Pages from 1415-00_i-xxxiv.pdf Contributors Contributors
Sandra M. Annesi, RN, MSN Assistant Professor Nursing Program Daytona Beach Community College DeLand, Florida
Chapter 25: Respiratory Care Modalities
Judith C. Bautch, PhD, RN, CS Professor Department of Nursing Winona State University Winona, Minnesota
Chapter 54: Assessment and Management of Patients With Rheumatic Disorders
Jo Ann Brooks-Brunn, DNS, RN, FAAN, FCCP Assistant Professor Thoracic Surgery Pulmonary and Critical Care Medicine Indiana University School of Medicine Indianapolis, Indiana
Chapter 23: Management of Patients With Chest and Lower Respiratory Tract Disorders
Chapter 24: Management of Patients With Chronic Obstructive Pulmonary Disorders
Jacqueline Fowler Byers, PhD, RN, CNAA Associate Professor School of Nursing University of Central Florida Orlando, Florida
Chapter 21: Assessment of Respiratory Function
Kim Cantwell-Gab, BSN, RN, CVN, RVT, RDMS Vascular Surgery Nurse Specialist Department of Surgery, Division of Vascular Surgery University of Washington School of Medicine Seattle, Washington
Chapter 31: Assessment and Management of Patients With Vascular Disorders and Problems of Peripheral Circulation
Patricia E. Casey, RN, MSN Director, Regional Cardiovascular Program Kaiser Permanente Mid-Atlantic Region Rockville, Maryland
Chapter 27: Management of Patients With Dysrhythmias and Conduction Problems
Chapter 28: Management of Patients With Coronary Vascular Disorders
Chapter 29: Management of Patients With Structural, Infectious, and Inflammatory Cardiac Disorders
Chapter 30: Management of Patients With Complications From Heart Disease
Jill Cash, MSN, APRN, BC Family Nurse Practitioner Southern Illinois OB-GYN Associates, SC Carbondale, Illinois
Chapter 59: Assessment and Management of Patients With Hearing and Balance Disorders
Linda Carman Copel, PhD, RN, CS, CGP, DAPA Associate Professor Villanova University College of Nursing Villanova, Pennsylvania
Chapter 4: Health Education and Health Promotion Chapter 6: Homeostasis, Stress, and Adaptation Chapter 7: Individual and Family Considerations Related to Illness
Juliet Corbin, RNC, DNS, FNP Lecturer School of Nursing San Jose State University San Jose, California
Chapter 10: Chronic Illness
Susanna G. Cunningham, RN, PhD, FAAN, FAHA Professor Department of Biobehavioral Nursing and Health Systems University of Washington School of Nursing Seattle, Washington
Chapter 32: Assessment and Management of Patients With Hypertension
Lana Currance, RN, BSN, CCRN Chief Nursing Officer National Medical Response System Colorado 2 DMAT/Central U.S. NMRT-Weapons of
Mass Destruction Parker, Colorado
Chapter 72: Terrorism, Mass Casualty, and Disaster Nursing
Margaret A. Degler, RN, MSN, CRNP, CUNP Director, Continence Program West Office of the Center for Urologic Care of Berks County, P.C. West Reading, Pennsylvania
Chapter 12: Health Care of the Older Adult Chapter 43: Assessment of Renal and Urinary Tract Function Chapter 44: Management of Patients With Upper or Lower Urinary
Tract Dysfunction Chapter 45: Management of Patients With Urinary Disorders
Nancy E. Donegan, RN, BS, MPH Director, Infection Control Washington Hospital Center Washington, D.C.
