Medical-Surgical Nursing Concepts and Practice 3 EDITION Susan C. deWit, MSN, RN, CNS, PHN Formerly, Instructor of Nursing El Centro College Dallas, Texas Holly K. Stromberg, RN, BSN, MSN, PHN, CCRN Professor of Nursing Allan Hancock College; Staff Nurse/Nurse Educator Marian Medical Center Santa Maria, California Carol Vreeland Dallred, PhD, MSN, RN, WHNP-BC Professor of Nursing Kaplan School of Nursing; Faculty and Advanced Facilitator University of Phoenix; Oncology Clinical Specialist Ashfield Healthcare-Clinical Houston, Texas 2 Table of Contents Cover image Title page Copyright Dedication Selected Student Resources on Evolve General Resources Skills with Skill Performance Checklists Nursing Care Plans Patient Teaching Additional Content Animations Audio Clips Video Clips Contributor Reviewers LPN Advisory Board To the Instructor About the Text Pedagogical Features Organization of the Text LPN Threads For the Instructor For the Student To the Student Reading and Review Tools Chapter Features 3 Acknowledgments Unit I Medical–Surgical Nursing Settings Chapter 1 Caring for Medical-Surgical Patients Caring for Medical-Surgical Patients Roles of the LPN/LVN Employment Opportunities Ethical and Legal Practice Quality and Safety Health Care Today Financing of Health Care Providing Holistic Care Getting Ready for the NCLEX® Examination! Chapter 2 Critical Thinking and the Nursing Process Critical Thinking and Clinical Judgment Applying LPN/LVN Standards in Medical-Surgical Nursing Interdisciplinary (Collaborative) Care Plans Get Ready for the NCLEX® Examination! Unit II Medical–Surgical Patient Care Problems Chapter 3 Fluids, Electrolytes, Acid-Base Balance, and Intravenous Therapy Distribution and Regulation of Body Fluids Fluid Imbalances Osmolality Electrolytes Acid-Base System Acid-Base Imbalances Intravenous Fluid Therapy Community Care Get Ready for the NCLEX® Examination! Chapter 4 Care of Preoperative and Intraoperative Surgical Patients Surgery Technological Advances in Surgery Autologous Blood for Transfusion Bloodless Surgery The Surgical Team The Surgical Suite Anesthesia Potential Intraoperative Complications 4 Get Ready for the NCLEX® Examination! Chapter 5 Care of Postoperative Surgical Patients Immediate Postoperative Care Discharge Planning Community Care Get Ready for the NCLEX® Examination! Chapter 6 Infection Prevention and Control The Infectious Process and Disease The Body's Defense Against Infection Infection Prevention and Control Health Care–Associated Infections Sepsis and Septic Shock Community Care Get Ready for the NCLEX® Examination! Chapter 7 Care of Patients With Pain Theories of Pain Classification of Pain Perception of Pain Acute versus Chronic Pain Management of Pain Community Care Get Ready for the NCLEX® Examination! Chapter 8 Care of Patients With Cancer The Impact of Cancer Physiology of Cancer Classification of Tumors Metastasis Causative Factors Contributing Factors Measures to Prevent Cancer Detection of Cancer Common Therapies, Problems, and Nursing Care Evaluating the Effectiveness of Medical Treatment Common Problems Related to Cancer or Cancer Treatment Care for a Dying Cancer Patient Get Ready for the NCLEX® Examination! Chapter 9 Chronic Illness and Rehabilitation 5 Chronic Illness Rehabilitation Home Care Get Ready for the NCLEX® Examination! Unit III Immune System Chapter 10 The Immune and Lymphatic Systems Anatomy and Physiology of the Immune and Lymphatic Systems Protective Mechanisms of the Immune and Lymphatic Systems Immune and Lymphatic System Disorders Common Problems Related to the Immune and Lymphatic Systems Get Ready for the NCLEX® Examination! Chapter 11 Care of Patients With Immune and Lymphatic Disorders Immune Function and Dysfunction Immune Deficiency Disorders Therapeutic Immunosuppression Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome Human Immunodeficiency Virus Risk in Patients Older than 50 Years Community Education and Care Autoimmune Disorders Disorders of the Lymphatic System Disorders of Inappropriate Immune Response Get Ready for the NCLEX® Examination! Unit IV Respiratory System Chapter 12 The Respiratory System Overview of Anatomy and Physiology of the Respiratory System Causes of Respiratory Disorders Respiratory Disorders Common Respiratory Patient Care Problems Get Ready for the NCLEX® Examination! Chapter 13 Care of Patients With Disorders of the Upper Respiratory System Disorders of the Nose and Sinuses Obstruction and Trauma Community Care Get Ready for the NCLEX® Examination! Chapter 14 Care of Patients With Disorders of the Lower Respiratory System Respiratory Infectious Diseases 6 Restrictive Pulmonary Disorders Obstructive Pulmonary Disorders Pulmonary Vascular Disorders Chest Injuries Lung Disorders Common Therapeutic Measures Community Care Get Ready for the NCLEX® Examination! Unit V