Table Of ContentCONTENTS
UNIT I FOUNDATIONS OF CRITICAL UNIT V KIDNEY ALTERATIONS
CARE NURSING
25 Kidney Anatomy and Physiology, 681
1 Critical Care Nursing Practice, 1 26 Kidney Clinical Assessment and Diagnostic
2 Ethical Issues, 17 Procedures, 694
3 Legal Issues, 30 27 Kidney Disorders and Therapeutic Management, 707
4 Genetics and Genomics in Critical Care, 48
5 Patient and Family Education, 69 UNIT VI GASTROINTESTINAL
6 Psychosocial and Spiritual Alterations and ALTERATIONS
Management, 88
7 Sleep Alterations and Management, 104 28 Gastrointestinal Anatomy and Physiology, 737
8 Nutrition Alterations and Management, 115 29 Gastrointestinal Clinical Assessment and Diagnostic
9 Pain and Pain Management, 143 Procedures, 750
10 Sedation, Agitation, Delirium: Assessment and 30 Gastrointestinal Disorders and Therapeutic
Management, 170 Management, 763
11 End-of-Life Issues, 182
UNIT VII ENDOCRINE ALTERATIONS
UNIT II CARDIOVASCULAR
31 Endocrine Anatomy and Physiology, 788
ALTERATIONS
32 Endocrine Clinical Assessment and Diagnostic
Procedures, 800
12 Cardiovascular Anatomy and Physiology, 200
33 Endocrine Disorders and Therapeutic Management, 809
13 Cardiovascular Clinical Assessment, 222
14 Cardiovascular Diagnostic Procedures, 237
UNIT VIII MULTISYSTEM
15 Cardiovascular Disorders, 338
ALTERATIONS
16 Cardiovascular Therapeutic Management, 412
34 Trauma, 849
UNIT III PULMONARY 35 Shock, Sepsis, and Multiple Organ Dysfunction
ALTERATIONS Syndrome, 887
36 Burns, 926
17 Pulmonary Anatomy and Physiology, 467 37 Organ Donation and Transplantation, 951
18 Pulmonary Clinical Assessment, 488 38 Hematologic Disorders and Oncologic Emergencies, 997
19 Pulmonary Diagnostic Procedures, 502
20 Pulmonary Disorders, 514
UNIT IX SPECIAL POPULATIONS
21 Pulmonary Therapeutic Management, 549
39 The Obstetric Patient, 1017
40 The Pediatric Patient, 1041
UNIT IV NEUROLOGIC
41 The Older Adult Patient, 1072
ALTERATIONS
42 The Perianesthesia Patient, 1095
22 Neurologic Anatomy and Physiology, 587
23 Neurologic Clinical Assessment and Diagnostic APPENDIXES
Procedures, 620
24 Neurologic Disorders and Therapeutic A Nursing Management Plans of Care, 1119
Management, 646 B Physiologic Formulas for Critical Care, 1163
Critical Care Nursing
Diagnosis and Management
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Critical Care Nursing
seventh editon
Diagnosis and Management
Linda D. Urden, DNSc, RN, CNS, NE-BC, FAAN
Professor and Director
Master’s and International Nursing Programs
University of San Diego
San Diego, California
Kathleen M. Stacy, PhD, RN, CNS, CCRN, PCCN, CCNS
Clinical Nurse Specialist–Pulmonary/Medicine PCU
Palomar Medical Center
Escondido, California;
Clinical Associate Professor
Hahn School of Nursing and Health Science
University of San Diego
San Diego, California
Mary E. Lough, PhD, RN, CNS, CCRN, CNRN, CCNS
Clinical Nurse Specialist–Critical Care
Stanford Hospital and Clinics
Stanford, California;
Clinical Professor
Department of Physiological Nursing
University of California, San Francisco (UCSF)
San Francisco, California
3251 Riverport Lane
St. Louis, Missouri 63043
CRITICAL CARE NURSING: DIAGNOSIS AND MANAGEMENT ISBN: 978-0-323-09178-7
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To Pollyanna and Jasmine
LDU
To nursing students and those who teach them
in the classroom and clinical settings.
To my wonderful husband James
whose presence in my life has brought me an abundance of riches.
KMS
To Angela Mallett and Jim Schrempp
Two people who make the world a better place every day
MEL
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ABOUT THE AUTHORS
Linda D. Urden, DNSc, RN, CNS, NE-BC, FAAN
positions, including staff nurse, clinical educator, outcomes
Linda Urden received her diploma in nursing from Barnes manager, and nurse manager. Currently Kathleen is the Clinical
Hospital School of Nursing, St. Louis, Missouri; her BSN from Nurse Specialist for the Pulmonary/Medicine Progressive Care
Pepperdine University, Malibu, California; her MN, Cardiovas- Unit at Palomar Medical Center. As an advanced practitioner,
cular Clinical Nurse Specialist, from UCLA; and her DNSc from Kathleen collaborates with the health care team to facilitate the
the University of San Diego. She is doubly credentialled as achievement of optimal outcomes for the critically ill patient.
a clinical nurse specialist and in Executive Nursing by the As a consultant, she facilitates change to improve patient care.
American Nurses Credentialing Center and is a Fellow in the As an educator, Kathleen develops and implements programs
American Academy of Nursing. Linda has held a variety of to assist the staff with acquisition of the skills and knowledge
clinical and administrative positions, with accountabilities needed to care for the critically ill patient. As a researcher, she
for quality, evidence-based practice, research, education, and conducts nursing research with a focus on patient safety and
advanced practice. In her various positions she has striven to end-of-life care. Kathleen also holds a faculty position at the
create cultures that are sensitive to differentiated practice and Hahn School of Nursing and Health Science at University of
ensure healthy work environments supporting excellence in San Diego and an adjunct faculty position at San Diego State
nursing practice. In addition to this text, Linda coauthored University School of Nursing. In addition to this text, Kathleen
Priorities in Critical Care Nursing. Other publications are in the coauthored Priorities in Critical Care Nursing.
areas of heart failure, ethics, research, outcomes measurement,
Mary E. Lough, PhD, RN, CNS, CCRN, CNRN, CCNS
management and care delivery redesign, executive decision
support databases, and collaborative practice models, clinical Mary Lough is a critical care nurse with more than 30 years of
nurse practice outcomes, and Magnet environments. In addi- experience as a staff nurse, educator, and Clinical Nurse Special-
tion, she is a member of editorial boards and is a peer reviewer ist. Mary received her BSN from the University of Manchester
for several nursing journals. Her research is focused on clinical, in England and her MS and PhD from the University of Cali-
fiscal, quality, and behavioral outcomes of care delivery and fornia, San Francisco (UCSF). Mary is the Clinical Nurse Spe-
services. cialist for the medical/surgical/neuroscience/trauma ICU at
Stanford Hospital and Clinics in Palo Alto, California. She is
Kathleen M. Stacy, PhD, RN, CNS, CCRN, PCCN,
also a Clinical Professor in the Department of Physiological
CCNS Nursing at her alma mater, UCSF.
Kathleen Stacy has been a nurse for 34 years, the majority of Mary has been involved with all seven editions of Critical
which she has spent working in critical care. She graduated in Care Nursing: Diagnosis and Management, and she also has pub-
1978 with a BS in nursing from the State University of New York lished many other articles and research abstracts. As a clinician,
at Plattsburgh, in 1989 with an MS in critical care nursing from Mary appreciates the benefits of a clinically grounded textbook
San Diego State University, and in 2010 with a PhD in nursing because when she began her career as a critical care nurse so
from University of San Diego. She has held a variety of little information was available.
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