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Nursing Health Assessment: A Clinical Judgment Approach 4 HAR/PSC

Sharon Jensen, Debra Servello

Formāts: 1056 pages, height x width x depth: 2687x2062x1.50 mm, weight: 5150 g
Izdošanas datums: 11-Oct-2022
Izdevniecība: Lippincott Williams & Wilkins
ISBN-10: 1975176820
ISBN-13: 9781975176822

Citas grāmatas par šo tēmu:

Health systems & services - (Noliktavā: 14 punkts)

Cena: 172,79 €
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Formāts: 1056 pages, height x width x depth: 2687x2062x1.50 mm, weight: 5150 g
Izdošanas datums: 11-Oct-2022
Izdevniecība: Lippincott Williams & Wilkins
ISBN-10: 1975176820
ISBN-13: 9781975176822

Citas grāmatas par šo tēmu:

Health systems & services - (Noliktavā: 14 punkts)

Permanent link: https://www.kriso.lv/db/9781975176822.html

Keywords:

"Nursing Health Assessment: A Clinical Judgment Approach reflects a progressive, modern approach to both nursing education and clinical nursing practice. The goal is to combine the most successful elements of traditional health assessment texts with innovative elements to help students apply knowledge. The text includes a two-column format with normal and abnormal findings and also highlights priority and safety assessments that demand urgent attention. Quality and Safety Education for Nurses (QSEN) competencies and clinical judgment features that align with the new NCLEX Clinical Judgment Model"--

Equip students with the necessary clinical judgment for effective nursing health assessment with Nursing Health Assessment: A Clinical Judgment Approach, 4th Edition. This extensively revised and updated text combines fundamental knowledge and a progressive, student-friendly presentation with an emphasis on critical thinking and clinical decision-making to help students excel on the Next Generation NCLEX® and confidently transition to nursing practice.

Combining the fundamental coverage of a traditional nursing assessment text with a modern, student-friendly presentation and an enhanced emphasis on clinical judgment, Nursing Health Assessment: A Clinical Judgment Approach, 4th Edition, helps students easily develop the understanding, critical thinking, and decision-making skills to excel in any clinical setting.

A consistent, two-column format presents normal and abnormal findings and guides students progressively through realistic clinical case scenarios, instilling the nursing knowledge to observe and assess situations, prioritize patient concerns, and generate the best possible solutions. Case-based Next Generation NCLEX® (NGN) style questions throughout the text (and answers with rationales in an appendix) align with the NCSBN Clinical Judgment Model (NCJMM) to prepare students for success on the Next Generation NCLEX® and to help them confidently deliver safe patient care in any clinical setting.

New and Updated Features for the 4th Edition

NEW! 180 case-based Next Generation NCLEX® (NGN) style questions (and answers with rationales) boost students’ exam readiness and test-taking confidence.
NEW! NCSBN Clinical Judgment Measurement Model (NCJMM) cues, hypotheses, and evaluation components incorporated into case studies throughout the text strengthen students’ critical thinking and decision-making capabilities.
UPDATED! New and revised content familiarizes students with social determinants of health, incorporates unbiased language, and reflects current infection and source control measures.
UPDATED! Diagnoses incorporate International Classification for Nursing Practice [ ICNP] language to clarify challenging terminology.

Contributors

Reviewers

viii

Preface

UNIT 1 Foundations of Nursing Health Assessment

1 The Nurse's Role in Health Assessment

(19)

Structure And Function

(1)

Roles of the Professional Nurse

(2)

Provider of Care

(1)

Manager of Care

(1)

Member of a Profession

(1)

The registered nurse

(1)

The advanced practice registered nurse

(1)

Registered Nurse Versus Specialty or Advanced Practice Assessments

(1)

Teaching and Health Promotion

(1)

Wellness and Illness

(1)

Social Determinants of Health: Healthy People 2030

(1)

What Is Health Assessment?

(3)

Nursing Process

(1)

Assess

(1)

Diagnose

(1)

Identify outcomes

(1)

Plan care

(1)

Implement

(1)

Evaluate outcomes

(1)

Critical Thinking

(1)

Diagnostic Reasoning

(1)

Clinical Judgment

(1)

Types of Nursing Assessments

(2)

Emergency and Urgent Assessment

(1)

Comprehensive Assessment

(1)

Focused Assessment

(1)

Priority Setting

(1)

Frequency of Assessment

(1)

Lifespan Issues

(1)

Cultural Variations and Health Disparities

(1)

Components of the Health Assessment

(1)

Subjective Cues

(1)

Objective Cues

(1)

Documentation and Communication: Progress Note and SBAR

(1)

Frameworks for Health Assessment

(2)

Functional Assessment

(1)

Head-to-Toe Assessment

(1)

Body Systems Approach

(1)

Clinical Judgment

(1)

Deciding What to Do First

(1)

Priority Setting

(1)

Priority Setting Frameworks

(1)

Maslow's Hierarchy of Needs

(1)

Urgent and Acute Versus Chronic

(1)

Airway, Breathing, Circulation, Disability Framework

(1)

Safety/Risk Reduction

(1)

Nursing Process

(1)

Survival Potential

(1)

Least Restrictive Interventions

(1)

Using Evidence-Based Practice

(4)

Generate Solutions

(2)

Review Questions

(2)

2 The Health History and Interview

(29)

Structure And Function

(1)

The Communication Process

(3)

Therapeutic Communication

(1)

Nonverbal communication skills

(1)

Verbal communication skills

(1)

Subjective Cues

(1)

Nontherapeutic Responses

(5)

False Reassurance

(1)

Sympathy

(1)

Unwanted Advice

(1)

Biased questions

(1)

Changing the subject

(1)

Distractions

(1)

Technical or overwhelming language

(1)

Interrupting

(1)

Professional Expectations and Boundaries

(1)

Culturally Competent Communication

(1)

Patients with limited english skills

(1)

Working with an interpreter

(2)

Gender and sexual orientation bias

(1)

Objective Cues

(1)

