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Concept-Based Clinical Nursing Skills Loren Stein

Concept-Based Clinical Nursing Skills By Loren Stein

Concept-Based Clinical Nursing Skills by Loren Stein


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Concept-Based Clinical Nursing Skills Summary

Concept-Based Clinical Nursing Skills: Fundamental to Advanced by Loren Stein

Are you looking for a new way of learning skills? Do you want to learn how to problem solve and think conceptually? Stein and Hollen's Concept-Based Clinical Nursing Skills: Fundamental to Advanced covers over 250 nursing skills in an innovative concept-based format with excellent illustrations, concise rationales, and current evidence. Unlike any other text, Stein and Hollen incorporate an overarching framework of seven critical concepts - accuracy, client-centered care, infection control, safety, communication, evaluation, and health maintenance - to drive home the importance of these key themes in performing nursing skills. Each section balances need-to-know narrative with step-by-step skills, and every chapter includes a detailed case study with a concept map to help you apply knowledge and use clinical judgement in clinical situations involving nursing skills. Over 250 step-by-step nursing skills with over 900 photos and illustrations. Language and concepts reflect those used on the NCLEX. Concept-based approach to skills education pairs well with the Giddens framework. Accuracy, Client-Centered Care, Infection Control, Safety, Communication, Evaluation, and Health Maintenance are reinforced throughout as Critical Concepts to skills performance. Case studies with concept maps depict patients with problems that might be experienced in the clinical setting and are followed by a series of critical thinking questions with every chapter. Application of the QSEN competencies: A question that challenges you to apply a QSEN competency is provided within the critical thinking questions of each case study. Lessons from the Evidence boxes highlight and summarize current research that can contribute to evidence-based clinical practice; Lessons from the Courtroom boxes summarize actual court cases related to the skills in the chapter in order to help you understand legal implications; and Lessons from Experience boxes use a storytelling format to share the experiences of more experienced nurses with students. Application of the nursing process: Nursing diagnoses that include specific examples of client outcomes and nursing interventions are presented within each section of the chapters. Uses an easy-to-understand, conversational writing style. Organized to present fundamental skills first, then intermediate acute care skills, and finally advanced skills often performed in critical care. Critical concepts align with the quality and safety framework of the QSEN competencies. Emphasis on safety and client centered care. Expect the Unexpected boxes use a storytelling format to present unexpected situations that could occur and explore appropriate responses to them. Home Care, Lifespan, and Cultural Considerations provided in each chapter. Performing an Assessment chapter details physical assessment skills. Evolve site for students features skills video clips, skills checklists for all skills, and NCLEX-style review questions.

Table of Contents

UNIT I Fundamental Nursing Skills Foundations of Safe Client Care SECTION 1 Identifying a Client Application of the Nursing Process Critical Concepts: Identifying the Client SKILL 1.1 Identifying a Client SECTION 2 Preventing Infection Chain of Infection Preventing the Transmission of Infection Application of the Nursing Process Critical Concepts: Preventing Infection SKILL 1.2 Performing Hand Hygiene With an AlcoholBased Agent SKILL 1.3 Performing Hand Hygiene With Soap and Water SKILL 1.4 Applying and Removing Clean Gloves SKILL 1.5 Applying and Removing Personal Protective Equipment SECTION 3 Moving Clients Safely Benefits of Proper Client Positioning and Repositioning Ergonomics and Body Mechanics Summary Application of the Nursing Process Critical Concepts: Moving the Client Safely SKILL 1.6 Positioning a Client in Bed SKILL 1.7 Moving a Client up in Bed SKILL 1.8 Transferring a Client From Bed to Chair SKILL 1.9 Using a Sling Lift to Move a Client SKILL 1.10 Using a Sit-to-Stand Lift SKILL 1.11 Transferring Clients Laterally (From Bed to Stretcher) SKILL 1.12 Moving Clients Who Have Special Precautions (Logrolling) SECTION 4 Using Restraints Defining Restraints Use of Securing Devices Regulations Governing Use of Restraints Application of the Nursing Process Critical Concepts: Using Restraints SKILL 1.13 Applying and Removing Restraints SKILL 1.14 Applying a Mummy Restraint CHAPTER 2 Personal Care and Hygiene SECTION 1 Bathing a Client Skin Assessment Skin Care Bathing an Adult Bathing an Infant Application of the Nursing Process Critical Concepts: Bathing the Client SKILL 2.1 Assisting an Ambulatory Client With Bathing SKILL 2.2 Changing the Gown of a Client With an IV Line SKILL 2.3 Bathing an Adult Client in Bed SKILL 2.4 Providing Alternate Perineal Care SKILL 2.5 Providing Foot Care SKILL 2.6 Providing Nail Care SKILL 2.7 Bathing an Infant SECTION 2 Oral Hygiene Dentures Oral Care in the Acute Care Setting Application of the Nursing Process Critical Concepts: Providing Oral Care SKILL 2.8 Providing Oropharyngeal Suctioning With a Round-Tip Suction Catheter (Yankauer) SKILL 2.9 Providing Oral Hygiene for a Conscious Client SKILL 2.10 Providing Oral Hygiene for an Unconscious Client SKILL 2.11 Removing, Cleaning, and Inserting Dentures SECTION 3 Providing Hair Care Shaving Lice Application of the Nursing Process Critical Concepts: Providing Hair Care SKILL 2.12 Shampooing the Nonambulatory Client's Hair SKILL 2.13 Shampooing a Client With a Dry-Shampoo Cap SKILL 2.14 Shaving a Client SKILL 2.15 Caring for a Client With Lice SECTION 4 Eye and Ear Care Application of the Nursing Process Critical Concepts: Eye and Ear Care SKILL 2.16 Providing Eye Care for an Unconscious Client SKILL 2.17 Removing and Cleaning Contact Lenses SKILL 2.18 Removing, Cleaning, and Inserting an Artificial Eye SECTION 5 Assisting With Elimination Applying Concepts of Safety, Client-Centered Care, Collaboration, and Health Maintenance Bedside Commode, Urinals, Bedpans, and Condom Catheters Application of the Nursing Process Critical Concepts: Assisting With Elimination SKILL 2.19 Assisting a Client Using a Bedside Commode SKILL 2.20 Assisting a Client Using a Urinal SKILL 2.21 Assisting a Client Using a Bedpan SKILL 2.22 Applying a Condom Catheter SECTION 6 Making Beds Types of Beds Types of Mattresses Types of Bedding and Bed Making Application of the Nursing Process Critical Concepts: Changing a Bed SKILL 2.23 Changing an Unoccupied Bed SKILL 2.24 Making a Surgical Bed SKILL 2.25 Changing an Occupied Bed CHAPTER 3 Vital Signs and Vital Measurements Vital Signs SECTION 1 Assessing Temperature Sites and Methods of Temperature Assessment Application of the Nursing Process Critical Concepts: Assessing Temperature SKILL 3.1 Measuring Temperature With an Electronic Thermometer SKILL 3.2 Obtaining a Tympanic Temperature SKILL 3.3 Obtaining a Temperature Using a Temporal Artery Thermometer SECTION 2 Regulating Temperature Regulating Temperature Application of the Nursing Process Critical Concepts: Regulating Temperature SKILL 3.4 Using Conductive Cooling or Heating Therapy SKILL 3.5 Using an Infant Radiant Warmer SECTION 3 Assessing Pulses Location and Differentiation of Pulses Apical Pulse Technique for Assessing Pulses Alterations of the Client's Pulse Application of the Nursing Process Critical Concepts: Assessing Pulses SKILL 3.6 Obtaining a Radial Pulse Rate SKILL 3.7 Assessing Carotid Pulses SKILL 3.8 Assessing Peripheral Pulses SKILL 3.9 Using a Doppler Ultrasound Device to Assess Pulses SKILL 3.10 Obtaining an Apical Pulse SKILL 3.11 Obtaining an Apical-Radial Pulse SECTION 4 Assessing Respirations Assessing Respirations in Pediatric Clients Application of the Nursing Process Critical Concepts: Assessing Respirations SKILL 3.12 Obtaining a Respiratory Rate and Respiratory Assessment SECTION 5 Assessing Blood Pressure Classification of Hypertension Factors Affecting Blood Pressure Measuring Blood Pressure Application of the Nursing Process Critical Concepts: Assessing Blood Pressure SKILL 3.13 Palpating a Systolic Blood Pressure SKILL 3.14 Measuring a Systolic and Diastolic Blood Pressure by Auscultation SKILL 3.15 Measuring Blood Pressure With an Automatic Oscillometric Monitor SKILL 3.16 Using a Doppler Ultrasound Device to Hear Systolic Blood Pressure Vital Measurements SECTION 6 Assessing Oxygen Saturation Obtaining an SpO2 Reading Application of the Nursing Process Critical Concepts: Assessing Oxygen Saturation SKILL 3.17 Obtaining a Pulse Oximeter Measurement SECTION 7 Assessing Blood Glucose Application of the Nursing Process Critical Concepts: Assessing Blood Glucose SKILL 3.18 Obtaining Capillary Blood Glucose Measurements CHAPTER 4 Performing an Assessment The Assessment Process SECTION 1 Collecting Subjective and Objective Data Collecting Subjective Data Collecting Objective Data Performing a Preliminary Survey Summary Critical Concepts: Collecting Subjective and Objective Data SKILL 4.1 Performing a Preliminary Survey SECTION 2 Performing a Head-to-Toe or SystemSpecific Assessment Critical Concepts When Performing a Head-to-Toe or System-Specific Assessment Performing a Rapid Head-to-Toe Bedside Assessment Performing a System-Specific Assessment Summary Critical Concepts: Performing a Head-to-Toe or SystemSpecific Assessment SKILL 4.2 Performing a Rapid Head-to-Toe Bedside Assessment SKILL 4.3 Assessing the Skin/Integumentary System SKILL 4.4 Assessing the Head (HEENT) and Neck SKILL 4.5 Assessing the Neurologic System SKILL 4.6 Assessing the Thorax (Heart and Lungs) SKILL 4.7 Assessing the Abdomen SKILL 4.8 Assessing the Musculoskeletal System SKILL 4.9 Assessing the Genitourinary System CHAPTER 5 Nutrition and Gastrointestinal Tube Therapy Essential and Nonessential Nutrients Macronutrients and Micronutrients Digestion and Assimilation of Nutrients Nutritional Guidelines Alterations That Can Cause Nutritional Deficiencies SECTION 1 Nutritional Assessment Criteria Used for a Nutritional Screening or Assessment Assessing and Monitoring a Client's Food and Fluid Intake Summary Application of the Nursing Process Critical Concepts: Nutritional Assessment SKILL 5.1 Performing a Nutritional Screening SECTION 2 Assisting Clients With Oral Nutrition Types of Diets Preparing A Client to Receive a Meal Assisting A Client Who Has Difficulty Eating Application of the Nursing Process Critical Concepts: Assisting Clients With Oral Nutrition SKILL 5.2 Preparing a Client to Receive a Meal SKILL 5.3 Assisting Clients With a Physical or Cognitive Impairment SKILL 5.4 Assisting Clients With Dysphagia or Aspiration Risk SECTION 3 Providing Gastric Tube Therapy Nasogastric Sump Tube Levin Tubes and Gastric Lavage Tubes Placement and Care of a Nasogastric Sump Tube Summary Application of the Nursing Process Critical Concepts: Providing Gastric Tube Therapy SKILL 5.5 Placement and Care of a Nasogastric (NG) Sump Tube SKILL 5.6 Initiating and Managing Nasogastric (NG) Sump Tube Suction SKILL 5.7 Irrigating a Nasogastric (NG) Sump Tube SKILL 5.8 Discontinuing a Nasogastric (NG) Sump Tube SECTION 4 Providing Enteral Nutrition Routes of Enteral Feeding Daily Care for Clients With Gastrostomy, PEG, and Jejunostomy Tubes Delivery Methods for Enteral Nutrition Reducing Risks of Enteral Nutrition Home Care Considerations Providing Client-Centered Care During Enteral Nutrition Summary Application of the Nursing Process Critical Concepts: Providing Enteral Nutrition SKILL 5.9 Placement and Care of a Nasally Inserted Small-Bore Feeding Tube SKILL 5.10 Providing Care for a Client With a Gastrostomy, PEG Tube, or Jejunostomy SKILL 5.11 Administering a Tube Feeding (Intermittent or Continuous) SKILL 5.12 Using a Kangaroo Feeding Pump CHAPTER 6 Supporting Mobility and Immobilization SECTION 1 Supporting Mobility Collaborative Care for Clients With Assistive Devices Range of Motion Application of the Nursing Process Critical Concepts: Mobility SKILL 6.1 Assisting With Ambulation Using a Transfer Belt SKILL 6.2 Teaching the Client to Use a Cane SKILL 6.3 Teaching the Client