Brunner Suddarths Txtbk. of Med.-Surg. Nursing 12th ed. (2010)

Index 689 Aortic regurgitation. See Aortic Asymptomatic inflammatory prostatitis, insufficiency 561 Aortic stenosis, 68 AT. See Antithrombin (AT) Aortic valvuloplasty for aortic ATG. See Antithymocyte globulin regurgitation, 67 (ATG) Apheresis device, 76 Atherectomy, 63 Appendicitis, 69–71 Atherosclerosis, 57, 73–74 causes of, 69 clinical manifestations, 74 clinical manifestations, 69 management, 74 diagnosis, 69 pathologic processes, 73 gerontologic considerations, 70 risk factors, 73–74 medical management, 70 Atherosclerotic lesions, 73 nursing management, 70–71 Atherosclerotic plaque rupture, 17 APTT. See Activated partial Atromid-S. See Clofibrate Audiovestibular diagnostic procedures, thromboplastin time (APTT) ARDS. See Acute respiratory distress 432 Aura phase, migraine attack, 331 syndrome (ARDS) Autoimmune (cell-mediated and ARF. See Acute renal failure (ARF) Arimidex. See Anastrazole humoral) attack, 324 Arterial blood gas (ABG) analysis Autonomic hyperreflexia, 610–611 Autotransfusion, 558 in acute pancreatitis, 484 Avascular necrosis, 452 in AIDS, 15 Axillary lymph nodes, 140 in ARDS, 23 in burn injury, 112 B in hypothyroidism, 394 in lung cancer, 176 Back pain, low, 85–88 in PE, 573–574 assessment and diagnostic methods, in pulmonary heart disease, 578 85–86 in status asthmaticus, 83 causes of, 85 Arterial embolism, 71–73 medical management, 86 diagnostic findings, 72 nursing management medical management, 72 assessment, 86–87 nursing management, 72–73 interventions, 87–88 symptoms, 72 Arterial insufficiency of extremities, 536 Bacterial infection Arterial thrombosis, 71–73 acute pharyngitis, 541–542 Arteriography peritonitis, 538–541 for aortic aneurysm, 56 thyroiditis, 617–618 for arterial embolism, 72 for bone tumors, 93 Bacterial meningitis, 434 for cholelithiasis, 226 Bariatric surgery, 465 for liver tumors, 172 Basophilic tumors, 547 for perioperative nursing B-cell lymphomas in AIDS patients, 3 Bed rest management, 512 for RA, 74 in hepatitis B, 363 Arteriosclerosis, 73–74 in low back pain, 86 Arthritis, rheumatoid. See Rheumatoid in pheochromocytoma, 545 in viral pharyngitis, 542 arthritis (RA) Bell’s palsy, 88–90 Asterixis causes of, 88 medical management, 89 in hepatic encephalopathy, 357 nursing management in renal failure, 591 Asthma, 80–82 eye care, 89 assessment and diagnostic methods muscle tone, 89–90 Benign bone tumors, 92 for, 81 Benign prostatic hyperplasia (BPH), clinical manifestations, 80–81 community-based care, 82 90–92 home care, 82 assessment and diagnostic methods, medical management, 81 nursing management, 81–82 90–91 risk factors, 80 clinical manifestations, 90 status asthmaticus. See Status medical management, 91 nursing management, 92 asthmaticus Beta-adrenergic blockers, 63 Beta-blockers, 333

690 Index in cancer, 129–131 in cervical cancer, 147, 150 Bilateral adrenalectomy, 245 in cholelithiasis, 229, 230 Biliary drainage in CML, 421 in colorectal cancer, 152, 153 in acute pancreatitis, 483 in DIC, 272–273 in cholelithiasis and cholecystitis, in diverticular disease, 278 in endometrial cancer, 158 229–230 in epistaxis, 296 percutaneous, in liver cancer, 173 from esophageal varices, 297 Biochemical assays of blood and urine, in hemophilia, 354–356 and hemorrhage risk in cirrhosis, 237 94 in intracranial aneurysm, 58–59 Biologic response modifiers (BRMs), in iron-deficiency anemia, 43 in ITP, 397–398 135–136 in leukemia, 411 Biopsy in MG, 454 in multiple myeloma, 441 for ALS, 34 in musculoskeletal trauma, 452 for bladder cancer, 137 in peptic ulcer, 502 bone. See Bone biopsy prevention in leukemia, 412 bone marrow, 441 in prostate cancer, 186, 189 for bone tumors, 94 in RA, 78 for breast cancer, 140, 141 in renal failure, 591 for cancer, 122, 123 in stomach cancer, 199 for cervical cancer, 147 in subdural hematoma, 338 for colorectal cancer, 152 and thrombocytopenia, 616–617 for esophageal cancer, 160 in thrombocytopenia, 616 for gastric cancers, 196 in ulcerative colitis, 632, 634 for gastritis, 314 in vaginal cancer, 203–204 for Hodgkin’s disease, 370 in vein disorders, 655 incisional, skin cancer, 193 in vulvar tumors, 205 for KS, 408 Bleeding disorder, 272 for laryngeal cancer, 165 Blood tests for liver cancer, 172 for anaphylaxis, 36 for lung cancer, 176 for angina pectoris, 63 for nephritic syndrome, 461 for asthma, 81 for oral cancer, 178 for colorectal cancer, 152 for pancreatic cancer, 181, 182 for peptic ulcer, 504 for pemphigus, 498 for pulmonary embolism, 573 for peptic ulcer, 502 for systemic lupus erythematosus, 614 for pericarditis, 509 for ulcerative colitis, 633 pleural Blood transfusions for bleeding esophageal varices, 299 for pleural effusion, 548 for cholelithiasis, 225 for pneumonia, 550 hepatitis C due to, 364 for pneumothorax, 557 hepatitis D due to, 364 for prostate cancer, 185 for prostate cancer, 186 for thrombocytopenia, 616 for unconscious patient, 643 for thyroid cancers, 202 BMT. See Bone marrow transplantation for uterine cancers, 158 for vulvar sarcoma, 205 (BMT) Bisphosphonates, 442 Body contouring after weight loss, 465 Bladder cancer, 136–138 Body image management assessment and diagnostic methods, in breast cancer, 144 137 in burn injury, 117, 118–119 clinical manifestations, 136 in cancer, 127 medical management, 137 in cervical cancer, 149 risk factor for, 136 in colorectal cancer, 156 Bladder control in Cushing syndrome, 247 in CVA, 222 in RA, 78 in Huntington disease, 371 Body temperature management in malignant melanoma, 191 in burn injury, 111 in MS, 447 Bladder dysfunction, 150 Bleeding in acute pancreatitis, 482 in AML, 419 in anemia, 38, 39 in brain injury, 339

Index 691 in chronic pyelonephritis, 583 Brain tumors, 100–104 in head injury, 344 assessment and diagnostic methods, in heart failure, 346 102 in hyperthyroidism, 386 classification, 101 in perioperative nursing, 526–527 clinical manifestations in toxic epidermal necrolysis, 624 focal/localized, 102 in unconscious patient, 644 increased ICP, 101–102 Bone biopsy for osteomyelitis, 469 incidence of, 100 Bone infections, 469–470 medical treatments, 103 Bone marrow transplantation (BMT) metastasization of, 100–101 for AML, 420 for aplastic anemia, 42 BRCA gene mutation, 140 for brain tumors, 103 Breast cancer, 138–146 for cancer, 134–135 for CML, 422 assessment and diagnostic methods, Bone tumors, 92–95 140 assessment and diagnostic findings, clinical manifestations, 140 93–94 complications, 145 benign, 92 histologic types of, 138 clinical manifestations, 93 inflammatory carcinoma, 139 malignant, 92–93 medical management, 140–141 medical management, 94 Paget’s disease, 139 nursing management, 94–95 postperative nursing interventions secondary, 93 Bowel decompression, 98 body image, 144 Bowel management continuing care, 146 in CVA, 222 coping, 144–145 in diarrhea, 11–12 pain management, 144 in MS, 447 positive adjustment, 144–145 in osteoporosis, 476–477 postoperative sensations, 144 in Parkinson’s disease, 492 self-care, 145–146 in perioperative nursing, 518 sexual function, 145 in SCI, 609 preoperative nursing interventions, in unconscious patient, 644 Bowel obstruction, large, 96–97 143–144 clinical manifestations, 96 prevention strategies medical management, 96–97 nursing management, 97 chemoprevention, 140 Bowel obstruction, small, 97–99 long-term surveillance, 139 clinical manifestations, 97–98 prophylactic mastectomy, 140 medical management, 98 prognoses of, 139 nursing management, 98–99 protective factors, 139 Brachytherapy risk factors, 139 for brain tumors, 103 staging of, 140 for cervical cancer, 148 surgical treatment for prostate cancer, 186 assessment, 141–142 Bradycardia nursing diagnoses, 142 and cardiac arrest, 207 planning/goals, 142–143 and GBS, 324 Breast-conserving surgery, 141 and head injury, 336 Breathing patterns and increased intracranial pressure, in acute pancreatitis, 484 in COPD, 232 402 in increased ICP, 403–404 and myasthenia gravis, 455 in SCI, 607–608 and pneumonia, 551, 553 Breath, shortness of and spinal cord injury, 604, 606, 608 and acute coronary syndrome, 18 Bradykinesia in Parkinson’s disease, 489 and angina pectoris, 62 Brain abscess, 99–100 and cancer, 134 clinical manifestations, 99 and cardiomyopathies, 209 management, medical and nursing, and cerebral vascular accident, 220 and COPD, 233–234 100 and coronary atherosclerosis, 242 prevention, 99 and end-stage renal disease, 591 Brain injury. See Head injury and heart failure, 349 and HIV infection, 2, 8 and hypertension, 378 and malignant melanoma, 195

692 Index Breath, shortness of (continued) physical mobility, 115 and mitral regurgitation, 437 skin integrity, 114 and mitral valve prolapse, 439 nursing management, and pleural effusion, 548 and pneumonia, 550 emergent/resuscitative phase and pulmonary heart disease, 578 assessment, 109–110 and spinal cord injury, 606 body temperature, 111 fluid and electrolyte balance, 111 Broad-spectrum antibiotics gas exchange and airway clearance, for acute otitis media, 478 for diverticular disease, 277 110–111 for pelvic inflammatory disease (PID), pain and anxiety, 111–112 495–496 planning/goals, 118 for septic shock, 601 rehabilitation assessment, 117 Bronchiectasis, 104–105 collaborative problems, 118 causes of, 104 nursing diagnoses, 117 clinical manifestations, 104 self-care, 119 medical management, 104–105 total body surface area, 108–109 Burn wound care procedures, 113 Bronchitis, chronic, 105–106 Butterfly rash, 613 definition, 105 exacerbations of, 106 C Bronchogenic carcinoma, 175–178 CA125 antigen testing of ovarian assessment and diagnostic methods, cancer, 181 176 causes of, 175 Cachexia. See Wasting syndrome classification, 175 CAD. See Coronary artery disease clinical manifestations, 176 managing side effects of treatment in (CAD) breathing problems, 177 Calcification, degenerative, 68 fatigue, 177 Calcitriol. See Activated vitamin D psychological support, 177–178 Calcium antagonists, 333 medical management, 177 Calcium channel blockers, 581, 584 risk factors, 175 Calcium intake and osteoporosis, 475 Calcium stones, 64 Bronchopneumonia, 551 Calculous cholecystitis, 225 Buerger’s disease, 106–107 Campath. See Alemtuzumab Cancer, 121–136 clinical manifestations, 106–107 medical management, 107 in AIDS patients, 3 Bulbar muscle impairment, 34 clinical manifestations, 121–122 Bullectomy for COPD, 232 definition of, 121 Bullous impetigo, 400 diagnostic tests, 122 Burning pain, 106–107 grading, 123 Burn injury, 108–120 medical management, 123–124 depth of, 108 nursing management evaluation, patient outcomes, biologic response modifiers, 119–120 135–136 gerontologic considerations, 109 medical management, 109 bleeding and hemorrhage, 129–130 nursing interventions body image and self-esteem, activity tolerance, 118 127–128 body image and self-concept, bone marrow transplantation, 118–119 134–135 potential complications, 119 chemotherapy, 132–134 nursing management, fatigue, 127 hyperthermia, 135 acute/intermediate phase infection prevention, 128–129 assessment, 113 negative feelings, 128 complications, 116 nutritional problems, 126 coping strategies, 115 pain, 126–127 fluid balance, 113 radiation therapy, 131–132 infection, 113 septic shock, 129 nutrition, 113–114 surgery, 131 pain and discomfort, 114–115 tissue integrity, 124–125 patient and family processes, pathophysiology, 121 screening, 122 115–116

self-care, 130–131 Index 693 staging, 122–123 types Cardiomyopathies, 208–213 assessment, 210 bladder, 136–138 assessment and diagnostic methods, breast, 138–146 209 cervical, 147–151 classification, 208 colon, 151–157 clinical manifestations, 209 endometrial, 158–159 collaborative problems, 210 esophageal, 159–161 medical management kidneys, 161–164 surgical intervention, 209 larynx, 164–171 ventricular assist devices, 210 liver, 171–175 nursing diagnoses, 210 lung, 175–178 nursing interventions oral cavity, 178–180 activity tolerance, 211 ovarian, 180–181 anxiety reduction, 211 pancreas, 181–184 cardiac output, 211 pharynx, 178–180 continuing care, 212 prostate, 184–191 emotional responses, 211–212 rectum, 151–157 self-care, 212 skin, 191–195 pathophysiology, 209 stomach, 196–199 planning/goals, 211 testicular, 200–201 thyroid, 202–203 Cardiomyopathy in muscular urinary bladder, 136–138 dystrophies, 450 vaginaal, 203–204 vulva, 204–207 Cardiopulmonary resuscitation Cancer of endometrium, 158–159 (CPR) Cancer of oral cavity and pharynx, for anaphylaxis, 36 178–180 for anemia, 37 Cancer of urinary bladder, 136–138 for cardiomyopathies, 208 Carcinomas Cardiovascular stability, 525–526 Cataract, 213–214 bronchogenic. See Bronchogenic nursing management, 214 carcinoma senile, 213 surgical management, 214 cholangiocellular, 172 Catheterization, 91 of colon, 152 cardiac, 63, 67, 209, 348, 439, 580 of esophagus, 159 intermittent self, 445, 447 hepatocellular, 171–172, 362 intermittent sterile, 222 infiltrating ductal, 138 pulmonary artery, 23 inflammatory, 139 Catheter obstruction in prostate cancer, renal. See Renal tumors renal cell, 560 189 squamous cell, 164, 204 CD4 (T) cell and HIV infection, 1 Cardiac arrest, 207–208 CEA studies, 152 Cardiac tamponade Cecostomy for large bowel obstruction, clinical manifestations, 508–509 surgical management, 509 96 Cardiogenic shock, 596–598 Cell-mediated immunity, 619 causes of, 596 Cellular degeneration and Parkinson’s clinical manifestations, 597 fluid administration for, 598 disease, 488 hemodynamic monitoring in, 598 Central nervous system, infections of, medical management, 597 medications for, 598 253 prevention, 597 Centrilobular (centroacinar) type of Cardiomegaly and acute nephritic syndrome, 460 emphysema, 281 and anemia, 39 Cephalgia. See Headache and chronic glomerulonephritis, Cephalosporins, 436 Cephulac, 358 320 Cerebellopontine angle tumors, 102 and infective endocarditis, 284 Cerebellum tumors, 102 and rheumatic fever, 285 Cerebral angiography and sickle cell anemia, 49 for brain tumors, 102 for headache, 332 for head injury, 336 for intracranial aneurysm, 58 Cerebral concussion, 336–337 Cerebral contusion, 337

