Medical-surgical Nursing Demystified - WordPress
Medical-Surgical NursingDemystified
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Medical-Surgical NursingDemystifiedMary DiGiulio, RN, MSN, APRNDonna Jackson, RN, MSN, APRNJim KeoghNew York Chicago San Francisco Lisbon London MadridMexico City Milan New Delhi San Juan SeoulSingapore Sydney Toronto
Copyright 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Manufactured in the United States of America. Exceptas permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any formor by any means, or stored in a database or retrieval system, without the prior written permission of the publisher.0-07-159543-0The material in this eBook also appears in the print version of this title: 0-07-149450-2.All trademarks are trademarks of their respective owners. Rather than put a trademark symbol after every occurrence of a trademarkedname, we use names in an editorial fashion only, and to the benefit of the trademark owner, with no intention of infringement of thetrademark. Where such designations appear in this book, they have been printed with initial caps.McGraw-Hill eBooks are available at special quantity discounts to use as premiums and sales promotions, or for use in corporatetraining programs. For more information, please contact George Hoare, Special Sales, at george hoare@mcgraw-hill.com or (212)904-4069.TERMS OF USEThis is a copyrighted work and The McGraw-Hill Companies, Inc. (“McGraw-Hill”) and its licensors reserve all rights in and to thework. Use of this work is subject to these terms. Except as permitted under the Copyright Act of 1976 and the right to store andretrieve one copy of the work, you may not decompile, disassemble, reverse engineer, reproduce, modify, create derivative worksbased upon, transmit, distribute, disseminate, sell, publish or sublicense the work or any part of it without McGraw-Hill’s prior consent. You may use the work for your own noncommercial and personal use; any other use of the work is strictly prohibited. Your rightto use the work may be terminated if you fail to comply with these terms.THE WORK IS PROVIDED “AS IS.” McGRAW-HILL AND ITS LICENSORS MAKE NO GUARANTEES OR WARRANTIESAS TO THE ACCURACY, ADEQUACY OR COMPLETENESS OF OR RESULTS TO BE OBTAINED FROM USING THEWORK, INCLUDING ANY INFORMATION THAT CAN BE ACCESSED THROUGH THE WORK VIA HYPERLINK OR OTHERWISE, AND EXPRESSLY DISCLAIM ANY WARRANTY, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TOIMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. McGraw-Hill and its licensors do not warrant or guarantee that the functions contained in the work will meet your requirements or that its operation will beuninterrupted or error free. Neither McGraw-Hill nor its licensors shall be liable to you or anyone else for any inaccuracy, error oromission, regardless of cause, in the work or for any damages resulting therefrom. McGraw-Hill has no responsibility for the contentof any information accessed through the work. Under no circumstances shall McGraw-Hill and/or its licensors be liable for anyindirect, incidental, special, punitive, consequential or similar damages that result from the use of or inability to use the work, evenif any of them has been advised of the possibility of such damages. This limitation of liability shall apply to any claim or causewhatsoever whether such claim or cause arises in contract, tort or otherwise.DOI: 10.1036/0071494502
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To the memory of Jim, Rose, and Margotwho always believed in meTo DaveWho means more than he sometimes knowsTo Kathleen and Jacquelinewho have the world in front of themMary DiGiulio, RN, MSNTo KenThank you for loving me, believing in me, encouraging me, and running the racewith me. I’m glad I have you.Love, DonnaDonna Jackson, RN, MSNThis book is dedicated to Anne, Sandy, Joanne, Amber-Leigh Christine, and Shawn,without whose help and support this book couldn’t have been written.Jim Keogh
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For more information about this title, click hereCONTENTSCHAPTER 1IntroductionxivCardiovascular SystemHow the Cardiovascular System WorksJust the FactsAortic AneurysmAngina (Angina Pectoris)Myocardial Infarction (MI)Coronary Artery Disease (CAD)Peripheral Arterial Disease (PAD)Cardiac TamponadeCardiogenic ShockCardiomyopathyEndocarditisHeart Failure [Congestive Heart Failure (CHF)]Hypertension (HTN)Hypovolemic ShockMyocarditisPericarditisPulmonary EdemaRaynaud’s DiseaseRheumatic Heart DiseaseThrombophlebitisAtrial 54749515356