Chapter 70: Management of Patients With Infectious Diseases
Phyllis Dubendorf, RN, MSN, CS-ACNP Lecturer, Acute Care Nurse Practitioner Program School of Nursing University of Pennsylvania Philadelphia, Pennsylvania
Chapter 61: Management of Patients With Neurologic Dysfunction
Eleanor Fitzpatrick, RN, MSN, CRNP, CCRN Clinical Nurse Specialist Surgical ICU/Intermediate Surgical ICU Thomas Jefferson University Hospital Philadelphia, Pennsylvania
Chapter 39: Assessment and Management of Patients With Hepatic Disorders
Chapter 40: Assessment and Management of Patients With Biliary Disorders
Mary Beth Flynn, RN, MS CNS/Clinical Educator University of Colorado Hospital Clinical Faculty University of Colorado Health Science Center Denver, Colorado
Chapter 15: Shock and Multisystem Failure
Kathleen K. Furniss, MSN, APN-C Nurse Practitioner, Women’s Health Women’s Health Initiative University of Medicine and Dentistry of New Jersey and Associates in
Women’s Health Care Newark, New Jersey
Chapter 46: Assessment and Management of Female Physiologic Processes
Chapter 47: Management of Patients With Female Reproductive Disorders
Paula Graling, RN, MSN, CNS Clinical Nurse Specialist Perioperative Services Inova Fairfax Hospital Falls Church, Virginia
Chapter 18: Preoperative Nursing Management Chapter 19: Intraoperative Nursing Management Chapter 20: Postoperative Nursing Management
Randolph E. Gross, RN, MS, CS, AOCN Clinical Nurse Specialist Evelyn H. Louder Breast Center Memorial Sloan-Kettering Cancer Center New York, New York
Chapter 48: Assessment and Management of Patients With Breast Disorders
Doreen Grzelak, RN, MSN, AOCN Operations Manager Medical Imaging Center Department of Radiology Reston Hospital Center Reston, Virginia
Chapter 35: Management of Patients With Oral and Esophageal Disorders
Chapter 37: Management of Patients With Gastric and Duodenal Disorders
Janice L. Hinkle, PhD, RN, CNRN Assistant Professor Villanova University College of Nursing Villanova, Pennsylvania
Chapter 5: Health Assessment Chapter 62: Management of Patients With Cerebrovascular Disorders Chapter 65: Management of Patient With Oncologic
and Degenerative Neurologic Disorders
Ryan R. Iwamoto, ARNP, MN, AOCN Oncology Clinical Coordinator Genentech BioOncology, Inc. South San Francisco, California Nurse Practitioner Department of Radiation Oncology Virginia Mason Medical Center Clinical Instructor University of Washington and Seattle University Seattle, Washington
Chapter 49: Assessment and Management of Problems Related to Male Reproductive Processes
Joyce Young Johnson, RN, PhD, CCRN Assistant Chair Department of Nursing Georgia Perimeter College Clarkston, Georgia
Chapter 1: Health Care Delivery and Nursing Practice Chapter 2: Community-Based Nursing Practice Chapter 3: Critical Thinking, Ethical Decision Making,
and the Nursing Process Chapter 8: Perspectives in Transcultural Nursing
Rhonda Kyanko, RN, MS Nursing Education Coordinator National Rehabilitation Hospital Washington, DC
Chapter 11: Principles and Practices of Rehabilitation
Pamela J. LaBorde, MSN, RN Clinical Nurse Specialist, Patient Care Services University of Arkansas Medical Sciences Center Little Rock, Arkansas Formerly, Clinical Nurse Specialist, Burn Unit Orlando Regional Medical Center Orlando, Florida
Chapter 57: Management of Patients With Burn Injury
Dale Halsey Lea, RN, MPH, CGC, APGN, FAAN Assistant Director Southern Maine Regional Genetics Services Foundations for Blood Research Scarborough, Maine
Chapter 9: Genetics Perspectives in Nursing Practice
Dorothy B. Liddel, RN, MSN, ONC Associate Professor (Retired) Department of Nursing Columbia Union College Tacoma Park, Maryland
Chapter 66: Assessment of Musculoskeletal Function Chapter 67: Musculoskeletal Care Modalities Chapter 68: Management of Patients With Musculoskeletal Disorders Chapter 69: Management of Patients With Musculoskeletal Trauma