to Use a Walker SKILL 6.4 Teaching the Client to Use Crutches SKILL 6.5 Performing Active and Passive Range-ofMotion (ROM) Exercises SECTION 2 Supporting Immobilization Supporting Immobilization of a Limb or Joint Supporting Cervical Immobilization Pin Care Application of the Nursing Process Critical Concepts: Immobilization SKILL 6.6 Applying a Sling SKILL 6.7 Applying Bandages SKILL 6.8 Providing Cast Care SKILL 6.9 Managing Traction SKILL 6.10 Providing Pin-Site Care SKILL 6.11 Applying a Cervical Collar SKILL 6.12 Managing Halo Traction SECTION 3 Caring for a Client With an Amputation Postoperative Care Communication: Client Education and Collaboration Application of the Nursing Process Critical Concepts: Client With an Amputation SKILL 6.13 Exercising and Positioning the Residual Limb SKILL 6.14 Applying a Compression Bandage and Commercial Shrinker to a Residual Limb CHAPTER 7 Comfort Care The Impact of Pain Nociceptive and Neuropathic Pain Acute and Chronic Pain SECTION 1 Assessment of Pain and Discomfort Subjective and Objective Assessment of Pain Examples of Pain Tools Used for Assessment of Pain Assessment of Pain for Diverse Populations Lifespan Considerations: Older Adults and Pediatric Clients Summary of Best Practice Recommendations for Assessment of Pain Summary of Application of Critical Concepts for Assessment of Pain Application of the Nursing Process Critical Concepts: Assessment of Pain and Discomfort SKILL 7.1 Performing a Pain Assessment SECTION 2 Using Relaxation Measures to Promote Comfort Enhancing the Client's Environment Controlled Breathing Guided Imagery Massage Therapy Summary Application of the Nursing Process Critical Concepts: Using Relaxation Measures to Promote Comfort SKILL 7.2 Enhancing a Client's Environment SKILL 7.3 Assisting a Client With Controlled-Breathing Exercises SKILL 7.4 Assisting a Client With Guided Imagery Exercises SKILL 7.5 Providing a Back Massage SECTION 3 Using a TENS Unit to Promote Comfort Application of the Nursing Process Critical Concepts: Using a TENS Unit to Promote Comfort SKILL 7.6 Applying and Discontinuing a TENS Unit SECTION 4 Using Heat or Cold to Promote Comfort Safety Considerations and Precautions for Heat and Cold Therapy Different Types of Heat and Cold Therapy Summary Application of the Nursing Process Critical Concepts: Using Heat or Cold to Promote Comfort SKILL 7.7 Using a Heat or Cold Pack (Instant or Reusable) SKILL 7.8 Using an Ice Bag SKILL 7.9 Using a Portable Sitz Bath SKILL 7.10 Using Localized Circulating (Aqua) Heat or Cold Therapy SECTION 5 Using Patient-Controlled Analgesia to Promote Comfort Safety Considerations When Using PCA Therapy Summary Application of the Nursing Process Critical Concepts: Using Patient-Controlled Analgesia to Promote Comfort SKILL 7.11 Assessing a Client for Appropriateness of PCA Therapy SKILL 7.12 Initiating and Managing PCA Therapy SKILL 7.13 Teaching the Client and Family About PCA Therapy SKILL 7.14 Discontinuing PCA Therapy SECTION 6 Using Epidural Analgesia to Promote Comfort Safety Considerations for Epidural Catheters Potential Complications of Epidural Catheters Summary Application of the Nursing Process Critical Concepts: Using Epidural Analgesia to Promote Comfort SKILL 7.15 Caring for a Client With an Epidural Catheter SKILL 7.16 Assisting With Removal of an Epidural Catheter CHAPTER 8 End-of-Life Care Definition of End of Life End-of-Life Care and Palliative Care Nursing Initiatives and End-of-Life Care SECTION 1 Bereavement and Spiritual Care Caring for a Client and Family Who Are Grieving Theories of Grieving Types of Grief Children and Grief Nurses and Grief Providing Spiritual Care for a Client and Family Summary Application of the Nursing Process Critical Concepts: Bereavement and Spiritual Care SKILL 8.1 Caring for a Client and Family Who Are Grieving SKILL 8.2 Providing Spiritual Care for a Client and Family SECTION 2 Assisting a Client and Family With Advance Care Planning Tools Used for Advance Care Planning Application of the Nursing Process Critical Concepts: Assisting With Advance Care Planning SKILL 8.3 Assisting With Advance Directives and Do-NotResuscitate (DNR) Orders SECTION 3 Caring for a Client Near the End of Life Application of the Nursing Process Critical Concepts: Caring for a Client Near the End of Life SKILL 8.4 Providing Physical Care for a Client Who Is Dying SECTION 4 Caring for a Client After Death Application of the Nursing Process Critical Concepts: Caring for a Client After Death SKILL 8.5 Providing Postmortem Care UNIT II Intermediate Nursing Skills CHAPTER 9 Airway and Breathing SECTION 1 Maintaining the Health of the Respiratory System Deep Breathing and Coughing Incentive Spirometry Chest Physiotherapy Respiratory System-Specific Assessment Application of the Nursing Process Critical Concepts: Maintaining the Health of the Respiratory System SKILL 9.1 Instructing a Client in Deep-Breathing and Coughing Exercises SKILL 9.2 Instructing a Client to Use Incentive Spirometry SKILL 9.3 Performing Chest Physiotherapy (CPT) SECTION 2 Administering Oxygen Impaired Gas Exchange Using a High-Pressure Oxygen Cylinder Administering Supplemental Oxygen Summary Application of the Nursing Process Critical Concepts: Administering Oxygen SKILL 9.4 Using a High-Pressure Oxygen Cylinder SKILL 9.5 Using an Oxygen Flowmeter SKILL 9.6 Placing a Client on Oxygen by Nasal Cannula SKILL 9.7 Placing a Client on Oxygen by Face Mask SKILL 9.8 Placing a Client on Continuous Positive Airway Pressure (CPAP) SECTION 3 Establishing and Maintaining an Open Airway Oropharyngeal Airway Nasopharyngeal Airway Nasopharyngeal Suctioning Tracheostomy Suctioning an Artificial Airway Collecting Sputum Samples Summary Application of the Nursing Process Critical Concepts: Establishing and Maintaining an Open Airway SKILL 9.9 Inserting an Oropharyngeal Airway SKILL 9.10 Inserting a Nasopharyngeal Airway SKILL 9.11 Performing Nasopharyngeal Suctioning SKILL 9.12 Suctioning an Artificial Airway: Tracheostomy or Endotracheal Tube SKILL 9.13 Obtaining a Sputum Sample From a Client With an Artificial Airway SKILL 9.14 Cleaning a Tracheostomy and Replacing Tracheostomy Ties CHAPTER 10 Sterile Technique SECTION 1 Preparing a Sterile Field Application of the Nursing Process Critical Concepts: Preparing a Sterile Field SKILL 10.1 Opening a Sterile Pack SKILL 10.2 Applying and Removing Sterile Gloves SKILL 10.3 Opening a Sterile Barrier and Setting Up a Sterile Field SKILL 10.4 Adding Sterile Items to a Sterile Field and Draping a Sterile Field SKILL 10.5 Pouring a Sterile Liquid SECTION 2 Preparing to Enter a Sterile Perioperative Setting Surgical Attire Surgical Hand Antisepsis Surgical Gowns and Gloves Application of the Nursing Process Critical Concepts: Preparing to Enter a Sterile Perioperative Area SKILL 10.6 Performing a Surgical Handrub SKILL 10.7 Performing a Surgical Hand Scrub SKILL 10.8 Performing Surgical Gowning SKILL 10.9 Performing Closed Surgical Gloving CHAPTER 11 Medication Administration Medication Safety Initiatives Rights of Medication Administration Safely Processing Medication Orders Performing Preassessments Safely Preparing and Distributing Medications Performing Safety Checks Safety Considerations for High-Alert Medications Performing Dosage Calculation SECTION 1 Administering Oral Medications Types of Oral Medications Crushing/Altering Oral Medications Preparing and Administering Oral Medications Best-Practice Recommendations Pediatric Considerations Home Care and Geriatric Considerations Summary Application of the Nursing Process Critical Concepts: Administering Oral Medications SKILL 11.1 Administering Oral Medications (Tablets, Capsules, or Liquids) SECTION 2 Administering Enteral Medications Application of the Nursing Process Critical Concepts: Administering Enteral Medications SKILL 11.2 Administering a Medication Through a Nasogastric (NG) Tube or Enteral Device SECTION 3 Administering Mucous Membrane Applications Sublingual and Buccal Medications Nasal Instillations Inhalers and Nebulizers Rectal and Vaginal Administration Application of the Nursing Process Critical Concepts: Administering Mucous Membrane Applications SKILL 11.3 Administering Sublingual or Buccal Medications SKILL 11.4 Administering a Nasal Spray Medication SKILL 11.5 Administering Inhaled Medications SKILL 11.6 Administering Nebulized Medications SKILL 11.7 Administering a Rectal Suppository SKILL 11.8 Administering Vaginal Medications SECTION 4 Administering Topical Medications Topical Medications for Localized Effect Transdermal Medications for Systemic Effect Eye and Ear Medications Application of the Nursing Process Critical Concepts: Administering Topical Medications SKILL 11.9 Applying a Transdermal Patch SKILL 11.10 Administering an Eye Medication (Drops or Ointment) SKILL 11.11 Irrigating the Eyes SKILL 11.12 Instilling Ear (Otic) Drops SECTION 5 Administering Parenteral Medications Preparing Equipment for Injections Components of a Needle and Syringe Using Safety and Needleless Systems Preparing Medications Administering Injections Administering Intradermal Injections Administering Subcutaneous Injections Administering Intramuscular Injections Administering Insulin Summary Application of the Nursing Process Critical Concepts: Administering Parenteral Medications SKILL 11.13 Preparing a Medication From a Vial SKILL 11.14 Preparing a Medication From an Ampule SKILL 11.15 Preparing a Medication That Requires Reconstitution SKILL 11.16 Administering an Intradermal Injection SKILL 11.17 Administering a Subcutaneous Injection SKILL 11.18 Administering an Intramuscular Injection SKILL 11.19 Administering a Subcutaneous Insulin Injection SKILL 11.20 Caring for a Client With a Subcutaneous Insulin Pump (External) CHAPTER 12 Venous Access SECTION 1 Collecting Venous Blood Specimens Ensuring Accuracy Selecting a Vein Application of the Nursing Process Critical Concepts: Collecting Venous Blood Specimens SKILL 12.1 Selecting a Vein SKILL 12.2 Obtaining Venous Blood Specimens SECTION 2 Initiating, Dressing, and Discontinuing a Peripheral Intravenous Catheter Selecting a Vein Application of the Nursing Process Critical Concepts: Initiating a Peripheral Intravenous Line SKILL 12.3 Inserting and Dressing a Peripheral Intravenous Catheter SKILL 12.4 Changing a PIV Dressing SKILL 12.5 Discontinuing a Peripheral Intravenous Catheter SECTION 3 Intravenous Fluids Monitoring Intake and Output Types of Intravenous Fluids Infection Control Safety and the Rights of Intravenous Fluid Administration Intravenous Fluid Administration Sets Priming Administration Sets and Bubble Management Infusing Fluids Application of the Nursing Process Critical Concepts: Infusing Intravenous Fluids SKILL 12.6 Managing a Saline Lock SKILL 12.7 Preparing a Primary Intravenous Infusion SKILL 12.8 Replacing Intravenous Infusion Fluid SECTION 4 Administering Intravenous Medications Orders for Intravenous Medications Nursing Responsibilities Medication Preparation and Equipment Complications of Intravenous Medication Administration Application of the Nursing Process Critical Concepts: Administering Intravenous Medications SKILL 12.9 Administering Intermittent Intravenous Medication via Secondary Infusion SKILL 12.10 Administering Intravenous Medication via Intravenous Push SECTION 5 Administering a Blood Transfusion Different Types of Blood Components Types of Blood Transfusions ABO Compatibility System Safety Considerations Equipment Used for a Blood Transfusion Procedure for Administering a Blood Transfusion Possible Complications Application of the Nursing Process Critical Concepts: Administering a Blood Transfusion SKILL 12.11 Administering Packed Red Blood Cells (PRBCs) CHAPTER 13 Central Venous Access SECTION 1 Caring for a Client With a CVAD Tunneled Catheters Nontunneled Catheters Implanted Ports Power-Injection Capable Assisting With Insertion Complications of CVADs Drawing Blood From a CVAD Care for a Client With a Subcutaneous Port: Accessing and Deaccessing Discontinuing a CVAD Critical Concepts and CVADs Application of the Nursing Process Critical Concepts: Caring for the Client With a CVAD SKILL 13.1 Assisting With Insertion SKILL 13.2 Flushing Central Venous Access Devices SKILL 13.3 Changing the CVC or PICC Line Dressing SKILL 13.4 Changing the Needleless Connectors for a CVC/PICC Line SKILL 13.5 Collecting Blood Specimens/Blood Cultures SKILL 13.6 