694 Index Cerebral edema, 268 evaluation, patient outcomes, 151 in DKA, 266, 268 medical management, 148 in fulminant hepatic failure, 359 nursing diagnoses, 148–149 in head injury, 338 nursing interventions, 149–150 in increased intracranial pressure, 402 planning/goals, 149 in meningitis, 436 risk factors, 147 CHD. See Coronary heart disease (CHD) Cerebral tissue perfusion Chemical pleurodesis for pleural improving, 59–60, 404 in increased ICP, 404 effusion, 548 ineffective, 341 Chemoprevention of breast cancer, 140 Chemotherapy Cerebrospinal fluid (CSF) drainage, 335, 405 for AIDS-related lymphomas, 7 electrophoresis study, in multiple for AML, 420 sclerosis, 444 for bladder cancer, 137 examination in AD, 29 for bone tumors, 94 Gram staining of, 435 for breast cancer, 141 and increased intracranial pressure, for cancer, 123–124, 132–134 401 for CLL, 418–419 protein levels in, 325 for Hodgkin’s disease, 370 for KS, 7 Cerebrovascular accident (CVA), for liver tumors, 173 214–225 Chest auscultation, 281 Chest pain assessment in acute coronary syndrome, 18–19 acute phase, 217–218 in AIDS, 2 postacute phase, 218 in angina pectoris, 63, 65 in bronchogenic carcinoma, 176 assessment and diagnostic methods, in coronary atherosclerosis, 242 216 in lung abscesses, 423 in mitral valve prolapse, 439 categorization, 215 in paraesophageal hernia, 365 clinical manifestations in PE, 573 in pleural effusion, 548 communication loss, 216 in pneumonia, 551–552 motor loss, 215–216 in pulmonary embolism, 573, 575 perceptual disturbances, 216 Chest physical therapy, 578 sensory loss, 216 Cholecystectomy, 228 evaluation, patient outcomes, Choledochostomy assessment, 228 224–225 collaborative problems in, 229 medical management, 217 evaluation, patient outcomes, nursing interventions 230–231 ambulation, 220 of gallbladder, 228 bowel and bladder control, 222 nursing diagnoses in, 228 cognitive function, 222 planning/goals, 229 communication, 222–223 postoperative nursing interventions coping with sexual dysfunction, biliary drainage, 229–230 223 nutritional status, 230 exercise program, 220 pain management, 229 family coping, 223 respiratory problems, 229 mobility improvement, 219–220 self-care, 230 personal hygiene activities, 221 Cholelithiasis and cholecystitis, self-care, 224 sensory-perceptual difficulties, 221 225–231 shoulder pain prevention, 220–221 clinical manifestations, 226 skin integrity, 223 gallstones. See Gallstones patient recovering from gerontologic considerations, 226–227 collaborative problems in, 219 nutritional and supportive therapy for, nursing diagnoses of, 218–219 treatment planning/goals in, 219 227 prevention, 216–217 pharmacologic therapy for, 227 risk factors, 215 surgical management, 227–228 Cervical cancer, 147–151 Cholesteatoma, 479 assessment, 148 Cholesterol stones, 225 assessment and diagnostic findings, 147 clinical manifestations, 147 complications, 150

Index 695 Cholinesterase inhibitors, 30 Chronic thyroiditis, 618 Chondrosarcoma, 93 Chronic ulcers, 501 Chromophobic tumors, 547 Cidofovir for CMV retinitis, 6 Chronic alcoholism and cirrhosis, 235 Cigarette smoking Chronic bacterial prostatitis, 561 Chronic bronchitis,. See Bronchitis, and cataracts, 213 and chronic obstructive pulmonary chronic Chronic diarrhea, 586 disease, 231 Chronic gastritis, 313 and coronary atherosclerosis, 241 and hepatitis A, 361 symptoms, 313 and liver cancer, 172 treatment measures, 314 and lung cancer, 175 Chronic glomerulonephritis, 319–321 and oral cancer, 178 clinical manifestations, 319–320 and pancreatic cancer, 182 laboratory analysis, 320 Cilostazol, 537 nursing management, 321 Cirrhosis, hepatic, 235–238 treatment of, 320–321 clinical manifestations, 235 Chronic kidney disease (CKD), 319 liver function tests, 235 Chronic lymphocytic leukemia (CLL), medical management, 236 nursing management 417–419 chemotherapy for, 418–419 complications, 237 classification, 417–418 home- and community-based care, clinical manifestations, 418 Chronic muscle disorders, 449 237–238 Chronic myeloid leukemia (CML), injury risk, 236–237 nutritional status, 236 421–422 rest, 236 clinical manifestations, 421 skin care, 236 nursing management, 422 CKD. See Chronic kidney disease pharmacologic therapy for, 421–422 Chronic obstructive pulmonary disease (CKD) Clavicle fracture, 308 (COPD), 104, 231–234 CLL. See Chronic lymphocytic leukemia and aging, 231 clinical manifestations, 231 (CLL) complications of, 231 Clofibrate, 254 medical management, 232 Clonidine suppression test, 545 Chronic otitis media, 479–480 Cluster headaches, 334 clinical manifestations, 479 CML. See Chronic myeloid leukemia medical management, 479–480 nursing management, 480 (CML) Chronic pain and substance abuse, 53 CMV retinitis, 6 Chronic pancreatitis, 486–488 Cochlear disease, 431 clinical manifestations, 486–487 Cognitive management diabetes mellitus in, 487 diagnostic methods, 487 for AD, 31 incidence of, 486 for cerebrovascular accident (CVA), long-term alcohol consumption and, 222 486 for head injury, 344 surgery for, 486–487 for low back pain, 86 treatment, 487–488 for MS, 448 Chronic pharyngitis, 543 for multiple sclerosis (MS), 448 Chronic prostatitis/chronic pelvic pain for sickle cell anemia, 50 for TB, 631 syndrome (CP/CPPS), 561 for traumatic brain injury (TBI), 344 Chronic pulmonary disorders, 231 Colchicine Chronic pyelonephritis, 582–583 for cirrhosis, 236 Chronic renal failure (CRF), 591–594 for gout, 323 for pericarditis, 509 clinical manifestations, 591–592 Colonoscopy dialysis, 593 for iron deficiency anemia, 44 in elderly people, 592 for large bowel obstruction, 96 nursing management for pancreatic cancer, 181 Colorectal cancer, 151–157 fluid status, 593 abdominal and rectal examination, self-care, 594 nutritional therapy for, 593 152 pharmacologic management, 592–593 assessment, 153–154 CEA studies, 152

696 Index Colorectal cancer (continued) for leukemia, 414, 415 clinical manifestations, 151–152 for osteomyelitis, 472–473 collaborative problems/complications, for Parkinson’s disease, 492–494 154 for peptic ulcer, 506–507 in elderly people, 152–153 for perioperative nursing, 530 evaluation, patient outcomes, 157 for peripheral arterial occlusive incidence of, 151 medical management, 153 disease, 538 nursing diagnoses, 154 for prostate cancer, 190 nursing interventions for psoriasis, 569 emotional support, 155 for pulmonary embolism (PE), fluid and electrolyte balance, 156 healthy diet, 155–156 576–577 home- and community-based care, for RA, 78, 79 156–157 for sickle cell anemia, 53 patient preparation for surgery, for ulcerative colitis, 638 154–155 for vulvar tumors, 206 planning/goals, 154 Compartment syndrome, 112 surgical management, 153 management of, 306 survival rates, 151 manifestations of, 303–304 Compensated cirrhosis, 235 Coma, 639 Complex regional pain syndrome Combination chemotherapy (CRPS), 303 for Hodgkin’s disease, 370 management of, 307 for lymphoma, 7 Compression therapy, 656–657 Communication management Computed tomography (CT) scan in AD, 32 for acute pancreatitis, 482 in CVA, 222–223 for acute renal failure, 588 in GBS, 327 for Alzheimer’s disease, 29 in laryngeal cancer, 168 for aortic aneurysms, 55 in Parkinson’s disease, 493 for bone tumors, 93 Community-based care for brain tumors, 100, 102 for ACS, 21–22 for breast cancer, 140 for acute nephritic syndrome, 461 for bronchiectasis, 104 for acute pancreatitis, 485 for cancer, 122 for AD, 31, 32 for cervical cancer, 147 for Addison’s disease, 27–28 for chronic glomerulonephritis, 320 for AIDS, 15–16 for chronic pancreatitis, 487 for appendicitis, 71 for diverticular disease, 276 for asthma, 82 for empyema, 281 for breast cancer, 145–146 for esophageal cancer, 160 for burn injury, 119 for headache, 332 for cancer, 130–131 for increased intracranial pressure, for cardiomyopathies, 212 for cholelithiasis and cholecystitis, 402 for intracranial aneurysms, 58 230 for large bowel obstruction, 96 for chronic renal failure (CRF), 594 for liver cancer, 172 for colorectal cancer, 156–157 for low back pain, 85 for CVA, 221, 224 for lung abscesses, 423 for cystitis (lower UTI), 252 for meningitis, 435 for diabetes mellitus, 260, 263 for Parkinson’s disease, 489 for epilepsy, 294–295 for pericarditis, 509 for gastric cancer, 199 for pheochromocytoma, 545 for gastritis, 315 for pleural effusion, 547 for GBS, 328 for pulmonary embolism, 573 for head injury, 345 for regional enteritis, 586 for heart failure (HF), 353 for spinal cord injury, 604 for hepatic cirrhosis, 237–238 for ulcerative colitis, 633 for hiatal hernia, 367–368 Congenital lymphedema, 425 for hypertension, 379 Conjunctival retraction, 625 for hyperthyroidism, 386 Constipation, 238–240 for hypothyroidism, 395–396 in appendicitis, 69 for intracranial aneurysm, 61 causes, 238 clinical manifestations, 238

diagnosis, 239 Index 697 in diverticular disease, 276, 278 and headache, 381 Coronary atherosclerosis and CAD, in large bowel obstruction, 96 241–243 medical management, 239 in multiple sclerosis, 444, 447 clinical manifestations, 242 nursing management, 239–240 prevention, CHD, 242–243 in Parkinson’s disease, 489 risk factors, 241–242 Contact dermatitis, 240–241 Coronary heart disease (CHD) clinical manifestations, 240 prevention, 242–243 medical management, 240–241 risk factors, 242 nursing management, 241 Cor pulmonale. See Heart failure (HF) types, 240 Corticosteroids Continuing care for acute nephritic syndrome, 461 in acute nephritic syndrome, 462 for ALL, 417 in acute pancreatitis, 485–486 and Bell’s palsy, 89 in breast cancer, 145–146 for multiple myeloma, 442 in cancer, 130–131 for pemphigus, 498 in cardiomyopathies, 212 for pericarditis, 509 in cervical cancer, 150 for SLE, 614 in chronic renal failure (CRF), 594 Corticosteroid therapy in COPD, 234 for brain abscess, 100 in diabetes mellitus, 263–264 prednisone, 89 in epilepsy, 295 Cough in GBS, 328 in AIDS, 2 in head injury, 346 in amyotroic lateral sclerosis, 34 in heart failure (HF), 353 in asthma, 84 in hiatal hernia, 368 in bronchiectasis, 104 in hypertension, 380 in chronic bronchitis, 105 in hyperthyroidism, 387 in chronic pharyngitis, 543 in hypothyroidism, 396 in COPD, 231 in laryngeal cancer, 171 in fracture, 303 in leukemia, 415 in left-sided HF, 347 in MS, 449 in lung abscesses, 423 in osteomyelitis, 473 in lung cancer, 176 in Parkinson’s disease, 494 in pericarditis, 508 in peptic ulcer, 507 in pleurisy, 550 in prostate cancer, 191 in pneumonia, 551–552 in ulcerative colitis, 638–639 in rib fractures, 312 in vulvar tumors, 207 in spinal cord injury, 608 Contusions, 452, 453 in TB, 629, 631 COPD. See Chronic obstructive CPR. See Cardiopulmonary resuscitation pulmonary disease (COPD) (CPR) Coping management Cranial arteries, 334 Cranial nerves, weakness in muscles in breast cancer, 143, 144–145 in burn injury, 115 supplied by, 34 in CVA, 223 CRF. See Chronic renal failure (CRF) in epilepsy, 294 Crohn’s disease. See Regional enteritis in hyperthyroidism, 385 CRPS. See Complex regional pain in MS, 448 in psoriasis, 569 syndrome (CRPS) in RA, 78 Cryptococcal meningitis, primary in sickle cell anemia, 52 in ulcerative colitis, 637 therapy for, 5–6 Cordectomy for laryngeal cancer, 165 Cryptococcus neoformans, 3 Corneal integrity in unconscious Cryptogenic strokes, 215 CSF. See Cerebrospinal fluid (CSF) patient, 643–644 CTA. See CT angiography (CTA) Coronary artery disease (CAD) CT angiography (CTA) and acute coronary syndrome, 18 for aortic aneurysm, 55 and diabetes mellitus, 255 for cerebral vascular accident, 55 and hypertension, 377 CT scan. See Computed tomography and ischemic cardiomyopathy, 208 (CT) scan Curling’s ulcer, 112 Cushing syndrome, 243–248 assessment, 245 causes of, 243

