Essentials for Nursing Practice

Get a solid foundation in essential nursing principles, concepts, and skills! Essentials for Nursing Practice, 9th Edition combines everything you need from your fundamentals course and streamlines it into a format that’s perfect for busy nursing students. The ninth edition retains many classic features, including chapter case studies, procedural guidelines, and special considerations for various age groups, along with new content including a chapter on Complementary and Alternative Therapies , interactive clinical case studies on Evolve, a new Reflective Learning section, and QSEN activities to encourage active learning. Thoroughly reviewed by nursing clinical experts and educators, this new edition ensures you learn nursing Essentials with the most accurate, up-to-date, and easy-to-understand book on the market. Progressive case studies are introduced at the beginning of the chapter and are then used to tie together the care plan, concept map, and clinical decision-making exercises. Focused Patient Assessment tables include actual questions to help you learn how to effectively phrase questions to patients as well as target physical assessment techniques. Nursing skills at the end of each chapter feature full-bleed coloring on the edge of the page to make them easy to locate. Safety guidelines for nursing skills sections precede each skills section to help you focus on safe and effective skills performance. Detailed care plans in the text and on Evolve demonstrate the application of the 5-step nursing process to individual patient problems to help you understand how a plan is developed and how to evaluate care. Unexpected outcomes and related interventions for skills alert you to possible problems and appropriate nursing action. Patient Teaching boxes help you plan effective teaching by first identifying an outcome, then developing strategies on how to teach, and finally, implementing measures to evaluate learning. Care of the Older Adult boxes highlight key aspects of nursing assessment and care for this growing population. Key points neatly summarize the most important content for each chapter to help you review and evaluate learning. Evidence-Based Practice boxes include a PICO question, summary of the results of a research study, and a F description of how the study has affected nursing practice ― in every chapter. Patient-Centered Care boxes address racial and ethnic diversity along with the cultural differences that impact socioeconomic status, values, geography, and religion. 65 Skills and procedural guidelines provide clear, step-by-step instructions for providing safe nursing care. 5-step nursing process provides a consistent framework for clinical chapters. Concept maps visually demonstrate planning care for patients with multiple diagnoses. NOC outcomes, NIC interventions, and NANDA diagnoses are incorporated in care plans to reflect the standard used by institutions nationwide. NEW! Chapter on Complementary, Alternative, and Integrative Therapies addresses new content now included on the NCLEX® exam. NEW! Clinical case studies guide you through creation of care plans and foster clinical thinking. NEW! UNIQUE! Reflective Learning section helps you better understand and reflect on your clinical and simulation experiences as you move through your first nursing course NEW! QSEN activities woven throughout help you process what you’ve learned and develop an eye for safety NEW! Updated standards and evidence throughout includes the newest INS and WOCN standards and mean you’ll be delivering the best care possible Front Cover Inside Front Cover Brief contents Essentials for Nursing Practice Copyright Page Contributors Dedication Preface to the Instructor Features New to This Edition Learning Supplements for Students Teaching Supplements for Instructors Multimedia Supplements for Instructors and Students Acknowledgments Table Of Contents Unit 1 Concepts in Nursing 1 Professional Nursing Objectives Key Terms Media Resources Case Study: Lucas Introduction History of Nursing Florence Nightingale The Civil War to the Beginning of the Twentieth Century Twentieth Century Twenty-First Century Influences