Medical Surgical Nursing at a Glance 1st Edition by Ian Peate ISBN 9781118902653 1118902653

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ISBN 10: 1118902653
ISBN 13: 9781118902653
Author: Ian Peate

Medical Surgical Nursing at a Glance 1st Edition Table of contents:

Part 1 Nursing practice

1 What is Nursing?

Figure 1.1 Three definitions of nursing

Figure 1.2 Some elements associated with the role of the nurse

Defining nursing

The function of the nurse

Care giver

Communicator

Advocate

Teacher/health promoter

Change agent

Leader and manager

Researcher

The changing role of the nurse

2 The 6 Cs

Figure 2.1 The 6 Cs of nursing.

Compassion in practice

The 6 Cs

Care

Compassion

Competence

Communication

Courage

Commitment

Areas of action

3 Accountability and Responsibility

Table 3.1 The purpose of the Code

Table 3.2 The key facets of the Code

Figure 3.1 Four spheres of accountability

Statutory regulation

Nursing and Midwifery Council

The Code of Professional Conduct

Accountability

Public accountability

Accountability to the patient

Employer accountability

Accountability to the profession

4 Risk and Safety

Table 4.1 Resources available to help nurses manage risk and enhance patient safety

Table 4.2 An example of a Modified Early Warning System (there are various systems available)

Resources

Risk assessment tools

Early warning systems

Surgical safety checklist

5 Patient-Centred Care

Figure 5.1 Some components of patient-centred care

Table 5.1 Types of patient-centred care

Patient-centredness

Partnership working

Fundamental needs

People first

Working with others

6 Team Working

Table 6.1 Features of a team

Figure 6.1 Characteristics of an effective team

Principles underpinning team work

Characteristics of teams

Team values

Honesty

Discipline

Creativity

Humility

Curiosity

Barriers to effective team working

Conflict

Part 2 General care

7 Health Assessment

Figure 7.1 The nursing process

Table 7.1 Some assessment techniques

Figure 7.2 Abdominal palpation

Table 7.2 The SMART approach to goal setting

Health

Assessing needs

Health history

A systematic approach to care: the nursing process

Assessment

Nursing diagnosis

Planning

Implementation

Evaluation

8 Intravenous Therapy

Table 8.1 Types of vascular access device (VAD). These can be inserted peripherally or centrally

Figure 8.1 Intramuscular, intravenous and subcutaneous injections

Vascular access devices

The principles of care

Potential complications

Care issues

Fluid balance

9 Blood Transfusion

Figure 9.1 Blood groups

Figure 9.2 Barcodes used to reduce risk

The blood

Blood types

Alternatives to blood transfusion

Autologous blood

Need for transfusion

Transfusion safety

Fluid overload

Reducing transfusion errors

10 Nutrition

Figure 10.1 Chemical degradation

Figure 10.2 The eatwell plate

Table 10.1 Basic information required to make an assessment of nutritional needs

The role of the nurse

Malnutrition

Assessment

Assessment tools

Nutrients

The eatwell plate

11 Pain

Figure 11.1 Chronic pain

Table 11.1 Factors influencing pain

Table 11.2 The main changes associated with chronic pain

Figure 11.2 The analgesic ladder

Table 11.3 Routes of administration for analgesics

Pain receptors

Factors influencing pain

Types of pain

Acute pain

Chronic pain

Location of pain

Assessment of pain

Pain scales

Pain management

Pharmacological interventions

Non-pharmacological interventions

12 Infection Prevention and Control: I

Figure 12.1 The chain of infection

Figure 12.2 Five moments of hand washing

Figure 12.3 Hand washing technique

Table 12.1 The modes of transmission

Healthcare-associated infections

Hand hygiene

Transmission of infection

13 Infection Prevention and Control: II

Table 13.1 The modes of transmission

Table 13.2 The principles underpinning asepsis

Modes of transmission

Methods of reducing the spread of infection

Standard Precautions

Transmission-based precautions

Personal protective equipment

Sharps

Waste disposal

Spillage

Asepsis and aseptic technique

Indwelling devices

Part 3 Medical nursing

Immune system

14 HIV

Table 14.1 The signs and symptoms of late HIV

Figure 14.1 The main symptoms of acute HIV

Table 14.2 Risk factors associated with HIV

Human immunodeficiency virus

HIV risk factors

Signs and symptoms of HIV

Early stage

Late stage

HIV testing

Treatment

Postexposure prophylaxis

HIV prevention

Pre-exposure prophylaxis

15 Systemic Lupus Erythematosus

Figure 15.1 A range of symptoms associated with SLE

Table 15.1 SLE general manifestations

Table 15.2 A person may be classified as having lupus if 4 or more of the 11 criteria below are present