698 Index Cushing syndrome (continued) in prostate cancer, 189 clinical manifestations, 243–244 symptoms, 605–606 collaborative problems, 246 Degenerative joint disease. See diagnostic findings, 244 evaluation, patient outcomes, Osteoarthritis (OA) 248 Dehydration medical management, 244–245 nursing diagnoses, 245–246 and acidosis, 97 nursing interventions in and acute renal failure, 588 body image, 247 and Addison’s disease, 25 patient education, 248 and diarrhea, 270 rest and activity, 246–247 and DKA, 264, 265 risk of injury and infection, 246 in DKA, 265 skin integrity, 247 and hyperglycemic hyperosmolar planning/goals, 246 nonketotic syndrome, 374 Cutaneous lesions and hypovolemic shock, 598 in AIDS, 3 in large bowel obstruction, 96 in KS, 408 and morbid obesity, 465 and sickle cell anemia, 51 CVA. See Cerebrovascular accident and small bowel obstruction, 97, 98 (CVA) and status asthmaticus, 82, 84 Dehydration and shock, 436 Cyanosis Delta agent. See Hepatitis D in Addison’s disease, 25 Dementia in aortic aneurysms, 55 and Alzheimer’s disease, 30 in emphysema, 281 and anemia, 39 in pneumothorax, 558 and ESRD, 592 in Raynaud’s phenomenon, 584 and Huntington disease, 371 and Parkinson’s disease, 489 Cyclophosphamide, 418 Dental/oral hygiene management. See Cyclosporine therapy, 76 Oral hygiene management long-term effects, 43 Depression Cystectomy for bladder cancer, 137 Cystine stones, 648 in AIDS, 4 Cystitis (lower UTI), 249–252 in cancer of larynx, 167 in cerebral vascular accident, 216 assessment, 250–251 in cushing syndrome, 244, 245, 247 clinical manifestations, 249 in endometriosis, 286 collaborative problems, 251 in epilepsies, 291, 292 in elderly patients, 249 in HIV/AIDS patients, 4 evaluation, patient outcomes, 252 in Huntington disease, 372 nursing diagnoses, 251 in laryngeal cancer, 167–168 nursing interventions in malignant melanoma, 194 in morbid obesity, 464 home- and community-based care, in multiple sclerosis, 443–444 252 in Parkinson’s disease, 489 Desmopressin (DDAVP), 254 pain management, 251 Dexamethasone, 436, 442 pharmacologic therapy for Diabetes insipidus, 253–255 causes of, 253 acute/long-term, 250 clinical manifestations, 253 patient education and, 249 fluid deprivation test, 253–254 planning/goals, 251 nursing management, 254–255 Cytoprotective agents, 503 Diabetes mellitus, 255–264 acute complications of, 255, 257 D assessment and diagnostic methods, Danazol, 287 256 DCM. See Dilated cardiomyopathy chronic complications of, 257 in elderly patients, 257 (DCM) gestational, 256 DDAVP. See Desmopressin (DDAVP) medical management, 257–258 Death anxiety nursing management in acute coronary syndrome, 20 continuing care, 263–264 in angina pectoris, 64 patient education, 259–263 Decadron. See Dexamethasone self-care, 263 Decompensated cirrhosis, 235 Deep partial-thickness burns, 108 Deep vein thrombosis, 531 endovascular management, 655 monitoring and managing, 150

nutritional management, 258–259 Index 699 prevention, 256 type 1, 255 heparin infusion, 274 type 2, 255–256 tissue ischemia, 273 Diabetic ketoacidosis (DKA), 264–269 nursing management assessment and diagnostic findings, fear and anxiety, 275 fluid volume, 274 265 hemodynamic status, 274 causes of, 264 skin integrity, 274 medical management tissue perfusion, 275 pathophysiology of, 272 acidosis, 266 Distal sensory polyneuropathy dehydration, 265 electrolyte loss, 265–266 (DSPN), 3 signs and symptoms of, 256, 264 Distributive shock, 112 Diabetic teaching plan, 259–260 Diuretics for edema, 463 Dialysis, 589 Diverticular disease, 275–279 Diarrhea, 269–272 in Addison’s disease, 25 clinical manifestations, 276 in AIDS, 2, 3, 7, 10, 12 congenital predisposition, 275 in cancer of endometrium, 157 dietary and pharmacologic causes of, 269–270 clinical manifestations, 270 management, 276–277 complications of, 270 gerontologic considerations, 276 in diabetic ketoacidosis, 265 surgical resection of, 277 in hyperthyroidism, 381, 385 Diverticulitis medical management, 271 assessment, 277 nursing management, 271–272 clinical manifestations, 276 in peptic ulcer, 502 collaborative problems in, 278 in regional enteritis, 586 complications of, 275 types of, 269 dietary and pharmacologic in ulcerative colitis, 634–635 in urolithiasis, 647 management of, 276–277 Diazepam, 432 evaluation, patient outcomes, 279 DIC. See Disseminated intravascular nursing diagnoses, 278 nursing interventions coagulation (DIC) Dietary management elimination patterns, 278 pain management, 278 in Ménière’s disease, 432 for potential complications, in peptic ulcer, 503 Diffuse axonal injury, 337–338 278–279 Digestive disturbances, 319 planning/goals, 278 Digitalis toxicity and myocarditis, 459 Diverticulosis, 275 Digital rectal examination (DRE) clinical manifestations, 276 for benign prostatic hyperplasia and Dizziness in angina pectoris, 62 prostatectomy, 90 in aortic valve stenosis, 68 for prostate cancer, 185 in headache, 331 of prostate cancer, 185 in intracranial (cerebral) aneurysm, Digital rest pain, 106–107 Dilantin. See Phenytoin 57 Dilated cardiomyopathy (DCM), 208 in left-sided HF, 347 Discomfort management in pericarditis, 509 in breast cancer, 144 in pheochromocytoma, 544 in burn injury, 114–115 in polycythemia vera, 560 in malignant melanoma, 194 DKA. See Diabetic ketoacidosis (DKA) in prostate cancer, 188 Donepezil, 30 in vulvar tumors, 206 Donepezil hydrochloride, 30 Dissecting aneurysm Dopamine levels and Parkinson’s clinical manifestations, 55 diagnostic findings, 56 disease, 488 Disseminated intravascular coagulation Doppler echocardiography (DIC), 272–275 for mitral regurgitation, 437 clinical manifestations, 272–273 of mitral regurgitation, 437–438 diagnosis, 273 for mitral stenosis, 438 medical management DRE. See Digital rectal examination (DRE) Dry cold, 453 DSPN. See Distal sensory polyneuropathy (DSPN) Ductal carcinoma in situ, 139

700 Index Dyschezia, 286 cerebral Dyspnea in DKA, 266, 268 in fulminant hepatic failure, 359 in acute coronary syndrome, 19 in head injury, 338 in acute respiratory distress syndrome, in increased intracranial pressure, 402 23 in meningitis, 436 in anaphylaxis, 36 in anemia, 38, 39 in contact dermatitis, 240 in angina pectoris, 62 in contusion, 337 in aortic insufficiency, 67 in Cushing syndrome, 245, 247 in aortic valve stenosis, 68 in end-stage renal disease, 591 in asthma, 80 in fractures, 303 in cancer of larynx, 164 in nephrotic syndrome, 462 in COPD, 231 peripheral, 281 in left-sided HF, 347 in peritonitis, 538 in lung cancer, 176 pulmonary, 22, 267, 303, 320, in mitral stenosis, 438 in PE, 572 570–572 in pleural effusion, 548 in rheumatoid arthritis, 74 in pulmonary arterial hypertension, in right-sided HF, 348, 349 EEG. See Electroencephalogram 580 in pulmonary embolism, 572 (EEG) Dysrhythmia, 290 Elbow fractures, management of, 309 Dysrhythmias, 18 Electrocardiogram (ECG) in ACS, 19 in angina pectoris, 64 for burn injury, 116 in cardiogenic shock, 597 for cardiogenic shock, 598 in coronary Atherosclerosis, 242 for cardiomyopathies, 209 in diabetic ketoacidosis, 265 for chronic glomerulonephritis, 320 in diarrhea, 270 for diabetic ketoacidosis, 266 in GBS, 325 for heart failure, 348 in heart failure, 352 for pericarditis, 509 in hypoparathyroidism, 391–392 Electroencephalogram (EEG) in myocarditis, 459 for brain tumors, 100 in pulmonary embolism, 574 for hepatic encephalopathy, 357 Electrolyte management E in AIDS, 9 in ARF, 590 EBRT. See External beam radiation in burn injury, 111 therapy (EBRT) in colorectal cancer, 156 in DKA, 265, 267 ECG. See Electrocardiogram (ECG) in head injury, 342–343 Echocardiography in leukemia, 414 in pemphigus, 500 for acute respiratory distress Electromyographic (EMG) studies syndrome, 23 for amyotroic lateral sclerosis, 34 for headache, 332 for cerebral vascular accident, 216 for myasthenia gravis, 455 doppler Elephantiasis, 425 Elimination patterns, normal for mitral regurgitation, 437 in diverticular disease, 278 for mitral stenosis, 438 in ulcerative colitis, 636 for hypertension, 377 Embolism transesophageal arterial, 71–73 for aortic aneurysms, 55 cerebral, 210 for arterial embolism, 72 fat, 303, 306 Edema pulmonary, 189, 206, 207, 327, in acute coronary syndrome, 20 in acute nephritic syndrome, 460 572–577 in anaphylaxis, 36 in spinal cord injury, 606 in asthma, 80 Embolization in brain tumors, 102 in infective endocarditis, 284 in burn injury, 112, 115 for liver tumors, 173 in cancer Emergency management, 305 of larynx, 167 Emergency thoracotomy, 559 of lung, 176 of vagina, 203 in cardiomyopathies, 209

Index 701 EMG studies. See Electromyographic seizure range, 290–291 (EMG) studies self-care in, 294–295 single-drug therapy for, 292 Emotional support status epilepticus, 293 in acute gastritis, 315 surgical management, 292 in burn injury, 111 Epistaxis, 296–297 in cerebral vascular accident, 221 risk factors, 296 in colorectal cancer, 155 treatment of, 296–297 in end-stage renal disease, 594 Erythema in epididymitis, 288 in contact dermatitis, 240 in gastric cancer, 198 in exfoliative dermatitis, 300 in gout, 321 in regional enteritis, 586 in leukemia, 441 in toxic epidermal necrolysis, 621 in multiple sclerosis, 448 Escherichia coli in ovarian tumors, 181 and cystitis, 250 in pancreatic cancer, 183 and epididymitis, 288 in perioperative nursing management, and peritonitis, 539 530–531 Esophageal cancer, 159–161 assessment and diagnostic methods, 160 Emphysema, pulmonary, 280–281 clinical manifestations, 159 Empyema, 281–282 medical management, 161 nursing management, 161–162 clinical manifestations, 281 risk factors, 159 treatment, 282 Esophageal varices, bleeding, 297–300 Endocarditis assessment and diagnostic methods, infective. See Infective endocarditis rheumatic. See Rheumatic 298 clinical manifestations, 297 endocarditis medical management, 298–299 Endogenous hormones and prostate nonsurgical treatment, 298 nursing management, 299–300 cancer, 184 risk factors for, 297 Endolymphatic hydrops, 431 surgical management, 299 Endometriosis, 286–288 Eustachian tube dysfunction, 477 Exercise management clinical manifestations, 286 in CVA, 220 diagnosis of, 286–287 in diabetes mellitus, 258 nursing management, 287–288 in peripheral arterial occlusive pharmacologic therapy for, 287 surgical management, 287 disease, 537 Endoscopy in vein disorders, 657 for bleeding esophageal varices, 298 Exfoliative dermatitis, 300–301 for cancer of larynx, 164 causes of, 300 for chronic pancreatitis, 487 clinical manifestations, 300–301 fiberoptic, 314 management, 301 for gastritis, 314 External beam radiation therapy for iron-deficiency anemia, 43 for peptic ulcer, 502 (EBRT) End-stage renal disease. See Chronic for breast cancer, 141 for prostate cancer, 186 renal failure (CRF) External heat application for Eosinophilic tumors, 546 Epididymitis, 288–289 hypothyroidism, 395 Eye care, 89 clinical manifestations, 288–289 management, 289 F Epidural hematoma, 338 Epilepsies, 290–295 Facial muscle tone, 89–90 assessment, 292 Facial pain, 89 assessment and diagnostic methods, Facial paralysis. See Bell’s palsy Family coping, supporting 291 continuing care in, 295 in burn injury, 112 evaluation, patient outcomes, 295 in cerebral vascular accident, 223 nursing diagnoses, 292–293 in head injury, 344–345 nursing interventions Fat embolism syndrome manifestations of, 303 fear of seizures, 294 prevention and management of, 306 general care and injury prevention, 293–294 planning/goals, 293 postictal state, 291

702 Index Fatigue in pneumonia, 555 in anemia, 40 in pulmonary embolism, 575 in cancer, 127 Fractures, 302–312 in heart failure (HF), 350–351 of clavicle, 308 in leukemia, 414 clinical signs and symptoms of, 303 in RA, 77 and compartment syndrome, 303–304 complications of, 303 Fear management in GBS, 327–328 Femoral shaft fractures, management of, management of, 306–307 definition, 302 311–312 diagnosis, 304 Fetor hepaticus in hepatic and DIC, 304 of elbow, 309 encephalopathy, 357 emergency management, 305 Fibula fractures, management of, 312 and fat embolism syndrome, 303 Finasteride, 91 of femur, 311–312 Flash pulmonary edema, 570 of fingers, 310 Fludarabine, 418 gerontologic considerations, 304–305 Fluid balance management of hand, 310 of hip, 312 in acute pancreatitis, 485 of humeral neck, 308 in Addison’s disease, 27 managing closed, 307 in ARF, 588, 590 managing open, 307 in burn injury, 111, 113 of pelvis, 310–311 in colorectal cancer, 156 reduction, 305–306 in DKA, 267 of rib, 312 in gastritis, 315 and systemic embolization, 303 in head injury, 342–343 of tibia and fibula, 312 in hypovolemic shock, 599 types of, 302 in leukemia, 414 of wrist, 309–310 in Ménière’s disease, 433 Frontal lobe tumors, 102 in pemphigus, 500 Full-thickness burns, 108 in perioperative nursing, 529 Fulminant hepatic failure, 359–360 in prostate cancer, 188–189 clinical manifestations, 359 in toxic epidermal necrolysis, management, 360 Fulminant infection, 435 624 Fungal infection, 3 in unconscious patient, 643 Fusiform aneurysm, 54 Fluid deprivation test, 253–254 Fluid intake G in perioperative nursing, 515 in ulcerative colitis, 636 Gait problems, 489 Fluid overload, 268 Gallbladder infections, 225 Fluid redistribution, 599 Gallstones Fluid restriction, 50 Fluid status assessment nonsurgical removal of, 227 in AIDS, 9 types of, 225 in DIC, 274 Ganciclovir for CMV retinitis, 6 in heart failure (HF), 351 Gangrene of toe, below-knee Folic acid deficiency medical management, 46–47 amputation in, 107 pathophysiology, 45 Gas exchange Foscarnet for CMV retinitis, 6 Fowler’s position impaired, 210, 326, 341, 411, 527 in AIDS, 13 promoting, 110 in angina pectoris, 64 Gastric cancer, 196–199 in arterial embolism and arterial assessment, 197 chemotherapy for, 197 thrombosis, 70 clinical manifestations, 196 in cancer of larynx, 168 home- and community-based care, in cancer of vulva, 206 in cholelithiasis, 229 199 in esophageal cancer, 160 nursing diagnoses, 197 in hiatal hernia, 367 nursing interventions in pancreatitis, 484 in pelvic infection, 496 anxiety management, 197–198 in perioperative nursing management, nutrition, 198 pain management, 198 534 psychosocial support, 198–199

