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Critical Care Nursing. Diagnosis and Management PDF

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CONTENTS UNIT I FOUNDATIONS OF CRITICAL UNIT V KIDNEY ALTERATIONS CARE NURSING 25  Kidney Anatomy and Physiology, 681  1  Critical Care Nursing Practice, 1 26  Kidney Clinical Assessment and Diagnostic   2  Ethical Issues, 17 Procedures, 694  3  Legal Issues, 30 27  Kidney Disorders and Therapeutic Management, 707  4  Genetics and Genomics in Critical Care, 48  5  Patient and Family Education, 69 UNIT VI GASTROINTESTINAL  6  Psychosocial and Spiritual Alterations and  ALTERATIONS Management, 88  7  Sleep Alterations and Management, 104 28  Gastrointestinal Anatomy and Physiology, 737  8  Nutrition Alterations and Management, 115 29  Gastrointestinal Clinical Assessment and Diagnostic   9  Pain and Pain Management, 143 Procedures, 750 10  Sedation, Agitation, Delirium: Assessment and  30  Gastrointestinal Disorders and Therapeutic  Management, 170 Management, 763 11  End-of-Life Issues, 182 UNIT VII ENDOCRINE ALTERATIONS UNIT II CARDIOVASCULAR 31  Endocrine Anatomy and Physiology, 788 ALTERATIONS 32  Endocrine Clinical Assessment and Diagnostic  Procedures, 800 12  Cardiovascular Anatomy and Physiology, 200 33  Endocrine Disorders and Therapeutic Management, 809 13  Cardiovascular Clinical Assessment, 222 14  Cardiovascular Diagnostic Procedures, 237 UNIT VIII MULTISYSTEM 15  Cardiovascular Disorders, 338 ALTERATIONS 16  Cardiovascular Therapeutic Management, 412 34  Trauma, 849 UNIT III PULMONARY 35  Shock, Sepsis, and Multiple Organ Dysfunction  ALTERATIONS Syndrome, 887 36  Burns, 926 17  Pulmonary Anatomy and Physiology, 467 37  Organ Donation and Transplantation, 951 18  Pulmonary Clinical Assessment, 488 38  Hematologic Disorders and Oncologic Emergencies, 997 19  Pulmonary Diagnostic Procedures, 502 20  Pulmonary Disorders, 514 UNIT IX SPECIAL POPULATIONS 21  Pulmonary Therapeutic Management, 549 39  The Obstetric Patient, 1017 40  The Pediatric Patient, 1041 UNIT IV NEUROLOGIC 41  The Older Adult Patient, 1072 ALTERATIONS 42  The Perianesthesia Patient, 1095 22  Neurologic Anatomy and Physiology, 587 23  Neurologic Clinical Assessment and Diagnostic  APPENDIXES Procedures, 620 24  Neurologic Disorders and Therapeutic   A  Nursing Management Plans of Care, 1119 Management, 646 B  Physiologic Formulas for Critical Care, 1163 Critical Care Nursing Diagnosis and Management YOU’VE JUST PURCHASED MORE THAN A TEXTBOOK!* Evolve Student Learning Resources for Urden, Stacy & Lough: Critical Care Nursing, Seventh Edition, offer the following features: • Review questions for NCLEX, CCRN and  PCCN certifications • Mosby’s Nursing Skills Procedures • Animations and Videos • Critical Care Glossary Activate the complete learning experience that comes with each NEW textbook purchase by registering your access code at http://evolve.elsevier.com/Urden/criticalcare/ If you purchased a used book and the code at the right has already been revealed, the code may have been used and cannot be re-used for registration. To purchase access to these valuable study resources, simply follow the link above. REGISTER TODAY! * Evolve Student Resources are provided free with each NEW book purchase only. Critical Care Nursing seventh editon Diagnosis and Management Linda D. Urden, DNSc, RN, CNS, NE-BC, FAAN Professor and Director Master’s and International Nursing Programs University of San Diego San Diego, California Kathleen M. Stacy, PhD, RN, CNS, CCRN, PCCN, CCNS Clinical Nurse Specialist–Pulmonary/Medicine PCU Palomar Medical Center Escondido, California; Clinical Associate Professor Hahn School of Nursing and Health Science University of San Diego San Diego, California Mary E. Lough, PhD, RN, CNS, CCRN, CNRN, CCNS Clinical Nurse Specialist–Critical Care Stanford Hospital and Clinics Stanford, California; Clinical Professor Department of Physiological Nursing University of California, San Francisco (UCSF) San Francisco, California 3251 Riverport Lane St. Louis, Missouri 63043 CRITICAL CARE NURSING: DIAGNOSIS AND MANAGEMENT ISBN: 978-0-323-09178-7 Copyright © 2014, 2010 by Mosby, an imprint of Elsevier Inc. Copyright © 2006, 2002, 1998, 1994, 1990 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. NANDA International Nursing Diagnoses: Definitions and Classifications 2012-2014; Herdman T.H. (ED); copyright © 2012, 1994-2012 NANDA International; used by arrangement with John Wiley & Sons, Limited. