Lewis's Medical-Surgical Nursing in Canada Assessment and Management of Clinical Problems 5th Edition

Master the role and skills of the medical-surgical nurse in Canada with the book that has it all! Lewis's Medical-Surgical Nursing in Canada: Assessment and Management of Clinical Problems, 5th Edition reflects the expertise of nurses from across Canada with evidence-informed guidelines, a focus on clinical trends, and a review of pathophysiology. Clear examples make it easy to understand every concept in nursing care — from health promotion to acute intervention to ambulatory care. An Evolve website includes new case studies to enhance your skills in clinical judgement and prepare you for the Next Generation NCLEX®, CPNRE®, and REx-PNTM. From Canadian educators Jane Tyerman and Shelley L. Cobbett, this comprehensive guide provides a solid foundation in perioperative care as well as nursing care of disorders by body system. Easy-to-understand content is written and reviewed by leading experts in the field, ensuring that information is comprehensive, current, and clinically accurate. More than 800 full-colour illustrations and photographs demonstrate disease processes and related anatomy and physiology. Focus on key areas includes the determinants of health, patient and caregiver teaching, age-related considerations, collaborative care, cultural considerations, nutrition, home care, evidence-informed practice, and patient safety. Nursing Assessment chapters focus on individual body systems and include a brief review of related anatomy and physiology, a discussion of health history and non-invasive physical assessment skills, and note common diagnostic studies, expected results, and related nursing responsibilities. Unfolding case studies in each assessment chapter help you apply important concepts and procedures to real-life patient care. UNIQUE! Levels of Care approach organizes nursing management into three levels: health promotion, acute intervention, and ambulatory and home care. Nursing Management chapters focus on the pathophysiology, clinical manifestations, laboratory and diagnostic study results, interprofessional care, and nursing management of various diseases and disorders, and are organized to follow the steps of the nursing process (assessment, nursing diagnoses, planning, implementation, and evaluation). Safety Alerts and Drug Alerts highlight important safety issues in patient care. Informatics boxes discuss the importance and use of technology with topics such as use of social media in the context of patient privacy, teaching patients to manage self-care using smartphone apps, and using Smart infusion pumps. Cultural Competence and Health Equity in Nursing Care chapter discusses culture as a determinant of health, especially in regard to Indigenous populations; health equity and health equality issues as they relate to marginalized groups in Canada; and practical suggestions for developing cultural competence in nursing care. More than 60 comprehensive nursing care plans on the Evolve website include defining characteristics, expected outcomes, specific nursing interventions with rationales, evaluation criteria, and collaborative problems. Front Cover CONTENTS LEWIS’S Medical-Surgical Nursing in Canada LEWIS’S Medical-Surgical Nursing in Canada: Assessment and Management of Clinical Problems Copyright CONTENTS ABOUT THE AUTHORS CONTRIBUTORS REVIEWERS Dedication PREFACE 1 - Concepts in Nursing Practice 1 - Introduction to Medical-Surgical Nursing Practice in Canada THE CANADIAN HEALTH CARE CONTEXT Complex Health Care Environments Patient-Centred Care The Profession of Nursing in Canada Teamwork and Interprofessional Collaboration Informatics and Technology Critical Thinking in Nursing Evidence-Informed Practice THE NURSING PROCESS Phases of the Nursing Process Interrelatedness of Phases NURSING CARE PLANS Concept Maps Clinical (Critical) Pathways DOCUMENTATION FUTURE CHALLENGES OF NURSING REVIEW QUESTIONS REFERENCES RESOURCES 2 - Cultural Competence and Health Equity in Nursing Care Cultural Landscape of Canada Exploring The Concepts: Definitions And Meanings Health Equity Social Justice and Equity in Nursing Care Cultural Safety and Cultural Competence ABCDE of Cultural Competence Dynamics of Difference Culturally Competent Practice Environment THE NURSE’S SELF-ASSESSMENT Culturally Competent Patient Assessment Bridging Cultural Distances Working In Diverse Teams Conclusion Review Questions References Resources 3 - Health History and Physical Examination Data Collection Interviewing Considerations Teamwork and Collaboration Data Organization Biographical Data Reason for Seeking Care Current Health or History of Current Illness Past Health History Family Health History Review of Systems