from jcu.edu.au - James Cook University

KOZIERAND ERB'S
FUNDAMENTALS
OF NURSING
FIRST AUSTRAlIAN EDITION
VOLUME ONE
Cover art
Roben 5lUurman is a Noongar from Western Austra lia who does Aboriginal an as a result of meet-
ing hi s birth mother in 1994. He is from th e Stolen Gene rati ons.
The cover of this book is adapted from one of his paintings called Pathways th rough the Sea. Thi
painting shows that knowing o ne's ability in un env ironme nt reflects knowing what to do in s ituoti ons
and circumstances-in this case kn owi ng the seasons and cycles of the sea.
Starfish indicate a form of tenaciousness, because when one of their arms is cul off it grows back
agai n. Th is tenaciollsness fo r life is a lso I'e fl ectecl in the amOllnl of clot work thm is inrli c:nive of thi ~
slOry.
Tenacity and persiste nce is also reflec ted in the fie ld of nursing. Due to nurses' will ingness to
make a difference to promote lifc, in many respects they are the unsung heroes that stay true to their
pathway. Much like the pathway of tbe sea, they are always there.
Thj s book cover is dedicated to would-be nurses who read this book and to the ones out in remote
places that have had to make do with little.
Robe rt Stuurman, artist
KOZIERAND ERB'S
FUNDAMENTALS
OF NURSING
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FIRST AUSTRALIAN EDITION
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AUDREY 13Er.MAN
NICHOLE HArNEY
SHIRLEE J. SNYDEr.
YONI LUXFORD
13AR13ARA KOZIEr.
LORNA MOXHAM
GLENORA Er.13
TANYA PARK
mACY LEVEn-JONES
13AR13ARA PARKEr.
mUDY DWYEr.
KEr.RY REID-SEARL
MAJELLA HALES
DAVID STANLEY
Copyright «:l Pearson Auslralia (a division of Pearson Australia Group Pty Ltd) 2010
Pca~u
Australia
Unit 4, Level 3
14 Aquatic Drive
Frenchs Forest NSW 2086
wwwpearson com pu
Authorised ndnpl:uion from The Un ited ST:lT("$. eli itinn p.nTi tletl Knt.;pr
~ F.rb '.f F'",u}nIllPlltnls
of Nur,~;" g . Rt h edition. ISRN 0111714686 by
Berman, Audrey; Snyder, Shirlee; Kozicr, Barbara; Erb, Glenora, published by PCtmQn Education, Inc, publishing as Prentice Hall ,
Copyright @ 2008.
1st adaptation editJon publiShed by Pearson AUStralla. Copyright 192010.
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away.
Senior Acquisitions Edilor: Michelle Aarons
Senior Project Editor: Katie Millar
Managing Development Editor: Michael Stone
bdltonal Coonhnalor: Yvonne ShepherdlFranny Gustafson
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Cvvel illustralion by Raben Sluunnan
Typeset by Midland TypesetterS. Australia
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National LibfW)' of Australia
Cllt~ l ogui ns-in-Pub l ic:tlion
Data
Kozier and Erb's Fundamentals of Nursing/Berman, Audrey [et al.].
1s t Australian ed.
978144250469 1 (pbk: Voll)
~7tsl4425U47U7 (pbk: Vol 2)
9781442504714 (pbk: Vol 3)
Includes index.
Notes:
Nursin2.
Subjects:
Nursing Process.
Nursing Care.
Other AuthOrs/Contributors:
Title:
Ed ition:
ISBN:
Bet tnan, AuJley.
Kozier. Barbara.
Erb, Glenora Lea.
Dewey Number: 6 10.73
Every effort has been made to lrace and acknowledge copyright. However. should any infringement have occurred. the publishers tender lheir
apologies and invite copyright owners to contact them.
