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Chapter 48 skin integrity and wound care test bank

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Clinical Decision Support System, Healthcare Reimbursement, Health-Related Views And Laws Are Shaped By Social, Political, And Historical Factors Discussion

clinical decision support system, healthcare reimbursement, health-related views and laws are shaped by social, political, and historical factors discussion

1. (100 words) How does clinical decision support system CDS fit in with the goal of rewarding “quality over quantity” in healthcare reimbursement?

2. (200 words) Provide an example of how healthcare informatics can enhance quality over quantity within the healthcare setting use evidence-based practice to support your reasoning.

3. (200 words) If the answer to lowering healthcare costs is payment based on “value over volume,” then does this favor the adoption of clinical decision support system CDS or argue against it? What is your rationale?

The United States’ health-related views and laws are shaped by social, political, and historical factors that are often part of the larger debate over individual rights versus the collective good. Based on this idea please discuss your thoughts on the following public health topics.

1. (100 words) Should childhood immunizations be mandatory or optional and why ?

2. (100 words) What are the benefits and risk associated with childhood immunizations?

3. (200 words) Should higher insurance rates or taxes be used to punish poor health choices (e.g., cigarettes, “junk” food)? Would this be unfair to individuals, or is this fair since all Americans pay a portion of the healthcare costs to care for people who make these choices?

4. (200 words) Should, in light of the current Covid-19 situation, should we be required to social distance, wear masks when we are in public, and be on lockdown when community numbers are higher?

Use APA 7th edition to support your discussion and at least three reference including the textbook

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Brief Contents UNIT 1 The Nature of Nursing 1 Chapter 1 Historical and Contemporary Nursing

Practice 2

Chapter 2 Evidence-Based Practice and Research in Nursing 26

Chapter 3 Nursing Theories and Conceptual Frameworks 37 Chapter 4 Legal Aspects of Nursing 47 Chapter 5 Values, Ethics, and Advocacy 73

UNIT 2 Contemporary Health Care 88 Chapter 6 Health Care Delivery Systems 89 Chapter 7 Community Nursing and Care Continuity 105 Chapter 8 Home Care 118 Chapter 9 Electronic Health Records and Information

Technology 129

UNIT 3 The Nursing Process 143 Chapter 10 Critical Thinking and Clinical Reasoning 144 Chapter 11 Assessing 155 Chapter 12 Diagnosing 175 Chapter 13 Planning 189 Chapter 14 Implementing and Evaluating 208 Chapter 15 Documenting and Reporting 221

UNIT 4 Health Beliefs and Practices 243 Chapter 16 Health Promotion 244 Chapter 17 Health, Wellness, and Illness 262 Chapter 18 Culturally Responsive Nursing Care 276 Chapter 19 Complementary and Alternative Healing

Modalities 295

UNIT 5 Life Span Development 311 Chapter 20 Concepts of Growth and Development 312 Chapter 21 Promoting Health from Conception Through

Adolescence 328

Chapter 22 Promoting Health in Young and Middle-Aged Adults 353 Chapter 23 Promoting Health in Older Adults 364 Chapter 24 Promoting Family Health 386

UNIT 6 Integral Aspects of Nursing 397 Chapter 25 Caring 398 Chapter 26 Communicating 411 Chapter 27 Teaching 438 Chapter 28 Leading, Managing, and Delegating 462

UNIT 7 Assessing Health 476 Chapter 29 Vital Signs 477 Chapter 30 Health Assessment 513

UNIT 8 Integral Components of Client Care 601 Chapter 31 Asepsis 602 Chapter 32 Safety 640 Chapter 33 Hygiene 669 Chapter 34 Diagnostic Testing 718 Chapter 35 Medications 750 Chapter 36 Skin Integrity and Wound Care 828 Chapter 37 Perioperative Nursing 865

UNIT 9 Promoting Psychosocial Health 903 Chapter 38 Sensory Perception 904 Chapter 39 Self-Concept 922 Chapter 40 Sexuality 934 Chapter 41 Spirituality 954 Chapter 42 Stress and Coping 972 Chapter 43 Loss, Grieving, and Death 989

UNIT 10 Promoting Physiological Health 1009 Chapter 44 Activity and Exercise 1010 Chapter 45 Sleep 1066 Chapter 46 Pain Management 1086 Chapter 47 Nutrition 1127 Chapter 48 Urinary Elimination 1174 Chapter 49 Fecal Elimination 1210 Chapter 50 Oxygenation 1241 Chapter 51 Circulation 1287 Chapter 52 Fluid, Electrolyte, and Acid–Base Balance 1308

Further enhance your Clinical Reasoning with the additional resources below. For more information and purchasing options visit www.mypearsonstore.com.

Break Through to improving results

MyNursingLab provides a guided learning path that is proven to help students synthesize vast amounts of information, guiding them from memorization to true understanding through application.

Thinking Like a Nurse in Clinical Thinking Like a Nurse for NCLEX-RN® Success

Align ed to

the

2013 NCL

EX-R N®

Test Plan

Clinical references across the nursing curriculum available.

Courses | Hello Instructors | Account | Help & Support

Course Home

Syllabus

Assignment Calendar

Course Content

eText

Class Preparation

Class Master

Submissions

Kozier and Erb’s Fundamentals of Nursing 10e

1 Historic and Contemporary Nursing Practice

2 Evidence-Based Practice and Research in Nursing

3 Nursing Theories and Conceptual Frameworks

4 Legal Aspects of Nursing

5 Values, Ethics, and Advocacy

6 Health Care Delivery Systems

7 The Nurse-Patient Relationship and Therapeutic Communication

8 Home Care

9 Electronic Health Records and Information Technology

10 Critical Thinking and Clinical Reasoning

11 Assessing

12 Diagnosing

13 Planning

14 Implementing and Evaluating

15 Documenting and Reporting

16 Health Promotion

Available for your favorite

electronic device!

NURSE’S DRUG GUIDE Wilson • Shannon • Shields

2016

NURSE’S DRUG GUIDE

Wilson • Shannon • Shields

• Thousands of drugs organized alphabetically

• Indexed by generic and trade drug names

• Complete IV drug information

PEARSON

PEARSON

www.pearsonhighered.com

PEARSON NURSE’S DRUG GUIDE 2016 NURSES AGREE: Pearson Nurse’s Drug Guide provides all the information you need for safe, effective drug administration in any setting!