Managing Subcutaneous Ports: Accessing, Changing the Dressing, and Deaccessing SKILL 13.7 Discontinuing a Central Line SECTION 2 Infusing Fluids With a CVAD Infusing Fluids Application of the Nursing Process Critical Concepts: Infusing Fluids Through a CVAD SKILL 13.8 Infusing IV Fluids SKILL 13.9 Initiating TPN and/or Lipids CHAPTER 14 Bowel Management SECTION 1 Supporting Healthy Bowel Elimination Characteristics of Stool Bowel Elimination Problems Application of the Nursing Process Critical Concepts: Supporting Healthy Bowel Elimination SKILL 14.1 Performing Digital Stimulation and Evacuation SKILL 14.2 Inserting Rectal Tubes SKILL 14.3 Applying a Fecal Collection Pouch SKILL 14.4 Setting Up a Fecal Management System SECTION 2 Administering Enemas Application of the Nursing Process Critical Concepts: Administering Enemas SKILL 14.5 Administering a Cleansing Enema SKILL 14.6 Administering a Commercially Prepared Enema SECTION 3 Collecting Specimens Application of the Nursing Process Critical Concepts: Collecting Specimens SKILL 14.7 Collecting a Stool Specimen SKILL 14.8 Obtaining a Stool Specimen for Occult Blood SECTION 4 Caring for a Client With a Bowel Diversion Care of the Stoma and Peristomal Skin Irrigating a Colostomy Cecostomy Application of the Nursing Process Critical Concepts: Caring for a Client With a Bowel Diversion SKILL 14.9 Pouching a Stoma SKILL 14.10 Irrigating an Ostomy CHAPTER 15 Urine Elimination Urine Elimination SECTION 1 Collecting Urine Measurements and Specimens Assessing Production and Volume of Urine Collecting Specimens Application of the Nursing Process Critical Concepts: Obtaining Urine Measurements and Specimens SKILL 15.1 Measuring and Recording Intake and Output SKILL 15.2 Measuring Urine Volume With a Portable Bladder Scanner SKILL 15.3 Obtaining a Urine Specimen From a Closed Urinary Drainage System SKILL 15.4 Obtaining a Urine Specimen Using the Clean-Catch Method SKILL 15.5 Obtaining a 24-Hour Urine Specimen SKILL 15.6 Obtaining a Bagged Urine Specimen From an Infant or Child SECTION 2 Urine Elimination With a Transurethral Catheter Types of Transurethral Catheters Infection Control With Urinary Catheters Communication and Urinary Catheters Providing Client-Centered Care to Specific Populations Bladder Irrigation Application of the Nursing Process Critical Concepts: Urine Elimination With a Transurethral Catheter SKILL 15.7 Inserting and Removing a Straight Catheter in a Female Client SKILL 15.8 Inserting and Removing a Straight Catheter in a Male Client SKILL 15.9 Inserting an Indwelling Foley Catheter in a Female Client SKILL 15.10 Inserting an Indwelling Foley Catheter in a Male Client SKILL 15.11 Removing an Indwelling Foley Catheter SKILL 15.12 Managing an Indwelling Foley Catheter SKILL 15.13 Performing Intermittent Closed Bladder Irrigation SKILL 15.14 Performing Continuous Closed Bladder Irrigation SECTION 3 Urine Elimination With a Urinary Diversion Suprapubic Catheter Urinary Diversions Application of the Nursing Process Critical Concepts: Urine Elimination With a Urinary Diversion SKILL 15.15 Providing Suprapubic Catheter Care SKILL 15.16 Changing a Stoma Appliance on an Ileal Conduit SKILL 15.17 Catheterizing and Irrigating a Continent Urostomy CHAPTER 16 Wound Care SECTION 1 Providing Wound Care Wound Types The Impact of Wounds Client Considerations Wound Assessment Wound Care Collecting Wound Specimens Managing Complex Wounds Dressing Selection and Application Application of the Nursing Process Critical Concepts: Providing Wound Care SKILL 16.1 Dressing Change for a Primary-Intention Wound SKILL 16.2 Collecting Wound Specimens SKILL 16.3 Removing Sutures and Staples SKILL 16.4 Dressing a Partial- or Full-Thickness Wound SECTION 2 Managing Wound Drainage Drains and Negative-Pressure Wound Therapy Application of the Nursing Process Critical Concepts: Managing Wound Drainage SKILL 16.5 Managing a Penrose Drain SKILL 16.6 Emptying a Jackson-Pratt (JP) Drain or Hemovac SKILL 16.7 Negative-Pressure Wound Therapy (NPWT) SECTION 3 Preventing and Treating Pressure Injury and Venous and Diabetic Ulcers Pressure Injury Venous Ulcers Preventing Diabetic Ulcers Application of the Nursing Process Critical Concepts: Preventing and Treating Pressure Injury and Venous and Diabetic Ulcers SKILL 16.8 Applying Compression Dressings or Unna Boot SKILL 16.9 Foot Examination and Monofilament Testing SKILL 16.10 Measuring the Ankle-Brachial Index (ABI) CHAPTER 17 Perioperative Care SECTION 1 Providing Preoperative Education and Care Factors Affecting Surgical Risks Nursing History and Physical Examination Cultural Considerations Informed Consent Preoperative Teaching Application of the Nursing Process Critical Concepts: Preoperative Care SKILL 17.1 Preparing a Client for Surgery SKILL 17.2 Instructing Client on Thrombosis Prevention SECTION 2 Providing Intraoperative Care Roles of the Surgical Team Surgical Verification Client Positioning Maintaining Safety: Latex Sensitivity/Allergy Types of Anesthesia Preparing the Client's Skin Closing the Wound Application of the Nursing Process SECTION 3 Managing Postoperative Care Postoperative Nursing Care Postoperative Assessment Postoperative Teaching Application of the Nursing Process Critical Concepts: Providing Postoperative Care SKILL 17.3 Admitting a Postoperative Client SKILL 17.4 Applying Pressure Dressings to Control Bleeding SKILL 17.5 Applying and Removing Antiembolism Stockings SKILL 17.6 Managing Sequential Compression Devices SKILL 17.7 Managing Continuous Passive Motion UNIT III Advanced Nursing Skills CHAPTER 18 Advanced Respiratory Management SECTION 1 Caring for a Client With Invasive Mechanical Ventilation The Airway: Endotracheal Tubes Providing Mechanical Ventilation Nursing Care for Clients Who Are Receiving Mechanical Ventilation Reducing the Risk of Complications of Mechanical Ventilation Application of the Nursing Process Critical Concepts: Caring for a Client With Invasive Mechanical Ventilation SKILL 18.1 Caring for a Client Receiving Mechanical Ventilation Arterial Blood Gases Acid-Base Imbalances SECTION 2 Caring for a Client Who Requires Arterial Blood Gas Sampling Indwelling Arterial Catheter Sampling Arterial Puncture Sampling Application of the Nursing Process Critical Concepts: Arterial Blood Gas Sampling SKILL 18.2 Obtaining Arterial Blood Gases From a Peripheral Arterial Line SKILL 18.3 Obtaining Arterial Blood Gases From the Radial Artery SECTION 3 Caring for a Client With a Chest Tube Chest Drainage Systems Caring for the Client With a Chest Tube and Chest Drainage System Troubleshooting the Chest Tube and Drainage System Application of the Nursing Process Critical Concepts: Caring for a Client With a Chest Tube SKILL 18.4 Assisting With Chest Tube Insertion SKILL 18.5 Maintaining a Chest Tube System and Performing an Occlusive Dressing Change SKILL 18.6 Assisting With Removal of a Chest Tube CHAPTER 19 Advanced Cardiovascular Care Cardiovascular System SECTION 1 Caring for a Client on Cardiac Monitoring Cardiac Conduction System The ECG Tracing Equipment Used in ECG Monitoring Lead Placement for ECG Monitoring Types of ECG Monitoring Performing a 12-Lead ECG Possible Safety and Technical Issues With ECG Monitoring Summary Application of the Nursing Process Critical Concepts: Caring for a Client on Cardiac Monitoring SKILL 19.1 Placing a Client on a Continuous ECG Monitor (Hardwire or Telemetry) SKILL 19.2 Performing a Diagnostic 12-Lead ECG SECTION 2 Caring for a Client With a Dysrhythmia or Altered Cardiac Conduction Dysrhythmias and Conduction Disorders Using Synchronized Cardioversion Summary Application of the Nursing Process Critical Concepts: Caring for a Client With a Dysrhythmia or Altered Cardiac Conduction SKILL 19.3 Performing or Assisting With Elective Cardioversion SECTION 3 Caring for a Client With a Cardiac Pacemaker Cardiac Pacemakers How a Pacemaker Works: Major Functions and Components Types of Pacemakers Temporary Pacemakers Permanent Pacemakers Possible Complications/Safety Issues With Pacemakers Application of the Nursing Process Critical Concepts: Caring for a Client With a Pacemaker SKILL 19.4 Caring for a Client With a Transcutaneous Pacemaker (TCP) SKILL 19.5 Caring for a Client With a Transvenous Pacemaker (TVP) SECTION 4 Caring for a Client With a Cardiac Emergency Caring for a Client With Ischemic Chest Pain Emergency Cardiac Catheterization Providing Emergency Defibrillation Caring for a Client Who Is in Cardiac Arrest Application of the Nursing Process Critical Concepts: Caring for a Client With a Cardiac Emergency SKILL 19.6 Providing Care for a Client With Acute Ischemic Chest Pain SKILL 19.7 Caring for a Client After an Emergency Cardiac Catheterization SKILL 19.8 Providing Emergency (Asynchronous) Manual Defibrillation SKILL 19.9 Responding to a Client (Adult) in Cardiac Arrest CHAPTER 20 Advanced Neurologic Care Intracranial Processes Major Neurologic Injuries: Traumatic and Nontraumatic SECTION 1 Advanced Neurologic Assessment Performing a Neurologic Assessment Assessment of Level of Consciousness Assessment of Pupillary Response and Function Using a Pupillometer Device for Assessment of Pupils Assessment of Verbal Response and Function Assessment of Motor and Sensory Function Assessment of Deep Tendon Reflexes Lifespan Considerations Diagnostic Procedures Summary Application of the Nursing Process Critical Concepts: Advanced Neurologic Assessment SKILL 20.1 Performing a Neurologic Assessment SKILL 20.2 Using a Pupillometer SKILL 20.3 Assisting With a Lumbar Puncture SECTION 2 Caring for a Client With Increased Intracranial Pressure Interventions for Clients With Increased ICP Caring for a Client With an External Ventricular Drain and Performing ICP Monitoring Summary Application of the Nursing Process Critical Concepts: Caring for a Client With Increased Intracranial Pressure SKILL 20.4 Caring for a Client With an External Ventricular Drain (EVD) and Obtaining Intracranial Pressure (ICP) Readings SECTION 3 Caring for a Client With a Neurologic Emergency Caring for a Client Who Is Having a Seizure Caring for a Client Who May Be Having an Acute Stroke Summary Application of the Nursing Process Critical Concepts: Caring for a Client With a Neurologic Emergency SKILL 20.5 Caring for a Client Who Requires Seizure Precautions SKILL 20.6 Assessing a Client Who May Be Having an Acute Stroke ILLUSTRATION CREDITS INDEX UNIT I Fundamental Nursing Skills Foundations of Safe Client Care SECTION 1 Identifying a Client Application of the Nursing Process Critical Concepts: Identifying the Client SKILL 1.1 Identifying a Client SECTION 2 Preventing Infection Chain of Infection Preventing the Transmission of Infection Application of the Nursing Process Critical Concepts: Preventing Infection SKILL 1.2 Performing Hand Hygiene With an AlcoholBased Agent SKILL 1.3 Performing Hand Hygiene With Soap and Water SKILL 1.4 Applying and Removing Clean Gloves SKILL 1.5 Applying and Removing Personal Protective Equipment SECTION 3 Moving Clients Safely Benefits of Proper Client Positioning and Repositioning Ergonomics and Body Mechanics Summary Application of the Nursing Process Critical Concepts: Moving the Client Safely SKILL 1.6 Positioning a Client in Bed SKILL 1.7 Moving a Client up in Bed SKILL 1.8 Transferring a Client From Bed to Chair SKILL 1.9 Using a Sling Lift to Move a Client SKILL 1.10 Using a Sit-to-Stand Lift SKILL 1.11 Transferring Clients Laterally (From Bed to Stretcher) SKILL 1.12 Moving Clients Who Have Special Precautions (Logrolling) SECTION 4 Using Restraints Defining Restraints Use of Securing Devices Regulations Governing Use of Restraints Application of the Nursing Process Critical Concepts: Using Restraints SKILL 1.13 Applying and Removing Restraints SKILL 1.14 Applying a Mummy Restraint CHAPTER 2 Personal Care and Hygiene SECTION 1 Bathing a Client Skin Assessment Skin Care Bathing an Adult Bathing an Infant Application of the Nursing Process Critical Concepts: Bathing the Client SKILL 2.1 Assisting an Ambulatory Client With Bathing SKILL 2.2 Changing the Gown of a Client With an IV Line SKILL 2.3 Bathing an Adult Client in Bed SKILL 2.4 Providing Alternate Perineal Care SKILL 2.5 Providing Foot Care SKILL 2.6 Providing Nail Care SKILL 2.7 Bathing an Infant SECTION 2 Oral Hygiene Dentures Oral Care in the Acute Care Setting Application of the Nursing Process Critical Concepts: Providing Oral Care SKILL 