Functional Health Assessment General Survey Physical Examination Types of Assessment Comprehensive Assessment Focused Assessment Emergency Assessment Using Assessment Approaches Problem Identification And Nursing Diagnoses Review Questions References 4 - Patient and Caregiver Teaching Role of Patient And Caregiver Teaching Teaching–Learning Process Caregiver and Holistic Support Process of Patient Teaching Assessment Diagnosis Planning Age-Related Considerations Implementation Evaluation Continuity of Educational Care Documentation of the Educational Process The Standardized Teaching Plan Review Questions References Resources 5 - Chronic Illness The Epidemiology of Chronic Diseases Health: Acute Illness, Chronic Illness, and the Health–Illness Continuum Factors Contributing to Chronic Illness Risk Factors for Chronic Illness Prevention of Chronic Illness The Role of Genetics The Role of Aging Disability in Chronic Illness Psychosocial Dimensions of Chronic Illness Illness Behaviour and the Sick Role Self-Efficacy Health-Related Hardiness Mood Disorders Fatigue Stigma Quality of Life Living With Chronic Illness Chronic Illness and Caregiving Conceptual Models of Chronic Illness Illness Trajectory Shifting Perspectives Model of Chronic Illness SELF-MANAGEMENT The Emerging Paradigm of Chronic Care References Review Questions Resources 6 -Community-Based Nursing and Home Care Community Health and the Patient’s Health Care Journey Community Health Settings Public Health Care Primary Health Care Definition and Importance of Home Care Home Care Services Funding and Utilization of Home Care Services Populations Served by Home Health Care Providers Overview Home Health Nursing and Family-Centred Care Home Health Nursing Practice Knowledge and Skills Summary References Review Questions Resources 7 - Older Persons Demographics of Aging Attitudes Toward Aging Biological Theories of Aging Social Theories of Aging Universal Health Care AGE-RELATED PHYSIOLOGICAL CHANGES Older Populations at Risk Older Women Older Persons With Cognitive Impairment or Dementia Older Newcomers to Canada Older Persons Living in Rural Settings Older Persons Who Are Homeless Frail Older Persons Older Persons With Chronic Illness Socially Isolated Older Persons Covid- Indigenous Older Persons Social Support and the Older Person Caregivers Elder Mistreatment and Abuse Care Alternatives for Older Persons Independent Living Options Community-Based Care for Older Persons Long-Term Care Facilities Acute Care Settings Legal and Ethical Issues Review Questions 8 - Stress and Stress Management Definition of Stress Sources of Stress Levels of Stress Theoretical Conceptualizations of Stress Responses to Stress Physiological Influence Endocrine System Immune System Socioenvironmental Influence Individual Influence Effects of Stress on Health Stress-Related Disorders Stress Management Coping Types of Coping Review Questions References Resources 9 - Sleep and Sleep Disorders Sleep Inefficient Sleep And Sleep Disturbances Sleep Disturbances in the Hospital Insomnia Narcolepsy Circadian Rhythm Sleep–Wake Disorders Sleep-Disordered Breathing Surgical Interventions Special Concerns for Hospitalization of Patients With Obstructive Sleep Apnea Sleep Movement Disorders Sleep Special Sleep Needs of Nurses Review Questions References Resources 10 - Pain Pain Magnitude of The Pain Problem Definitions of Pain Dimensions of Pain And The Pain Process Physiological Dimension of Pain Causes And Types of Pain Nociceptive Pain Neuropathic Pain Acute and Chronic Pain Pain Assessment Initial Pain Assessment Sensory–Discriminative Component Nature of Pain Motivational–Affective, Behavioural, Cognitive–Evaluative, and Sociocultural Components Indigenous Considerations Basic Principles Medication Therapy for Pain Traditional Medicinal Therapies of Indigenous Populations In Canada Nonpharmacological Therapy for Pain Effective Communication Barriers to Effective Pain Management Institutionalizing Pain Education And Management Fear of Hastening Death by Administering Analgesics Use of Placebos in Pain Assessment and Treatment Cognitively Impaired Individuals Patients With Substance Use Problems Review Questions References Resources 11 - Substance Use Substance Use In Canada Factors That Influence Substance Use Neurophysiology of Substances Attitudes Toward People Experiencing Substance-Related Problems Key Concepts And Approaches The Harm Reduction Perspective Trauma-Informed and Culturally Competent Approaches to Care Health Promotion Nicotine Characteristics Physiological Effects of Use Electronic Cigarettes Health Complications Interprofessional Care: Nursing Interventions for Tobacco Use Disorder Characteristics Effects of Use Complications Interprofessional Care Characteristics Effects