on Nursing Health Care Reform and Costs Demographic Changes Medically Underserved Population Need for Emergency Preparedness Workplace Issues Nursing Shortage Professionalism Licensed Practical Nurse/Licensed Vocational Nurse Education Registered Nurse Education Advanced Education Continuing and In-Service Education Theory Service Autonomy and Accountability Code of Ethics Developing Professionalism in Your Career Nursing Practice Nurse Practice Acts Licensure and Certification Licensure. Certification. Standards of Nursing Practice Responsibilities and Roles of the Nurse Caregiver Advocate Educator Communicator Leader Manager Career Development Advanced Practice Registered Nurse. Clinical Nurse Specialist. Nurse Practitioner. Certified Nurse-Midwife. Certified Registered Nurse Anesthetist. Nurse Educator. Nurse Administrator. Nurse Researcher. Professional Nursing Organizations Trends in Nursing Quality and Safety Education for Nurses Emerging Technologies Genomics Public Perception of Nursing Effect of Nursing on Politics and Health Policy Key Points Reflective Learning Review Questions References 2 Health and Wellness Objectives Key Terms Media Resources Case Study: Charlie Introduction Definition of Health Models of Health and Illness Health Belief Model Health Promotion Model Basic Human Needs Model Holistic Health Model Healthy People Documents Variables Influencing Health Beliefs and Health Practices Internal Variables Developmental Stage. Intellectual Background. Emotional Factors. Spiritual Factors. External Variables Family Role and Practices. Socioeconomic Factors. Health Promotion, Wellness, and Illness Prevention Three Levels of Prevention Risk Factors Nonmodifiable Risk Factors. Modifiable Risk Factors. Environment. Risk Factor Identification. Changing Health Behaviors. Illness Acute and Chronic Illness Self-Management Variables Influencing Illness Behavior Internal Variables. External Variables. Impact of Illness on Patient and Family Behavioral and Emotional Changes Impact on Body Image Impact on Self-Concept Impact on Family Roles and Family Dynamics The Nurse’s Role in Health and Illness Key Points Reflective Learning Review Questions References 3 The Health Care Delivery System Objectives Key Terms Media Resources Case Study: Dorinda Cardei Traditional Levels of Health Care Integrated Health Care Delivery Preventive and Primary Health Care Services Secondary and Tertiary Care Hospitals. Discharge Planning. Intensive Care. Mental Health Facilities. Rural Hospitals. Restorative Care Home Care. Rehabilitation. Continuing Care Nursing Centers. Assisted Living. Respite Care. Adult Day Care Centers. Hospice. Health Care Costs and Quality Patient Satisfaction Issues in Health Care Delivery for Nursing Nursing Shortage Patient-Centered Care Magnet Recognition Program Technology in Health Care Health Care Disparities Key Points Reflective Learning Review Questions References 4 Community-Based Nursing Practice Objectives Key Terms Media Resources Case Study: Homeless in the Community Introduction Achieving Healthy Populations and Communities Public Health Nursing Community Health Nursing Nursing Practice in Community Health Community-Based Nursing Vulnerable Populations Immigrant Populations. Poor and Homeless People. People With Mental Illness. Older Adults. Competency in Community- Based Nursing Caregiver Case Manager Educator Epidemiologist Community Assessment Changing Patients’ Health Key Points Reflective Learning Review Questions References 5 Legal Principles in Nursing Objectives Key Terms Media Resources Case Study: Lynette Donovan Introduction Legal Limits of Nursing Sources of Law Criminal Law Torts Standards of Care Malpractice Insurance Documentation Risk Management and Quality Improvement Good Samaritan Laws Consent Restraints Death and Dying Advance Directives Organ and Tissue Donation Autopsies Confidentiality and Privacy Confidentiality and Social Media Other Legal Issues in Nursing Practice Health Care Provider Orders Nursing Students Patient Abandonment and Assignment Issues Controlled Substances Reporting Obligations Key Points Reflective Learning Review Questions References Statutes Cases 6 Ethics Objectives