Essentials of Certified Nursing Assisting

Nursing assistants must be prepared to provide person-centered, individualized care. Essentials of Certified Nursing Assisting provides a foundation for the new nursing assistant to promote caregiver excellence and consumer satisfaction; it is designed to empower the nursing assistant so that she may offer quality care and increase quality of life while acknowledging new health care trends.

Essentials of Certified Nursing Assisting details care for not just the elderly population, but populations that are gender specific, age based, and setting specific to address the changing face of our health care delivery. Consumers of health care want to look at alternative health care options, they want their care to be individualized to meet their specific demands and needs, and they want quality in the product they are purchasing. This book addresses these themes in relation to the changing caregiving standards of the nursing assistant.

Essentials of Certified Nursing Assisting focuses on person-centered care while also including up-to-date information on skin care and pressure ulcer prevention from the National Pressure Ulcer Advisory Panel, infection control practices from the Centers for Disease Control (CDC) and the World Health Organization (WHO), dementia care techniques from the Alzheimer’s Association, and person-centered bathing interventions to reduce anxiety in clients with dementia from the authors of Bathing without a Battle®. Comprehensive step-by-step skills will assist your students throughout their coursework. A chapter devoted to medications as applied to the role and scope of practice of the nursing assistant, fulfilling the Wisconsin Department of Health Services nurse aide training requirement, is included within the textbook. An accompanying workbook helps the nursing assistant student synthesize the new knowledge with various application-level exercises. Instructor resources including classroom activities, PowerPoints, and a 380-question test bank are available upon request.

Table of Contents

  1. A Note to Nursing Assistant Instructors xx
  2. A Note to the Reader xxi
  3. Acknowledgments xxii
  4. About the Author xxiii
  5. Chapter 1: The History of Healthcare in the United States 3
    1. LO 1.1 A Brief History of Healthcare in the United States 4
    2. LO 1.2 The Beginning of Modern Healthcare 5
      1. The Modernization of Medicine 6
    3. LO 1.3 The Cost of Healthcare 7
    4. LO 1.4 Healthcare Today 9
    5. Summary of Learning Outcomes 11
    6. Get Up and Think! 11
    7. Reflect on This! 12
    8. Let’s Review! 12
    9. Multiple Choice Questions 12
    10. References 13
  6. Chapter 2: Responding to Emerging Trends in Healthcare 15
    1. LO 2.1 Who Is Your Client? 16
    2. LO 2.2 Consumerism in America 16
    3. LO 2.3 Home Healthcare Versus Facility Care 18
    4. LO 2.4 Alternative Therapies 20
    5. LO 2.5 Why the Nursing Assistant Needs to Know These Trends 21
    6. Summary of Learning Outcomes 23
    7. Get Up and Think! 23
    8. Reflect on This! 24
    9. Let’s Review! 24
    10. Multiple Choice Questions 24
    11. References 25
  7. Chapter 3: Healthcare Settings and Governance 27
    1. LOs 3.1–3.4 Work Settings for the Nursing Assistant 28
      1. Acute Care Settings 28
      2. Subacute or Rehabilitation Facility 30
      3. Long-Term Care 31
      4. Assisted-Living Communities 32