of Use Interprofessional Care Characteristics Effects of Use Interprofessional Care Stimulants Cocaine, Amphetamines, And Prescription Stimulants Characteristics Acute Effects of Use Complications Interprofessional Care Characteristics Effects of Use Complications Interprofessional Care Other Substances Inhalants Hallucinogens Gamma Hydroxybutyrate (Ghb) Acute Pain Management Considerations Perioperative Care Review Questions References Resources 12 - Complementary and Alternative Therapies Natural Products Herbal Therapy Cannabis Clinical Applications of Cannabis Mind–Body Practices Massage Therapy Prayer Alternative Systems of Care Indigenous Health Traditional Chinese Medicine Acupuncture ENERGY-BASED THERAPIES Therapeutic Touch Review Questions References Resources 13 - Palliative and End-of- Life Care Hospice Palliative Care Integrated Hospice Palliative Care Approach Physical Manifestations of The End of Life Death Psychosocial Manifestations of The End of Life Grief And Bereavement Spiritual Needs At the End of Life LEGAL AND ETHICAL ISSUES AFFECTING END-OF- LIFE CARE Advance Care Planning and Advance Directives Resuscitation Palliative Sedation Organ and Tissue Donation Special Needs of Family Caregivers Special Needs of Nurses Review Questions References Resources 2 - Pathophysiological Mechanisms of Disease 14 - Inflammation and Wound Healing CELL INJURY Cell Adaptation to Sublethal Injury Causes of Lethal Cell Injury Cell Apoptosis and Necrosis DEFENCE AGAINST INJURY Mononuclear Phagocyte System Inflammatory Response Acute Intervention Causes and Pathophysiological Features Clinical Manifestations Cultural Implications REVIEW QUESTIONS REFERENCES RESOURCES 15 - Genetics BASIC PRINCIPLES OF GENETICS: GENES, CHROMOSOMES, AND DNA Genes Chromosomes Deoxyribonucleic Acid (DNA) Human Genome Project Inheritance Patterns Single-Gene Disorders Chromosomal Disorders Multifactorial Inheritance Taking a Family History Genetic Screening and Testing Interpreting Genetic Test Results Gene Therapy Review Questions References Resources 16 - Altered Immune Response and Transplantation Normal Immune Response Antigens Types of Immunity Lymphoid Organs Cytokines Comparison of Humoral and Cell-Mediated Immunity Effects of Aging on the Immune System Altered Immune Response Hypersensitivity Reactions Allergic Disorders Assessment Diagnostic Studies Interprofessional Care Latex Allergies Multiple Chemical Sensitivities Autoimmunity Autoimmune Diseases Apheresis Immunodeficiency Disorders Primary Immunodeficiency Disorders Secondary Immunodeficiency Disorders Human Leukocyte Antigen System Organ Transplantation Tissue Typing Transplant Rejection Immunosuppressive Therapy Calcineurin Inhibitors Mycophenolate Mofetil (CellCept) Sirolimus (Rapamune) Monoclonal Antibodies Polyclonal Antibodies Graft-Versus- Host Disease Alternative Strategies Transplantation of Organs from Deceased Donor Ex Vivo Transplantation Hepatitis C–Infected Organ Transplants Xenotransplantation Stem Cell Transplantation Hybridoma Technology: Monoclonal Antibodies Review Questions References Resources 17 - Infection and Human Immunodeficiency Virus Infection INFECTIONS Causes of Infections Emerging Infections Human Immunodeficiency Virus Infection Significance of the Epidemic Transmission of Human Immunodeficiency Virus Pathophysiology Clinical Manifestations and Complications Drug Therapy Interprofessional Care Review Questions References RESOURCES 18 - Cancer Definition and Incidence Biological Processes of Cancer Defects in Cellular Proliferation Defects in Cellular Differentiation Development of Cancer Role of the Immune System Classification of Cancer Anatomical Site Classification Histological Analysis Classification Classifying Extent of Disease Prevention and Detection of Cancer Diagnosis of Cancer Biopsy Goals and Modalities Clinical Trials Surgical Therapy Cure and Control Supportive and Palliative Surgical Procedures Rehabilitative Management Chemotherapy Effect on Cells Classification of Chemotherapeutic Medications Preparation and Administration of Chemotherapeutic Agents Methods of Administration Effects of Chemotherapy on Normal Tissues Treatment Plan Radiation Therapy Effects of Radiation Simulation and Treatment Measurement of Radiation Goals of Radiation Therapy Late Effects of Radiation Treatment and Chemotherapy Biological and Targeted Therapy Toxic and Adverse Effects of Biological Agents Bone Marrow and Stem Cell Transplantation Types of Bone Marrow Transplants Peripheral Stem Cell Transplantation Cord Blood Stem Cells Gene Therapy Complications Resulting from Cancer Infection Oncological Emergencies Management of Cancer Pain Psychosocial Care Review Questions References Resources 19 - Fluid, Electrolyte, and Acid–Base Imbalances