Index 703 planning/goals, 197 in diverticular disease, 276 prognosis, 196 in end-stage renal disease, 592 removal, 196 in hepatitis B, 362 resection of, 196 in hip fractures, 304–305 risk factors, 196 in hypertension, 379 Gastric restriction procedures, 465 in hyperthyroidism, 382 Gastrinoma. See Zollinger–Ellison in hypoglycemia, 387 in hypothyroidism and myxedema, syndrome Gastritis, 313–316 394 in multiple myeloma, 441 assessment and diagnostic findings, in osteomyelitis, 469 314 in osteoporosis, 474 in perioperative nursing management, causes of, 313 clinical manifestations, 313 512–513, 513 medical management, 314 in pneumonia, 552 nursing management in pulmonary tuberculosis, 629 in septic shock, 601 anxiety, 314–315 Gestational diabetes, 256 fluid balance, 315 Gingival hyperplasia, 294 nutrition, 315 Glasgow Coma Scale (GCS) pain, 315 for head injury, 340 self-care in, 315 for increased intracranial pressure, Gastrointestinal disorder in AIDS, 2 403 bleeding for unconscious patient, 640 in colorectal cancer, 154 Glaucoma, 316–319 in hemophilia, 354 clinical manifestations, 317 in cholelithiasis, 230 diagnostic tests for, 317 hemorrhage, 616 increased IOP, 316 inflammation nursing management, 318–319 in regional enteritis, 585 prevalence of, 316 in ulcerative colitis, 635 treatment in morbid obesity, 465 in muscular dystrophies, 450 medications, 318 in small bowel obstruction, 98 objectives, 317–318 varices, 235 surgery, 318 Gastrointestinal (GI) tract types of, 317 chronic blood loss from, 43 Gliomas, 101 function assessment, 39 Glomerular damage, 462 function in perioperative nursing, Glomerulonephritis, chronic. See 527 Chronic glomerulonephritis upper, barium study of, 586 GnRH agonists, 287 Gastrointestinal varices, 235 Gout, 321–323 GBS. See Guillain–Barré syndrome clinical manifestations, 322–323 (GBS) diagnosis, 323 GCS. See Glasgow Coma Scale (GCS) management, 323 Genetic counseling pathophysiology, 322 Graft-versus-host disease (GVHD), in epilepsies, 295 in muscular dystrophies, 450 135 Germinal tumors, 200 Gram-negative organisms Gerontologic considerations in acute pancreatitis, 482 and bone infections, 470 in acute renal failure (ARF), 588 and lung abscesses, 423 in anemia, 39 and osteomyelitis, 470 in angina pectoris, 62–63 and pneumonia, 551 in aortic aneurysms, 54–55 and septic shock, 600 in appendicitis, 70 Gram-positive organisms in burn injury, 109 and bone infections, 470 in cholelithiasis and cholecystitis, 226 and septic shock, 600 in chronic obstructive pulmonary Grand mal seizures, 291 Graves’ disease. See Hyperthyroidism disease, 231 Grief management in colorectal cancer, 152 in AIDS, 15 in cystitis, 249 in cancer, 128 in diabetes mellitus, 257 in leukemia, 414–415

704 Index Guillain–Barré syndrome (GBS), medical management, 336 324–329 nursing management, 337 scalp trauma, 336 assessment (ongoing and critical), subdural hematoma, 338–339 325–326 Hearing and communication in clinical manifestations, 324 mastoiditis, 429 collaborative problems, 326 Heart failure (HF), 346–353 diagnostic findings, 325 medical management, 325 assessment, 349 nursing diagnoses, 326 assessment and diagnostic methods, nursing interventions 348 communication, 327 collaborative problems, 349–350 evaluation, patient outcomes, left-sided, 347 mechanism of, 346–347 328–329 monitoring, 116 fear and anxiety, 327–328 nursing diagnoses, 349 home- and community-based care, nursing interventions 328 activity tolerance, 350 nutrition, 327 anxiety control, 351–352 physical mobility, 326–327 fatigue reduction, 350–351 potential complications, 328 fluid status, 351 respiratory function, 326 home- and community-based care, pathophysiology, 324 planning/goals, 326 353 GVHD. See Graft-versus-host disease potential problems, 352 sense of powerlessness, 352 (GVHD) pharmacologic therapy for, 348 planning/goals, 350 H right-sided, 348 signs and symptoms of, 347 Haemophilus influenzae surgical management, 348 acute otitis media due to, 477 Helicobacter pylori meningitis due to, 434 and chronic gastritis, 313 and peptic ulcer, 501 Haldol. See Haloperidol decanoate Hematomas Haloperidol decanoate, 372 in aortic aneurysm, 557 Hand trauma management, 309–310 in breast cancer, 144 Hashimoto’s thyroiditis. See Chronic in contusion, 337, 452 epidural, 338 thyroiditis in head injury, 336 Headache, 330–335 in hemophilia, 354 in intracerebral hemorrhage, 339 assessment and diagnostic methods, in intracranial hemorrhage, 338 332 in scalp trauma, 336 subdural, 338–339 in brain tumors, 101 in wound, 533 clinical manifestations, 331 Hematuria migraine, 330–331 and acute nephritic syndrome, 460 nursing management and breast cancer, 138 and prostate cancer, 185, 186 continuing care, 334 and pyuria, 647 pain, 333 and renal tumors, 162 self-care, 333–334 and urolithiasis, 657 primary, 330 and UTI, 90 secondary, 330 Hemodynamic status treatment in anemia, 37 acute attack, 332 in DIC, 274 pharmacologic therapy, 333 in spinal cord injury, 602 types of Hemophilia, 354–356 cluster headaches, 334 clinical manifestations, 354–355 cranial arteries, 334 management, 355–356 tension headaches, 334–335 Hemopneumothorax, 556 Head injury, 335–346 Hemorrhage assessment and diagnostic methods, in AML, 419 336 causes of, 335 cerebral concussion after, 336–337 clinical manifestations, 335–336 diffuse axonal injury, 337–338 epidural hematoma, 338 fracture of skull, 336

Index 705 in cervical cancer, 150 HHNS. See Hyperglycemic in DIC, 273 hyperosmolar nonketotic from esophageal varices, 297 syndrome (HHNS) in infective endocarditis, 283 in prostate cancer, 189 Hiatal hernia, 365–368 risk factors for, 297 clinical manifestations, 365–366 in thyroid cancer, 203 diagnosis, 366 treatment in perioperative nursing, esophageal condition and reflux in assessment of, 366 532–533 evaluation, patient outcomes, 368 Hemostatic mechanisms in DIC, 272 home- and community-based care, Hemothorax, 556, 557 367–368 Heparin-induced thrombocytopenia, nursing diagnoses, 366–367 nutritional intake in, 367 656 pain management, 367–368 Heparin infusion, 274 planning/goals, 367 Heparin therapy medical management, 366 types of, 365 for arterial embolism, 72 for diverticular disease, 275 High-flow supplemental oxygen, 83 for vein disorders, 655 HIV antibodies, confirmation methods Hepatic cirrhosis, 235–238 clinical manifestations, 235 for, 4–5 liver function tests, 235 HIV-associated neurocognitive disorders, medical management, 236 nursing management 3–4 HIV encephalopathy, 3, 10, 13 complications, 237 HIV-related peripheral neuropathy, 3 home- and community-based care, Hodgkin’s disease, 368–371 237–238 assessment and diagnostic methods, injury risk, 236–237 370 nutritional status, 236 rest, 236 clinical manifestations, 369 skin care, 236 nursing management, 370–371 Hepatic coma, 235 treatment, 370 Hepatic encephalopathy, 356–359 Home care clinical manifestations, 357 for ACS, 21–22 etiologic factors in, 357 for acute nephritic syndrome, 461 medical management, 358 for acute pancreatitis, 485 nursing management, 358–359 for AD, 31, 32 serum ammonia levels in, 358 for Addison’s disease, 27–28 Hepatic failure (HF) for AIDS, 15–16 associated with portal hypertension, for appendicitis, 71 for asthma, 82 357 for breast cancer, 145–146 fulminant. See Fulminant hepatic for burn injury, 119 for cancer, 130–131 failure for cardiomyopathies, 212 Hepatic resection, 173–174 in cervical cancer, 150 Hepatitis A for cholelithiasis and cholecystitis, clinical manifestations, 360–361 230 management, 361–362 for chronic renal failure (CRF), 594 prevention, 361 for colorectal cancer, 156–157 Hepatitis B, 362–364 for CVA, 221, 224 clinical manifestations, 362 for cystitis (lower UTI), 252 gerontologic considerations, 362 for diabetes mellitus, 260, 263 medical management, 363 for epilepsy, 294–295 nursing management, 363–364 for gastric cancer, 199 Hepatitis B virus (HBV), 362 for gastritis, 315 Hepatitis C, 364 for GBS, 328 Hepatitis D, 364 for head injury, 345 Hepatitis E, 364–365 for heart failure (HF), 353 Hepatitis G, 365 for hepatic cirrhosis, 237–238 Hepatocellular carcinoma (HCC), 171 in hepatic cirrhosis, 237–238 etiology, 172 for hiatal hernia, 367–368 Hereditary bleeding disorders, 354 for hypertension, 379 HF. See Heart failure (HF); Hepatic for hyperthyroidism, 386 failure (HF)

706 Index Home care (continued) Hyperlipidemia for hypothyroidism, 395–396 in acute pancreatitis, 481 for intracranial aneurysm, 61 in cerebral vascular accident, 215 for leukemia, 414, 415 in chronic glomerulonephritis, 319 for osteomyelitis, 472–473 in end-stage renal disease, 591 for Parkinson’s disease, 492–494 in nephrotic syndrome, 462 for peptic ulcer, 506–507 for perioperative nursing, 530 Hypertension, 375–380 for peripheral arterial occlusive assessment, 378 disease, 538 assessment and diagnostic methods, in peripheral arterial occlusive 377 disease, 538 classification, 375 for prostate cancer, 190 clinical manifestations, 376–377 for psoriasis, 569 collaborative problems, 378 for pulmonary embolism (PE), definition, 375 576–577 essential (primary), 375–376 for RA, 78, 79 evaluation, patient outcomes, 380 for sickle cell anemia, 53 gerontologic considerations, 379–380 for ulcerative colitis, 638 medical management, 377 for vulvar tumors, 206 nursing diagnoses, 378 nursing interventions, 378–379 Hormone therapy planning/goals, 378 for BPH, 91 secondary, 376 for breast cancer, 141 for cervical cancer, 150 Hyperthermia for leukemia, 412 for cancer treatment, 135 for prostate cancer, 186 for liver tumors, 173 thyroid, 619 Hyperthyroidism, 381–387 Hospital-acquired endocarditis, 283 assessment, 384 Hospital care in acute nephritic causes of, 381 clinical manifestations, 381–382 syndrome, 461 diagnostic findings, 382 H2-receptor antagonists, 503 in elderly patients, 382 Human immunodeficiency virus (HIV) medical management, 382–384 nursing diagnoses, 384 infection nursing interventions retroviruses, 1 body temperature, 386 stage of, 1 continuing care, 387 Humeral neck fractures, management of, coping measures, 385 self-care, 386 308 well-balanced meals, 385 Humidified oxygen, 620 planning/goals, 384 Huntington disease, 371–373 in thyroid storm, 620 clinical features of, 371–372 Hypertrophic cardiomyopathy (HCM), diagnosis, 372 208 genetic marker, 372 nursing management, 372–373 Hypocalcemia treatment, 372 in acute pancreatitis, 482 Hydrocephalus, 60 in AIDS, 6 Hydrocortisone, 620 in cardiogenic shock, 597 Hydroxyurea for sickle cell anemia, in hypoparathyroidism, 390–391 49–50 Hypoglycemia, 387–390 Hypercalcemia causes of, 387 in elderly people, 387–388 in bone tumors, 94 medical management, 389 in diabetes insipidus, 253 mild, 388 in liver tumors, 172 moderate, 388 in multiple myeloma, 441, 442 nursing management, 389–390 in peptic ulcer, 501 severe, 388–389 Hyperglycemia, long-term, 255 symptoms, 388 Hyperglycemic hyperosmolar nonketotic Hypogonadism, 186 syndrome (HHNS), 373–375 Hypokalemia, 268 biochemical defect in, 373 Hypokinesia in Parkinson’s disease, 489 clinical manifestations, 374 Hyponatremia, 61 nursing management, 374–375 Hypoparathyroidism, 390–392 pathophysiology of, 373 treatment of, 374

