Foundations of basic nursing

1077 Pages·2011·4.45 MB·English

by  Lois White

BRIEF CONTENTS
Unit 1: Foundations / 1 Unit 5: Health Promotion / 299
1 Student Nurse Skills for Success ......................2 14 Wellness Concepts .........................................300
2 Holistic Care ......................................................32 15 Self-Concept ....................................................315
3 Nursing History, Education, and 16 Spirituality .......................................................326
Organizations ................................................44 17 Complementary/Alternative Therapies ..........342
4 Legal and Ethical Responsibilities ..................62 18 Basic Nutrition ................................................363
19 Rest and Sleep ................................................403
20 Safety/Hygiene ................................................416
Unit 2: The Health Care
Environment / 89 Unit 6: Infection Control / 439
5 The Health Care Delivery 21 Infection Control/Asepsis ..............................440
System ............................................................90 22 Standard Precautions and Isolation ..............458
6 Arenas of Care .................................................105 23 Bioterrorism ....................................................467
Unit 3: Communication / 121 Unit 7: Fundamental Nursing
Care / 483
7 Communication ...............................................122
8 Client Teaching ................................................143
24 Fluid, Electrolyte, and Acid-Base
9 Nursing Process/Documentation/
Balance ........................................................484
Informatics ...................................................161
25 Medication Administration and
IV Therapy ....................................................515
Unit 4: Developmental and 26 Assessment .....................................................552
27 Pain Management ...........................................573
Psychosocial
28 Diagnostic Tests ..............................................601
Concerns / 197
Unit 8: Nursing Procedures / 657
10 Life Span Development ..................................198
11 Cultural Considerations ..................................229 29 Basic Procedures ............................................658
12 Stress, Adaptation, and Anxiety ....................257 30 Intermediate Procedures ................................809
13 End-of-Life Care ..............................................273 31 Advanced Procedures ....................................925
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Th ird Edition
DEDICATIONS
Lois White:
To my beloved husband, John, who is on his last great adventure and learning
experience.
Gena Duncan:
To my husband, who gives me unconditional love and brings balance, calmness, and
excitement to my life.
To Lois White, who modeled the role of an author and committed much of her life
to this textbook.
To Wendy Baumle, for her hard work and dedication in developing this textbook.
Thanks.
To future nurses who are caring and competent.
Wendy Baumle:
This book is dedicated to my beloved family—Patrick, Taylor, Madeline, Blair,
Connor, Janet, and Robert—for their love and support, to Juliet Steiner for inspiring
me and for making a difference in my life, to Gena Duncan for her guidance and
friendship, and to my friends, colleagues, and students for their support and valuable
insight into today’s nursing education.
Foundations
of Basic
Nursing
Th ird Edition
Lois White,
RN, PhD
Former Chairperson and Professor Department of Vocational
Nurse Education, Del Mar College, Corpus Christi, Texas
Gena Duncan,
RN, MSEd, MSN
Former Associate Professor of Nursing, Ivy Tech Community
College, Fort Wayne, Indiana
Wendy Baumle,
RN, MSN
James A. Rhodes State College, School of Nursing, Lima, Ohio
Australia • Brazil • Japan • Korea • Mexico • Singapore • Spain • United Kingdom • United States
Foundations of Basic Nursing, Th ird Edition © 2001, 2005, 2011 Delmar Cengage Learning
Lois White, RN, PhD, Gena Duncan, RN, MSEd,
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Printed in the United States of America
1 2 3 4 5 6 7 12 11 10 09
CONTENTS
Contributors / xxıı Develop a Time-Management Plan .................... 9
Procedure Contributors / xxiv Analyze Time Commitments .............................. 10
Reviewers / xxvi Know Yourself .............................................. 10
Clarify Goals ............................................... 11
Market Reviewers and Class Test Participants / xxvıı
Set Priorities ............................................... 11
Preface / xxix
Discipline Yourself ......................................... 12
About the Authors / xxxııı Develop a Study Strategy ............................... 12
Acknowledgments / xxxv Set Up the Environment ................................... 12
How to Use This Text / xxxvı Gather Your Resources.................................... 12
How to Use StudyWARE™ / xli Minimize Interruptions ..................................... 13
Get to Know the Textbook ................................. 13
Set Up the Study Plan ..................................... 13
UNIT 1 Note Taking ................................................. 14
Prepare for Exams ......................................... 15
Foundations / 1 Participate in Test Reviews ............................... 16
Learn from Mistakes ....................................... 16
CHAPTER 1: STUDENT NURSE Talk with Instructors ....................................... 16
Practice Critical Thinking ............................... 16
SKILLS FOR SUCCESS / 2
Skills of Critical Thinking .................................. 16
Introduction .................................................. 3 Critical Reading .......................................... 16
Learning ...................................................... 3 Critical Listening ......................................... 17
Develop a Positive Attitude .............................. 3 Critical Speaking ........................................ 17
Critical Writing ............................................ 17
Create Positive Self-Images ............................... 3
Standards for Critical Thinking ............................ 17
Recognize Your Abilities .................................... 4
Clarity ..................................................... 17
Identify Realistic Expectations ............................. 4
Accuracy ................................................. 18
Develop Your Basic Skills ................................ 5
Precision .................................................. 18
