Copyright © 2007 by F A Davis 00William & Hopper (F)-FM 11/2/06 2:59 PM Page iii Copyright © 2007 by F A Davis UNDERSTANDING Medical Surgical Nursing THIRD EDITION LINDA S WILLIAMS, MSN, RNBC Professor of Nursing Jackson Community College Jackson, Michigan PAULA D HOPPER, MSN, RN Professor of Nursing Jackson Community College Jackson, Michigan 00William & Hopper (F)-FM 11/2/06 8:22 PM Page iv Copyright © 2007 by F A Davis F A Davis Company 1915 Arch Street Philadelphia, PA 19103 www.fadavis.com Copyright © 2007 by F A Davis Company Copyright © 2003, 1999 by F A Davis Company All rights reserved This product is protected by copyright No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher Printed in the United States of America Last digit indicates print number: 10 Acquisitions Editors: Lisa B Deitch/Jonathan Joyce Director of Content Development: Darlene D Pedersen Special Projects Editor: Shirley A Kuhn Senior Project Editor: Ilysa H Richman Art and Design Manager: Carolyn O’Brien As new scientific information becomes available through basic and clinical research, recommended treatments and drug therapies undergo changes The author(s) and publisher have done everything possible to make this book accurate, up to date, and in accord with accepted standards at the time of publication The author(s), editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of the book Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation The reader is advised always to check product information (package inserts) for changes and new information regarding dose and contraindications before administering any drug Caution is especially urged when using new or infrequently ordered drugs ISBN 13: 978-0-8036-1491-8 ISBN 10: 0-8036-1491-8 Library of Congress Cataloging-in-Publication Data Understanding medical-surgical nursing / [edited by] Linda S Williams, Paula D Hopper — 3rd ed p ; cm Includes bibliographical references and index ISBN 0-8036-1491-8 I Nursing Surgical nursing I Williams, Linda S (Linda Sue), 1954II Hopper, Paula D [DNLM: Nursing Care Nursing WY 100 U548 2007] RT41.W576 2007 617′.0231—dc22 2006035577 Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by F A Davis Company for users registered with the Copyright Clearance Center (CCC) Transactional Reporting Service, provided that the fee of $.10 per copy is paid directly to CCC, 222 Rosewood Drive, Danvers, MA 01923 For those organizations that have been granted a photocopy license by CCC, a separate system of payment has been arranged The fee code for users of the Transactional Reporting Service is: 8036-1491 07 / ϩ $.10 Disclaimer: Some images in the original version of this book are not available for inclusion in the eBook 00William & Hopper (F)-FM 11/2/06 2:59 PM Page v Copyright © 2007 by F A Davis To our students, this is for you We hope it helps you achieve your dreams Linda and Paula In memory of my mother who was so proud of the book that she took it everywhere to show to people I will miss her joy in seeing this edition To my dad who has always been supportive and kept me company on my breaks from writing during this revision To Garland, with love, whose support I needed more than ever before during this past year Thank you To Jami and Anthony, who’s joy in life are their wonderful children, Dimitri, Alex, and Ayla who also bring me joy To my sister Lisa and her family Ken, Michael, and Nathan for their ongoing support To Christine, Anna, and Suzee for encouragement and a listening ear when it was needed most LINDA S WILLIAMS To Dave, with love, for his continued love and support To Dan and Libby, my two other favorite people in the world I am so proud of you both And to my Dad, who proudly displays our books even though he doesn’t have to read them PAULA D HOPPER 00William & Hopper (F)-FM 11/2/06 2:59 PM Page vi Copyright © 2007 by F A Davis This page has been left intentionally blank 00William & Hopper (F)-FM 11/2/06 2:59 PM Page vii Copyright © 2007 by F A Davis Preface Welcome to the third edition of Understanding Medical Surgical Nursing! We have fully updated all the material, and have added exciting new information on home health care, end-of-life care, disaster response and bioterrorism, stroke, and more We continue to work hard to provide a text written at an understandable level, with features that help students understand, apply, and practice the challenging content required to function as practical/vocational nurses We are thankful to the many students who tell us they find the book very readable, and actually enjoyable We are overjoyed to hear from several nursing programs that their NCLEX scores soared after adopting this textbook We continue to emphasize understanding, critical thinking, and application throughout the book We believe that a student who learns to think critically will be better able to apply information to new situations We hope both students and instructors find this third edition a practical tool for learning and understanding medical-surgical nursing FEATURES OF THE BOOK We have kept our most popular features from the first two editions, and added new ones based on reader input • Questions to Guide Your Reading begin each chapter In our experience, the standard objectives found in many textbooks have little meaning and provide little assistance to students Literature suggests that comprehension increases when students read guiding questions before reading the text So we have provided a series of questions that students should keep in mind as they read These questions can be translated easily back into objectives by instructors who prefer this format • Special features written by actual patients, called Patient Perspectives, were added in the second edition Many more have been added to this edition These stories help to make patients’ experiences with illness more meaningful and personal for students • Web links are included in the text to help students further research on topics of interest Every effort was made to use only major established web sites that are unlikely to change in the near future • One of our most popular features, Critical Thinking Exercises, has been expanded to help students practice and think about what they are learning We have added more math calculations and documentation practice to Critical Thinking Exercises where applicable • Review questions at the end of each chapter have been updated and include alternate format items to reflect NCLEX-PN • Suggested Answers for the Critical Thinking Exercises and Review Questions are included Research supports the importance of immediate feedback to reinforce learning, so we feel strongly that students should have access to correct answers while they are studying, without having to wait for their next instructor contact Since there can be many answers to some of the critical thinking questions, we have provided sample answers to help stimulate students’ thinking • The effects of aging on body systems have been converted from text format to a mindmap format We believe this visual representation is easier to understand and apply than the traditional text • We have changed our Nursing Process format from text to bullet lists It is very easy to read, clearly stands out, and makes interventions with rationale very clear to students • More Learning Tips, a very popular feature in past editions, have been added New to the third edition are Nursing Care Tips and Safety Tips • JCAHO National Patient Safety Goals are reflected in many of the safety tips to give students an introduction to these safety goals • Nursing assessment, laboratory tests, and medications have been placed in consistent tables that are easy to read and understand vii 00William & Hopper (F)-FM 11/2/06 2:59 PM Page viii Copyright © 2007 by F A Davis viii Preface • Summary boxes including nursing diagnoses have been expanded and included for most major disorders • A pronunciation key for new words is found at the beginning of each chapter • A review of anatomy and physiology is presented at the beginning of each unit • Word-building footnotes are found throughout the chapters to make complex medical terminology easier to understand • Nursing care plans with geriatric considerations have been updated • Boxed presentations of Cultural Considerations, Gerontological Issues, Home Health Hints, Ethical Considerations, and Nutrition Notes provide valuable supplemental information and help students relate text material to real life situations • Many new photographs and drawings have been added to illustrate important concepts • A comprehensive, updated glossary of new words is included in the appendix TO STUDENTS: HOW TO USE THIS BOOK As you begin each chapter, carefully read the section labeled Questions to Guide your Reading Then, when you are finished reading each chapter, go back and make sure you can answer each question You will find a list of new words and their pronunciations at the beginning of each chapter These words appear in bold at their first use in a chapter, and they also appear in the glossary at the end of the book By learning the meanings of these words as you encounter them, you will increase your understanding of the material You also will encounter other learning tips to increase your understanding and retention of the material You may want to develop your own memory techniques in addition to those provided (If you think of a good one, send it to us and you may find it in the next edition!) Many of the learning tips have been developed and used in our own classrooms We find them helpful in fostering understanding of complex concepts or as memory aids However, we want to stress that memorization is not the primary focus of the text but rather a foundation for understanding and thinking about more complex information Understanding and application will serve you far better than memorization when dealing with new situations Each chapter includes critical thinking case studies designed to help you apply material that has been presented A series of questions related to the case study will help you integrate the material with what you already know These questions emphasize critical thinking, which is based on a foundation of recall and understanding of material To enhance your learning, try to answer the questions before looking up the answers at the end of the chapter Review questions appear at the end of each chapter to help you prepare for chapter tests, and also for the NCLEXPN Again, to