      5. Home Healthcare 33
      6. Hospice Services 34
      7. Respite Services 35
    2. LO 3.5 Advanced Training and Opportunities 36
    3. Summary of Learning Outcomes 37
    4. Get Up and Think! 38
    5. Reflect on This! 38
    6. Let’s Review! 38
    7. Multiple Choice Questions 39
  8. Chapter 4: The Nursing Assistant Role and Scope of Practice 41
    1. LO 4.1 Members of the Healthcare Team 42
    2. LO 4.2 Scope of Practice for the Nursing Assistant 43
    3. LO 4.3 Chain of Command 44
    4. LO 4.4 Delegated Tasks 45
    5. LO 4.5 Teaching Versus Reinforcing 47
    6. LO 4.6 Time Management and Organization 48
    7. Summary of Learning Outcomes 48
    8. Get Up and Think! 49
    9. Reflect on This! 49
    10. Let’s Review! 50
    11. Multiple Choice Questions 50
    12. Reference 51
  9. Chapter 5: Communication 53
    1. Communication in Healthcare 54
    2. LO 5.1 Causes of Medical Errors 54
    3. LO 5.2 Subjective Versus Objective Data 56
    4. LO 5.3 Oral Reporting 58
    5. LO 5.4 Written Documentation and the Nursing Assistant 58
    6. LO 5.5 Verbal Versus Nonverbal Communication 62
      1. Verbal Communication 62
      2. Nonverbal Communication 63
    7. LO 5.6 Therapeutic Communication 64
    8. LO 5.7 Confrontational Situations 66
    9. Summary of Learning Outcomes 67
    10. Get Up and Think! 67
    11. Reflect on This! 68
    12. Let’s Review! 68
    13. Multiple Choice Questions 68
    14. Reference 69
  10. Chapter 6: Professionalism in Healthcare 71
    1. LO 6.1 Education and Certification 72
      1. Nurse Aide Registry 72
      2. Continuing Education 73
    2. LO 6.2 Job Searching 73
      1. Applications 74
      2. Resume 75
    3. LO 6.3 Interviewing 78
    4. LO 6.4 Accepting and Resigning From a Position 79
    5. LO 6.5 Acting Like a Professional 80
      1. Dependability 80
      2. Promptness 80
      3. Customer Service 80
      4. Flexibility 81
      5. Hygiene 81
    6. Summary of Learning Outcomes 83
    7. Get Up and Think! 83
    8. Reflect on This! 84
    9. Let’s Review! 84
    10. Multiple Choice Questions 85
  11. Chapter 7: Legal and Ethical Issues 87
    1. LO 7.1 Client Rights 88
      1. Health Insurance Portability and Accountability Act (HIPAA) 88
      2. Informed Consent 89
    2. LO 7.2 Client Responsibilities 90
    3. LO 7.3 Employee Rights 90
    4. LO 7.4 Employee Responsibilities 91
      1. Following the Care Plan 91
      2. Mandatory Reporting 92
    5. LO 7.5 Laws 93
      1. Invasion of Privacy 94
      2. Misappropriation of Funds 95
      3. Negligence 95
      4. Abandonment 95
      5. False Imprisonment 96
      6. Neglect 96
      7. Assault and Battery 96
      8. Abuse 97
    6. LO 7.6 Cultural Awareness 98
    7. Summary of Learning Outcomes 99
    8. Get Up and Think! 100
    9. Reflect on This! 100
    10. Let’s Review! 100
    11. Multiple Choice Questions 101
  12. Chapter 8: Body Structures and Functioning Processes 103
    1. LO 8.1 Basic Structures 104
    2. LO 8.2 Tissue Types 104
    3. LO 8.3 Body Systems 105
      1. Integumentary System 105
      2. Musculoskeletal System 106
      3. Respiratory System 109
      4. Cardiovascular System 111
      5. Nervous System 113
      6. Sensory Organs 115
      7. Endocrine System 118
      8. Digestive System 120
      9. Urinary System 123
      10. Reproductive System 124
    4. Summary of Learning Outcomes 127