2.8 Providing Oropharyngeal Suctioning With a Round-Tip Suction Catheter (Yankauer) SKILL 2.9 Providing Oral Hygiene for a Conscious Client SKILL 2.10 Providing Oral Hygiene for an Unconscious Client SKILL 2.11 Removing, Cleaning, and Inserting Dentures SECTION 3 Providing Hair Care Shaving Lice Application of the Nursing Process Critical Concepts: Providing Hair Care SKILL 2.12 Shampooing the Nonambulatory Client's Hair SKILL 2.13 Shampooing a Client With a Dry-Shampoo Cap SKILL 2.14 Shaving a Client SKILL 2.15 Caring for a Client With Lice SECTION 4 Eye and Ear Care Application of the Nursing Process Critical Concepts: Eye and Ear Care SKILL 2.16 Providing Eye Care for an Unconscious Client SKILL 2.17 Removing and Cleaning Contact Lenses SKILL 2.18 Removing, Cleaning, and Inserting an Artificial Eye SECTION 5 Assisting With Elimination Applying Concepts of Safety, Client-Centered Care, Collaboration, and Health Maintenance Bedside Commode, Urinals, Bedpans, and Condom Catheters Application of the Nursing Process Critical Concepts: Assisting With Elimination SKILL 2.19 Assisting a Client Using a Bedside Commode SKILL 2.20 Assisting a Client Using a Urinal SKILL 2.21 Assisting a Client Using a Bedpan SKILL 2.22 Applying a Condom Catheter SECTION 6 Making Beds Types of Beds Types of Mattresses Types of Bedding and Bed Making Application of the Nursing Process Critical Concepts: Changing a Bed SKILL 2.23 Changing an Unoccupied Bed SKILL 2.24 Making a Surgical Bed SKILL 2.25 Changing an Occupied Bed CHAPTER 3 Vital Signs and Vital Measurements Vital Signs SECTION 1 Assessing Temperature Sites and Methods of Temperature Assessment Application of the Nursing Process Critical Concepts: Assessing Temperature SKILL 3.1 Measuring Temperature With an Electronic Thermometer SKILL 3.2 Obtaining a Tympanic Temperature SKILL 3.3 Obtaining a Temperature Using a Temporal Artery Thermometer SECTION 2 Regulating Temperature Regulating Temperature Application of the Nursing Process Critical Concepts: Regulating Temperature SKILL 3.4 Using Conductive Cooling or Heating Therapy SKILL 3.5 Using an Infant Radiant Warmer SECTION 3 Assessing Pulses Location and Differentiation of Pulses Apical Pulse Technique for Assessing Pulses Alterations of the Client's Pulse Application of the Nursing Process Critical Concepts: Assessing Pulses SKILL 3.6 Obtaining a Radial Pulse Rate SKILL 3.7 Assessing Carotid Pulses SKILL 3.8 Assessing Peripheral Pulses SKILL 3.9 Using a Doppler Ultrasound Device to Assess Pulses SKILL 3.10 Obtaining an Apical Pulse SKILL 3.11 Obtaining an Apical-Radial Pulse SECTION 4 Assessing Respirations Assessing Respirations in Pediatric Clients Application of the Nursing Process Critical Concepts: Assessing Respirations SKILL 3.12 Obtaining a Respiratory Rate and Respiratory Assessment SECTION 5 Assessing Blood Pressure Classification of Hypertension Factors Affecting Blood Pressure Measuring Blood Pressure Application of the Nursing Process Critical Concepts: Assessing Blood Pressure SKILL 3.13 Palpating a Systolic Blood Pressure SKILL 3.14 Measuring a Systolic and Diastolic Blood Pressure by Auscultation SKILL 3.15 Measuring Blood Pressure With an Automatic Oscillometric Monitor SKILL 3.16 Using a Doppler Ultrasound Device to Hear Systolic Blood Pressure Vital Measurements SECTION 6 Assessing Oxygen Saturation Obtaining an SpO2 Reading Application of the Nursing Process Critical Concepts: Assessing Oxygen Saturation SKILL 3.17 Obtaining a Pulse Oximeter Measurement SECTION 7 Assessing Blood Glucose Application of the Nursing Process Critical Concepts: Assessing Blood Glucose SKILL 3.18 Obtaining Capillary Blood Glucose Measurements CHAPTER 4 Performing an Assessment The Assessment Process SECTION 1 Collecting Subjective and Objective Data Collecting Subjective Data Collecting Objective Data Performing a Preliminary Survey Summary Critical Concepts: Collecting Subjective and Objective Data SKILL 4.1 Performing a Preliminary Survey SECTION 2 Performing a Head-to-Toe or SystemSpecific Assessment Critical Concepts When Performing a Head-to-Toe or System-Specific Assessment Performing a Rapid Head-to-Toe Bedside Assessment Performing a System-Specific Assessment Summary Critical Concepts: Performing a Head-to-Toe or SystemSpecific Assessment SKILL 4.2 Performing a Rapid Head-to-Toe Bedside Assessment SKILL 4.3 Assessing the Skin/Integumentary System SKILL 4.4 Assessing the Head (HEENT) and Neck SKILL 4.5 Assessing the Neurologic System SKILL 4.6 Assessing the Thorax (Heart and Lungs) SKILL 4.7 Assessing the Abdomen SKILL 4.8 Assessing the Musculoskeletal System SKILL 4.9 Assessing the Genitourinary System CHAPTER 5 Nutrition and Gastrointestinal Tube Therapy Essential and Nonessential Nutrients Macronutrients and Micronutrients Digestion and Assimilation of Nutrients Nutritional Guidelines Alterations That Can Cause Nutritional Deficiencies SECTION 1 Nutritional Assessment Criteria Used for a Nutritional Screening or Assessment Assessing and Monitoring a Client's Food and Fluid Intake Summary Application of the Nursing Process Critical Concepts: Nutritional Assessment SKILL 5.1 Performing a Nutritional Screening SECTION 2 Assisting Clients With Oral Nutrition Types of Diets Preparing A Client to Receive a Meal Assisting A Client Who Has Difficulty Eating Application of the Nursing Process Critical Concepts: Assisting Clients With Oral Nutrition SKILL 5.2 Preparing a Client to Receive a Meal SKILL 5.3 Assisting Clients With a Physical or Cognitive Impairment SKILL 5.4 Assisting Clients With Dysphagia or Aspiration Risk SECTION 3 Providing Gastric Tube Therapy Nasogastric Sump Tube Levin Tubes and Gastric Lavage Tubes Placement and Care of a Nasogastric Sump Tube Summary Application of the Nursing Process Critical Concepts: Providing Gastric Tube Therapy SKILL 5.5 Placement and Care of a Nasogastric (NG) Sump Tube SKILL 5.6 Initiating and Managing Nasogastric (NG) Sump Tube Suction SKILL 5.7 Irrigating a Nasogastric (NG) Sump Tube SKILL 5.8 Discontinuing a Nasogastric (NG) Sump Tube SECTION 4 Providing Enteral Nutrition Routes of Enteral Feeding Daily Care for Clients With Gastrostomy, PEG, and Jejunostomy Tubes Delivery Methods for Enteral Nutrition Reducing Risks of Enteral Nutrition Home Care Considerations Providing Client-Centered Care During Enteral Nutrition Summary Application of the Nursing Process Critical Concepts: Providing Enteral Nutrition SKILL 5.9 Placement and Care of a Nasally Inserted Small-Bore Feeding Tube SKILL 5.10 Providing Care for a Client With a Gastrostomy, PEG Tube, or Jejunostomy SKILL 5.11 Administering a Tube Feeding (Intermittent or Continuous) SKILL 5.12 Using a Kangaroo Feeding Pump CHAPTER 6 Supporting Mobility and Immobilization SECTION 1 Supporting Mobility Collaborative Care for Clients With Assistive Devices Range of Motion Application of the Nursing Process Critical Concepts: Mobility SKILL 6.1 Assisting With Ambulation Using a Transfer Belt SKILL 6.2 Teaching the Client to Use a Cane SKILL 6.3 Teaching the Client to Use a Walker SKILL 6.4 Teaching the Client to Use Crutches SKILL 6.5 Performing Active and Passive Range-ofMotion (ROM) Exercises SECTION 2 Supporting Immobilization Supporting Immobilization of a Limb or Joint Supporting Cervical Immobilization Pin Care Application of the Nursing Process Critical Concepts: Immobilization SKILL 6.6 Applying a Sling SKILL 6.7 Applying Bandages SKILL 6.8 Providing Cast Care SKILL 6.9 Managing Traction SKILL 6.10 Providing Pin-Site Care SKILL 6.11 Applying a Cervical Collar SKILL 6.12 Managing Halo Traction SECTION 3 Caring for a Client With an Amputation Postoperative Care Communication: Client Education and Collaboration Application of the Nursing Process Critical Concepts: Client With an Amputation SKILL 6.13 Exercising and Positioning the Residual Limb SKILL 6.14 Applying a Compression Bandage and Commercial Shrinker to a Residual Limb CHAPTER 7 Comfort Care The Impact of Pain Nociceptive and Neuropathic Pain Acute and Chronic Pain SECTION 1 Assessment of Pain and Discomfort Subjective and Objective Assessment of Pain Examples of Pain Tools Used for Assessment of Pain Assessment of Pain for Diverse Populations Lifespan Considerations: Older Adults and Pediatric Clients Summary of Best Practice Recommendations for Assessment of Pain Summary of Application of Critical Concepts for Assessment of Pain Application of the Nursing Process Critical Concepts: Assessment of Pain and Discomfort SKILL 7.1 Performing a Pain Assessment SECTION 2 Using Relaxation Measures to Promote Comfort Enhancing the Client's Environment Controlled Breathing Guided Imagery Massage Therapy Summary Application of the Nursing Process Critical Concepts: Using Relaxation Measures to Promote Comfort SKILL 7.2 Enhancing a Client's Environment SKILL 7.3 Assisting a Client With Controlled-Breathing Exercises SKILL 7.4 Assisting a Client With Guided Imagery Exercises SKILL 7.5 Providing a Back Massage SECTION 3 Using a TENS Unit to Promote Comfort Application of the Nursing Process Critical Concepts: Using a TENS Unit to Promote Comfort SKILL 7.6 Applying and Discontinuing a TENS Unit SECTION 4 Using Heat or Cold to Promote Comfort Safety Considerations and Precautions for Heat and Cold Therapy Different Types of Heat and Cold Therapy Summary Application of the Nursing Process Critical Concepts: Using Heat or Cold to Promote Comfort SKILL 7.7 Using a Heat or Cold Pack (Instant or Reusable) SKILL 7.8 Using an Ice Bag SKILL 7.9 Using a Portable Sitz Bath SKILL 7.10 Using Localized Circulating (Aqua) Heat or Cold Therapy SECTION 5 Using Patient-Controlled Analgesia to Promote Comfort Safety Considerations When Using PCA Therapy Summary Application of the Nursing Process Critical Concepts: Using Patient-Controlled Analgesia to Promote Comfort SKILL 7.11 Assessing a Client for Appropriateness of PCA Therapy SKILL 7.12 Initiating and Managing PCA Therapy SKILL 7.13 Teaching the Client and Family About PCA Therapy SKILL 7.14 Discontinuing PCA Therapy SECTION 6 Using Epidural Analgesia to Promote Comfort Safety Considerations for Epidural Catheters Potential Complications of Epidural Catheters Summary Application of the Nursing Process Critical Concepts: Using Epidural Analgesia to Promote Comfort SKILL 7.15 Caring for a Client With an Epidural Catheter SKILL 7.16 Assisting With Removal of an Epidural Catheter CHAPTER 8 End-of-Life Care Definition of End of Life End-of-Life Care and Palliative Care Nursing Initiatives and End-of-Life Care SECTION 1 Bereavement and Spiritual Care Caring for a Client and Family Who Are Grieving Theories of Grieving Types of Grief Children and Grief Nurses and Grief Providing Spiritual Care for a Client and Family Summary Application of the Nursing Process Critical Concepts: Bereavement and Spiritual Care SKILL 8.1 Caring for a Client and Family Who Are Grieving SKILL 8.2 Providing Spiritual Care for a Client and Family SECTION 2 Assisting a Client and Family With Advance Care Planning Tools Used for Advance Care Planning Application of the Nursing Process Critical Concepts: Assisting With Advance Care Planning SKILL 8.3 Assisting With Advance Directives and Do-NotResuscitate (DNR) Orders SECTION 3 Caring for a Client Near the End of Life Application of the Nursing Process Critical Concepts: Caring for a Client Near the End of Life SKILL 8.4 Providing Physical Care for a Client Who Is Dying SECTION 4 Caring for a Client After Death Application of the Nursing Process Critical Concepts: Caring for a Client After Death SKILL 8.5 Providing Postmortem Care UNIT II Intermediate Nursing Skills CHAPTER 9 Airway and Breathing SECTION 1 Maintaining the Health of the Respiratory System Deep Breathing and Coughing Incentive Spirometry Chest Physiotherapy Respiratory System-Specific Assessment Application of the Nursing Process Critical Concepts: Maintaining the Health of the Respiratory System SKILL 9.1 Instructing a Client in Deep-Breathing and Coughing Exercises SKILL 9.2 Instructing a Client to Use Incentive Spirometry SKILL 9.3 Performing Chest Physiotherapy (CPT) SECTION 2 Administering Oxygen Impaired Gas Exchange Using a High-Pressure Oxygen Cylinder Administering Supplemental Oxygen Summary Application of the Nursing Process Critical Concepts: Administering Oxygen SKILL 9.4 Using a High-Pressure Oxygen Cylinder SKILL 9.5 Using an Oxygen Flowmeter SKILL 9.6 Placing a Client on Oxygen by