Delmar's Fundamental and Advanced Nursing Skills

CONTENTS......Page 6
Contributing Authors......Page 10
Reviewers......Page 12
Preface......Page 13
Acknowledgments......Page 18
About the Authors......Page 19
CHAPTER 1 • PHYSICAL ASSESSMENT......Page 21
1-1 Physical Assessment......Page 22
1-2 Taking a Temperature......Page 48
1-3 Taking a Pulse......Page 60
1-4 Counting Respirations......Page 67
1-5 Taking Blood Pressure......Page 73
1-6 Weighing a Client, Mobile and Immobile......Page 81
1-7 Measuring Intake and Output......Page 88
1-8 Breast Self-Examination......Page 94
1-9 Collecting a Clean-Catch, Midstream Urine Specimen......Page 102
1-10 Testing Urine for Specific Gravity, Ketones, Glucose, and Occult Blood......Page 109
1-11 Performing a Skin Puncture......Page 116
1-12 Measuring Blood Glucose Levels......Page 121
1-13 Collecting Nose, Throat, and Sputum Specimens......Page 128
1-14 Testing for Occult Blood with a Hemoccult Slide......Page 136
CHAPTER 2 • SAFETY AND INFECTION CONTROL......Page 141
2-1 Handwashing......Page 142
2-2 Proper Body Mechanics and Safe Lifting......Page 147
2-3 Assisting with Ambulation and Safe Falling......Page 157
2-4 Donning and Removing Clean and Contaminated Gowns and Gloves......Page 164
2-5 Donning a Cap and Mask......Page 170
2-6 Removing Contaminated Items......Page 175
2-7 Applying Sterile Gloves via the Open Method......Page 182
2-8 Surgical Scrub......Page 188
2-9 Applying Sterile Gloves and Gown via the Closed Method......Page 194
2-10 Applying Restraints......Page 199
2-11 Emergency Airway Management......Page 209
2-12 Administering Cardiopulmonary Resuscitation (CPR)......Page 215
2-13 Performing the Heimlich Maneuver......Page 229
2-14 Responding to Accidental Poisoning......Page 239
2-15 Emergency Client Transport......Page 244
CHAPTER 3 • PATIENT CARE AND COMFORT......Page 255
3-1 The Effective Communication Process......Page 256
3-2 Guided Imagery......Page 265
3-3 Progressive Muscle Relaxation......Page 271
3-4 Therapeutic Massage......Page 278
3-5 Applying Moist Heat......Page 284
3-6 Warm Soaks and Sitz Baths......Page 290
3-7 Applying Dry Heat......Page 295
3-8 Using a Thermal Blanket and an Infant Radiant Heat Warmer......Page 303
3-9 Applying Cold Treatment......Page 311
3-10 Assisting with a Transcutaneous Electrical Nerve Stimulation (TENS) Unit......Page 318
CHAPTER 4 • BASIC CARE......Page 327
4-1 Changing Linens in an Unoccupied Bed......Page 328
4-2 Changing Linens in an Occupied Bed......Page 336
4-3 Turning and Positioning a Client......Page 342
4-4 Moving a Client in Bed......Page 350
4-5 Assisting with a Bedpan or Urinal......Page 357
4-6 Assisting with Feeding......Page 364
4-7 Bathing a Client in Bed......Page 371
4-8 Oral Care......Page 378
4-9 Perineal and Genital Care......Page 388
4-10 Eye Care......Page 394
4-11 Hair and Scalp Care......Page 402
4-12 Hand and Foot Care......Page 410
4-13 Shaving a Client......Page 418
4-14 Giving a Back Rub......Page 424
4-15 Changing the IV Gown......Page 429
4-16 Assisting from Bed to Stretcher......Page 435
4-17 Assisting from Bed to Wheelchair, Commode, or Chair......Page 441
4-18 Assisting from Bed to Walking......Page 447
4-19 Using a Hydraulic Lift......Page 454
4-20 Administering Preoperative Care......Page 461
4-21 Preparing a Surgical Site......Page 470
4-22 Assessing Immediate Postoperative Care......Page 479
4-23 Postoperative Exercise Instruction......Page 487
4-24 Administering Passive Range of Motion (ROM) Exercises......Page 495
4-25 Postmortem Care......Page 508
CHAPTER 5 • MEDICATION ADMINISTRATION......Page 515
5-1 Administering Oral, Sublingual, and Buccal Medications......Page 516
5-2 Administering Eye and Ear Medications......Page 524
5-3 Administering Skin/Topical Medications......Page 533
5-4 Administering Nasal Medications......Page 540
5-5 Administering Rectal Medications......Page 546
5-6 Administering Vaginal Medications......Page 552
5-7 Administering Nebulized Medications......Page 559
5-8 Administering an Intradermal Injection......Page 567
5-9 Administering a Subcutaneous Injection......Page 572
