Fundamentals of Nursing Standards & Practice Fourth Edition

116 Pages·2010·4.19 MB·English

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Fundamentals
of Nursing
Standards & Practice
Fourth Edition
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Fundamentals
of Nursing
Standards & Practice
Fourth Edition
Sue C. DeLaune, MN, RN
Assistant Professor
RN-BSN Coordinator
William Carey University
School of Nursing
New Orleans, Louisiana
President and Education Director
SDeLaune Consulting
Mandeville, Louisiana
Patricia K. Ladner, RN, MS, MN
Former Consultant for Nursing Practice
Louisiana State Board of Nursing
New Orleans, Louisiana
Australia (cid:129) Brazil (cid:129) Japan (cid:129) Korea (cid:129) Mexico (cid:129) Singapore (cid:129) Spain (cid:129) United Kingdom (cid:129) United States
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FundamentalsofNursing:StandardsandPractice ª2011,2006,2002,1998,Delmar,CengageLearning
FourthEdition
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To Jenniferand RyanCardinal, KatieandJacob Segrave,and Sarabethand JayAccardo.
I especiallywantto thankmyhusband andbestfriend, Jay,forhiscontinuedsupportand
beliefin me.I wantto acknowledgemyfather, GlynnEdwardCarter, forunending
supportandencouragement,especiallyformyacademicendeavors.
-SCD
To Wayne,Kelly,WayneJr., Gretchen,and Michael.
-PKL
Wededicatethisbook to ourgrandchildren:CamilleAnnaCardinal, CarolineAlexa
Cardinal,Leah Marie Ladner, CharlesThomasLee, MichaelandJoshuaLadner, and
Cooperand PaigeLadner.
Youare ourfuture.‘‘G’’and‘‘Mimi’’
Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
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Brief Contents
UNIT 1: Nursing’sPerspective:Past, Present, andFuture
Chapter 1 Evolution of Nursing andNursing Education 3
Chapter 2 Nursing Theory 23
Chapter 3 Research andEvidence-BasedPractice 41
Chapter 4 Health Care Delivery, Quality,andtheContinuumof Care 53
UNIT 2: Nursing Process:TheStandardofCare
Chapter 5 Critical Thinking,Decision Making,andthe NursingProcess 75
Chapter 6 Assessment 89
Chapter 7 Nursing Diagnosis 109
Chapter 8 Planning andOutcome Identification 125
Chapter 9 Implementation 139
Chapter 10 Evaluation 153
UNIT 3: Professional Accountability
Chapter 11 Leadership, Delegation,and Power 165
Chapter 12 Legal andEthical Responsibilities 187
Chapter 13 DocumentationandInformatics 213
UNIT 4: PromotingClientHealth
Chapter 14 Nursing,Healing,and Caring 245
Chapter 15 Communication 261
Chapter 16 Health andWellnessPromotion 281
Chapter 17 FamilyandCommunity Health 297
Chapter 18 TheLifeCycle 309
Chapter 19 TheOlder Client 357
Chapter 20 Cultural Diversity 379
Chapter 21 Client Education 401
UNIT 5: RespondingtoBasic PsychosocialNeeds
Chapter 22 Self-Concept 423
Chapter 23 Stress, Anxiety, Adaptation,and Change 439
Chapter 24 Spirituality 463
Chapter 25 Lossand Grief 475
UNIT 6: RespondingtoBasic Physiological Needs
Chapter 26 Vital Signs 501
Chapter 27 PhysicalAssessment 539
Chapter 28 Diagnostic Testing 601
Chapter 29 Safety, InfectionControl, andHygiene 653
Chapter 30 Medication Administration 749
Chapter 31 Complementaryand Alternative Modalities 833
Chapter 32 Oxygenation 859
Chapter 33 Fluidsand Electrolytes 919
Chapter 34 Nutrition 993
Chapter 35 Comfort andSleep 1043
Chapter 36 Mobility 1087
Chapter 37 SkinIntegrity andWoundHealing 1161
Chapter 38 Sensation,Perception, andCognition 1207
Chapter 39 Elimination 1231
Chapter 40 Nursing Care of thePerioperativeClient 1295
Glossary 1337
References 1363
Index 1383
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TABLE OF
CONTENTS
ListofProcedures/xix DoctoralPrograms.............................. 17
Contributors/xxiii StaffDevelopmentandContinuingEducation ....... 18
Reviewers/xxv PreparingNursesforTomorrow’s
Preface/xxix Challenges ................................. 18
HowtoUseThisText/xxxiii DifferentiatedPractice........................... 19
Acknowledgments/xxxvi AcceleratedDegreePrograms.................... 19
TechnologyChangesinNursingEducation ......... 19
AbouttheAuthors/xxxvii
ServiceLearning ............................... 20
CHAPTER 2
UNIT 1
NURSING THEORY / 23
Nursing’s Perspective: Past,
ComponentsoftheTheoreticalFoundation..... 24
Present, and Future / 1 WhatIsaConcept?............................. 24
WhatIsaProposition? .......................... 24
CHAPTER 1 WhatIsaTheory? .............................. 24
UseofTheoriesfromOtherDisciplines......... 25
EVOLUTION OF NURSING AND NURSING
ImportanceofNursingTheories............... 25
EDUCATION / 3 ScopeofTheories ........................... 26
EvolutionofNursing .......................... 4 GrandTheories ................................ 26
OriginsofNursing ............................... 4 Middle-RangeTheories.......................... 26
ReligiousInfluences.............................. 7 Micro-RangeTheories........................... 26
DemandsofWar ................................ 7 EvolutionofNursingTheory................... 26