Nasal Cannula SKILL 9.7 Placing a Client on Oxygen by Face Mask SKILL 9.8 Placing a Client on Continuous Positive Airway Pressure (CPAP) SECTION 3 Establishing and Maintaining an Open Airway Oropharyngeal Airway Nasopharyngeal Airway Nasopharyngeal Suctioning Tracheostomy Suctioning an Artificial Airway Collecting Sputum Samples Summary Application of the Nursing Process Critical Concepts: Establishing and Maintaining an Open Airway SKILL 9.9 Inserting an Oropharyngeal Airway SKILL 9.10 Inserting a Nasopharyngeal Airway SKILL 9.11 Performing Nasopharyngeal Suctioning SKILL 9.12 Suctioning an Artificial Airway: Tracheostomy or Endotracheal Tube SKILL 9.13 Obtaining a Sputum Sample From a Client With an Artificial Airway SKILL 9.14 Cleaning a Tracheostomy and Replacing Tracheostomy Ties CHAPTER 10 Sterile Technique SECTION 1 Preparing a Sterile Field Application of the Nursing Process Critical Concepts: Preparing a Sterile Field SKILL 10.1 Opening a Sterile Pack SKILL 10.2 Applying and Removing Sterile Gloves SKILL 10.3 Opening a Sterile Barrier and Setting Up a Sterile Field SKILL 10.4 Adding Sterile Items to a Sterile Field and Draping a Sterile Field SKILL 10.5 Pouring a Sterile Liquid SECTION 2 Preparing to Enter a Sterile Perioperative Setting Surgical Attire Surgical Hand Antisepsis Surgical Gowns and Gloves Application of the Nursing Process Critical Concepts: Preparing to Enter a Sterile Perioperative Area SKILL 10.6 Performing a Surgical Handrub SKILL 10.7 Performing a Surgical Hand Scrub SKILL 10.8 Performing Surgical Gowning SKILL 10.9 Performing Closed Surgical Gloving CHAPTER 11 Medication Administration Medication Safety Initiatives Rights of Medication Administration Safely Processing Medication Orders Performing Preassessments Safely Preparing and Distributing Medications Performing Safety Checks Safety Considerations for High-Alert Medications Performing Dosage Calculation SECTION 1 Administering Oral Medications Types of Oral Medications Crushing/Altering Oral Medications Preparing and Administering Oral Medications Best-Practice Recommendations Pediatric Considerations Home Care and Geriatric Considerations Summary Application of the Nursing Process Critical Concepts: Administering Oral Medications SKILL 11.1 Administering Oral Medications (Tablets, Capsules, or Liquids) SECTION 2 Administering Enteral Medications Application of the Nursing Process Critical Concepts: Administering Enteral Medications SKILL 11.2 Administering a Medication Through a Nasogastric (NG) Tube or Enteral Device SECTION 3 Administering Mucous Membrane Applications Sublingual and Buccal Medications Nasal Instillations Inhalers and Nebulizers Rectal and Vaginal Administration Application of the Nursing Process Critical Concepts: Administering Mucous Membrane Applications SKILL 11.3 Administering Sublingual or Buccal Medications SKILL 11.4 Administering a Nasal Spray Medication SKILL 11.5 Administering Inhaled Medications SKILL 11.6 Administering Nebulized Medications SKILL 11.7 Administering a Rectal Suppository SKILL 11.8 Administering Vaginal Medications SECTION 4 Administering Topical Medications Topical Medications for Localized Effect Transdermal Medications for Systemic Effect Eye and Ear Medications Application of the Nursing Process Critical Concepts: Administering Topical Medications SKILL 11.9 Applying a Transdermal Patch SKILL 11.10 Administering an Eye Medication (Drops or Ointment) SKILL 11.11 Irrigating the Eyes SKILL 11.12 Instilling Ear (Otic) Drops SECTION 5 Administering Parenteral Medications Preparing Equipment for Injections Components of a Needle and Syringe Using Safety and Needleless Systems Preparing Medications Administering Injections Administering Intradermal Injections Administering Subcutaneous Injections Administering Intramuscular Injections Administering Insulin Summary Application of the Nursing Process Critical Concepts: Administering Parenteral Medications SKILL 11.13 Preparing a Medication From a Vial SKILL 11.14 Preparing a Medication From an Ampule SKILL 11.15 Preparing a Medication That Requires Reconstitution SKILL 11.16 Administering an Intradermal Injection SKILL 11.17 Administering a Subcutaneous Injection SKILL 11.18 Administering an Intramuscular Injection SKILL 11.19 Administering a Subcutaneous Insulin Injection SKILL 11.20 Caring for a Client With a Subcutaneous Insulin Pump (External) CHAPTER 12 Venous Access SECTION 1 Collecting Venous Blood Specimens Ensuring Accuracy Selecting a Vein Application of the Nursing Process Critical Concepts: Collecting Venous Blood Specimens SKILL 12.1 Selecting a Vein SKILL 12.2 Obtaining Venous Blood Specimens SECTION 2 Initiating, Dressing, and Discontinuing a Peripheral Intravenous Catheter Selecting a Vein Application of the Nursing Process Critical Concepts: Initiating a Peripheral Intravenous Line SKILL 12.3 Inserting and Dressing a Peripheral Intravenous Catheter SKILL 12.4 Changing a PIV Dressing SKILL 12.5 Discontinuing a Peripheral Intravenous Catheter SECTION 3 Intravenous Fluids Monitoring Intake and Output Types of Intravenous Fluids Infection Control Safety and the Rights of Intravenous Fluid Administration Intravenous Fluid Administration Sets Priming Administration Sets and Bubble Management Infusing Fluids Application of the Nursing Process Critical Concepts: Infusing Intravenous Fluids SKILL 12.6 Managing a Saline Lock SKILL 12.7 Preparing a Primary Intravenous Infusion SKILL 12.8 Replacing Intravenous Infusion Fluid SECTION 4 Administering Intravenous Medications Orders for Intravenous Medications Nursing Responsibilities Medication Preparation and Equipment Complications of Intravenous Medication Administration Application of the Nursing Process Critical Concepts: Administering Intravenous Medications SKILL 12.9 Administering Intermittent Intravenous Medication via Secondary Infusion SKILL 12.10 Administering Intravenous Medication via Intravenous Push SECTION 5 Administering a Blood Transfusion Different Types of Blood Components Types of Blood Transfusions ABO Compatibility System Safety Considerations Equipment Used for a Blood Transfusion Procedure for Administering a Blood Transfusion Possible Complications Application of the Nursing Process Critical Concepts: Administering a Blood Transfusion SKILL 12.11 Administering Packed Red Blood Cells (PRBCs) CHAPTER 13 Central Venous Access SECTION 1 Caring for a Client With a CVAD Tunneled Catheters Nontunneled Catheters Implanted Ports Power-Injection Capable Assisting With Insertion Complications of CVADs Drawing Blood From a CVAD Care for a Client With a Subcutaneous Port: Accessing and Deaccessing Discontinuing a CVAD Critical Concepts and CVADs Application of the Nursing Process Critical Concepts: Caring for the Client With a CVAD SKILL 13.1 Assisting With Insertion SKILL 13.2 Flushing Central Venous Access Devices SKILL 13.3 Changing the CVC or PICC Line Dressing SKILL 13.4 Changing the Needleless Connectors for a CVC/PICC Line SKILL 13.5 Collecting Blood Specimens/Blood Cultures SKILL 13.6 Managing Subcutaneous Ports: Accessing, Changing the Dressing, and Deaccessing SKILL 13.7 Discontinuing a Central Line SECTION 2 Infusing Fluids With a CVAD Infusing Fluids Application of the Nursing Process Critical Concepts: Infusing Fluids Through a CVAD SKILL 13.8 Infusing IV Fluids SKILL 13.9 Initiating TPN and/or Lipids CHAPTER 14 Bowel Management SECTION 1 Supporting Healthy Bowel Elimination Characteristics of Stool Bowel Elimination Problems Application of the Nursing Process Critical Concepts: Supporting Healthy Bowel Elimination SKILL 14.1 Performing Digital Stimulation and Evacuation SKILL 14.2 Inserting Rectal Tubes SKILL 14.3 Applying a Fecal Collection Pouch SKILL 14.4 Setting Up a Fecal Management System SECTION 2 Administering Enemas Application of the Nursing Process Critical Concepts: Administering Enemas SKILL 14.5 Administering a Cleansing Enema SKILL 14.6 Administering a Commercially Prepared Enema SECTION 3 Collecting Specimens Application of the Nursing Process Critical Concepts: Collecting Specimens SKILL 14.7 Collecting a Stool Specimen SKILL 14.8 Obtaining a Stool Specimen for Occult Blood SECTION 4 Caring for a Client With a Bowel Diversion Care of the Stoma and Peristomal Skin Irrigating a Colostomy Cecostomy Application of the Nursing Process Critical Concepts: Caring for a Client With a Bowel Diversion SKILL 14.9 Pouching a Stoma SKILL 14.10 Irrigating an Ostomy CHAPTER 15 Urine Elimination Urine Elimination SECTION 1 Collecting Urine Measurements and Specimens Assessing Production and Volume of Urine Collecting Specimens Application of the Nursing Process Critical Concepts: Obtaining Urine Measurements and Specimens SKILL 15.1 Measuring and Recording Intake and Output SKILL 15.2 Measuring Urine Volume With a Portable Bladder Scanner SKILL 15.3 Obtaining a Urine Specimen From a Closed Urinary Drainage System SKILL 15.4 Obtaining a Urine Specimen Using the Clean-Catch Method SKILL 15.5 Obtaining a 24-Hour Urine Specimen SKILL 15.6 Obtaining a Bagged Urine Specimen From an Infant or Child SECTION 2 Urine Elimination With a Transurethral Catheter Types of Transurethral Catheters Infection Control With Urinary Catheters Communication and Urinary Catheters Providing Client-Centered Care to Specific Populations Bladder Irrigation Application of the Nursing Process Critical Concepts: Urine Elimination With a Transurethral Catheter SKILL 15.7 Inserting and Removing a Straight Catheter in a Female Client SKILL 15.8 Inserting and Removing a Straight Catheter in a Male Client SKILL 15.9 Inserting an Indwelling Foley Catheter in a Female Client SKILL 15.10 Inserting an Indwelling Foley Catheter in a Male Client SKILL 15.11 Removing an Indwelling Foley Catheter SKILL 15.12 Managing an Indwelling Foley Catheter SKILL 15.13 Performing Intermittent Closed Bladder Irrigation SKILL 15.14 Performing Continuous Closed Bladder Irrigation SECTION 3 Urine Elimination With a Urinary Diversion Suprapubic Catheter Urinary Diversions Application of the Nursing Process Critical Concepts: Urine Elimination With a Urinary Diversion SKILL 15.15 Providing Suprapubic Catheter Care SKILL 15.16 Changing a Stoma Appliance on an Ileal Conduit SKILL 15.17 Catheterizing and Irrigating a Continent Urostomy CHAPTER 16 Wound Care SECTION 1 Providing Wound Care Wound Types The Impact of Wounds Client Considerations Wound Assessment Wound Care Collecting Wound Specimens Managing Complex Wounds Dressing Selection and Application Application of the Nursing Process Critical Concepts: Providing Wound Care SKILL 16.1 Dressing Change for a Primary-Intention Wound SKILL 16.2 Collecting Wound Specimens SKILL 16.3 Removing Sutures and Staples SKILL 16.4 Dressing a Partial- or Full-Thickness Wound SECTION 2 Managing Wound Drainage Drains and Negative-Pressure Wound Therapy Application of the Nursing Process Critical Concepts: Managing Wound Drainage SKILL 16.5 Managing a Penrose Drain SKILL 16.6 Emptying a Jackson-Pratt (JP) Drain or Hemovac SKILL 16.7 Negative-Pressure Wound Therapy (NPWT) SECTION 3 Preventing and Treating Pressure Injury and Venous and Diabetic Ulcers Pressure Injury Venous Ulcers Preventing Diabetic Ulcers Application of the Nursing Process Critical Concepts: Preventing and Treating Pressure Injury and Venous and Diabetic Ulcers SKILL 16.8 Applying Compression Dressings or Unna Boot SKILL 16.9 Foot Examination and Monofilament Testing SKILL 16.10 Measuring the Ankle-Brachial Index (ABI) CHAPTER 17 Perioperative Care SECTION 1 Providing Preoperative Education and Care Factors Affecting Surgical Risks Nursing History and Physical Examination Cultural Considerations Informed Consent Preoperative Teaching Application of the Nursing Process Critical Concepts: Preoperative Care SKILL 17.1 Preparing a Client for Surgery SKILL 17.2 Instructing Client on Thrombosis Prevention SECTION 2 Providing Intraoperative Care Roles of the Surgical Team Surgical Verification Client Positioning Maintaining Safety: Latex Sensitivity/Allergy Types of Anesthesia Preparing the Client's Skin Closing the Wound Application of the Nursing Process SECTION 3 Managing Postoperative Care Postoperative Nursing Care Postoperative Assessment Postoperative Teaching Application of the Nursing Process Critical Concepts: Providing Postoperative Care SKILL 17.3 Admitting a Postoperative Client SKILL 17.4 Applying Pressure Dressings to Control Bleeding SKILL 