Fundamentals of Nursing, Australia & New Zealand, 3rd Edition
DeLAUNE, LADNER, McTIER, TOLLEFSON
CONTENTS
Guide to the text x
Guide to the online resources xiv
Preface xvi
Language and terminology xix
About the authors xx
Acknowledgements xxiii
UNIT 01
NURSING PERSPECTIVES:
PAST, PRESENT AND FUTURE 1
CHAPTER 01
Evolution of Nursing Education and Theory 2
Introduction 3
Evolution of nursing education in Australia and
New Zealand 3
Trends in nursing education in Australia and
New Zealand 11
Theoretical foundations 14
Scope of theories 16
Evolution of nursing theory 16
Selected nursing theories 19
Chapter resources 25
CHAPTER 02
Research and Evidence-Based Practice 29
Introduction 30
Research: substantiating the science of nursing 30
Research process 32
Research utilisation 35
Evidence-based practice 37
Evidence reports 38
Trends in research and evidence-based practice 39
Chapter resources 40
CHAPTER 03
Health Care Delivery 42
Introduction 43
Health care delivery: organisational frameworks 43
Health care team 44
Factors influencing the delivery of health care 45
Responses to health care changes and challenges 47
Continuum of care 48
Quality management in health care 51
Organisational structure for quality management 53
Nursing’s role in quality management 55
Trends in health care delivery 56
Chapter resources 56
UNIT 02
NURSING PROCESS: THE STANDARD OF CARE 59
CHAPTER 04
Critical Thinking, Decision-Making and the
Nursing Process 60
Introduction 61
Critical thinking 61
The nursing process 64
Five steps of the nursing process 64
Critical thinking applied in nursing 69
Chapter resources 70
CHAPTER 05
Clinical Assessment 72
Introduction 73
Purpose of assessment 73
The three types of assessment 74
Data collection 75
Situational awareness 82
Verifying and organising data 84
Interpreting and documenting data 85
Data documentation 86
Chapter resources 94
CHAPTER 06
Problem Identification 97
Introduction 98
What is problem identification? 98
Importance of problem identification 99
Components of problem identification 100
Clinical judgement in nursing: identifying problem statements 101
Avoiding errors in the development and use of
problem identification 103
Chapter resources 105
CHAPTER 07
Planning 107
Introduction 108
Purpose of planning 108
Process of planning 108
Establishing goals and expected outcomes 110
Components of goals and expected outcomes 111
Problems frequently encountered in planning 112
Planning nursing interventions 113
Nursing care plan 116
Chapter resources 117
CHAPTER 08
Implementation 119
Introduction 120
Purpose of implementation 120
Requirements for effective implementation 120
Implementation activities 120
Delegation of tasks 126
Chapter resources 128
CHAPTER 09
Evaluation 130
Introduction 131
Evaluation of care 131
Components of evaluation 131
Methods of evaluation 132
Evaluation and quality of care 133
Evaluation and accountability 135
Multidisciplinary collaboration in evaluation 135
Chapter resources 137
UNIT 03
PROFESSIONAL ACCOUNTABILITY 139
CHAPTER 10
Leadership and Delegation 140
Introduction 141
Professional nursing practice 141
Professional accountability 142
Legislative accountability 144
Individual accountability 145
Leadership in nursing 147
Power 152
Chapter resources 155
CHAPTER 11
Legal and Ethical Responsibilities 158
Introduction 159
Legal foundations of nursing 159
Legal responsibilities and roles of nurses 168
Legislation affecting nursing practice 170
Ethical foundations of nursing 171
Ethical principles 174
Values and ethics 175
Ethical codes of practice 176
Ethical dilemmas and ethical decision-making 177
Chapter resources 179
CHAPTER 12
Documentation and Informatics 183
Introduction 184
The role of informatics 184
Clinical information systems 184
Documentation as communication 186
Principles of effective documentation 192
Methods of documentation 196
Computers in nursing 201
Chapter resources 203
UNIT 04
PROMOTING HEALTH 207
CHAPTER 13
Nursing, Healing and Caring 208
Introduction 209
Nursing’s therapeutic value 209
Theoretical perspectives of caring 211
Health care relationship 214
Caring and communication and characteristics of
therapeutic nurses 217
Therapeutic value of the nursing process 221
Chapter resources 223
CHAPTER 14
Communication 227
Introduction 228
The communication process 228
Modes of communication 233
Types of communication 235
Barriers to therapeutic communication 238
Communication roadblocks 240