Homeostasis Water Content of the Body Body Fluid Compartments Calculation of Fluid Gain or Loss Electrolytes Measurement of Electrolytes Electrolyte Composition of Fluid Compartments MECHANISMS CONTROLLING FLUID AND ELECTROLYTE MOVEMENT Diffusion Facilitated Diffusion Active Transport Osmosis Hydrostatic Pressure Oncotic Pressure Fluid Movement In Capillaries Fluid Shifts Fluid Movement Between Extracellular Fluid and Intracellular Fluid Fluid Spacing Hypothalamic and Pituitary Regulation Adrenal Cortical Regulation Renal Regulation Cardiac Regulation Gastrointestinal Regulation Insensible Water Loss Fluid and Electrolyte Imbalances Sodium and Extracellular Fluid Volume Imbalances Potassium Imbalances Calcium Imbalances Phosphate Imbalances Magnesium Imbalances Protein Imbalances Acid–Base Imbalances Blood Gas Values Subjective Data Important Health Information Objective Data Oral Fluid And Electrolyte Replacement Intravenous Fluid And Electrolyte Replacement Central Venous Access Devices Centrally Inserted Catheters Peripherally Inserted Central Catheters Implanted Infusion Ports Complications Removal of Central Venous Access Devices Review Questions References Resources 3 - Perioperative Care 20 - Nursing Management: Preoperative Care SURGICAL SETTINGS Elective Inpatient Surgery SURGICAL WAIT TIMES PREOPERATIVE ADMISSION ASSESSMENT DAY-OF- SURGERY ASSESSMENT REVIEW QUESTIONS REFERENCES RESOURCES 21 - Nursing Management: Intraoperative Care Department Layout Preoperative Holding Area Operating Room Registered Nurse Practical Nurse Surgeon and Assistant Registered Nurse First Assistant Anaesthesiologist Advanced Nursing Practice Roles Classification of Anaesthesia General Anaesthesia Local Anaesthesia Moderate Sedation Patient After Surgery Exceptional Clinical Events In The Operating Room Anaphylactic Reactions Malignant Hyperthermia Major Blood Loss Review Questions References Resources 22 - Nursing Management: Postoperative Care Postoperative Care in the Postanaesthesia Care Unit Initial Assessment Etiology Etiology Etiology Etiology Etiology Etiology Etiology Etiology Etiology Discharge From The Postanaesthesia Care Unit Care of The Postoperative Patient On The Clinical Unit Ambulatory and Inpatient Surgery Discharge Review Questions References Resources 4 - Conditions Related to Altered Sensory Input 23 - Nursing Assessment: Visual and Auditory Systems THE VISUAL SYSTEM STRUCTURES AND FUNCTIONS Internal Structures and Functions ASSESSMENT DIAGNOSTIC STUDIES THE AUDITORY SYSTEM STRUCTURES AND FUNCTIONS External Ear Middle Ear Inner Ear Transmission of Sound and Implications for Hearing Loss ASSESSMENT Important Health History DIAGNOSTIC STUDIES Tests for Hearing Acuity Specialized Tests Test for Vestibular Function REVIEW QUESTIONS REFERENCES RESOURCES 24 - Nursing Management: Visual and Auditory Conditions VISUAL CONDITIONS CORRECTABLE REFRACTIVE ERRORS Surgical Therapy UNCORRECTABLE VISUAL IMPAIRMENT Levels of Visual Impairment EYE TRAUMA Inflammation and Infection DRY EYE DISORDERS STRABISMUS Corneal Scars and Opacities Keratoconus Cataract RETINOPATHY RETINAL DETACHMENT Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies AGE-RELATED MACULAR DEGENERATION Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Interprofessional Care GLAUCOMA Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Interprofessional Care INTRAOCULAR INFLAMMATION AND INFECTION ENUCLEATION OCULAR TUMOURS OCULAR MANIFESTATIONS OF SYSTEMIC DISEASES AUDITORY CONDITIONS EXTERNAL EAR AND CANAL External Otitis Cerumen and Foreign Bodies in the External Ear Canal Trauma Malignancy of the External Ear Acute Otitis Media Otitis Media With Effusion Otosclerosis INNER EAR CONDITIONS Ménière’s Disease Benign Paroxysmal Positional Vertigo Acoustic Neuroma Hearing Loss and Deafness REVIEW QUESTIONS REFERENCES RESOURCES 25 - Nursing Assessment: Integumentary System Structures Functions of the Integumentary System Assessment of The Integumentary System Assessment of Dark Skin Colour Diagnostic Studies Of The Integumentary System Review Questions References 26 - Nursing Management: Integumentary Conditions Health Promotion Environmental Hazards Rest and Sleep Exercise Hygiene Nutrition Malignant Skin Neoplasms Risk Factors Nonmelanoma Skin Cancers Actinic Keratosis Basal Cell Carcinoma Squamous Cell Carcinoma Melanoma Clinical Manifestations Interprofessional Care Atypical/Dysplastic Nevus Bacterial Infections Viral Infections Fungal Infections Infestations and Insect Bites Allergic Dermatological Conditions Cutaneous Medication Reactions Benign Dermatological Conditions Diagnostic Studies Treatment Cosmetic Procedures Body Art and Tattoos Uses Types Review Questions References Resources 27 - Nursing Management: Burns TYPES OF BURN INJURY