5-10 Administering an Intramuscular Injection......Page 578
5-11 Administering Medication via Z-track Injection......Page 584
5-12 Withdrawing Medication from a Vial......Page 590
5-13 Withdrawing Medication from an Ampoule......Page 596
5-14 Mixing Medications from Two Vials into One Syringe......Page 602
5-15 Preparing an IV Solution......Page 609
5-16 Adding Medications to an IV Solution......Page 615
5-17 Administering Medications via Secondary Administration Sets (Piggyback)......Page 621
5-18 Administering Medications via IV Bolus or IV Push......Page 628
5-19 Administering Medications via Volume-Control Sets......Page 634
5-20 Administering Medication via a Cartridge System......Page 640
5-21 Administering Patient-Controlled Analgesia (PCA)......Page 645
5-22 Administering Epidural Analgesia......Page 651
5-23 Managing Controlled Substances......Page 657
CHAPTER 6 • NUTRITION AND ELIMINATION......Page 665
6-1 Inserting and Maintaining a Nasogastric Tube......Page 666
6-2 Assessing Placement of a Large-Bore Feeding Tube......Page 674
6-3 Assessing Placement of a Small-Bore Feeding Tube......Page 680
6-4 Removing a Nasogastric Tube......Page 686
6-5 Feeding and Medicating via a Gastrostomy Tube......Page 692
6-6 Maintaining Gastrointestinal Suction Devices......Page 701
6-7 Applying a Condom Catheter......Page 707
6-8 Inserting an Indwelling Catheter: Male......Page 713
6-9 Inserting an Indwelling Catheter: Female......Page 721
6-10 Routine Catheter Care......Page 729
6-11 Obtaining a Residual Urine Specimen from an Indwelling Catheter......Page 733
6-12 Irrigating a Urinary Catheter......Page 737
6-13 Irrigating the Bladder Using a Closed-System Catheter......Page 744
6-14 Removing an Indwelling Catheter......Page 752
6-15 Catheterizing a Noncontinent Urinary Diversion......Page 757
6-16 Maintaining a Continent Urinary Diversion......Page 763
6-17 Pouching a Noncontinent Urinary Diversion......Page 769
6-18 Administering Peritoneal Dialysis......Page 774
6-19 Administering an Enema......Page 782
6-20 Digital Removal of Fecal Impaction......Page 795
6-21 Inserting a Rectal Tube......Page 801
6-22 Irrigating and Cleaning a Stoma......Page 806
6-23 Changing a Bowel Diversion Ostomy Appliance: Pouching a Stoma......Page 812
CHAPTER 7 • OXYGENATION......Page 819
7-1 Administering Oxygen Therapy......Page 820
7-2 Assisting a Client with Controlled Coughing and Deep Breathing......Page 829
7-3 Assisting a Client with an Incentive Spirometer......Page 834
7-4 Administering Pulmonary Therapy and Postural Drainage......Page 839
7-5 Administering Pulse Oximetry......Page 843
7-6 Measuring Peak Expiratory Flow Rates......Page 849
7-7 Administering Intermittent Positive-Pressure Breathing (IPPB)......Page 857
7-8 Assisting with Continuous Positive Airway Pressure (CPAP)......Page 863
7-9 Preparing the Chest Drainage System......Page 868
7-10 Maintaining the Chest Tube and Chest Drainage System......Page 878
7-11 Measuring the Output from a Chest Drainage System......Page 885
7-12 Obtaining a Specimen from a Chest Drainage System......Page 889
7-13 Removing a Chest Tube......Page 893
7-14 Ventilating the Client with an Ambu Bag......Page 898
7-15 Inserting the Pharyngeal Airway......Page 905
7-16 Maintaining Mechanical Ventilation......Page 910
7-17 Suctioning Endotracheal and Tracheal Tubes......Page 916
7-18 Maintaining and Cleaning Endotracheal Tubes......Page 923
7-19 Maintaining and Cleaning the Tracheostomy Tube......Page 929
7-20 Maintaining a Double Cannula Tracheostomy Tube......Page 935
7-21 Plugging the Tracheostomy Tube......Page 942
CHAPTER 8 • CIRCULATORY......Page 945
8-1 Performing Venipuncture (Blood Drawing)......Page 946
8-2 Starting an IV......Page 954
8-3 Inserting a Butterfly Needle......Page 961
8-4 Preparing the IV Bag and Tubing......Page 968
8-5 Setting the IV Flow Rate......Page 974
8-6 Assessing and Maintaining an IV Insertion Site......Page 980
8-7 Changing the IV Solution......Page 985
8-8 Discontinuing the IV and Changing to a Heparin Lock......Page 991