    5. Get Up and Think! 128
    6. Reflect on This! 128
    7. Let’s Review! 129
    8. Multiple Choice Questions 129
  13. Chapter 9: Common Diseases and Disorders 131
    1. LO 9.1 Understanding Disease Processes 132
    2. LO 9.2 Risk Factors 132
    3. LO 9.3 Emergency Medical Services 132
    4. LO 9.4 Common Diseases and Disorders 133
      1. Integumentary System 133
      2. Musculoskeletal System 136
      3. Respiratory System 139
      4. Cardiovascular System 141
      5. Nervous System 144
      6. Sensory Organs 147
      7. Endocrine System 149
      8. Digestive System 153
      9. Urinary System 156
      10. Reproductive System 159
    5. Summary of Learning Outcomes 160
    6. Get Up and Think! 161
    7. Reflect on This! 162
    8. Let’s Review! 162
    9. Multiple Choice Questions 163
    10. Reference 163
  14. Chapter 10: Infection Control Practices 165
    1. Introduction 166
    2. LO 10.1 The Importance of Hand Washing 166
      1. Germ Theory 166
      2. Global Society and Spread of Disease 167
    3. LO 10.2 Chain of Infection 168
    4. LO 10.3 Primary Prevention 169
    5. LO 10.4 Body Defense Mechanisms 170
    6. LO 10.5 Hand Hygiene 172
    7. LO 10.6 Standard Precautions 176
      1. Personal Protective Equipment (PPE) 176
    8. LO 10.7 Specialty Precautions 180
      1. Airborne Precautions 180
      2. Droplet Precautions 180
      3. Contact Precautions 181
      4. Transporting a Client to and From an Isolation Room 181
      5. Blood Spill Kits 182
      6. Double-Bagging Technique 183
    9. LO 10.8 Drug-Resistant Infections 184
      1. MRSA Infection 184
      2. VRE 184
    10. Summary of Learning Outcomes 185
    11. Get Up and Think! 186
    12. Reflect on This! 186
    13. Let’s Review! 187
    14. Multiple Choice Questions 187
    15. Skills 187
    16. References 190
  15. Chapter 11: Body Mechanics and Workplace Safety 193
    1. Introduction 194
    2. LO 11.1 Exposure to Blood-Borne Pathogens and Chemicals 194
    3. LO 11.2 Latex Allergies 196
    4. LO 11.3 Injury Prevention 197
      1. Ergonomics 197
      2. Moving Clients 198
      3. Lifestyle Choices to Prevent Back Injuries 199
      4. Slips, Trips, and Falls 200
    5. LO 11.4 Fire Safety 200
    6. LO 11.5 Natural Disasters 201
    7. LO 11.6 Bomb Threats 203
    8. LO 11.7 Workplace Violence 203
    9. Summary of Learning Outcomes 204
    10. Get Up and Think! 205
    11. Reflect on This! 206
    12. Let’s Review! 206
    13. Multiple Choice Questions 207
  16. Chapter 12: Reducing Client Injury and Falls 209
    1. Introduction 210
    2. LO 12.1 Why Falls and Immobility Are Dangerous 210
    3. LO 12.2 Risk Factors for Falling 211
    4. LO 12.3 Care During a Fall 212
    5. LO 12.4 Care After a Fall 213
    6. LO 12.5 How to Prevent Fall Injuries 214
    7. LO 12.6 Alarm Systems 216
    8. LO 12.7 Other Strategies 217
    9. Summary of Learning Outcomes 217
    10. Get Up and Think! 218
    11. Reflect on This! 219
    12. Let’s Review! 219
    13. Multiple Choice Questions 219
    14. Skills 220
  17. Chapter 13: Restraints and Restraint Alternatives 223
    1. LO 13.1 Restraints 224
    2. LO 13.2 Working With Restraints 224
    3. LO 13.3 Types of Restraints 225
    4. LO 13.4 Risks of Using Restraints 227
    5. LO 13.5 Instances When Restraints Are Allowed 228
    6. LO 13.6 Side Rails 229
    7. LO 13.7 Restraint Alternatives 229