vi Contributors
Martha V. Manning, RN, MSN Nurse Clinician Inova Emergency Care Center at Fairfax Fairfax, Virginia
Chapter 34: Assessment of Digestive and Gastrointestinal Function Chapter 38: Management of Patients With Intestinal
and Rectal Disorders
Barbara J. Maschak-Carey, RN, MSN, CDE Clinical Nurse Specialist Department of Endocrinology, Diabetes and Metabolism University of Pennsylvania Health System Philadelphia, Pennsylvania
Chapter 41: Assessment and Management of Patients With Diabetes Mellitus
Agnes Masny, RN, MPH, MSN, CRNP Research Associate/Nurse Practitioner Population Science Division, Family Risk Assessment Program Fox Chase Cancer Center Philadelphia, Pennsylvania
Chapter 9: Genetics Perspectives in Nursing
Lou Ann McGinty, MSN, RN Nurse Science Clinical Specialist Capitol Health System Trenton, New Jersey
Chapter 64: Management of Patients With Infectious, Inflammatory, and Autoimmune Neurologic Disorders
Nancy A. Morrissey, RN,C, PhD Patient Care Director Mental Health and Behavioral Center Inova Alexandria Hospital Alexandria, Virginia
Chapter 36: Gastrointestinal Intubation and Special Nutritional Modalities
Martha A. Mulvey, RN, MS, CNS Advanced Practice Nurse Neurosciences University of Medicine and Dentistry of New Jersey,
University Hospital Newark, New Jersey
Chapter 14: Fluids and Electrolytes: Balance and Distribution
Victoria Navarro, RN, MAS, MSN Director of Clinical Services Wilmer Eye Institute The Johns Hopkins Medical Institutions Baltimore, Maryland
Chapter 58: Assessment and Management of Patients With Eye and Vision Disorders
Donna Nayduch, RN-CS, MSN, CCRN Trauma Regional Director Banner Health Greeley, Colorado
Chapter 71: Emergency Nursing Chapter 72: Terrorism, Mass Casualty, and Disaster Nursing
Kathleen Nokes, PhD, RN, FAAN Professor Hunter-Bellevue School of Nursing New York, New York
Chapter 52: Management of Patients With HIV Infection and AIDS
Janet A. Parkosewich, RN, MSN, CCRN Cardiac Clinical Nurse Specialist Department of Patient Services Yale-New Haven Hospital New Haven, Connecticut
Chapter 26: Assessment of Cardiovascular Function
Anne Gallagher Peach, RN, MSN Chief Operating Officer M.D. Anderson Cancer Center Orlando Orlando, Florida
Chapter 22: Management of Patients With Upper Respiratory Tract Disorders
JoAnne Reifsnyder, PhD, RN, AOCN Postdoctoral fellow, Psychosocial Oncology School of Nursing University of Pennsylvania Philadelphia, Pennsylvania
Chapter 17: End-of-Life Care
Susan A. Rokita, RN, MS, CRNP Nurse Coordinator, Cancer Center Oncology Clinical Nurse Specialist Milton S. Hershey Medical Center of Pennsylvania State University Hershey, Pennsylvania
Chapter 16: Oncology: Nursing Management in Cancer Care
Al Rundio, PhD, RN, ANP Associate Professor Medical College of Pennsylvania/Hahnemann University College of Nursing and Health Professions Philadelphia, Pennsylvania
Chapter 50: Assessment of Immune Function Chapter 51: Management of Patients With Immunodeficiency Chapter 53: Assessment and Management of Patients
With Allergic Disorders
Catherine Sackett, RN, BS, CANP Ophthalmic Research Nurse Practitioner Wilmer Eye Institute Retinal Vascular Center The Johns Hopkins Medical Institutions Baltimore, Maryland
Chapter 58: Assessment and Management of Patients With Eye and Vision Disorders
Linda Schakenbach, RN, CNS, MSN, CCRN, COCN, CWCN, CS Clinical Nurse Specialist, Critical Care Inova Alexandria Hospital Alexandria, Virginia
Chapter 27: Management of Patients With Dysrhythmias and Conduction Problems
Chapter 28: Management of Patients With Coronary Vascular Disorders
Chapter 29: Management of Patients With Structural, Infectious, and Inflammatory Cardiac Disorders
Contributors vii