Thermal Burns Chemical Burns Cold Thermal Injury CLASSIFICATION OF BURN INJURY Extent of Burn Location of Burn Patient Risk Factors PHASES OF BURN MANAGEMENT Prehospital Care Emergent Phase ACUTE PHASE REHABILITATION PHASE Pathophysiological Changes and Clinical Manifestations Complications EMOTIONAL NEEDS OF THE PATIENT AND CAREGIVERS SPECIAL NEEDS OF THE NURSING STAFF REFERENCES 5 - Conditions of Oxygenation:Ventilation 28 - Nursing Assessment: Respiratory System STRUCTURES AND FUNCTIONS OF THE RESPIRATORY SYSTEM Upper Respiratory Tract Lower Respiratory Tract Chest Wall Respiratory Defence Mechanisms ASSESSMENT OF THE RESPIRATORY SYSTEM Important Health Information Blood Studies Oximetry Sputum Studies Skin Tests Lung Biopsy Thoracentesis Pulmonary Function Tests Exercise Testing REVIEW QUESTIONS REFERENCES RESOURCES 29 - Nursing Management: Upper Respiratory Conditions Deviated Septum Nasal Fracture Surgical Procedures Epistaxis Allergic Rhinitis Clinical Manifestations Acute Viral Rhinitis Influenza Clinical Manifestations Sinusitis Clinical Manifestations Polyps Foreign Bodies Conditions Related to the Pharynx Acute Pharyngitis Clinical Manifestations Peritonsillar Abscess Airway Obstruction Tracheostomy Laryngeal Polyps Head and Neck Cancer Clinical Manifestations Diagnostic Studies Interprofessional Care Review Questions References Resources 30 - Nursing Management: Lower Respiratory Conditions Acute Bronchitis Pneumonia Etiology Types of Pneumonia Pathophysiology Clinical Manifestations Complications Diagnostic Studies Interprofessional Care Tuberculosis Etiology and Pathophysiology Clinical Manifestations Interprofessional Care Atypical Mycobacteria Pulmonary Fungal Infections Interprofessional Care Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Interprofessional Care Etiology and Pathophysiology Clinical Manifestations and Complications Diagnostic Studies Environmental Lung Diseases Clinical Manifestations Interprofessional Care Lung Cancer Etiology Pathophysiology Clinical Manifestations Diagnostic Studies Interprofessional Care Other Types of Lung Tumours Chest Trauma And Thoracic Injuries Pneumothorax Clinical Manifestations Interprofessional Care Fractured Ribs Flail Chest Chest Tubes And Pleural Drainage Chest Tube Insertion Pleural Drainage Chest Surgery Preoperative Care Surgical Therapy Postoperative Care Restrictive Respiratory Disorders Types Clinical Manifestations Thoracentesis Interprofessional Care Pleurisy Atelectasis Interstitial Lung Disease Idiopathic Pulmonary Fibrosis Sarcoidosis Vascular Lung Disorders Pulmonary Edema Etiology and Pathophysiology Clinical Manifestations Complications Diagnostic Studies Interprofessional Care Pulmonary Hypertension Primary Pulmonary Hypertension Etiology and Pathophysiology Clinical Manifestations Interprofessional Care Secondary Pulmonary Hypertension Cor Pulmonale Clinical Manifestations Interprofessional Care Lung Transplantation Review Questions References Resources 31 - Nursing Management: Obstructive Pulmonary Diseases Asthma Pathophysiology Triggers of Asthma Attacks Clinical Manifestations Asthma Control and Severity Diagnostic Studies for Asthma Interprofessional Care Medication Therapy Chronic Obstructive Pulmonary Disease Pathophysiology Clinical Manifestations Clinical Assessment Interprofessional Care Cystic Fibrosis Etiology and Pathophysiology Clinical Manifestations Complications Diagnostic Studies Interprofessional Care Review Questions References Resources 6 - Conditions of Oxygenation:Transport 32 - Nursing Assessment: Hematological System Bone Marrow Blood Iron Metabolism Clotting Mechanisms Spleen Lymph System Liver ASSESSMENT OF THE HEMATOLOGICAL SYSTEM Important Health Information DIAGNOSTIC STUDIES OF THE HEMATOLOGICAL SYSTEM Radiological Studies Biopsies Molecular Cytogenetics and Gene Analysis REVIEW QUESTIONS REFERENCES RESOURCES 33 - Nursing Management: Hematological Conditions Anemia Definition and Classification Clinical Manifestations Integumentary Changes Cardiopulmonary Manifestations IRON-DEFICIENCY ANEMIA Etiology Clinical Manifestations Diagnostic Studies Interprofessional Care Etiology Clinical Manifestations Interprofessional Care Megaloblastic Anemias Cobalamin Deficiency Etiology Clinical Manifestations Diagnostic Studies Interprofessional Care Folic Acid Deficiency Anemia of Chronic Disease Aplastic Anemia Etiology Clinical Manifestations Diagnostic Studies Anemia Caused By Blood Loss Acute Blood Loss Clinical Manifestations Diagnostic Studies Chronic Blood Loss Anemia Caused By Increased Erythrocyte Destruction Sickle Cell Disease Clinical Manifestations Complications Diagnostic Studies Acquired Hemolytic Anemia Hemochromatosis Polycythemia Etiology and Pathophysiology Clinical Manifestations and