Systemic lupus erythematosus

Risk factors

Signs and symptoms

Investigations and diagnosis

Management and care

16 Irritable Bowel Syndrome

Figure 16.1 Irritable bowel syndrome

Figure 16.2 Areas of spasm associated with irritable bowel syndrome

Figure 16.3 Some signs and symptoms of irritable bowel syndrome

Signs and symptoms

Investigations and diagnosis

Care and management

Pharmacological and psychological interventions

Respiratory system

17 Asthma

Figure 17.1 Changes in the airways from asthma

Table 17.1 Key nursing actions

Table 17.2 Overview of bronchodilator therapies used for asthma

Causes of asthma

Signs and symptoms of acute asthma

Investigations and diagnosis

Care and management

Aftercare

18 Pulmonary Embolism

Figure 18.1 Pulmonary embolism

Table 18.1 Risk factors associated with pulmonary embolism

Table 18.2 Tests used in making a diagnosis of pulmonary embolism

Causes of pulmonary embolism

Signs and symptoms of pulmonary embolism

Investigations and diagnosis

Care and management

19 Pneumonia

Figure 19.1 Signs and symptoms of pneumonia (main symptoms in bold)

Signs and symptoms

Investigations and diagnosis

Care and management

Prevention

Haematology

20 Iron Deficiency Anaemia

Table 20.1 Classifications of anaemia

Figure 20.1 Signs and symptoms of IDA

Table 20.2 Other possible investigations needed to confirm the cause of IDA

Iron deficiency anaemia

Signs and symptoms

Investigations and diagnosis

Care and management

21 Thrombocytopenia

Figure 21.1 Components of platelet plug formation

Figure 21.2 Blood clot

Thrombocytopenia

Causes of thrombocytopenia

Signs and symptoms

Investigations and diagnosis

Care and management

22 Leukaemia

Figure 22.1 Signs and symptoms of leukaemia

Table 22.1 Four general classifications of leukaemia

Table 22.2 Investigations and tests

Table 22.3 Key nursing considerations

Leukaemia

Risk factors for leukaemia

Signs and symptoms

Investigations and diagnosis

Care and management

Cardiovascular system

23 Myocardial Infarction

Figure 23.1 Signs and symptoms of acute myocardial infarction (women)

Figure 23.2 Typical distribution of referred pain

Table 23.1 The PQRST mnemonic for assessing chest pain

Myocardial infarction

Signs and symptoms

Investigations and diagnosis

Care and management

24 Heart Failure

Figure 24.1 Signs and symptoms of heart failure

Table 24.1 Categories of heart failure

Table 24.2 Severity of heart failure – New York Heart Association (NYHA) Functional Classification

Heart failure

Causes of heart failure

Signs and symptoms (Figure 24.1)

Investigations and diagnosis

Care and management

25 Angina

Table 25.1 Types of angina

Table 25.2 Severity of angina graded by the degree to which the condition limits activities