Key Terms Media Resources Case Study Ethics Basic Definitions Ethical Principles Codes of Ethics Developing a Personal Point of View Ethical Theory Deontology Utilitarianism Virtue Ethics Feminist Ethics Ethics of Care Casuistry How to Process an Ethical Dilemma Ethical Issues in Nursing Care at the End of Life Disability and Difference Social Media Conclusion Key Points Reflective Learning Review Questions References 7 Evidence-Based Practice Objectives Key Terms Evolve Media Resources Case Study: Cathy and Tom Introduction A Case for Evidence-Based Practice Evidence-Based Practice Steps Cultivate a Spirit of Inquiry Ask the Clinical Question in PICOT Format Search for the Best Evidence Critically Appraise the Evidence Integrate the Best Evidence Evaluate the Outcomes of the Practice Decision or Change Outcomes Measurement Process Measurement Communicate the Outcomes of the Evidence-Based Practice Decision Sustain Knowledge Use Nursing Research Quality Improvement and Performance Improvement Quality Improvement/Performance Improvement Programs Relationship Between Evidence-Based Practice, Research, and Quality Improvement Key Points Reflective Learning Review Questions References Unit 2 Processes in Nursing Care 8 Critical Thinking Objectives Key Terms Media Resources Case Study: William Myers Introduction Clinical Judgment in Nursing Practice Critical Thinking Defined Reflection Knowing the Patient Levels of Critical Thinking in Nursing Basic Critical Thinking Complex Critical Thinking Commitment Critical Thinking Competencies General Critical Thinking Competencies Scientific Method. Problem Solving. Decision Making. Specific Critical Thinking Competencies Diagnostic Reasoning and Inference. Clinical Decision Making. The Nursing Process as a Competency Critical Thinking Model Competence Specific Knowledge Base Experience Attitudes for Critical Thinking Confidence. Thinking Independently. Fairness. Responsibility and Accountability. Risk Taking. Discipline. Perseverance. Creativity. Curiosity. Integrity. Humility. Standards for Critical Thinking Intellectual Standards. Professional Standards. Developing Critical Thinking Skills Critical Thinking Synthesis Key Points Reflective Learning Review Questions References 9 Nursing Process Objectives Key Terms Media Resources Case Study: Mrs. Tillman Introduction Assessment Data Collection Types of Data. Sources of Data. Patient. Family and Significant Others. Health Care Team. Medical Records. Other Records and the Scientific Literature. Nurse’s Experience. Methods of Data Collection. Patient-Centered Interview. Orientation Phase Including Setting an Agenda. Working Phase—Collecting Assessment or Nursing Health History. Termination Phase—Ending the Interview. Interview Techniques. Observation. Physical Examination. Diagnostic and Laboratory Data. Cultural Considerations in Assessment Interpreting and Validating Assessment Data Data Documentation and Communication Nursing Diagnosis Critical Thinking and the Nursing Diagnostic Process Formulating the Nursing Diagnosis Types of Nursing Diagnoses. Components of a Nursing Diagnosis. Diagnostic Label. Related Factor. Definition. PES Format. Cultural Relevance of Nursing Diagnoses. Concept Mapping Nursing Diagnoses. Sources of Diagnostic Errors. Errors in Data Collection. Errors in Interpretation and Analysis of Data. Errors in Data Clustering. Errors in the Diagnostic Statement. Documentation and Informatics Planning Establishing Priorities Critical Thinking in Setting Goals and Expected Outcomes Goals of Care. Role of the Patient in Goal Setting. Expected Outcomes. Nursing Outcomes Classification. Guidelines for Writing Goals and Expected Outcomes. Critical Thinking in Planning Nursing Care Types of Interventions. Selection of Interventions. Nursing Interventions Classification. Systems for Planning Nursing Care Hand-Off Reporting. Student Care Plans. Concept Mapping. Consulting Other Health Care Professionals When to Consult. How to Consult. Implementation Standard Nursing Interventions Clinical Practice Guidelines and Protocols. Nursing Intervention Classification Interventions. Critical Thinking in Implementation Implementation Process