• Organized alphabetically and indexed by generic and trade drug names

• Dosages across the lifespan from neonate to older adults

• Dosage with adjustments for clinically relevant conditions

• Complete IV preparation and administration information

• Clinically relevant drug interactions with food, herbals, and other drugs

• Pharmacologic and therapeutic classifications for every drug

• Unique glossary of clinical conditions and their related signs and symptoms

• Prototype drugs for each drug classification

• NEW! Black box warnings throughout

Comprehensive Current Clinically Relevant

Available for your favorite

electronic device!

2016

Simplify your study time by using the resources included with this textbook at http://www.nursing.pearsonhighered.com

using your

Begin Thinking LIKE A NURSE

PEARSON RESOURCES

A00_BERM4362_10_SE_FEP.indd 4-5 04/12/14 8:14 PM

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Brief Contents UNIT 1 The Nature of Nursing 1 Chapter 1 Historical and Contemporary Nursing

Practice 2

Chapter 2 Evidence-Based Practice and Research in Nursing 26

Chapter 3 Nursing Theories and Conceptual Frameworks 37 Chapter 4 Legal Aspects of Nursing 47 Chapter 5 Values, Ethics, and Advocacy 73

UNIT 2 Contemporary Health Care 88 Chapter 6 Health Care Delivery Systems 89 Chapter 7 Community Nursing and Care Continuity 105 Chapter 8 Home Care 118 Chapter 9 Electronic Health Records and Information

Technology 129

UNIT 3 The Nursing Process 143 Chapter 10 Critical Thinking and Clinical Reasoning 144 Chapter 11 Assessing 155 Chapter 12 Diagnosing 175 Chapter 13 Planning 189 Chapter 14 Implementing and Evaluating 208 Chapter 15 Documenting and Reporting 221

UNIT 4 Health Beliefs and Practices 243 Chapter 16 Health Promotion 244 Chapter 17 Health, Wellness, and Illness 262 Chapter 18 Culturally Responsive Nursing Care 276 Chapter 19 Complementary and Alternative Healing

Modalities 295

UNIT 5 Life Span Development 311 Chapter 20 Concepts of Growth and Development 312 Chapter 21 Promoting Health from Conception Through

Adolescence 328

Chapter 22 Promoting Health in Young and Middle-Aged Adults 353 Chapter 23 Promoting Health in Older Adults 364 Chapter 24 Promoting Family Health 386

UNIT 6 Integral Aspects of Nursing 397 Chapter 25 Caring 398 Chapter 26 Communicating 411 Chapter 27 Teaching 438 Chapter 28 Leading, Managing, and Delegating 462

UNIT 7 Assessing Health 476 Chapter 29 Vital Signs 477 Chapter 30 Health Assessment 513

UNIT 8 Integral Components of Client Care 601 Chapter 31 Asepsis 602 Chapter 32 Safety 640 Chapter 33 Hygiene 669 Chapter 34 Diagnostic Testing 718 Chapter 35 Medications 750 Chapter 36 Skin Integrity and Wound Care 828 Chapter 37 Perioperative Nursing 865

UNIT 9 Promoting Psychosocial Health 903 Chapter 38 Sensory Perception 904 Chapter 39 Self-Concept 922 Chapter 40 Sexuality 934 Chapter 41 Spirituality 954 Chapter 42 Stress and Coping 972 Chapter 43 Loss, Grieving, and Death 989

UNIT 10 Promoting Physiological Health 1009 Chapter 44 Activity and Exercise 1010 Chapter 45 Sleep 1066 Chapter 46 Pain Management 1086 Chapter 47 Nutrition 1127 Chapter 48 Urinary Elimination 1174 Chapter 49 Fecal Elimination 1210 Chapter 50 Oxygenation 1241 Chapter 51 Circulation 1287 Chapter 52 Fluid, Electrolyte, and Acid–Base Balance 1308

Further enhance your Clinical Reasoning with the additional resources below. For more information and purchasing options visit www.mypearsonstore.com.

Break Through to improving results

MyNursingLab provides a guided learning path that is proven to help students synthesize vast amounts of information, guiding them from memorization to true understanding through application.

Thinking Like a Nurse in Clinical Thinking Like a Nurse for NCLEX-RN® Success

Align ed to

the

2013 NCL

EX-R N®

Test Plan

Clinical references across the nursing curriculum available.

Courses | Hello Instructors | Account | Help & Support

Course Home

Syllabus

Assignment Calendar

Course Content

eText

Class Preparation

Class Master

Submissions

Kozier and Erb’s Fundamentals of Nursing 10e

1 Historic and Contemporary Nursing Practice

2 Evidence-Based Practice and Research in Nursing

3 Nursing Theories and Conceptual Frameworks

4 Legal Aspects of Nursing

5 Values, Ethics, and Advocacy

6 Health Care Delivery Systems

7 The Nurse-Patient Relationship and Therapeutic Communication

8 Home Care

9 Electronic Health Records and Information Technology

10 Critical Thinking and Clinical Reasoning

11 Assessing

12 Diagnosing

13 Planning

14 Implementing and Evaluating

15 Documenting and Reporting

16 Health Promotion

Available for your favorite

electronic device!

NURSE’S DRUG GUIDE Wilson • Shannon • Shields

2016

NURSE’S DRUG GUIDE

Wilson • Shannon • Shields

• Thousands of drugs organized alphabetically

• Indexed by generic and trade drug names

• Complete IV drug information

PEARSON

PEARSON

www.pearsonhighered.com

PEARSON NURSE’S DRUG GUIDE 2016 NURSES AGREE: Pearson Nurse’s Drug Guide provides all the information you need for safe, effective drug administration in any setting!

• Organized alphabetically and indexed by generic and trade drug names

• Dosages across the lifespan from neonate to older adults

• Dosage with adjustments for clinically relevant conditions

• Complete IV preparation and administration information

• Clinically relevant drug interactions with food, herbals, and other drugs

• Pharmacologic and therapeutic classifications for every drug

• Unique glossary of clinical conditions and their related signs and symptoms

• Prototype drugs for each drug classification

• NEW! Black box warnings throughout

Comprehensive Current Clinically Relevant

Available for your favorite

electronic device!