Phases of the Interview Process

(1)

Preinteraction Phase

(1)

Beginning Phase

(1)

Working Phase

(1)

Closing Phase

(1)

Health History Sources

(1)

Primary and Secondary Data Sources

(1)

Reliability of the Source

(1)

Components of the Health History

(9)

Demographic Data

(1)

Reason for Seeking Care

(1)

History of Present Illness

(1)

Location

(1)

Onset/duration/timing

(1)

Intensity

(1)

Quality/description

(1)

Aggravating/associated/alleviating factors

(1)

Pain goal

(1)

Functional goal

(1)

Past Health History

(1)

Childhood illnesses

(1)

Past illnesses

(1)

Surgeries

(1)

Injuries and trauma

(1)

Obstetric history

(1)

Health screening

(1)

Genetics

(1)

Current Medications

(1)

Allergies

(1)

Family History

(1)

Functional Health Assessment

(2)

Growth and Development

(1)

Review of Systems

(3)

Psychosocial and Lifestyle Factors

(4)

Social, Cultural, and Spiritual Assessment

(1)

Mental Health Assessment

(1)

Neglect, Abuse, and Violence Assessment

(1)

Sexual History

(1)

Life Span Considerations

(1)

Challenging Situations

(1)

Hearing impairment

(1)

Low level of consciousness

(1)

Cognitive impairment

(1)

Mental illness

(1)

Anxiety

(1)

Crying

(1)

Anger

(1)

Use of alcohol, drugs, or mind-altering substances

(1)

Personal questions and boundaries

(1)

Sexual aggression

(1)

Clinical Judgment

(4)

Review Questions

(2)

3 Techniques, Safety, and Infection Control

(20)

Structure And Function

(1)

Safety Precautions to Prevent Infection

(4)

Standard Precautions and Transmission-Based Precautions

(1)

Hand hygiene

(1)

Personal protective equipment

(3)

Subjective Cues

(1)

Objective Cues

(1)

Basic and Advanced Techniques

(7)

Inspection

(1)

Palpation

(1)

Light palpation

(1)

Moderate palpation

(1)

Bimanual deep palpation

(1)

Percussion

(1)

Direct percussion

(1)

Indirect percussion

(1)

Percussion sounds

(1)

Auscultation

(1)

The stethoscope

(1)

Advanced Techniques and Special Equipment

(1)

Ophthalmoscope

(1)

Otoscope

(1)

Tuning fork

(1)

Reflex hammer

(1)

Equipment for a Complete Physical Assessment

(1)

Older Adults

(1)

Cultural Variations and Health Disparities

(1)

Clinical Judgment

(1)

Make Clinical Decisions

(4)

Review Questions

(1)

4 Documentation and Interprofessional Communication

(22)

Structure And Function

(1)

Patient Medical Record

(2)

Purposes of the Medical Record

(1)

Legal document

(1)

Communication and care planning

(1)

Quality assurance

(1)

Financial reimbursement

(1)

Education

(1)

Research

(1)

Components of the Medical Record

(1)

Electronic Medical Record

(1)

Subjective Cues

(1)

Priority Urgent Assessment

(1)

Objective Cues

(1)

Principles Governing Documentation

(2)

Confidentiality

(1)

Accuracy and Completeness

(1)

Logical Organization

(1)

Timeliness

(1)

Conciseness

(1)

Documentation

(5)

Nursing Admission Assessment

(1)

Flow Sheets

(1)

Plan of Care and Clinical Pathway

(1)

Progress or Case Note

(1)

Narrative notes

(1)

Soap notes

(1)

Pie notes

(1)

Dar note

(1)

Charting by Exception

(1)

Discharge Note

(1)

Home Care Documentation

(1)

Long-Term Care Documentation

(1)

Written Handoff Summary

(1)

Verbal Communication

(2)

Verbal Handoff Summary

(1)

Reporting

(1)

Qualities of effective reporting

(1)

Clinical Judgment

(4)

Sbar Model

(1)

Reporting to the Primary Healthcare Provider

(1)

Phone and urgent communication

(3)

Review Questions

(5)

UNIT 2 General Examinations

5 Vital Signs and General Survey

(36)

Structure And Function

(1)

Subjective Cues

(1)

Priority Urgent Assessment

(1)

Subjective Data Collection

(3)

Assessment of Risk Factors

(1)

Teaching and Health Promotion

(1)

Common Symptoms

(2)

Objective Cues

(1)

Equipment

(1)

Preparation

(1)

General Survey

(2)

Anthropometric Measurements

(3)

Vital Signs

102

(17)

Temperature

102

(1)

Determine which route to use

103

(1)

Oral route

103

(1)

Axillary route

103

(1)

Tympanic membrane

103

(1)

Temporal artery

104

(1)

Rectal route

104

(2)

Pulse

106

(3)

Respirations

109

(2)

Oxygen Saturation

111

(1)

Blood Pressure

112

(6)

Vital Signs Monitor

118

(1)

Doppler Technique

118

(1)

Older Adults

119

(1)

General Survey

119

(1)

Height and Weight

119

(1)

Temperature

119

(1)

Pulse

119

(1)

Respirations

119

(1)

Pulse Oximetry

119

(1)

Blood Pressure

119

(1)

Cultural Variations and Health Disparities

120

(1)

Clinical Judgment

120

(1)

Make Clinical Decisions

120

(6)

Analyze Laboratory and Diagnostic Testing

120

(3)

Generate Solutions

123

(3)

Review Questions

126

(1)

Tables of Abnormal Findings

127

(2)

6 Pain Assessment

129

(23)

Structure And Function

130

(1)

Neuroanatomy of Pain

130

(2)

Peripheral Nervous System

130

(1)

Central Nervous System

130

(1)

Gate Control Theory

131

(1)

Nociception

131

(1)

Types of Pain

132

(2)

Acute Pain

132

(1)

Chronic Pain

133

(1)

Neuropathic Pain

133

(1)

Nociplastic Pain

133

(1)