Reassessing the Patient. Reviewing and Revising the Care Plan. Organizing Resources and Delivering Care. Time Management. Equipment. Personnel. Environment. Patient. Anticipating and Preventing Complications. Identifying Areas of Assistance. Implementation Skills. Cognitive Skills. Interpersonal Skills. Psychomotor Skills. Direct Care Activities of Daily Living. Instrumental Activities of Daily Living. Physical Care Techniques. Lifesaving Measures. Counseling. Teaching. Controlling for Adverse Reactions. Preventive Measures. Indirect Care Communicating Nursing Interventions. Delegating, Supervising, and Evaluating Work of Other Staff Members. Evaluation Critical Thinking and Evaluation Evaluation Process Comparing Achieved Effect With Goals and Outcomes. Collecting Data. Interpreting and Summarizing Findings. Recognizing Errors or Unmet Outcomes. Revising the Care Plan. Discontinuing a Care Plan. Modifying a Care Plan. Key Points Reflective Learning Review Questions References 10 Informatics and Documentation Objectives Key Terms Media Resources Case Study: Mr. Roland Health Care Informatics Health Care Information System Clinical Information System Nursing Information Systems Clinical Decision Support Systems Confidentiality of Medical Record and Patient Information Security Mechanisms for Privacy and Confidentiality Handling and Disposal of Health Care Information Interprofessional Communication Within the Health Care Team Purposes of Records Communication Legal Record of Patient Care Health Care Reimbursement Quality Improvement Research Nursing Education Guidelines and Standards for Quality Nursing Documentation Factual Accurate Current Organized Complete Methods of Documentation The Shift to Electronic Documentation Problem-Oriented Medical Record Database. Problem List. Care Plan. Progress Notes. Narrative Documentation Charting by Exception Case Management and Critical Pathways Common Record-Keeping Forms Nursing Admission History Flow Sheets and Graphic Records Patient Care Summary Standardized Care Plans Discharge Summary Forms Acuity Rating Systems Documentation in Home Care Settings Documentation in Long-Term Care Settings Reporting Hand-Off Report Change-of-Shift Report Transfer Reports Documentation of Telephone Reports, Telephone Orders, and Verbal Orders Telephone Reports. Telephone Orders and Verbal Orders. Incident or Occurrence Reports Key Points Reflective Learning Review Questions References 11 Communication Objectives Key Terms Media Resources Case Study: Elmer “Bud” Johnson Introduction The Power of Communication Basic Elements of the Communication Process Levels of Communication Forms of Communication Verbal Communication Vocabulary. Denotative and Connotative Meaning. Pacing. Intonation and Volume. Clarity and Brevity. Timing and Relevance. Nonverbal Communication Personal Appearance. Posture and Gait. Facial Expression. Eye Contact. Gestures. Territoriality and Space. Factors Influencing Communication Health Literacy The Nurse-Patient Relationship AIDET. Nurse–Health Team Member Relationships Reporting. Teamwork. Effects of Stress. Communication Within Caring Relationships Establishing a Therapeutic Relationship Professionalism. Courtesy. Avoid Terms of Endearment and Excessive Socializing. Confidentiality. Trust. Acceptance and Respect. Presence. Communication Within the Nursing Process Assessment Physical and Emotional Factors. Developmental Factors. Older Adult Considerations. Sociocultural Factors. Language. Gender. Nursing Diagnosis Planning Goals and Outcomes. Setting Priorities. Collaborative Care. Implementation Therapeutic Communication Techniques. Conveying Empathy. Active Listening. Sharing Observations. Using Silence. Providing Information. Clarifying. Focusing. Paraphrasing. Summarizing. Self-Disclosure. Instilling Hope. Nontherapeutic Communication Techniques. Inattentive Listening. Overusing Medical Vocabulary. Prying or Asking Personal Questions. Giving Approval or Disapproval. Changing the Subject. Automatic Responses. False Reassurance. Asking for Explanations. Arguing. Being Defensive. Sympathy. Decision Making and Communication. Assertiveness and Autonomy. Avoiding Passive Responses. Avoiding