective Synchronized Cardioversion 1052
Critical Thinking Application 1054
Unit 2 Arterial Blood Pressure Monitoring 1056
Performing the Allen's Test 1058
Assisting with Arterial Line Insertion 1058
Maintaining Arterial Line Function 1060
Withdrawing Arterial Blood Samples 1061
Removing Arterial Catheter 1062
Critical Thinking Application 1063
Unit 3 Pulmonary Artery Pressure (Hemodynamic) Monitoring 1066
Assisting Physician with Catheter Insertion 1068
Obtaining Pressure Readings 1070
Obtaining Cardiac Output Measurements 1071
Leveling the Transducer and Zeroing the Monitor 1072
Critical Thinking Application 1073
Unit 4 Mechanical Ventilation 1074
Caring for Clients on Ventilators 1076
Providing Positive End-Expiratory Pressure (PEEP) 1078
Providing Continuous Positive Airway Pressure (CPAP/BIPAP) 1078
Critical Thinking Application 1079
Unit 5 Weaning from Ventilation to Extubation 1083
Weaning the Mechanically Ventilated Client 1083
Critical Thinking Application 1084
Management Guidelines 1085
Delegation of Responsibilities 1085
Information Flow 1086
Chapter 34 Home Care Management 1087
Unit 1 Admission to Home Care 1091
Identifying Eligibility for Medicare Reimbursement 1097
Completing Admission Documentation 1098
Maintaining Nurse's Safety 1098
Assessing Home for Safe Environment 1099
Evaluating Client's Safety 1100
Assessing Caregiver's Safety 1100
Unit 2 Infection Control 1101
Nursing Diagnoses 1101
Preparing for Client Care 1102
Disposing of Waste Material in the Home Setting 1103
Cleansing Thermometer 1104
Caring for an AIDS or HIV Client in the Home 1104
Cleansing Equipment in the Home Setting 1105
Teaching Preventive Measures in the Home 1105
Teaching Safer Practices to IV Drug Users 1106
Unit 3 Body Mechanics 1108
Nursing Diagnoses 1108
Positioning Nonhospital Bed for Client Care 1109
Moving a Helpless Client Up in Bed Without Assistance 1109
Unit 4 Hygienic Care 1110
Nursing Diagnoses 1111
Bathing Client in the Home 1112
Transferring Client to Tub or Shower 1112
Adapting Bedmaking to the Home 1113
Providing Pressure Ulcer Care 1113
Preparing Normal Saline 1113
Removing Lice 1114
Unit 5 Medications 1115
Nursing Diagnoses 1115
Administering Medications 1116
Sterilizing Nondisposable Medication Equipment 1117
Unit 6 Total Parenteral Nutrition 1118
Nursing Diagnoses 1119
Administering Total Parenteral Nutrition (TPN) in the Home 1120
Discontinuing TPN Infusion 1120
Unit 7 Urinary Elimination 1121
Nursing Diagnoses 1121
Using Clean Technique for Intermittent Self-Catheterization 1123
Administering Chronic Ambulatory Peritoueal Dialysis (CAPD) 1123
Changing Dressing for CAPD Client 1125
Unit 8 Respiratory Care 1126
Nursing Diagnoses 1126
Caring for Oxygen Equipment 1128
Teaching Safety Measures for Oxygen Use 1128
Managing Ventilator Equipment 1128
Providing Catheter Care for Transtracheal Catheter 1129
Teaching the Client Catheter Care 1130
Unit 9 Circulatory Care 1132
Nursing Diagnoses 1132
Monitoring Pacemaker at Home 1133
Checking with Pacemaker Clinic via Telephone 1134
Instructing in Use of Holter Monitor 1134.
Notes:
Includes bibliographical references (pages 1135-1142) and index.
Contributor:
Duell, Donna, 1938-
Martin, Barbara, PhD
ISBN:
0838515665
9780838515662
OCLC:
42771838