Older Adults

134

(1)

Cultural Variations and Health Disparities

134

(1)

Subjective Cues

135

(1)

Priority Urgent Assessment

135

(1)

Subjective Data Collection

135

(2)

Assessment of Risk Factors

135

(1)

Teaching and Health Promotion

135

(1)

Common Symptoms

135

(2)

Objective Cues

137

(1)

Pain Assessment Tools

138

(3)

One-Dimensional Pain Scales

138

(1)

Numeric pain intensity scale

138

(1)

Visual analogue scale (vas)

139

(1)

Multidimensional Pain Scales

139

(1)

Brief pain inventory

139

(1)

Mcgill pain questionnaire

139

(1)

The pain, enjoyment and general activity (peg) tool

140

(1)

Clinically aligned pain assessment (capa) tool

140

(1)

Lifespan Considerations

141

(2)

Newborns, Infants, and Children

141

(1)

Older Adults

142

(1)

Special Considerations

143

(2)

Patients Unable to Report Pain

143

(1)

The Opioid Crisis

143

(1)

Patients With Opioid Tolerance

143

(1)

Reassessing and Documenting Pain

144

(1)

Barriers to Pain Assessment

144

(1)

Clinical Judgment

145

(1)

Make Clinical Decisions

145

(1)

Analyze Laboratory and Diagnostic Testing

145

(4)

Prioritize Hypotheses and Take Action

145

(2)

Generate Solutions

147

(2)

Review Questions

149

(3)

7 Nutritional Assessment

152

(28)

Structure And Function

153

(1)

Nutritional Concepts

153

(3)

Primary Nutrients

153

(1)

Carbohydrates

153

(1)

Proteins and amino acids

153

(1)

Lipids and fatty acids

153

(1)

Vitamins and minerals

154

(1)

Supplements

154

(1)

Fluid and electrolytes

155

(1)

Food Safety and Food Security

156

(1)

Food-borne pathogens

156

(1)

Organic food

156

(1)

Food security

156

(1)

Nutritional Guidelines

156

(1)

Lifespan Considerations

156

(2)

People Who Are Pregnant

156

(1)

Infants, Children, and Adolescents

157

(1)

Older Adults

157

(1)

Cultural Variations and Health Disparities

158

(1)

Subjective Cues

159

(1)

Priority Urgent Assessment

159

(1)

Subjective Data Collection

159

(7)

Assessment of Risk Factors

160

(2)

Teaching and Health Promotion

162

(1)

Common Symptoms

162

(2)

Comprehensive Nutritional History

164

(1)

Food records

164

(1)

Direct observation

164

(2)

Objective Cues

166

(1)

Basic and Advanced Techniques

166

(1)

Equipment

166

(1)

Preparation

166

(1)

Comprehensive Physical Assessment

166

(5)

Clinical Judgment

171

(1)

Make Clinical Decisions

171

(5)

Analyze Laboratory and Diagnostic Testing

171

(1)

Serum proteins

171

(1)

Hemoglobin and hematocrit

171

(1)

Lymphocyte count

171

(1)

Creatinine excretion

172

(1)

Nitrogen balance

172

(1)

Skin testing

172

(1)

Lipid measurements

172

(1)

Other laboratory tests

172

(1)

Prioritize Hypotheses and Take Action

172

(4)

Review Questions

176

(1)

Tables of Abnormal Findings

177

(3)

8 Assessment of Developmental Stages

180

(25)

Structure And Function

181

(1)

Psychosocial Development

181

(2)

Infant: Trust Versus Mistrust: Stage I

181

(1)

Toddler: Autonomy Versus Shame and Doubt: Stage II

181

(1)

Preschooler: Initiative Versus Guilt: Stage III

181

(1)

School-Age Child: Industry Versus Inferiority: Stage IV

182

(1)

Adolescent: Identity Versus Role Confusion: Stage V

182

(1)

Early Adult: Intimacy Versus Isolation: Stage VI

182

(1)

Middle Adult: Generativity Versus Stagnation: Stage VII

182

(1)

Late Adult: Ego Integrity Versus Despair: Stage VIII

182

(1)

Cognitive Development

183

(2)

Infant: Sensorimotor Stage I

183

(1)

Toddler and Preschooler: Preoperational Stage II

184

(1)

School-Age Child: Concrete Operations III

184

(1)

Adolescent: Formal Operations IV

185

(1)

Young Adult: Formal Operations

185

(1)

Development of Wisdom and Values in Adults

185

(1)

Middle Adult: Cognitive Expertise

185

(1)

Older Adult: Wisdom

186

(1)

Physical Development

186

(2)

Newborn and Infant

186

(1)

Child and Adolescent

187

(1)

Adults and Older Adults

188

(1)

Cultural Variations and Health Disparities

188

(1)

Subjective Cues

189

(1)

Priority Urgent Assessment

189

(1)

Subjective Data Collection

189

(5)

Assessment of Risk Factors

190

(1)

Teaching and Health Promotion

191

(1)

Infants, children, and adolescents

191

(2)

Adolescents

193

(1)

Older adults

193

(1)

Objective Cues

194

(1)

Comprehensive Physical Assessment

194

(5)

Clinical Judgment

199

(1)

Make Clinical Decisions

199

(4)

Analyze Laboratory and Diagnostic Testing

199

(1)

Prioritize Hypotheses and Take Action

199

(2)

Generate Solutions

201

(2)

Review Questions

203

(2)

9 Mental Health, Violence, and Substance Use Disorder

205

(31)

Structure And Function

206

(1)

Role of the Nurse in Mental Health

206

(1)

Violence

206

(1)

Substance Use Disorder and Addiction

207

(3)

Definitions

207

(1)

Statistics

208

(1)

Alcohol Use Disorder

208

(2)

Opioid Crisis

210

(1)

Subjective Cues

210

(1)

Priority Urgent Assessment

210

(1)

Subjective Data Collection

210

(11)

Interviewing Patients About Violence

211

(1)

Documentation and legal issues related to violence

211

(1)