cause of, 390 Index 707 clinical manifestations, 390–391 medical management, 391 in leukemia, 412–413 nursing management, 391–392 in mastoiditis, 429 Hypopituitarism, 392 in osteomyelitis, 472 Hypotension in sickle cell anemia, 52 in PE, 574 Infective endocarditis, 282–285 treatment, 531–532 causative microorganisms, 282–283 Hypothermia prevention clinical manifestations, 283–284 in toxic epidermal necrolysis, 624 complications, 284 Hypothyroidism, 392–396 diagnosis of, 284 causes of, 393 medical management, 284 clinical manifestations, 393–394 nursing management, 284–285 in elderly population, 394 risk factors for, 283 nursing management, 395–396 Infiltrating ductal carcinoma, 138 pharmacologic therapy for, 395 Infiltrating lobular carcinoma, 138 types of, 392–393 Inflammatory carcinoma, 139 Hypovolemic shock, 598–600 Influenza, 406–407 causes of, 598 mortality, 407–408 clinical manifestations, 599 prevention, 407 nursing management, 599–600 Informed consent, 512 pharmacologic therapy for, 599 Inhalation injury, 113 in small bowel obstruction, 97 signs of, 110 Hysterectomy, 148 Injury reduction in Cushing syndrome, 246 I in head injury, 343–344 in mastoiditis, 429–430 Idiopathic thrombocytopenic purpura in MS, 447 (ITP), 397–399 in osteoporosis, 477 Inpatient surgery, 512–513 causes of, 397 Insulin-dependent diabetes mellitus. See clinical manifestations, 397 diagnosis, 397 Type 1 diabetes immunosuppressive medications for, Insulin injections 398 self-administration of, 261–263 nursing management, 398–399 for type 1 diabetes, 255 IgE-mediated chemicals and allergic for type 2 diabetes, 258 Insulin reaction. See Hypoglycemia reaction, 35 Integumentary system, 613 Ileoanal anastomosis, 96–97 Intensification therapy for ALL, 417 Imatinib for CML, 421 Intercostal nerve block, 550 Immunosuppressive therapy, 76 Intestinal decompression, 605 Intestinal obstruction, 96 for fungal endocarditis, 283 Intra-aortic balloon counterpulsation, for ITP, 398 for liver tumors, 173 598 for MG, 456 Intracerebral hemorrhage and for myocarditis, 458 for pemphigus, 498 hematoma, 339 for renal tumors, 162 Intracranial (cerebral) aneurysm. See for SLE, 614 Impetigo, 399–400 Aneurysm, intracranial Increased intracranial pressure (ICP). Intracranial hemorrhage, 338 Intracranial lesion, localized, 100 See Intracranial pressure (ICP), Intracranial pressure (ICP), increased, increased Infection 316, 401–406 and peritonitis, 235 in abscess, 99 prevention. See Infection prevention assessment, 402–403 in prostate cancer, 189 clinical manifestations, 401–402 Infection prevention collaborative problems, 403 in ARF, 590 diagnostic methods for, 402 in burn injury, 113 evaluation, patient outcomes, 406 in cancer, 128–129 in intracranial aneurysm, 58 in Cushing syndrome, 246 nursing diagnoses, 403 in HIV/AIDS patients, 12 nursing interventions in increased ICP, 405 breathing pattern, 404 cerebral tissue perfusion, 404 infection prevention, 405

708 Index Intracranial pressure (ICP) (continued) nursing interventions negative fluid balance, 404–405 continuing care, 651 patency of airway, 403–404 fluid intake and ambulation, 650 potential complications, 405–406 home care, 651 pain management, 649 pharmacologic therapy for, 402 self-care, 650–651 planning/goals, 403 Intracranial surgery and brain abscess, Klebsiella species, 423, 531, 539 KS. See Kaposi’s sarcoma (KS) 99 Kyphosis, 474 Intrathecal chemotherapy, 417 Intravenous antibiotic therapy for L osteomyelitis, 470 Lactulose, 358 Intravenous immunoglobulin (IVIG) Laparoscopic cholecystectomy, 228 Large bowel obstruction. See Bowel for GBS, 325 for toxic epidermal necrolysis, 622 obstruction, large Intravenous (IV) drug use and Laryngeal cancer, 164–171 staphylococcal endocarditis, 283 assessment, 166 Iron-deficiency anemia. See Anemia, assessment and diagnostic methods, iron-deficiency 164–165 Iron malabsorption, 43 clinical manifestations, 164 Irritability evaluation, patient outcomes, 171 laryngectomy in, 166–171 and Cushing syndrome, 247 medical management, 165 and cystitis, 251 nursing diagnoses, 166 and fractures, 304 nursing interventions and head injury, 336 and hyperthyroidism, 381, 384 anxiety and depression, 167–168 and hypoparathyroidism, 391 home- and community-based care, Ischemic cardiomyopathy, 208 Ischemic stroke. See Cerebrovascular 170–171 nutrition and hydration, 168–169 accident (CVA) patent airway, 168 Itching. See Pruritus patient education, 167 ITP. See Idiopathic thrombocytopenic postoperative complications, purpura (ITP) 169–170 self-concept, 169 J planning/goals, 167 potential complications, 167 Jaundice risk factors, 164 in hepatitis A, 360–361 Laryngectomy in hepatitis B, 362 complications after, 169 in liver tumors, 172, 173 in laryngeal cancer, 166–171 in megaloblastic anemia, 46–47 Laser surgery in pancreatic cancer, 182 for endometriosis, 287 in sickle cell anemia, 49 for glottic cancers, 165 Laser trabeculoplasty for glaucoma, 318 Joint dislocations, 452 LCIS. See Lobular carcinoma in situ Joint integrity in unconscious patient, (LCIS) 643 Leg ulcers, 53 Joint involvement in RA, 75 Lentigo-maligna melanoma, 192 Lesions K atherosclerotic, 73, 74 Kaposi’s sarcoma (KS), 408–409 circular, 192 in AIDS patients, 3, 408 cutaneous chemotherapy for, 7 clinical manifestations, 408 in AIDS, 3 diagnostic findings, 408 in KS, 408 nursing management, 409 inflammatory, 66 treatment left-sided, 152 with alpha-interferon, 409 metastatic, 101 goals, 408 new pigmented, 194 rectal, 152 Kidney stones recurrent, 158 assessment, 648–649 right-sided, 151 collaborative problems/complications, skin 649 diagnosis, 649 evaluation, patient outcomes, 652

Index 709 in KS, 7 Lmphedema malignant, 124, 125 nursing management, 426 in ulcerative colitis, 632 surgical management, 425–426 structural, 291, 330 uremic GI, 588 Lobular carcinoma in situ (LCIS), 140 Leukemia, 410–416 Locked-in syndrome, 639 acute lymphocytic. See Acute Low back pain. See Back pain, low Low-dose antidepressant medications, lymphocytic leukemia (ALL) acute myeloid. See Acute myeloid 76 Low platelet count. See leukemia (AML) assessment, 410 Thrombocytopenia blood and bone marrow studies, 410 Lumpectomy for breast cancer, 141 chronic lymphocytic. See Chronic Lund and Browder method, 108 Lung abscess, 422–424 lymphocytic leukemia (CLL) chronic myeloid. See Chronic myeloid at-risk patients, 422 causitive organisms, 422–423 leukemia (CML) clinical manifestations, 423 classification, 410 nursing management, 424 collaborative problems, 411–412 pharmacologic therapy for, 423–424 evaluation, patient outcomes, 416 prevention, 423 nursing diagnoses, 411 treatment, 423 nursing interventions Lung cancers. See Bronchogenic anxiety and grief management, carcinoma 414–415 Lymphatic drainage, manual, 425 Lymphatic obstruction, 425 bleeding prevention, 412 Lymphedema, 424–426 continuing care, 415 fatigue reduction, 414 classification, 424 fluid and electrolyte balance, 414 congenital, 425 infection prevention, 412–413 Lymph node removal, 141, 193 nutritional intake, 413 oral mucosa, 413 M pain management, 413–414 self-care, 414, 415 Macrovascular (large vessel) disease, 257 spiritual and religious practices, 415 Magnesium sulfate, 83 terminal care, 415 Magnetic resonance imaging (MRI) planning/goals, 412 signs and symptoms, 410 for acute renal failure, 588 Leukemic cell infiltration in ALL, 416 for AD, 29 Leukemic cells proliferation within for epilepsies, 291 for gout, 320 organs, 419 for headache, 332 Leukocyte counts for increased intracranial pressure, 402 for low back pain, 85 in ALL, 416 for meningitis, 435 in AML, 420 for osteomyelitis, 470 in arterial embolism, 71 for spinal cord injury, 604 in CML, 421 for ulcerative colitis, 633 in empyema, 281 Malignant bone tumors, 92 Levodopa, 372 types of, 93 Levothroid, 395 Malignant melanoma, 191–195 Leydig cell tumors, 200 acral-lentiginous, 193 Limb-sparing (salvage) procedures, 94 assessment, 194 Liver enlargement, 235 discomfort management in, 194 Liver function tests, 235 evaluation, patient outcomes, 195 Liver tumors, 171–175 incidence and mortality rates, 191–192 clinical manifestations, 172 lentigo-maligna, 192 diagnosis, 172 metastasis complications, 195 HCC, 171–172 nodular, 192–193 medical management nursing diagnoses, 194 pain management in, 194 chemotherapy, 173 planning/goals, 194 hepatic resection, 173–174 prognosis, 192 percutaneous biliary drainage, 173 risk factors, 192 radiation therapy, 172–173 superficial spreading, 192 nursing management, postoperative, surgical management, 193 174–175

710 Index Manual lymphatic drainage, 425 MG. See Myasthenia gravis (MG) Mastectomy for breast cancer, 141 MI. See Myocardial infarction (MI) Mastoidectomy, 479 Microvascular (small vessel) disease, 257 Mastoiditis, 427–431 Middle ear acute, 427 acute infection of. See Acute otitis chronic, 427 media evaluation, patient outcomes, 430–431 home- and community-based care, chronic infection of. See Chronic otitis media 430 mastoid surgery for Migraine headache, 330–331 Minicholecystectomy, 228 anxiety reduction, 428 Minimally invasive therapy for BPH, 91 assessment of, 427–428 Mitral regurgitation (insufficiency), hearing and communication, 429 infection prevention, 429 437–438 injury prevention, 429–430 Mitral stenosis, 438–439 nursing diagnoses of, 428 Mitral valve opening, 438 pain management, 429 Mitral valve prolapse, 439–440 planning/goals of, 428 taste disturbance, 430 clinical manifestations, 439–440 Mastoid surgery for mastoiditis management, 440 anxiety reduction, 428 Mobility management assessment of, 427–428 in burn injury, 115 hearing and communication, 429 in CVA, 219–220 infection prevention, 429 in GBS, 326–327 injury prevention, 429–430 Parkinson’s disease, 492 nursing diagnoses of, 428 in perioperative nursing, 516 pain management, 429 in RA, 77–78 planning/goals of, 428 in SCI, 608 taste disturbance, 430 MODS. See Multiple organ dysfunction Mechanical ventilation for status syndrome (MODS) asthmaticus, 83 Moist cold, 453 Meclizine, 432 Moraxella catarrhalis and acute otitis Ménière’s disease, 431–433 media, 477 clinical manifestations, 431 Morbid obesity, 464–466 cochlear, 431 diagnostic procedures for, 432 body weight, 464 pharmacologic therapy for, 432 complications, 464 self-care, 433 nursing management, 465–466 surgical management, 432 pharmacologic management, 464 and vertigo surgical management, 465 Mouth care in unconscious patient, 643 adjusting to disability, 433 MS. See Multiple sclerosis (MS) anxiety reduction, 433 Mucositis injury prevention, 432–433 in cancer, 134 vestibular, 431 in leukemia, 413 Meningeal irritation, 434–435 Mucous membrane integrity in toxic Meningiomas, 101 Meningitis, 434–437 epidermal necrolysis, 623–624 classification, 434 Mucus plugging of airway, 105 clinical manifestations, 434–435 Multiple myeloma, 440–442 diagnostic findings, 435 medical management, 436 clinical manifestations, 441 nursing management, 436–437 corticosteroids for, 442 pathophysiology of, 434 diagnosis of, 441 prevention, 435–436 gerontologic considerations, 441 Mental status assessment, 527 and immunoglobulin, 441 of HIV/AIDS patients, 8 nursing management, 442 Meridia. See Sibutramine HCl Multiple organ dysfunction syndrome Mestinon. See Pyridostigmine bromide Metastasis, 195 (MODS), 273 Metastatic bone cancer treatment, 94 Multiple organ failure in acute Metastatic bone disease, 93 Methotrexate, 567 pancreatitis, 485 Multiple sclerosis (MS), 442–449 assessment, 445–446 clinical manifestations, 443–444 courses of, 443 demyelination of brain, 442–443 diagnostic findings, 444

Index 711 evaluation, patient outcomes, 449 digitalis toxicity and, 459 nursing diagnoses, 446 medical management, 458 nursing interventions nursing management, 459 Myringotomy bladder and bowel control, 447 for acute otitis media, 478 continuing care, 449 for chronic otitis media, 479 coping mechanisms, 448 Myxedema, 393–395 home management, 448 injury prevention, 447 N physical mobility, 446–447 self-care, 448–449 Nasal sprays, 543 sensory and cognitive function, 448 Navane. See Thiothixene hydrochloride sexual dysfunction, 448 Needle aspiration, 282 pathophysiology, 443 Neoplasms pharmacologic therapy for disease modification, 444–445 brain, 101 symptom management, 445 malignant, 121, 191 planning/goals, 446 of musculoskeletal system, 92 Murmur of mitral regurgitation, 440 Nephritic syndrome, acute, 460–462 Muscle contraction headache, 334–335 clinical manifestations, 460 Muscle fibers diagnostic findings, 460–461 in arteriosclerosis, 73 nursing management atrophic changes in, 33 degenerative changes, 75, 458 continuing care, 462 Muscular dystrophies, 449–451 hospital care, 461 clinical manifestations, 450 self-care, 461 nursing management, 450–451 pathophysiology, 460 pathologic features, 449 pharmacologic therapy for, 461 supportive management, 450 Nephrotic syndrome, 462–463 Musculoskeletal disorders and back pain, Neurologic assessment of aplastic anemia, 41 85 of cerebral vascular accident, 217 Musculoskeletal system of intracranial aneurysm, 58–59 of megaloblastic anemia, 47 injury to, 451 Neuromuscular irritability, 391 in SLE, 613 Neuropathic disease, 257 Musculoskeletal trauma, 451–454 Neurosensory changes in chronic clinical manifestations, 452 contusions, 452 glomerulonephritis, 320 dislocation of joint, 452 Nimodipine (Nimotop), 58 medical management, 453 Nodular melanoma, 192–193 nursing management, 453–454 Nonallergenic anaphylaxis sprains, 452 strains, 452 (anaphylactoid) reaction, 35 X-ray examination, 453 Nongerminal tumors, 200 Myasthenia gravis (MG), 454–457 Non–insulin-dependent diabetes assessment and diagnostic findings, mellitus. See Type 2 diabetes 455 Nonlymphocytic leukemia, 419 clinical manifestations, 454–455 Non–small cell lung cancer (NSCLC), complications, 455 nursing management, 456–457 175 pharmacologic therapy for, 455–456 Nonsteroidal anti-inflammatory drugs Mycobacterium avium complex (MAC) (NSAIDs) disease, 5 for anaphylaxis, 35 Mydriatics, 213 for disseminated intravascular Myocardial infarction (MI), 17–22 coagulation, 274 assessment methods, 18 for endometriosis, 286 causes of, 17–18 for gastritis, 313 clinical manifestations, 18 for KS, 409 diagnostic methods, 18 for low back pain, 86 medical management for osteoarthritis, 467 for peptic ulcer, 501 goals, 18 for pericarditis, 509 MIDCAB, 19 for SLE, 614 pharmacologic therapy for, 19 for subacute thyroiditis, 618 Myocarditis, 457–459 for systemic lupus erythematosus, 614 Nosebleed. See Epistaxis