8-9 Administering a Blood Transfusion......Page 997
8-10 Assessing and Responding to Transfusion Reactions......Page 1005
8-11 Assisting with the Insertion of a Central Venous Catheter......Page 1011
8-12 Changing the Central Venous Dressing......Page 1017
8-13 Changing the Central Venous Tubing......Page 1023
8-14 Maintaining a Central Venous Catheter......Page 1028
8-15 Measuring Central Venous Pressure (CVP)......Page 1033
8-16 Drawing Blood from a Central Venous Catheter......Page 1040
8-17 Infusing Total Parenteral Nutrition (TPN) and Fat Emulsion through a Central Venous Catheter......Page 1046
8-18 Removing the Central Venous Catheter......Page 1055
8-19 Inserting a Peripherally Inserted Central Catheter (PICC)......Page 1060
8-20 Administering Peripheral Vein Total Parenteral Nutrition......Page 1069
8-21 Hemodialysis Site Care......Page 1076
8-22 Using an Implantable Venous Access Device......Page 1082
8-23 Caring for an Implanted Venous Access Device......Page 1089
8-24 Obtaining an Arterial Blood Gas Specimen......Page 1095
8-25 Assisting with the Insertion and Maintenance of an Epidural Catheter......Page 1101
CHAPTER 9 • SKIN INTEGRITY AND WOUND CARE......Page 1109
9-1 Bandaging......Page 1110
9-2 Applying a Dry Dressing......Page 1118
9-3 Applying a Wet-to-Damp Dressing (Wet to Dry to Moist Dressing)......Page 1124
9-4 Applying a Transparent Dressing......Page 1131
9-5 Applying a Pressure Bandage......Page 1136
9-6 Changing Dressings around Therapeutic Puncture Sites......Page 1142
9-7 Irrigating a Wound......Page 1151
9-8 Packing a Wound......Page 1156
9-9 Cleaning and Dressing a Wound with an Open Drain......Page 1164
9-10 Dressing a Wound with Retention Sutures......Page 1171
9-11 Obtaining a Wound Drainage Specimen for Culturing......Page 1178
9-12 Maintaining a Closed Wound Drainage System......Page 1183
9-13 Care of the Jackson-Pratt (JP) Drain Site and Emptying the Drain Bulb......Page 1189
9-14 Removing Skin Sutures and Staples......Page 1196
9-15 Preventing and Managing the Pressure Ulcer......Page 1203
9-16 Managing Irritated Peristomal Skin......Page 1213
9-17 Pouching a Draining Wound......Page 1219
CHAPTER 10 • IMMOBILIZATION AND SUPPORT......Page 1225
10-1 Applying an Elastic Bandage......Page 1226
10-2 Applying a Splint......Page 1232
10-3 Applying an Arm Sling......Page 1238
10-4 Applying Antiembolic Stockings......Page 1244
10-5 Applying a Pneumatic Compression Device......Page 1249
10-6 Applying Abdominal, T-, or Breast Binders......Page 1255
10-7 Applying Skin Traction—Adhesive and Nonadhesive......Page 1261
10-8 Assisting with the Insertion of Pins or Nails......Page 1268
10-9 Maintaining Traction......Page 1275
10-10 Assisting with Casting—Plaster and Fiberglass......Page 1281
10-11 Cast Care and Comfort......Page 1287
10-12 Cast Bivalving and Windowing......Page 1293
10-13 Cast Removal......Page 1298
10-14 Assisting with a Continuous Passive Motion Device......Page 1303
10-15 Assisting with Crutches, Cane, or Walker......Page 1309
CHAPTER 11 • SPECIAL PROCEDURE......Page 1319
11-1 Administering an Electrocardiogram......Page 1320
11-2 Magnetic Resonance Imaging (MRI)......Page 1326
11-3 Assisting with Computed Tomography (CT) Scanning......Page 1330
11-4 Assisting with a Liver Biopsy......Page 1335
11-5 Assisting with a Thoracentesis......Page 1342
11-6 Assisting with Abdominal Paracentesis......Page 1350
11-7 Assisting with a Bone Marrow Biopsy/Aspiration......Page 1356
11-8 Assisting with a Lumbar Puncture......Page 1363
11-9 Assisting with Amniocentesis......Page 1370
11-10 Assisting with Bronchoscopy......Page 1376
11-11 Assisting with Gastrointestinal Endoscopy......Page 1386
11-12 Assisting with a Proctosigmoidoscopy......Page 1396
11-13 Assisting with Arteriography......Page 1402
11-14 Positron-Emission Tomography Scanning......Page 1409
REFERENCES......Page 1415
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I......Page 1427
J......Page 1429
M......Page 1430
P......Page 1431
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T......Page 1434
W......Page 1435
Z......Page 1436