Reading ..................................................... 5
Relevance ................................................ 18
Arithmetic and Mathematics ............................... 6
Consistency .............................................. 18
Writing ....................................................... 6
Logic ...................................................... 18
Listening ..................................................... 6
Depth ..................................................... 18
Speaking .................................................... 7
Breadth ................................................... 18
Develop Your Learning Style ............................ 7
Fairness ................................................... 18
Classifi cation of Learning Styles .......................... 8
Reasoning and Problem Solving ......................... 19
Strategies for Learning ..................................... 9
v
vi CONTENTS
Purpose ................................................... 19 Sleep, Rest, Relaxation, and Exercise ..................38
The Question at Issue ................................... 19 Intellectual Wellness .......................................38
Assumptions ............................................. 19 Sociocultural Wellness ....................................38
Point of View ............................................. 19 Psychological Wellness ...................................39
Data and Information .................................... 19 Spiritual Wellness ..........................................39
Concepts ................................................. 19 Nurture Yourself............................................40
Inferences and Conclusions ............................ 19 CHAPTER 3: NURSING
Implications and Consequences ....................... 19
Traits of a Disciplined Thinker ............................20 HISTORY, EDUCATION, AND
Critical Thinking and the Nursing Process ...............20 ORGANIZATIONS / 44
Develop Test-Taking Skills ..............................21
Attitude and Expectations .................................21 Introduction .................................................45
Preparation .................................................21 Historical Overview .......................................45
Minimize Anxiety ...........................................22 Evolution of Nursing .......................................45
Improve Test-Taking Skills ................................22 Early Civilizations ........................................45
Read Carefully ...........................................22 Ancient Greece ..........................................45
Know the Vocabulary ....................................24 Roman Empire ...........................................45
Do Not Infer Additional Data ............................24 Middle Ages ..............................................45
Identify Priorities Correctly ..............................24 Renaissance .............................................45
Know the Material .......................................24 Industrial Revolution .....................................45
Go with the First Answer ................................24 Religious Infl uences .......................................47
Behaviors in the Testing Room ...........................24 Florence Nightingale ......................................47
Your Program is Almost Completed .................25 The Civil War and Nursing ...............................48
Scope of Practice/Competence ...........................25 Men in Nursing .............................................49
Tasks of the UAP ..........................................25 The Women’s Movement ..................................49
Duty Delegation ............................................26 Nursing Pioneers and Leaders ...........................49
Prioritizing Care ............................................27 Linda Richards ...........................................49
The Nursing Team .........................................27 Mary Mahoney ...........................................49
From Student to LP/VN ..................................28 Adelaide Nutting .........................................49
Lavinia Dock .............................................49
Examination and Licensure ...............................28
The NCLEX-PN® ........................................28 Isabel Hampton Robb ...................................49
Lillian Wald ...............................................49
Your License ..............................................29
Mary Breckenridge ......................................50
Mamie Hale ..............................................50
CHAPTER 2: HOLISTIC CARE / 32 Practical Nursing Pioneer Schools ...................50
Ballard School .............................................50
Introduction .................................................33 Thompson Practical Nursing School .....................50
Interrelated Concepts of Health .......................33 Household Nursing School ...............................50
Holistic Care ...............................................33 Nursing in the Twentieth Century .....................50
Nursing the Whole Person ................................34 Flexner Report .............................................50
Wellness ....................................................34 Early Insurance Plans .....................................51
Maslow’s Hierarchy of Needs .............................34 Visiting Nurses Associations ............................51
Physiological Needs .....................................34 Blue Cross and Blue Shield ............................51
Safety and Security Needs .............................35 Landmark Reports in Nursing Education ................51
Love and Belonging Needs.............................35 Goldmark Report ........................................51
Self-Esteem Needs ......................................35 Brown Report ............................................51
Self-Actualization Needs ................................35 Institute of Research and Service in Nursing
Providing Quality Care ...................................35 Education Report ........................................51
Self-Awareness ............................................35 Other Health Care Initiatives ..............................52
Development of Self-Concept ............................35 Costs and Quality Controls ...............................52
Self-Care as a Prerequisite to Client Care ..........36 Health Care Reform .......................................52
Physical Wellness .........................................36 Nursing Education ........................................52