FlorenceNightingale(1820–1910) .................. 8 KnowledgeDevelopmentinNursing ........... 28
NursingPioneersandLeaders..................... 9 MetaparadigmofNursing........................ 28
NursingintheTwentiethCentury.................. 11 ParadigmsinNursing ........................... 29
SocialForcesAffectingNursing................... 14 SelectedNursingTheories.................... 30
NursingEducationOverview.................. 15 FlorenceNightingale............................ 30
DiplomaEducation ............................. 15 EarlyNursingTheories .......................... 30
AssociateDegreePrograms...................... 17 ContemporaryNursingTheories .................. 33
BaccalaureatePrograms......................... 17 TheoriesfortheNewWorldviewofNursing ......... 37
Master’sPrograms ............................. 17 ContinuingEvolutionofNursingTheory ........ 38
vii
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viii TABLEOFCONTENTS
CHAPTER 3
UNIT 2
RESEARCH AND EVIDENCE-BASED
Nursing Process: The Standard
PRACTICE / 41
of Care / 73
Research:SubstantiatingtheScienceof
Nursing .................................... 42
CHAPTER 5
HistoricalDevelopment.......................... 42
Framework.................................... 43 CRITICAL THINKING, DECISION
ResearchUtilization............................. 47
MAKING, AND THE NURSING
NursingStudents............................... 47
PROCESS / 75
Evidenced-BasedPractice.................... 48
EvidenceReports............................... 49 CriticalThinking............................. 76
TrendsinResearchandEvidence-BasedPractice.... 50 ComponentsofCriticalThinking .................. 76
DevelopmentofCriticalThinkingSkills............. 77
CriticalThinkingandCreativity.................... 78
CHAPTER 4 CriticalThinkingandProblemSolving.............. 78
CriticalThinkingandDecisionMaking.............. 78
HEALTH CARE DELIVERY, QUALITY,
TheNursingProcess......................... 79
AND THE CONTINUUM OF CARE / 53 HistoricalPerspective........................... 79
HealthCareDelivery:Organizational OverviewoftheNursingProcess.................. 79
Frameworks ................................ 54 Assessment................................... 79
Diagnosis..................................... 81
PublicSector .................................. 54
OutcomeIdentificationandPlanning............... 83
PrivateSector.................................. 55
Implementation ................................ 84
HealthCareTeam ........................... 55
Evaluation..................................... 84
Nurse:RolesandFunctions...................... 55
CriticalThinkingAppliedinNursing............ 85
AdvancedPracticeNurse:RolesandFunctions...... 55
ReimbursementMethods..................... 57
PrivateInsurance............................... 57
CHAPTER 6
ManagedCare................................. 57
GovernmentPlans.............................. 58 ASSESSMENT / 89
FactorsInfluencingtheDeliveryof PurposeofAssessment ...................... 90
HealthCare................................. 59 TypesofAssessment ........................ 90
Cost ......................................... 59 ComprehensiveAssessment ..................... 90
Access ....................................... 60 FocusedAssessment ........................... 90
Quality........................................ 60 OngoingAssessment ........................... 91
NursingSupplyandDemand ..................... 60 DataCollection.............................. 91
ResponsestoHealthCareChanges ........... 60
TypesofData.................................. 91
NursingAgendaforHealthCareReform............ 60 SourcesofData................................ 91
PublicversusPrivatePrograms................... 61 MethodsofDataCollection ...................... 92
VulnerablePopulations.......................... 61 DataVerification ............................ 96
CommunityNursingOrganizations ................ 61
DataOrganization ........................... 97
ContinuumofCare .......................... 62
AssessmentModels ............................ 97
LevelsofCare ................................. 62
DataInterpretation .......................... 98
HealthCareSettings............................ 62
DataDocumentation......................... 98
FragmentationofCare........................... 63
TypesofAssessmentFormats.................... 98
QualityManagementinHealthCare............ 65
DefiningQuality................................ 65
FactorsInfluencingQualityinHealthCare .......... 66 CHAPTER 7
QualityandHealthCareEconomics ............... 67
PrinciplesofQualityImprovement................. 67 NURSING DIAGNOSIS / 109
CustomerSatisfaction........................... 67 WhatIsaNursingDiagnosis? ................ 110
OrganizationalStructureforQuality ComparisonofNursingandMedical
Management................................ 68 Diagnoses.................................... 110
OrganizationalCulture........................... 68 HistoricalPerspective....................... 111