Complications Diagnostic Studies Interprofessional Care Conditions of Hemostasis Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Interprofessional Care Hemophilia and Von Willebrand Disease Clinical Manifestations and Complications Diagnostic Studies Interprofessional Care Disseminated Intravascular Coagulation Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Interprofessional Care Neutropenia Clinical Manifestations Diagnostic Studies Myelodysplastic Syndrome Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Leukemia Etiology and Pathophysiology Classification Clinical Manifestations Diagnostic Studies Interprofessional Care Lymphomas Hodgkin’s Lymphoma Etiology and Pathophysiology Clinical Manifestations Diagnostic and Staging Studies NON-HODGKIN’S LYMPHOMA Etiology and Pathophysiology Clinical Manifestations Diagnostic and Staging Studies Multiple Myeloma Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Interprofessional Care Disorders of The Spleen Blood Component Therapy Administration Procedure Blood Transfusion Reactions Autotransfusion Review Questions References Resources 7 - Conditions of Oxygenation:Perfusion 34 - Nursing Assessment: Cardiovascular System Heart DIAGNOSTIC STUDIES OF THE CARDIOVASCULAR SYSTEM Invasive Studies REVIEW QUESTIONS REFERENCES RESOURCES 35 - Nursing Management: Hypertension Normal Regulation of Blood Pressure Sympathetic Nervous System Vascular Endothelium Renal System Endocrine System Hypertension Subtypes of Hypertension Etiology Pathophysiology of Primary Hypertension Clinical Manifestations Complications Hypertensive Heart Disease Diagnostic Studies Interprofessional Care Hypertensive Crisis Clinical Manifestations Review Questions References Resources 36 - Nursing Management: Coronary Artery Disease and Acute Coronary Syndrome Coronary Artery Disease Etiology and Pathophysiology Developmental Stages Collateral Circulation Risk Factors for Coronary Artery Disease Nonmodifiable Risk Factors Major Modifiable Risk Factors Modifiable Contributing Risk Factors Health Promotion Cholesterol-Lowering Medication Therapy Antiplatelet Therapy Chronic Stable Angina Prinzmetal’s Angina Interprofessional Management Medication Therapy Diagnostic Studies Acute Coronary Syndrome Etiology and Pathophysiology Unstable Angina Myocardial Infarction Clinical Manifestations of Myocardial Infarction Healing Process Complications of Myocardial Infarction Unstable Angina and Myocardial Infarction Other Measures Interprofessional Care Emergent Percutaneous Coronary Intervention Fibrinolytic Therapy Medication Therapy Nutritional Therapy Coronary Surgical Revascularization Sudden Cardiac Death Etiology and Pathophysiology Review Questions References Resources 37 - Nursing Management: Heart Failure Heart Failure Etiology and Pathophysiology Types of Heart Failure Clinical Manifestations of Heart Failure Clinical Manifestations of Chronic Heart Failure Classification of Heart Failure Diagnostic Studies Interprofessional Care: Chronic Heart Failure Referral to Multidisciplinary Clinics or Specialist Care for Heart Failure Cardiac Transplantation Advance Care Planning and Goals of Care Medication Therapy: Chronic Heart Failure Diuretics Angiotensin-Converting Enzyme Inhibitors Neprilysin Inhibitors β-­Adrenergic Blockers Mineralocorticoid Receptor Antagonists Inotropic Medications Nutritional Therapy: Heart Failure General Principles Cardiac Transplantation Mechanical Cardiac Support Devices Review Questions References Resources 38 - Nursing Management: Dysrhythmias Rhythm Identification and Treatment Conduction System Nervous Control of the Heart Electrocardiographic Monitoring Types of Monitoring Assessment of Cardiac Rhythm Electrophysiological Mechanisms of Dysrhythmias Evaluation of Dysrhythmias Types of Dysrhythmias Antidysrhythmia Medications Defibrillation Pacemakers Radiofrequency Ablation Therapy Electrocardiographic Changes Associated with Acute Coronary Syndrome Ischemia Injury and Infarction Patient Monitoring Syncope Review Questions References Resources 39 - Nursing Management: Inflammatory and Structural Heart Disorders Inflammatory Disorders of the Heart Infective Endocarditis Classification Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Interprofessional Care Acute Pericarditis Etiology and Pathophysiology Clinical Manifestations Complications Diagnostic Studies Interprofessional Care Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Interprofessional Care Rheumatic Fever and Heart Disease Etiology and Pathophysiology Clinical Manifestations Complications Diagnostic Studies Interprofessional Care Valvular Heart Disease Etiology and Pathophysiology Clinical Manifestations Etiology and Pathophysiology Clinical Manifestations Etiology and Pathophysiology Clinical