    8. Summary of Learning Outcomes 231
    9. Get Up and Think! 231
    10. Reflect on This! 232
    11. Let’s Review! 232
    12. Multiple Choice Questions 232
    13. Reference 233
    14. Skill 233
  18. Chapter 14: Basic First Aid Measures 235
    1. Introduction 236
    2. LO 14.1 Airway Obstruction 236
    3. LO 14.2 Cardiac Arrest 237
    4. LO 14.3 Syncope 238
    5. LO 14.4 Seizures 239
    6. LO 14.5 Hemorrhage 241
    7. LO 14.6 Shock 242
    8. LO 14.7 Burns 243
    9. LO 14.8 Poisoning 244
    10. Summary of Learning Outcomes 244
    11. Get Up and Think! 245
    12. Reflect on This! 246
    13. Let’s Review! 246
    14. Multiple Choice Questions 247
    15. Skills 247
  19. Chapter 15: Stress Reduction and Management Techniques 253
    1. LO 15.1 Why Is Healthcare So Stressful? 254
    2. LO 15.2 Ways to Prevent Stress From Taking Charge 256
    3. LO 15.3 Time-Management Techniques to Reduce Stress While at Work 257
    4. LO 15.4 Preventing Stress and Promoting Job Satisfaction 258
      1. Good General Health 258
      2. Yoga 259
      3. Meditation 259
      4. Pet Therapy 260
      5. Humor 260
      6. Journaling 261
      7. Visualization Techniques 261
      8. Breathing Exercises 262
    5. LO 15.5 Client Stressors 263
      1. Pain 263
      2. Illness 263
      3. Sleep Deprivation 263
      4. Anxiety and Depression 264
      5. Grief 264
      6. Coach Your Clients 265
    6. Summary of Learning Outcomes 265
    7. Get Up and Think! 265
    8. Reflect on This! 266
    9. Let’s Review! 266
    10. Multiple Choice Questions 267
    11. Skills 267
  20. Chapter 16: Holistic Care of Clients 271
    1. LO 16.1 Holistic Care 272
    2. LO 16.2 Maslow’s Hierarchy of Needs 272
      1. Human Needs 272
      2. Application of Maslow’s Hierarchy to Caregiving 274
    3. LO 16.3 Growth and Development 275
    4. LO 16.4 Quality of Life 277
    5. LO 16.5 Meeting the Needs of Loved Ones 282
    6. Summary of Learning Outcomes 283
    7. Get Up and Think! 283
    8. Reflect on This! 284
    9. Let’s Review! 284
    10. Multiple Choice Questions 284
  21. Chapter 17: Client Room Environment 287
    1. Introduction 288
    2. LO 17.1 Safety 288
    3. LO 17.2 The Physical Environment 289
    4. LO 17.3 Individual Room Requirements 290
    5. LO 17.4 Noise and Odor Control 292
      1. Noise Control 292
      2. Odor Control and Cleanliness 293
    6. LO 17.5 Transfers and Discharges 294
    7. LO 17.6 Current Trends 295
    8. Summary of Learning Outcomes 296
    9. Get Up and Think! 297
    10. Reflect on This! 297
    11. Let’s Review! 298
    12. Multiple Choice Questions 298
    13. Reference 299
  22. Chapter 18: Preventing Skin Breakdown 301
    1. LO 18.1 The Importance of Healthy Skin 302
    2. LO 18.2 Types of Skin Breakdown 302
      1. Rashes 302
      2. Friction and Shearing 303
      3. Pressure Ulcers 303
    3. LO 18.3 Stages of Pressure Ulcers 305
    4. LO 18.4 Risk Factors for Developing Pressure Ulcers 307
    5. LO 18.5 Interventions for Preventing Skin Breakdown 308
      1. Inspection and Cleanliness 309
      2. Positioning and Turning 309
      3. Pressure-Relieving Devices 310
      4. Positioning Devices 311
      5. Incontinence Care 311
      6. Nutrition and Hydration 312
      7. Reducing the Microclimate 313
    6. Summary of Learning Outcomes 313
    7. Get Up and Think! 314
    8. Reflect on This! 314
    9. Let’s Review! 314