17.5 Applying and Removing Antiembolism Stockings SKILL 17.6 Managing Sequential Compression Devices SKILL 17.7 Managing Continuous Passive Motion UNIT III Advanced Nursing Skills CHAPTER 18 Advanced Respiratory Management SECTION 1 Caring for a Client With Invasive Mechanical Ventilation The Airway: Endotracheal Tubes Providing Mechanical Ventilation Nursing Care for Clients Who Are Receiving Mechanical Ventilation Reducing the Risk of Complications of Mechanical Ventilation Application of the Nursing Process Critical Concepts: Caring for a Client With Invasive Mechanical Ventilation SKILL 18.1 Caring for a Client Receiving Mechanical Ventilation Arterial Blood Gases Acid-Base Imbalances SECTION 2 Caring for a Client Who Requires Arterial Blood Gas Sampling Indwelling Arterial Catheter Sampling Arterial Puncture Sampling Application of the Nursing Process Critical Concepts: Arterial Blood Gas Sampling SKILL 18.2 Obtaining Arterial Blood Gases From a Peripheral Arterial Line SKILL 18.3 Obtaining Arterial Blood Gases From the Radial Artery SECTION 3 Caring for a Client With a Chest Tube Chest Drainage Systems Caring for the Client With a Chest Tube and Chest Drainage System Troubleshooting the Chest Tube and Drainage System Application of the Nursing Process Critical Concepts: Caring for a Client With a Chest Tube SKILL 18.4 Assisting With Chest Tube Insertion SKILL 18.5 Maintaining a Chest Tube System and Performing an Occlusive Dressing Change SKILL 18.6 Assisting With Removal of a Chest Tube CHAPTER 19 Advanced Cardiovascular Care Cardiovascular System SECTION 1 Caring for a Client on Cardiac Monitoring Cardiac Conduction System The ECG Tracing Equipment Used in ECG Monitoring Lead Placement for ECG Monitoring Types of ECG Monitoring Performing a 12-Lead ECG Possible Safety and Technical Issues With ECG Monitoring Summary Application of the Nursing Process Critical Concepts: Caring for a Client on Cardiac Monitoring SKILL 19.1 Placing a Client on a Continuous ECG Monitor (Hardwire or Telemetry) SKILL 19.2 Performing a Diagnostic 12-Lead ECG SECTION 2 Caring for a Client With a Dysrhythmia or Altered Cardiac Conduction Dysrhythmias and Conduction Disorders Using Synchronized Cardioversion Summary Application of the Nursing Process Critical Concepts: Caring for a Client With a Dysrhythmia or Altered Cardiac Conduction SKILL 19.3 Performing or Assisting With Elective Cardioversion SECTION 3 Caring for a Client With a Cardiac Pacemaker Cardiac Pacemakers How a Pacemaker Works: Major Functions and Components Types of Pacemakers Temporary Pacemakers Permanent Pacemakers Possible Complications/Safety Issues With Pacemakers Application of the Nursing Process Critical Concepts: Caring for a Client With a Pacemaker SKILL 19.4 Caring for a Client With a Transcutaneous Pacemaker (TCP) SKILL 19.5 Caring for a Client With a Transvenous Pacemaker (TVP) SECTION 4 Caring for a Client With a Cardiac Emergency Caring for a Client With Ischemic Chest Pain Emergency Cardiac Catheterization Providing Emergency Defibrillation Caring for a Client Who Is in Cardiac Arrest Application of the Nursing Process Critical Concepts: Caring for a Client With a Cardiac Emergency SKILL 19.6 Providing Care for a Client With Acute Ischemic Chest Pain SKILL 19.7 Caring for a Client After an Emergency Cardiac Catheterization SKILL 19.8 Providing Emergency (Asynchronous) Manual Defibrillation SKILL 19.9 Responding to a Client (Adult) in Cardiac Arrest CHAPTER 20 Advanced Neurologic Care Intracranial Processes Major Neurologic Injuries: Traumatic and Nontraumatic SECTION 1 Advanced Neurologic Assessment Performing a Neurologic Assessment Assessment of Level of Consciousness Assessment of Pupillary Response and Function Using a Pupillometer Device for Assessment of Pupils Assessment of Verbal Response and Function Assessment of Motor and Sensory Function Assessment of Deep Tendon Reflexes Lifespan Considerations Diagnostic Procedures Summary Application of the Nursing Process Critical Concepts: Advanced Neurologic Assessment SKILL 20.1 Performing a Neurologic Assessment SKILL 20.2 Using a Pupillometer SKILL 20.3 Assisting With a Lumbar Puncture SECTION 2 Caring for a Client With Increased Intracranial Pressure Interventions for Clients With Increased ICP Caring for a Client With an External Ventricular Drain and Performing ICP Monitoring Summary Application of the Nursing Process Critical Concepts: Caring for a Client With Increased Intracranial Pressure SKILL 20.4 Caring for a Client With an External Ventricular Drain (EVD) and Obtaining Intracranial Pressure (ICP) Readings SECTION 3 Caring for a Client With a Neurologic Emergency Caring for a Client Who Is Having a Seizure Caring for a Client Who May Be Having an Acute Stroke Summary Application of the Nursing Process Critical Concepts: Caring for a Client With a Neurologic Emergency SKILL 20.5 Caring for a Client Who Requires Seizure Precautions SKILL 20.6 Assessing a Client Who May Be Having an Acute Stroke ILLUSTRATION CREDITS INDEX UNIT I Fundamental Nursing Skills Foundations of Safe Client Care SECTION 1 Identifying a Client Application of the Nursing Process Critical Concepts: Identifying the Client SKILL 1.1 Identifying a Client SECTION 2 Preventing Infection Chain of Infection Preventing the Transmission of Infection Application of the Nursing Process Critical Concepts: Preventing Infection SKILL 1.2 Performing Hand Hygiene With an AlcoholBased Agent SKILL 1.3 Performing Hand Hygiene With Soap and Water SKILL 1.4 Applying and Removing Clean Gloves SKILL 1.5 Applying and Removing Personal Protective Equipment SECTION 3 Moving Clients Safely Benefits of Proper Client Positioning and Repositioning Ergonomics and Body Mechanics Summary Application of the Nursing Process Critical Concepts: Moving the Client Safely SKILL 1.6 Positioning a Client in Bed SKILL 1.7 Moving a Client up in Bed SKILL 1.8 Transferring a Client From Bed to Chair SKILL 1.9 Using a Sling Lift to Move a Client SKILL 1.10 Using a Sit-to-Stand Lift SKILL 1.11 Transferring Clients Laterally (From Bed to Stretcher) SKILL 1.12 Moving Clients Who Have Special Precautions (Logrolling) SECTION 4 Using Restraints Defining Restraints Use of Securing Devices Regulations Governing Use of Restraints Application of the Nursing Process Critical Concepts: Using Restraints SKILL 1.13 Applying and Removing Restraints SKILL 1.14 Applying a Mummy Restraint CHAPTER 2 Personal Care and Hygiene SECTION 1 Bathing a Client Skin Assessment Skin Care Bathing an Adult Bathing an Infant Application of the Nursing Process Critical Concepts: Bathing the Client SKILL 2.1 Assisting an Ambulatory Client With Bathing SKILL 2.2 Changing the Gown of a Client With an IV Line SKILL 2.3 Bathing an Adult Client in Bed SKILL 2.4 Providing Alternate Perineal Care SKILL 2.5 Providing Foot Care SKILL 2.6 Providing Nail Care SKILL 2.7 Bathing an Infant SECTION 2 Oral Hygiene Dentures Oral Care in the Acute Care Setting Application of the Nursing Process Critical Concepts: Providing Oral Care SKILL 2.8 Providing Oropharyngeal Suctioning With a Round-Tip Suction Catheter (Yankauer) SKILL 2.9 Providing Oral Hygiene for a Conscious Client SKILL 2.10 Providing Oral Hygiene for an Unconscious Client SKILL 2.11 Removing, Cleaning, and Inserting Dentures SECTION 3 Providing Hair Care Shaving Lice Application of the Nursing Process Critical Concepts: Providing Hair Care SKILL 2.12 Shampooing the Nonambulatory Client's Hair SKILL 2.13 Shampooing a Client With a Dry-Shampoo Cap SKILL 2.14 Shaving a Client SKILL 2.15 Caring for a Client With Lice SECTION 4 Eye and Ear Care Application of the Nursing Process Critical Concepts: Eye and Ear Care SKILL 2.16 Providing Eye Care for an Unconscious Client SKILL 2.17 Removing and Cleaning Contact Lenses SKILL 2.18 Removing, Cleaning, and Inserting an Artificial Eye SECTION 5 Assisting With Elimination Applying Concepts of Safety, Client-Centered Care, Collaboration, and Health Maintenance Bedside Commode, Urinals, Bedpans, and Condom Catheters Application of the Nursing Process Critical Concepts: Assisting With Elimination SKILL 2.19 Assisting a Client Using a Bedside Commode SKILL 2.20 Assisting a Client Using a Urinal SKILL 2.21 Assisting a Client Using a Bedpan SKILL 2.22 Applying a Condom Catheter SECTION 6 Making Beds Types of Beds Types of Mattresses Types of Bedding and Bed Making Application of the Nursing Process Critical Concepts: Changing a Bed SKILL 2.23 Changing an Unoccupied Bed SKILL 2.24 Making a Surgical Bed SKILL 2.25 Changing an Occupied Bed CHAPTER 3 Vital Signs and Vital Measurements Vital Signs SECTION 1 Assessing Temperature Sites and Methods of Temperature Assessment Application of the Nursing Process Critical Concepts: Assessing Temperature SKILL 3.1 Measuring Temperature With an Electronic Thermometer SKILL 3.2 Obtaining a Tympanic Temperature SKILL 3.3 Obtaining a Temperature Using a Temporal Artery Thermometer SECTION 2 Regulating Temperature Regulating Temperature Application of the Nursing Process Critical Concepts: Regulating Temperature SKILL 3.4 Using Conductive Cooling or Heating Therapy SKILL 3.5 Using an Infant Radiant Warmer SECTION 3 Assessing Pulses Location and Differentiation of Pulses Apical Pulse Technique for Assessing Pulses Alterations of the Client's Pulse Application of the Nursing Process Critical Concepts: Assessing Pulses SKILL 3.6 Obtaining a Radial Pulse Rate SKILL 3.7 Assessing Carotid Pulses SKILL 3.8 Assessing Peripheral Pulses SKILL 3.9 Using a Doppler Ultrasound Device to Assess Pulses SKILL 3.10 Obtaining an Apical Pulse SKILL 3.11 Obtaining an Apical-Radial Pulse SECTION 4 Assessing Respirations Assessing Respirations in Pediatric Clients Application of the Nursing Process Critical Concepts: Assessing Respirations SKILL 3.12 Obtaining a Respiratory Rate and Respiratory Assessment SECTION 5 Assessing Blood Pressure Classification of Hypertension Factors Affecting Blood Pressure Measuring Blood Pressure Application of the Nursing Process Critical Concepts: Assessing Blood Pressure SKILL 3.13 Palpating a Systolic Blood Pressure SKILL 3.14 Measuring a Systolic and Diastolic Blood Pressure by Auscultation SKILL 3.15 Measuring Blood Pressure With an Automatic Oscillometric Monitor SKILL 3.16 Using a Doppler Ultrasound Device to Hear Systolic Blood Pressure Vital Measurements SECTION 6 Assessing Oxygen Saturation Obtaining an SpO2 Reading Application of the Nursing Process Critical Concepts: Assessing Oxygen Saturation SKILL 3.17 Obtaining a Pulse Oximeter Measurement SECTION 7 Assessing Blood Glucose Application of the Nursing Process Critical Concepts: Assessing Blood Glucose SKILL 3.18 Obtaining Capillary Blood Glucose Measurements CHAPTER 4 Performing an Assessment The Assessment Process SECTION 1 Collecting Subjective and Objective Data Collecting Subjective Data Collecting Objective Data Performing a Preliminary Survey Summary Critical Concepts: Collecting Subjective and Objective Data SKILL 4.1 Performing a Preliminary Survey SECTION 2 Performing a Head-to-Toe or SystemSpecific Assessment Critical Concepts When Performing a Head-to-Toe or System-Specific Assessment Performing a Rapid Head-to-Toe Bedside Assessment Performing a System-Specific Assessment Summary Critical Concepts: Performing a Head-to-Toe or SystemSpecific Assessment SKILL 4.2 Performing a Rapid Head-to-Toe Bedside Assessment SKILL 4.3 Assessing the Skin/Integumentary System SKILL 4.4 Assessing the Head (HEENT) and Neck SKILL 4.5 Assessing the Neurologic System SKILL 4.6 Assessing the Thorax (Heart and Lungs) SKILL 4.7 Assessing the Abdomen SKILL 4.8 Assessing the Musculoskeletal System SKILL 4.9 Assessing the Genitourinary System CHAPTER 5 Nutrition and Gastrointestinal Tube Therapy Essential and Nonessential Nutrients Macronutrients and Micronutrients Digestion and Assimilation of Nutrients Nutritional Guidelines Alterations That Can Cause Nutritional Deficiencies SECTION 1 Nutritional Assessment Criteria Used for a Nutritional Screening or Assessment Assessing and Monitoring a Client's Food and Fluid Intake Summary Application of the Nursing Process Critical Concepts: Nutritional Assessment SKILL 5.1 Performing a Nutritional Screening SECTION 2 Assisting Clients With Oral Nutrition Types of Diets Preparing A Client to Receive a Meal Assisting A Client Who Has Difficulty Eating Application of the Nursing Process Critical Concepts: Assisting