Manifestations Etiology and Pathophysiology Clinical Manifestations Etiology and Pathophysiology Clinical Manifestations Etiology and Pathophysiology Diagnostic Studies for Valvular Heart Disease Cardiomyopathy Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Review Questions References Resources 40 - Nursing Management: Vascular Disorders Peripheral Artery Disease Etiology and Pathophysiology of Peripheral Artery Disease Clinical Manifestations Critical Limb Ischemia Complications Diagnostic Studies Interprofessional Care Etiology and Pathophysiology Clinical Manifestations Complications Interprofessional Care Other Peripheral Arterial Disorders Etiology and Pathophysiology Clinical Manifestations Diagnostics Medical Therapy Surgical and Interventional Therapy Raynaud’s Phenomenon Clinical Manifestations Interventional Therapy Interprofessional Care Other Vascular Disorders Aortic Aneurysms Etiology and Pathophysiology Classification Clinical Manifestations Complications Diagnostic Studies Surgical Intervention Endovascular Intervention Interprofessional Care Aortic Dissection Etiology and Pathophysiology Clinical Manifestations Complications Diagnostic Studies Conservative Therapy Endovascular Intervention Surgical Intervention Interprofessional Care Venous Disorders Phlebitis Venous Thromboembolism Etiology and Pathophysiology Deep Vein Thrombosis Varicose Veins Etiology and Pathophysiology Clinical Manifestations and Complications Diagnostic Studies Interprofessional Care Chronic Venous Insufficiency and Venous leg Ulcers Etiology and Pathophysiology Clinical Manifestations and Complications Interprofessional Care Review Questions References Resources 8 - Conditions of Ingestion,Digestion, Absorption, and Elimination 41 - Nursing Assessment: Gastrointestinal System STRUCTURES AND FUNCTIONS OF THE GASTROINTESTINAL SYSTEM Ingestion and Propulsion of Food Subjective Data Important Health Information Objective Data DIAGNOSTIC STUDIES OF THE GASTROINTESTINAL SYSTEM Endoscopy Liver Biopsy Liver Function Studies REVIEW QUESTIONS REFERENCES RESOURCES 42 - Nursing Management: Nutritional Conditions Nutritional Conditions Healthy Nutrition Major Nutrients Vegetarian Diet Culturally Competent Care Malnutrition Etiology of Malnutrition Pathophysiology of Starvation Clinical Manifestations Dysphagia Oral Nutrition Enteral Nutrition Parenteral Nutrition Review Questions References Resources 43 - Nursing Management: Obesity Obesity Classifications of Body Weight and Obesity Epidemiology of Obesity Etiology and Pathophysiology Health Risks Associated With Obesity Metabolic Syndrome Etiology and Pathophysiology Medication Therapy Orlistat (Xenical) Liraglutide (Saxenda) Naltrexone HCL/ Bupropion HCL (Contrave®) Bariatric Surgical Therapy Restrictive Surgeries Malabsorptive Surgery Combination of Restrictive and Malabsorptive Surgery Cosmetic Surgical Therapy Ambulatory and Home Care Review Questions References Resources 44 - Nursing Management: Upper Gastrointestinal Conditions Nausea and Vomiting Etiology and Pathophysiology Clinical Manifestations Interprofessional Care Foodborne Illness Escherichia coli O157:H7 Poisoning Oral Inflammations and Infections Oral Cancer Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Interprofessional Care Esophageal Disorders Gastroesophageal Reflux Disease Etiology and Pathophysiology Clinical Manifestations Complications Diagnostic Studies Interprofessional Care Hiatal Hernia Types Etiology and Pathophysiology Clinical Manifestations Complications Diagnostic Studies Esophageal Cancer Etiology and Pathophysiology Clinical Manifestations Complications Diagnostic Studies Interprofessional Care Eosinophilic Esophagitis Esophageal Diverticula Esophageal Strictures Achalasia Esophageal Varices Gastritis Types Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Gastric Cancer Etiology and Pathophysiology Clinical Manifestations Diagnostic Studies Interprofessional Care

Master the role and skills of the medical-surgical nurse in Canada with the book that has it all! Lewis's Medical-Surgical Nursing in Canada: Assessment and Management of Clinical Problems, 5th Edition reflects the expertise of nurses from across Canada with evidence-informed guidelines, a focus on clinical trends, and a review of pathophysiology. Clear examples make it easy to understand every concept in nursing care — from health promotion to acute intervention to ambulatory care. An Evolve website includes new case studies to enhance your skills in clinical judgement and prepare you for the Next Generation NCLEX®, CPNRE®, and REx-PNTM. From Canadian educators Jane Tyerman and Shelley L. Cobbett, this comprehensive guide provides a solid foundation in perioperative care as well as nursing care of disorders by body system.

