PREFACE FOR THE SIXTH EDITION The practice of nursing continues to evolve . . . the practice of caring is timeless. Nurses today must be able to grow and evolve in order to meet the demands of a dramatically changing health care system. They need skills in communication and interpersonal relations to become effective members of a collaborative health care team. They need to think critically and be creative in implementing nursing strategies with clients of diverse cultural backgrounds in increasingly diverse 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. They need to understand holistic healing modalities and complementary therapies. And, they need to continue their unique role that demands a blend of nurturance, sensitivity, caring, empathy, commitment, and skill based on a broad base of knowledge. Fundamentals of Nursing: Concepts, Process, and Practice, Sixth Edition, addresses the concepts of contemporary professional nursing. These concepts include but are not limited to: caring, wellness, health promotion, disease prevention, holistic care, multiculturalism, nursing theories, nursing informatics, nursing research, ethics, and advocacy. With this edition, every chapter has been extensively revised. The content has been updated to reflect the latest nursing research and the increasing emphasis upon wellness and home- and community-based care. Many of the changes are in response to suggestions and comments from reviewers and nurses using the text. This text has been designed so that it can be used with a variety of nursing theories and conceptual frameworks. NEW FEATURES In this edition, we have added new chapters that address the latest nursing and health care trends, and have provided new features designed to enhance clinical skills. Five New Chapters Chapter 7: Community-Based Nursing and Care Continuity Chapter 8: Health Promotions Chapter 9: Home Care Chapter 10: Nursing Informatics Chapter 15: Holistic Health Modalities Critical Thinking Focus Thirty Focus on Critical Thinking boxes throughout the text present case studies followed by four to six questions designed to encourage the learner to apply critical thinking skills (eg, analyze, compare, contemplate, interpret, evaluate, etc.). These critical thinking activities can be used in classroom settings or in clinical conferences by instructors with students, by groups of students, or by the individual students. Because there are no discrete right or wrong answers to the critical thinking questions, Critical Thinking Possibilities are provided in Appendix A for each question. Integration of NIC and NOC Aspects of Nursing Interventions Classification (NIC) and Nursing Outcomes Classification (NOC) are addressed throughout the test. In Chapter 19, Planning, the Nursing Outcomes Classification and The Nursing Interventions Classification are explained, and two new tables outline the Domains and Classes of the NIC Taxonomy and provide an example of a Standardized Patient Outcome (Mobility Level) from NOC. Specific nursing interventions from NIC are suggested in the "Planning" sections of the clinical chapters as guides for planning care. In addition, NIC is integrated in the Nursing Care Plans that appear in several clinical chapters. Home Care Assessment Planning Guides The expansion in home health care delivery has emphasized the need for early discharge planning and continuity of care in the home. Home Care Assessment Guides provided in the "Planning" sections of the clinical chapters (Units 8, 9, and 10) direct the nurse to assess (a) the client: self-care abilities, level of knowledge, needs for assistive devices, and so on; (b) the family/caregiver: abilities and responses to assist the client; and (c) community resources available, such as home health agencies, support groups, and equipment and supply companies. Home Care Teaching Guides are also provided in the "Planning" sections of most clinical chapters. These guides are designed to help clients facilitate self-care, monitor problems, understand medication effects, perform prescribed therapies, and alter lifestyle patterns. Nursing Care Plans Thirteen new Nursing Care Plans appear in selected clinical chapters in this edition. These care plans provide assessment data, NANDA nursing diagnoses, client goals, desired outcomes, and nursing interventions relevant to the scenario presented. A new feature in these care plans is the use of nursing interventions and selected activities from the Nursing Intervention Classification (NIC). Procedures Each procedure in this edition contains a purpose statement, an assessment focus, a list of equipment, a list of step-by-step interventions describing how to perform the procedure, and an evaluation focus box. Also included are two new features: Lifespan Considerations and Home Care Considerations boxes. Critical Pathways The Critical Pathway concept is introduced in Chapter 6, Health Care Delivery Systems. Because many agencies develop their own critical pathways, only three pathways have been retained in this edition—in Chapters 6, 34, and 37. HALLMARK FEATURES This edition of Fundamentals of Nursing: Concepts, Process, and Practice retains many of the features that have been well received by users of this text, including:
Use of the nursing process as a framework for nursing care in all clinically oriented chapters. "Nursing Process In Action" feature—The client, Amanda Aquilini, is used as a frame of reference for applying content in all phases of the nursing process in Chapter 17, Assessing; Chapter 18, Diagnosing; Chapter 19, Planning; and Chapter 20, Implementing and Evaluating. Emphasis on wellness and the nurse's role in health promotion (Chapter 8, Health Promotion and Chapter 11, Health, Wellness, and Illness). Wellness Teaching Boxes—designed to help students focus on wellness information that helps clients live healthier lives. Clinical Guidelines Boxes—provide instant-access summaries of clinical do's and don'ts. Client Teaching Boxes—quick reference displays that focus on the client's learning needs. Updated nursing research notes that describe relevant studies and relate them to clinical practice. A detailed table of contents, glossary, and index to enhance use of the text. COMPLETE TEACHING/LEARNING PACKAGE To supplement the text and facilitate active student learning, we include a variety of student learning aids in our comprehensive supplements package. For the Student: NEW! Free Companion Web Site for nursing students includes online quizzing, chapter outlines, and Internet resources.NEW! Student Tutorial CD-ROM. This addition to the teaching/learning package is an interactive student program that contains NCLEX-style multiple-choice and fill-in questions. Students are able to test their knowledge and gain immediate feedback through rationales provided for both right and wrong answers. This CD-ROM is packaged with every copy of the text and is free to students. Clinical Companion. The Companion, revised by Karen Van Leuven, RN, PhD, includes pertinent information students can use in the clinical setting (assessment guides, safety information, medical terminology, and communication tips) and is packaged free with the text or may be purchased separately. Study Guide written by Karen Van Leuven, RN, PhD, reinforces the clinical application of key concepts presented in the text. It also offers various types of review questions and learning exercises. Procedures Supplement with Checklists. This supplement, compiled by Suzanne C. Beyea, RN, CS, PhD and revised by Sammie Justesen, RN, BSN, features approximately 80 additional procedures and includes checklists to document student progress. Checklists for Procedures in the Text. This tool lists key steps for the procedures in the text and can be used to help students evaluate their learning performance. Fluid and Electrolyte Module. This booklet, by Audrey J. Berman, PhD, RN, AOCN and Karen Van Leuven, RN, PhD, helps reinforce fluid and electrolyte balance concepts through case studies and application questions. For the Instructor: NEW! Instructor's Presentation CD-ROM. For lecture presentation purposes, this cross-platform CDROM includes illustrations from the text. Instructor's Guide by Audrey J. Berman, PhD, RN, AOCN; Sharon Shipton, RN, AS, BSN, MSN, PhD; and Heidi Ann Walker, RN, BSN. This time saving aid provides chapter outlines, objectives, discussion questions, suggestions, for audiovisual materials, and learning activities for classroom and clinical conferences. 1000-Item Test Bank by Audrey J. Berman, PhD, RN, AOCN; Rebecca Ball Griffin, RN, BS, MS; Allen Hamilton, RN, BSN, MS; and Dawna Martich, RN, BSN, MSN. Available in printed form or as computer software for IBM-compatible computers, this updated and revised test bank helps faculty quickly and easily create numerous unique examinations. Transparency Acetates. A set of full-color transparencies provide visual support for lectures. ACKNOWLEDGMENTS We wish to extend a sincere thank you to the talented team involved in the sixth edition of this book:
The contributors who provided content in their areas of expertise. They are listed on page iii. All of our reviewers, who provided so many helpful comments. They are listed on pages iv and v. The nursing students, for their questioning minds and motivation, and the nursing instructors, who provided many valuable suggestions for this edition. Virginia Simione Jutson, Project Editor, and Wendy Earl, Managing Editor. Their dedication, expertise, commitment to an excellent book, and good-natured support in launching this revision and carrying it through to completion is revealed in the final product. Stephanie Kellogg, Associate Editor, and Susan Teahan, Publishing Assistant, who always graciously provided help instantly when it was needed. David Rich, Production Coordinator. It was a privilege to work with Dave again on yet another revision. We appreciate his many qualities and talents—sunny disposition, flexibility, sense of humor, and the wealth of experience he brings to deal with the seemingly endless details associated with production. Anita Wagner, Copy Editor, not only because of her suggestions about syntax and style, but also because her inquiring nature provoked much thought about the clarity and consistency of content. The copy edit was exceptional. Bradley Burch, Art and Design Manager. We feel fortunate to have had Brad coordinating and working competently behind the scenes on another of our books. The cover designer, Yvo Riezebos Design; the interior designer, Andrew Ogus Design; and photographers Elena Dorfman and Jenny Thomas have provided a visually appealing book and confirm the saying that "one picture is worth a thousand words." Grace Wong, who coordinated the extensive supplement package. We feel fortunate to have had this package in such capable hands. Katherine Pitcoff, indexer, whose meticulous reading of each page and attention to detail is evident in the comprehensive index. Kristin Barendsen and Martha Ghent, proofreaders, whose detective's eye for detail while "proofing" the entire manuscript was invaluable. Mary Tobin, typist. We value her accommodating, congenial nature and help with this manuscript. Joan Andrews, Carole MacFarlane, and Linda Edge at the Registered Nurses Association of British Columbia, who located and provided the many reference materials we needed. Finally, we thank the staff at Addison Wesley Nursing for their many years of help for all six editions of this book. As authors we feel fortunate to have worked with you. We will miss your special interest, talents, and support. Barbara Kozier Glenora Erb Audrey Berman Karen Burke
--This text refers to an alternate
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edition.
by Suzanne CO'Connell Smeltzer
by Audrey J. Berman
by Shirlee Snyder
by Patricia A. Potter