Hematologic System Chapter 15 The Hematologic System Overview of Anatomy and Physiology of the Hematologic System Causes of Hematologic Disorders Prevention of Hematologic Disorders Diagnostic Tests and Procedures Common Problems Related to Disorders of the Hematologic System Get Ready for the NCLEX® Examination! Chapter 16 Care of Patients With Hematologic Disorders Disorders of the Hematologic System Therapies Frequently Used in the Management of Hematologic Disorders Community Care Get Ready for the NCLEX® Examination! Unit VI Cardiovascular System Chapter 17 The Cardiovascular System Overview of Anatomy and Physiology of the Cardiovascular System Cardiovascular Disease Common Problems of Patients With Cardiovascular Disorders Get Ready for the NCLEX® Examination! Chapter 18 Care of Patients With Hypertension and Peripheral Vascular Disease Hypertension Arteriosclerosis and Atherosclerosis Peripheral Vascular Disease Venous Disorders Community Care Get Ready for the NCLEX® Examination! Chapter 19 Care of Patients With Cardiac Disorders Disorders of the Heart 7 Inflammatory and Infectious Diseases of the Heart Cardiac Valve Disorders Common Therapies and Their Nursing Implications Community Care Get Ready for the NCLEX® Examination! Chapter 20 Care of Patients With Coronary Artery Disease and Cardiac Surgery Coronary Artery Disease Surgical and Nonsurgical Treatment Options Community Care Get Ready for the NCLEX® Examination! UNIT VII Neurologic System Chapter 21 The Neurologic System* Anatomy and Physiology of the Neurologic System Causative Factors Involved in Neurologic Disorders Prevention of Neurologic Disorders Evaluation of Neurologic Status Common Neurologic Patient Care Problems Get Ready for the NCLEX® Examination! Chapter 22 Care of Patients With Head and Spinal Cord Injuries Traumatic Brain (Head) Injuries Increased Intracranial Pressure Injuries of the Spine and Spinal Cord Back Pain and Ruptured Intervertebral Disk (“Slipped Disk”) Get Ready for the NCLEX® Examination! Chapter 23 Care of Patients With Brain Disorders Seizure Disorders and Epilepsy Transient Ischemic Attack Cerebrovascular Accident (Stroke, Brain Attack) Brain Tumor Infectious and Inflammatory Disorders of the Nervous System Headaches Cranial Nerve Disorders Get Ready for the NCLEX® Examination! Chapter 24 Care of Patients With Peripheral Nerve and Degenerative Neurologic Disorders Parkinson Disease Multiple Sclerosis Alzheimer Disease 8 Amyotrophic Lateral Sclerosis Guillain-Barré Syndrome Poliomyelitis and Postpolio Syndrome Huntington Disease Myasthenia Gravis Restless Leg Syndrome Community Care Get Ready for the NCLEX® Examination! Unit VIII Sensory System Chapter 25 The Sensory System: Eye and Ear Anatomy and Physiology of the Eye The Eye Community Care Anatomy and Physiology of the Ear The Ear Community Care Get Ready for the NCLEX® Examination! Chapter 26 Care of Patients With Disorders of the Eyes and Ears Common Disorders of the Eye Nursing Care of Patients Having Eye Surgery Community Care Common Disorders of the Ear Nursing Care of Patients Having Ear Surgery Community Care Get Ready for the NCLEX® Examination! Unit IX Gastrointestinal System Chapter 27 The Gastrointestinal System Anatomy and Physiology of the Gastrointestinal System The Gastrointestinal System Get Ready for the NCLEX® Examination! Chapter 28 Care of Patients With Disorders of the Upper Gastrointestinal System Eating Disorders Upper Gastrointestinal Disorders Common Therapies for Disorders of the Gastrointestinal System Get Ready for the NCLEX® Examination! Chapter 29 Care of Patients With Disorders of the Lower Gastrointestinal System 9 Disorders of the Abdomen and Bowel Ostomy Surgery and Care Anorectal Disorders Community Care Get Ready for the NCLEX® Examination! Chapter 30 Care of Patients With Disorders of the Gallbladder, Liver, and Pancreas Disorders of the Gallbladder Disorders of the Liver Disorders of the Pancreas Community Care Get Ready for the NCLEX® Examination! Unit X Musculoskeletal System Chapter 31 The Musculoskeletal System Anatomy and Physiology of the Musculoskeletal System Musculoskeletal Disorders Get Ready for the NCLEX® Examination! Chapter 32 Care of Patients With Musculoskeletal and Connective Tissue Disorders Connective Tissue Disorders Inflammatory Disorders of the Musculoskeletal System Community Care Get Ready for the NCLEX® Examination! Unit XI Urinary System Chapter 33 The Urinary System Anatomy and Physiology of the Urologic System The Urologic System Common Urologic Problems Get Ready for the NCLEX® Examination! Chapter 34 Care of Patients With Disorders of the Urinary System Inflammatory Disorders of the Urinary Tract Obstructions of the Urinary Tract Urologic System Trauma Urologic System Cancers Renal Failure Community Care Get Ready for the NCLEX® Examination! Unit XII Endocrine System 10