Grooming .................................................36 Types of Programs .........................................53
Body Mechanics .........................................36 Licensed Practical/Vocational Nursing.................53
Posture ....................................................37 Registered Nursing ......................................53
Smoking ..................................................37 Continuing Education and Staff
Drugs and Alcohol .......................................37 Development ..........................................53
Nutrition ...................................................37 Trends in Nursing Education ..............................55
CONTENTS vii
Competency Development .............................55 Caring-Based Theory .....................................79
Delivery of Care ..........................................55 Ethics and Values .........................................79
Nursing Organizations ...................................55 Values Clarifi cation ........................................79
National League for Nursing ..............................55 Codes of Ethics ............................................79
National Association of Practical Nurse Education Client Rights ................................................79
and Service ..............................................55 Ethical Dilemmas ..........................................81
National Federation of Licensed Practical Nurses ......58 Euthanasia .................................................81
American Nurses Association ............................58 Refusal of Treatment ......................................81
National Council of State Boards of Nursing ............58 Scarcity of Resources .....................................81
CHAPTER 4: LEGAL AND Ethical Decision Making.................................81
ETHICAL RESPONSIBILITIES / 62 Nursing and Ethics .......................................83
Ethics Committees .........................................83
Introduction .................................................63 Nurse as Client Advocate .................................84
Basic Legal Concepts ....................................63 Nurse as Whistle-Blower ..................................84
Defi nition of Law ...........................................63
Sources of Law ............................................63
Public Law ...............................................63 UNIT 2
Civil Law ..................................................64
The Law and Nursing Practice ........................65 The Health Care
Standards of Practice......................................65
Legal Issues in Practice ...................................66 Environment / 89
Physician’s Orders .......................................66
Floating ...................................................66 CHAPTER 5: THE HEALTH CARE
Inadequate Staffing ......................................66
DELIVERY SYSTEM / 90
Critical Care ..............................................66
Pediatric Care ............................................66 Introduction .................................................91
Nurse–Client Relationship ..............................66 Levels of Health Care Services ........................91
Torts ........................................................66
Primary Care ...............................................91
Intentional Torts ...........................................67
Secondary Care ...........................................91
Unintentional Torts .......................................68
Tertiary Care ...............................................92
Legal Risk ..................................................69
Health Care Delivery System ...........................92
Federal Antifraud Laws ..................................69
Providers/Consumers .....................................92
State Reporting Requirements .........................69
Public Sector .............................................92
Professional Discipline ....................................69
Public/Private Sector ....................................93
Sanctions .................................................69
Private Sector ............................................93
Disciplinary Data Banks .................................69
Settings .....................................................93
Documentation .............................................70
Personnel and Services ...................................93
Informed Consent .........................................70
Health Care Team ..........................................93
Advance Directives .......................................72
Health Care Economics .................................93
Durable Power of Attorney for Health Care ..............72
Private Insurance ..........................................93
Living Will ................................................... 74
Managed Care .............................................95
Incident Reports ........................................... 74
Health Maintenance Organizations ....................96
Liability Insurance ........................................75 Preferred Provider Organizations .......................96
Impaired Nurse .............................................75 Exclusive Provider Organizations ......................96
Concept of Ethics ......................................... 76 Federal Government Plans .............................96
Health Care and Ethics.................................... 76 Medicare .................................................96
Ethical Principles .......................................... 76 Medicaid .................................................97
Autonomy ................................................... 76 State Children’s Health Insurance
Nonmalefi cence ...........................................77 Program ................................................97
Benefi cence ................................................77 Factors Infl uencing Health Care ......................97
Justice ......................................................77 Cost .........................................................97
Veracity .....................................................78 Access ......................................................98
Fidelity ......................................................78 Quality ......................................................98
Ethical Theories ............................................78 Challenges within the Health Care System ........98
Teleology ...................................................78 Disillusionment with Providers ............................98