Figure 25.1 Angina

Figure 25.2 Insertion of stent to improve cardiac blood flow

Signs and symptoms

Investigations and diagnosis

Care and management

Health promotion

Neurological system

26 Meningitis

Figure 26.1 Signs and symptoms of meningitis

Figure 26.2 Lumbar puncture

Meningococcal disease

Bacterial meningitis

Viral meningitis

Investigations and diagnosis

27 Subarachnoid Haemorrhage

Figure 27.1 Subarachnoid haemorrhage

Table 27.1 Some neurological deficits associated with brain injury

Subarachnoid haemorrhage

Risk factors associated with subarachnoid haemorrhage

Signs and symptoms

Investigations and diagnosis

Care and management

28 Epilepsy

Table 28.1 Generalised seizures: descriptions

Epilepsy

Signs and symptoms

Classification of epilepsy

Focal or partial seizures

Generalised seizures

Status epilepticus

Non-epileptic seizures

Investigations and diagnosis

Treatment and care

Gastrointestinal system

29 Gastro-oesophageal Reflux Disease

Figure 29.1 Signs and symptoms of GORD

Table 29.1 Recommended lifestyle changes

Figure 29.2 Gastroscopy

Gastro-oesophageal reflux disease

Signs and symptoms

Investigations and diagnosis

Treatment and care

Referral for endoscopy

Lifestyle

30 Diverticular Disease

Figure 30.1 Diverticular disease

Figure 30.2 Colonoscopy

Diverticulosis

Diverticular bleeding

Diverticulitis

Risk factors associated with diverticular disease

Signs and symptoms

Investigations and diagnosis

Care and management

31 Constipation

Figure 31.1 Constipation

Table 31.1 Some causes of constipation

Table 31.2 Some drugs used in the treatment of constipation

Constipation

Signs and symptoms

Investigations and diagnosis

Care and treatment

Promoting health

Musculoskeletal system

32 Osteoporosis

Table 32.1 Causes of osteoporosis

Figure 32.1 Normal and osteoporotic spine

Table 32.2 Some investigations used to diagnose osteoporosis

Osteoporosis

Risk features for osteoporosis

Signs and symptoms

Investigations and diagnosis

Care and treatment

33 Gout

Figure 33.1 Gout

Table 33.1 Risk factors for gout

Figure 33.2 Risk foods and joints affected

Classification and risk factors

Signs and symptoms

Investigations and diagnosis

Care and treatment

34 Rheumatoid Arthritis

Figure 34.1 Rheumatoid arthritis: joints affected

Table 34.1 Some localised symptoms

Table 34.2 Other features of the condition

Table 34.3 Some treatment options

Rheumatoid arthritis

Signs and symptoms

Investigations and diagnosis

Care and treatment

Endocrine system

35 Diabetes Mellitus

Table 35.1 Some of the types of diabetes mellitus

Table 35.2 Risk factors for diabetes

Table 35.3 Components of a plan of care

Type 1 diabetes mellitus

Type 2 diabetes mellitus

Signs and symptoms

Investigations and diagnosis

Treatment and care

36 Thyrotoxicosis

Figure 36.1 Signs and symptoms of thyrotoxicosis

Table 36.1 Classic signs and symptoms of thyrotoxicosis

Thyroid gland

Risk factors

Signs and symptoms

Investigations and diagnosis

Care and treatment

Medications

Radioactive iodine

Surgery

Reproductive system

37 Erectile Dysfunction

Table 37.1 Some causes of ED

Table 37.2 Investigations for ED

Table 37.3 Psychogenic and organic causes of ED

Figure 37.1 Model of vascular events controlling erection

Erectile dysfunction

Erection

Risk factors and causes of erectile dysfunction

Signs and symptoms

Investigations and diagnosis

Care and treatment

38 Chlamydia

Figure 38.1 The impact of chlamydia on the female reproductive system

Table 38.1 Female and male symptoms

Table 38.2 Other symptoms that may be suggestive of chlamyidal infection in both sexes

Table 38.3 Female and male signs

Chlamydia

Risk factors

Signs and symptoms

Investigations and diagnosis

Care and treatment

39 Dysmenorrhoea

Figure 39.1 Typical sites of pain associated with dysmenorrhoea

Table 39.1 Some menstrual terms and conditions

Table 39.2 Medical conditions associated with increased risk

Table 39.3 Details of comprehensive history

Dysmenorrhoea

Classification

Primary dysmenorrhoea

Secondary dysmenorrhoea

Risk factors

Signs and symptoms

Investigations and diagnosis

Care and treatment

The skin

40 Eczema

Figure 40.1 Eczema

Table 40.1 Eczema triggers

Table 40.2 Signs and symptoms of atopic eczema

Table 40.3 A guide to the severity of eczema

Causes of atopic eczema

Impact of eczema

Signs and symptoms

Investigations and diagnosis

Care and treatment

41 Psoriasis

Figure 41.1 Psoriasis

Figure 41.2 Common sites of psoriasis

Figure 41.3 Penetration of UVA and UVB radiation

Psoriasis

Risk factors

Signs and symptoms

Investigations and diagnosis

Care and treatment

42 Skin Cancer

Table 42.1 The ABCDE of melanoma

Table 42.2 Assessing changes in moles (lesions)

Malignant melanoma

Risk factors

Signs and symptoms

Investigations and diagnosis

Care and treatment

Cancer

43 Lung Cancer

Figure 43.1 Types of cancer caused by smoking

Table 43.1 Benign and malignant tumours

Table 43.2 Classification

Lung cancers

Signs and symptoms

Investigations and diagnosis

Care and treatment

44 Cervical Cancer

Table 44.1 Stages of cervical cancer

Table 44.2 Signs and symptom of cervical cancer

Vaccination

Risk factors

Grading/staging cervical cancer

Signs and symptoms

Investigations and diagnosis

Care and treatment

45 Prostate Cancer

Table 45.1 Signs and symptoms of local, locally invasive and metastatic prostate disease