    10. Multiple Choice Questions 315
  23. Chapter 19: Bedmaking 317
    1. Introduction 318
    2. LO 19.1 Linens 318
    3. LO 19.2 Infection Control 320
    4. LO 19.3 Body Mechanics 321
    5. LO 19.4 The Closed Versus Open Bed 322
    6. LO 19.5 Making the Unoccupied and Occupied Bed 324
      1. Unoccupied Bed 324
      2. Occupied Bed 324
    7. Summary of Learning Outcomes 327
    8. Get Up and Think! 327
    9. Reflect on This! 328
    10. Let’s Review! 328
    11. Multiple Choice Questions 329
    12. Skills 329
  24. Chapter 20: Positioning Clients 335
    1. Introduction 336
    2. LO 20.1 Frequency of Repositioning Clients 336
    3. LO 20.2 Basic Positions for Clients in Bed 337
    4. LO 20.3 Position to Relieve Pressure Sores 338
      1. Supine 338
      2. Fowler’s Position 338
      3. Prone Position 340
      4. Side-Lying Position 341
      5. Sims’s Position 342
      6. Tripod Position 342
    5. LO 20.4 Wheelchair Positioning 343
    6. Summary of Learning Outcomes 344
    7. Get Up and Think! 344
    8. Reflect on This! 344
    9. Let’s Review! 345
    10. Multiple Choice Questions 345
    11. Skills 346
    12. References 349
  25. Chapter 21: Moving, Transferring, and Transporting Clients 351
    1. Introduction 352
    2. LO 21.1 Moving a Client in Bed 352
    3. LO 21.2 Preventing Friction and Shearing Injuries 353
    4. LO 21.3 Log Rolling a Client 354
    5. LO 21.4 Moving a Client From Bed to Stretcher 355
    6. LO 21.5 Transferring the Client Using a One- and a Two-Assist Transfer 356
      1. Dangling 356
      2. Footwear 356
      3. Gait Belt 356
      4. One- and Two-Assist Transfers 357
      5. Mechanical Devices Used for Transfers 359
    7. LO 21.6 Transferring a Bariatric Client 361
    8. LO 21.7 Transporting a Client in a Wheelchair 362
    9. Summary of Learning Outcomes 364
    10. Get Up and Think! 365
    11. Reflect on This! 366
    12. Let’s Review! 366
    13. Multiple Choice Questions 366
    14. Skills 367
    15. References 381
  26. Chapter 22: Ambulation and Exercises for Clients 383
    1. Introduction 384
    2. LO 22.1 Why We Move 384
      1. Self-Esteem 384
      2. Effects on the Digestive System 384
      3. Effects on the Cardiovascular System 384
      4. Effects on the Integumentary System 385
      5. Effects on the Musculoskeletal System 385
    3. LO 22.2 Levels of Assistance 385
    4. LO 22.3 Safety Measures Used During Ambulation 387
    5. LO 22.4 Assistive Devices for Ambulation 388
    6. LO 22.5 Range-of-Motion Exercises 390
    7. LO 22.6 Soothing Sore Muscles 391
    8. Summary of Learning Outcomes 392
    9. Get Up and Think! 393
    10. Reflect on This! 393
    11. Let’s Review! 394
    12. Multiple Choice Questions 394
    13. Skills 395
  27. Chapter 23: Rehabilitation and Restorative Care 401
    1. LO 23.1 Therapy Services Overview 402
    2. LO 23.2 Rehabilitation Therapy 402
      1. Physical Therapy 402
      2. Occupational Therapy 403
      3. Speech Therapy 404
    3. LO 23.3 Activities Therapy 405
    4. LO 23.4 Restorative Care 406
    5. Summary of Learning Outcomes 407
    6. Get Up and Think! 408
    7. Reflect on This! 408
    8. Let’s Review! 409
    9. Multiple Choice Questions 409
  28. Chapter 24: Adaptive Equipment and Supportive Devices 411
    1. Introduction 412
    2. LO 24.1 The Client With a Prosthesis 412
      1. Prosthesis Overview 412