Margaret A. Spera, NP, APRN Nurse Practitioner Family Medical Associates Ridgefield, Connecticut Assistant Clinical Professor Yale University School of Nursing New Haven, Connecticut
Chapter 60: Assessment of Neurologic Function
Cindy Stern, RN, MSN Cancer Network Coordinator University of Pennsylvania Cancer Center University of Pennsylvania Health System Philadelphia, Pennsylvania
Chapter 16: Oncology: Nursing Management in Cancer Care
Christine Tea, RN, MSN, CNA Patient Care Director Main OR Perioperative Services Inova Fairfax Hospital Falls Church, Virginia
Chapter 18: Preoperative Nursing Management Chapter 19: Intraoperative Nursing Management Chapter 20: Postoperative Nursing Management
Mary Laudon Thomas, RN, MS, AOCN Hematology Clinical Nurse Specialist Veterans’ Administration, Palo Alto Health Care System Palo Alto, California
Chapter 33: Assessment and Management of Patients With Hematologic Disorders
Dorraine Day Watts, PhD, RN Interim Director of Research and Education Inova Health System Falls Church, Virginia
Chapter 63: Management of Patients With Neurologic Trauma
Joan Webb, RN, MSN Instructor College of Nursing Widener University Chester, Pennsylvania
Chapter 40: Assessment and Management of Patients With Biliary Disorders
Chapter 42: Assessment and Management of Patients With Endocrine Disorders
Joyce S. Willens, RN, PhD Assistant Professor College of Nursing Villanova University Villanova, Pennsylvania
Chapter 13: Pain Management
Iris Woodard, RN-CS, BSN, ANP Nurse Practitioner Department of Dermatology Kaiser Permanente Springfield, Virginia
Chapter 55: Assessment of Integumentary Function Chapter 56: Management of Patients With Dermatologic Problems
viii Contributors
Contributors Consultants and Reviewers
Debbie Amason, BSN, MS, RN Assistant Professor Floyd College Rome, Georgia
William Ames, MSN, RN, FNP Associate Professor Elizabethtown Community College Elizabethtown, Kentucky
Susan Arbogast, MS, RN Faculty Maricopa Community College District
Nursing Program, Phoenix College Campus
Phoenix, Arizona
Gail Armstrong, ND, RN Assistant Professor University of Colorado School of Nursing Denver, Colorado
Denise M. Ayers, MSN, RN Assistant Professor, Nursing Kent State University at Tuscarawas New Philadelphia, Ohio
Valerie Benedix, BSN, RN Nursing Instructor Clovis Community College Clovis, New Mexico
Ilene Borze, MS, CEN, RN Director, Nursing Continuing Education Faculty Gateway Community College Phoenix, Arizona
Donna Bowren, RN, MSN, CNOR, CRNFA Interim Chairperson, Division of Nursing
and Allied Health University of Arkansas Community College
at Batesville Batesville, Arkansas
Pat Bradley, RN, MEd MS Nursing Faculty Grossmont College El Cajon, California
Lynn Browning, RN, MSN BC Assistant Professor of Nursing Derry Patterson Wingo School of Nursing Charleston Southern University Charleston, South Carolina
Elizabeth Bruce, RN, MSN St. Clair Community College Chatham, Ontario
Shirley Cantrell, PhD, RN Associate Professor Piedmont College Demorest, Georgia
Donna Cartwright, MS, APRN Dean, Professional and Applied Technology
Education College of Eastern Utah Price, Utah
Pattie Garrett Clark, MSN, RN Associate Professor of Nursing Abraham Baldwin College Tifton, Georgia
Terry Cicero, MN, CCRN, RN Instructor, School of Nursing Seattle University Seattle, Washington
Tracey D. Cooper, RN, MSN Director, Nursing Learning Resources Lab Instructor, South Plains College Levelland, Texas
Dolly I. Daniel, BSN, CDE, RNC Diabetes Nurse Specialist Inova Alexandria Hospital Alexandria, Virginia
Toni Doherty, MSN, RN Associate Professor Department Head, Nursing Dutchess Community College Poughkeepsie, New York
Sandra Edwards, BScN, RN Instructor Grant MacEwan College Edmonton, Alberta, Canada
Mary Elliot, BScN, MEd, RN Professor Humber College of Applied Arts & Technology Etobicoke, Ontario, Canada