2016

Simplify your study time by using the resources included with this textbook at http://www.nursing.pearsonhighered.com

using your

Begin Thinking LIKE A NURSE

PEARSON RESOURCES

A00_BERM4362_10_SE_FEP.indd 4-5 04/12/14 8:14 PM

# 153613 Cust: Pearson Au: Berman Pg. No. i Title: Kozier & Erb’s Fundamentals of Nursing 10e

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Audrey Berman, PhD, RN Professor

Dean, Nursing Samuel Merritt University

Oakland, California

Shirlee J. Snyder, EdD, RN Former Dean and Professor, Nursing

Nevada State College Henderson, Nevada

Geralyn Frandsen, EdD, RN Professor of Nursing Maryville University St. Louis, Missouri

TENTH EDITION

FUNDAMENTALS OF NURSING

KOZIER & ERB’S

Concepts, Process, and Practice

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Publisher: Julie Levin Alexander Executive Product Manager: Katrin Beacom Program Manager: Melissa Bashe Editorial Assistant: Kevin Wilson Development Editor: Teri Zak Project Manager: Michael Giacobbe Production Editor: Roxanne Klaas, S4Carlisle Publishing Services Manufacturing Buyer: Maura Zaldivar-Garcia Art Director/Cover and Interior Design: Maria Guglielmo Director of Marketing: David Gesell

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Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All rights reserved. Manufactured in the United States of America. This publication is protected by Copyright and permission should be obtained from the publisher prior to any prohibited reproduction, stor- age in a retrieval system, or transmission in any form or by any means, electronic, mechanical, photocopying, recording, or likewise. For information regarding permission(s), write to: Rights and Permissions Department, 221 River Street, Hoboken, New Jersey 07030.

Notice: Care has been taken to confirm the accuracy of information presented in this book. The authors, editors, and the publisher, how- ever, cannot accept any responsibility for errors or omissions or for consequences from application of the information in this book and make no warranty, express or implied, with respect to its contents.

The authors and publisher have exerted every effort to ensure that drug selections and dosages set forth in this text are in accord with cur- rent recommendations and practice at time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package inserts of all drugs for any change in indications of dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.

Library of Congress Cataloging-in-Publication Data Berman, Audrey, author. Kozier & Erb’s fundamentals of nursing : concepts, practice, and process / Audrey Berman, Shirlee Snyder, and Geralyn Frandsen.—Tenth edition. p. ; cm. Kozier and Erb’s fundamentals of nursing Fundamentals of nursing Includes bibliographical references and index. ISBN 978-0-13-397436-2—ISBN 0-13-397436-7 I. Snyder, Shirlee, author. II. Frandsen, Geralyn, author. III. Title. IV. Title: Kozier and Erb’s fundamentals of nursing. V. Title: Fundamentals of nursing. [DNLM: 1. Nursing Process. 2. Nursing Care. 3. Nursing Theory. WY 100] RT41 610.73—dc23 2014018545 10 9 8 7 6 5 4 3 2 1

ISBN-13: 978-0-13-397436-2 ISBN-10: 0-13-397436-7

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Dedication Audrey Berman dedicates this tenth edition to everyone who ever played a part in its creation: to Barbara Kozier and Glenora Erb who started it all and taught me the ropes; to the publishers, editors, faculty authors, contributors, reviewers, and adopters who improved every edition; to the students and their clients who made all the hard work worthwhile; and to all my family and colleagues who allowed me the time and space to make these books my scholarly contribution to the profession.

Shirlee Snyder dedicates this edition to her husband, Terry J. Schnitter, for his unconditional love and support; and to all of the nursing students and nurse educators she has worked with and learned from during her nursing career.

Geralyn Frandsen dedicates this edition to her husband and fellow nursing colleague Gary. He is always willing to answer questions and provide editorial support. She also dedicates this edition to her children Claire and Joe and future son-in-law, John Conroy.

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About the Authors Audrey Berman, PhD, RN A San Francisco Bay Area native, Audrey Berman received her BSN from the University of California–San Francisco and later returned to that campus to obtain her MS in physiological nursing and her PhD in nursing. Her dissertation was entitled Sailing a Course Through Chemotherapy: The Experience of Women with Breast Cancer. She worked in oncol- ogy at Samuel Merritt Hospital prior to

beginning her teaching career in the diploma program at Samuel Merritt Hospital School of Nursing in 1976. As a faculty member, she participated in the transition of that program into a baccalaureate degree and in the development of the master of science and doctor of nursing practice programs. Over the years, she has taught a variety of medical–surgical nursing courses in the prelicensure programs. She currently serves as the dean of nursing at Samuel Merritt University and is the 2014–2016 president of the California Association of Colleges of Nursing.

Dr. Berman has traveled extensively, visiting nursing and health care institutions in Australia, Botswana, Brazil, Germany, Israel, Japan, Korea, the Philippines, the Soviet Union, and Spain. She serves on the board of directors for the Bay Area Tumor Institute and the East Bay American Heart Association. She is a member of the American Nurses Association and Sigma Theta Tau and is a site visitor for the Commission on Collegiate Nursing Education. She has twice par- ticipated as an NCLEX-RN item writer for the National Council of State Boards of Nursing. She has presented locally, nationally, and internationally on topics related to nursing education, breast cancer, and technology in health care.

Dr. Berman authored the scripts for more than 35 nursing skills videotapes in the 1990s. She was a coauthor of the sixth, seventh, eighth, ninth, and tenth editions of Fundamentals of Nursing and the fifth, sixth, seventh, and eighth editions of Skills in Clinical Nursing.

Shirlee J. Snyder, EdD, RN Shirlee J. Snyder graduated from Columbia Hospital School of Nursing in Milwaukee, Wisconsin, and sub- sequently received a bachelor of sci- ence in nursing from the University of Wisconsin–Milwaukee. Because of an interest in cardiac nursing and teach- ing, she earned a master of science in nursing with a minor in cardiovascular

clinical specialist and teaching from the University of Alabama in Birmingham. A move to California resulted in becoming a faculty member at Samuel Merritt Hospital School of Nursing in Oakland, California. Shirlee was fortunate to be involved in the phasing out of the diploma and ADN programs and development of a baccalaureate

intercollegiate nursing program. She held numerous positions dur- ing her 15-year tenure at Samuel Merritt College, including curricu- lum coordinator, assistant director–instruction, dean of instruction, and associate dean of the Intercollegiate Nursing Program. She is an associate professor alumnus at Samuel Merritt College. Her interest and experiences in nursing education resulted in Shirlee obtaining a doctorate of education focused on curriculum and instruction from the University of San Francisco.

Dr. Snyder moved to Portland, Oregon, in 1990 and taught in the ADN program at Portland Community College for 8 years. During this teaching experience she presented locally and nationally on top- ics related to using multimedia in the classroom and promoting eth- nic and minority student success.