712 Index NSCLC. See Non–small cell lung cancer clinical manifestations, 178 (NSCLC) medical management, 178–179 nursing management NS solution, 265 Numbness postperative, 179–180 preoperative, 179 in angina pectoris, 62 risk factors, 178 in cerebral vascular accident, 215 Oral chemotherapeutic agents, 422 in diabetes mellitus, 256 Oral hygiene management in hypoparathyroidism, 390 in cancer, 124, 126, 132 in MS, 443 in disseminated intravascular in peripheral arterial occlusive coagulation, 274 disease, 536 in epilepsies, 294 Nutritional therapy, 7–8 in increased intracranial pressure, 405 in laryngeal cancer, 170 for chronic renal failure (CRF), 593 in leukemia, 412, 413 for ulcerative colitis, 633 in lung abscesses, 423 for urolithiasis, 648 in pemphigus, 499 Nutrition management Oral mucosa in leukemia, 413 in acute pancreatitis, 484 Oral valganciclovir, 6 in AD, 32 Orchiectomy for testicular cancer, 201 in AIDS, 14 Organ damage, 285 in anemia, 39, 40 Orlistat, 464 in burn injury, 113–114 Orthostatic hypotension, 610 in cancer, 126 Osler nodes, 283 in cholelithiasis and cholecystitis, 230 Ossiculoplasty, 479 in cirrhosis, 236 Osteoarthritis (OA), 466–468 in colorectal cancer, 155–156 clinical manifestations, 466 in CVA, 221–222 conservative measures for, 467 in diabetes mellitus diagnostic findings, 466–467 nursing care, 467–468 blood glucose and blood pressure pharmacologic therapy for, 467 levels, 258 prevention, 467 risk factors, 466 caloric requirements, 258–259 Osteochondroma, 92 in gastritis, 315 Osteoclastomas, 92 in GBS, 327 Osteogenic sarcoma, 93 in head injury, 343 Osteoid osteoma, 92 in hiatal hernia, 367 Osteomalacia, 468–469 in HIV/AIDS patients, 8 clinical manifestations, 468 in hyperthyroidism, 385 in elderly patients, 469 in laryngeal cancer, 168–169 management, 469 in leukemia, 413 risk factors, 468 in Parkinson’s disease, 493 Osteomyelitis, 469–473 in perioperative nursing, 514–515, antibiotic medication for, 471 assessment, 471 527 bone infections, 469–470 in unconscious patient, 643 clinical manifestations, 470 continuing care in, 473 O evaluation, patient outcomes, 473 infection prevention, 472 OA. See Osteoarthritis (OA) intravenous antibiotic therapy for, Obesity 471 and Cushing syndrome, 243 nursing diagnoses, 471 and diabetes mellitus, 256 pain management, 472 morbid. See Morbid obesity pathogenic organisms, 470 and OA, 466 physical mobility improvement, 472 and pleural effusion, 547 planning/goals, 471 and vein disorders, 653 self-care in, 472–473 Occipital lobe tumors, 102 supportive measures, 470 Opioid analgesic agents, 648 surgical debridement for, 471 Opportunistic infections Osteoporosis, 473–477 symptoms of, 15 in elderly people, 474–475 treatment of MAC disease, 5 pneumocystis pneumonia, 5 Oral anticoagulants, 655 Oral cancers, 178–180 assessment, 178

Index 713 evaluation, patient outcomes, 477 in pericarditis, 510 medical management, 475 in perioperative nursing, 518, 526 risk factors, 474 in prostate cancer, 189 spontaneous vertebral fracture in RA, 77 in sickle cell anemia, 52 related to in toxic epidermal necrolysis, assessment of, 475–476 bowel activity in, 476–477 624–625 injury prevention in, 477 in ulcerative colitis, 636 medication therapy for, 476 in vulvar tumors, 206 nursing diagnoses, 476 Palm method, 109 pain management in, 476 Pancreatic cancer, 181–184 planning/goals, 476 clinical manifestations, 182 Osteoporotic compression fractures of diagnostic methods, 182–183 medical management, 183 vertebrae, 475 nursing management, 183–184 Osteosarcoma. See Osteogenic sarcoma risk factors, 182 Otitis media Pancreatic enzyme replacement therapy, acute. See Acute otitis media 487 chronic. See Chronic otitis media pancreatic necrosis, 485 Ovarian cancer, 180–181 Pancreatitis, 481 clinical manifestations, 180 incidence, 180 acute. See Acute pancreatitis medical management, 181 chronic. See Chronic pancreatitis nursing management, 181 Panlobular (panacinar) type of risk factors, 180 Oxalate stones, 648 emphysema, 280–281 Oxygenation Pannus formation, 75 blood, 298, 518 Papillary adenocarcinoma, 202 brain, 346 Papilledema, 102 cerebral, 291, 570 Paraesophageal hernia, 365–366 of heart muscle, 597 Paralytic ileus, 112 tissue, 58 Paresthesia, 107 Oxygen therapy, 575–576 Parkinson’s disease, 488–494 for PE, 575–576 for peritonitis, 540 assessment, 490–491 for pulmonary heart disease, 578 cardinal signs of, 488–489 for SCI, 605 diagnostic methods, 489–490 evaluation, patient outcomes, 494 P idiopathic form, 488 nursing diagnoses, 491 PACU. See Postanesthesia care unit nursing interventions (PACU) bowel elimination, 492 Paget’s disease, 139 communication improvement, Pain management 493 in ACS, 20–21 continuing care, 494 in acute pancreatitis, 483–484 coping abilities, 493 in AIDS, 13–14 mobility, 492 in angina pectoris, 65 nutritional needs, 493 in bone cancer, 95 self-care, 492–494 in breast cancer, 144 swallowing of food, 492–493 in burn injury, 111–112, 114–115 use of assistive devices, 493 in cancer, 126–127 pathophysiology, 488 in cervical cancer, 149–150 pharmacologic therapy for, 490 in cholelithiasis and cholecystitis, 229 planning/goals, 491–492 in diverticulitis, 278 surgical management, 490 in gastritis, 315–316 Partial laryngectomy for laryngeal in gout, 323 in hiatal hernia, 367 cancer, 165 in leukemia, 413–414 Passive limb movement, resistance to, in malignant melanoma, 194 in mastoiditis, 429 489 in osteomyelitis, 472 Patient education in osteoporosis, 476 in peptic ulcer, 505 back pain management, 86 burn injury prevention, 109 diabetes mellitus, 258 diabetic teaching plan, 259–260 experienced patients, 260–261

714 Index Patient education (continued) evaluation, patient outcomes, 507 insulin self-administration, and gastrinoma, 501 261–263 nursing diagnoses, 504 readiness to learn, 260 pain reduction in, 505 teaching approaches, 261 pharmacologic therapy for, 503 planning/goals, 505 postperative, 534–535 predisposing factors, 501 preoperative, 517 self-care in, 506–507 psoriasis, 568 surgical management, 504 surgical treatments, in breast cancer, Percutaneous biliary drainage for liver 143 tumors, 173 PBSCT. See Peripheral blood stem cell Percutaneous thrombectomy devices, 72 Percutaneous transhepatic transplant (PBSCT) PCI procedures for angina pectoris, 63 cholangiography (PTC), 183 PCP prophylaxis prevention, 6 Perfusion, maintaining, 41 PE. See Pulmonary embolism (PE) Perianal care, 637 PEA. See Pulseless electrical activity Perianal skin integrity, 11 Pericardial effusion in pericarditis, 511 (PEA) Pericarditis, 507–511 Pelvic examinations of ovarian cancer, assessment, 510 181 causes of, 508 Pelvic fracture management, 310–311 classification, 508 Pelvic infection. See Pelvic clinical manifestations, 508 diagnosis, 509 inflammatory disease (PID) evaluation, patient outcomes, 511 Pelvic inflammatory disease (PID), nursing diagnoses, 510 pain management in, 510 494–497 pericardial effusion in, 511 broad-spectrum antibiotic therapy for, pharmacologic therapy for, 509 planning/goals, 510 495–496 Perioperative nursing management, clinical manifestations, 495 complications, 495 511–538 nursing management, 496–497 active body movement, 516 pathophysiology, 495 airway management, 525 risk factors, 495 anxiety reduction, 514 Pemphigus, 497–501 assessment assessment, 498 clinical manifestations, 497–498 ambulatory surgery, 513 collaborative problems/complications, inpatient surgery, 512–513 body temperature, 526–527 499 bowel preparation for surgery, 518 corticosteroids for, 498 cardiovascular stability, 525–526 diagnosis, 498 DVT prevention, 531 evaluation, patient outcomes, 500 emotional support to patient and immunosuppressive agents for, 498 nursing diagnoses, 498–499 family, 530–531 nursing interventions evaluation, patient outcomes, 520, anxiety reduction, 499 536 fluid and electrolyte balance, 500 family’s needs, 520 oral hygiene, 499 fluid balance, 529 potential complications, 500 fluid intake, 515 skin integrity, 499 gerontologic considerations, 513–514 pathophysiology, 497 GI function, 527 planning/goals, 499 hemorrhage treatment, 532–533 Pentoxifylline, 537 hepatic and renal function, 515–516 Peptic ulcer, 501–507 home- and community-based care, anxiety reduction in, 505 assessment, 504 534–535 causes of, 501 hypotension treatment, 531–532 clinical manifestations, 502 informed consent, 512 collaborative problems/complications, mental status assessment, 527 mobility, 516 505 nursing diagnoses, 514 complications nutrition, 514–515, 527 operating room, 519 dizziness and nausea, 505–506 perforation and penetration, 506 continuing care in, 507 diagnostic tests for, 502

Index 715 pain management, 518, 526 of chronic renal failure (CRF), patient preparation for surgery, 592–593 518–519 of morbid obesity, 464 physical mobility, 528–529 Pharmacologic therapy planning/goals, 514 in postanesthesia care unit for acute nephritic syndrome, 461 for acute pulmonary edema, 571 documentation of information, 521 in anaphylaxis, 37 gerontologic considerations, 535 for angina pectoris, 63 PACU nurse, 521–522 for asthma, 81 postoperative period. See for bladder cancer, 137 for CML, 421–422 Postoperative nursing for cystitis (lower UTI), 250 management for diabetes insipidus, 254 preoperative patient education for glaucoma, 318 ambulatory surgical patient, 517 for headache, 333 deep-breathing and coughing for heart failure (HF), 348 exercises, 518 for hypothyroidism, 395 preparation procedures, 517 for hypovolemic shock, 599 psychosocial support, 514 for impetigo, 400 respiratory and cardiovascular status, for KS, 409 515 for lung abscess, 423–424 in same-day surgery, 522–523 for lymphedema, 425 self-care, 530 for Ménière’s disease, 432 shock treatment, 531–532 for myasthenia gravis (MG), 455–456 special needs of older patients, for osteoarthritis (OA), 467 519–520 for Parkinson’s disease, 490 spiritual help, 516 for peptic ulcer, 503 voluntary voiding, 528 for pericarditis, 509 wound complications for peripheral arterial occlusive infection, 533 wound dehiscence and disease, 537 evisceration, 534 for pulmonary tuberculosis, 629–630 Peripheral arterial occlusive disease, for sickle cell anemia, 49 536–538 for SLE, 614 clinical manifestations, 536–537 for trigeminal neuralgia, 627 diagnosis, 537 for ulcerative colitis, 633 home- and community-based care, for urolithiasis, 648 538 for vein disorders, 654–655 pharmacotherapy for, 537 Pharyngitis postoperative management acute. See Acute pharyngitis circulation through arterial repair, chronic. See Chronic pharyngitis 537–538 Phenytoin, 60 edema, 538 Pheochromocytoma, 544–546 fluid imbalances, 538 clinical manifestations, 544 surgery for, 537 diagnostic methods for, 545 Peripheral blood stem cell transplant incidence of, 544 (PBSCT) medical management, 545 for aplastic anemia, 42 nursing management, 545–546 for sickle cell anemia, 49 Phlebotomy, 560 Peripheral thrombolytic therapy, Photochemotherapy for psoriasis, contraindications to, 72 Peritoneal fluid, 482 567–568 Peritonitis, 538–541 Photodynamic techniques for bladder clinical features, 539 medical management, 539–540 cancer, 138 nursing management, 540–541 Physical mobility pathophysiology, 539 Personality changes in brain tumors, in burn injury, 115 102 in MS, 446–447 PET. See Positron-emission tomography in osteomyelitis, 472 (PET) in perioperative nursing, 528–529 Petechiae, 283 Physical safety in AD, 31 Pharmacologic management Phytotherapeutic agents, 91 PID. See Pelvic inflammatory disease (PID) Pituitary adenomas, 101