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. ISBN: 978-0-323-09178-7 Executive Content Strategist: Tamara Myers Senior Content Development Specialist: Linda Thomas Publishing Services Manager: Deborah L. Vogel Project Manager: Bridget Healy Design Direction: Amy Buxton Printed in Canada Last digit is the print number: 9 8 7 6 5 4 3 2 1 To Pollyanna and Jasmine LDU To nursing students and those who teach them in the classroom and clinical settings. To my wonderful husband James whose presence in my life has brought me an abundance of riches. KMS To Angela Mallett and Jim Schrempp Two people who make the world a better place every day MEL This page intentionally left blank ABOUT THE AUTHORS Linda D. Urden, DNSc, RN, CNS, NE-BC, FAAN positions, including staff nurse, clinical educator, outcomes Linda Urden received her diploma in nursing from Barnes manager, and nurse manager. Currently Kathleen is the Clinical Hospital School of Nursing, St. Louis, Missouri; her BSN from Nurse Specialist for the Pulmonary/Medicine Progressive Care Pepperdine University, Malibu, California; her MN, Cardiovas- Unit at Palomar Medical Center. As an advanced practitioner, cular Clinical Nurse Specialist, from UCLA; and her DNSc from Kathleen collaborates with the health care team to facilitate the the University of San Diego. She is doubly credentialled as achievement of optimal outcomes for the critically ill patient. a clinical nurse specialist and in Executive Nursing by the As a consultant, she facilitates change to improve patient care. American Nurses Credentialing Center and is a Fellow in the As an educator, Kathleen develops and implements programs American Academy of Nursing. Linda has held a variety of to assist the staff with acquisition of the skills and knowledge clinical and administrative positions, with accountabilities needed to care for the critically ill patient. As a researcher, she for quality, evidence-based practice, research, education, and conducts nursing research with a focus on patient safety and advanced practice. In her various positions she has striven to end-of-life care. Kathleen also holds a faculty position at the create cultures that are sensitive to differentiated practice and Hahn School of Nursing and Health Science at University of ensure healthy work environments supporting excellence in San Diego and an adjunct faculty position at San Diego State nursing practice. In addition to this text, Linda coauthored University School of Nursing. In addition to this text, Kathleen Priorities in Critical Care Nursing. Other publications are in the coauthored Priorities in Critical Care Nursing. areas of heart failure, ethics, research, outcomes measurement, Mary E. Lough, PhD, RN, CNS, CCRN, CNRN, CCNS management and care delivery redesign, executive decision support databases, and collaborative practice models, clinical Mary Lough is a critical care nurse with more than 30 years of nurse practice outcomes, and Magnet environments. In addi- experience as a staff nurse, educator, and Clinical Nurse Special- tion, she is a member of editorial boards and is a peer reviewer ist. Mary received her BSN from the University of Manchester for several nursing journals. Her research is focused on clinical, in England and her MS and PhD from the University of Cali- fiscal, quality, and behavioral outcomes of care delivery and fornia, San Francisco (UCSF). Mary is the Clinical Nurse Spe- services. cialist for the medical/surgical/neuroscience/trauma ICU at Stanford Hospital and Clinics in Palo Alto, California. She is Kathleen M. Stacy, PhD, RN, CNS, CCRN, PCCN, also a Clinical Professor in the Department of Physiological CCNS Nursing at her alma mater, UCSF. Kathleen Stacy has been a nurse for 34 years, the majority of Mary has been involved with all seven editions of Critical which she has spent working in critical care. She graduated in Care Nursing: Diagnosis and Management, and she also has pub- 1978 with a BS in nursing from the State University of New York lished many other articles and research abstracts. As a clinician, at Plattsburgh, in 1989 with an MS in critical care nursing from Mary appreciates the benefits of a clinically grounded textbook San Diego State University, and in 2010 with a PhD in nursing because when she began her career as a critical care nurse so from University of San Diego. She has held a variety of little information was available. vii This page intentionally left blank

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