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# 153613 Cust: Pearson Au: Berman Pg. No. e Title: Kozier & Erb’s Fundamentals of Nursing 10e
C/M/Y/K Short / Normal
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# 153613 Cust: Pearson Au: Berman Pg. No. d Title: Kozier & Erb’s Fundamentals of Nursing 10e
C/M/Y/K Short / Normal
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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.
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Thinking Like a Nurse in Clinical Thinking Like a Nurse for NCLEX-RN® Success
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EX-R N®
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Clinical references across the nursing curriculum available.
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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
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. e Title: Kozier & Erb’s Fundamentals of Nursing 10e
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# 153613 Cust: Pearson Au: Berman Pg. No. d Title: Kozier & Erb’s Fundamentals of Nursing 10e
C/M/Y/K Short / Normal
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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
C/M/Y/K Short / Normal
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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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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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The practice of nursing continues to evolve . . . the practice of caring is timeless.