• Easy-to-understand content is written and reviewed by leading experts in the field, ensuring that information is comprehensive, current, and clinically accurate.
• More than 800 full-colour illustrations and photographs demonstrate disease processes and related anatomy and physiology.
• Focus on key areas includes the determinants of health, patient and caregiver teaching, age-related considerations, collaborative care, cultural considerations, nutrition, home care, evidence-informed practice, and patient safety.
• Nursing Assessment chapters focus on individual body systems and include a brief review of related anatomy and physiology, a discussion of health history and non-invasive physical assessment skills, and note common diagnostic studies, expected results, and related nursing responsibilities.
• Unfolding case studies in each assessment chapter help you apply important concepts and procedures to real-life patient care.
• UNIQUE! Levels of Care approach organizes nursing management into three levels: health promotion, acute intervention, and ambulatory and home care.
• Nursing Management chapters focus on the pathophysiology, clinical manifestations, laboratory and diagnostic study results, interprofessional care, and nursing management of various diseases and disorders, and are organized to follow the steps of the nursing process (assessment, nursing diagnoses, planning, implementation, and evaluation).
• Safety Alerts and Drug Alerts highlight important safety issues in patient care.
• Informatics boxes discuss the importance and use of technology with topics such as use of social media in the context of patient privacy, teaching patients to manage self-care using smartphone apps, and using Smart infusion pumps.
• Cultural Competence and Health Equity in Nursing Care chapter discusses culture as a determinant of health, especially in regard to Indigenous populations; health equity and health equality issues as they relate to marginalized groups in Canada; and practical suggestions for developing cultural competence in nursing care.
• More than 60 comprehensive nursing care plans on the Evolve website include defining characteristics, expected outcomes, specific nursing interventions with rationales, evaluation criteria, and collaborative problems.

NEW! Coverage of the COVID-19 pandemic and the SARS-CoV-2 virus focuses on COVID's impact on nurses and patients alike. NEW! Updated content includes the latest Canadian statistics, research, clinical guidelines, assessment and screening tools, and more, all using SI units and metric measurements. NEW! Current and inclusive terminology supports Indigenous people and a commitment to eliminating gender bias and cisnormative language, including patient profiles that use preferred pronouns as well as initials in place of full names. NEW! Expanded and updated coverage of topics includes Bill C-14 and proposed Bill C-7, on medical assistance in dying (MAID), the Cannabis Act and its implications for certain disorders, rural and remote nursing, interprofessional collaboration, and Indigenous health vis--vis the Truth and Reconciliation Commission findings and its Calls to Action . NEW! Updated Introduction to Medical-Surgical Nursing Practice in Canada chapter focuses on critical thinking, clinical judgement, and clinical decision-making, and places nursing practice in a unique Canadian context. NEW! Updated Community-Based Nursing and Home Care chapter adds content on the impact of the COVID-19 pandemic, addressing changes such as home health monitoring and the integration of virtual care. NEW! Updated Substance Use chapter covers stigmatizing behaviours by health care providers that negatively impact patient outcomes, the impact of substance use experienced by Indigenous people, and treatment options for opioid use disorders. NEW! Updated Nursing Management: Obstructive Pulmonary Diseases chapter expands content on asthma, including an overview of environmental and physiological triggers, diagnostic testing, and treatment options, and adds modifications to respiratory treatment protocols and infection control practices resulting from the SARS-CoV-2 virus. NEW! Learning tools in the book and on the Evolve website help you develop skills in clinical reasoning and judgement, preparing you to succeed on the Next Generation NCLEX(R), CPNRE(R), and REx-PN(TM).