Alcohol and Drug Use Disorder Interview

212

(1)

Risk Factors for Mental Health Conditions

212

(4)

Dementia, Delirium, and Depression Assessment

216

(1)

Teaching and Health Promotion

217

(1)

Common Symptoms

217

(4)

Objective Cues

221

(1)

Comprehensive Mental Health Assessment

221

(8)

Clinical Judgment

229

(1)

Make Clinical Decisions

229

(5)

Analyze Laboratory and Diagnostic Testing

229

(1)

Prioritize Hypotheses and Take Action

230

(1)

Generate Solutions

231

(3)

Review Questions

234

(2)

10 Cultural Assessment

236

(25)

Structure And Function

237

(1)

Cultural Assessment and Cultural Competency

237

(1)

Characteristics of Culture

238

(1)

Nursing Models for Cultural Assessment and Care

238

(1)

Subjective Cues

238

(1)

Subjective Data Collection

238

(10)

Implementing the Cultural Assessment: Practical Aspects

242

(1)

Cultural health beliefs and practices

243

(5)

Objective Cues

248

(1)

Social Assessment

248

(4)

Social Determinants of Health

248

(1)

Social Assessment of the Individual

248

(1)

Social Assessment of the Community

249

(3)

Clinical Judgment

252

(1)

Making Clinical Decisions

252

(5)

Prioritize Hypothesis and Take Action

252

(5)

Review Questions

257

(4)

UNIT 3 Regional Examinations

11 Skin, Hair, and Nails Assessment

261

(51)

Structure And Function

262

(1)

Skin

262

(1)

Epidermis

262

(1)

Dermis

262

(1)

Subcutaneous Layer

262

(1)

Hair

263

(1)

Nails

263

(1)

Glands

264

(1)

Older Adults

264

(1)

Cultural Variations and Health Disparities

265

(2)

Subjective Cues

267

(1)

Priority Urgent Assessment

267

(1)

Subjective Data Collection

267

(7)

Assessment of Risk Factors

267

(3)

Teaching and Health Promotion

270

(1)

Common integumentary symptoms

271

(3)

Objective Cues

274

(1)

Basic and Advanced Techniques

274

(1)

Equipment

274

(1)

Preparation

274

(1)

Comprehensive Skin Assessment

274

(7)

Clinical Judgment

281

(1)

Make Clinical Decisions

281

(4)

Analyze Laboratory and Diagnostic Testing

281

(1)

Prioritize Hypotheses and Take Action

281

(2)

Generate Solutions

283

(2)

Review Questions

285

(1)

Tables of Abnormal Findings

286

(26)

12 Head and Neck Assessment, With Vision and Hearing Basics

312

(26)

Structure And Function

313

(1)

The Head

313

(1)

Skeletal Structure

313

(1)

Muscles

313

(1)

Blood Supply

313

(1)

Nerve Supply

313

(1)

Salivary Glands

314

(1)

Vision

314

(1)

Hearing

314

(1)

The Neck

314

(1)

Trachea

314

(1)

Thyroid and Parathyroid Glands

315

(1)

Lymphatics

315

(1)

Older Adults

315

(1)

Cultural Variations and Health Disparities

316

(1)

Subjective Cues

316

(1)

Priority Urgent Assessment

316

(1)

Subjective Data Collection

317

(4)

Assessment of Risk Factors

317

(1)

Teachinq and Health Promotion

318

(1)

Common Symptoms

318

(3)

Objective Cues

321

(1)

Basic and Advanced Techniques

321

(1)

Equipment

322

(1)

Preparation

322

(1)

Comprehensive Physical Assessment

322

(6)

Clinical Judgment

328

(1)

Make Clinical Decisions

328

(4)

Analyze Laboratory and Diagnostic Testing

328

(1)

Prioritize Hypotheses and Take Action

328

(2)

Generate Solutions

330

(2)

Review Questions

332

(2)

Tables of Abnormal Findings

334

(4)

13 Eye Assessment for Advanced and Specialty Practice

338

(36)

Structure And Function

339

(1)

The Eye

339

(1)

Extraocular Structures

339

(1)

Extraocular Muscle Function

339

(1)

Intraocular Structures

340

(1)

Vision

340

(1)

Older Adults

340

(2)

Cultural Variations and Health Disparities

342

(1)

Subjective Cues

342

(1)

Priority Urgent Assessment

342

(1)

Subjective Data Collection

343

(3)

Assessment of Risk Factors

343

(1)

Teaching and Health Promotion

344

(1)

Common Symptoms

344

(2)

Objective Cues

346

(1)

Basic and Advanced Techniques

346

(1)

Equipment (For Advanced Practice Assessment)

347

(1)

Preparation

347

(1)

Comprehensive Physical Assessment

347

(12)

Visual Acuity

347

(1)

Visual Fields

348

(1)

Extraocular Muscle Movements

348

(8)

Internal Ocular Structures

356

(3)

Clinical Judgment

359

(1)

Make Clinical Decisions

359

(5)

Analyze Laboratory and Diagnostic Testing

359

(1)

Prioritize Hypotheses and Take Actions

359

(2)

Generate Solutions

361

(3)

Review Questions

364

(1)

Tables of Abnormal Findings

365

(9)

14 Ear Assessment for Advanced and Specialty Practice

374

(28)

Structure And Function

375

(1)

Ear

375

(1)

External Ear

375

(1)

Middle Ear

376

(1)

Inner Ear

376

(1)

Hearing

376

(2)

Air and Bone Conduction

377

(1)

Hearing Difficulties

377

(1)

Vestibular Function

378

(1)

Older Adults

378

(1)

Cultural Variations and Health Disparities

378

(1)

Subjective Cues

378

(1)

Priority Urgent Assessment

378

(1)

Subjective Data Collection

379

(5)

Assessment of Risk Factors

379

(2)

Teaching and Health Promotion

381

(1)

Common Symptoms

381

(3)

Objective Cues

384

(1)

Basic and Advanced Techniques

384

(1)