Aggressive Responses. Humor. Responding to Aggressive Behavior. Touch. Communicating With Patients With Special Needs. Providing Alternative Communication Methods. Communicating With Children. Communicating With Older Adults. Evaluation Patient Outcomes. Patient Expectations. Key Points Reflective Learning Review Questions References 12 Patient Education Objectives Key Terms Media Resources Case Study: Latinka Drusko Standards for Patient Education Purposes of Patient Education Maintenance and Promotion of Health and Illness Prevention Restoration of Health Coping With Impaired Functioning Teaching and Learning Role of a Nurse in Teaching and Learning Domains of Learning Basic Learning Principles Motivation to Learn Readiness to Learn Ability to Learn Developmental Capability Age-Group Physical Capability Learning Environment Integrating Nursing and Teaching Processes Assessment Ability to Learn. Patient Expectations. Motivation to Learn. Teaching Environment. Learning Styles. Resources for Learning. Language and Cultural Factors. Health Literacy. Special Needs of Children. Middle Age Considerations. Older Adult Considerations. Nursing Diagnosis Planning Goals and Outcomes. Setting Priorities. Timing. Organizing Teaching Material. Collaborative Care. Implementation Teaching Approaches. Telling. Participating. Entrusting. Reinforcing. Incorporating Teaching With Nursing Care. Teaching Methods. One-on-One Discussion. Group Instruction. Preparatory Instruction. Demonstrations. Analogies. Role Play. Simulation. Use of Technology. Maintaining Attention and Participation. Illiteracy and Other Disabilities. Cultural Awareness. Evaluation Patient Outcomes. Patient Expectations. Documentation of Patient Teaching Key Points Reflective Learning Review Questions References 13 Managing Patient Care Objectives Key Terms Media Resources Case Study: Jennifer Introduction Building a Nursing Team Nursing Care Delivery Models Decision Making Staff Involvement Leadership Skills for Nursing Students Clinical Care Coordination Clinical Decisions. Organizational Skills. Priority Setting. Use of Resources. Time Management. Evaluation. Team Communication Delegation Key Points Reflective Learning Review Questions References Unit 3 Nursing Practice Foundations 14 Infection Prevention and Control Objectives Key Terms Media Resources Case Study: Mrs. Eldredge Introduction Scientific Knowledge Base Nature of Infection Chain of Infection Infectious Agent. Reservoir. Portal of Exit. Modes of Transmission. Portal of Entry. Susceptible Host. Course of Infection Defenses Against Infection Normal Flora. Body System Defenses. Inflammation. Immune Response. Health Care–Acquired Infection Asepsis. Nursing Knowledge Base Critical Thinking Synthesis Knowledge. Experience. Attitudes. Standards. Nursing Process Assessment Nursing History. Medical History. Diet History. Laboratory Data. Psychosocial Factors. Older Adult Considerations. Patient Expectations. Nursing Diagnosis Planning Goals and Outcomes. Setting Priorities. Collaborative Care. Implementation Health Promotion. Nutrition. Hygiene. Immunization. Adequate Rest and Regular Exercise. Acute Care. Medical Asepsis. Control or Elimination of Infectious Agents. Cleaning. Disinfection and Sterilization. Control or Elimination of Reservoirs. Control of Portals of Exit. Control of Transmission. Hand Hygiene. Isolation and Barrier Protection. Protective Environment. Personal Protective Equipment. Specimen Collection. Bagging. Removal of Protective Equipment. Transporting Patients. Control of Portals of Entry. Protection of the Susceptible Host. Role of the Infection Prevention and Control Department. Health Promotion in Health Care Workers and Patients. Surgical Asepsis. Preparation for Sterile Procedures. Principles of Surgical Asepsis. Restorative and Continuing Care. Evaluation Patient Outcomes. Patient Expectations. Key Points Reflective Learning Review Questions References 15 Vital Signs Objectives Key Terms Media Resources Case Study Ms. Coburn Guidelines for Measuring Vital Signs Body Temperature Body Temperature Regulation Neural and Vascular Control. Heat Production. Heat Loss. Skin in Temperature Regulation. Behavioral