Communication, critical thinking and nursing process 242
Chapter resources 245
CHAPTER 15
Health and Wellness Promotion 249
Introduction 250
Health, illness and wellness 250
Behaviours impacting on health 252
Health promotion 255
The individual as a holistic being 259
Needs and health 259
Promoting sexual health 260
Chapter resources 263
CHAPTER 16
Family and Community Health 267
Introduction 268
Family health 268
Characteristics of healthy families 268
Family development theories 271
Threats to family integrity 271
Community health and public-health nursing 275
Disaster preparedness 276
Chapter resources 277
CHAPTER 17
The Life Cycle 281
Introduction 282
Fundamental concepts of growth and development 282
Factors influencing growth and development 282
Theoretical perspectives of human development 284
Holistic framework for nursing 290
Stages of the life cycle: the adult 290
Chapter resources 300
CHAPTER 18
Paediatric Care 304
Introduction 305
The prenatal and neonate periods 305
The infant 309
The toddler and the preschool-aged child 315
The school-age child and preadolescent 320
The adolescent 327
Chapter resources 331
CHAPTER 19
The Older Adult 335
Introduction 336
Defining old age 336
Changes associated with ageing 339
Medications and the older adult 350
Abuse of the older adult 351
Nursing process and the older adult 352
Chapter resources 360
CHAPTER 20
Palliative Care 364
Introduction 365
Understanding palliative care 365
Palliative care 367
Disease trajectories 368
Working in palliative care 369
Provision of palliative care 370
Psychosocial, spiritual and emotional concerns 378
The dying process 380
Chapter resources 384
CHAPTER 21
Cultural Diversity 388
Introduction 389
Health of culturally and linguistically diverse populations 389
Multicultural communities working to improve health
outcomes 390
The health and wellbeing of multicultural communities 390
Concepts of culture 393
Culture in nursing care 395
First Nations cultures in Australia and Aotearoa
New Zealand 396
Culture in the nursing process 401
Chapter resources 404
CHAPTER 22
Aboriginal and Torres Strait Islander Peoples’ Health 410
Introduction 411
Culturally safe and responsive practice 411
History 413
Strength in partnerships 419
Communication in clinical practice 425
Chapter resources 429
CHAPTER 23
Rural and Remote Health 434
Introduction 435
Characteristics of rural and remote communities 435
Determinants of health 440
Access to and use of health care 448
Providing sustainable health care 450
Role of the rural and remote nurse 455
Health promotion 457
Chapter resources 459
CHAPTER 24
Health Care Education 464
Introduction 465
The importance of contemporary health education 465
Barriers to learning 466
Professional responsibilities related to teaching 468
Learning throughout the life cycle 468
Teaching–learning and the nursing process 471
Chapter resources 482
UNIT 05
RESPONDING TO BASIC PSYCHOSOCIAL NEEDS 485
CHAPTER 25
Self-Concept 486
Introduction 487
Components of self-concept 487
Development of self-concept 489
Factors affecting self-concept 491
Nursing process and self-concept 493
Chapter resources 500
CHAPTER 26
Stress, Anxiety, Adaptation and Change 503
Introduction 504
Stress, anxiety and adaptation 504
Types of stress 506
Manifestations of stress 506
Outcomes of stress 506
Stress and illness 511
Stress and change 512
Nursing process with anxious people 514
Personal stress-management approaches for the nurse 519
Chapter resources 523
CHAPTER 27
Spirituality 526
Introduction 527
Spirituality defined 527
Health and spirituality in Australian and New Zealand
First Nations’ cultures 529
Spirituality and aged care 531
Nursing process and spirituality 531
Chapter resources 535
CHAPTER 28
Loss and Grief 539
Introduction 540
Loss 540
Grief 541
Death 546
Care after death 554
Nurse’s self-care 555
Chapter resources 557
CHAPTER 29
Mental Health 560
Introduction 561
What is mental health? 561
The history of mental health care 562
The recovery model of mental health care 564
Common mental disorders 565
Assessment of mental disorders 569
Treatment of mental disorders 570
Dealing with stigma 571
Mental health promotion 572
Specialising in mental health nursing 573
Working with culturally and linguistically diverse
populations in mental health 574
Chapter resources 576
UNIT 06
RESPONDING TO BASIC PHYSIOLOGICAL NEEDS 579
CHAPTER 30
Vital Signs 580
Introduction 581