Equipment (For Advanced Practice Assessment)

384

(1)

Preparation

384

(1)

Comprehensive Physical Assessment

385

(6)

Clinical Judgment

391

(1)

Make Clinical Decisions

391

(6)

Analyze Laboratory and Diagnostic Testing

391

(1)

Prioritize Hypotheses and Take Action

391

(6)

Review Questions

397

(1)

Tables of Abnormal Findings

398

(4)

15 Nose, Sinuses, Mouth, and Throat Assessment

402

(43)

Structure And Function

403

(1)

Nose

403

(1)

Nerve and Blood Supply

404

(1)

Lymph Drainage

404

(1)

Sinuses

404

(1)

Mouth

405

(3)

Tongue

406

(1)

Salivary Glands

406

(1)

Teeth and Gums

407

(1)

Throat, Tonsils, and Adenoids

408

(1)

Older Adults

408

(1)

Cultural Variations and Health Disparities

408

(2)

Oral Health in Vulnerable Populations

409

(1)

Congenital Defects in Children

409

(1)

Cancer

409

(1)

Sleep-Disordered Breathing

410

(1)

Subjective Cues

410

(1)

Priority Urgent Assessment

410

(1)

Subjective Data Collection

410

(8)

Assessment of Risk Factors

410

(4)

Teaching and Health Promotion

414

(1)

Tobacco use

414

(1)

Sleep disorders

414

(1)

Cancer

414

(1)

Oral health

414

(1)

Hereditary hemorrhagic telangiectasia

414

(1)

Common Nose, Sinus, and Mouth Symptoms

414

(4)

Objective Cues

418

(1)

Basic and Advanced Techniques

418

(1)

Equipment

418

(1)

Preparation

418

(1)

Comprehensive Physical Assessment

419

(6)

Clinical Judgment

425

(1)

Make Clinical Decisions

425

(6)

Analyze Laboratory and Diagnostic Testing

425

(1)

Prioritize Hypotheses and Take Action

426

(2)

Generate Solutions

428

(3)

Review Questions

431

(1)

Tables of Abnormal Findings

432

(13)

16 Thorax and Lung Assessment

445

(38)

Structure And Function

446

(1)

The Thorax

446

(3)

Anterior Thoracic Landmarks

446

(2)

Posterior Thoracic Landmarks

448

(1)

Reference Lines

448

(1)

Lobes of the Lungs

449

(1)

The Respiratory Tract

450

(1)

Lower Respiratory Tract

450

(1)

Upper Respiratory Tract

451

(1)

Mechanics of Respiration

451

(1)

Older Adults

451

(1)

Cultural Variations and Health Disparities

452

(1)

Subjective Cues

452

(1)

Priority Urgent Assessment

452

(1)

Subjective Data Collection

453

(7)

Assessment of Risk Factors

453

(2)

Teaching and Health Promotion

455

(1)

Smoking cessation

455

(1)

Prevention of occupational exposure

455

(1)

Prevention of asthma

455

(1)

Immunizations

455

(1)

Common symptoms

456

(4)

Objective Cues

460

(1)

Basic and Advanced Techniques

460

(1)

Equipment

460

(1)

Preparation

460

(1)

Comprehensive Physical Assessment

460

(13)

Clinical Judgment

473

(1)

Make Clinical Decisions

473

(5)

Analyze Laboratory and Diagnostic Testing

473

(1)

Prioritize Hypotheses and Take Action

473

(5)

Review Questions

478

(1)

Tables of Abnormal Findings

479

(4)

17 Heart and Neck Vessels Assessment

483

(40)

Structure And Function

484

(1)

Anatomy

484

(3)

Neck Vessels

485

(1)

Heart Chambers

485

(1)

Valves

485

(1)

Heart Wall

486

(1)

Coronary Arteries and Veins

486

(1)

Conduction System

487

(1)

Physiology

487

(3)

Pulmonary and Systemic Circulation

487

(1)

Cardiac Cycle

488

(1)

Systole

488

(1)

Diastole

488

(1)

Relation to heart sounds (s1 and s2)

488

(1)

Cardiac output

488

(1)

Control of heart rate

489

(1)

Relation to electrocardiogram

489

(1)

Heart rhythm

489

(1)

Jugular Pulsations

490

(1)

Older Adults

490

(1)

Cultural Variations and Health Disparities

491

(1)

Subjective Cues

491

(1)

Priority Urgent Assessment

491

(1)

Subjective Data Collection

492

(6)

Assessment of Risk Factors

492

(1)

Teaching and Health Promotion

493

(1)

Smoking cessation

494

(1)

Control of blood pressure and cholesterol level

494

(1)

Common Symptoms

494

(4)

Objective Cues

498

(1)

Basic and Advanced Techniques

498

(1)

Equipment

499

(1)

Preparation

499

(1)

Comprehensive Physical Assessment

500

(9)

Auscultation

503

(1)

Extra heart sounds

504

(1)

Murmurs

504

(4)

Variations in heart sounds

508

(1)

Clinical Judgment

509

(1)

Make Clinical Decisions

509

(5)

Analyze Laboratory and Diagnostic Testing

509

(1)

Lipid profile

509

(1)

Cardiac enzymes and proteins

509

(1)

Electrocardiogram

509

(1)

Chest x-ray

509

(1)

Echocardiogram

509

(1)

Hemodynamic monitoring

509

(1)

Stress test

509

(1)

Cardiac catheterization and coronary angiography

509

(1)

Cardiac electrophysiology

509

(1)

Prioritize Hypotheses and Take Action

510

(4)

Review Questions

514

(1)

Tables of Abnormal Findings

515

(8)

18 Peripheral Vascular and Lymphatic Assessment

523

(33)

Structure And Function

524

(1)

Arterial System

524

(1)

Venous System

524

(2)

Capillaries

526

(1)

Lymphatic System

526

(1)

Older Adults

527

(1)

Cultural Variations and Health Disparities

528

(1)

Subjective Cues

529

(1)