Clients With Oral Nutrition SKILL 5.2 Preparing a Client to Receive a Meal SKILL 5.3 Assisting Clients With a Physical or Cognitive Impairment SKILL 5.4 Assisting Clients With Dysphagia or Aspiration Risk SECTION 3 Providing Gastric Tube Therapy Nasogastric Sump Tube Levin Tubes and Gastric Lavage Tubes Placement and Care of a Nasogastric Sump Tube Summary Application of the Nursing Process Critical Concepts: Providing Gastric Tube Therapy SKILL 5.5 Placement and Care of a Nasogastric (NG) Sump Tube SKILL 5.6 Initiating and Managing Nasogastric (NG) Sump Tube Suction SKILL 5.7 Irrigating a Nasogastric (NG) Sump Tube SKILL 5.8 Discontinuing a Nasogastric (NG) Sump Tube SECTION 4 Providing Enteral Nutrition Routes of Enteral Feeding Daily Care for Clients With Gastrostomy, PEG, and Jejunostomy Tubes Delivery Methods for Enteral Nutrition Reducing Risks of Enteral Nutrition Home Care Considerations Providing Client-Centered Care During Enteral Nutrition Summary Application of the Nursing Process Critical Concepts: Providing Enteral Nutrition SKILL 5.9 Placement and Care of a Nasally Inserted Small-Bore Feeding Tube SKILL 5.10 Providing Care for a Client With a Gastrostomy, PEG Tube, or Jejunostomy SKILL 5.11 Administering a Tube Feeding (Intermittent or Continuous) SKILL 5.12 Using a Kangaroo Feeding Pump CHAPTER 6 Supporting Mobility and Immobilization SECTION 1 Supporting Mobility Collaborative Care for Clients With Assistive Devices Range of Motion Application of the Nursing Process Critical Concepts: Mobility SKILL 6.1 Assisting With Ambulation Using a Transfer Belt SKILL 6.2 Teaching the Client to Use a Cane SKILL 6.3 Teaching the Client to Use a Walker SKILL 6.4 Teaching the Client to Use Crutches SKILL 6.5 Performing Active and Passive Range-ofMotion (ROM) Exercises SECTION 2 Supporting Immobilization Supporting Immobilization of a Limb or Joint Supporting Cervical Immobilization Pin Care Application of the Nursing Process Critical Concepts: Immobilization SKILL 6.6 Applying a Sling SKILL 6.7 Applying Bandages SKILL 6.8 Providing Cast Care SKILL 6.9 Managing Traction SKILL 6.10 Providing Pin-Site Care SKILL 6.11 Applying a Cervical Collar SKILL 6.12 Managing Halo Traction SECTION 3 Caring for a Client With an Amputation Postoperative Care Communication: Client Education and Collaboration Application of the Nursing Process Critical Concepts: Client With an Amputation SKILL 6.13 Exercising and Positioning the Residual Limb SKILL 6.14 Applying a Compression Bandage and Commercial Shrinker to a Residual Limb CHAPTER 7 Comfort Care The Impact of Pain Nociceptive and Neuropathic Pain Acute and Chronic Pain SECTION 1 Assessment of Pain and Discomfort Subjective and Objective Assessment of Pain Examples of Pain Tools Used for Assessment of Pain Assessment of Pain for Diverse Populations Lifespan Considerations: Older Adults and Pediatric Clients Summary of Best Practice Recommendations for Assessment of Pain Summary of Application of Critical Concepts for Assessment of Pain Application of the Nursing Process Critical Concepts: Assessment of Pain and Discomfort SKILL 7.1 Performing a Pain Assessment SECTION 2 Using Relaxation Measures to Promote Comfort Enhancing the Client's Environment Controlled Breathing Guided Imagery Massage Therapy Summary Application of the Nursing Process Critical Concepts: Using Relaxation Measures to Promote Comfort SKILL 7.2 Enhancing a Client's Environment SKILL 7.3 Assisting a Client With Controlled-Breathing Exercises SKILL 7.4 Assisting a Client With Guided Imagery Exercises SKILL 7.5 Providing a Back Massage SECTION 3 Using a TENS Unit to Promote Comfort Application of the Nursing Process Critical Concepts: Using a TENS Unit to Promote Comfort SKILL 7.6 Applying and Discontinuing a TENS Unit SECTION 4 Using Heat or Cold to Promote Comfort Safety Considerations and Precautions for Heat and Cold Therapy Different Types of Heat and Cold Therapy Summary Application of the Nursing Process Critical Concepts: Using Heat or Cold to Promote Comfort SKILL 7.7 Using a Heat or Cold Pack (Instant or Reusable) SKILL 7.8 Using an Ice Bag SKILL 7.9 Using a Portable Sitz Bath SKILL 7.10 Using Localized Circulating (Aqua) Heat or Cold Therapy SECTION 5 Using Patient-Controlled Analgesia to Promote Comfort Safety Considerations When Using PCA Therapy Summary Application of the Nursing Process Critical Concepts: Using Patient-Controlled Analgesia to Promote Comfort SKILL 7.11 Assessing a Client for Appropriateness of PCA Therapy SKILL 7.12 Initiating and Managing PCA Therapy SKILL 7.13 Teaching the Client and Family About PCA Therapy SKILL 7.14 Discontinuing PCA Therapy SECTION 6 Using Epidural Analgesia to Promote Comfort Safety Considerations for Epidural Catheters Potential Complications of Epidural Catheters Summary Application of the Nursing Process Critical Concepts: Using Epidural Analgesia to Promote Comfort SKILL 7.15 Caring for a Client With an Epidural Catheter SKILL 7.16 Assisting With Removal of an Epidural Catheter CHAPTER 8 End-of-Life Care Definition of End of Life End-of-Life Care and Palliative Care Nursing Initiatives and End-of-Life Care SECTION 1 Bereavement and Spiritual Care Caring for a Client and Family Who Are Grieving Theories of Grieving Types of Grief Children and Grief Nurses and Grief Providing Spiritual Care for a Client and Family Summary Application of the Nursing Process Critical Concepts: Bereavement and Spiritual Care SKILL 8.1 Caring for a Client and Family Who Are Grieving SKILL 8.2 Providing Spiritual Care for a Client and Family SECTION 2 Assisting a Client and Family With Advance Care Planning Tools Used for Advance Care Planning Application of the Nursing Process Critical Concepts: Assisting With Advance Care Planning SKILL 8.3 Assisting With Advance Directives and Do-NotResuscitate (DNR) Orders SECTION 3 Caring for a Client Near the End of Life Application of the Nursing Process Critical Concepts: Caring for a Client Near the End of Life SKILL 8.4 Providing Physical Care for a Client Who Is Dying SECTION 4 Caring for a Client After Death Application of the Nursing Process Critical Concepts: Caring for a Client After Death SKILL 8.5 Providing Postmortem Care UNIT II Intermediate Nursing Skills CHAPTER 9 Airway and Breathing SECTION 1 Maintaining the Health of the Respiratory System Deep Breathing and Coughing Incentive Spirometry Chest Physiotherapy Respiratory System-Specific Assessment Application of the Nursing Process Critical Concepts: Maintaining the Health of the Respiratory System SKILL 9.1 Instructing a Client in Deep-Breathing and Coughing Exercises SKILL 9.2 Instructing a Client to Use Incentive Spirometry SKILL 9.3 Performing Chest Physiotherapy (CPT) SECTION 2 Administering Oxygen Impaired Gas Exchange Using a High-Pressure Oxygen Cylinder Administering Supplemental Oxygen Summary Application of the Nursing Process Critical Concepts: Administering Oxygen SKILL 9.4 Using a High-Pressure Oxygen Cylinder SKILL 9.5 Using an Oxygen Flowmeter SKILL 9.6 Placing a Client on Oxygen by Nasal Cannula SKILL 9.7 Placing a Client on Oxygen by Face Mask SKILL 9.8 Placing a Client on Continuous Positive Airway Pressure (CPAP) SECTION 3 Establishing and Maintaining an Open Airway Oropharyngeal Airway Nasopharyngeal Airway Nasopharyngeal Suctioning Tracheostomy Suctioning an Artificial Airway Collecting Sputum Samples Summary Application of the Nursing Process Critical Concepts: Establishing and Maintaining an Open Airway SKILL 9.9 Inserting an Oropharyngeal Airway SKILL 9.10 Inserting a Nasopharyngeal Airway SKILL 9.11 Performing Nasopharyngeal Suctioning SKILL 9.12 Suctioning an Artificial Airway: Tracheostomy or Endotracheal Tube SKILL 9.13 Obtaining a Sputum Sample From a Client With an Artificial Airway SKILL 9.14 Cleaning a Tracheostomy and Replacing Tracheostomy Ties CHAPTER 10 Sterile Technique SECTION 1 Preparing a Sterile Field Application of the Nursing Process Critical Concepts: Preparing a Sterile Field SKILL 10.1 Opening a Sterile Pack SKILL 10.2 Applying and Removing Sterile Gloves SKILL 10.3 Opening a Sterile Barrier and Setting Up a Sterile Field SKILL 10.4 Adding Sterile Items to a Sterile Field and Draping a Sterile Field SKILL 10.5 Pouring a Sterile Liquid SECTION 2 Preparing to Enter a Sterile Perioperative Setting Surgical Attire Surgical Hand Antisepsis Surgical Gowns and Gloves Application of the Nursing Process Critical Concepts: Preparing to Enter a Sterile Perioperative Area SKILL 10.6 Performing a Surgical Handrub SKILL 10.7 Performing a Surgical Hand Scrub SKILL 10.8 Performing Surgical Gowning SKILL 10.9 Performing Closed Surgical Gloving CHAPTER 11 Medication Administration Medication Safety Initiatives Rights of Medication Administration Safely Processing Medication Orders Performing Preassessments Safely Preparing and Distributing Medications Performing Safety Checks Safety Considerations for High-Alert Medications Performing Dosage Calculation SECTION 1 Administering Oral Medications Types of Oral Medications Crushing/Altering Oral Medications Preparing and Administering Oral Medications Best-Practice Recommendations Pediatric Considerations Home Care and Geriatric Considerations Summary Application of the Nursing Process Critical Concepts: Administering Oral Medications SKILL 11.1 Administering Oral Medications (Tablets, Capsules, or Liquids) SECTION 2 Administering Enteral Medications Application of the Nursing Process Critical Concepts: Administering Enteral Medications SKILL 11.2 Administering a Medication Through a Nasogastric (NG) Tube or Enteral Device SECTION 3 Administering Mucous Membrane Applications Sublingual and Buccal Medications Nasal Instillations Inhalers and Nebulizers Rectal and Vaginal Administration Application of the Nursing Process Critical Concepts: Administering Mucous Membrane Applications SKILL 11.3 Administering Sublingual or Buccal Medications SKILL 11.4 Administering a Nasal Spray Medication SKILL 11.5 Administering Inhaled Medications SKILL 11.6 Administering Nebulized Medications SKILL 11.7 Administering a Rectal Suppository SKILL 11.8 Administering Vaginal Medications SECTION 4 Administering Topical Medications Topical Medications for Localized Effect Transdermal Medications for Systemic Effect Eye and Ear Medications Application of the Nursing Process Critical Concepts: Administering Topical Medications SKILL 11.9 Applying a Transdermal Patch SKILL 11.10 Administering an Eye Medication (Drops or Ointment) SKILL 11.11 Irrigating the Eyes SKILL 11.12 Instilling Ear (Otic) Drops SECTION 5 Administering Parenteral Medications Preparing Equipment for Injections Components of a Needle and Syringe Using Safety and Needleless Systems Preparing Medications Administering Injections Administering Intradermal Injections Administering Subcutaneous Injections Administering Intramuscular Injections Administering Insulin Summary Application of the Nursing Process Critical Concepts: Administering Parenteral Medications SKILL 11.13 Preparing a Medication From a Vial SKILL 11.14 Preparing a Medication From an Ampule SKILL 11.15 Preparing a Medication That Requires Reconstitution SKILL 11.16 Administering an Intradermal Injection SKILL 11.17 Administering a Subcutaneous Injection SKILL 11.18 Administering an Intramuscular Injection SKILL 11.19 Administering a Subcutaneous Insulin Injection SKILL 11.20 Caring for a Client With a Subcutaneous Insulin Pump (External) CHAPTER 12 Venous Access SECTION 1 Collecting Venous Blood Specimens Ensuring Accuracy Selecting a Vein Application of the Nursing Process Critical Concepts: Collecting Venous Blood Specimens SKILL 12.1 Selecting a Vein SKILL 12.2 Obtaining Venous Blood Specimens SECTION 2 Initiating, Dressing, and Discontinuing a Peripheral Intravenous Catheter Selecting a Vein Application of the Nursing Process Critical Concepts: Initiating a Peripheral Intravenous Line SKILL 12.3 Inserting and Dressing a Peripheral Intravenous Catheter SKILL 12.4 Changing a PIV Dressing SKILL 12.5 Discontinuing a Peripheral Intravenous Catheter SECTION 3 Intravenous Fluids Monitoring Intake and Output Types of Intravenous Fluids Infection Control Safety and the Rights of Intravenous Fluid Administration Intravenous Fluid Administration Sets Priming Administration Sets and Bubble Management Infusing Fluids Application of the Nursing Process Critical Concepts: Infusing Intravenous Fluids SKILL 12.6 Managing a Saline Lock