4234 FM.qxd 8/18/08 1:45 PM Page i Strategies for Managing Multisystem Disorders 4234 FM.qxd 8/18/08 1:45 PM Page ii 4234 FM.qxd 8/18/08 1:45 PM Page iii Strategies for Managing Multisystem Disorders 4234 FM.qxd 8/18/08 1:45 PM Page iv STAFF The clinical treatments described and recom- Executive Publisher mended in this publication are based on research Judith A. Schilling McCann,RN, MSN and consultation with nursing, medical, and le- gal authorities. To the best of our knowledge, Editorial Director these procedures reflect currently accepted prac- H. Nancy Holmes tice. Nevertheless, they can’t be considered ab- solute and universal recommendations. For indi- Clinical Director vidual applications, all recommendations must Joan M. Robinson,RN, MSN be considered in light of the patient’s clinical Senior Art Director condition and, before administration of new or Arlene Putterman infrequently used drugs, in light of the latest package-insert information. The authors and Editorial Project Manager publisher disclaim responsibility for any adverse Jennifer P. Kowalak effects resulting from the suggested procedures, from any undetected errors, or from the reader’s Clinical Project Manager misunderstanding of the text. Beverly Ann Tscheschlog,RN, BS © 2006 by Lippincott Williams & Wilkins. All Design rights reserved. This book is protected by copy- Debra Moloshok (book design right. No part of it may be reproduced, stored in andprojectmanager) a retrieval system, or transmitted, in any form or Editor by any means—electronic, mechanical, photo- Liz Schaeffer copy, recording, or otherwise—without prior written permission of the publisher, except for Clinical Editors brief quotations embodied in critical articles and Joanne M. Bartelmo,RN, MSN; reviews and testing and evaluation materials pro- MaryannFoley,RN, BSN; vided by publisher to instructors whose schools ColletteBishopHendler,RN, BS, CCRN; have adopted its accompanying textbook. Print- TamaraM.Kear,RN, MSN, CNN; ed in the United States of America. For informa- KateMcGovern,RN, MSN; tion, write Lippincott Williams & Wilkins, 323 JanaSciarra,RN,MSN,CRNP Norristown Road, Suite 200, Ambler, PA 19002- 2756. Copy Editors Kimberly Bilotta (supervisor), Heather Ditch, SMMD—D N O S A J J M A M F J Shana Harrington, Kelly Pavlovsky, 07 06 05 10 9 8 7 6 5 4 3 2 1 PamelaWingrod Digital Composition Services Library of Congress Diane Paluba (manager), Joyce Rossi Biletz, Cataloging-in-Publication Data Donna S. Morris Strategies for managing multisystem disorders p. ; cm. Manufacturing Includes bibliographical references and index. Patricia K. Dorshaw (director), Beth J. Welsh 1. Catastrophic illness. 2. Internal medicine. I. Lippincott Williams & Wilkins. [DNLM: 1. Diag- Editorial Assistants nosis. 2. Therapeutics—methods. 3. Patient Care Team.] Megan L. Aldinger, Karen J. Kirk, RC48.S77 2006 Linda K. Ruhf 616.07(cid:2)5—dc22 ISBN 1-58255-423-4 (alk. paper) 2005002803 Indexer Barbara Hodgson 4234 FM.qxd 8/18/08 1:45 PM Page v Contents Contributors and consultants vii Foreword ix Multisystem disorders (in alphabetical order) 1 Quick-reference guide to laboratory test results 374 Blood factors and products 384 Internet resources 386 Selected references 389 Index 390 v 4234 FM.qxd 8/18/08 1:45 PM Page vi 4234 FM.qxd 8/18/08 1:45 PM Page vii Contributors and consultants Beverly Anderson, RN, MSN Carrin L. Dvorak, RN, MSN Associate Professor Assistant Professor of Nursing Malcolm X College Cuyahoga Community College Chicago Cleveland Peggy Bozarth, RN, MSN Diane M. Ellis, RN, MSN, CCRN Professor Nursing Instructor Hopkinsville (Ky.) Community College Villanova (Pa.) University Service Excellence Consultant Glen Mills, Pa. Deirdre Herr Byers, RN, BSN, CCRN Staff Nurse Southeast Georgia Health System Emilie M. Fedorov, RN, MSN, CS Brunswick Nurse Manager Cleveland Clinic Foundation Merry Jahn Chandler, RN, MA, MSN Assistant Professor, College of Nursing Stephen Gilliam, FNP, PhD, APRN,BC McNeese State University Assistant Professor Lake Charles, La. Medical College of Georgia School of Nursing Athens Margaret Davis, MSN, RN Assistant Professor of Nursing Central Florida Community College Margaret M. Gingrich, RN, MSN Ocala Associate Professor Harrisburg (Pa.) Area Community College Louise M. Diehl-Oplinger, RN, MSN, APRN,BC, CCRN Mary T. Kowalski, RN, BA, MSN Family Nurse Practitioner Director/Instructor Vocational Nursing & Coventry Cardiology Associates HealthCareer Programs Phillipsburg, N.J. Cerro Coso Community