assess your learning, try to answer the questions before looking up the answers at the back of the book A bibliography at the end of each unit provides sources for additional reading material Web sites have been included in many chapters We believe it is important for you to interact with current technology to expand your information resources The following appendices are included for easy reference: • NANDA nursing diagnoses • Lab values • Common medical abbreviations (Although it is still important to know the abbreviations, many can increase risk of errors Check www.JCAHO.org for a list of abbreviations to avoid.) • Common prefixes and suffixes to help learn word building techniques SUPPLEMENTAL MATERIALS • A new Electronic Student Guide is included with the book This provides practice in the form of objective (fill-in, labeling, and flashcard) exercises, and case studies There are also review questions and a practice NCLEX test We have also included a brief math tutorial using Unit Analysis, and practice calculation problems Answers are provided to all exercises for immediate feedback • A paperback Student Workbook is available to provide the student additional contact and practice with the material Each chapter includes vocabulary practice, objective exercises, a case study or other critical thinking practice and review questions written in NCLEX-PN format Answers provide immediate feedback Rationales are provided for non-anatomy review question answers • An Instructor’s Resource Disk includes an Electronic Instructor’s Guide that provides materials for use in the classroom Each chapter has a chapter outline with suggested classroom activities Also included are student activities for printing and using for individual practice or for collaborative learning activities These activities help the student to interact with the material, understand it, and apply it Many of the activities are based on real patient cases and have been used with our own practical nursing students Feedback from students has helped to refine the exercises We believe the use of collaborative learning has greatly enhanced our students’ success in achieving their educational and licensure goals Another benefit is the sense of community the students develop as a result of working in groups A brief introduction and guidelines for using collaborative learning techniques is 00William & Hopper (F)-FM 11/2/06 2:59 PM Page ix Copyright © 2007 by F A Davis Preface included Also included is an expanded Electronic Test Bank, available to instructors who adopt the textbook, which provides test questions that assist students to prepare for NCLEX-PN These questions have been prepared according to test item writing protocols The questions are in multiple choice and alternate format, and test recall, application, and analysis of material Many of the test questions have been developed, used and refined by the authors in their own medical-surgical courses ix for practical nursing students The program allows instructors to choose and modify the questions that best suit their classroom needs Finally, for the instructor’s convenience, there is a comprehensive Power Point program for classroom presentations Images from the text have been added for the third edition Each presentation can be modified, reduced, or expanded by individual instructors to suit their needs 00William & Hopper (F)-FM 11/2/06 2:59 PM Page x Copyright © 2007 by F A Davis This page has been left intentionally blank 00William & Hopper (F)-FM 11/2/06 2:59 PM Page xi Copyright © 2007 by F A Davis Acknowledgements Many people helped us make this book a reality First and foremost are our students, who provided us with the inspiration to undertake this project We hope that they continue to find this text worth reading The F.A Davis Company has been an exceptional publishing partner We feel fortunate to have had their continued enthusiasm and confidence in our book The staff at F.A Davis has guided us through this project for three editions to help us create a student-friendly book that truly promotes understanding of medical-surgical nursing Lisa Deitch, Shirley Kuhn, Ilysa Richman, Darlene Pedersen, Doris Wray, and many others have been extremely patient and kind as we worked hard to provide a quality text and meet deadlines We thank the staff of W.A Foote Memorial Hospital in Jackson, Michigan for allowing us access to their facility and patients for a great photo shoot Our photographer, Robert Conway, did a terrific job of obtaining some challenging shots Contributors from across the United States and Canada, including many well-known experts in their fields, brought expertise and diversity to the content Their hard work is much appreciated Reviewers from throughout the United States provided insights that enhanced the quality of the text Elizabeth Hopper provided invaluable organizational assistance Many of our co-workers have contributed to this book and given us ongoing encouragement and validation of the worthiness of this project Elizabeth Ackley, MarinaMartinez Kratz, Sharon Nowak, Debra Perry-Philo, Carroll Lutz, Suzanne Fox, Linda Nabozny, and Anna Ricks were especially helpful in providing material, advice, and encouragement We wish to thank everyone who played a role, however large or small, in helping us to provide a tool to help students realize their dreams of becoming an LPN or LVN We hope this book will help train nurses who can provide safe and expert care because we have helped them to learn to think critically xi 64William & Hopper (F)-Index 11/2/06 2:50 PM Page 1339 Copyright © 2007 by F A Davis Index Lymph node biopsy, 516 Lymphadenopathy, 963 Lymphangiography, 515–516 Lymphangitis, 441 Lymphatic system, 441, 509, 511, 511–512 diagnostic tests, 515–516 disorders, 540–542 gerontologic issues, 512 history taking, 512–513 lymphatic vessels, 511, 511–512 nodes and nodules, 512 nursing assessment, 512–513, 513t physical examination, 514 spleen, 512 thymus, 512 Lymphedema, 514 Lymphocytes, 289, 290 viral infection, 514 Lymphoid structures, 97 Lymphoma(s), 544b non-Hodgkin’s, 541–542 nursing care plan, 537–538b, 543–544b Lysozymes, 96 M Macrophages, 96 Macular degeneration, 180, 251, 1151b, 1170, 1171, 1179–1180 Magnesium imbalances, 72 Magnetic resonance imaging breasts, 887 cancer, 156 cardiovascular system, 359 musculoskeletal system, 985–987, 987, 987b nervous system, 1051–1052 Major depression, 1280 Malabsorption See Absorption disorders Malignant hyperthermia, 188 Malignant melanoma, 1235, 1239 Malignant tumors, 147, 147t Mallory-Weiss tear, 674 Malnutrition chronic heart faiure, 485 Malpractice, 27 Mammary glands, 880 Mammography, 152, 155, 156, 887, 887 Mammoplasty, 904 reconstruction, 904 Managed health care, 14 Management model continuous quality, 16 Mania, 1280 Marsupialization, 926 Masks oxygen therapy, 560, 560 Massage therapy, 54 Mastalgia, 900 Mastectomy, 901 nursing care plan, 902–903b reconstruction, 904–905, 905 Mastitis, 900 Mastopexy, 904 Mechanical assistive devices chronic heart failure, 490–491 Mechanical hyperventilation hematoma, 1072 Mechanical ventilation chronic obstructive pulmonary disease, 607–608 Medicaid, 14 Medical asepsis, 99, 99 Medicare and diagnosis-related groups, 13–14 Medications acne vulgaris, 1231 administration, 105 alcohol abuse and dependence, 1289 angina pectoris, 416–417t anticoagulants, 399t anticonvulsant, 1068, 1068t asthma, 610–611 atherosclerosis, 407 burns, 1247, 1248t cardiovascular system, 354, 368, 369b causing disturbed throught processes, 1093b causing erectile dysfunction, 950, 950t cerebrovascular accident, 1113, 1114t chemotherapy, 160–161t chronic heart failure, 486–490, 487–489t, 495 chronic obstructive pulmonary disease, 605–606 Crohn’s disease, 697t depot, 918 diabetes mellitus, 859–863 disturbed thought processes, 1094t ears, 1159 end of life, 282t endocrine disorders, 848t eyes, 1151–1152, 1153b, 1165–1166t -food interactions, 1281b gallbladder disorders, 734t, 742–743 gastroesophageal reflux disease, 673 gastrointestinal system, 640–641 glaucoma, 1176–1177 gout, 1010 hemolytic transfusion reactions, 308t herniated disk, 1079 herpes simplex, 1228 herpes zoster, 1228 HIV and AIDS, 340 HIV infection, 330–332t, 330–333 hormone alterations disorders, 908–909t hypertension, 378b, 379–381t immune system, 299 inflammations of vagina and vulva, 911t integumentary system, 1209 intracorporeal erectile dysfunction, 950–951 lipid-lowering, 408t liver disorders, 734t lower respiratory tract disorders, 606–607t 1339 lupus erythematosus, 316t, 317t male reproductive system disorders, 936–937t mental health, 1277, 1278–1279t, 1281, 1281b multiple sclerosis, 1128 myocardial infarction, 423, 424–426t older adults management, 255 oral contraceptives, 917–918 oral hypoglycemic, 862, 862t osteoarthritis, 1017–1019, 1018t osteoporosis, 1007 ototoxic, 1183t Paget’s disease, 1008 pancreatic disorders, 734t Parkinson’s disease, 1100t peptic ulcer disease, 677, 678t peripheral arterial disease, 431 peripheral nervous system disorders, 1129t preoperative, 183–184, 184t preoperative review, 179–180 psoriasis, 1225 renal failure, 800 rheumatoid arthritis, 1021–1022 sexually transmitted diseases, 961t shock, 116t stone formation, 784t systemic lupus erythematous, 1011–1012 thrombophlebitis, 398 ulcerative colitis, 697t urinary tract infections, 780, 780t Medroxyprogesterone acetate, 918 Medulla, 1040 Megacolon, 688 Ménière’s disease, 1161, 1194–1195 Meninges, 1042 Meningioma, 1074, 1075 Meningitis, 1054–1058, 1057t, 1058, 1058b Menopause, 879, 907–908 Menstrual cycle, 880–881 Menstrual disorders, 905–908, 909t Mental health, 1261–1264 anxiety disorders, 1275–1277, 1280b behavior management, 1269–1270 cognitive behavior therapy, 1270 conversion disorder, 1282–1284 coping, 1266–1267 counseling, 1270 cultural considerations, 1263b disorders, 1275–1290 electroconvulsive therapy, 1271, 1271b generalized anxiety disorder, 1275–1276 group therapy, 1270–1271 major depression, 1280 mental illness, 33 milieu, 1269 mood disorders, 1277–1281 nutrition, 1281b obsessive-compulsive disorder, 1276 panic disorder, 1275 person-centered/humanistic therapy, 1270 64William & Hopper (F)-Index 11/2/06 2:50 PM Page 1340 Copyright © 2007 by F A Davis 1340 Index Mental health (Continued) phobias, 1275 posttraumatic stress disorder, 1276 psychoanalysis, 1269 psychopharmacology, 1269 psychotherapies, 1269–1270 relaxation therapy, 1271–1272 schizophrenia, 1284–1286, 1287b