Pearson Australia is a division of
--
PEARSON
VOLUME 1
VOLUME 2
UNIT 1
THE NATURE OF NURSING
UNIT 6
INTEGRAl ASPECTS OF
NURSING
CHAPTER I
1
Hjstorical and Contemporary Nursing
2
Practi ce
CHAPTER 2
Nurse Education, Research and
Evidence-Based Practice
23
CHAPTER 3
Nursing Theories and Conceptual
Frameworks
Legal Aspects of Nursing
Values, Ethics and Advocacy
38
55
86
CHAPTER 4
CHAPTER 5
UNIT 2
CONTEMPORARY HEALTH CARE 105
CHAPTER 6
CHAPTER 7
CHAPTER 8
CHAPTER 9
Health Care Delivery Systems
Community Health Nursing
Home Care
Nursing Informatics
UNIT3
THE NURSING PROCESS
CHAPTcK IU
CHAPTER II
CHAPTER 12
CHAPTER 13
CHAPTER 14
CIIAPTERI5
Critical 'flunking and the Nursing
Process
Assessing
Diagnosi ng
Planning
Implementing and Evaluating
Documenting and Reporting
UNIT4
HEALTH BEUnS AND
PRACTICES
CHAPTER 16
CHAPTER 17
CHAPTER 18
CHAPTER 19
?O
Health Promotion
Health, Wellness and Illness
Cultures and Nursing
Complementary and Alternative
Therapies
CHAPTER 2 1
CHAPTER 22
CHAPTER 23
CHAPTER 24
r.nnr:f':pt.c;: nf Growth
l22
133
147
167
168
18 1
202
218
241
254
277
UNIT 5
UFESPAN DEVELOPMENT
<CHAPTER
106
278
305
323
343
361
~nci
Development
Promoting Health from Conception
through to Adolescence
Promoting Health in Young and
Middle-Aged Adults
Promoting Health in Older Adults
Promoting Family Health
362
381
409
423
448
CHAPTER 25
CHAPTER 26
CHAPTER 27
CHAPTER 28
Caring
Communicating
Teaching
Leading, Managing and Delegating
UNIT 7
ASSESSING HEALTH
CHAPTER 29
CHAPTER 30
Vital Signs
Health Assessment
UNIT 8
INTEGRAL COMPONENTS OF
CUENTCARE
46:5
464
482
517
546
561
562
607
699
Asepsis
Safety
Hygiene
Diagnostic Testi ng
Medications
Skin Integrity and Wound Care
Peri operative Nursing
700
744
780
839
875
949
987
UNIT9
PROMOTING PSYCHOSOCIAL
HEALTH
1031
CHAPTER 3 1
CHAPTER 32
CHAPTER 33
CHAPTER 34
CHAPTER 35
CHAPTER 36
CHAPTER 37
VOLUME J
CHAPTER 38
CHAPTER 39
CHAPTER 40
CHAPTER 41
CHAPTER 42
CHAPTER 43
Sensory Perception
Self-Concept
Sexuality
Spirituality
Stress and Coping
Loss, Grievi ng and Death
UNIT 10
PROMOTING PHYSIOLOGIC
HEALTH
CHAPTER 44
CHAPTER 45
CHAPTER 46
CHAPTER 47
CHAPTER 48
CHAPTER 49
CHAPTER 50
CHAPTER 5 1
CHAPTER 52
1163
Activity and Exercise
lI 64
Sleep
Pain Management
1220
1246
1292
1345
1386
l422
1467
Nutrition
Urinary Elimination
Faecal Elimination
Oxygenation
Circulation
Fluid, Electrolyte and Acid- Base
Balance
Glossary
Index
1032
1056
J073
1098
11 18
1139
1492
GI
11
ABOUT THE ORIGINATING AUTHORS
ABOUT THE AUSTRALIAN AUTHORS
PREFACE TO THE FIRST AUSTRALIAN EDITION
CONTRIBUTORS
XIII
Con tractu al Arrangemen ts in Nursing
67
xv
Selected L egal Aspects of Nursing Prac tice
71
Areas of Potential Liability in Nursing
Legal Protections in Nursing Practice
Reporting Crimes, Torts and Unsafe Practices
76
K2
Legal Responsibilities of Students
82
XVII
XXIV
CHAPTERS
VOLUME 1
UNIT 1
THE NATURE OF NURSING
1
CHAPTER 1
HISTORICAL AND CONTEMPORARY
NURSING PRACTICE
Historical Perspectives
Cnntp.mpnr:1 ry N llrsine Pr::tcticp.