      2. Types of Prostheses 414
      3. Care Measures 415
    3. LO 24.2 The Client With an Orthosis 415
      1. Orthosis Overview 415
      2. Care Measures 415
    4. LO 24.3 Adaptive Tools Used at Meal Times 416
    5. LO 24.4 Adaptive Tools for Grooming and Other ADLs 418
    6. Summary of Learning Outcomes 418
    7. Get Up and Think! 419
    8. Reflect on This! 419
    9. Let’s Review! 420
    10. Multiple Choice Questions 420
  29. Chapter 25: Vital Signs 423
    1. LO 25.1 Introduction 424
    2. LO 25.2 When Vital Signs Are Taken 424
    3. LO 25.3 Infection Control 425
    4. LO 25.4 Accurately Measuring Vital Signs 425
      1. Temperature 425
      2. Pulse 428
      3. Respiration 429
      4. Pulse Oximetry 430
      5. Blood Pressure 431
      6. Height 435
      7. Weight 435
    5. Summary of Learning Outcomes 437
    6. Get Up and Think! 437
    7. Reflect on This! 438
    8. Let’s Review! 438
    9. Multiple Choice Questions 438
    10. Skills 439
    11. References 449
  30. Chapter 26: Bathing 451
  31. Introduction 452
  32. LO 26.1 Routine Bathing 452
  33. LO 26.2 Distressed Bathing 453
    1. Alternatives to Tub Bathing and Showering 454
    2. Easing Distressed Bathing 454
  34. LO 26.3 Rinseless Systems 455
  35. LO 26.4 Peri-Care 456
  36. LO 26.5 Bed Baths 459
    1. Partial Bed Bath 459
    2. Complete Bed Bath 461
  37. LO 26.6 Shower and Tub Baths 462
    1. Shower 462
    2. Whirlpool Tub Bath 464
    3. Hair Care 465
  38. LO 26.7 Responsibilities on Bath Day 465
  39. Summary of Learning Outcomes 466
  40. Get Up and Think! 467
  41. Reflect on This! 467
  42. Let’s Review! 468
  43. Multiple Choice Questions 468
  44. Skills 469
  45. Reference 485
  • Chapter 27: Grooming 487
    1. LO 27.1 Promoting Independence 488
    2. LO 27.2 Dressing 488
      1. Dressing a Client With One-Sided Weakness 489
    3. LO 27.3 Hair 489
    4. LO 27.4 Vision and Hearing 490
      1. Glasses and Contacts 490
      2. Hearing Aids 491
    5. LO 27.5 Shaving 492
    6. LO 27.6 Oral Care 494
    7. LO 27.7 Nail and Foot Care 498
      1. Nail Care 498
      2. Foot Care 499
    8. Summary of Learning Outcomes 500
    9. Get Up and Think! 501
    10. Reflect on This! 501
    11. Let’s Review! 501
    12. Multiple Choice Questions 502
    13. Skills 502
  • Chapter 28: Nutrition 517
  • Introduction 518
  • LO 28.1 MyPlate and MyPyramid 518
  • LO 28.2 Nutrients Essential for Life 519
    1. Calories 519
    2. Carbohydrates 519
    3. Proteins 519
    4. Fats 520
    5. Vitamins and Minerals 520
  • LO 28.3 Water and Fluid Needs 522
  • LO 28.4 Food Groups 523
    1. Grains 523
    2. Fruits 524
    3. Vegetables 524
    4. Dairy Products 525
    5. Protein 525
  • LO 28.5 Types of Diets 526
    1. Specialty Diets 526
    2. Mechanically Altered Diets and Fluids 529
    3. Thickened Fluids 530
    4. Diets for the Postsurgical Client 530
    5. Mechanical Feeding 531
  • LO 28.6 Problems With Digestion 532
    1. Nausea, Vomiting, and Diarrhea 532
    2. Malnutrition and Overeating 533
  • LO 28.7 Feeding Dependent Clients 534
  • Summary of Learning Outcomes 536
  • Get Up and Think! 537
  • Reflect on This! 538
  • Let’s Review! 538
  • Multiple Choice Questions 538
  • Skill 539
  • References 541
  • Chapter 29: Elimination 543
    1. Introduction 544
    2. LO 29.1 Urinary Elimination via Catheter 544
      1. Types of Catheters 544