viiiMedical-Surgical Nursing DemystifiedVentricular FibrillationVentricular TachycardiaAortic Insufficiency (AI)Mitral InsufficiencyMitral StenosisMitral Valve ProlapseTricuspid InsufficiencyCrucial Diagnostic TestsQuiz585962636567697182CHAPTER 2Respiratory SystemHow the Respiratory System WorksJust the FactsAcute Respiratory Distress Syndrome nchitisCor PulmonaleEmphysemaLung CancerPleural EffusionPneumoniaPneumothoraxRespiratory AcidosisTuberculosis (TB)Acute Respiratory FailurePulmonary EmbolismInfluenzaCrucial Diagnostic 22124127130132140CHAPTER 3Immune SystemHow the Immune System WorksJust the FactsAcquired Immunodeficiency Syndrome (AIDS)AnaphylaxisAnkylosing Spondylitis143144145145147149
ContentsixKaposi’s Sarcoma(KS)LymphomaRheumatoid ArthritisSclerodermaMononucleosisEpstein-Barr Virus/Chronic Fatigue SyndromeLyme DiseaseSeptic ShockSystemic Lupus Erythematosus (SLE)Crucial Diagnostic TestsQuiz151153155157159160162163165167171CHAPTER 4Hematologic SystemHow the Hematologic System WorksJust the FactsAnemiaAplastic Anemia (Pancytopenia)Iron Deficiency AnemiaPernicious AnemiaDisseminated Intravascular Coagulation (DIC)HemophiliaLeukemiaMultiple MyelomaPolycythemia VeraSickle Cell AnemiaDeep Vein Thrombosis (DVT)Idiopathic Thrombocytopenic Purpura (ITP)Crucial Diagnostic 9201203206CHAPTER 5Nervous SystemHow the Nervous System WorksJust the FactsHead InjuryAmyotrophic Lateral Sclerosis (ALS)Bell’s PalsyBrain AbscessBrain TumorCerebral Aneurysm209210212212216218219222225
xMedical-Surgical Nursing DemystifiedEncephalitisGuillain-Barré SyndromeHuntington’s Disease (Chorea)MeningitisMultiple Sclerosis (MS)Myasthenia GravisParkinson’s DiseaseSpinal Cord InjuryStrokeSeizure DisorderCrucial Diagnostic ER 6Musculoskeletal SystemHow the Musculoskeletal System WorksJust the FactsCarpal Tunnel teoporosisCrucial Diagnostic TestsQuiz261262263263266268271273275277280CHAPTER 7Gastrointestinal SystemHow the Gastrointestinal System WorksJust the FactsAppendicitisCholecystitisCirrhosisCrohn’s DiseaseDiverticulitis DiseaseGastroenteritisGastroesophageal Reflux Disease (GERD)Gastrointestinal BleedGastritisHepatitisHiatal Hernia283284286286288290294297299301304306308311
ContentsCHAPTER 8CHAPTER 9xiIntestinal Obstruction and Paralytic IleusPancreatitisPeritonitisPeptic Ulcer Disease (PUD)Ulcerative ColitisCrucial Diagnostic TestsQuiz313315317319322324329Endocrine SystemHow the Endocrine System WorksJust the FactsHypothyroidism (Myxedema)Hyperthyroidism (Graves’ Disease)Simple GoiterHypopituitarismHyperpituitarism (Acromegaly and Gigantism)HyperprolactinemiaDiabetes InsipidusSyndrome of Inappropriate Antidiuretic HormoneSecretion (SIADH)Addison’s DiseaseCushing’s SyndromePrimary Aldosteronism (Conn’s rathyroidismDiabetes MellitusMetabolic Syndrome (Syndrome X/DysmetabolicSyndrome)Crucial Diagnostic ry SystemHow the Genitourinary System WorksJust the FactsBenign Prostatic Hypertrophy (BPH)Bladder CancerAcute GlomerulonephritisKidney 8363365370
xiiMedical-Surgical Nursing DemystifiedKidney StonesProstate CancerPyelonephritisRenal FailureTesticular CancerUrinary Tract InfectionCrucial Diagnostic TestsQuiz382384386388390392394396CHAPTER 10Integumentary SystemHow the Integumentary System WorksJust the FactsBurnsDermatitisSkin CancersCellulitisPressure UlcersWounds and HealingCrucial Diagnostic TestsQuiz399400401401403405407409411413415CHAPTER 11Fluids and ElectrolytesHow Fluids and Electrolytes WorkJust the nesemiaMetabolic AcidosisMetabolic ionCrucial Diagnostic 1443444446448
ContentsxiiiCHAPTER 12Mental HealthA Look at Mental HealthJust the FactsAnxietyPanic DisorderDepressionBipolar DisorderSchizophreniaAnorexia NervosaBulimia 69471CHAPTER 13Perioperative CarePerioperative CareSurgical ClassificationsThe Preoperative PeriodThe Intraoperative PeriodThe Postoperative PeriodJust the FactsCardiovascular ComplicationsRespiratory ComplicationsInfectionGastrointestinal 492CHAPTER 14Women’s HealthThe Female BodyJust the FactsBreast CancerCervical CancerDysmenorrheaEctopic PregnancyEndometrial CancerFibroids (Leiomyomas)InfertilityMenopauseOvarian CancerOvarian Masses, Benign495496497497500502503505507508510512514
Medical-Surgical Nursing DemystifiedxivCHAPTER 15Pelvic Inflammatory Disease (PID)Trophoblastic DiseasePregnancyLabor & DeliveryPostpartumRh IncompatibilityPreeclampsia and EclampsiaCrucial Diagnostic TestsQuiz515517519522524526527529531Pain ManagementPainJust the FactsAcute PainChronic PainPeripheral NeuropathyPhantom Limb PainSubstance Use DisordersDrug AddictionCrucial Diagnostic Test535536537537540542544545550553Quiz553Final Exam557Answers to Quiz and Exam Questions577Glossary581Index589