Control. Considerations for Older Adults. Temperature Alterations Fever. Hyperthermia. Hypothermia. Measurement of Temperature Sites. Thermometers. Electronic Thermometers. Chemical Thermometers. Pulse Locating a Peripheral Pulse Using a Stethoscope Assessment of Pulse Pulse Rate. Pulse Rhythm. Strength and Equality. Blood Pressure Physiology of Arterial Blood Pressure Blood Pressure Variations Hypertension. Hypotension. Measurement of Blood Pressure Blood Pressure Equipment. Auscultation. Ultrasonic Stethoscope. Palpation. Electronic Blood Pressure Machines. Blood Pressure Assessment in Lower Extremities. Assessment of Blood Pressure in Children. Respiration Assessment of Ventilation Measurement of Respiration Respiratory Rate. Ventilatory Depth. Ventilatory Rhythm. Measurement of Oxygen Saturation (Pulse Oximetry) Measurement of End-Tidal Carbon Dioxide Special Considerations Documenting Vital Signs Safety Guidelines for Nursing Skills Skill 15.1 Measuring Body Temperature Delegation Considerations Equipment Step/ Rationale Recording and Reporting Unexpected Outcomes and Related Interventions Skill 15.2 Assessing Radial and Apical Pulses Delegation Considerations Equipment Step/ Rationale Recording and Reporting Unexpected Outcomes and Related Interventions Skill 15.3 Blood Pressure Measurement Delegation Considerations Equipment Step/ Rationale Recording and Reporting Unexpected Outcomes and Related Interventions Skill 15.4 Assessing Respiration Delegation Considerations Equipment Step/ Rationale Recording and Reporting Unexpected Outcomes and Related Interventions Skill 15.5 Measuring Oxygen Saturation (Pulse Oximetry) Delegation Considerations Equipment Step/ Rationale Recording and Reporting Unexpected Outcomes and Related Interventions Key Points Reflective Learning Review Questions References 16 Health Assessment and Physical Examination Objectives Key Terms Media Resources Case Study: Mr. Neal Introduction Purposes of Health Assessment and Physical Examination Cultural Sensitivity Integration of Physical Assessment With Nursing Care Skills of Physical Examination Inspection Palpation Percussion Auscultation Olfaction Preparation for Examination Environment Equipment Physical Preparation of a Patient Positioning. Psychological Preparation of a Patient Assessment of Different Age-Groups Organization of the Examination General Survey General Appearance and Behavior Vital Signs Height and Weight Skin, Hair, and Nails Skin Nursing History. Color. Moisture. Temperature. Texture. Turgor. Vascularity. Edema. Lesions. Hair and Scalp Nursing History. Nails Nursing History. Head and Neck Head Nursing History. Eyes Nursing History. Visual Acuity. Visual Fields. External Eye Structures. Position and Alignment. Eyebrows. Eyelids. Lacrimal Apparatus. Conjunctivae and Sclerae. Corneas. Pupils and Irises. Internal Eye Structures. Ears Nursing History. Auricles. Ear Canals and Eardrums. Hearing Acuity. Nose and Sinuses Nursing History. Nose. Sinuses. Mouth and Pharynx Nursing History. Lips. Buccal Mucosa, Gums, and Teeth. Tongue and Floor of Mouth. Palate. Pharynx. Neck Nursing History. Neck Muscles. Lymph Nodes. Thyroid Gland. Carotid Artery and Jugular Vein. Trachea. Thorax and Lungs Nursing History Posterior Thorax Lateral Thorax Anterior Thorax Heart Nursing History Inspection and Palpation Auscultation Vascular System Health History Carotid Arteries Jugular Veins Peripheral Arteries and Veins Peripheral Arteries. Ultrasound Stethoscopes. Tissue Perfusion. Peripheral Veins. Lymphatic System Breasts Female Breasts Nursing History. Inspection. Palpation. Male Breasts Abdomen Nursing History Inspection Skin. Umbilicus. Contour and Symmetry. Enlarged Organs or Masses. Movement or Pulsations. Auscultation Bowel Motility. Vascular Sounds. Palpation Aortic Pulsation. Female Genitalia and Reproductive Tract Nursing History Preparation of the Patient External Genitalia Speculum Examination of Internal Genitalia Male Genitalia Nursing History Sexual Maturity Penis Scrotum Inguinal Ring and Canal Rectum and Anus Nursing History Inspection Digital Palpation Musculoskeletal System Nursing History General Inspection Palpation Range of Joint Motion Muscle