SKILL 12.7 Preparing a Primary Intravenous Infusion SKILL 12.8 Replacing Intravenous Infusion Fluid SECTION 4 Administering Intravenous Medications Orders for Intravenous Medications Nursing Responsibilities Medication Preparation and Equipment Complications of Intravenous Medication Administration Application of the Nursing Process Critical Concepts: Administering Intravenous Medications SKILL 12.9 Administering Intermittent Intravenous Medication via Secondary Infusion SKILL 12.10 Administering Intravenous Medication via Intravenous Push SECTION 5 Administering a Blood Transfusion Different Types of Blood Components Types of Blood Transfusions ABO Compatibility System Safety Considerations Equipment Used for a Blood Transfusion Procedure for Administering a Blood Transfusion Possible Complications Application of the Nursing Process Critical Concepts: Administering a Blood Transfusion SKILL 12.11 Administering Packed Red Blood Cells (PRBCs) CHAPTER 13 Central Venous Access SECTION 1 Caring for a Client With a CVAD Tunneled Catheters Nontunneled Catheters Implanted Ports Power-Injection Capable Assisting With Insertion Complications of CVADs Drawing Blood From a CVAD Care for a Client With a Subcutaneous Port: Accessing and Deaccessing Discontinuing a CVAD Critical Concepts and CVADs Application of the Nursing Process Critical Concepts: Caring for the Client With a CVAD SKILL 13.1 Assisting With Insertion SKILL 13.2 Flushing Central Venous Access Devices SKILL 13.3 Changing the CVC or PICC Line Dressing SKILL 13.4 Changing the Needleless Connectors for a CVC/PICC Line SKILL 13.5 Collecting Blood Specimens/Blood Cultures SKILL 13.6 Managing Subcutaneous Ports: Accessing, Changing the Dressing, and Deaccessing SKILL 13.7 Discontinuing a Central Line SECTION 2 Infusing Fluids With a CVAD Infusing Fluids Application of the Nursing Process Critical Concepts: Infusing Fluids Through a CVAD SKILL 13.8 Infusing IV Fluids SKILL 13.9 Initiating TPN and/or Lipids CHAPTER 14 Bowel Management SECTION 1 Supporting Healthy Bowel Elimination Characteristics of Stool Bowel Elimination Problems Application of the Nursing Process Critical Concepts: Supporting Healthy Bowel Elimination SKILL 14.1 Performing Digital Stimulation and Evacuation SKILL 14.2 Inserting Rectal Tubes SKILL 14.3 Applying a Fecal Collection Pouch SKILL 14.4 Setting Up a Fecal Management System SECTION 2 Administering Enemas Application of the Nursing Process Critical Concepts: Administering Enemas SKILL 14.5 Administering a Cleansing Enema SKILL 14.6 Administering a Commercially Prepared Enema SECTION 3 Collecting Specimens Application of the Nursing Process Critical Concepts: Collecting Specimens SKILL 14.7 Collecting a Stool Specimen SKILL 14.8 Obtaining a Stool Specimen for Occult Blood SECTION 4 Caring for a Client With a Bowel Diversion Care of the Stoma and Peristomal Skin Irrigating a Colostomy Cecostomy Application of the Nursing Process Critical Concepts: Caring for a Client With a Bowel Diversion SKILL 14.9 Pouching a Stoma SKILL 14.10 Irrigating an Ostomy CHAPTER 15 Urine Elimination Urine Elimination SECTION 1 Collecting Urine Measurements and Specimens Assessing Production and Volume of Urine Collecting Specimens Application of the Nursing Process Critical Concepts: Obtaining Urine Measurements and Specimens SKILL 15.1 Measuring and Recording Intake and Output SKILL 15.2 Measuring Urine Volume With a Portable Bladder Scanner SKILL 15.3 Obtaining a Urine Specimen From a Closed Urinary Drainage System SKILL 15.4 Obtaining a Urine Specimen Using the Clean-Catch Method SKILL 15.5 Obtaining a 24-Hour Urine Specimen SKILL 15.6 Obtaining a Bagged Urine Specimen From an Infant or Child SECTION 2 Urine Elimination With a Transurethral Catheter Types of Transurethral Catheters Infection Control With Urinary Catheters Communication and Urinary Catheters Providing Client-Centered Care to Specific Populations Bladder Irrigation Application of the Nursing Process Critical Concepts: Urine Elimination With a Transurethral Catheter SKILL 15.7 Inserting and Removing a Straight Catheter in a Female Client SKILL 15.8 Inserting and Removing a Straight Catheter in a Male Client SKILL 15.9 Inserting an Indwelling Foley Catheter in a Female Client SKILL 15.10 Inserting an Indwelling Foley Catheter in a Male Client SKILL 15.11 Removing an Indwelling Foley Catheter SKILL 15.12 Managing an Indwelling Foley Catheter SKILL 15.13 Performing Intermittent Closed Bladder Irrigation SKILL 15.14 Performing Continuous Closed Bladder Irrigation SECTION 3 Urine Elimination With a Urinary Diversion Suprapubic Catheter Urinary Diversions Application of the Nursing Process Critical Concepts: Urine Elimination With a Urinary Diversion SKILL 15.15 Providing Suprapubic Catheter Care SKILL 15.16 Changing a Stoma Appliance on an Ileal Conduit SKILL 15.17 Catheterizing and Irrigating a Continent Urostomy CHAPTER 16 Wound Care SECTION 1 Providing Wound Care Wound Types The Impact of Wounds Client Considerations Wound Assessment Wound Care Collecting Wound Specimens Managing Complex Wounds Dressing Selection and Application Application of the Nursing Process Critical Concepts: Providing Wound Care SKILL 16.1 Dressing Change for a Primary-Intention Wound SKILL 16.2 Collecting Wound Specimens SKILL 16.3 Removing Sutures and Staples SKILL 16.4 Dressing a Partial- or Full-Thickness Wound SECTION 2 Managing Wound Drainage Drains and Negative-Pressure Wound Therapy Application of the Nursing Process Critical Concepts: Managing Wound Drainage SKILL 16.5 Managing a Penrose Drain SKILL 16.6 Emptying a Jackson-Pratt (JP) Drain or Hemovac SKILL 16.7 Negative-Pressure Wound Therapy (NPWT) SECTION 3 Preventing and Treating Pressure Injury and Venous and Diabetic Ulcers Pressure Injury Venous Ulcers Preventing Diabetic Ulcers Application of the Nursing Process Critical Concepts: Preventing and Treating Pressure Injury and Venous and Diabetic Ulcers SKILL 16.8 Applying Compression Dressings or Unna Boot SKILL 16.9 Foot Examination and Monofilament Testing SKILL 16.10 Measuring the Ankle-Brachial Index (ABI) CHAPTER 17 Perioperative Care SECTION 1 Providing Preoperative Education and Care Factors Affecting Surgical Risks Nursing History and Physical Examination Cultural Considerations Informed Consent Preoperative Teaching Application of the Nursing Process Critical Concepts: Preoperative Care SKILL 17.1 Preparing a Client for Surgery SKILL 17.2 Instructing Client on Thrombosis Prevention SECTION 2 Providing Intraoperative Care Roles of the Surgical Team Surgical Verification Client Positioning Maintaining Safety: Latex Sensitivity/Allergy Types of Anesthesia Preparing the Client's Skin Closing the Wound Application of the Nursing Process SECTION 3 Managing Postoperative Care Postoperative Nursing Care Postoperative Assessment Postoperative Teaching Application of the Nursing Process Critical Concepts: Providing Postoperative Care SKILL 17.3 Admitting a Postoperative Client SKILL 17.4 Applying Pressure Dressings to Control Bleeding SKILL 17.5 Applying and Removing Antiembolism Stockings SKILL 17.6 Managing Sequential Compression Devices SKILL 17.7 Managing Continuous Passive Motion UNIT III Advanced Nursing Skills CHAPTER 18 Advanced Respiratory Management SECTION 1 Caring for a Client With Invasive Mechanical Ventilation The Airway: Endotracheal Tubes Providing Mechanical Ventilation Nursing Care for Clients Who Are Receiving Mechanical Ventilation Reducing the Risk of Complications of Mechanical Ventilation Application of the Nursing Process Critical Concepts: Caring for a Client With Invasive Mechanical Ventilation SKILL 18.1 Caring for a Client Receiving Mechanical Ventilation Arterial Blood Gases Acid-Base Imbalances SECTION 2 Caring for a Client Who Requires Arterial Blood Gas Sampling Indwelling Arterial Catheter Sampling Arterial Puncture Sampling Application of the Nursing Process Critical Concepts: Arterial Blood Gas Sampling SKILL 18.2 Obtaining Arterial Blood Gases From a Peripheral Arterial Line SKILL 18.3 Obtaining Arterial Blood Gases From the Radial Artery SECTION 3 Caring for a Client With a Chest Tube Chest Drainage Systems Caring for the Client With a Chest Tube and Chest Drainage System Troubleshooting the Chest Tube and Drainage System Application of the Nursing Process Critical Concepts: Caring for a Client With a Chest Tube SKILL 18.4 Assisting With Chest Tube Insertion SKILL 18.5 Maintaining a Chest Tube System and Performing an Occlusive Dressing Change SKILL 18.6 Assisting With Removal of a Chest Tube CHAPTER 19 Advanced Cardiovascular Care Cardiovascular System SECTION 1 Caring for a Client on Cardiac Monitoring Cardiac Conduction System The ECG Tracing Equipment Used in ECG Monitoring Lead Placement for ECG Monitoring Types of ECG Monitoring Performing a 12-Lead ECG Possible Safety and Technical Issues With ECG Monitoring Summary Application of the Nursing Process Critical Concepts: Caring for a Client on Cardiac Monitoring SKILL 19.1 Placing a Client on a Continuous ECG Monitor (Hardwire or Telemetry) SKILL 19.2 Performing a Diagnostic 12-Lead ECG SECTION 2 Caring for a Client With a Dysrhythmia or Altered Cardiac Conduction Dysrhythmias and Conduction Disorders Using Synchronized Cardioversion Summary Application of the Nursing Process Critical Concepts: Caring for a Client With a Dysrhythmia or Altered Cardiac Conduction SKILL 19.3 Performing or Assisting With Elective Cardioversion SECTION 3 Caring for a Client With a Cardiac Pacemaker Cardiac Pacemakers How a Pacemaker Works: Major Functions and Components Types of Pacemakers Temporary Pacemakers Permanent Pacemakers Possible Complications/Safety Issues With Pacemakers Application of the Nursing Process Critical Concepts: Caring for a Client With a Pacemaker SKILL 19.4 Caring for a Client With a Transcutaneous Pacemaker (TCP) SKILL 19.5 Caring for a Client With a Transvenous Pacemaker (TVP) SECTION 4 Caring for a Client With a Cardiac Emergency Caring for a Client With Ischemic Chest Pain Emergency Cardiac Catheterization Providing Emergency Defibrillation Caring for a Client Who Is in Cardiac Arrest Application of the Nursing Process Critical Concepts: Caring for a Client With a Cardiac Emergency SKILL 19.6 Providing Care for a Client With Acute Ischemic Chest Pain SKILL 19.7 Caring for a Client After an Emergency Cardiac Catheterization SKILL 19.8 Providing Emergency (Asynchronous) Manual Defibrillation SKILL 19.9 Responding to a Client (Adult) in Cardiac Arrest CHAPTER 20 Advanced Neurologic Care Intracranial Processes Major Neurologic Injuries: Traumatic and Nontraumatic SECTION 1 Advanced Neurologic Assessment Performing a Neurologic Assessment Assessment of Level of Consciousness Assessment of Pupillary Response and Function Using a Pupillometer Device for Assessment of Pupils Assessment of Verbal Response and Function Assessment of Motor and Sensory Function Assessment of Deep Tendon Reflexes Lifespan Considerations Diagnostic Procedures Summary Application of the Nursing Process Critical Concepts: Advanced Neurologic Assessment SKILL 20.1 Performing a Neurologic Assessment SKILL 20.2 Using a Pupillometer SKILL 20.3 Assisting With a Lumbar Puncture SECTION 2 Caring for a Client With Increased Intracranial Pressure Interventions for Clients With Increased ICP Caring for a Client With an External Ventricular Drain and Performing ICP Monitoring Summary Application of the Nursing Process Critical Concepts: Caring for a Client With Increased Intracranial Pressure SKILL 20.4 Caring for a Client With an External Ventricular Drain (EVD) and Obtaining Intracranial Pressure (ICP) Readings SECTION 3 Caring for a Client With a Neurologic Emergency Caring for a Client Who Is Having a Seizure Caring for a Client Who May Be Having an Acute Stroke Summary Application of the Nursing Process Critical Concepts: Caring for a Client With a Neurologic Emergency SKILL 20.5 Caring for a Client Who Requires Seizure Precautions SKILL 20.6 Assessing a Client Who May Be Having an Acute Stroke ILLUSTRATION CREDITS INDEX

Additional information

GOR013504263
9780323625579
0323625576
Concept-Based Clinical Nursing Skills: Fundamental to Advanced by Loren Stein
Used - Very Good
Paperback
Elsevier - Health Sciences Division
20200619
904
N/A
Book picture is for illustrative purposes only, actual binding, cover or edition may vary.
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