somatoform/psychosomatic disorders, 1281–1284 substance abuse disorders, 1286–1290 therapeutic measures, 1268–1272 unipolar depression, 1280 Mental illness, 1261–1264 diagnostic tests, 1264–1266 older adult, 1290–1292 and physical disorders compared, 1264–1266 Mental status, 1047–1048 Mental status changes chronic heart faiure, 485 end of life, 281–282 Mental status examination, 1264–1265t Metabolic acidosis, 73–74 Metabolic alkalosis, 74 Metabolic syndrome, 855 Metastasis, 150, 151 lung cancer, 622 Metastatic bone disease, 1009 Metastatic brain tumors, 1074, 1075 Methicillin-resistant Staphylococcus aureus, 102 Mexican Americans gastrointestinal system, 643b Midbrain, 1041 MIDCABG, 410 Migraine headaches, 1066 Milieu, 1269 Mineralocorticoids, 817 Miotics, 1176 Mitosis, 145–146 Mitral regurgitation, 446t diagnostic tests, 449 etiology, 448–449 pathophysiology, 448–449 signs and symptoms, 449 therapeutic interventions, 449, 449 Mitral stenosis, 445, 446t diagnostic tests, 448 etiology, 447–448 pathophysiology, 447 signs and symptoms, 448 therapeutic interventions, 448, 449 Mitral valve ball valve prosthesis, 449, 449 Mitral valve prolapse, 446t complications, 447 diagnostic tests, 447, 447b etiology, 445–446 pathophysiology, 445 signs and symptoms, 446 therapeutic interventions, 447, 447b Mobility postoperative, 200–201 Mobility and ambulation amputation, 1029 Mononucleosis, 97–98 Mons pubis, 880 Mood disorders differential diagnosis, 1280 etiological theories, 1280 therapeutic interventions, 1281 types, 1277, 1280–1281 Morality, 18 Motor disturbances cerebrovascular accident, 1111, 1114–1115, 1115 Motor function spinal injury, 213, 213t Motor neurons, 1037, 1037, 1038–1039 Mucolytic agents, 591 Mucopurulent cervicitis, 958 Mucositis, 157–158 Mucous membranes defense mechanism, 96 impaired oral AIDS, 339 Multifocal, 468 Multiple myeloma, 536–540 diagnostic tests, 539, 539 etiology, 536 nursing process, 539–540 pathophysiology, 536 signs and symptoms, 538–539 therapeutic interventions, 539 Multiple sclerosis, 1127, 1127–1129, 1128b Murmurs, 352, 358, 446 Muscle biopsy musculoskeletal system, 988 Muscle contraction headaches, 1065–1066 Muscle relaxation progressive, 52 Muscles, 977, 980–981, 981 functional assessment, 1049 Muscular dystrophy, 1014–1015 Muscular system aging, 243, 244t Musculoskeletal system aging, 981–982, 982, 982b amputation, 1027–1031 anatomy and physiology, 977 appendicular skeleton, 980, 980t arthrocentesis, 989 arthrography, 985 arthroscopy, 988 assessment, 982–984, 983b bone and soft tissue disorders, 992–1009 bone biopsy, 988 bursitis, 992 carpal tunnel syndrome, 993 computed tomography, 985, 985 diagnostic tests, 984t, 984–989, 986t dislocations, 992 fractures See Fractures gallium/thallium scans, 988 hip replacement, 1023, 1023–1027, 1024, 1025 history taking, 982 knee replacement, 1027, 1027 magnetic resonance imaging, 985–987, 987, 987b muscle biopsy, 988 muscle structure and arrangement, 980–981, 981 myelogram, 985 nerve conduction studies, 989 nervous system, 981 neuromuscular junction, 981 nuclear medicine scans, 987 objective data, 982–984 Paget’s disease, 1008 physical assessment, 982–984 psychosocial assessment, 984 radiographic tests, 985 rib cage, 980 rotator cuff injury, 992–993 skeletal structure, 977–978, 978 skull, 978–979, 979 sprains, 992 strains, 992 subjective data, 982 surgery, 1023–1031 synovial joints, 980, 980 tissues, 977–980 total joint replacement, 1023–1027 ultrasonography, 988 vertebral column, 979–980 x-rays, 985 Myalgia, 582 Myasthenia gravis, 1129–1134, 1133, 1133t Myectomy, 397 Myelogram, 1052 musculoskeletal system, 985 Myeloperoxidase antigen, 365 Myocardial infarction, 407, 418–430, 421b activity, 423 cardiac rehabilitation and exercise, 426–430 complications, 420t diagnostic tests, 422, 422 diet and weight loss, 423 gerontological implications, 422 glucose control, 423 medications, 423, 423–425t nursing process, 423, 427–429t oxygen therapy, 423 pathophysiology, 418–419, 419 patient education, 426 signs and symptoms, 419–420 smoking, 423 therapeutic interventions, 422b, 422–423 ventricular aneurysm repair, 423 women and heart health, 420–422 Myocardial revascularization, 410 Myocarditis, 113, 388 Myocardium, 112 Myoglobin, 366, 984 Myomectomy, 925 Myopia, 1169, 1169 Myringoplasty, 1191 Myringotomy, 1191 Myxedema, 832, 833 N Nadir, 159 Nailbeds clubbing, 357, 357 64William & Hopper (F)-Index 11/2/06 2:50 PM Page 1341 Copyright © 2007 by F A Davis Index Nails, 1202, 1207 Nasal cavities anatomy, 549 Nasal polyps, 578 Nasogastric tubes insertion and maintenance, 656b Nasoseptoplasty, 578 Natural killer cells, 290 Naturopathy, 51–52 Nausea, 663 Navajo people immune system disorder, 293b Near-drowning, 220–221 Nebulized mist treatments, 561, 561 Needle(s) IV, 82, 83 Needle sticks HIV transmission, 326 Negligence, 27 Neoplasms, 146 Neoplastic disorders inner ear, 1194 Nephrectomy, 790–791 Nephrogenic, 826 Nephrolithotomy, 785 Nephrons, 751, 752, 798t Nephropathy, 867 Nephrosclerosis, 793 Nephrostomy tube, 788, 788 Nephrotic syndrome, 792 Nephrotoxic, 762 Nephrotoxins common, 796t Nerve conduction studies musculoskeletal system, 989 Nerve root damage spinal surgery, 1080 Nerves diabetes complications, 867 Nervous system, 981 activities of daily living, 1053 aging, 244t, 250–251, 1043, 1045 anatomy and physiology, 1037–1043 angiogram, 1052 assessment, 1043–1050, 1045t, 1046t autonomic, 1042–1043, 1044, 1044t brain See Brain central See Central nervous system cerebrospinal fluid, 1042 communication, 1053–1054 computed tomography, 1051 consciousness level, 1047, 1047t, 1048 cranial nerves, 1042, 1043t diagnostic tests, 1050–1053 electroencephalogram, 1052–1053 eye assessments, 1048, 1048–1049 health history, 1046 heart rate regulation, 349, 349 lumbar puncture, 1050–1051, 1051 magnetic resonance imaging, 1051–1052 meninges, 1042 mental status, 1047–1048 moving and positioning, 1053 muscle function assessment, 1049 myelogram, 1052 nerve impulse, 1039 nerve tissue, 1037–1039 nerve tracts, 1039 nerves, 1039 nutrition, 1054 peripheral See Peripheral nervous system physical assessment, 1046–1050 spinal cord See Spinal cord subjective data, 1046, 1046t synapses, 1038, 1038 x-ray examination, 1051 Neuralgia, 1137 trigeminal neuralgia, 1138, 1138 Neurodegenerative disorders, 1085–1105 Neuroglia, 1037, 1038t Neurological function postoperative, 191 Neurological system See Nervous system Neuromuscular disorders, 1127–1137 Neuromuscular junction, 981 Neurons motor, 1037, 1037, 1038–1039 sensory, 1037, 1037, 1038 Neuropathic, 127 Neuropathy(ies), 857, 1137 Neurotransmitters central nervous system, 1262t Neurovascular assessment, 983t Neurovascular compromise fractures, 1001 postoperative hip replacement, 1026 Neutrophils, 291 bacterial infection, 513 Nitroglycerin, 415 sublingual, 415, 418b Nociceptive, 127 Nocturia, 249, 827, 855 chronic heart failure, 485 Nodal rhythm, 459 Non-Hodgkin’s lymphoma(s), 541–542 Hodgkin’s disease versus, 542t Nonnucleoside reverse transcriptase inhibitors (NNRTIs), 330t Nonopioids, 128, 128t Nonrebreather mask, 560 Norepinephrine, 111, 817 North American Nursing Diagnosis Association (NANDA), Nose anatomy, 549 deviated septum, 578 disorders, 577–579 epistaxis, 577–578 polyps, 578 postsurgical teaching, 579b rhinoplasty, 578, 1239t sinusitis, 578–579 Nosebleed See Epistaxis Nuchal rigidity, 1057 Nuclear imaging cancer, 156 Nuclear medicine scans musculoskeletal system, 987 Nuclear scanning gastrointestinal system, 648t, 651 thyroid gland, 823 1341 Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs), 331–332t Nursing process, 5–10 acromegaly, 831–832 acute (fulminant) liver failure, 724 adrenalectomy, 847 adrenocortical insufficiency, 845 alcohol abuse and dependence, 1289–1290 alternative and complementary therapies, 55 anemias, 313 angina pectoris, 418 ankylosing spondylitis, 316–318 anxiety disorders, 1277 aplastic anemia, 525 assessment See Assessment phase of nursing process atherosclerosis, 411–412 Bell’s palsy, 1139–1140 bimanual palpation, 889 bone cancer, 1009 brain tumor, 1075 breast biopsy, 888 breast modification surgeries, 905 burns, 1249–1250, 1250–1255b cancer, 162–170 cancer of testes, 948 cardiac pacemakers, 472–473 cardiac transplantation, 498–499, 499–500b cardiovascular disorders inflammatory and infectious, 388–403 carpal tunnel syndrome, 993 cataracts, 1178–1179 central access devices, 89 cerebrovascular disorder, 1118–1123 chest drainage, 564–565, 565b chest trauma, 619 chronic heart failure, 492–496, 494–495b chronic illness, 238b, 238–239 chronic obstructive pulmonary disease, 608 colon cancer, 708–710 communication, 16, 16 constipation, 689 contact dermatitis, 310 coronary artery disease, 411–412 cranial nerve disorders, 1139–1140 Crohn’s disease, 696 Cushing’s disease, 847 cystourethroscopy, 896 cytology, 889–890 data collection, data documentation, 6–7 dehydration, 61–62 delegation process, 17 depression, 1282–1283b dermatitis, 1223–1224 deviated septum, 578 diabetes insipidus, 827–828 diabetes mellitus, 869 diabetic retinopathy, 1174–1175 diagnosis phase See Diagnosis phase of nursing process diarrhea, 690b 64William & Hopper (F)-Index 11/2/06 2:50 PM Page 1342 Copyright © 2007 by F A Davis 1342 Index Nursing process (Continued) disseminated intravascular coagulation, 531 diverticulosis and diverticulitis, 694–695 drug abuse and dependence, 1290 dwarfism, 830 dysmenorrhea, 906 dysrhythmias, 475b, 475–476 eating disorders, 665–666 end of life, 277–281b endometriosis, 907 endoscopic examinations, 891–892 epistaxis, 577–578 erectile dysfunction, 952 esophageal cancer, 671–672 evaluation phase See Evaluation phase of nursing process external ear disorders, 1188–1190 eye inflammation and infection, 1167–1168, 1168t eye surgery, 1178–1179, 1179t eye trauma, 1181 fertility disorders, 915–916, 916–917 flow and cycle disorders, 906 fluid excess, 63–64 fluid imbalances, 60–64 fractures, 1004–1005 gallbladder disorders, 744–745 gastric bleeding, 680 gastric surgery, 681–682 gastroesophageal reflux disease, 673–674 genital organs displacement disorders, 912–913 glaucoma, 1177–1178 glomerulonephritis, 794 goiter, 839 grieving family, 283 Guillain-Barré syndrome, 1136 gynecological surgery, 929 Hashimoto’s thyroiditis, 314 health-care team, 14 health promotion older adult, 255–257, 256t hearing impairment, 1183–1184 hemolytic transfusion reaction, 306–308 hemophilia, 533–534 hepatitis, 721–723 HIV and AIDS, 334–341 Hodgkin’s disease, 541 