Deontology .................................................78 Positive Perception of Nurses ..........................99
Situational Theory .........................................78 Loss of Control .............................................99
viii CONTENTS
Changing Practice Settings ...............................99
UNIT 3
Decreased Hospital Use ..................................99
Vulnerable Populations ....................................99
Communication / 121
Ethical Issues .............................................100
Nursing’s Response to Health Care
CHAPTER 7: COMMUNICATION /
Challenges ...............................................................................................100
122
Nursing’s Agenda for Health Care Reform ..............100
Standardization of Care ..................................100
Introduction ................................................123
Advanced Practice ........................................101
Process of Communication ...........................123
Public vs. Private Programs ..............................101
Sender .....................................................123
Public Health ..............................................101
Message ...................................................123
Community Health ........................................101
Channel ...................................................123
Issues and Trends ........................................101
Receiver ...................................................123
CHAPTER 6: ARENAS OF Feedback ..................................................123
CARE / 105 Infl uences .................................................124
Methods of Communication ...........................124
Introduction ................................................106 Verbal Communication ...................................124
Agency Licensure, Certifi cation, and Speaking/Listening .....................................124
Accreditation .........................................106 Intonation ................................................124
Licensure ..................................................106 Writing/Reading .........................................124
Certifi cation ...............................................106 Nonverbal Communication ...............................124
Accreditation ..............................................106 Gestures .................................................125
Acute Care Hospital .....................................106 Facial Expressions ......................................125
Nursing Units ..............................................106 Posture and Gait ........................................125
Specialized Client Care Units ............................106 Touch.....................................................125
Surgical Units .............................................106 Eye Contact .............................................125
Diagnostic Departments .................................107 Body Position ...........................................125
Clinical Laboratory ......................................107 Physical Appearance ...................................125
Radiology (Nuclear Medicine) .........................107 Infl uences on Communication .......................125
Other Diagnostic Services .............................107 Age.........................................................125
Therapy Departments ....................................107 Developmental Level .....................................126
Support Services .........................................107 Education..................................................126
Role of the LP/VN ........................................107 Emotions ..................................................126
Long-Term Care ...........................................107 Culture .....................................................127
Long-Term Care Facilities ................................108 Language..................................................128
Subacute Care ............................................109 Attention ...................................................128
Continuing Care Retirement Communities .............109 Surroundings ..............................................128
Assisted Living ............................................109 Congruency of Messages ..............................128
Adult Day Care ............................................109 Listening/Observing .....................................128
Respite Care ..............................................109 Psychosocial Aspects of
Foster Care ................................................109 Communication .....................................128
Role of the LP/VN ........................................110 Gestures ...................................................128
Outpatient Care ...........................................110 Style .......................................................128
Role of the LP/VN ........................................110 Passive ..................................................129
Home Health Care ........................................110 Aggressive ..............................................129
Role of the LP/VN ........................................ 111 Assertive .................................................129
Hospice ..................................................... 111 Meaning of Space ........................................129
Rehabilitation..............................................113 Meaning of Time ..........................................130
The Interdisciplinary Health Care Team.................113 Cultural Values ............................................130
Functional Assessment and Evaluation for Political Correctness ......................................130
Rehabilitation .............................................113 Therapeutic Communication ..........................130
Role of the LP/VN ........................................114 Goals of Therapeutic Communication ..................130
Rehabilitation Settings ...................................114 Develop Trust ............................................130
Hospital Inpatient Program ............................114 Obtain or Provide Information..........................130
Skilled Nursing Facility .................................114 Show Caring ............................................130
Outpatient Rehabilitation ...............................114 Explore Feelings ........................................131
Home Rehabilitation ....................................114 Behaviors/Attitudes to Enhance Communication ......131