Table 45.2 Treatment options for prostate cancer

Epidemiology

Risk factors

Signs and symptoms

Investigations and diagnosis

Staging

Care and treatment

The senses

46 Glaucoma

Figure 46.1 Glaucoma

Table 46.1 Some ophthalmological examinations

Sight

Glaucoma

Signs and symptoms

Symptoms of open-angle glaucoma

Symptoms of closed-angle glaucoma

Investigations and diagnosis

Care and treatment

47 Conjunctivitis

Figure 47.1 Conjunctivitis

Figure 47.2 Test for visual acuity

Figure 47.3 Instillation of eye ointment

The conjunctiva

Conjunctivitis

Signs and symptoms

Investigations and diagnosis

Care and treatment

48 Age-Related Macular Degeneration

Figure 48.1 The eye showing the position of the macula

Figure 48.2 Normal macula and degenerated

Age-related macular degeneration (AMD)

Classification

Dry AMD

Wet AMD

Signs and symptoms

Investigations and diagnosis

Care and treatment

Part 4 Surgical nursing

Principles of care

49 Preoperative Care

Table 49.1 Types of surgery

Table 49.2 Types of surgery and degree of urgency along with the perceived degree of risk

Table 49.3 Information giving

Preoperative care

Anxiety

Information giving

Preoperative teaching

Preparing for surgery

Checklists

50 Perioperative Care

Table 50.1 Sample of patient care plan

Preoperative visiting

Perioperative care planning

Preoperative checks

The perioperative environment

The anaesthetic room

Intraoperative care

51 Postoperative Care

Table 51.1 Criteria to be met prior to a patient being discharged from the recovery room

Table 51.2 The six physiological parameters associated with the National Early Warning Score (NEWS)

Table 51.3 Issues the nurse must take into consideration prior to discharging the patient from the recovery room to the ward

Postoperative care

Immediate postoperative care

National Early Warning Score

Respiratory system

52 Thoracotomy

Figure 52.1 Types of lung surgery

Table 52.1 Some types of thoracotomy

Surgery of the lung

Lung biopsy

Wedge resection

Metastasectomy

Segmentectomy

Lobectomy

Sleeve resection

Pneumonectomy

Video-assisted thoracoscopy (VATS)

Sternotomy

Risk factors

Preoperative care

Postoperative care

53 Chest Drain

Table 53.1 Indications for chest drain insertion

Figure 53.1 The pleural space

Figure 53.2 A chest tube

Figure 53.3 Underwater seal drainage

The pleural space

Ventilation

Chest tube (Figure 53.2)

Underwater seal drainage

Care and management

Removal of the chest drain

Aftercare

Haematology

54 Stem Cell Transplantation

Figure 54.1 Haematopoiesis

Figure 54.2 Stem cell transplant

Stem cells

Autologous and allogeneic transplantation

Bone marrow transplantation

Stem cell transplant

Care and management

55 Splenectomy

Figure 55.1 The location of the abdominal organs

Table 55.1 Functions of the spleen

The spleen

Splenectomy

Incision

Care and management

Cardiovascular system

56 Coronary Artery Bypass Graft

Figure 56.1 Coronary artery bypass graft

Table 56.1 Potential complications

Preoperative care

Postoperative care

Discharge

57 Cardiac Valve Surgery

Figure 57.1 Valve replacement

Figure 57.2 Insertion of stent to improve cardiac blood flow

Valvular heart disease

Causes of valvular heart disease

Treatment options

Surgical approaches

Postoperative care

Anticoagulants

58 Varicose Veins

Figure 58.1 Varicose veins

Figure 58.2 Veins of the legs prone to varicosity

Risk factors

Signs and symptoms

Investigations and diagnosis

Care and treatment

Neurological system

59 Craniotomy

Figure 59.1 Craniotomy

Table 59.1 Some indications for craniotomy

Figure 59.2 The protective coverings of the brain

Indications

Preoperative preparation

Potential postoperative complications

Postoperative nursing care

60 Neurosurgical Clipping

Figure 60.1 Clipping of an aneurysm

Figure 60.2 Aneurysms of the brain

Aneurysm

Signs and symptoms

Causes

Diagnosis

Types of aneurysm

Treatment

Postoperative care and recovery

Gastrointestinal system

61 Appendicectomy

Figure 61.1 Appendicitis

Figure 61.2 The risk of developing appendicitis with age

The appendix

Appendicitis

Signs and symptoms

Investigations and diagnosis

Care and treatment

Postoperative care

62 Right-sided Hemicolectomy

Figure 62.1 The large bowel

Figure 62.2 Right sided hemi colectomy

The large bowel

Colonic surgery

Preoperative care

Postoperative care

Potential postoperative complications

63 Bariatric Surgery

Figure 63.1 Types of gastric bypass

Table 63.1 Other forms of gastric surgery

Types of surgery

Adjustable gastric banding

Gastric bypass (Roux-en-Y)