The physiological principles of oxygen delivery 581
Recording of vital signs 582
Pulse 587
Blood pressure 591
Respirations 600
Temperature 605
Oxygen saturation 608
Level of consciousness 611
The nursing process and vital signs 612
Chapter resources 615
CHAPTER 31
Physical Assessment 619
Introduction 620
Purposes of physical examination 620
Preparation for physical examination 622
Assessment techniques 627
Diagnostic testing 630
Physical assessment: areas to be assessed 639
Post-assessment care of the person 675
Data documentation 676
Chapter resources 676
CHAPTER 32
Safety, Infection Control and Hygiene 680
Introduction 681
Creating a culture of safety for people needing
health care 681
Safety for health care workers 687
Infection-control basic practice 690
Hygiene 698
Assessment 700
Problem identification and interventions 705
Outcome identification and planning 707
Implementation 708
Evaluation 731
Chapter resources 733
CHAPTER 33
Medication Administration 739
Introduction 740
Medication standards and legislation 740
Pharmacokinetics 741
Medication nomenclature 743
Medication action 743
Professional roles in medication administration 748
Systems of weight and measure 750
Medication dose calculations 751
Safe medication administration 751
Medication compliance and legal aspects of
administering medications 757
Assessment 760
Problem identification and planning and outcome
identification 762
Implementation 763
Evaluation 777
Chapter resources 779
CHAPTER 34
Traditional and Complementary Therapies 783
Introduction 784
Historical influences on contemporary practices 785
Allopathic medicine 787
Contemporary trends in T&CM 788
Holism and nursing practice 789
Complementary therapies and interventions 790
Nursing and T&CM approaches 805
Chapter resources 807
CHAPTER 35
Oxygenation 813
Introduction 814
Physiology of oxygenation 814
Factors affecting oxygenation 819
Assessment 824
Problem identification 835
Planning and outcomes 838
Implementation 838
Evaluation 848
Chapter resources 851
CHAPTER 36
Fluids and Electrolytes 854
Introduction 855
Physiology of fluid and acid-base balance 855
Disturbances in electrolyte and acid-base balance 860
Assessment 871
Problem identification 875
Implementation 878
Evaluation 892
Chapter resources 896
CHAPTER 37
Nutrition 899
Introduction 900
Physiology of nutrition 900
Understanding nutrients 903
Promoting proper nutrition 909
Factors affecting nutrition 912
Assessing nutrition 914
Problem identification 921
Implementation 923
Evaluation 934
Chapter resources 936
CHAPTER 38
Pain Management, Comfort and Sleep 941
Introduction 942
Pain 942
Physiology of pain 944
A person-centred pain assessment 948
Pharmacological pain management 956
Non-pharmacological interventions 965
Evaluation 968
Rest and sleep 969
Factors affecting rest and sleep 971
Nursing interventions that promote comfort, rest and sleep 973
Chapter resources 978
CHAPTER 39
Mobility 982
Introduction 983
Overview of mobility 983
Physiology of mobility 985
Physical activity 986
Factors affecting mobility 994
Physiological effects of mobility
and immobility 996
Assessment 998
Problem identification 1003
Planning and outcomes 1004
Implementation 1006
Evaluation 1022
Chapter resources 1024
CHAPTER 40
Skin Integrity and Wound Healing 1027
Introduction 1028
Physiology of wound healing 1028
Factors affecting wound healing 1030
Wound classification 1033
Wound assessment 1036
Problem identification 1038
Planning and outcomes 1039
Implementation 1039
Pressure injuries 1046
Chapter resources 1059
CHAPTER 41
Sensation, Perception and Cognition 1064
Introduction 1065
Physiology of sensation, perception and cognition 1065
Factors affecting sensation, perception and cognition 1071
Sensory, perceptual and cognitive alterations 1072
Assessment 1073
Problem identification 1078
Implementation 1078
Evaluation 1084
Chapter resources 1085
CHAPTER 42
Elimination 1088
Introduction 1089
Physiology of elimination 1089
Factors affecting elimination 1093
Assessment 1093
Problem identification: common alterations in elimination 1099
Planning and outcomes 1104
Implementation 1105
Evaluation 1117
Chapter resources 1119
CHAPTER 43
Perioperative Nursing Care 1123
Introduction 1124
Surgical interventions 1124
Preoperative phase 1127
Intraoperative phase 1143
Post-op phase 1149
Chapter resources 1156
Answers to review questions 1159
Glossary 1162
Symbols and abbreviations 1188
Index 1192