      2. The Nursing Assistant’s Role in Care of the Client With a Catheter 545
      3. Cleaning the Catheter 546
      4. Changing the Collection Bag to a Leg Bag 547
      5. Positioning the Client With a Collection Bag 547
      6. Protecting the Privacy of the Client Who Uses a Catheter 548
      7. Emptying the Collection or Leg Bag 548
      8. Cleaning Collection and Leg Bags 548
    3. LO 29.2 Urostomy 549
    4. LO 29.3 Incontinence 549
      1. Care of the Client Who Is Incontinent 549
      2. Types of Incontinence Products 550
    5. LO 29.4 Dialysis 551
      1. Hemodialysis 551
      2. Peritoneal Dialysis 551
      3. Care of the Client Who Is on Dialysis 552
    6. LO 29.5 Bowel Elimination 552
    7. LO 29.6 Ostomies 553
    8. LO 29.7 Digestive Tract Bleeding 555
    9. LO 29.8 Devices Used for Elimination 556
    10. Summary of Learning Outcomes 558
    11. Get Up and Think! 559
    12. Reflect on This! 559
    13. Let’s Review! 560
    14. Multiple Choice Questions 560
    15. Skills 561
  • Chapter 30: Specimen Collection 575
    1. Introduction 576
    2. LO 30.1 Basic Principles of Collection and Transport 576
    3. LO 30.2 Urine Specimens 577
    4. LO 30.3 Straining for Kidney Stones 578
    5. LO 30.4 Fecal Specimens 579
    6. LO 30.5 Occult Blood 580
    7. Summary of Learning Outcomes 581
    8. Get Up and Think! 581
    9. Reflect on This! 582
    10. Let’s Review! 582
    11. Multiple Choice Questions 583
    12. Skills 583
  • Chapter 31: Oxygen Therapy and Respiratory Interventions 589
    1. LO 31.1 Why Supplemental Oxygen Is Needed 590
    2. LO 31.2 The Nursing Assistant’s Role in Oxygen Therapy 590
    3. LO 31.3 Delivery Routes 592
    4. LO 31.4 Delivery Systems 593
    5. LO 31.5 Interventions to Ease Anxiety Related to Breathing Difficulties 595
    6. LO 31.6 Interventions to Aid Lung Function 595
      1. Coughing and Deep Breathing Exercises 595
      2. Incentive Spirometry 596
    7. Summary of Learning Outcomes 596
    8. Get Up and Think! 597
    9. Reflect on This! 597
    10. Let’s Review! 598
    11. Multiple Choice Questions 598
    12. Skills 599
  • Chapter 32: Care for the Medical and Surgical Client 603
    1. Introduction 604
    2. LO 32.1 The Medical Client 604
    3. LO 32.2 The Postsurgical Client 605
    4. LO 32.3 Diet for the Postsurgical Client 605
    5. LO 32.4 Activity for the Postsurgical Client 606
    6. LO 32.5 Weight-Bearing Status 607
    7. LO 32.6 Respiratory Complications 607
    8. LO 32.7 Cardiac Complications 608
    9. LO 32.8 Intravenous Therapy 609
    10. Summary of Learning Outcomes 610
    11. Get Up and Think! 611
    12. Reflect on This! 611
    13. Let’s Review! 611
    14. Multiple Choice Questions 612
    15. Skills 612
  • Chapter 33: Care for the Client With Communication Disorders 617
    1. Introduction 618
    2. LO 33.1 Hearing-Impaired Clients 618
    3. LO 33.2 Speech-Impaired Clients 619
    4. LO 33.3 Emotional Communication Deficits 621
    5. Summary of Learning Outcomes 622
    6. Get Up and Think! 622
    7. Reflect on This! 622
    8. Let’s Review! 623
    9. Multiple Choice Questions 623
  • Chapter 34: Care for the Client With Cancer 625
    1. Introduction 626
    2. LO 34.1 What Is Cancer? 626
    3. LO 34.2 What Causes Cancer? 627
    4. LO 34.3 How Is Cancer Diagnosed? 629
      1. Staging Cancer 630
    5. LO 34.4 Treatment Options 630