ProcessImprovement........................... 70 Research .................................... 111
Nursing’sRoleinQualityManagement......... 70 PurposesofNursingDiagnoses.............. 111
TrendsinHealthCareDelivery ................ 71 Professionalism............................... 111
Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
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TABLE OF CONTENTS ix
Communication............................... 112 NursingInterventions .......................... 144
Holistic,IndividualizedCare..................... 112 EvaluatingInterventions ........................ 149
NursingDiagnosesandNursingInformatics........ 112 DocumentationofInterventions.................. 149
ComponentsofaNursingDiagnosis.......... 114
TheTwo-PartStatement........................ 115
TheThree-PartStatement....................... 115 CHAPTER 10
CategoriesofNursingDiagnoses............. 115 EVALUATION / 153
TaxonomyofNursingDiagnoses ............. 116
EvaluationofClientCare .................... 154
ClinicalJudgmentinNursing:Developing
ComponentsofEvaluation................... 154
NursingDiagnoses ......................... 116
Techniques................................... 154
GeneratingCues .............................. 117
SourcesofData............................... 155
ValidatingCues ............................... 117
GoalsandExpectedOutcomes.................. 155
InterpretingCues.............................. 117
MethodsofEvaluation ...................... 155
ClusteringCues............................... 118
EstablishingStandards......................... 155
UsingNANDA-ApprovedNursingDiagnoses....... 118
CollectingData................................ 155
WritingtheNursingDiagnosisStatement .......... 118
DeterminingGoalAchievement .................. 155
AvoidingErrorsinDevelopmentandUse
RelatingNursingActionstoClientStatus.......... 155
ofNursingDiagnoses ....................... 118
JudgingtheValueofNursingInterventions......... 155
AssessmentErrors............................. 118
ReassessingtheClient’sStatus.................. 155
DiagnosticErrors.............................. 119
ModifyingthePlanofCare...................... 155
LimitationsofNursingDiagnosis ............. 120
CriticalThinkingandEvaluation.................. 156
OvercomingBarriersandLimitations
EvaluationandQualityofCare ............... 156
toNursingDiagnosis........................ 120
ElementsinEvaluatingtheQualityofCare ......... 156
NursingAudit................................. 158
CHAPTER 8 PeerEvaluation ............................... 159
EvaluationandAccountability................ 159
PLANNING AND OUTCOME
MultidisciplinaryCollaborationin
IDENTIFICATION / 125 Evaluation................................. 159
PurposesofPlanningandOutcome
Identification............................... 126
ProcessofPlanningandOutcome
Identification............................... 126
UNIT 3
CriticalThinking............................... 126
EstablishingPriorities .......................... 127 Professional Accountability / 163
EstablishingGoalsandExpectedOutcomes ....... 128
ComponentsofGoalsandExpectedOutcomes .... 129
CHAPTER 11
ProblemsFrequentlyEncounteredinPlanning...... 130
PlanningNursingInterventions................... 132 LEADERSHIP, DELEGATION, AND
EvaluatingCare ............................... 134 POWER / 165
NursingOutcomesClassification(NOC)....... 134
ProfessionalNursingPractice................ 166
PlanofCare ............................... 135
CriteriaofaProfession ......................... 166
TypesofCarePlans............................ 135
ProfessionalAccountability.................. 168
StrategiesforEffectiveCarePlanning......... 136
ElementsofProfessionalAccountability........... 168
LegislativeAccountability....................... 170
CHAPTER 9 IndividualAccountability........................ 171
StudentAccountability ......................... 172
IMPLEMENTATION / 139
AdvancedPracticeNursing.................. 172
PurposesofImplementation................. 140 LeadershipinNursing....................... 175
RequirementsforEffectiveImplementation.... 140 ManagerialFunctions .......................... 175
CognitiveSkills................................ 140 LeadershipStyles ............................. 175
PsychomotorSkills ............................ 140 LeadershipCharacteristics...................... 175
InterpersonalSkills ............................ 140 Power....................................... 180
ImplementationActivities.................... 140 Mentoring.................................... 181
OngoingAssessment .......................... 140 Networking................................... 181
EstablishmentofPriorities ...................... 141 Empowerment................................ 182
AllocationofResources ........................ 142 PoliticsofNursing.......................... 182
Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
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