Cheryl Fenton, BHSc, RN Professor Mohawk College Burlington, Ontario, Canada
Kathie Folsom, RN, BSN, MS Department Chair Skagit Valley College Oak Harbor, Washington
Donna Funk, MN/E ONC, RN Professor of Nursing Brigham Young University Rexburg, Idaho
Vicki Garlock, BSN, MSN, RN Professor, Nursing Department Pensacola Junior College Pensacola, Florida
Mary Catherine Gebhart, MSN, CRRN, RN Instructor Georgia State University Atlanta, Georgia
Donna Gullette, DNS, RN Associate Professor, Critical Care Chair Mississippi University for Women Columbus, Mississippi
Carol Heinrich, PhD, RN Associate Professor Department of Nursing East Stroudsburg University East Stroudsburg, Pennsylvania
Sandra Hendelman, MS, RN Adjunct Professor of Nursing Palm Beach Community College Lake Worth, Florida South College
Judith Ann Hughes, EdD, RN Associate Degree Nursing Coordinator Southwestern Community College Sylva, North Carolina
Sadie Pauline Hutson, MSN, RN, CRNP Cancer Research Training Award
PreDoctoral Fellow National Cancer Institute,
Clinical Genetics Branch Rockville, MD
Jennifer Johnson. MSN, RN C Assistant Professor of Nursing Kent State University, Tuscarawas Campus New Philadelphia, Ohio
Susan J. Lamanna, MA, MSN, RN ANP Associate Professor Onondaga Community College Syracuse, New York
Joan Ann Leach, MS, ME, RNC Professor of Nursing Capital Community College Hartford, Connecticut
Gayle Lee, PhD, RN, CCRN Faculty Brigham Young University Rexburg, Idaho
Brenda Lohri-Posey, EdD, RN Assistant Dean of Learning, Nursing
& Program Coordination Belmont Technical College St. Clairesville, Ohio
Rhonda McLain, MN, RN Assistant Professor of Nursing Clayton College & State University Morrow, Georgia
Pat Nashef, MHSc BA (CPMHN)c, RN Professional Practice Clinician,
Mental Health Services
Halton Healthcare Services Oakville, Ontario Clinical Faculty McMaster University School of Nursing Hamilton, Ontario
Lauren O’Hare, MSN, EdD, RN Assistant Professor of Nursing Wagner College Staten Island, New York
Caroline Ostand, BC, MSN, RN Clinical Instructor University of Charleston Charleston, West Virginia
Thena E. Parrott, PhD, RNCS Director, Associate Degree Nursing Program Blinn College Bryan, Texas
Billie Phillips, PhD, RN, CDFS Assistant Professor Tennessee Wesleyan College Fort Sanders Nursing Department Athens, Tennessee
Pam Primus, BSN, RN Nurse Educator Casper College Casper, Wyoming
Betty E. Richards, RN, MSN Professor of Nursing Middle Georgia College Cochran, Georgia
Patsy Ruppert Rider, MSN, CS, RN Clinical Instructor in Nursing University of Texas at Austin School of Nursing Austin, Texas
Kathleen L. Russ, MSN, RN Dean of Student Support/Health Careers Gateway Technical College Kenosha, Wisconsin
Esther Salinas, MSN, MSEd, RN Associate Professor of Nursing Del Mar College Corpus Christi, Texas
Marsha Sharp, MSN, RN Associate Professor Elizabethtown Community College Elizabethtown, Kentucky
Kelli Simmons, MS, CS, M-SCNS, RN Cardiothoracic Clinical Nurse Specialist University of Missouri Hospitals and Clinics Columbia, Missouri
Terri Small, MSN, RN C Assistant Professor of Nursing Waynesburg College Waynesburg, Pennsylvania
Darla R. Ura, MA, ANP-CS, RN Clinical Associate Professor Emory University Atlanta, Georgia
Weibin Yang, MD Assistant Professor of Physical Medicine and
Rehabilitation Medicine (PM&R) University of Illinois Chicago, Illinois
x Consultants and Reviewers
xi
Preface
As the 21st century begins, nurses face a future characterized by changes comparable to those of no preceding century:
• Science and technology have made the world smaller by making it more accessible.
• Mass communication is more widespread, and information is now just an instant away and very easy to obtain.
• Economies are more global than regional. • Industrial and social changes have made world travel and
cultural exchange common.