INTRODUCTIONEvery patient knows to seek medical help when his or her aches and pains becometoo much to bear, but how does the healthcare provider determine what is wrong andwhat to do to restore the patient to good health? The answer depends on the patient’ssigns and symptoms and the results from medical tests. In this book you will learnto identify these signs and symptoms, interpret the medical test results, and performthe nursing interventions that will assist in solving or alleviating the patient’s medical problem.Medical-Surgical Nursing Demystified contains 15 chapters, each providing adescription of a major body system and the diseases and disorders which can affectthat system. The discussion of each disease or disorder is divided into the followingsections: What Went Wrong?PrognosisHallmark Signs and SymptomsInterpreting Test ResultsTreatmentNursing DiagnosesNursing InterventionCrucial Diagnostic TestsThe “What Went Wrong?” section presents a brief description of how the body isaffected when the particular disease or disorder occurs. The “Prognosis” section discusses the possibilities of curing this disease and permanent damage which canoccur. The remaining sections present the information as lists of symptoms, diagnoses, etc. that make it easy for you to learn and that also serve as a useful tool forlater reference.A Look InsideSince Medical-Surgical Nursing can be challenging for the beginner, this book waswritten to provide an organized, outline approach to learning about major diseasesCopyright 2007 by The McGraw-Hill Companies, Inc. Click here for terms of use.
xviMedical-Surgical Nursing Demystifiedand the part the nurse can play in the treatment process. The following paragraphsprovide a thumbnail description of each chapter.CHAPTER 1 CARDIOVASCULAR SYSTEMThe mere mention of the cardiovascular system brings all sorts of images to mind;however, these impressions are based on our experience as patients. Healthcareproviders have a different view because they see it as a system that distributes nutrients and oxygen throughout the body and delivers carbon dioxide and metabolic byproducts to various organs for removal from the body. Failure of the cardiovascularsystem has a compound effect because it interacts with the body’s other systemscausing a chain reaction of events. Healthcare providers need a thorough understanding of what can go wrong with the cardiovascular system; in this chapter you willearn to recognize cardiovascular system disorders and to perform the interventionsthat can assist in restoring its function.CHAPTER 2 RESPIRATORY SYSTEMThe respiratory system interacts with cells in the body to exchange oxygen and carbon dioxide, enabling the oxygenation of all cells in the body. In this chapter youwill learn which diseases and disorders can disrupt the respiratory system, how torecognize these conditions, and what steps you can take to assist in curing the respiratory system problems.CHAPTER 3 IMMUNE SYSTEMRemember the last time you experienced a bad cut. The site of the injury becameswollen and red and you might have felt feverish. This happened because yourimmune system was trying to heal the wound by attacking the microorganisms thatwere invading your body. However, the abilities to fight off disease and to heal awound are compromised when the immune system malfunctions. In this chapter youwill learn about immune system disorders and what actions the nurse can perform toassist in the patient’s recovery,CHAPTER 4 HEMATOLOGIC SYSTEMThe hematologic system produces and circulates blood cells throughout the body. Anydisorder of this system jeopardizes the functioning of every organ in the body. This
Introductionxviichapter explores the hematologic system and its common disorders and discusses howto care for patients who experience them.CHAPTER 5 NERVOUS SYSTEMThe nervous system is the body’s command center that receives impulses and sendsan appropriate response. In this chapter you will learn about the disorders that causethe malfunctioning of the nervous system and the interventions that mitigate neurological problems.CHAPTER 6 MUSCULOSKELETAL SYSTEMThe musculoskeletal system is the body’s superstructure that provides strength andmovement. In this chapter you will learn about disorders of the musculoskeletal system and the treatments for restoring its functions.CHAPTER 7 GASTROINTESTINAL SYSTEMThe body receives nourishment and excretes waste through the gastrointestinal system.Any disorder of the GI tract might disrupt the body’s ability to store carbohydrates,lipids, and protein, all of which are used to energize cells. You will learn about thesedisorders and what to do about them in this chapter.CHAPTER 8 ENDOCRINE SYSTEMThe endocrine system is the body’s messenger. It turns on and off messages that directthe action of organs. Endocrine disorders cause chaos, as messages become misdirected. Endocrine system disorders and what to do about them are presented in thischapter.CHAPTER 9 GENITOURINARY SYSTEMReproductive organs and the urinary system come from the same embryologicalorigin, which is why they are combined in the genitourinary system. Disruptions ofthe genitourinary system are caused by a variety of disorders, some associated morewith one gender than the other. In this chapter you will learn about these disordersand the treatments which can correct them.