Another career opportunity in 1998 led her to the Community College of Southern Nevada in Las Vegas, Nevada, where Dr. Snyder was the nursing program director with responsibilities for the associ- ate degree and practical nursing programs for 5 years. During this time she coauthored the fifth edition of Kozier & Erb’sTechniques in Clinical Nursing with Audrey Berman.

In 2003, Dr. Snyder returned to baccalaureate nursing educa- tion. She embraced the opportunity to be one of the nursing faculty teaching the first nursing class in the baccalaureate nursing program at the first state college in Nevada, which opened in 2002. From 2008 to 2012, she was the dean of the School of Nursing at Nevada State College in Henderson, Nevada. She is currently retired.

Dr. Snyder enjoyed traveling to the Philippines (Manila and Cebu) in 2009 to present all-day seminars to approximately 5,000 nursing students and 200 nursing faculty. She is a member of the American Nurses Association and Sigma Theta Tau. She has been a site visitor for the National League for Nursing Accrediting Commission and the Northwest Association of Schools and Colleges.

Geralyn Frandsen, EdD, RN Geralyn Frandsen graduated in the last class from DePaul Hospital School of Nursing in St. Louis, Missouri. She earned a bachelor of science in nursing from Maryville College. She attended Southern Illinois University at Edwardsville, earn- ing a master of science degree in nursing with specializations in community health and nursing education. Upon completion,

she accepted a faculty position at her alma mater Maryville College, which has since been renamed Maryville University. In 2003 she com- pleted her doctorate in higher education and leadership at Saint Louis University. Her dissertation was Mentoring Nursing Faculty in Higher Education. Her review of literature was incorporated in the Maryville University Guide to Promotion and Tenure.

In service to the university, she has been a member and chair of the promotion and tenure committee for the past 10 years. She is a tenured full professor and currently serves as assistant director

iv

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Point and My Nursing Lab. This is an online resource to assist stu- dents in reviewing content in their nursing fundamentals course. She has authored both the Nursing Fundamentals: Pearson Reviews and Rationales and, in 2007, Pharmacology Reviews and Rationales.

Dr. Frandsen has completed the End-of-Life Nursing Education Consortium train-the-trainer courses for advanced practice nurses and the doctorate of nursing practice. She is passionate about end-of- life care and teaches a course to her undergraduate students. She also teaches undergraduate pharmacology and advanced pharmacothera- peutics. Her advanced pharmacotherapeutics class is taught at the university and online. Dr. Frandsen is a member of Sigma Theta Tau International, the American Nurses’ Association, and serves as a site visitor for the Commission on Collegiate Nursing Education.

of the Catherine McCauley School of Nursing at Maryville. When educating undergraduate and graduate students, she utilizes a variety of teaching strategies to engage her students. When teaching under- graduate pharmacology she utilizes a team teaching approach, plac- ing students in groups to review content. Each student is also required to bring a completed ticket to class covering the content to be taught. The practice of bringing a ticket to class was introduced to her by Dr. Em Bevis, who is famous for the Toward a Caring Curriculum.

Dr. Frandsen has authored textbooks in pharmacology and nursing fundamentals. In the ninth edition of Kozier & Erb’s Fundamentals of Nursing she contributed the chapters on Safety, Diagnostic Testing, Medications, Perioperative Nursing, and Fecal Elimination. In 2013 she was the fundamentals contributor for Ready

About the Authors v

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We wish to extend a sincere thank you to the talented team involved in the tenth edition of this book: the contributors and reviewers who provide content and very helpful feedback; the nursing students, for their questioning minds and motivation; and the nursing instructors, who provided many valuable suggestions for this edition.

We would like to thank the editorial team, especially Kelly Trakalo, executive acquisitions editor, for her continual support, Melissa Bashe, Program Manager, Pearson Nursing, and most of all Teri Zak, development editor, for keeping our noses to the grind-

stone and especially for her dedication and attention to detail that promoted an excellent outcome once again. Many thanks to the pro- duction team of Michael Giaccobe, production liaison, and Roxanne Klaas, production editor, for producing this book with precision, and to the design team led by Maria Siener and Maria Guglielmo, art directors, for providing a truly beautiful design for this textbook.

Audrey Berman Shirlee Snyder

Geralyn Frandsen

Acknowledgments

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Thank You

vii

We would like to extend our heartfelt thanks to our colleagues from schools of nursing across the country who have given their time generously to help us create this learning package. These individuals helped us develop this textbook and supplements by reviewing chapters, art, and media, and by answering a myriad of questions right up until the time of publication. Kozier & Erb’s Fundamentals of Nursing, Tenth Edition, has benefited immeasurably from their efforts, insights, suggestions, objections, encouragement, and inspiration, as well as from their vast experience as teachers and nurses. Thank you again for helping us set the foundation for nursing excellence.

Contributors to the Tenth Edition Sherrilyn Coffman, PhD, RN Professor, Associate Dean Nevada State College Chapter 25: Caring

Elizabeth Johnston Taylor, PhD, RN Associate Professor, Loma Linda University Research Director, Mary Potter Hospice Wellington South, New Zealand Chapter 41: Spirituality

Reviewers of the Tenth Edition Mary Anderson, RN, MSN Chicago State University Chicago, IL

Kathy Anglin, MSN, RN Texarkana College Texarkana, TX

Barbara Celia, EdD, RN Drexel University Philadelphia, PA

Sarah Dempsey, MSN, RN Maryville University St. Louis, MO

Mary Ann Gaster, MEd, MSN Central Carolina Community College Pittsboro, NC

Susan Growe, MSN, RN, OCN Nevada State College Henderson, NV

Helena Gunnell, MEd, BSN, RN Jones County Community College Ellisville, MS

Sandy Gustafson, MA, RN Hibbing Community College Hibbing, MN

Elizabeth Long, DNP, APRN, GNP-BC Lamar University Beaumont, TX

Colleen Marzilli, DNP, MBA, RN University of Texas at Tyler Tyler, TX

Florence Miller, MSN, MPH Chicago State University Chicago, IL

Sharon M. Nowak, MSN Jackson College Jackson, MI

Martha Olson MSN, MS, RN Iowa Lakes Community College Emmetsburg, Iowa

Laura Warner, MSN, RN Ivy Tech Community College Greenfield, IN

Cindy Zeller, MSN, CPNP Frederick Community College Frederick, MD

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The practice of nursing continues to evolve . . . the practice of caring is timeless.

