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LWBK151-3970G-FM-i-xxvi.qxd 11/21/2008 10:06 AM Page i Aptara Inc. Community Health Nursing Promoting and Protecting the Public’s Health LWBK151-3970G-FM-i-xxvi.qxd 11/21/2008 10:06 AM Page ii Aptara Inc. LWBK151-3970G-FM-i-xxvi.qxd 11/21/2008 10:06 AM Page iii Aptara Inc. Community Health Nursing Promoting and Protecting the Public’s Health 7th Edition Judith A.Allender,EdD, MSN, MEd, RN Professor Emerita of Nursing Department of Nursing, College of Health and Human Services California State University, Fresno Fresno, California Cherie Rector,PhD, MSN, RN Professor Department of Nursing California State University, Bakersfield Bakersfield, California Kristine D.Warner,PhD, MPH, RN Associate Professor School of Nursing California State University, Chico Chico, California LWBK151-3970G-FM-i-xxvi.qxd 11/21/2008 10:06 AM Page iv Aptara Inc. Senior Acquisitions Editor: Hilarie Surrena Managing Editor: Katherine Burland Production Project Manager: Cynthia Rudy Director of Nursing Production:Helen Ewan Senior Managing Editor / Production: Erika Kors Design Coordinator: Joan Wendt Manufacturing Coordinator:Karin Duffield Production Services / Compositor:Aptara, Inc. 7th edition Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins. Copyright © 2005 and 2001 by Lippincott Williams & Wilkins. Copyright © 1996 by Barbara Walton Spradley and Judith Ann Allender. Copyright © 1990, 1985, and 1981 by Barbara Walton Spradley. All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To request permission, please contact Lippincott Williams & Wilkins at 530 Walnut Street, Philadelphia, PA 19106, via email at [email protected], or via our website at lww.com (products and services). 9 8 7 6 5 4 3 2 1 Printed in China Library of Congress Cataloging-in-Publication Data Allender,Judith Ann. Community health nursing :promoting and protecting the public’s health / Judith A. Allender,Cherie Rector,Kristine D. Warner. — 7th ed. p. ; cm. Includes bibliographical references and index. ISBN-13:978-0-7817-6584-8 ISBN-10:0-7817-6584-6 1. Community health nursing. 2. Public health nursing. I. Rector,Cherie L. II. Warner,Kristine D. III. Title. [DNLM: 1. Community Health Nursing. 2. Health Promotion. WY 106 A425c 2010] RT98S68 2010 610.73(cid:2)43—dc22 2008045578 Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application of this information in a particular situation remains the professional responsibility of the practitioner; the clinical treatments described and recommended may not be considered absolute and universal recommendations. The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with the current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new or infrequently employed drug. Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care provider to ascertain the FDA status of each drug or device planned for use in his or her clinical practice. LWW.com LWBK151-3970G-FM-i-xxvi.qxd 11/21/2008 10:06 AM Page v Aptara Inc. To my husband Gil, with love and thanks. Judy Allender To my husband—my greatest supporter—and to my children and grandchildren, who make it all worthwhile. Cherie Rector To my son Sean and his wife Angela, my daughters Erin and Kathleen Whalen, and the best mom in the world, Dolores Warner—thank you for your unwavering love and support. Kris Warner v LWBK151-3970G-FM-i-xxvi.qxd 11/21/2008 10:06 AM Page vi Aptara Inc. LWBK151-3970G-FM-i-xxvi.qxd 11/21/2008 10:07 AM Page vii Aptara Inc. About the Authors ❂ Dr. Judith A. Allender has been a nurse for more than 45 grants, research, publications, and presentations have years. For 30 of those years, she taught nursing—first at focused largely on child and adolescent health, school nurs- Good Samaritan Hospital in Cincinnati, Ohio, and later at ing, nursing education, and disadvantaged students. She California State University, Fresno where she retired as a earned an associate’s degree in nursing from the College of Professor Emerita. Her nursing practice experiences were the Sequoias more than 30 years ago, and a bachelor of varied. She worked with surgical patients, in intensive care science in nursing degree from the Consortium of the Cali- units, as a school nurse, in-patient hospice, home care, and fornia State Universities, Long Beach. She has a master’s community health nursing. She has authored five nursing degree in nursing (clinical specialist, community health) textbooks in addition to this one. During her long career, she and a School Nurse Credential from California State Uni- received several awards. She was voted RN of the Year in versity, Fresno. Her doctorate of philosophy in educational Education for the Central Valley of California in 1998. The psychology is from the University of Southern California. fourth edition of this textbook received a Robert Wood John- Dr. Rector and her husband have three grown sons, five son award in 2001 for the end-of-life care content. In 2005, grandsons, and a granddaughter. she was inducted into the Central San Joaquin Valley, Cali- Dr. Kristine Warner, also a native Californian, is an fornia Nursing Hall of Fame. Presently, Dr. Allender con- associate professor at California State University, Chico sults for a nonprofit immigrant and refugee center and with a specialization in public/community health nursing. writes a weekly health column for a local newspaper. She With more than 3 decades of experience in the field of pub- received her undergraduate nursing degree from the State lic/community health, she has taught in nursing programs in University of New York in Plattsburgh; a master’s degree in both Pennsylvania and California. Undergraduate and grad- guidance and counseling from Xavier University in Cincin- uate courses she has taught include community health nurs- nati, Ohio; a master’s in nursing from Wright State Univer- ing, nursing research, program planning and development, sity in Dayton, Ohio; and a doctorate of education from the and health policy. Her nursing career began in adult and University of Southern California. When not busy at home, pediatric acute care, and she has practiced home care and she can be found traveling around the world. She and her public health in rural and urban settings. Her current profes- husband have a blended family with five children, 14 grand- sional interests include evidence-based practice, nursing children, and two great-grandchildren. education, emergency preparedness, and health needs of Dr. Cherie Rector is a native Californian who is cur- vulnerable populations. Her grants, research, publications, rently a Professor at California State University, Bakers- and presentations have focused on emergency preparedness, field Department of Nursing, where she teaches community poverty, chronic illness, and nutrition. Dr. Warner is a retired health nursing. She served as director of the School Nurse Navy Nurse Corps Captain, having ended a 29-year career Credential Program and the RN to BSN Program there and of both active and reserve service in 2002. She was recalled was formerly the coordinator of the School Nurse Creden- to active duty and stationed in the Saudi Arabian desert dur- tial Program at California State University, Fresno, where ing the first Gulf War as Assistant Charge Nurse of a 20-bed she also taught community health nursing. She has served medical unit. She received her bachelor of science in nurs- as the director of Allied Health and the Disabled Students ing from Harris College of Nursing, Texas Christian Univer- Program at College of the Sequoias. She has consulted with sity; master of public health (community health nursing) and school districts and hospitals in the areas of child health, master of science (community health nursing and nursing research, and evidence-based practice and has practiced education) from the University of South Florida; and doc- community health and school nursing, as well as neonatal torate of philosophy in nursing from the University of Penn- nursing in the acute care setting. She has taught undergrad- sylvania. Dr. Warner has three grown children and one uate and graduate level courses in community health, vul- daughter-in-law. She was a resident of Germany for 2 years nerable populations, research, and school nursing. Her in the early 1980s and has traveled extensively in Europe. vii LWBK151-3970G-FM-i-xxvi.qxd 11/21/2008 10:07 AM Page viii Aptara Inc.