home health patient, 267 Huntington’s disease, 1102 hypercalcemia, 71–72 hyperkalemia, 69 hypernatremia, 67 hyperparathyroidism, 843 hypersensitivity disorders, 305–306 hypertension, 382–384, 383–384b hyperthermia, 218–219 hyperthyroidism, 837–838 hypocalcemia, 70–71 hypogammaglobulinemia, 318 hypokalemia, 68 hyponatremia, 67 hypoparathyroidism, 842 hypothermia, 216–217, 217t hypothyroidism, 834 idiopathic thrombocytopenic purpura, 532 incontinence, 771, 772b, 773b infections, 105–108 infective endocarditis, 390, 391t, 392b inflammations of vagina and vulva, 910–911 influenza, 583–584 ingested poisoning, 219–220 inner ear disorders, 1195–1196 intestinal obstruction, 705–706 intracranial surgery, 1076–1077 intravenous therapy, 85 intubation, 570–572 irritable bowel syndrome, 701 labyrinthitis, 1193 laryngectomee, 585–588 leadership, 14–17 leukemia, 536, 537–538b liver failure, 728–731 LPN/LVN, 5, 5t lung cancer, 623 lupus erythematosus, 314–316 lymphangitis, 441 lymphoma, 537–538b, 543–544b male infertility tests, 897 malignant disorders of reproductive system, 928 malignant skin lesions, 1238–1239 management functions, 15–16 mastitis, 900 mechanical ventilation, 573, 573b Ménière’s disease, 1195 menopause, 908 mental evaluation, 1264–1265t middle ear disorders, 1192–1193 multiple myeloma, 539–540 multiple sclerosis, 1128–1129 muscular dystrophy, 1015 myasthenia gravis, 1133–1134 myocardial infarction, 427–429b myocarditis, 394–395 nausea and vomiting, 663 near-drowning, 220–221 neurological disorder, 1061–1065 nursing care team, obesity, 668–669 obstructive disorders, 612–614 osteoarthritis, 1019–1020 osteogenesis imperfecta, 1014 osteomyelitis, 1006 ostomy, 711–716 otosclerosis, 1192 pain, 133–139 pancreatic cancer, 740 pancreatitis, 736–738b Parkinson’s disease, 1099–1101 pelvic examination, 888, 889 pemphigus, 1235 peptic ulcer disease, 679 pericarditis, 394 peripheral arterial disease, 433–435b pheochromocytoma, 844 plan of care See Plan of care pneumothorax, 618 postanesthesia care unit, 190–192 postoperative, 193, 193–201, 194–195b postoperative cardiac surgery, 454, 455–456b premenstrual syndrome, 907 preoperative cardiac surgery, 454 preoperative patients, 179–181, 180t prostatitis, 935–938 psoriasis, 1225 psychiatric emergencies, 221 pulmonary embolism, 615–616 radiation treatment, 157–159 radiographic procedures, 891 renal calculi, 785–787 renal failure, 805, 806–808b renal system assessment, 769–770 respiratory failure, 620–621 respiratory system, 553t restrictive disorders, 601–602 retinal detachment, 1175–1176 rheumatic carditis, 388–389 rheumatoid arthritis, 1022–1023 schizophrenia, 1285–1286 seizures, 1069–1070 serum sickness, 309–310 sexually transmitted diseases, 968–971 shock, 115–117, 118b shock or anaphylaxis, 209–210 sickle cell anemia, 528–529 sinusitis, 579 skin infection, 1231–1232 somatoform disorders, 1284 spinal cord injury, 1085 spinal surgery, 1080–1081 swabs and smears, 890 symptom assessment guide, 6b syndrome of inappropriate antidiuretic hormone, 828–829 systemic lupus erythematous, 1012 thoracic surgery, 625–626 thromboangiitis obliterans, 432 thrombophlebitis, 400–402 thyroidectomy, 840–841 tracheostomy, 568–570b trauma, 213–215 traumatic brain injury, 1073–1074 trigeminal neuralgia, 1139–1140 tuberculosis, 596–599 ulcerative colitis, 698 upper respiratory infection, 580–581t urinary tract infections, 781–782 valvular disorders, 451, 452b vascular surgery, 438, 439–440b, 440 venous disorders, 437–438 visual impairment, 1171–1172 Nursing unit postoperative, 192–193, 193 Nutrition absorption disorders, 703b anemias, 521, 522b atherosclerosis, 406, 407b burns, 1246b cancer patient, 167b cardiac transplantation, 497b cardiovascular system, 369b chronic heart failure, 486 constipation, 689b 64William & Hopper (F)-Index 11/2/06 2:50 PM Page 1343 Copyright © 2007 by F A Davis Index cultural influences, 37–38, 644b dementia, 1098b diabetes mellitus, 856–857, 858b eyes, 1151b gastrointestinal system, 641 home health hints, 659 imbalanced AIDS, 339 liver failure, 729 mental health, 1281b nervous system therapy, 1054 older adult, 248b ostomy, 715, 715b pancreatitis, 735b peripheral parenteral, 658 postoperative, 200, 201b postoperative gastric surgery, 683 renal calculi, 785b renal failure, 800, 801b respiratory disease, 613b surgery, 176–177, 177b swallowing disorders, 1121b thyroid disorders, 839b total parenteral, 89, 89b, 658 upper gastrointestinal conditions, 665b urinary tract infections, 782b Nystagmus, 1049 O Obesity diagnosis, 666 etiology, 666 nursing process, 668–669 surgical management, 667–668 therapeutic interventions, 667 Obsession, 1276 Obsessive-compulsive disorder, 1276 Obstipation, 688 Obstructive disorders, 602–614 Occult blood, 646 Occupational therapists, 14 home health care team, 262 Oliguria, 786 Oncology, 146 Oncoviruses, 148 Operating room, 185, 186 Ophthalmia neonatorum, 960 Ophthalmologist, 1150 Ophthalmoscope, 1150 Opioid antagonists, 128, 130 Opioids, 123b, 128–130 adverse effects, 131, 131b Optician, 1151 Optimum level of functioning, 254 Optometrist, 1151 Oral cancer nursing management, 671 pathophysiology and etiology, 670 therapeutic interventions, 671, 671 Oral cavity anatomy and physiology, 633, 633 assessment, 643 Oral contraceptives, 918 Oral glucose tolerance test, 855–856 Oral health, 669, 670b Oral hydration maintenance in older people, 62b Oral hypoglycemic medication, 862, 862t Oral inflammatory disorders, 669–670 Oral secretions end of life, 276 Orchiectomy, 946 Orchitis, 947 Orgasm, 892 Orientation, 1264 Orthopedic trauma, 212–213 Orthopnea, 483 Orthostatic hypotension, 356 spinal cord injuries, 1082 Orthotopic bladder substitution, 789–790, 790 Osler’s node, 389, 390 Osmolality, 826 Osmolarity, 60 Osmosis, 59–60 Osteoarthritis, 1015–1020, 1016t causes and types, 1016 diagnostic tests, 1017 nursing process, 1019–1020 pathophysiology, 1015–1016 signs and symptoms, 1016–1017, 1017 therapeutic interventions, 1017–1019 Osteogenesis imperfecta, 1009, 1014 Osteomyelitis, 1005–1006, 1006 Osteopathic medicine, 52 Osteoporosis, 69–70, 245, 1006–1008 diagnostic tests, 1007 etiology, 1007 pathophysiology, 1006–1007 signs and symptoms, 1007 therapeutic interventions, 1007–1008 types, 1007 Osteosarcoma, 1008–1009 Ostomy, 710–716 appliances, 714 home health hints, 716 nursing care plan, 713b nursing process, 711–716 nutrition, 715, 715b preoperative care, 711 resources and support groups, 716t Otalgia, 1155 Otitis external, 1184–1185 Otoplasty, 1240t Otorrhea, 1155 Otosclerosis, 1182, 1191–1192 Otoscopic examination, 1158 Ototoxic, 1155 Outcome and Assessment Information Set (OASIS), 266 Ovarian cancer, 928 Ovaries, 879, 880 Oxygen consumption chronic heart failure, 495 Oxygen saturation test, 557 Oxygen therapy cardiovascular system, 368 chronic heart failure, 486, 493 chronic obstructive pulmonary disease, 604 fluid excess, 63 1343 masks, 560, 560 myocardial infarction, 423 nasal cannula, 560, 560 risks, 561 transtracheal catheter, 560–561, 561 Oxytocin, 816 P P wave, 460 Pacemakers, 471, 471–473, 472 home health hints, 476 nursing care, 472–473 Pacific Islanders, 45–46 Paget’s disease, 1008 Pain AIDS, 338 amputation, 1029 appendicitis, 692, 692 assessment, 133–134, 134, 134t, 192 cognitive-behavioral interventions, 132 cultural considerations, 124–125b definitions, 125–127 diagnosis, 134–138, 192 ethical considerations, 123b, 139 evaluation, 139, 192 gerontological issues, 136b history, 134, 135 management myths and barriers, 126 nondrug therapies, 132–133 nursing care plan, 136–137b nursing process, 133–139 patient control, 136–137 patient education, 138–139 physical agents, 132–133 postoperative, 192, 195–196 postoperative hip replacement, 1026 puzzle, 123 referred sites, 127 scales, 134, 134, 136 team management, 138 transmission mechanisms, 127 treatment options, 128–133 types, 127–128 Palliation, 157 Palpation abdomen, 645 bimanual, 888–889 breast examination, 885 cardiovascular system, 357, 357 ears, 1155–1156 eyes, 1149–1150 female reproductive system, 888–889 respiratory system, 553–554, 555 skin, 1206–1207 thyroid gland, 821, 821–822 Pancreas, 818 anatomy and physiology, 637 assessment, 639t, 640t disorders, 732–741 laboratory tests, 647t transplant, 863 Pancreatectomy, 739 Pancreatitis, 732–738, 735b acute, 732–734 complications, 733, 735 diagnostic tests, 733, 738 nursing care plan, 736–738b 64William & Hopper (F)-Index 11/2/06 2:50 PM Page 1344 Copyright © 2007 by F A Davis 1344 Index Pancreatitis (Continued) pathophysiology and etiology, 733, 734–735 prevention, 733, 735 signs and symptoms, 733, 735 treatment, 733, 738 Pancreatoduodenectomy, 739, 740 Pancytopenia, 524 Panhysterectomy, 930 Panic disorder, 1275 Panmyelosis, 529 Pap smear, 889, 890, 927 Para, 885 Paranasal sinuses, 555 Paraparesis, 1082 Paraphimosis, 946 Paraplegia, 1082 Parasites genital, 967 Parasitic skin disorders, 1232–1234 Parathyroid glands, 817 disorders, 841–843, 842t Parathyroid hormone, 817 Paresis, 1045 Paresthesia, 1053 Parkinson’s disease, 1094–1101, 1098, 1098t, 1104t Paroxysmal nocturnal dyspnea, 483–484 Partial-thickness burns, 215, 215 Passive immunity, 292 Paternalism, 22 Pathogen, 93 Pathological fractures, 536 Pathophysiology and etiology acne vulgaris, 1231, 1231 acromegaly, 831 acute (fulminant) liver failure, 723 acute respiratory distress syndrome, 620 acute respiratory failure, 619–620 adenoiditis, 582 adrenocortical insufficiency, 844–845 Alzheimer’s disease, 1103 amyotrophic lateral sclerosis, 1134 anaphylaxis, 208–209 anemias, 312–313, 521 angina pectoris, 412–430 ankylosing spondylitis, 316 anxiety disorders, 1275 aortic regurgitation, 450 aortic stenosis, 449–450 asthma, 608 atherosclerosis, 405–406 Bartholin’s cysts, 926 Bell’s palsy, 1138 benign prostatic hyperplasia, 939 bladder cancer, 788–790 blindness, 1170 brain tumors, 1074 burns, 1243, 1244, 1246t cancer, 147 cancer of kidney, 790–791 cancer of larynx, 584–588 cancer of prostate, 944–945 cancer of testes, 947 carpal tunnel syndrome, 993 cataracts, 1178 cellulitis, 1230 cerebral aneurysm, 1116, 1116 cervical cancer, 927 chlamydiosis, 959 chronic liver failure, 724–725 chronic obstructive pulmonary disease, 602, 602–603, 603 colon cancer, 707 constipation, 688 coronary artery disease, 407 Crohn’s disease, 695 Cushing’s disease, 845–846 cyclic breast discomfort, 900 cystic fibrosis, 611 dehydration, 60, 60b dementia, 1092–1093 dermatitis, 1222 dermoid cysts, 926 deviated septum, 578 diabetes