Priority Urgent Assessment

529

(1)

Subjective Data Collection

529

(6)

Assessment of Risk Factors

529

(2)

Teaching and Health Promotion

531

(1)

Patients with peripheral arterial disease

531

(1)

Patients with venous disease

532

(1)

Patients with lymphatic disorders

532

(1)

Common Symptoms

532

(3)

Objective Cues

535

(1)

Basic and Advanced Techniques

535

(1)

Equipment

536

(1)

Preparation

536

(1)

Comprehensive Physical Assessment

536

(8)

Clinical Judgment

544

(1)

Make Clinical Decisions

544

(5)

Analyze Laboratory and Diagnostic Testing

544

(1)

Prioritize Hypotheses and Take Action

545

(4)

Review Questions

549

(1)

Tables of Abnormal Findings

550

(6)

19 Breast and Axillae Assessment

556

(29)

Structure And Function

557

(1)

Landmarks

557

(1)

Breast Structures

557

(1)

Axillae and Lymph Nodes

558

(1)

Lifespan Considerations

558

(2)

Pregnancy

558

(1)

Newborns and Infants

559

(1)

Children and Adolescents

559

(1)

Older Adults

560

(1)

Breasts in Males Assigned at Birth

560

(1)

Cultural Variations and Health Disparities

560

(2)

Subjective Cues

562

(1)

Priority Urgent Assessment

562

(1)

Subjective Data Collection

562

(5)

Assessment of Risk Factors

562

(2)

Teaching and Health Promotion

564

(1)

Teaching the Self-breast Examination

564

(1)

Common Symptoms

564

(3)

Objective Cues

567

(1)

Basic and Advanced Techniques

567

(1)

Equipment

568

(1)

Preparation

568

(1)

Comprehensive Physical Assessment

568

(7)

Clinical Judgment

575

(1)

Make Clinical Decisions

575

(6)

Analyze Laboratory and Diagnostic Testing

575

(1)

Prioritize Hypotheses and-Take Action

576

(2)

Generate Solutions

578

(3)

Review Questions

581

(1)

Tables of Abnormal Findings

582

(3)

20 Abdominal Assessment

585

(39)

Structure And Function

586

(1)

Anatomical Landmarks

586

(2)

Reference Lines

588

(1)

Abdominal Organs

588

(1)

Gastrointestinal Organs

588

(1)

Genitourinary Organs

588

(1)

Blood Vessels, Peritoneum, and Muscles

588

(1)

Ingestion and Digestion

589

(1)

Absorption of Nutrients

589

(1)

Elimination

589

(1)

Older Adults

589

(1)

Cultural Variations and Health Disparities

590

(1)

Subjective Cues

590

(1)

Priority Urgent Assessment

590

(1)

Subjective Data Collection

590

(9)

Assessment of Risk Factors

590

(3)

Teaching and Health Promotion

593

(1)

Colorectal cancer

593

(1)

Food-borne illnesses

594

(1)

Hepatitis

594

(1)

Common Symptoms

594

(5)

Objective Cues

599

(1)

Basic and Advanced Techniques

599

(1)

Equipment

600

(1)

Preparation

600

(1)

Comprehensive Physical Assessment

600

(12)

Clinical Judgment

612

(1)

Make Clinical Decisions

612

(5)

Analyze Laboratory and Diagnostic Testing

612

(1)

Esophagogastroduodenoscopy

612

(1)

Barium enema

612

(1)

Colonoscopy

612

(1)

Endoscopic retrograde Cholangiopancreatography

612

(1)

Computed tomography scan

612

(1)

Magnetic resonance imaging

612

(1)

Prioritize Hypotheses and Take Action

612

(2)

Generate Solutions

614

(3)

Review Questions

617

(1)

Tables of Abnormal Findings

618

(6)

21 Musculoskeletal Assessment

624

(49)

Structure And Function

625

(1)

Bones

625

(1)

Muscles

625

(1)

Joints

625

(4)

Temporomandibular Joint

626

(1)

Shoulder

626

(1)

Elbow

627

(1)

Wrist and Hand

628

(1)

Hip

628

(1)

Knee

628

(1)

Ankle and Foot

629

(1)

Spine

629

(1)

Older Adults

629

(1)

Cultural Variations and Health Disparities

630

(1)

Subjective Cues

630

(1)

Priority Urgent Assessment

630

(1)

Subjective Data Collection

631

(2)

Assessment of Risk Factors

631

(2)

Teaching and Health Promotion

633

(1)

Bone density

633

(1)

Scoliosis screening

633

(1)

Common Musculoskeletal Symptoms

633

(4)

Objective Cues

637

(1)

Basic and Advanced Techniques

637

(1)

Equipment

637

(1)

Preparation

637

(1)

Initial Survey

638

(3)

Comprehensive Physical Assessment

641

(18)

Risk for Falling

657

(2)

Clinical Judgment

659

(1)

Make Clinical Decisions

659

(5)

Analyze Laboratory and Diagnostic Testing

659

(1)

Prioritize Hypothesis and Take Action

659

(2)

Generate Solutions

661

(3)

Review Questions

664

(1)

Tables of Abnormal Findings

665

(8)

22 Neurological and Mental Status Assessment

673

(49)

Structure And Function

674

(1)

Central Nervous System

674

(5)

Brain

674

(1)

Cerebrum

674

(2)

Brainstem

676

(1)

Cerebellum

677

(1)

Protective Structures of the Central Nervous System

677

(1)

Spinal Cord

678

(1)

Peripheral Nervous System

679

(2)

Cranial Nerves

679

(1)

Spinal Nerves

679

(1)

Autonomic Nervous System

680

(1)

Reflexes

680

(1)

Older Adults

681

(1)

Cultural Variations and Health Disparities

681

(1)

Subjective Cues

682

(1)

Priority Urgent Assessment

682

(1)

Subjective Data Collection

683

(6)

Assessment of Risk Factors

683

(2)

Teaching and Health Promotion

685

(1)