80
2
3
q
Roles and Functions of the Nurse
II
VALUES, ETHICS AND ADVOCACY
86
Values
Morality and Ethics
Nursing Ethics
90
Specific Ethica1 Issues
95
Advocacy
99
87
92
UNIT 2
CONTEMPORARY HEALTH CARE
lOS
Criteria of a Profession
13
CHAPTER 6
SociaLisalion to Nun:iing
15
HEALTH CARE DELIVERY SYSTEMS
Factors Influencing Contemporary Nursing Practice
Nursing Organisations
IS
Types of Health Care Services
Types of Health Care Agencies and Services
Providers of Health Care
Factors Affecting Health Care Delivery
107
108
III
23
The Au stralian Hca ltJl Syste m
11 4
Nurse Education
24
117
Types of Educationa l Programs
25
Frameworks for Care
Financing Health Care
Nursing Research and Evidence-Based Practice
Critiquing Research Repol1s
28
34
18
CHAPTER 2
NURSE EDUCATION, RESEARCH AND
EVIDENCE-IJASED PRACTICE
CHAPTER 3
NURSING THEORIES AND CONCEPTUAL
FRAMEWORKS
lntroductlOn to Theories
The Metaparadigm for N ursing
Purposes of Nursing Theory
Overview of Selected Nursing Theories
Nursi ng Theorists in A ustralia
Critique of Nursing Theorv
38
39
40
41
42
106
11 3
11 8
CHAPTER 7
COMMUNITY HEALTH NURSING
Health Care Reform
Community-Based Health Care
Community Health
Community Health and Primary Care
Community-Based Nursing
122
123
124
125
126
129
CHAPTER 8
HOME CARE
133
49
Home H ealth N ursi ng
134
49
The Home Health Care System in Australia
Roles of the Home Health Nurse
136
138
13Y
CHAPTER 4
Perspectives of Home Care Clients
LEGAL ASPEGS OF NURSING
55
Legal Aspects of Nursing
Regulation of Nursing Practice
56
64
Selected Dimensions of Home Health Nursing
The Practice of Nursing in the Home
The Future of Home Health Care
139
142
143
Contents
CHAPTER 15
CHAPTER 9
NURSING INFORMATICS
VII
147
DOCUMENTING AND REPORTING
254
Ge neral Concepts
148
Ethical and Legal Considerations
255
CompUlers in Nursing and Midwifery Practice
153
159
Pu rposes of Patient Records
255
Documentarian Systems
Co mputers in Nursing Adm ini stration
16 1
Documenting Nursi ng Activi ties
Computers in Nursing and Midwifery Research
162
Documentation in Residential Aged Care Facil ities
Home Care Documentation
256
264
266
Computers in Nursing and M.idwifery Education
UNIT 3
THE NURSING PROCESS
167
CHAPTER 10
CRITICAL THINKING AND THE NURSING PROCESS
168
C ritical Thjnking
169
Skills in Critical Thinking
170
Attitudes that Foster Critical Thinking
Standards of Critical Thinking
I7l
267
General Guidelines for Recording
267
Reporting
270
UNIT 4
HEAlTH BELIEFS AND PRACTICES 277
CHAPTER 16
HEALTH PROMOTION
App lying Critical Thi nking to Nursing Practice
173
173
Developing Critical-Thi nki ng Attitude s and Ski lls
176
Indi vidual Health
Appl yi ng Theoretical Frameworks
279
280
Defini ng Health Promotion
285
CHAPTER 11
ASSESSING
181
278
Overview of the Nursing Process
[82
Sites for Health Promotion Activities
Health Promotion Model
285
287
Assessing
Cullt::t,.:tiJ 'g D aLa
186
t 86
Stages of Health Behaviour Cbange
The Nurse's Role in Health Promo tion
289
29 1
Organising Data
195
NURSING MANAGEMENT
292
Validating Data