716 Index Pituitary tumors, 546–547 for liver tumor, 172 Plant alkaloids, 134 for unconscious patient, 640 Plasma exchange, 456 Postanesthesia care, 521 Plasmapheresis, 442 Postanesthesia care unit (PACU) Plasmapheresis (plasma exchange), 325 documentation of information, 521 Pleural effusion, 547–549 home care nurse and, 523–524 nurse responsibilities, 521–522 clinical manifestations, 548 patient’s readiness for discharge from, nursing management, 549 treatment modalities, 548–549 522 Pleurisy, 549–550 same-day surgery, 522–523 PML. See Progressive multifocal Postoperative complications, prevention leukoencephalopathy (PML) of Pneumocystis jiroveci, 2 deep vein thrombosis, 531 Pneumocystis pneumonia, 5 gerontologic considerations, 535 Pneumonia, 550–556 hematoma, 533 hemorrhage, 532–533 antibiotics for, 553 hypotension and shock, 531–532 assessment, 553 wound dehiscence and evisceration, classification, 551 clinical manifestations, 551–552 534 collaborative problems/complications, wound sepsis, 533 Postoperative corticosteroid 554 in elderly patients, 552–553 replacement, 545 nursing diagnoses, 554 Postoperative nursing care, 465 nursing interventions in brain abscess, 99 airway patency, 554 in morbid obesity, 465 fluid intake, 555 in pulmonary embolism, 576 patient education, 555 in small bowel obstruction, 97 rest, 554–555 Postoperative nursing management self-care, 555–556 in clinical unit, 524 pathophysiology, 551 in home care, 523–524 planning/goals, 554 nursing interventions Pneumothorax, 556–559 clinical manifestations, 558 airway maintenance, 525 medical management, 558–559 bladder distention, 528 nursing management, 559 cardiovascular stability, 525–526 simple, 556–557 deep vein thrombosis, 531 tension, 557 emotional support to patient and traumatic, 557 POAG. See Primary openangle family, 530–531 fluid balance, 529 glaucoma (POAG) GI function, 527 Polycythemia, 559–561 hemorrhage, 532–533 hyperthermia, 527 classification, 559–560 hypothermia, 526 clinical manifestations, 560 mental status assessment, 527 medical management, 560–561 mobility, 528–529 nursing management, 561 nutrition, 527 Polycythemia vera, 560 pain management, 526 Polydipsia self-care, 530 in diabetes insipidus, 253 shock, 531–532 in diabetes mellitus, 256 patient’s physiologic equilibrium, 520 Polyradiculoneuritis. See Guillain–Barré postanesthesia care, 521 in same-day surgery, 522–523 syndrome (GBS) Postoperative sensations in breast Polyuria cancer, 144 in diabetes insipidus, 253 Preinfarction angina, 17 in diabetes mellitus, 256 Preoperative patient education Portosystemic encephalopathy (PSE). ambulatory surgical patient, 517 See Hepatic encephalopathy deep-breathing and coughing Positron-emission tomography (PET) exercises, 518 for brain tumors, 102 preparation procedures, 517 for breast cancer, 140 Priapism leading to impotence, 53 for cancer, 122 Primary brain tumors, 100 for cervical cancer, 147 Primary headache, 330 for esophageal cancer, 160

Index 717 Primary malignant musculoskeletal medical management, 564 tumors, 92–93 nursing management, 564–565 Psoralens and ultraviolet A (PUVA) Primary openangle glaucoma (POAG), 317 therapy, 567 Psoriasis, 565–569 Primary polycythemia. See Polycythemia vera assessment, 568 clinical manifestations, 565–566 Primary pulmonary hypertension, 579 diagnostic methods for, 566 Prodrome phase, migraine attack, 331 medical management Progressive multifocal photochemotherapy, 567–568 leukoencephalopathy (PML), 4 removal of scales, 566 Progressive muscle weakness in ALS, 34 systemic therapy, 567 Promethazine, 432 topical therapy, 567 Prophylactic antimicrobial therapy, 583 nursing interventions Prophylactic mastectomy of breast coping strategies, 569 patient education, 568 cancer, 140 self-care, 569 Prophylactic treatment skin integrity, 568–569 pathophysiology, 565 for CLL, 418 psychological considerations, 566 for gout, 323 Psychiatric changes in Parkinson’s Propylthiouracil (PTU), 620 Proscar. See Finasteride disease, 489 Prostate cancer, 184–191 Psychosocial support advanced stage, 184–185 diagnostic methods, 185 in ARF, 590–591 medical management in burn injury, 118–119 Psychotherapy for Huntington disease, hormone therapy, 186 radiation therapy, 186 372 radical prostatectomy, 185 PTC. See Percutaneous transhepatic prostatectomy assessment, 187 cholangiography (PTC) diagnosis, 187 PTU. See Propylthiouracil (PTU) evaluation, patient outcomes, 191 Pulmonary arterial hypertension, planning/goals, 187 postoperative nursing 579–581 anticoagulation therapy for, 580 interventions, 188–191 clinical manifestations, 580 preoperative nursing interventions, diagnostic evaluation, 580 lung transplantation, 581 188 nursing management, 581 risk factors, 184 pathophysiology, 580 Prostatectomy primary, 579 assessment, 187 secondary, 579 diagnosis, 187 Pulmonary care measures, 111 evaluation, patient outcomes, 191 Pulmonary circulation and planning/goals, 187 postoperative nursing interventions, hypertrophies, 438 Pulmonary complications after BMT, 188–191 preoperative nursing interventions, 135 Pulmonary edema 188 Prostate gland acute. See Acute pulmonary edema monitoring and managing, 116 enlargement. See Benign prostatic Pulmonary embolism (PE), 572–577 hyperplasia (BPH) clinical manifestations, 572–573 diagnostic methods for, 573 inflammation. See Prostatitis medical management Prostate-specific antigen (PSA) level, anticoagulation therapy, 574 91, 185 cardiopulmonary system Prostatism, 90 Prostatitis, 561–563 stabilization, 573–574 surgical management, 574–575 causes of, 561 thrombolytic therapy, 574 clinical manifestations, 562 nursing management nursing management, 562–563 anxiety reduction, 576 treatment goals, 562 chest pain, 575 types of, 561 invasive procedures, 575 Pruritus, 563–565 oxygen therapy, 575–576 causes of, 563 clinical manifestations, 564

718 Index Pulmonary embolism (PE) (continued) RAST. See Radioallergosorbent test postoperative nursing care, 576 (RAST) self-care, 576–577 thrombus formation prevention, Raynaud’s phenomenon, 584–585 575 clinical manifestations, 584 medical management, 584–585 prevention, 573 nursing management, 585 Pulmonary heart disease, 577–579 prognosis for, 584 causes of, 577 Recovery phase, migraine attack, 331 clinical manifestations, 577–578 Rectal lesions, 152 medical management, 578 Reed–Sternberg cell, 369 nursing management, 578–579 Reflux vomiting in small bowel Pulmonary parenchyma, necrosis of, 422 Pulmonary tuberculosis, 628–631 obstruction, 97 adherence to treatment regimen for, Regional enteritis, 585–586 Rehabilitation of burn injury 630 assessment and diagnostic methods, assessment, 117 collaborative problems, 118 629 nursing diagnoses, 117 clinical manifestations, 629 Renal artery embolization, 163 in elderly people, 629 Renal failure mode of transmission, 628 acute. See Acute renal failure (ARF) nursing management, 630–631 chronic. See Chronic renal failure nutritional regimen for, 630 pharmacologic therapy for, 629–630 (CRF) preventing spreading of, 630–631 Renal insufficiency and chronic renal risk factors, 628–629 Pulseless electrical activity (PEA), 207 failure, 320 PUVA therapy. See Psoralens and Renal tumors, 161–164 ultraviolet A (PUVA) therapy assessment and diagnostic methods, Pyelonephritis 162 acute. See Acute pyelonephritis clinical manifestations, 162 chronic. See Chronic pyelonephritis medical management, 162–163 Pyridostigmine bromide, 455–456 nursing management, 163–164 risk factors, 162 R types, 161 Reperfusion procedures for angina RA. See Rheumatoid arthritis (RA) Radiation-associated skin impairments, pectoris, 63 Respiratory distress, 169 125 Respiratory gasping, 208 Radiation therapy Respiratory management for bladder cancer, 138 in ACS, 21 for brain tumors, 103 in AIDS, 8 for cancer, 123–124, 131–132 in GBS, 326 for KS, 7, 409 Rest for laryngeal cancer, 165 in AD, 32 for liver tumors, 172–173 in cirrhosis, 236 for multiple myeloma, 442 in Cushing syndrome, 246–247 for pituitary tumors, 547 in low back pain, 86 for prostate cancer, 186 in ulcerative colitis, 637 Radical cystectomy for bladder cancer, Resting tremors, 489 Reteplase, 19 137 Retroperitoneal lymph node dissection Radical mastectomy for breast cancer, (RPLND), 201 141 Retroviruses, 1 Radical nephrectomy for renal tumors, Rheumatic endocarditis, 285–286 162 causative agents, 285 Radical prostatectomy of prostate incidence of, 285–286 Rheumatic heart disease, 285 cancer, 185 Rheumatoid arthritis (RA), 74–80 Radioactive iodine therapy, 202 community-based care, 79 diagnostic findings, 75–76 for hyperthyroidism, 383 home care, 79–80 Radioallergosorbent test (RAST), 36 inflammatory disorder, 74 Radiofrequency thermal ablation, 173 medical management, 76 Rapid streptococcal antigen test medication side effects, 78–79 (RSAT), 541 Rash, 435

Index 719 nursing management, 76–78 nursing management, 596 prevalence, 75 oily form of, 595 Rib fractures, management of, 312 Secondary bone tumors. See Metastatic Rimonabant, 464 Risk factors bone disease for AIDS, 1–2 Secondary brain tumors, 100 for Alzheimer’s disease (AD), 28 Secondary headache, 330 for asthma, 80 Secondary osteoporosis, 474 for atherosclerosis, 73–74 Secondary polycythemia, 560 for bladder cancer, 136 Secondary pulmonary hypertension, 579 for breast cancer, 139 Secondary thrombocytopenia, 617 for bronchogenic carcinoma, 175 Seizure precautions, 60 for cerebrovascular accident (CVA), Seizures, 435 215 complex partial, 290 for cervical cancer, 147 generalized, 291 for coronary atherosclerosis and reducing fear of, 294 simple partial, 290 CAD, 241–242 Self-care, 638 for coronary heart disease (CHD), in acute nephritic syndrome, 461 in acute pancreatitis, 485 242 in AD, 31 for epistaxis, 296 in angina pectoris, 65–66 for esophageal cancer, 159 in appendicitis, 71 for esophageal varices, bleeding, 297 in breast cancer, 145–146 for gastric cancer, 196 in burn injury, 119 for hemorrhage, 297 in cancer, 130–131 for infective endocarditis, 283 in cardiomyopathies, 212 for laryngeal cancer, 164 in cholelithiasis and cholecystitis, 230 for malignant melanoma, 192 in chronic renal failure (CRF), 594 for oral cancers, 178 in colorectal cancer, 156–157 for osteoarthritis (OA), 466 in Cushing syndrome, 248 for osteomalacia, 468 in CVA, 221, 224 for osteoporosis, 474 in cystitis (lower UTI), 252 for ovarian cancer, 180 deficit related to pain, 166 for pancreatic cancer, 182 in diabetes mellitus, 260, 263 for pelvic inflammatory disease (PID), in DKA, 268–269 in epilepsy, 294–295 495 in gastric cancer, 199 for prostate cancer, 184 in gastritis, 315 for pulmonary tuberculosis, 628–629 in GBS, 328 for renal tumors, 162 in head injury, 345 for septic shock, 600 in hiatal hernia, 367–368 for spinal cord injuries (SCI), 602 in hypertension, 379 for testicular cancer, 200 in hyperthyroidism, 386 for thyroid cancer, 202 in hypothyroidism, 395–396 for tuberculosis, pulmonary, 628–629 in intracranial aneurysm, 61 for vaginal cancer, 203 in leukemia, 414, 415 for vein disorders, 653 in Ménière’s disease, 433 for vulvar tumors, 204 in MS, 448–449 Rituximab, 418 in osteomyelitis, 472–473 RNA virus of Enterovirus family, 360 in Parkinson’s disease, 492–494 RPLND. See Retroperitoneal lymph in peptic ulcer, 506–507 in perioperative nursing, 530 node dissection (RPLND) in PID, 496–497 Rule of Nines, 108 in prostate cancer, 190 in psoriasis, 569 S in pulmonary embolism (PE), 576–577 in RA, 78 Saccular aneurysm, 54 in ulcerative colitis, 638 Sandostatin, 7 in vulvar tumors, 206 Schwann cell in GBS, 324 Self-concept, improving SCI. See Spinal cord injuries (SCI) in burn injury, 118–119 Seborrhea, 595 in laryngeal cancer, 169 Seborrheic dermatoses, 595–596 dry form of, 595 genetic predisposition for, 595 medical management, 595–596

720 Index Self-esteem management in psoriasis, 568–569 in AIDS, 4 in SCI, 609 in cancer, 127–128 in toxic epidermal necrolysis, in hyperthyroidism, 385 in liver tumors, 171 623–624 in unconscious patient, 643 Senile (age-related) cataracts, 213 in vulvar tumors, 206 Sensory deprivation in intracranial Skin lesions in KS, 7 aneurysm, 60 malignant, 124, 125 Sensory function in MS, 448 in ulcerative colitis, 632 Sensory-perceptual difficulties, 221 SLE. See Systemic lupus erythematosus Sensory stimulation (SLE) in intracranial aneurysm, 60 Sleep pattern disturbance prevention, in unconscious patient, 645 in urolithiasis, 646 344 Sentinel lymph node biopsy, 141 Sliding hernia, 365 Sepsis, 116, 625 Small cell lung cancer, 175 Septic shock, 600–602 Smoking in cancer, 129 clinical manifestations, 601 and Buerger’s disease, 106 in elderly persons, 601 cessation, 503 pathophysiology, 600 and chronic pancreatitis, 486 risk factors, 600 Social interaction Sertoli cell tumors, 200 in AD, 32 Serum ammonia levels, 358 in burn injury, 115–116 Serum amylase levels, 482 enhancing, in AIDS, 14–15 Serum lipase levels, 482 Soft tissue sarcomas treatment, 94 Severe hypothyroidism, 394 Soltamox. See Tamoxifen Sexual activity, 145 Sore throat. See Acute pharyngitis in MS, 448 Speech rehabilitation in vulvar tumors, 206 in cancer of larynx, 165 Sexual dysfunction in cerebral vascular accident, 222 coping with, in CVA, 223 in MS, 447–448 in prostate cancer, 189 in oral cancer, 179 Shock Speech therapy, 165 in acute pancreatitis, 485 Spinal cord injuries (SCI), 602–612 cardiogenic. See Cardiogenic shock assessment, 606–607 hypovolemic. See Hypovolemic shock assessment and diagnostic methods, septic. See Septic shock treatment in 604 categorization of, 603 fracture, 306 causes of, 602 perioperative nursing, 531–532 collaborative problems/complications, Shoulder pain, 220–221 Sibutramine HCl, 464 607 Sickle hemoglobin (HbS) gene, 48 complications Simple pneumothorax, 556–557, 558 Single-drug therapy for epilepsies, 292 deep vein thrombosis, 605–606 Skin and mucous membranes of spinal and neurogenic shock, 605 spinal shock, 604 HIV/AIDS patients, 8 emergency management, 604 Skin care evaluation, patient outcomes, in ARF, 590 611–612 in cirrhosis, 236 incomplete, 603 Skin integrity medical management in acute pancreatitis, 484 in AIDS, 11 high-dose corticosteroids, 604 in burn injury, 114 oxygenation, 605 in cholelithiasis and cholecystitis, surgery, 605 neurologic level, 603 229–230 nursing diagnoses, 607 in Cushing syndrome, 247 nursing interventions in CVA, 223 adaptation to disturbed sensory in DIC, 274 in head injury, 344 perception, 609 in pemphigus, 499 autonomic hyperreflexia, 610–611 bowel function, 609 breathing and airway clearance, 607–608