Today’s nurses enter a realm of opportunities and challenges for providing high-quality, evidence-based care in traditional as well as new and innovative health care settings. The rapid changes in health care mandate that nurses be prepared to provide or plan care across the continuum of settings—from hospital or clinic, to home, to community agencies or hospice settings—and during all phases of illness. Recent research has indicated that nurses make significant contributions to the health care outcomes of patients who are hos- pitalized. Therefore, today’s nurses must be prepared to identify patients’ short- and long-term needs quickly and to collaborate ef- fectively with patients and families, other members of the health care team, and community agencies to create a seamless system of care. The continued emphasis on health promotion efforts to keep well people healthy and to promote a higher level of well-being among those with acute and chronic illnesses requires today’s nurses to as- sist patients in adopting healthy lifestyles and strategies. Mapping of the human genome and other advances in genetics have moved the issue of genetics to the bedside and increased the need for nurses to become knowledgeable about genetics-related issues.
In preparing for these vast opportunities and responsibilities, today’s nurses must be well informed and up-to-date, not only in nursing knowledge and skills but also in research findings, scien- tific advances, and the ethical dilemmas inherent in many areas of clinical practice. More than ever, today’s nurses need to think crit- ically, creatively, and compassionately.
This tenth edition of Brunner & Suddarth’s Textbook of Medical- Surgical Nursing is designed for the 21st century and nurses’ need to be knowledgeable, highly skilled, perceptive, caring, and compas- sionate. A goal of the textbook is to provide balanced attention to the art and science of adult medical-surgical nursing. It addresses nursing care issues from a physiological, pathophysiological, and psychosocial context and assists the reader to identify priorities of care from that context.
ABOUT THE TENTH EDITION The tenth edition of Brunner and Suddarth’s Textbook of Medical Surgical Nursing was constructed to provide today’s nursing stu- dents with an understanding of the nurse’s role in health and illness within evolving practice environments and across the spectrum of health and illness. The textbook’s content has been revised and up- dated by experts in the field to reflect current practice and advances in health care and technology.
NEW CHAPTERS: GENETICS, END-OF-LIFE CARE, AND BIOTERRORISM Nursing knowledge is constantly expanding. Chapter 9, Genetics Perspectives in Nursing Practice, was written in response to genetics information identified during the last few years. Every nurse needs to be aware of the influence of genetics on health and illness, and every nurse needs to have the knowledge and skill to answer pa- tients’ questions concerning their heredity and health. In addition to Chapter 9, genetics content has been incorporated into each clinical unit of the textbook.
Chapter 17, End-of-Life Care, also new to the tenth edition, ad- dresses some of the questions posed by technologies that can pro- long life, often in the face of insurmountable obstacles. The chapter discusses the nurse’s role as it pertains to quality of life, prolonga- tion of dying, pain relief, allocation of resources, ethical issues, communication, healing, spirituality, and patient and family care. It emphasizes the pivotal role of the nurse in providing end-of-life care.
A third new chapter—Chapter 72, Terrorism, Mass Casualty, and Disaster Nursing—completes the text by reviewing the nurse’s role in relation to patients affected by terrorism and other disasters. Among the issues addressed are emergency preparedness and plan- ning, triage in cases of mass casualty, radiation, chemical and bio- logic weapons, ethical conflict, stress management, and survival.
NANDA, NIC, NOC: LINKS, LANGUAGES, AND CONCEPT MAPS Although Brunner & Suddarth’s Textbook of Medical-Surgical Nursing has long used nursing diagnoses developed by the North American Nursing Diagnosis Association (NANDA), this edition presents the links between the NANDA diagnoses and the Nurs- ing Interventions Classification (NIC) and Nursing-sensitive Out- comes Classification (NOC). The opening page of each unit presents a concept map illustrating these three classification sys- tems and their relationships. Each unit’s concept map is accom- panied by a case study and a chart presenting examples of actual NANDA, NIC, and NOC terminologies related to the case study. This material is included to introduce the reader to the NIC and NOC language and classifications and bring them to life in the clinical realm. Faculty and students alike may use some of the issues presented in the case studies as a springboard for develop- ing their own concept maps.
RECENT NURSING RESEARCH AND OTHER FEATURES As before, Nursing Research Profiles included in the chapters identify the implications…