insipidus, 826–827 diabetes mellitus, 852 diabetic nephropathy, 792 diabetic retinopathy, 1172 diverticulosis and diverticulitis, 693, 693–694 dwarfism, 829 dysmenorrhea, 906 ear infections, 1184–1185, 1190 ear masses, 1185 ear trauma, 1187 encephalitis, 1058–1059 endometrial cancer, 927–928 endometriosis, 907 epistaxis, 577 esophageal cancer, 671 eye trauma, 1180 fibrocystic breast disease, 900 fibroid tumors, 925 flow and cycle disorders, 905 fractures, 993 fungal infections, 1228 gastritis, 674 gastroesophageal reflux disease, 673 genital organs developmental disorders, 912 genital organs displacement disorders, 912 genital parasites, 967 glaucoma, 1176 glomerulonephritis, 793 goiter, 838 gonorrhea, 960 gout, 1009–1010 Guillain-Barré syndrome, 1135 Hashimoto’s thyroiditis, 313 hemophilia, 532 hepatitis, 720–721 hepatitis B, 967 herniated disks, 1078 herpes simplex, 1225–1227 herpes simplex infection, 963–964 herpes zoster, 1228 hiatal hernia, 672, 672 Hodgkin’s disease, 540 Huntington’s disease, 1101 hypercalcemia, 71 hyperkalemia, 68–69 hypernatremia, 67 hyperosmolar, hyperglycemic, nonketotic syndrome, 866 hyperparathyroidism, 842 hyperthyroidism, 834 hypocalcemia, 69–70 hypogammaglobulinemia, 318 hypokalemia, 67–68 hyponatremia, 65 hypoparathyroidism, 841 hypothyroidism, 832–833 impacted cerumen, 1185 inflammations of vagina and vulva, 909–910 influenza, 582 inner ear tumors, 1194 intracranial pressure, 1059 irritable bowel syndrome, 699–700 keratitis, 1167 ketoacidosis, 866 labyrinthitis, 1193 laryngitis, 582 leukemia, 534, 536 lung cancer, 621–622 lupus erythematosus, 314, 316t macular degeneration, 1179, 1180 malignant breast disorders, 900–901 malignant skin lesions, 1235–1238 mastitis, 900 Ménière’s disease, 1194 meningitis, 1057 menopause, 907–908 mental illness, 1261 mitral regurgitation, 448–449 mitral valve prolapse, 445–446 mood disorders, 1280 multiple myeloma, 536 multiple sclerosis, 1127 muscular dystrophy, 1015 myasthenia gravis, 1129–1132 myocardial infarction, 418–419, 419 myocarditis, 394 nasal polyps, 578 oral cancer, 670 osteoarthritis, 1015–1016 osteogenesis imperfecta, 1014 osteomyelitis, 1005–1006 osteoporosis, 1006–1007 otosclerosis, 1191 ovarian cancer, 928 Paget’s disease, 1008 pancreatic cancer, 739 pancreatitis, 733, 734–735 Parkinson’s disease, 1094 pediculosis, 1232 pelvic inflammatory disease, 959 pemphigus, 1234 peptic ulcer disease, 676 peripheral arterial disease, 431 peritonitis, 693 pharyngitis, 582 pheochromocytoma, 843–844 pleurisy, 599–600 pneumonia, 591–592 polycystic ovary syndrome, 926 polycythemia, 529 polyps, 925–926 postpolio syndrome, 1136 premenstrual syndrome, 906–907 64William & Hopper (F)-Index 11/2/06 2:50 PM Page 1345 Copyright © 2007 by F A Davis Index pressure ulcers, 1214 psoriasis, 1224, 1224–1225 pulmonary embolism, 615–616 pulmonary fibrosis, 601 pyelonephritis, 779 Raynaud’s disease, 432 reactive hypoglycemia, 871b renal calculi, 783, 784t renal failure, 795 reproductuve system cysts, 926 retinal detachment, 1175–1176 rheumatoid arthritis, 1020–1021 rhinitis, 579 scabies, 1233 schizophrenia, 1285 scleroderma, 1013–1014 seizure disorders, 1067 shock, 111–113 sickle cell anemia, 525–526 sinusitis, 578–579 somatoform disorders, 1282 spinal cord injuries, 1081–1082 substance abuse disorders, 1288 syndrome of inappropriate antidiuretic hormone, 828 syphilis, 960–963 systemic lupus erythematous, 1010–1011 thrombophlebitis, 397–398 tonsillitis, 582 toxic shock syndrome, 911–912 traumatic brain injury, 1070–1071 trichomoniasis, 963 trigeminal neuralgia, 1138 tuberculosis, 594 ulcerative colitis, 698 uterine prolapse, 914, 915 varicose veins, 437 vulvar cancer, 927 Patient communication end of life, 275–276, 276 Patient-controlled analgesia, 130 Patient education abortion, 924 acromegaly, 831 amyotrophic lateral sclerosis, 1135 ankylosing spondylitis, 316–318 anticoagulant therapy, 402b cancer of prostate, 945 chronic heart failure, 496, 496b condom use, 326, 326b dehydration, 62 disseminated intravascular coagulation, 531 endoscopic examinations, 892 erectile dysfunction, 952–953 fertility disorders, 915–916, 917 fluid excess, 64 fractures, 1005 gallbladder disorders, 745 genital organs developmental disorders, 912 genital warts, 967 Guillain-Barré syndrome, 1136 Hashimoto’s thyroiditis, 314 HIV, 340 Hodgkin’s disease, 541 home health nursing, 266–267 hypertension, 381 hyperthyroidism, 838 hypokalemia, 68b, 69b hypothyroidism, 834 idiopathic autoimmune hemolytic anemia, 313 inflammations of vagina and vulva, 910–911 Kegel exercises, 770–771, 771b laryngectomee, 588 liver failure, 731 lupus erythematosus, 314–316 medication administration, 105 medications in heart failure, 495–496 muscular dystrophy, 1015 myasthenia gravis, 1133–1134 myocardial infarction, 426 nasal surgery, 579b neurological disorder, 1065 opportunistic infection prevention, 337–338t opportunistic infections signs and symptoms, 339b osteoarthritis, 1020 pain, 139 pancreatic cancer, 741 pediculosis, 1233 pernicious anemia, 313 polycythemia, 530 prostatitis, 938 respiratory disease, 614 rheumatoid arthritis, 1023 scabies, 1233 sickle cell anemia, 529 signs and symptoms of bleeding, 532b systemic lupus erythematous, 1013 thrombophlebitis, 402b total hip replacement, 1027b toxic shock syndrome, 912 transplant rejection, 312 trigeminal neuralgia, 1138 urinary tract infections, 781, 782b valvular disorders, 451 Patient safety, for intravenous therapy, 81 Patient Self Determination Act, 271 Pedicle graft, 904 Pediculosis, 1232–1233 Pelvic examination female reproductive system, 888, 889 Pelvic inflammatory disease, 959 Pemphigus, 1234–1235 Penicillins, 103t Penile implants, 951, 951 Penis, 882–883 cancer, 946–947 disorders, 946–947 Penumbra, 1109 Peptic ulcer disease, 676t complications, 678 diagnosis, 676 etiology, 675 nursing care plan, 679b nursing process, 678 pathophysiology, 675 signs and symptoms, 675 therapeutic interventions, 676, 677t 1345 Perception, 243 Percussion, 357 abdomen, 645 respiratory system, 554 Percutaneous balloon valvuloplasty, 448, 448 Percutaneous liver biopsy, 649t, 653 Percutaneous transluminal angioplasty peripheral arterial disease, 431–432 Percutaneous transluminal coronary angioplasty, 408–409, 409 Pericardial effusion, 171, 393 Pericardial friction rub rheumatic carditis, 388 Pericardial membranes, 347 Pericardial tamponade, 113 Pericardiectomy, 393 Pericardiocentesis, 393, 394 Pericarditis, 388, 391–394, 393t Perimenopausal, 907 Peripheral arterial disease, 430–432 diagnostic tests, 431 nursing care plan, 433–435b pathophysiology, 431 therapeutic interventions, 431–432 Peripheral intravenous therapy See Intravenous therapy Peripheral nervous system, 1037–1038 disorders, 1127–1141, 1137t Peripheral parenteral nutrition, 658 Peripheral vascular resistance, 374, 481t, 481–482, 482 Peripheral vascular stress test, 364 Peripheral vascular system disorders, 430–442 Peristalsis, 633 Peristomal, 712 Peritoneal dialysis, 803–804, 804 Peritonitis, 693 Pernicious anemia, 312–313 Perserverance, Person-centered/humanistic therapy, 1270 Personal protective equipment, 326 Personal space, 34–35 Personality changes brain injury, 1073 Petechiae, 389, 390, 512, 524, 524, 1206 Peyronie’s disease, 946 Phagocytosis, 96, 636 Pharmacists, 14 Pharyngitis, 582 Pharynx anatomy, 549–550 anatomy and physiology, 633 Pheochromocytoma, 843–844 Phimosis, 946 Phlebotomy, 529–530 Phobias, 1275 Phosphorus musculoskeletal system, 984 Photophobia, 1057, 1167 Physical agents, 132–133 Physical dependence, 126 Physical therapist(s), 14 home health care team, 262 Physical therapy herniated disk, 1079 Physical therapy assistants, 14 64William & Hopper (F)-Index 11/2/06 2:50 PM Page 1346 Copyright © 2007 by F A Davis 1346 Index Physician home health care team, 261 Physician assistants, 14 Physiological changes aging, 243–253, 244–245t Phytoestrogens, 908 Piggy back/secondary infusion, 78, 78 Pigmented nevus, 1237t Pituitary gland, 815–816 anterior, 816 disorders, 826–832 posterior, 815–816 tumors, 832 Placebos, 132 Plague clinical presentation, 224 diagnosis, 224 etiology, 224 therapeutic intervention, 224 Plan of care, 8–9 AIDS, 335–336b benign prostatic hyperplasia, 941–943b brain tumor or injury, 1062–1064b burns, 1250–1255b cancer, 164–165b cardiac valvular disorders, 452b cerebrovascular accident, 1119–1120b chronic heart failure, 494b contact dermatitis, 311b depression, 1282–1283b diabetes mellitus, 870–871b disturbed thought processes, 1095–1997b dysrhythmias, 475–476b end of life, 278–281b evaluation, 10 external fixation of lower extremity, 1002–1003b fracture of hip, 1000b genital herpes, 965–966b hearing loss, 1186–1187b hypertension, 383–384b hypothermia, 217b hypothyroidism, 836–837b hysterectomy, 930–931b implementation, 9–10 incontinence, 772b, 773b interventions identification, intraoperative nursing diagnoses, 186b malignant breast disorders, 901 mastectomy, 902–903b myocardial infarction, 427–429b occlusive dressings, 1210–1211b and outcomes establishment, pain, 136–137b peripheral arterial occlusive disorders, 433–435b postoperative cardiac or transplant surgery, 499–501b postoperative cardiac surgery, 455–456b postoperative patient, 194–195b postoperative vascular surgery, 439–440b pressure ulcers, 1220–1221b progressive neuromuscular disorder, 1130–1132b renal failure, 806–808b shock, 118–119b spinal cord injury, 1085–1092b thyroidectomy, 840–841 tracheostomy, 568–570b visual loss, 1173–1174b Plaque, 376 Plasma, 509 Plasma proteins synthesis, 636 Plasmapheresis, 1128, 1130t Platelets, 510–511 Plethysmography, 365 Pleural effusion, 600–601, 622 Pleural membranes anatomy, 550 Pleurisy, 599–600 Pleuritis, 599–600 Pneumocystis carinii pneumonia AIDS, 329 Pneumonectomy, 623, 624 Pneumonia complications, 593 diagnostic tests, 593, 593 etiology, 592, 622 pathophysiology, 591–592 prevention, 592–593, 593b signs and symptoms, 593 therapeutic interventions, 593–594 Pneumothorax, 617, 617–618, 618b closed, 617 open, 617 signs and symptoms, 618 spontaneous, 617, 617 tension, 617–618 therapeutic intervantions, 618 traumatic, 617, 617 Poikilothermy, 357 Point of maximum impulse, 357 Poisoning, 219–220 Poisons inhaled, 219 injected, 219 Polycystic kidney disease, 791 Polycystic ovary syndrome, 926 Polycythemia, 603 nursing care, 530 pathophysiology and etiology, 529 patient education, 530 signs and symptoms, 529 treatment, 529–530 Polycythemia vera, 529 Polydipsia, 827, 855 Polymyositis, 1009, 1014 Polyphagia, 