Stroke prevention

685

(1)

Injury prevention

685

(1)

Chronic neurological conditions

685

(1)

Common Symptoms

685

(4)

Objective Cues

689

(1)

Basic and Advanced Techniques

689

(1)

Equipment

689

(1)

Preparation

689

(1)

Comprehensive Physical Assessment

690

(14)

Neurological Assessment in Selected Situations

704

(3)

Screening Examination of a Healthy Patient

704

(1)

Serial Neurological Assessment and Documentation

704

(1)

Assessment of Meningeal Signs

705

(1)

Assessing the Unconscious Patient

705

(1)

Brain Herniation Syndromes

706

(1)

Clinical Judgment

707

(1)

Make Clinical Decisions

707

(6)

Analyze Laboratory and Diagnostic Testing

707

(1)

Anatomical imaging

707

(1)

Electrical conduction testing

707

(1)

Cerebrospinal fluid/spinal procedures

707

(1)

Prioritize Hypotheses and Take Action

708

(2)

Generate Solutions

710

(3)

Review Questions

713

(1)

Tables of Abnormal Findings

714

(8)

23 Male Genitalia and Rectal Assessment

722

(39)

Structure And Function

723

(1)

External Genitalia

723

(1)

Internal Genitalia

724

(1)

Testes

724

(1)

Ducts

725

(1)

Glands

725

(1)

Rectum and Anus

725

(1)

Rectum

725

(1)

Anal Canal and Anus

726

(1)

Life Span Considerations

726

(1)

Newborns and Infants

726

(1)

Children and Adolescents

726

(1)

Older Adults

726

(1)

Cultural Variations and Health Disparities

727

(1)

Subjective Cues

728

(1)

Priority Urgent Assessment

728

(1)

Subjective Data Collection

729

(7)

Assessment of Risk Factors

729

(3)

Teaching and Health Promotion

732

(1)

Health goals

732

(1)

Testicular self-examination

732

(1)

Screening for prostate cancer

733

(1)

Common Symptoms

733

(3)

Objective Cues

736

(1)

Basic and Advanced Techniques

736

(1)

Equipment

736

(1)

Preparation

736

(1)

Comprehensive Physical Assessment

737

(8)

Additional Techniques

739

(6)

Clinical Judgment

745

(1)

Make Clinical Decisions

745

(5)

Analyze Laboratory and Diagnostic Testing

745

(1)

Prioritize Hypotheses and Take Action

745

(2)

Generate Solutions

747

(3)

Review Questions

750

(1)

Tables of Abnormal Findings

751

(10)

24 Female Genitalia and Rectal Assessment

761

(46)

Structure And Function

762

(1)

External Genitalia

762

(1)

Internal Genitalia

762

(2)

Vagina

762

(1)

Uterus

762

(1)

Cervix

763

(1)

Fallopian Tubes

763

(1)

Ovaries

763

(1)

Rectum, Anal Canal, and Anus

764

(1)

Rectum

764

(1)

Anal Canal and Anus

764

(1)

Hormone Regulation

764

(1)

Life Span Considerations

764

(3)

Pregnancy

764

(1)

Infants, Children, and Adolescents

765

(2)

Menopausal and Older Adults

767

(1)

Cultural Variations and Health Disparities

767

(1)

Subjective Cues

767

(1)

Priority Urgent Assessment

767

(1)

Subjective Data Collection

768

(10)

Assessment of Risk Factors

769

(4)

Teaching and Health Promotion

773

(1)

Common Symptoms

774

(1)

Life span considerations

775

(3)

Objective Cues

778

(1)

Basic and Advanced Techniques

778

(1)

Equipment

778

(1)

Preparation

778

(2)

Comprehensive Physical Assessment

780

(9)

Clinical Judgment

789

(1)

Make Clinical Decisions

789

(4)

Analyze Laboratory and Diagnostic Testing

789

(1)

Prioritize Hypotheses and Take Action

790

(1)

Generate Solutions

791

(2)

Review Questions

793

(1)

Tables of Abnormal Findings

794

(13)

UNIT 4 Special Populations and Foci

25 Pregnancy

807

(33)

Structure And Function

808

(1)

Preconception

808

(1)

First Trimester (0 to 13 Weeks)

809

(1)

Second Trimester (13 to 26 Weeks)

810

(1)

Third Trimester (26 to 40 Weeks)

810

(1)

Determining Weeks of Gestation

811

(1)

Role of the Registered Nurse in the Outpatient Setting

811

(1)

Cultural Variations and Health Disparities

812

(1)

Infant Health Disparities

812

(1)

Birthing Parent Health Disparities

812

(1)

Subjective Cues

813

(1)

Priority Urgent Assessment

813

(1)

Subjective Data Collection

814

(7)

Assessment of Risk Factors

814

(3)

Teaching and Health Promotion

817

(1)

Common Symptoms

818

(3)

Objective Cues

821

(1)

Equipment

821

(1)

Preparation

821

(1)

Comprehensive Physical Assessment

822

(8)

Clinical Judgment

830

(1)

Make Clinical Decisions

830

(7)

Analyze Laboratory and Diagnostic Testing

830

(1)

Prioritize Hypotheses and Take Action

830

(4)

Generate Solutions

834

(3)

Review Questions

837

(1)

Tables of Abnormal Findings

838

(2)

26 Newborns and Infants

840

(38)

Structure And Function

841

(1)

Physical Growth

841

(1)

Motor Development

841

(1)

Psychosocial and Cognitive Development

841

(1)

Language Development

841

(1)

Cultural Variations and Health Disparities

841

(1)

Subjective Cues

842

(1)

Priority Urgent Assessment

842

(1)

Subjective Data Collection

843

(5)

Assessment of Risk Factors

843

(1)

Teaching and Health Promotion

844

(1)

Safe sleep habits

844

(1)

Choking

844

(1)

Cardiopulmonary resuscitation training for caregivers

844

(1)

Immunization schedules

845

(1)

Child safety car seat

845

(1)

Poison control

845

(1)