College Ridgecrest, Calif. Laurie Donaghy, RN, CEN Staff Nurse Grace G. Lewis, RN, MS, CNS, APRN,CS Frankford Hospital Assistant Professor of Nursing Philadelphia Georgia Baptist College of Nursing of Mercer University Atlanta Shelba Durston, RN, MSN, CCRN Nursing Instructor San Joaquin Delta College Valerie Mignatti, RN, BSN Stockton, Calif. Clinical Cardiovascular Nurse Staff Nurse Hospital of the University of Pennsylvania San Joaquin General Hospital Philadelphia French Camp, Calif. vii 4234 FM.qxd 8/18/08 1:45 PM Page viii viii Contributors and consultants Jolynne Myers, RNBC, MSN, MSEd, ANP Employee Health & Worker’s Compensation Coordinator Baptist—Lutheran Medical Center Kansas City, Mo. Abby Plambeck, RN, BSN Freelance Writer Milwaukee Cynthia A. Prows, RN, MSN, CNS Clinical Nurse Specialist, Genetics Children’s Hospital Medical Center Cincinnati Donna Scemons, RN, MSN, FNP-C, CNS, CWOCN Family Nurse Practitioner Healthcare Systems, Inc. Panorama City, Calif. Colleen R. Walsh, RN, MSN, ONC, CS, ACNP-BC Faculty, Graduate Nursing University of Southern Indiana SchoolofNursing & Health Professions Evansville 4234 FM.qxd 8/18/08 1:45 PM Page ix Foreword It’s a prevalent perception in the health care pathophysiology, including how multiple community that caring for patients in this body systems are affected; assessment, millennium is challenging and, at times, which includes clinical findings and diag- complex, because of the high level of acuity nostic test results; collaborative manage- of patients not only in hospitals but also in ment; and treatment and care. The various home-care agencies, long-term care facilities, charts, tables, and illustrations supplement and physicians’ offices. Furthermore, the and condense essential information through- number of patients who have multiple diag- out the text. Further, special icons highlight noses (with increasing severity) is on the critical information including: rise. Health care professionals and students ■ Watchful eye—describes what to look for alike are required to have a broad knowledge and how to adapt care in patients with a base about these multisystem conditions, in- multisystem disorder who may also have a cluding their causes, assessment findings, coexisting disorder or who may develop and care management. Indeed, today’s health complications. care professional must see beyond the pa- ■ Red flag—highlights emergency or life- tient’s primary diagnosis and be adept at un- threatening findings that signal immediate covering coexisting disorders, anticipating intervention. complications, and determining how these ■ Up close—diagrams the underlying problems interact and influence the progress pathophysiologic processes of the given and positive response of patients to treat- multisystem disorder. ment. ■ Drug alert—emphasizes possible compli- Strategies for Managing Multisystem Disor- cations of multisystem disorders related to ders covers more than 75 disorders and how drug therapy. each condition can interact and affect other Helpful appendices include quick-refer- diseases. One of the premier features of this ence guide to laboratory test results, blood book is its emphasis on the multidiscipli- factors and products, and Internet resources. nary team approach—a growing trend in to- In summary, Strategies for Managing Multi- day’s health care arena regardless of the clin- system Disordersaddresses disorders that re- ical setting. For example, the patient with quire comprehensive, coordinated, and inte- myocardial infarction may also suffer from grated interventions. No doubt, it will help diabetes mellitus and thyroid disease, neces- today’s health care professional meet the sitating the counsel of an endocrinologist challenge of providing the best possible care who can help adapt the treatment and care to patients with multisystem disorders. plan. The pregnant patient with asthma may need the services of a dietician to monitor Evelyn Yeaw,RN, PhD weight gain during her pregnancy because Professor and Chairperson Nursing excess weight gain may increase diaphrag- Education matic elevation and decrease functional Graduate Program residual capacity. University of Rhode Island Strategies for Managing Multisystem Disor- South Kingston ders is organized A-to-Z for quick retrieval of information, when needed. Each multisys- tem disorder entry concisely covers overview, which includes description, inci- dence, risk factors, prognosis; etiology; ix 4234 FM.qxd 8/18/08 1:45 PM Page x