Nurses today must grow and evolve to meet the demands of a dramatically changing health care system. They need skills in sci- ence, technology, communication, and interpersonal relations to be effective members of the collaborative health care team. They need to think critically and be creative in implementing nursing strate- gies to provide safe and competent nursing care for clients of diverse cultural backgrounds in increasingly varied settings. They need skills in teaching, leading, managing, and the process of change. They need to be prepared to provide home- and community-based nursing care to clients across the life span—especially to the increasing numbers of older adults. They need to understand legal and ethical principles, holistic healing modalities, and complementary therapies. And, they need to continue their unique client advocacy role, which demands a blend of nurturance, sensitivity, caring, empathy, commitment, and skill founded on a broad base of knowledge.

Kozier & Erb’s Fundamentals of Nursing, Tenth Edition, addresses the concepts of contemporary professional nursing. These concepts include but are not limited to caring, wellness, health promotion, dis- ease prevention, holistic care, critical thinking and clinical reason- ing, multiculturalism, nursing theories, nursing informatics, nursing research, ethics, and advocacy. In this edition, every chapter has been reviewed and revised. The content has been updated to reflect the latest nursing evidence and the increasing emphasis on aging, wellness, safety, interprofessional practice, and home- and community-based care.

ORGANIZATION The detailed table of contents at the beginning of the book makes its clear organization easy to follow. Continuing with a strong focus on nursing care, the tenth edition of this book is divided into 10 units.

Unit 1, The Nature of Nursing, clusters five chapters that provide comprehensive coverage of introductory concepts of nursing.dawni
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Brief Contents UNIT 1 The Nature of Nursing 1 Chapter 1 Historical and Contemporary Nursing

Practice 2

Chapter 2 Evidence-Based Practice and Research in Nursing 26

Chapter 3 Nursing Theories and Conceptual Frameworks 37 Chapter 4 Legal Aspects of Nursing 47 Chapter 5 Values, Ethics, and Advocacy 73

UNIT 2 Contemporary Health Care 88 Chapter 6 Health Care Delivery Systems 89 Chapter 7 Community Nursing and Care Continuity 105 Chapter 8 Home Care 118 Chapter 9 Electronic Health Records and Information

Technology 129

UNIT 3 The Nursing Process 143 Chapter 10 Critical Thinking and Clinical Reasoning 144 Chapter 11 Assessing 155 Chapter 12 Diagnosing 175 Chapter 13 Planning 189 Chapter 14 Implementing and Evaluating 208 Chapter 15 Documenting and Reporting 221

UNIT 4 Health Beliefs and Practices 243 Chapter 16 Health Promotion 244 Chapter 17 Health, Wellness, and Illness 262 Chapter 18 Culturally Responsive Nursing Care 276 Chapter 19 Complementary and Alternative Healing

Modalities 295

UNIT 5 Life Span Development 311 Chapter 20 Concepts of Growth and Development 312 Chapter 21 Promoting Health from Conception Through

Adolescence 328

Chapter 22 Promoting Health in Young and Middle-Aged Adults 353 Chapter 23 Promoting Health in Older Adults 364 Chapter 24 Promoting Family Health 386

UNIT 6 Integral Aspects of Nursing 397 Chapter 25 Caring 398 Chapter 26 Communicating 411 Chapter 27 Teaching 438 Chapter 28 Leading, Managing, and Delegating 462

UNIT 7 Assessing Health 476 Chapter 29 Vital Signs 477 Chapter 30 Health Assessment 513

UNIT 8 Integral Components of Client Care 601 Chapter 31 Asepsis 602 Chapter 32 Safety 640 Chapter 33 Hygiene 669 Chapter 34 Diagnostic Testing 718 Chapter 35 Medications 750 Chapter 36 Skin Integrity and Wound Care 828 Chapter 37 Perioperative Nursing 865

UNIT 9 Promoting Psychosocial Health 903 Chapter 38 Sensory Perception 904 Chapter 39 Self-Concept 922 Chapter 40 Sexuality 934 Chapter 41 Spirituality 954 Chapter 42 Stress and Coping 972 Chapter 43 Loss, Grieving, and Death 989

UNIT 10 Promoting Physiological Health 1009 Chapter 44 Activity and Exercise 1010 Chapter 45 Sleep 1066 Chapter 46 Pain Management 1086 Chapter 47 Nutrition 1127 Chapter 48 Urinary Elimination 1174 Chapter 49 Fecal Elimination 1210 Chapter 50 Oxygenation 1241 Chapter 51 Circulation 1287 Chapter 52 Fluid, Electrolyte, and Acid–Base Balance 1308

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Kozier and Erb’s Fundamentals of Nursing 10e

1 Historic and Contemporary Nursing Practice

2 Evidence-Based Practice and Research in Nursing

3 Nursing Theories and Conceptual Frameworks

4 Legal Aspects of Nursing

5 Values, Ethics, and Advocacy

6 Health Care Delivery Systems

7 The Nurse-Patient Relationship and Therapeutic Communication

8 Home Care

9 Electronic Health Records and Information Technology

10 Critical Thinking and Clinical Reasoning

11 Assessing

12 Diagnosing

13 Planning

14 Implementing and Evaluating

15 Documenting and Reporting

16 Health Promotion

Available for your favorite

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2016

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PEARSON NURSE’S DRUG GUIDE 2016 NURSES AGREE: Pearson Nurse’s Drug Guide provides all the information you need for safe, effective drug administration in any setting!

• Organized alphabetically and indexed by generic and trade drug names

• Dosages across the lifespan from neonate to older adults

• Dosage with adjustments for clinically relevant conditions

• Complete IV preparation and administration information

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PEARSON RESOURCES

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Brief Contents UNIT 1 The Nature of Nursing 1 Chapter 1 Historical and Contemporary Nursing

Practice 2

Chapter 2 Evidence-Based Practice and Research in Nursing 26

Chapter 3 Nursing Theories and Conceptual Frameworks 37 Chapter 4 Legal Aspects of Nursing 47 Chapter 5 Values, Ethics, and Advocacy 73

UNIT 2 Contemporary Health Care 88 Chapter 6 Health Care Delivery Systems 89 Chapter 7 Community Nursing and Care Continuity 105 Chapter 8 Home Care 118 Chapter 9 Electronic Health Records and Information