855 Polyps, 925–926 nasal, 578 Polyuria, 799, 827, 855 Pons, 1041 Portal hypertension, 725, 725, 728–729 Positioning chronic heart failure, 493 fluid excess, 63, 63 nervous system therapy, 1053 respiratory conditions, 559 Positive-pressure ventilation noninvasive, 573–574, 574 Positron emission tomography, 365 Postanesthesia care unit, 190, 190, 190b cardiovascular function, 191 discharge, 191, 192t family visitation, 191 neurological function, 191 pain, 192 respiratory function, 190–191 Postcardiotomy syndrome, 497 Postcoital, 916 Postcoital douching, 921–922 Postictal, 1068 Postoperative care, 189–203 cardiac surgery, 413–414b discharge, 201–202, 202 home health hints, 202–203 hypophysectomy, 832 nutrition, 200, 201b postanesthesia care unit, 190, 190, 190b room preparation, 184, 185t Postpolio syndrome, 1136–1137 Posttraumatic stress disorder, 1276 Posttraumatic syndrome, 1073 Potassium food sources, 66b, 799b Potassium imbalances, 67–69 Potassium-sparing diuretics, 379t Powerlessness chronic illness, 234–235, 235 PR interval, 461, 461 Pramlintide (Symlin), 862–863 Prediabetes, 854–855 Pregnancy termination See Abortion Preload, 367, 481 Premenstrual syndrome, 906–907 Prenicious anemia, 683 Preoperative care checklist, 182–183, 183 consent, 181–182, 182 diagnostic tests, 179, 180t hypophysectomy, 832 instructions, 178–179 intracranial surgery, 1076 routines, 178 spinal surgery, 1080 Presbycusis, 1149b, 1155, 1182 Presbyopia, 1169 Pressure garment burns, 1249, 1250 Pressure ulcers, 246, 246 complications, 1215 debridement, 1218 diagnostic tests, 1215 negative pressure wound therapy, 1219, 1219 nursing process, 1219, 1220–1221b pathophysiology and etiology, 1214 prevention, 1214–1215, 1215b risk, 1216–1217t signs and symptoms, 1215 staging criteria, 1219, 1219 therapeutic interventions, 1215–1219 wound cleansing, 1218 wound dressings, 1218 64William & Hopper (F)-Index 11/2/06 2:50 PM Page 1347 Copyright © 2007 by F A Davis Index Prevention dehydration, 60 fluid excess, 62–63 hypercalcemia, 71 hyperkalemia, 69 hypernatremia, 67 hypocalcemia, 70 hypokalemia, 68 hyponatremia, 65, 67b Priapism, 946 Primary survey, 207, 207t, 207–208 Prinzmetal’s angina, 412 Prions, 94 Privacy maintenance, 19, 20 Private duty nursing, 267 Problem solving, 4–5 Proctitis, 958–959 Proctosigmoidoscopy, 649t, 652 Prodromal, 1066 Prostaglandins, 127 Prostate, 882 transurethral resection, 939–940, 940 Prostate cancer complications, 945 diagnostic tests, 945 pathophysiology and etiology, 944–945 patient education, 946 signs and symptoms, 945 treatment, 945–946 Prostate disorders, 935–946 benign prostatic hyperplasia, 938–944, 945b cancer, 944–946 prostatitis, 935–938 Prostate-specific antigen, 896 Prostatectomy, 940–941, 944, 946 Prostatic acid phosphatase, 896–897 Prostatitis complications, 935 diagnostic tests, 935 nursing process, 935–938 pathophysiology and etiology, 935 prevention, 935 signs and symptoms, 935 treatment, 935 Prosthesis amputation, 1029–1030, 1030 Protein synthesis, 145, 145 Protozoa, 94 Pruritis, 1223 Pseudoaddiction, 127 Pseudodementia, 1291 Psoriasis, 1224, 1224–1225 Psychiatric emergencies, 221–222 Psychoanalysis, 1269 Psychogenic, 826–827 Psychological changes aging, 254–255 Psychological dependence, 127 Psychopharmacology, 1269, 1277 Psychosomatic disorders, 1281–1282 Psychotherapy, 1269–1270, 1281, 1285, 1289 Puerperal, 958 Pulmonary angiography, 558 Pulmonary artery hypertension, 616–617 Pulmonary disease chronic obstructive See Chronic obstructive pulmonary disease Pulmonary edema, 482, 483t diagnosis, 483 pathophysiology, 482 signs and symptoms, 482–483 therapeutic interventions, 483 Pulmonary embolism, 616b complications, 615 diagnostic tests, 615 etiology, 615 nursing process, 615–616 pathophysiology, 614, 614–615 prevention, 615 signs and symptoms, 615 therapeutic interventions, 615 Pulmonary fibrosis, 601 Pulmonary function studies, 558, 558t Pulmonary hypertension, 113–114 Pulmonary vascular disorders, 614–617 Pulse deficit, 355 Pulse oximetry, 557 Pulses auscultation, 354–356 Purpura, 512 idiopathic thrombocytopenic, 531–532 Pursed-lip breathing, 559 Purulent, 1220 Purulent discharge, 198, 200 Purulent exudate, 96 Pyelogram intravenous, 769 Pyelonephritis, 779–781 Pyloric obstruction, 683 Q QRS complex, 461, 461 QRS interval, 461, 461 Quadriparesis, 1082 Quadriplegia, 1082 R Radiation cancer risk, 148 safety considerations, 158, 158–159 Radiation therapy brain tumors, 1075 cancer, 148, 157–159 Radical prostatectomy, 940–941, 944, 946 Radioactive iodine, 838 Radiographic procedures female reproductive system, 891 Radiographic tests musculoskeletal system, 985 Radioisotope imaging cardiovascular system, 364 Radiological procedures cancer, 155–156, 156 Range of motion, 243 Range-of-motion exercises, 245, 245 Raynaud’s disease, 432 Reality orientation, 254 Receptors, 1202 Rectocele, 913, 914 Red blood cells, 509–510 disorders, 521–530 1347 Reflex arc, 1039–1040 Registered nurse home health care team, 261–262 Regurgitation, 445 Rehabilitation burns, 1248–1249, 1249, 1250 cerebral aneurysm and subarachnoid hemorrhage, 1118 chronic obstructive pulmonary disease, 607, 607 myocardial infarction, 426–430 traumatic brain injury, 1074 Relaxation therapy, 52–54, 1271–1272 Religion mental health, 1261–1264 Religious artifacts, 36, 36 Remyelination, 1135 Renal calculi, 784t, 785t complications, 785 diagnostic tests, 783 location, 783 nursing process, 785–787 nutrition, 785b pathophysiology and etiology, 783, 784t prevention, 785 signs and symptoms, 783 treatment, 783–785, 786 Renal complications spinal cord injuries, 1082 Renal failure acute, 794–796 chronic, 796–798, 797b dialysis, 800 dietary changes, 800, 801b diuretic phase, 795 effects on body systems, 798t intrarenal failure, 795–796 medications, 800 nursing process, 805, 806–808b oliguric phase, 795 pathophysiology and etiology, 795 postrenal failure, 795–796 prerenal failure, 795–796 recovery phase, 795 symptoms, 798–800, 799 treatment, 795–796, 800–804 Renal system chronic disease, 791–793 trauma, 791 tumors, 788–791 Renin-angiotensin-aldosterone mechanism, 351–352, 352 Replantation, 1028 Reproductive life planning, 917–923 barrier methods, 919, 919–920, 920 contraceptive implants, 918 depot medications, 918 estrogen-progestogen contraceptive ring, 919 intrauterine devices, 921 natural family planning, 921 ongoing research, 922 oral contraceptives, 917–918 spermicides, 920–921 spinal cord injury, 1091t sterilization, 922–923 transdermal contraceptive patch, 919 64William & Hopper (F)-Index 11/2/06 2:50 PM Page 1348 Copyright © 2007 by F A Davis 1348 Index Reproductive system female aging, 883, 883 anatomy and physiology, 879, 879–883 benign growths, 925–926 breast assessment, 885, 885–886 diagnostic procedures, 893t disorders, 900–933 fertility disorders, 914–917, 916t history, 883–885 malignant disorders, 927–928 menstrual disorders, 905–908, 906t normal function baselines, 883 objective assessment, 886t subjective assessment, 884–885t tumors, 929t male aging, 883, 883 anatomy and physiology, 881–883, 882 assessment, 892–897, 894t breast self-examination, 896 diagnostic tests, 896–897, 897t history taking, 892–893 medications for disorders, 936–937t objective assessment, 895t physical examination, 893–895 subjective assessment, 894t testicular self-examination, 896, 896, 896b Resection, 624 Reservoir, 93 Respectfulness, 21 Respiration acid-base balance and, 551–552 regulation, 551 Respiratory acidosis, 73 Respiratory alkalosis, 74 Respiratory distress syndrome acute, 620 Respiratory excursion, 553, 555 Respiratory failure acute, 619–620 nursing process, 620–621 Respiratory system abnormal lung sounds, 556t abnormal respiratory patterns, 553, 554 acute bronchitis, 591 adenoiditis, 582–583 aging, 244t, 247, 552 anatomy and physiology, 549t, 549–552 arterial blood gas analysis, 557t assessment, 555t auscultation, 554–555, 556, 556t blood tests, 555–556, 557t breathing exercises, 559 bronchiectasis, 591, 591 bronchoscopy, 558 chest drainage, 563–565, 564, 565b chest physiotherapy, 561–562, 563 chest x-ray examination, 557 coughing, 559 deviated septum, 578 diagnostic tests, 555–558 epistaxis, 577–578 flutter mucus clearance device, 562, 563 incentive spirometry, 561, 563 infections, 100, 107, 579–584, 580t nursing care plan, 580–581t influenza, 583–584 inhalers, 561, 562 intubation, 570–572 laryngitis, 582 lower tract disorders, 590–629 malignant disorders, 584–588 mechanical ventilation, 572, 572–573 nasal polyps, 578 nebulized mist treatments, 561, 561 nursing assessment, 553t nutrition in disease, 613b obstructive disorders, 602–612 oxygen saturation test, 557 oxygen therapy, 559–561 palpation, 553–554, 555 percussion, 554 pharyngitis, 582 pneumonia, 591–593, 593, 594b positioning, 559 postoperative, 190–191, 193 protective mechanisms, 549t pulmonary angiography, 558 pulmonary function studies, 558, 558t restrictive disorders, 599–601 rhinitis, 579–582 rhinoplasty, 578 sinusitis, 578–579 smoking cessation, 558–559, 559t spinal cord injuries, 1084 sputum culture and sensitivity, 556–557, 557 suctioning, 567–570, 571b therapeutic measures, 558–574 thoracentesis, 562–563 throat culture, 557 tonsillitis, 582–583 tracheostomy, 565–567, 566, 567, 567b, 568–570b, 571b trauma, 617–619 upper tract disorders, 577–589 ventilation-perfusion scan, 557–558 viral infections, 584 Respiratory therapists, 14 Respiratory therapy technicians, 14 Respite care, 237, 262 Respondeat superior, 27 Rest patterns aging, 254–255 Restlessness terminal, 282 Restrictive cardiomyopathy, 396 Restrictive disorders, 599–601 nursing process, 601–602 Resynchronization therapy, 490 Retinal detachment, 1175–1176 Retinopathy, 857 diabetic, 857, 1170, 1171, 1172–1175 Retroflexion, 913, 914 Retrograde, 907, 940 Retrograde cholangiopancreatography endoscopic, 652, 652 Retroversion, 906, 913, 914 Rheumatic carditis, 388 Rheumatic fever, 388, 388t Rheumatoid arthritis, 1020–1023 diagnosis, 1021 etiology, 1021 pathophysiology, 1020, 1020–1021 signs and symptoms, 1021, 1021 therapeutic interventions, 1021–1022 Rhinitis allergic, 303 diagnostic tests, 580 pathophysiology and etiology, 579 signs and symptoms, 579, 580t therapeutic interventions, 580–582 Rhinophototherapy, 303 Rhinoplasty, 578, 1239t Rhytidoplasty, 1240t Rib cage, 980 Rib fractures, 618 Rickettsiae, 94 Rinne test, 1157, 1157–1158, 1158t Role alterations chronic illness, 236–237 Romberg’s test, 1049, 1158 Rotator cuff injury, 992–993 Roux-en-Y