xviiiMedical-Surgical Nursing DemystifiedCHAPTER 10 INTEGUMENTARY SYSTEMDiseases and disorders of the Integumentary system expose the body to invasion ofviruses, bacteria and other microorganisms because the primary defense—the skin—is disrupted. In this chapter, you will learn about these diseases and disorders anddiscover ways to mitigate them.CHAPTER 11 FLUIDS AND ELECTROLYTESFluids and electrolytes must be in balance for the body to properly function. Animbalance causes the body to compensate in ways that can have a rippling effectthroughout other systems. In this chapter you will learn about fluids and electrolytedisorders and how to intervene to restore their balance.CHAPTER 12 MENTAL HEALTHDisorders that affect the mind can interfere with daily activities and lead to selfdestructive behaviors. In this chapter, you will learn about mental health disorders, how torecognize them, and steps that can be taken to minimize their influence on the patient.CHAPTER 13 PERIOPERATIVESurgical intervention is a radical but, at times, necessary treatment for a patient’scondition. However, surgery can expose the patient to a set of disorders that wouldotherwise be avoided if no surgery had occurred. You will learn about these disorders and how to handle them in this chapter.CHAPTER 14 WOMEN’S HEALTHThe women’s health chapter covers a multitude of conditions that affect women.Here you will learn how to recognize these conditions, the medication used to treatthem, and the interventions that can mitigate their ill effects on the patient.CHAPTER 15 PAIN MANAGEMENTPain is associated with many disorders and must be successfully managed to reduce its disruptive affect on the patient’s well-being. You will learn the techniquesfor managing pain in this chapter.
ABOUT THE AUTHORSMary DiGiulio is an Adult Nurse Practitioner on the faculty in the School of Nursing atUMDNJ in Newark, NJ and in practice in Teaneck, NJ. She has taught nursing at thegraduate, baccalaureate and pre-licensure levels and presented for RN and PN reviewcourses and nurse refresher courses.Donna Jackson is an Adult Nurse Practitioner currently in practice in Teaneck, NJ. Sheis on the Adv
the nursing interventions that will assist in solving or alleviating the patient’s med- ical problem. Medical-Surgical Nursing Demystified contains 15 chapters, each providing a
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(i) Medical Surgical Nursing a Cardio Vascular & Thoracic Nursing 75-81 b Critical Care Nursing 82-88 c Medical Surgical Nursing –Oncology Nursing 89-95 d Medical Surgical Nursing - Neurosciences Nursing 96-102 e Medical Surgical Nursing
Practical Nursing Series: Medical-Surgical Nursing II This free sample provided by CIMC www.okcimc.com 800.654.4502 Medical Surgical Nursing II, used in conjunction with Medical Surgical Nursing I, replaces the 2002 version of Nursing Focus. The curriculum adheres to the revised objectives approved by the Oklahoma Board of Nursing.
in medical surgical nursing? 3. 3 min Describe the domain of medical surgical nursing. DOMAIN OF MEDICAL AND SURGICAL NURSING (NURSING AS A PROFESSION): Nursing practice today is composed of a wide variety of roles and responsibilities necessary to meet the health care needs of society.
brother’s life ended in death by the hands of his brother. We are going to see what the Holy Spirit revealed that caused the one to murder his flesh and blood. We are also going to see God’s expectation and what he needed to operate in as his brother’s keeper. My desire is for us to all walk away with a greater burden for each other as we see each other as ourselves and uphold each other .