Technology 129

UNIT 3 The Nursing Process 143 Chapter 10 Critical Thinking and Clinical Reasoning 144 Chapter 11 Assessing 155 Chapter 12 Diagnosing 175 Chapter 13 Planning 189 Chapter 14 Implementing and Evaluating 208 Chapter 15 Documenting and Reporting 221

UNIT 4 Health Beliefs and Practices 243 Chapter 16 Health Promotion 244 Chapter 17 Health, Wellness, and Illness 262 Chapter 18 Culturally Responsive Nursing Care 276 Chapter 19 Complementary and Alternative Healing

Modalities 295

UNIT 5 Life Span Development 311 Chapter 20 Concepts of Growth and Development 312 Chapter 21 Promoting Health from Conception Through

Adolescence 328

Chapter 22 Promoting Health in Young and Middle-Aged Adults 353 Chapter 23 Promoting Health in Older Adults 364 Chapter 24 Promoting Family Health 386

UNIT 6 Integral Aspects of Nursing 397 Chapter 25 Caring 398 Chapter 26 Communicating 411 Chapter 27 Teaching 438 Chapter 28 Leading, Managing, and Delegating 462

UNIT 7 Assessing Health 476 Chapter 29 Vital Signs 477 Chapter 30 Health Assessment 513

UNIT 8 Integral Components of Client Care 601 Chapter 31 Asepsis 602 Chapter 32 Safety 640 Chapter 33 Hygiene 669 Chapter 34 Diagnostic Testing 718 Chapter 35 Medications 750 Chapter 36 Skin Integrity and Wound Care 828 Chapter 37 Perioperative Nursing 865

UNIT 9 Promoting Psychosocial Health 903 Chapter 38 Sensory Perception 904 Chapter 39 Self-Concept 922 Chapter 40 Sexuality 934 Chapter 41 Spirituality 954 Chapter 42 Stress and Coping 972 Chapter 43 Loss, Grieving, and Death 989

UNIT 10 Promoting Physiological Health 1009 Chapter 44 Activity and Exercise 1010 Chapter 45 Sleep 1066 Chapter 46 Pain Management 1086 Chapter 47 Nutrition 1127 Chapter 48 Urinary Elimination 1174 Chapter 49 Fecal Elimination 1210 Chapter 50 Oxygenation 1241 Chapter 51 Circulation 1287 Chapter 52 Fluid, Electrolyte, and Acid–Base Balance 1308

Further enhance your Clinical Reasoning with the additional resources below. For more information and purchasing options visit www.mypearsonstore.com.

Break Through to improving results

MyNursingLab provides a guided learning path that is proven to help students synthesize vast amounts of information, guiding them from memorization to true understanding through application.

Thinking Like a Nurse in Clinical Thinking Like a Nurse for NCLEX-RN® Success

Align ed to

the

2013 NCL

EX-R N®

Test Plan

Clinical references across the nursing curriculum available.

Courses | Hello Instructors | Account | Help & Support

Course Home

Syllabus

Assignment Calendar

Course Content

eText

Class Preparation

Class Master

Submissions

Kozier and Erb’s Fundamentals of Nursing 10e

1 Historic and Contemporary Nursing Practice

2 Evidence-Based Practice and Research in Nursing

3 Nursing Theories and Conceptual Frameworks

4 Legal Aspects of Nursing

5 Values, Ethics, and Advocacy

6 Health Care Delivery Systems

7 The Nurse-Patient Relationship and Therapeutic Communication

8 Home Care

9 Electronic Health Records and Information Technology

10 Critical Thinking and Clinical Reasoning

11 Assessing

12 Diagnosing

13 Planning

14 Implementing and Evaluating

15 Documenting and Reporting

16 Health Promotion

Available for your favorite

electronic device!

NURSE’S DRUG GUIDE Wilson • Shannon • Shields

2016

NURSE’S DRUG GUIDE

Wilson • Shannon • Shields

• Thousands of drugs organized alphabetically

• Indexed by generic and trade drug names

• Complete IV drug information

PEARSON

PEARSON

www.pearsonhighered.com

PEARSON NURSE’S DRUG GUIDE 2016 NURSES AGREE: Pearson Nurse’s Drug Guide provides all the information you need for safe, effective drug administration in any setting!

• Organized alphabetically and indexed by generic and trade drug names

• Dosages across the lifespan from neonate to older adults

• Dosage with adjustments for clinically relevant conditions

• Complete IV preparation and administration information

• Clinically relevant drug interactions with food, herbals, and other drugs

• Pharmacologic and therapeutic classifications for every drug

• Unique glossary of clinical conditions and their related signs and symptoms

• Prototype drugs for each drug classification

• NEW! Black box warnings throughout

Comprehensive Current Clinically Relevant

Available for your favorite

electronic device!

2016

Simplify your study time by using the resources included with this textbook at http://www.nursing.pearsonhighered.com

using your

Begin Thinking LIKE A NURSE

PEARSON RESOURCES

A00_BERM4362_10_SE_FEP.indd 4-5 04/12/14 8:14 PM

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Audrey Berman, PhD, RN Professor

Dean, Nursing Samuel Merritt University

Oakland, California

Shirlee J. Snyder, EdD, RN Former Dean and Professor, Nursing

Nevada State College Henderson, Nevada

Geralyn Frandsen, EdD, RN Professor of Nursing Maryville University St. Louis, Missouri

TENTH EDITION

FUNDAMENTALS OF NURSING

KOZIER & ERB’S

Concepts, Process, and Practice

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Publisher: Julie Levin Alexander Executive Product Manager: Katrin Beacom Program Manager: Melissa Bashe Editorial Assistant: Kevin Wilson Development Editor: Teri Zak Project Manager: Michael Giacobbe Production Editor: Roxanne Klaas, S4Carlisle Publishing Services Manufacturing Buyer: Maura Zaldivar-Garcia Art Director/Cover and Interior Design: Maria Guglielmo Director of Marketing: David Gesell

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Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All rights reserved. Manufactured in the United States of America. This publication is protected by Copyright and permission should be obtained from the publisher prior to any prohibited reproduction, stor- age in a retrieval system, or transmission in any form or by any means, electronic, mechanical, photocopying, recording, or likewise. For information regarding permission(s), write to: Rights and Permissions Department, 221 River Street, Hoboken, New Jersey 07030.

Notice: Care has been taken to confirm the accuracy of information presented in this book. The authors, editors, and the publisher, how- ever, cannot accept any responsibility for errors or omissions or for consequences from application of the information in this book and make no warranty, express or implied, with respect to its contents.