bypass, 667, 669 S Safe care, 3–5 Safety alphabet, 256t Safety considerations home health nursing, 265, 265b Salpingitis, 959 Salpingo-oophorectomy bilateral, 930 Salpingoscopy, 888 Salt hypertension, 377 SARS, 584 Scabies, 1233–1234, 1234 Schizophrenia, 1284–1286, 1287b nursing process, 1285–1286 pathophysiology and etiology, 1285 phases, 1284 symptoms, 1284–1285 therapeutic interventions, 1285, 1286t types, 1285 Scleroderma, 1013–1014 Sclerosis, 1127 Sebaceous glands, 1202 Seborrhea, 1222 Seborrheic keratosis, 1236t Secondary survey, 208, 208t Sedation conscious, 189 Seizure disorders, 1067–1070 Seizures clonic-tonic, 1067–1068 epilepsy, 1067–1068 generalized, 1067–1068 interventions, 1070t partial, 1067 psychosocial effects, 1069 64William & Hopper (F)-Index 11/2/06 2:50 PM Page 1349 Copyright © 2007 by F A Davis Index Self-care postoperative hip replacement, 1027 Self-determination, 1291 Self-esteem situational low HIV infection, 339–340 Seminal vesicles, 882 Semipermeable membrane, 59 Sensorineural hearing loss, 1182 Sensory deprivation, 251 Sensory neurons, 1037, 1037, 1038 Sensory overload, 252 Sensory system, 1145–1198 aging, 244–245t, 251–253, 252, 1146 Septicemia (Sepsis), 102, 111 Serological, 963 Serosanguineous drainage, 198 Serum muscle enzymes, 985 Serum sickness, 309–310 Severe acute respiratory syndrome, 584 Severe combined immunodeficiency syndrome (SCIDS), 293b Sexual assault nurse examiner, 890b Sexual devices erectile dysfunction, 951 Sexual functioning male, 948–954, 953b Sexuality aging, 245t, 253 chronic illness, 235–236 nursing assessment, 253b Sexually transmitted diseases, 959–967, 962b gerontological issues, 968b medications, 961t myths, 970–971t nursing process, 968–971 related disorders, 958–959 reporting, 967–968 Shingles, 1228 Shock anaphylactic, 114, 208–209, 292 cardiogenic, 113, 208 classification, 113, 114t complications, 113 definition, 111 distributive, 114–115, 208 extracardiac, 113 hemodynamic changes, 111, 112t hypovolemic, 113, 208, 212 medications, 116t metabolic changes, 111, 112t neurogenic, 115 obstructive, 113–114, 208 organs and organ systems effects, 111–113, 112t pathophysiology, 111–113 patient assessment, 115–117 septic, 114–115 signs and symptoms, 111, 112t, 208, 209b summary, 117t therapeutic interventions, 115, 115t, 208b types, 208 Short stature, 829–830 Sickle cell anemia, 521b diagnostic tests, 527 etiology, 526 nursing process, 528–529 pathophysiology, 525–526 patient teaching, 529 signs and symptoms, 526–527, 527, 528 treatment, 527–528 Sickle cell crisis, 526 Silent ischemia, 414 Sinoatrial node, 459 Sinus bradycardia, 464 Sinus rhythm normal, 464, 464 Sinus tachycardia, 464–465, 466 Sinuses disorders, 577–579 Sinusitis complications, 579 diagnostic tests, 579 nursing process, 579 pathophysiology and etiology, 578–579 signs and symptoms, 579 therapeutic interventions, 579 Skeletal system aging, 243–245, 244t Skin See also Integumentary system acne vulgaris, 1231, 1231 aging, 245, 246, 246 anatomy and physiology, 1201, 1201–1202 benign lesions, 1236–1238t biopsy, 1207 blanching, 1214 breakdown following hip replacement, 1025 breakdown following spinal cord injury, 1082 color, 1203 defense mechanism, 96 dermatological surgery, 1239–1240t disorders, 1214–1241 fungal infections, 1228, 1229–1230t herpes simplex, 1225–1228 herpes zoster, 1228 HIV infection, 339 infectious disorders, 1126–1227t, 1225–1232 inflammatory disorders, 1222–1225 integrity and cleanliness, 1206 lesions, 1204–1205, 1205, 1206, 1235–1239 malignant lesions, 1235–1239 palpation, 1206–1207 parasitic disorders, 1232–1234 pediculosis, 1232–1233 pemphigus, 1234–1235 pressure ulcers See Pressure ulcers psoriasis, 1224, 1224–1225 scabies, 1233–1234, 1234 testing, 1208 tugor and texture, 1206 Skin grafts burns, 1247–1248, 1248, 1249t Skull, 978–979, 979 Sleep patterns aging, 254–255 end of life, 281 1349 Small-bowel obstruction, 704–705, 705, 705b Small intestine anatomy and physiology, 634, 635 Smallpox, 222–223 classification, 222 complications, 223 diagnosis, 223 infection control, 223 postexposure isolation, 223 Smears, 890 Smoking atherosclerosis, 406 cardiovascular system, 368 cessation, 558–559, 604, 605b, 606 hypertension, 378 interventions to stop, 559t myocardial infarction, 423 presurgical, 177 Snakebites, 220 Snellen’s chart, 1147, 1148 Social isolation HIV and AIDS, 339 Social organization, 35–36 Social workers, 14 home health care team, 262 Sodium food sources, 65b Sodium chloride solutions, 79 Sodium imbalances, 65–67 Sodium intake reduction, 65b Somatoform disorders, 1281–1284 Somatotropin See Growth hormone Sonography See Ultrasound Sorrow chronic illness, 234 Spanish/Hispanics/Latinos, 39–40 Speech therapist home health care team, 262 Spermicides, 921 Spider angiomas, 644 Spider bites black widow spider, 220 brown recluse spider, 220 Spinal blocks, 188, 188–189 Spinal cord, 1039–1040, 1040 cervical injuries, 1082 compression, 170 disorders, 1078–1085 herniated disks, 1078, 1078–1081 immobilization, 212 injuries, 1081–1085, 1083, 1084, 1085, 1093b spinal cord reflexes, 1039 spinal nerves, 1039 spinal shock, 1082 spinal stenosis, 1081, 1081 surgery, 1079–1081 thoracic and lumbar injuries, 1082 Spinal stenosis, 1081, 1081 Spinal trauma, 212 impairment of motor function, 213, 213t Spiritual distress chronic illness, 234 Spirituality, 234 mental health, 1261–1264 64William & Hopper (F)-Index 11/2/06 2:50 PM Page 1350 Copyright © 2007 by F A Davis 1350 Index Spirometry incentive, 178, 179 Spleen, 511 disorders, 542–545 Splenectomy, 299, 544–545 complications, 544–545 patient teaching, 544 postoperative care, 544 preoperative care, 544 Splenomegaly, 481, 542 Splints, 996 Sprains, 992 Sputum culture and sensitivity, 556–557, 557 Squamous cell carcinoma, 1235, 1238 ST segment, 462, 462 Stapedectomy, 1191–1192 Staphylococcus, 98 Staphylococcus aureus methicillin-resistant, 102 Statins, 408t, 415, 426t Status asthmaticus, 608–609 Status epilepticus, 1069, 1069b Steatorrhea, 647, 682, 683 Stem cell therapy autologous adult chronic heart failure, 491 Stenosis, 390 mitral See Mitral stenosis Stents, 438 coronary artery, 409, 409–410 ureteral, 788, 788 Stereotypes, 32 Stereotyping, 39b Sterile technique, 99 Sterilization, 922–923 Sternotomy, 370 Stomach anatomy and physiology, 633–634, 634 cancer, 680–681, 681t distention postoperative gastric surgery, 683 Stoma(s), 709, 710 location, 711t types, 711, 712 Stomatitis, 162, 669–670 Stool tests, 646–647 Strains, 992 Stress, 1261 Stress incontinence, 770, 772b Stress test(s), 363–364, 364 Stress ulcers, 678 Stressor, 1266 Striae, 644 Stroke See Cerebrovascular accident Student nurses, 14 Subarachnoid, 1042 Subarachnoid bolt monitor, 1060, 1061 Subarachnoid hemorrhage, 1116, 1116–1118 Subcutaneous tissue, 1202 Subdural hematoma, 1071, 1071 Substance abuse disorders, 1286–1290, 1291b differential diagnosis, 1288 ethical considerations, 1288b, 1291 etiological theories, 1288 spinal cord injuries, 1082 therapeutic interventions, 1288–1289, 1290 types, 1288 Suctioning, 567–570, 571b Sudoriferous glands, 1202 Suffering, 126 Sugars fast, 864, 865b Suicide older adult, 1292b Sulfonamides, 104t Summons, 27 Superior vena cava syndrome, 170, 622 Suprapubic, 941 Suprapubic catheter, 774 Surface trauma, 211 Surgeons, 174 Surgery adrenalectomy, 847 ambulatory discharge, 193, 201–202, 202 cancer, 157 carotid stenosis, 1114 cerebral aneurysm, 1117, 1117 chronic disorders, 178 chronic obstructive pulmonary disease, 607 dermatological, 1239–1240t diabetes mellitus, 868–869 ears, 1194t eyes, 1178–1179, 1179t gastric, 680–684, 681, 682 gerontological issues, 176–177b, 181b health-care team roles, 186 herniated disk, 1079–1080 hydration and nutrition, 176–177, 177b immune system, 299 inpatient discharge, 201–202, 202 intestinal recovery, 713b intracranial, 1076–1077 intraoperative phase, 184–189 lung cancer, 622, 623 musculoskeletal system, 1023–1031 nursing care plan, 186b obesity, 667–668 osteoarthritis, 1019 outcomes factors influencing, 175–178 Parkinson’s disease, 1099 patient admission, 179, 180t patient arrival, 186–187 perioperative phases, 175, 175t plastic, 1239–1240t postoperative phase See Postoperative care preoperative care See Preoperative care preoperative phase, 175–184 preparation, 182–184 procedure suffixes, 174t purposes, 174–175, 175t renal calculi, 784–785 rheumatoid arthritis, 1022 spinal cord injury, 1085 thoracic, 624–626 thyroidectomy, 840 transfer, 184, 184, 189 urgency levels, 174, 175t video-assisted thorascopic, 624 wound care, 197–200 wound infections, 102 Surgical asepsis, 99 Surgical Care Improvement Project, 174 Swabs, 890 Swallowing disorders nutrition, 1121b Sweat glands, 1202 Sympatholytics, 379–380t Symptom assessment guide, 6b Synapses, 1038, 1038 Syndrome of inappropriate antidiuretic hormone, 828–829 Syndrome X, 855 Synovial joints, 980, 980 Synovitis, 982–983 Syphilis, 960–963, 962b, 963 Systemic lupus erythematous, 1010–1013 diagnostic tests, 1011 nursing process, 1012 pathophysiology, 1010–1011 signs and symptoms, 1011, 1011, 1012t therapeutic interventions, 1011–1012 T T cells and B cells, 290 T wave, 461 Tachycardia, 111, 192, 212, 464 chronic heart failure, 484 ventricular, 469, 469–470 Tachydysrhythmias, 423 Tachypnea, 111, 220, 600 Tamponade, 940 esophagogastric, 727–728, 728 Technetium 99m sestamibi, 365 Technetium pyrophosphate scan, 365 Temperature end of life, 276 Tension headaches, 1065–1066 Tension pneumothorax, 113 Teratoma, 926 Terminal restlessness, 282 Testes, 881 cancer, 947–948 disorders, 947–948 male infertility, 953–954 undescended, 947 Testicular self-examination, 896, 896b Tetanus, 211 Tetracyclines, 104t Thalamus, 1041 Thalassemia, 521 Thallium imaging cardiovascular system, 364 Theological perspectives on ethics, 24 Thermography breasts, 887 Thiazide, 379t Thoracentesis, 562–563 Thoracic surgery 64William & Hopper (F)-Index 11/2/06 2:50 PM Page 1351 Copyright © 2007 by F A Davis Index nursing process, 625–626 postoperative nursing care, 625 preoperative nursing care, 625 types, 624 Thoracotomy, 624, 624b Thought processes disturbed, 1085–1105, 1094t, 1095–1097b Thrill, 355 Throat culture, 557 Thrombectomy, 438 Thromboangiitis obliterans, 432 Thrombocytopenia, 159 bleeding prevention, 527b Thromboembolic complications fractures, 1001–1003 postoperative hip replacement, 1026–1027 Thrombolytic, 1112 Thrombolytic therapy ischemic brain attack, 1112–1113 Thrombolytics, 423, 425t, 1112 Thrombophlebitis, 397, 