Index 721 comfort measures, 610 of COPD, 232 home- and community-based care, of Cushing syndrome, 246 of endometriosis, 287 611 of epilepsies, 292 mobility improvement, 608 of esophageal varices, bleeding, 299 orthostatic hypotension, 610 of glaucoma, 318 skin integrity, 609 of heart failure (HF), 348 planning/goals, 607 of hepatic tumor, 173–174 respiratory problems in, 603 of hyperthyroidism, 383 risk factors, 602 of large bowel obstruction, 96–97 Spinal fusion, 450 of laryngeal cancer, 165 Splenectomy for ITP, 398 of lymphedema, 425–426 Spontaneous bleeding, 656 of Ménière’s disease, 432 Sprains, 452, 453 of mitral regurgitation (insufficiency), Squamous cell cancer, 147 Staphylococcus aureus 438 bllous impetigo due to, 400 of morbid obesity, 465 bone infections due to, 470 of osteoarthritis (OA), 467 Statin therapy, 537 of osteomyelitis, 470 Status asthmaticus, 82–84 of Parkinson’s disease, 490 causes of, 82 of peptic ulcer, 504 clinical manifestations, 83 of peripheral arterial occlusive medical management, 83 nursing management, 83–84 disease, 537 Status epilepticus, 293 of pheochromocytoma, 545 Stereotactic radiation therapy of pituitary tumors, 547 for pituitary tumors, 547 of pulmonary embolism (PE), Stevens–Johnson syndrome, 621–625 Stomatitis in cancer, 124–125 574–575 Stones (calculi). See Urolithiasis of SCI, 605 Strains, 452, 453 of small bowel obstruction, 97 Streptococcus pneumoniae of trigeminal neuralgia, 627 acute otitis media due to, 477 of ulcerative colitis, 633–634 acute pharyngitis due to, 541, 542 of vaginal cancer, 204 Stress reduction, 503 Sympathectomy, 585 Stress ulcer, 501–502. See also Peptic Sympathetic innervation, 605 Sympatholytic agents, 620 ulcer Syndrome of inappropriate antidiuretic Strokes, 215 Subacute thyroiditis, 618 hormone (SIADH), 612 Subdural hematoma, 338–339 Synthroid, 395 Superficial partial-thickness burns, 108 Systemic antibiotic therapy for Superficial spreading melanoma, 192 Supportive care impetigo, 400 Systemic chemotherapy for liver tumors, for AML, 420 for muscular dystrophies, 450 173 for osteomyelitis, 470 Systemic embolization, 303 for sickle cell anemia, 50 Systemic lupus erythematosus (SLE), Suprapubic cystostomy, 91 Surgical management 613–615 of aortic aneurysm, 56 clinical manifestations, 613–614 of aortic regurgitation, 67 diagnosis, 614 of Bell’s palsy, 89 nursing management, 615 of bladder cancer, 137 pathophysiology of, 613 of BPH, 91 pharmacologic therapy for, 614 of brain tumors, 103 Systemic therapy for psoriasis, 567 of cancer, 123–124, 131 Systolic murmur, 437 of cardiac tamponade, 509 of cardiomyopathies, 209 T of cataract, 214 of cholelithiasis and cholecystitis, Tamoxifen, 141 Taste disturbance in mastoiditis, 430 227–228 Taxanes, 134 of chronic pancreatitis, 486–487 TBI. See Traumatic brain injury (TBI) of colorectal cancer, 153 TEE. See Transesophageal echocardiography (TEE) Teletherapy for prostate cancer, 186 Temporary replacement therapy with hydrocortisone, 245

722 Index Tension headaches, 334–335 TNM system, 122 Tension pneumothorax, 557, 558 Tobacco smoke Terminal care in leukemia, 415 Testicular cancer, 200–201 and lung cancers, 175 and status asthmaticus, 84 assessment and diagnostic methods, Tonsillectomy, 543 200–201 Topical antibacterial therapy, 400 Topical corticosteroid cream, 595 classification, 200 Topical therapy for psoriasis, 567 clinical manifestations, 200 Toxic epidermal necrolysis, 621–625 management, 201 assessment and diagnostic findings, risk factors, 200 Therapeutic exercise program, 450 622 Thiazide diuretics, 254 assessment of, 622–623 Thiothixene hydrochloride, 372 clinical manifestations, 621 Thoracentesis. See Needle aspiration collaborative problems/complications, Thoracic aortic aneurysms, 54 clinical manifestations, 55 623 diagnostic findings, 55–56 complications, 621 Thought processes evaluation, patient outcomes, 625 in AIDS, 13 medical management, 622 in cerebral vascular accident, 222 nursing diagnoses, 623 in Cushing syndrome, 247 nursing interventions in CVA, 222 Thromboangiitis obliterans. See anxiety management, 625 conjunctival retraction, 625 Buerger’s disease fluid balance, 624 Thrombocytopenia, 616–617 hypothermia prevention, 624 Thrombolytic therapy, 19, 574 pain management, 624–625 Thrombophlebitis, 653 sepsis, 625 Thrombosis in prostate cancer, 189 skin and mucous membrane Thrombus formation prevention, 575 Thymectomy for MG, 456 integrity, 623–624 Thyroid cancer, 202–203 planning/goals, 623 Trabectome surgery, 318 medical management, 202 Transesophageal echocardiography nursing management, 203 risk factors, 202 (TEE) Thyroidectomy, 202 for aortic aneurysms, 55 Thyroid hormone for arterial embolism, 72 interaction with drugs, 395 of mitral regurgitation, 438 replacement, 394 Transfusion therapy, 50 therapy, 619 Transsphenoidal hypophysectomy, 244 Thyroiditis Transurethral incision of the prostate acute. See Acute thyroiditis chronic. See Chronic thyroiditis (TUIP), 91 Thyroid storm, 619–621 Transurethral microwave heat treatment clinical manifestations, 620 medical management, 620 (TUMT), 91 nursing management, 621 Transurethral needle ablation (TUNA), Thyrotoxic crisis. See Thyroid storm Tibia fractures, management of, 312 91 Tic douloureux. See Trigeminal neuralgia Transurethral resection of prostate Tissue integrity management in cancer alopecia, 125 (TURP), 91, 185 radiation-associated skin impairments, Transurethral resection (TUR), 137 Transvaginal ultrasound of ovarian 125 skin lesions, 125 cancer, 181 stomatitis, 124–125 Trauma Tissue ischemia, 273 Tissue perfusion, ineffective abdominal, 557 cardiac, 20–21, 64, 347 blunt, 337, 557 cerebral, 59, 341, 403–404 multiple organ, 502 peripheral blood flow, 210 nasal, 297 TMP-SMZ. See Trimethoprim- rectal, 413 scalp, 336 sulfamethoxazole (TMP-SMZ) Traumatic brain injury (TBI) assessment, 340 causes of, 335 collaborative problems, 342 mild, 336–337 motor functions, 340–341 neurologic signs, 341

Index 723 nursing diagnoses, 341–342 occipital lobe, 102 nursing interventions ovarian, 180 primary musculoskeletal, 93 airway maintenance, 342 primary vulvar, 204 body temperature maintenance, sites, 93 stages of, 122–123 344 stromal, 180 cognitive functioning, 344 testicular, 200 evaluation, patient outcomes, 346 TUMT. See Transurethral microwave family coping, 344–345 fluid and electrolyte balance, heat treatment (TUMT) TUNA. See Transurethral needle 342–343 home- and community-based care, ablation (TUNA) TUR. See Transurethral resection 345–346 injury prevention, 343–344 (TUR) nutrition, 343 TURP. See Transurethral resection of potential complications, 345 skin integrity, 344 prostate (TURP) planning/goals, 342 Tympanic membrane perforation, 478 Traumatic dislocations, 452 Tympanotomy. See Myringotomy Traumatic pneumothorax, 557 Type 1 diabetes, 255 Tremor at rest, 489 Type 2 diabetes, 255–256 Trendelenburg position, 599 Trigeminal neuralgia, 626–628 U clinical manifestations, 626 nursing interventions, 627–628 Ulcerative colitis, 632–639 pathophysiology, 626 assessment and diagnostic methods, pharmacologic therapy for, 627 632–633 surgical management, 627 assessment findings, 634–635 Trimethoprim-sulfamethoxazole (TMP- bleeding in, 632 clinical manifestations, 632 SMZ), 5, 562 collaborative problems/complications, Trimodal therapy for bladder cancer, 137 635 Tuberculosis, pulmonary, 628–631 evaluation, patient outcomes, 639 nursing diagnoses, 635 adherence to treatment regimen for, nursing interventions 630 anxiety management, 637 continuing care, 638–639 assessment and diagnostic methods, coping measures, 637 629 fluid intake, 636 normal elimination patterns, 636 clinical manifestations, 629 pain management, 636 in elderly people, 629 perianal care, 637 mode of transmission, 628 potential complications, 637–638 nursing management, 630–631 rest, 637 nutritional regimen for, 630 self-care, 638 pharmacologic therapy for, 629–630 nutritional therapy for, 633 preventing spreading of, 630–631 pharmacologic therapy for, 633 risk factors, 628–629 planning/goals, 635 TUIP. See Transurethral incision of the surgical management, 633–634 prostate (TUIP) Ulcers Tumors acute, 502 asymptomatic, 502 adrenal, 244 esophageal, 501 benign bone, 92 nonhealing, 470 cerebellar, 101 oral, 586, 614 cerebellopontine angle, 102 perforated, 539 cerebellum, 102 stomal, 465 colorectal, 153 early-stage, 165 Ultrasound-guided injection of alcohol, ectopic ACTH-secreting, 245 173 frontal lobe, 102 germinal, 200 Ultraviolet B (UVB) light therapy, 568 grading, 123 Unconscious patient, 639–646 hormonal-dependent, 141 intracranial, 292, 339 assessment, 640–641 malignant, 101, 164, 175, 612 assessment and diagnostic methods, of motor cortex, 102 neoplastic, 548 640

724 Index Unconscious patient (continued) anticoagulant therapy for, 655–656 collaborative problems/complications, assessment and diagnostic methods, 641 evaluation, patient outcomes, 646 654 medical management, 640 clinical manifestations, 654 nursing diagnoses, 641 endovascular management, 655 nursing interventions heparin-induced thrombocytopenia, airway maintenance, 642 body temperature management, 656 644 pharmacologic therapy for, 654–655 bowel function, 644 prevention, 654 corneal integrity, 643–644 risk factors for, 653 fluid balance, 643 self-care for, 657–658 mouth care, 643 spontaneous bleeding, 656 nutritional needs, 643 Venom immunotherapy, 36 patient protection, 642 Venous thrombosis, 653 potential complications, 645–646 Ventricular assist devices, 210 sensory stimulation, 645 Vertebroplasty for multiple myeloma, skin and joint integrity, 643 urinary retention prevention, 644 442 planning/goals, 641–642 Vestibular disease, 431 Vinca alkaloids, 417 Ureteral colic, 646 Vincristine, 134 Uricosuric agents for gout, 323 Viral infections Uric stones, 648 Urinary incontinence in prostate cancer, Guillain–Barré syndrome, 324–329 pharyngitis, 541–542 189 Viral pharyngitis, 541–542 Urinary retention prevention, 644 Virchow’s triad, 653 Urinary stasis, 90 Visceral damage, 116 Urinary tract infections (UTI), 90 Visual impairment, 213 Urolithiasis, 646–652. See also Kidney Vitamin B12 deficiency medical management, 47 stones pathophysiology, 45–46 assessment and diagnostic methods, Vitamin D intake, 469 Vitamin K therapy, 299 647 Vocal cord stripping for laryngeal in bladder, 647 factors favoring formation of, 646 cancer, 165 pharmacologic and nutritional Vomiting therapy for, 648 and food intake, 102 in renal pelvis, 647 in small bowel obstruction, 97 stone removal procedures, 648 Vulvar tumors, 204–207 Uterine cancers, 158–159 assessment, 205 UTI. See Urinary tract infections (UTI) assessment and diagnostic methods, V 205 clinical manifestations, 205 Vaginal cancer, 203–204 postoperative nursing interventions clinical manifestations, 204 nursing management, 204 continuing care, 207 risk factors, 203 home- and community-based care, Valium. See Diazepam 207 Valve replacement for aortic pain and discomfort, 206 potential complications, 206–207 regurgitation, 67 skin integrity, 206 Valvuloplasty preoperative nursing interventions anxiety management, 205 aortic, 67 skin preparation for surgery, 206 percutaneous transluminal, 439 risk factors, 204 Vancomycin hydrochloride, 436 Vascular occlusion, 71 W Vasodilator therapy, 107 for aortic regurgitation, 67 Warfarin, 655 for heart failure (HF), 348 Wasting syndrome, 2–3 for Ménière’s disease, 432 Vasospasm, 60 fluid, and electrolyte disturbances, 15 secondary, 71 Water-hammer (Corrigan’s) pulse, 67 Vein disorders, 653–658 Weakness in Addison’s disease, 26 in AIDS, 2, 4, 10

in amyotroic lateral sclerosis, 34 Index 725 in angina pectoris, 62 in Bell’s palsy, 88–89 wound dehiscence and evisceration, in cerebral vascular accident, 215 534 in diverticular disease, 276 in head injury, 337 Wound contamination, 206, 533 in lung abscesses, 423 Wound cultures, 8, 471 in lung cancer, 176 Wound dehiscence, 131, 534 in multiple sclerosis, 446, 448 Wound disruption, 534 in myasthenia gravis, 454 Wound drainage specimens, 601 in prostate cancer, 185 Wound drainage systems, 525, 529 in testicular cancer, 200 Wound surface, 114 Weight-bearing exercise, 475 Wound swelling, 533 Weight loss Wrist fractures, management of, involuntary, 2 progressive, 159, 182, 381 309–310 Weight loss diet, 464 Weight reduction, 259 X White blood cells (WBCs) Xenical. See Orlistat unregulated proliferation of, 410 Xenon-enhanced CT scan, 216 Wound bacteria, 624 X-ray studies Wound breakdown, 167, 169–170 Wound complications for bone tumors, 93 infection, 533 for hiatal hernia, 366 for liver tumors, 172 for osteoporosis, 474 Z Zollinger–Ellison syndrome, 501