The authors and publisher have exerted every effort to ensure that drug selections and dosages set forth in this text are in accord with cur- rent recommendations and practice at time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package inserts of all drugs for any change in indications of dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.

Library of Congress Cataloging-in-Publication Data Berman, Audrey, author. Kozier & Erb’s fundamentals of nursing : concepts, practice, and process / Audrey Berman, Shirlee Snyder, and Geralyn Frandsen.—Tenth edition. p. ; cm. Kozier and Erb’s fundamentals of nursing Fundamentals of nursing Includes bibliographical references and index. ISBN 978-0-13-397436-2—ISBN 0-13-397436-7 I. Snyder, Shirlee, author. II. Frandsen, Geralyn, author. III. Title. IV. Title: Kozier and Erb’s fundamentals of nursing. V. Title: Fundamentals of nursing. [DNLM: 1. Nursing Process. 2. Nursing Care. 3. Nursing Theory. WY 100] RT41 610.73—dc23 2014018545 10 9 8 7 6 5 4 3 2 1

ISBN-13: 978-0-13-397436-2 ISBN-10: 0-13-397436-7

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Dedication Audrey Berman dedicates this tenth edition to everyone who ever played a part in its creation: to Barbara Kozier and Glenora Erb who started it all and taught me the ropes; to the publishers, editors, faculty authors, contributors, reviewers, and adopters who improved every edition; to the students and their clients who made all the hard work worthwhile; and to all my family and colleagues who allowed me the time and space to make these books my scholarly contribution to the profession.

Shirlee Snyder dedicates this edition to her husband, Terry J. Schnitter, for his unconditional love and support; and to all of the nursing students and nurse educators she has worked with and learned from during her nursing career.

Geralyn Frandsen dedicates this edition to her husband and fellow nursing colleague Gary. He is always willing to answer questions and provide editorial support. She also dedicates this edition to her children Claire and Joe and future son-in-law, John Conroy.

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About the Authors Audrey Berman, PhD, RN A San Francisco Bay Area native, Audrey Berman received her BSN from the University of California–San Francisco and later returned to that campus to obtain her MS in physiological nursing and her PhD in nursing. Her dissertation was entitled Sailing a Course Through Chemotherapy: The Experience of Women with Breast Cancer. She worked in oncol- ogy at Samuel Merritt Hospital prior to

beginning her teaching career in the diploma program at Samuel Merritt Hospital School of Nursing in 1976. As a faculty member, she participated in the transition of that program into a baccalaureate degree and in the development of the master of science and doctor of nursing practice programs. Over the years, she has taught a variety of medical–surgical nursing courses in the prelicensure programs. She currently serves as the dean of nursing at Samuel Merritt University and is the 2014–2016 president of the California Association of Colleges of Nursing.

Dr. Berman has traveled extensively, visiting nursing and health care institutions in Australia, Botswana, Brazil, Germany, Israel, Japan, Korea, the Philippines, the Soviet Union, and Spain. She serves on the board of directors for the Bay Area Tumor Institute and the East Bay American Heart Association. She is a member of the American Nurses Association and Sigma Theta Tau and is a site visitor for the Commission on Collegiate Nursing Education. She has twice par- ticipated as an NCLEX-RN item writer for the National Council of State Boards of Nursing. She has presented locally, nationally, and internationally on topics related to nursing education, breast cancer, and technology in health care.

Dr. Berman authored the scripts for more than 35 nursing skills videotapes in the 1990s. She was a coauthor of the sixth, seventh, eighth, ninth, and tenth editions of Fundamentals of Nursing and the fifth, sixth, seventh, and eighth editions of Skills in Clinical Nursing.

Shirlee J. Snyder, EdD, RN Shirlee J. Snyder graduated from Columbia Hospital School of Nursing in Milwaukee, Wisconsin, and sub- sequently received a bachelor of sci- ence in nursing from the University of Wisconsin–Milwaukee. Because of an interest in cardiac nursing and teach- ing, she earned a master of science in nursing with a minor in cardiovascular

clinical specialist and teaching from the University of Alabama in Birmingham. A move to California resulted in becoming a faculty member at Samuel Merritt Hospital School of Nursing in Oakland, California. Shirlee was fortunate to be involved in the phasing out of the diploma and ADN programs and development of a baccalaureate

intercollegiate nursing program. She held numerous positions dur- ing her 15-year tenure at Samuel Merritt College, including curricu- lum coordinator, assistant director–instruction, dean of instruction, and associate dean of the Intercollegiate Nursing Program. She is an associate professor alumnus at Samuel Merritt College. Her interest and experiences in nursing education resulted in Shirlee obtaining a doctorate of education focused on curriculum and instruction from the University of San Francisco.

Dr. Snyder moved to Portland, Oregon, in 1990 and taught in the ADN program at Portland Community College for 8 years. During this teaching experience she presented locally and nationally on top- ics related to using multimedia in the classroom and promoting eth- nic and minority student success.

Another career opportunity in 1998 led her to the Community College of Southern Nevada in Las Vegas, Nevada, where Dr. Snyder was the nursing program director with responsibilities for the associ- ate degree and practical nursing programs for 5 years. During this time she coauthored the fifth edition of Kozier & Erb’sTechniques in Clinical Nursing with Audrey Berman.

In 2003, Dr. Snyder returned to baccalaureate nursing educa- tion. She embraced the opportunity to be one of the nursing faculty teaching the first nursing class in the baccalaureate nursing program at the first state college in Nevada, which opened in 2002. From 2008 to 2012, she was the dean of the School of Nursing at Nevada State College in Henderson, Nevada. She is currently retired.

Dr. Snyder enjoyed traveling to the Philippines (Manila and Cebu) in 2009 to present all-day seminars to approximately 5,000 nursing students and 200 nursing faculty. She is a member of the American Nurses Association and Sigma Theta Tau. She has been a site visitor for the National League for Nursing Accrediting Commission and the Northwest Association of Schools and Colleges.

Geralyn Frandsen, EdD, RN Geralyn Frandsen graduated in the last class from DePaul Hospital School of Nursing in St. Louis, Missouri. She earned a bachelor of science in nursing from Maryville College. She attended Southern Illinois University at Edwardsville, earn- ing a master of science degree in nursing with specializations in community health and nursing education. Upon completion,

she accepted a faculty position at her alma mater Maryville College, which has since been renamed Maryville University. In 2003 she com- pleted her doctorate in higher education and leadership at Saint Louis University. Her dissertation was Mentoring Nursing Faculty in Higher Education. Her review of literature was incorporated in the Maryville University Guide to Promotion and Tenure.