    6. LO 34.5 Common Side Effects of Cancer and Treatment 632
    7. LO 34.6 Palliative Care 634
    8. Summary of Learning Outcomes 634
    9. Get Up and Think! 635
    10. Reflect on This! 635
    11. Let’s Review! 636
    12. Multiple Choice Questions 636
    13. Reference 637
  • Chapter 35: Care for the Client With a Positive HIV Status 639
    1. LO 35.1 HIV Versus AIDS 640
    2. LO 35.2 HIV Transmission 640
    3. LO 35.3 Effects of HIV and AIDS 641
    4. LO 35.4 Testing for HIV 642
    5. LO 35.5 Preventing an HIV Infection 643
    6. LO 35.6 Rights of Individuals With HIV/AIDS 645
    7. Summary of Learning Outcomes 645
    8. Get Up and Think! 646
    9. Reflect on This! 646
    10. Let’s Review! 647
    11. Multiple Choice Questions 647
    12. References 647
  • Chapter 36: Care for the Client With Dementia 649
    1. LO 36.1 Types of Dementia 650
    2. LO 36.2 Risk Factors for Dementia 650
    3. LO 36.3 Treatment of Dementia 651
    4. LO 36.4 Diagnosing Dementia 651
      1. Stages of Dementia 652
      2. Common Signs, Symptoms, and Behaviors Associated With Dementia 653
    5. LO 36.5 Managing the Behaviors Associated With Dementia 655
      1. Meeting Unmet Needs of the Client 655
      2. Therapeutic Interventions 656
      3. Maintaining Function 658
      4. Approach to Specific Behaviors 658
      5. Improving Meal Time 659
      6. Managing Pain 660
      7. Sleep Disturbances 661
      8. Toileting Interventions 661
      9. Bathing Interventions 662
      10. Wandering and Elopement Safety Measures 663
      11. Discouraging Sexual Inappropriateness 664
    6. LO 36.6 Remember the Families 664
    7. LO 36.7 Caregiver Strain 665
    8. Summary of Learning Outcomes 666
    9. Get Up and Think! 667
    10. Reflect on This! 667
    11. Let’s Review! 668
    12. Multiple Choice Questions 668
    13. References 669
  • Chapter 37: End-of-Life Care 671
    1. Introduction 672
    2. LO 37.1 Body System Changes 672
      1. Respiratory Changes 672
      2. Cardiovascular Changes 673
      3. Nervous System and Sensory Organ Changes 673
      4. Digestive Changes 674
      5. Urinary Changes 675
    3. LO 37.2 Special Care for the Dying Client 675
    4. LO 37.3 Faith and Religion 676
    5. LO 37.4 Care for the Family 677
    6. LO 37.5 Post-Mortem Care 678
    7. Summary of Learning Outcomes 679
    8. Get Up and Think! 680
    9. Reflect on This! 680
    10. Let’s Review! 680
    11. Multiple Choice Questions 681
    12. Skill 681
  • Chapter 38: Common Medications 685
    1. LO 38.1 Scope of Practice 686
    2. LO 38.2 Drug Names 687
    3. LO 38.3 Actions of Medications 687
      1. Allergic Drug Reactions 687
      2. Drug Interactions 688
    4. LO 38.4 Medication Classifications 689
      1. Analgesics 689
      2. Antibiotics 690
      3. Bronchodilators 691
      4. Antihypertensives 691
      5. Anti-Anginals 692
      6. Cardiotonics 692
      7. Anticoagulants 693
      8. Diuretics 693
      9. Antidiabetics 694
      10. Medications to Relieve Constipation 694
    5. Summary of Learning Outcomes 695
    6. Get Up and Think! 696
    7. Reflect on This! 696
    8. Let’s Review! 697
    9. Multiple Choice Questions 697
  • Appendix A: Common Medical Abbreviations and Directional Terminology 699
  • Common Medical Abbreviations 699
  • Directional Terms 701
  • Appendix B: ISMP List of Error-Prone Abbreviations 702
  • Appendix C: Glossary 704
  • Index 711