739 complications, 400 deep vein signs, 400 immobility, 398 IV therapy, 398 pathophysiology and etiology, 397–398 plan of care, 401b prevention, 398 prophylactic antiembolism devices, 398 prophylactic medication, 398 signs and symptoms, 397, 400 superficial vein signs, 400 treatment, 400 Thrombosis, 409, 1109, 1110 arterial, 430 deep vein, 1082 Thymus, 97, 511 Thyroid gland, 816–817 cancer, 839–840 disorders, 832–841, 833t nuclear scanning, 823 palpation, 821, 821–822 Thyroid hormone abnormalities, 832t, 832–838 Thyroid-stimulating hormone, 816 Thyroid storm, 834–836 Thyroidectomy, 840–841 Thyroiditis Hashimoto’s, 313 Thyrotoxic crisis, 834–836, 841 Tilt table test, 363 Time orientation, 35 Tissues bone tissue, 977 cells and, 146 musculoskeletal system, 977–980 Tolerance, 1286 pain, 126–127 Tomography breasts, 887 Tonicity, 60 Tonsillectomy, 582–583 Tonsillitis, 582–583 Torts, 27, 27b Total hip replacement See Hip replacement Total joint replacement, 1023–1027 Total parenteral nutrition, 89, 89b, 658 Tourniquet, 82 Toxemia, 112 Toxic shock syndrome, 911–912 Trabeculoplasty, 1177, 1177 Trachea anatomy, 550 Tracheostomy, 565–567, 566, 567, 567b, 568–570b, 571b Tracheostomy tube, 671, 671 Tracheotomy, 565 Trachoma, 1164b Traction, 997–999, 998 cervical injuries, 1084, 1084 herniated disk, 1079 Traditions, 31 Transcellular fluid, 59 Transdermal contraceptive patch, 919 Transdermal patch, 130 Transesophageal echocardiogram, 364 Transfusion blood See Blood, administration Transient ischemic attack, 1109 Transillumination, 895 Transjugular intrahepatic portosystemic shunt, 727, 727 Transmyocardial laser revascularization, 410–411 Transplant rejection, 310–312, 312t Transplantation cardiac See Cardiac transplantation ethical considerations, 732b kidney, 804–805, 805, 805b liver, 731, 731b lung, 624 pancreas, 863 Transplants home health hints, 319 Transtelephonic event recorders, 363 Transtracheal catheter, 560–561, 561 Transurethral resection of prostate, 939–940, 940 Transurethral suppository, 951 Trauma, 210–215 abdominal, 212 assessment, 213, 213 chest, 212 diagnosis, 213–215 ears, 1187, 1192 evaluation, 213–215 eyes, 1180–1181 falls versus battery or assault, 211b gerontological issues, 210b head, 211 hypovolemic shock, 113 mechanism of injury, 210b, 210–211 nursing process, 213–215 orthopedic, 212–213 renal system, 791 respiratory system, 617–619 spinal, 212 surface, 211 Tremor essential, 1098t 1351 Trendelenburg position, 115 Triage, 222 Trichomoniasis, 962b, 963 Trigeminal neuralgia, 1138, 1138 Trigeminy, 468 Tropia, 1149 Troponin cardiac, 365 Trousseau’s sign, 70, 70 Trustworthiness, 21 T-tube, 731, 743, 743 Tube feedings, 655–658 complications, 657t Tuberculin skin test, 595, 595t Tuberculosis AIDS, 329 complications, 595 diagnostic tests, 595, 595t etiology, 594 gerontological issues, 594b nursing process, 596–599 pathophysiology, 594 prevention, 594–595 signs and symptoms, 594–595 therapeutic interventions, 595–596, 596b Tuning fork tests auditory acuity, 1157, 1157–1158, 1158 U U wave, 462 Ulcerative colitis complications, 698 diagnostic tests, 698 nursing process, 699 pathophysiology and etiology, 698 signs and symptoms, 698 therapeutic interventions, 698 Ulcers pressure See Pressure ulcers Ultrasound breasts, 887, 887 cancer, 156 endoscopic, 653 eyes, 1150 female reproductive system, 890–891 gastrointestinal system, 648t, 653 male reproductive system, 896 musculoskeletal system, 988 renal, 762 Unconsciousness end of life, 282 Unifocal, 468 Unipolar depression, 1280 Unstable angina, 412–414 Upper GI series, 648t, 650 Uremia, 755, 796 Ureters, 754 Urethra, 754, 882–883 Urethral strictures, 782 Urethritis, 778–779, 958 Urethroplasty, 782 Urge incontinence, 770–771, 771b, 772b Urinalysis, 760–762, 761t 64William & Hopper (F)-Index 11/2/06 2:50 PM Page 1352 Copyright © 2007 by F A Davis 1352 Index Urinary system age-related changes, 754, 754b, 755 anatomy and physiology, 751–754 assessment, 755–760, 756–760t diagnostic procedures, 765–768t diagnostic tests, 760–770, 761t, 762–768t, 769 endoscopic procedures, 762 health history, 755 home health hints, 775 incontinence, 249–250, 770–771 indwelling catheters, 771–774, 774b infections See Urinary tract infections intake and output, 760 intermittent catheterization, 774 lung sounds, 760 physical assessment, 755–760 postoperative function, 197 renal calculi See Renal calculi renal function tests, 762–764t urine See Urine vital signs, 755 Urinary tract infections complications, 780–781 medications, 780, 780t nursing process, 781–782 nutrition, 782b predisposing factors, 778 prevention, 782b symptoms, 778 types, 778–781 Urine amount, 754 characteristics, 754 color, 754 constituents, 754 elimination, 753–754 formation, 752–753 functional incontinence, 771, 773b glomerular filtration, 752 glucose and ketone monitoring, 863, 864 incontinence, 249–250, 770–771, 772b, 773b obstructions, 781–788 overflow incontinence, 771 pH, 754 retention management, 771, 774 specific gravity, 754 stress incontinence, 770, 772b total incontinence, 771 tubular reabsorption, 752–753 tubular secretion, 753 ureters, 754 urethra, 754 urge incontinence, 770–771, 771b, 772b urinalysis, 760–762, 761t urinary bladder, 754 urination reflex, 754 Urine tests, 823 Urodynamic, 939 Urological obstructions, 781–788 Urosepsis, 780, 939 Urticaria, 114, 302, 304–305 blood transfusion, 517 Uterine position disorders, 914, 914 Uterine prolapse, 914, 915 Uterus, 879–880, 880 Utilitarianism, 23 V Vaccines cancer, 153 Vagina, 880, 880 irritations and inflammations, 908–911, 910t Vaginosis, 909–910 Vagotomy, 681 Values cultural considerations and influences, 31 ethics and, 17–26 Valvotomy, 450 Valvular disorders cardiac See Cardiac valvular disorders Valvuloplasty, 448, 448 Vancomycin-resistant enterococci, 102, 102–103 Variant angina, 412 Varices, 725 Varicocele, 895, 947 Varicose veins pathophysiology and etiology, 436 signs and symptoms, 436–437 therapeutic interventions, 437 Variola major, 222 Vascular bypass surgery, 438, 440 Vascular disorders pulmonary, 614–617 Vascular surgery, 438–441 angioplasty, 438 bypasses and grafts, 438 complications, 438–440 embolectomy, 438 endarterectomy, 438 nursing process, 438, 439–440b, 440 postoperative therapeutic interventions, 440 stents, 438 thrombectomy, 438 Vasculitis, 1013, 1110 Vasectomy, 922, 922–923, 948 Vasodilators angina pectoris, 415 direct, 381t myocardial infarction, 423, 424–425t Vasospasm subarachnoid hemorrhage, 1117, 1118 Vasovasotomy, 948 Vectors rickettsiae, 94 Veins, 350, 351 disorders, 397–402 thrombophlebitis, 400 Vena cava filter, 400, 401 Venous access alternative, 88, 88–89 difficult, 83b Venous insufficiency, 437–438 Venous stasis ulcers, 437–438 Ventilation, 550 mechanical, 572, 572–573, 573b noninvasive positive-pressure, 573–574, 574 Ventilation-perfusion scan, 557–558 Ventilator, 572, 572, 572b Ventilator-associated pneumonia, 592 Ventricles, 1040 Ventricular aneurysm repair, 491, 492 myocardial infarction, 423 Ventricular assist devices, 491, 491 Ventricular contractions premature, 468, 468–469 Ventricular diastole, 459 Ventricular drain, 1060, 1060 Ventricular escape rhythm, 459 Ventricular fibrillation, 470, 470–471 Ventricular repolarization, 461, 462 Ventricular systole, 459 Ventricular tachycardia, 469, 469–470 Ventriculoperitoneal shunt, 1117, 1118 Venturi mask, 560 Veracity, 20 Verrucous, 964 Vertebrae, 979 Vertebral column, 979–980 Vesicant, 159 Vesicular, 964 Video-assisted thorascopic surgery, 624 Viral infections AIDS, 329 Viral load testing HIV, 330 Viral pneumonia, 592 Virchow’s triangle, 397, 398t Viruses, 94 cancer risk, 148 Viscosity, 374 Vision, 1145–1153 astigmatism, 1169 blindness, 1170–1172, 1172b, 1173–1174b cataracts, 251, 1151b, 1170, 1171, 1178–1179 corneal light reflex test, 1148 cover test, 1149 disorders, 1164b, 1164–1181 field abnormalities, 1171 glaucoma, 1170, 1171 hyperopia, 1169, 1169 impairment, 1170–1172, 1172b, 1173–1174b macular degeneration, 251, 1151b, 1179–1180, 1180 myopia, 1169, 1169 physiology, 1146 presbyopia, 1169 refractive errors, 1168–1170, 1169 retinal detachment, 1175–1176 visual acuity, 1147–1148 visual fields by confrontation, 1147–1148 Visual disturbances cerebrovascular accident, 1111 Vital signs brain injury, 1073 Vitamin B12, 683 64William & Hopper (F)-Index 11/2/06 2:50 PM Page 1353 Copyright © 2007 by F A Davis Index Vitamin D activation, 636 Volvulus, 704, 705 Vomiting, 663 nursing process, 663 therapeutic interventions, 663 Vulva irritations and inflammations, 908–911 Vulvar cancer, 927 Vulvovaginitis, 958 W Warfarin thrombophlebitis, 398 Wart, 1237t Waste products removal, 800 Water body normal distribution, 59 Water balance disturbance, 798–799 Weber test, 1158, 1158, 1158t Weight reduction hypertension, 377 myocardial infarction, 423 Welfare rights, 28 Wellness See Health and wellness West Nile virus, 584 Western medicine, 50 WHAT’S UP?, 6, 6b cardiovascular system, 353–354, 354t ear disorders, 1155, 1192t, 1195t eye surgery, 1179t gastrointestinal system, 638 headaches, 1066–1067 hearing, 1184t herniated disks, 1078 immune system, 293 nervous system, 1046, 1046t skin infection, 1231–1232 visual impairment, 1171, 1171t Whipple’s procedure, 739, 740 White blood cells, 289, 509 bacterial infection, 513 disorders, 534–536 Withdrawal, 1286–1287 Wood’s light examination, 1207–1208 Worldview, 31 Wound(s) closed, 211 dressings, 1218 1353 negative pressure wound therapy, 1219, 1219 open, 211 surgical, 197–198, 198 care, 197–200 complications, 198, 200 dehiscence, 177, 198, 200 drains, 198 dressings, 198–199 evisceration, 198, 200 healing, 198, 198t, 199 infections, 102 Wound cleansing pressure ulcers, 1218 Wound culturing integumentary system, 1208b X X-rays cardiovascular system, 358, 359 musculoskeletal system, 985 nervous system, 1051 Xerostomia, 158, 670b Y Yeast infection, 670b Yohimbine, 950 ... Davis UNDERSTANDING Medical Surgical Nursing THIRD EDITION LINDA S WILLIAMS, MSN, RNBC Professor of Nursing Jackson Community College Jackson, Michigan PAULA D HOPPER, MSN, RN Professor of Nursing. .. Nursing Diagnosis Impaired mobility ϭ nursing Ineffective coping nursing Herniated disk ϭ medical Fractured femur ϭ medical Diabetes ϭ medical Impaired gas exchange ϭ nursing Appendicitis ϭ medical. .. instructors find this third edition a practical tool for learning and understanding medical- surgical nursing FEATURES OF THE BOOK We have kept our most popular features from the first two editions, and