Breast/chestfeeding

845

(1)

Formula feeding

846

(1)

Tooth Decay

846

(1)

Common Symptoms

846

(2)

Objective Cues

848

(1)

Equipment

848

(1)

Preparation

848

(1)

Comprehensive Physical Assessment

849

(16)

Clinical Judgment

865

(1)

Make Clinical Decisions

865

(5)

Analyze Laboratory and Diagnostic Testing

865

(1)

Prioritize Hypothesis and Take Action

865

(2)

Generate Solutions

867

(3)

Review Questions

870

(2)

Tables of Abnormal Findings

872

(6)

27 Children and Adolescents

878

(31)

Structure And Function

879

(1)

Physical Growth

879

(1)

Motor Development

879

(1)

Language

879

(1)

Psychosocial and Cognitive Development

880

(1)

Cultural Variations and Health Disparities

880

(1)

Subjective Cues

880

(1)

Priority Urgent Assessment

880

(1)

Subjective Data Collection

881

(8)

Assessment of Risk Factors

881

(4)

Teaching and Health Promotion

885

(1)

Immunization schedules

886

(1)

Car safety

886

(1)

American association of poison control centers

886

(1)

Safety at home

886

(1)

Fire safety

887

(1)

Water safety

887

(1)

Outdoor safety

887

(1)

Prevention of substance and alcohol use

887

(1)

Nutrition and prevention of obesity

887

(1)

Prevention of dental caries

887

(1)

Mental health issues

887

(1)

Promotion of contraception and sexually transmitted infection prevention

887

(1)

Common Symptoms

888

(1)

Objective Cues

889

(1)

Equipment

889

(1)

Preparation

889

(2)

Developmental Screening

890

(1)

Comprehensive Physical Assessment

891

(11)

Clinical Judgment

902

(1)

Make Clinical Decisions

902

(4)

Analyze Laboratory and Diagnostic Testing

902

(1)

Prioritize Hypotheses and Take Action

902

(2)

Generate Solutions

904

(2)

Review Questions

906

(3)

28 Older Adults

909

(30)

Structure And Function

910

(1)

Skin, Hair, and Nails

910

(1)

Head and Neck

910

(1)

Eyes and Vision

910

(1)

Ears and Hearing

910

(1)

Nose, Sinuses, Mouth, and Throat

911

(1)

Thorax and Lungs

911

(1)

Heart and Neck Vessels

911

(1)

Peripheral Vascular System and Lymphatics

911

(1)

Breasts/Chest and Lymphatics

912

(1)

Abdomen, Metabolism, and Elimination

912

(1)

Musculoskeletal System

912

(1)

Neurological System

912

(1)

Genitourinary Systems

912

(1)

Endocrine System

912

(1)

Cultural Variations and Health Disparities

913

(1)

Subjective Cues

913

(1)

Priority Urgent Assessment

913

(1)

Subjective Data Collection

913

(9)

Interviewing the Older Adult

913

(2)

Assessment of Risk Factors

915

(3)

Teaching and Health Promotion

918

(1)

Overall assessmenttools for health promotion

919

(1)

Nutrition

919

(1)

Polypharmacy and medications

919

(1)

Safety

919

(1)

Common Symptoms

919

(3)

Objective Cues

922

(1)

Equipment

922

(1)

Preparation

922

(1)

Comprehensive Physical Assessment

923

(6)

Clinical Judgment

929

(1)

Make Clinical Decisions

929

(4)

Analyze Laboratory and Diagnostic Testing

929

(1)

Prioritize Hypotheses and Take Action

929

(2)

Generate Solutions

931

(2)

Review Questions

933

(6)

UNIT 5 Putting It All Together

29 Assessment of the Hospitalized Adult

939

(20)

Structure And Function

940

(1)

Structure and Function: Foundation for Assessment

940

(1)

Types of Hospital Assessments

940

(1)

Assessment, Accountability, and Delegation

941

(1)

Patient Safety and Risk Reduction in the Hospital Setting

941

(2)

Safety Interventions for Hospitalized Patients

942

(1)

Older Adults

943

(1)

Cultural Variations and Health Disparities

943

(1)

Subjective Cues

944

(1)

Urgent Assessment

944

(1)

Subjective Data Collection

945

(1)

Objective Cues

946

(1)

Equipment

946

(1)

Preparation

946

(1)

Communicating the Assessment

946

(1)

Comprehensive Admitting Assessment

947

(1)

Shift and Focused Hospital Assessments

948

(1)

General Shift Assessment

948

(1)

Focused Shift Assessment

948

(1)

Specialized Assessments for the Hospitalized Patient

948

(3)

Clinical Judgment

951

(1)

Make Clinical Decisions

951

(5)

Analyze Laboratory and Diagnostic Testing

951

(1)

Prioritize Hypotheses and Take Action

951

(2)

Generate Solutions

953

(3)

Review Questions

956

(3)

30 Head-to-Toe Assessment of the Adult

959

(28)

Subjective Cues

960

(1)

Priority Urgent Assessment

960

(1)

Subjective Data Collection

960

(9)

Focused History

960

(1)

Past Medical History

961

(1)

Review of Systems

961

(1)

Psychosocial history

962

(1)

Functional health status

962

(1)

Activities of daily living

962

(1)

Teaching and Health Promotion

962

(6)

Common Symptoms

968

(1)

Objective Cues

969

(1)

Equipment

969

(1)

Preparation

970

(1)

Comprehensive Physical Assessment

970

(11)

Clinical Judgment

981

(1)

Make Clinical Decisions

981

(4)

Analyze Laboratory and Diagnostic Testing

981

(1)

Prioritize Hypotheses and Take Action

981

(4)

Review Questions

985

(2)

Appendix A Answers to Review Questions

987

(18)

Appendix B Answers to Next Generation NCLEX Style Questions

1005

(30)

Illustration Credit List

1035

(4)

Index

1039

Nursing Health Assessment: A Clinical Judgment Approach 4 HAR/PSC

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