Sleeve gastrectomy

Biliopancreatic diversion

Potential complications

Recommendations

Musculoskeletal system

64 Arthroscopy

Figure 64.1 Arthroscopy

Figure 64.2 The meniscus and cruciate ligaments

The meniscus and cruciate ligaments

Meniscal injury of the knee

Making a diagnosis

Conservative management

Knee arthroscopy

Recovery and discharge

65 Lower Limb Amputation

Figure 65.1 Levels of lower limb amputation

Table 65.1 Common level amputations

Table 65.2 Dressing types

Types of amputation

Amputation

Preoperative care

Postoperative care

66 Laminectomy

Figure 66.1 Conditions that may require laminectomy

Table 66.1 Types of back surgery

Back surgery

Lumbar laminectomy

Risks and complications

Preoperative care

Postoperative care

Endocrine system

67 Pituitary Surgery

Figure 67.1 The pituitary gland and the organs it acts on

Table 67.1 The hormones of the anterior and posterior pituitary gland

Figure 67.2 Transphenoidal surgery

Pituitary gland

Pituitary surgery

Transsphenoidal hypophysectomy

Preoperative preparation

Postoperative care

Discharge and follow-up

68 Thyroidectomy

Figure 68.1 Types of thyroid surgery

Figure 68.2 Laryngeal nerves and the thyroid gland

Disorders of the thyroid gland

Hyperthyroidism

Types of thyroid operations

Preoperative care

Potential postoperative complications

Postoperative care

Discharge and follow-up

69 Orchidectomy

Figure 69.1 orchidectomy

Types of orchidectomy

Simple orchiectomy

Subcapsular orchidectomy

Inguinal orchidectomy

Preoperative care

Postoperative care

Discharge and follow-up

Reproductive system

70 Vasectomy

Figure 70.1 Vasectomy

Types of vasectomy

Conventional vasectomy

No-scalpel vasectomy

Risks

Preoperative care

Postoperative care

Postvasectomy semen analysis

71 Dilation and curettage

Figure 71.1 The hysteroscope

Figure 71.2 Dilation and curettage

Dilation and curettage

Potential risks associated with D&C

Preoperative care

Postoperative care

72 Cone Biopsy

Figure 72.1 Cone biopsy

Cone biopsy

Potential risks associated with cone biopsy

Preoperative care

Postoperative care

Discharge advice

The skin

73 Burns

Table 73.1 Types of burn

Figure 73.1 The Rule of Nines

Types of burn

Classification of burns

Nursing care

74 Skin Grafts

Figure 74.1 Common sites of skin graft collection

Figure 74.2 A full thickness graft with vein and artery

Skin flaps

Flap classification

Blood supply

Tissue to be transferred

Location of donor site

Performing flap surgery

Postoperative care and discharge

75 Cosmetic and Plastic Surgery

Figure 75.1 Full abdominoplasty

Table 75.1 Some potential complications post abdominoplasty

Cosmetic surgery

Plastic surgery

Abdominoplasty

Full abdominoplasty

Mini abdominoplasty

Preoperative care

Postoperative care

The eyes and ears

76 Cataract

Table 76.1 Some changes in vision that can occur with cataracts

Figure 76.1 Normal lens (a) and lens affected by cataract (b)

Figure 76.2 Phacoemulsification

Treatment for cataract

Types of surgery

Phacoemulsification (small-incision surgery)

Standard extracapsular cataract extraction (ECCE)

Preoperative care

Postoperative care

77 Mastoidectomy

Table 77.1 Advice for those recovering from ear surgery

The mastoid

Indications for mastoidectomy

Preoperative care

Postoperative care

Potential complications following surgery

Facial nerve injury

Hearing loss

Vertigo

Change in taste

Vascular injury

Dural damage

Back Matter

Appendix 1: Normal Values

Haematology

White cell differential

Erythrocyte sedimentation rate

Plasma viscosity

Coagulation screen

Coagulation factors

Haematinics

Haemoglobin electrophoresis

Chemistry

Urine

Lipids and lipoproteins

Blood H+ 35–45 nmol/L

Immunology/rheumatology

Serum immunoglobins

Cerebrospinal fluid

Urine

Faeces

Appendix 2: Glossary of Terms

Further Reading

Index

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