In service to the university, she has been a member and chair of the promotion and tenure committee for the past 10 years. She is a tenured full professor and currently serves as assistant director

iv

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Point and My Nursing Lab. This is an online resource to assist stu- dents in reviewing content in their nursing fundamentals course. She has authored both the Nursing Fundamentals: Pearson Reviews and Rationales and, in 2007, Pharmacology Reviews and Rationales.

Dr. Frandsen has completed the End-of-Life Nursing Education Consortium train-the-trainer courses for advanced practice nurses and the doctorate of nursing practice. She is passionate about end-of- life care and teaches a course to her undergraduate students. She also teaches undergraduate pharmacology and advanced pharmacothera- peutics. Her advanced pharmacotherapeutics class is taught at the university and online. Dr. Frandsen is a member of Sigma Theta Tau International, the American Nurses’ Association, and serves as a site visitor for the Commission on Collegiate Nursing Education.

of the Catherine McCauley School of Nursing at Maryville. When educating undergraduate and graduate students, she utilizes a variety of teaching strategies to engage her students. When teaching under- graduate pharmacology she utilizes a team teaching approach, plac- ing students in groups to review content. Each student is also required to bring a completed ticket to class covering the content to be taught. The practice of bringing a ticket to class was introduced to her by Dr. Em Bevis, who is famous for the Toward a Caring Curriculum.

Dr. Frandsen has authored textbooks in pharmacology and nursing fundamentals. In the ninth edition of Kozier & Erb’s Fundamentals of Nursing she contributed the chapters on Safety, Diagnostic Testing, Medications, Perioperative Nursing, and Fecal Elimination. In 2013 she was the fundamentals contributor for Ready

About the Authors v

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vi

We wish to extend a sincere thank you to the talented team involved in the tenth edition of this book: the contributors and reviewers who provide content and very helpful feedback; the nursing students, for their questioning minds and motivation; and the nursing instructors, who provided many valuable suggestions for this edition.

We would like to thank the editorial team, especially Kelly Trakalo, executive acquisitions editor, for her continual support, Melissa Bashe, Program Manager, Pearson Nursing, and most of all Teri Zak, development editor, for keeping our noses to the grind-

stone and especially for her dedication and attention to detail that promoted an excellent outcome once again. Many thanks to the pro- duction team of Michael Giaccobe, production liaison, and Roxanne Klaas, production editor, for producing this book with precision, and to the design team led by Maria Siener and Maria Guglielmo, art directors, for providing a truly beautiful design for this textbook.

Audrey Berman Shirlee Snyder

Geralyn Frandsen

Acknowledgments

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vii

Thank You

vii

We would like to extend our heartfelt thanks to our colleagues from schools of nursing across the country who have given their time generously to help us create this learning package. These individuals helped us develop this textbook and supplements by reviewing chapters, art, and media, and by answering a myriad of questions right up until the time of publication. Kozier & Erb’s Fundamentals of Nursing, Tenth Edition, has benefited immeasurably from their efforts, insights, suggestions, objections, encouragement, and inspiration, as well as from their vast experience as teachers and nurses. Thank you again for helping us set the foundation for nursing excellence.

Contributors to the Tenth Edition Sherrilyn Coffman, PhD, RN Professor, Associate Dean Nevada State College Chapter 25: Caring

Elizabeth Johnston Taylor, PhD, RN Associate Professor, Loma Linda University Research Director, Mary Potter Hospice Wellington South, New Zealand Chapter 41: Spirituality

Reviewers of the Tenth Edition Mary Anderson, RN, MSN Chicago State University Chicago, IL

Kathy Anglin, MSN, RN Texarkana College Texarkana, TX

Barbara Celia, EdD, RN Drexel University Philadelphia, PA

Sarah Dempsey, MSN, RN Maryville University St. Louis, MO

Mary Ann Gaster, MEd, MSN Central Carolina Community College Pittsboro, NC

Susan Growe, MSN, RN, OCN Nevada State College Henderson, NV

Helena Gunnell, MEd, BSN, RN Jones County Community College Ellisville, MS

Sandy Gustafson, MA, RN Hibbing Community College Hibbing, MN

Elizabeth Long, DNP, APRN, GNP-BC Lamar University Beaumont, TX

Colleen Marzilli, DNP, MBA, RN University of Texas at Tyler Tyler, TX

Florence Miller, MSN, MPH Chicago State University Chicago, IL

Sharon M. Nowak, MSN Jackson College Jackson, MI

Martha Olson MSN, MS, RN Iowa Lakes Community College Emmetsburg, Iowa

Laura Warner, MSN, RN Ivy Tech Community College Greenfield, IN

Cindy Zeller, MSN, CPNP Frederick Community College Frederick, MD

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viii

The practice of nursing continues to evolve . . . the practice of caring is timeless.

Nurses today must grow and evolve to meet the demands of a dramatically changing health care system. They need skills in sci- ence, technology, communication, and interpersonal relations to be effective members of the collaborative health care team. They need to think critically and be creative in implementing nursing strate- gies to provide safe and competent nursing care for clients of diverse cultural backgrounds in increasingly varied settings. They need skills in teaching, leading, managing, and the process of change. They need to be prepared to provide home- and community-based nursing care to clients across the life span—especially to the increasing numbers of older adults. They need to understand legal and ethical principles, holistic healing modalities, and complementary therapies. And, they need to continue their unique client advocacy role, which demands a blend of nurturance, sensitivity, caring, empathy, commitment, and skill founded on a broad base of knowledge.

Kozier & Erb’s Fundamentals of Nursing, Tenth Edition, addresses the concepts of contemporary professional nursing. These concepts include but are not limited to caring, wellness, health promotion, dis- ease prevention, holistic care, critical thinking and clinical reason- ing, multiculturalism, nursing theories, nursing informatics, nursing research, ethics, and advocacy. In this edition, every chapter has been reviewed and revised. The content has been updated to reflect the latest nursing evidence and the increasing emphasis on aging, wellness, safety, interprofessional practice, and home- and community-based care.

ORGANIZATION The detailed table of contents at the beginning of the book makes its clear organization easy to follow. Continuing with a strong focus on nursing care, the tenth edition of this book is divided into 10 units.

Unit 1, The Nature of Nursing, clusters five chapters that provide comprehensive coverage of introductory concepts of nursing.

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