Tone and Strength Neurological System Nursing History Mental and Emotional Status Level of Consciousness Behavior and Appearance Language Intellectual Function Memory. Knowledge. Abstract Thinking. Judgment. Cranial Nerve Function Sensory Function Motor Function Coordination. Balance. Reflexes. After the Examination Key Points Reflective Learning Review Questions References 17 Medication Administration Objectives Key Terms Media Resources Case Study: Esther Simmons Scientific Knowledge Base Medication Legislation and Standards Federal Regulations. State and Local Regulation of Medication. Health Care Agencies and Medication Laws. Medication Regulations and Nursing Practice. Nontherapeutic Medication Use Pharmacological Concepts Medication Names. Classification. Medication Forms. Pharmacokinetics as the Basis of Medication Actions Absorption. Route of Administration. Ability of a Medication to Dissolve. Blood Flow to the Site of Administration. Body Surface Area. Lipid Solubility. Distribution. Circulation. Membrane Permeability. Protein Binding. Metabolism. Excretion. Types of Medication Action Therapeutic Effects. Adverse Drug Effects. Side Effects. Toxic Effects. Idiosyncratic Reactions. Allergic Reactions. Medication Tolerance and Dependence. Medication Interactions. Medication Dose Responses Routes of Administration Oral Routes. Sublingual Administration. Buccal Administration. Parenteral Routes. Topical Administration. Inhalation Route. Intraocular Route. Systems of Medication Measurement Metric System. Household Measurements. Solutions. Nursing Knowledge Base Clinical Calculations Conversions Within One System. Conversion Between Systems. Dosage Calculations. The Ratio and Proportion Method. The Formula Method. Dimensional Analysis. Pediatric Calculations. Administering Medications Health Care Provider’s Role. Types of Orders in Acute Care Agencies. Standing Orders. prn Orders. Single (One-Time) Orders. STAT Orders. NOW Orders. Prescriptions. Pharmacist’s Role. Distribution Systems. Unit Dose. Automated Medication Dispensing Systems. Nurse’s Role. Medication Errors Critical Thinking Synthesis Knowledge. Experience. Attitudes. Standards. Right Medication. Right Dose. Right Patient. Right Route. Right Time. Right Documentation. Maintaining Patients’ Rights. Nursing Process Assessment History. Allergies. Medication History. Diet History. Physical Examination. Patient’s Health Literacy Level. Patient’s Current Condition. Patient’s Attitude About Medication Use. Older Adult Considerations. Patient’s Knowledge and Understanding of Medication Therapy. Patient Expectations. Nursing Diagnosis Planning Goals and Outcomes. Setting Priorities. Collaborative Care. Implementation Health Promotion. Patient Education and Behavioral Support. Acute Care. Receiving, Transcribing, and Communicating Medication Orders. Accurate Dosage Calculation and Measurement. Correct Administration. Avoidance of Distractions. Recording Medication Administration. Restorative and Continuing Care. Special Considerations for Administering Medications to Specific Age-Groups. Infants and Children. Older Adults. Polypharmacy. Evaluation Patient Outcomes. Patient Expectations. Oral Administration Topical Medication Applications Skin Applications Mucous Membrane Applications Nasal Instillation. Eye Instillation. Ear Instillation. Vaginal Instillation. Rectal Instillation. Administering Medications by Inhalation Administering Medications by Irrigations Parenteral Administration of Medications Equipment Syringes. Needles. Disposable Injection Units. Preparing an Injection From an Ampule Preparing an Injection From a Vial Mixing Medications Mixing Medications From a Vial and an Ampule. Mixing Medications From Two Vials. Insulin Preparation Administering Injections Subcutaneous Injections. Intramuscular Injections. Injection Sites. Ventrogluteal Muscle. Vastus Lateralis Muscle. Deltoid Muscle. Intradermal Injections. Safety in Administering Medications by Injection Needleless Devices. Intravenous Administration. Large-Volume Infusions. Intravenous Bolus. Volume-Controlled Infusions. Intermittent Venous Access. Administration of Intravenous Therapy in the Home. Safety Guidelines