Assessment Made Incredibly Easy, 4th Edition

415 Pages·2008·15.84 MB·English

by  Springhouse

910300FM.qxd 8/26/08 14:10 Page vi
910300FM.qxd 08/30/2008 5:36 PM Page i
Assessment
yy
ll
bb
dii
d
ee
d e
a
mrr
c
c
n
n
I
I
!
!
yy
ss ®
aa
EE
910300FM.qxd 8/26/08 14:10 Page ii
Staff The clinical treatments described and recommended in this
publication are based on research and consultation with nurs-
ing, medical, and legal authorities. To the best of our knowl-
Executive Publisher edge, these procedures reflect currently accepted practice.
Judith A. Schilling McCann, RN, MSN Nevertheless, they can’t be considered absolute and universal
recommendations. For individual applications, all recommen-
Editorial Director
dations must be considered in light of the patient’s clinical con-
David Moreau dition and, before administration of new or infrequently used
drugs, in light of the latest package-insert information. The au-
Clinical Director
thors and publisher disclaim any responsibility for any adverse
Joan M. Robinson, RN, MSN effects resulting from the suggested procedures, from any un-
Art Director detected errors, or from the reader’s misunderstanding of the
text.
Mary Ludwicki
Electronic Project Manager © 2008 by Lippincott Williams & Wilkins. All rights reserved.
John Macalino This book is protected by copyright. No part of it may be repro-
duced, stored in a retrieval system, or transmitted, in any form
Senior Managing Editor or by any means—electronic, mechanical, photocopy, record-
Jaime Stockslager Buss, MSPH, ELS ing, or otherwise—without prior written permission of the pub-
lisher, except for brief quotations embodied in critical articles
Clinical Project Manager
and reviews and testing and evaluation materials provided by
Kate Stout, RN, MSN, CCRN publisher to instructors whose schools have adopted its ac-
companying textbook. Printed in the United States of America.
Editor
For information, write Lippincott Williams & Wilkins, 323 Norris-
Margaret Eckman
town Road, Suite 200, Ambler, PA 19002-2756.
Copy Editor
ASSESSIE4E010108
Dorothy P. Terry
Designer
Lynn Foulk Library of Congress Cataloging-in-Publication
Data
Illustrator
Assessment made incredibly easy!.—4th ed.
Bot Roda, Judy Newhouse, Betty Winnberg p. ; cm.
Includes bibliographical references and index.
Digital Composition Services 1. Nursing assessment--Handbooks, manuals,
Diane Paluba (manager), Joyce Rossi Biletz, etc. I. Lippincott Williams & Wilkins.
[DNLM: 1. Nursing Assessment—methods—
Donald G. Knauss, Donna S. Morris Handbooks. 2. Physical Examination—meth-
ods—Handbooks. WY 49 A846 2008]
Associate Manufacturing Manager RT48.A876 2008
Beth J. Welsh 616.07'5--dc22
ISBN-13: 978-0-7817-7910-4 (alk. paper)
Editorial Assistants ISBN-10: 0-7817-7910-3 (alk. paper) 2007037087
Karen J. Kirk, Jeri O’Shea, Linda K. Ruhf
Indexer
Barbara Hodgson
910300FM.qxd 8/26/08 14:10 Page iii
Contents
Contributors and consultants iv
Not another boring foreword v
Part I Beginning the assessment 1
1 Health history 3
2 Fundamental physical assessment techniques 23
3 Nutritional assessment 41
4 Mental health assessment 57
Part II Assessing body systems 73
5 Skin, hair, and nails 75
6 Neurologic system 103
7 Eyes 135
8 Ears, nose, and throat 159
9 Cardiovascular system 187
10 Respiratory system 221
11 Breasts and axillae 253
12 Gastrointestinal system 271
13 Female genitourinary system 295
14 Male genitourinary system 323
15 Musculoskeletal system 343
Appendices and index 369
Practice makes perfect 370
Glossary 396
Selected references 399
Credits 400
Index 401
iii
910300FM.qxd 8/26/08 14:10 Page iv
Contributors and consultants
Lillian Craig, RN, MSN, FNP-C Monica Narvaez Ramirez, RN, MSN,
Adjunct Faculty Nursing Instructor
Oklahoma Panhandle State University University of the Incarnate Word School of Nursing & Health
Goodwell, OK Professions
San Antonio, TX
Caroline Dorsen, MSN, APRN-BC, FNP
Coordinator, Adult Primary Care Program/Clinical Instructor Donna Scemons, RN, MSN, FNP-C, CNS, CWOCN
New York University College of Nursing President
New York, NY Healthcare Systems, Inc.
Castaic, CA
Valerie J. Flattes, MS, APRN, BC-ANP
Instructor, Clinical Bruce Austin Scott, MSN, APRN-BC
University of Utah College of Nursing Nursing Instructor
Salt Lake City, UT San Joaquin Delta College
Stockton, CA
Shirley Lyon Garcia, RN, BSN
Staff Nurse
Nursing Program Director, PNE
Marshall Medical Center
McDowell Technical Community College
Placerville, CA
Marion, NC
Janice Donaldson Hausauer, RN, MS, FNP Allison J. Terry, RN, MSN, PhD
Director, Center for Nursing
Adjunct Assistant Professor
Alabama Board of Nursing
Montana State University College of Nursing
Montgomery, AL
Bozeman, MT
Kathleen M. Lamaute, MA, MS, EdD, APRN-BC, CNAA-BC, FNP
Professor
South University
West Palm Beach, FL
iv
910300FM.qxd 8/26/08 14:10 Page v
Not another boring foreword
If you’re like me, you’re too busy to wade through a foreword that uses pretentious
terms and umpteen dull paragraphs to get to the point. So let’s cut right to the chase!
Here’s why this book is so terrific:
1. It will teach you all the important things you need to know about ECG interpretation.
(And it will leave out all the fluff that wastes your time.)
2. It will help you remember what you’ve learned.
3. It will make you smile as it enhances your knowledge and skills.
Don’t believe me? Try these recurring logos on for size:
Peak technique illustrates and describes the best ways to perform specific physical
examination techniques.
Bridging the gap explains cultural variables that may influence the health assessment.
Handle with care needs a description to replace this from ages and stages: pinpoints age-
related variations in assessment findings.
Interpretation station provides surefire guidelines for interpreting assessment findings
quickly and easily.
Memory jogger helps the reader remember important points.
See? I told you! And that’s not all. Look for me and my friends in the
margins throughout this book. We’ll be there to explain key concepts,
provide important care reminders, and offer reassurance. Oh, and if you
don’t mind, we’ll be spicing up the pages with a bit of humor along the
way, to teach and entertain in a way that no other resource can.
I hope you find this book helpful. Best of luck throughout
your career!
Joy
v
910300FM.qxd 8/26/08 14:10 Page vi
910301.qxd 8/26/08 12:32 Page 1
Part I Beginning the assessment
1 Health history 3
2 Fundamental physical assessment
techniques 23
3 Nutritional assessment 41
4 Mental health assessment 57
910301.qxd 8/26/08 12:32 Page 2