for Nursing Skills Skill 17.1 Administering Oral Medications Delegation Considerations Equipment Step/ Rationale Recording and Reporting Unexpected Outcomes and Related Interventions Skill 17.2 Administering Eye (Ophthalmic) Medications Delegation and Collaboration Equipment Eyedrops/Ointment Only Step/ Rationale Recording and Reporting Unexpected Outcomes and Related Interventions Skill 17.3 Using Metered-Dose or Dry Powder Inhalers Delegation and Collaboration Equipment Step/ Rationale Recording and Reporting Unexpected Outcomes and Related Interventions Skill 17.4 Preparing Injections From Vials and Ampules Delegation Considerations Equipment Medication in an Ampule Medication in a Vial Both Step/ Rationale Unexpected Outcomes and Related Interventions Skill 17.5 Administering Injections Delegation and Collaboration Equipment Step/ Rationale Recording and Reporting Unexpected Outcomes and Related Interventions Skill 17.6 Administering Medications by Intravenous Bolus Delegation Considerations Equipment Step/ Rationale Recording and Reporting Unexpected Outcomes and Related Interventions Skill 17.7 Administering Intravenous Medications by Piggyback, Intermittent Infusion Sets, and Mini-Infusion Pumps Delegation and Collaboration Equipment Piggyback or Mini-Infusion Pump Volume-Control Administration Set Step/ Rationale Recording and Reporting Unexpected Outcomes and Related Interventions Key Points Reflective Learning Review Questions References 18 Fluid, Electrolyte, and Acid-Base Balances Objectives Key Terms Media Resources Case Study: Mrs. Reynolds Introduction Scientific Knowledge Base Distribution of Body Fluids Composition of Body Fluids Movement of Water and Electrolytes Fluid Balance. Fluid Intake. Fluid Distribution. Fluid Output. Antidiuretic Hormone. Aldosterone. Atrial Natriuretic Peptide. Electrolyte Balance. Sodium Regulation. Potassium Balance. Calcium Balance. Magnesium Balance. Chloride Regulation. Bicarbonate Regulation. Phosphate Balance. Acid-Base Balance. Acid Production. Acid Buffering. Acid Excretion. Disturbances in Fluid, Electrolyte, and Acid-Base Balances Fluid Imbalances. Extracellular Fluid Volume Imbalances. Osmolality Imbalances. Electrolyte Imbalances Potassium Imbalances. Calcium Imbalances. Magnesium Imbalances. Chloride Imbalances. Acid-Base Imbalances. pH. PaCO2. PaO2. SaO2. Base Excess. Bicarbonate. Types of Acid-Base Imbalances. Nursing Knowledge Base Critical Thinking Synthesis Knowledge Experience Attitudes Standards Nursing Process Assessment Nursing History. Age. Older Adult Considerations. Environment. Dietary Intake. Lifestyle. Medications. Medical History. Physical Assessment. Daily Weights and Fluid Intake and Output Measurement. Laboratory Studies. Patient Expectations. Nursing Diagnosis Planning Goals and Outcomes. Setting Priorities. Collaborative Care. Implementation Health Promotion. Acute Care. Enteral Replacement of Fluids. Restriction of Fluids. Parenteral Replacement of Fluids and Electrolytes. Parenteral Nutrition. Intravenous Therapy. Vascular Access Devices. Types of Solutions. Equipment. Initiating Peripheral Intravenous Access. Regulating Infusion Flow Rate. Maintaining the System. Changing IV Fluid Containers, Tubing, and Dressings. Helping Patients Protect IV Integrity. Complications of IV Therapy. Discontinuing Peripheral IV Access. Blood Replacement. Autologous Transfusion. Allogeneic Transfusion. ABO System. Rh System. Transfusion Reactions and Other Adverse Effects. Interventions for Acid-Base Imbalances. Arterial Blood Gas Measurement. Restorative and Continuing Care. Home Intravenous Therapy. Nutritional Support. Medication Safety. Evaluation Patient Outcomes. Patient Expectations. Safety Guidelines for Nursing Skills Skill 18.1 Initiating Intravenous Therapy Delegation Considerations Equipment Step/ Rationale Recording and Reporting Unexpected Outcomes and Related Interventions Skill 18.2 Regulating Intravenous Flow Rate Delegation Considerations Equipment Step/ Rationale Recording and Reporting Unexpected Outcomes and Related Interventions Skill 18.3 Changing Intravenous Solution Essentials for Nursing Practice, Ninth Edition (2019) 1299pp. 978-0-323-48184-7