Documenting Data
198
199
CHAPTER 12
DIAGNOSING
CHAPTE R 17
HEALTH, WELLNESS AND ILLNESS
202
305
Concepts of H ealth , Wellness and WeUbein g
3U6
308
NANDA- I: The Australian Context
203
Models of Heal th and Wellness
NANDA-I Nursing Diagnoses
203
206
Variables I nfluencing Health Status, Beliefs and
Practices
3 11
213
Health Beljef Models
313
Health Care Concordance
Ill ness and Disease
317
The Diagnostic Process
Ongoi ng Development of Nursing Diagnoses
CHAPTER 13
PLANN ING
218
The C lassi fi catjo ll System in Austra lia
219
Types of Planni ng
219
Developing Nursing Care Plans
The Planning Process
220
225
233
The Nursing Interventi ons C lass ificati on
CHAPTE R 14
IMPLEMENTING AND EVALUATING
Implementing
Eval uati ng
316
241
242
245
CHAPTER 18
CULTURES AND NURSING
323
Na liullal Organisid ions and Tre nd s
324
Cultu ral Nursing Ca re
325
Concepts Related to C ultura l Nursing Care
Heritage Consistency
Selected Parameters for Cultu ral Nurs ing Care
326
328
329
Providing Cultural Nurs ing Care
334
NURSING MANAGEMENT
33<1
VI Ll
Contents
CHAPTE R 24
C HAPTER 19
COMPLEMENTARY AND ALTERNATIVE THERAPIES
343
PROMOTI NG FAMI LY HEALTH
448
Basic Concepts
344
Fami ly Healtb
Ethnocentrism and M edical Intransigence
346
Applying Theoretical Frameworks to Famil ies
451
NURSING MANAGEMENT
453
UNIT 5
LIFESPAN DEVELOPMENT
361
449
VOLUME 2
UNIT 6
INTEGRAl ASPECTS OF NURSING 463
C HAPTE R 20
CONCEPTS OF GROWTH AND DEVELOPMENT
362
363
364
364
C HAPTER 25
Stages of Growth and Development
Growth and Development Theories
Applying Growth and Developme nt Concepts to
Nursing Practice
376
Nursing Theories on Caring
Types or Knowledge I II Nurslllg
Factors lnfl uenci ng Growth and Development
Conception and Prenatal Development
Neonates and Infants (Birth to I Year)
Toddlers ( I to 3 Years)
Preschoolers (4 and S Years)
School-Age Children (6 to 12 Years)
Adolescents ( 12 to 18 Years)
Young Adu lts (20 to 40 Years)
Middle-Agen Anult< (40
10
65 Years)
464
465
465
470
47 1
473
381
382
384
390
393
396
399
C HAPTER 22
PROMOTING HEALTH IN YOUNG AND
MIDDLE-AGED ADULTS
Professionalisation of Caring
Caring Encounters
Maintaining Caring Practice
C HAPTER 21
PROMOTING HEALTH FROM CONCEPTION
THROUGH TO ADOlESCENCE
CARING
CHAPTE R 26
COMMUNICATING
Communjcating
Therapeutic Relation hips
Group and Team Communication
483
497
502
Communication and the Nursing Process
NURSING MANAGEMENT
505
Communication Among Health Professio nals
508
409
C l lAPTE R 27
410
415
TEACHING
Teaching
Learning
CHAPTER 23
482
504
517
518
521
The Internet and Health lnformation
Nurse as Educator
526
424
NURSING MANAGEMENT
527
Attitudes Toward Ageing
Gero ntological Nursing
425
426
C HAPTE R 28
Care Settings for Older Adults
Ageillg
427
429
111e: Nurse as Leader and Manager
547
Psychosocial Ageing
435
Leadership
547
Cognitive Abilities and Ageing
Moral Reasoning
438
438
439
Management
Clinical Governance
550
The Nurse as Deiegalor
Change
Types of Change
554
PROMOTING HEALTH IN OLDER ADULTS
423
Characteristics of Older Adults in Australia
Physjulu~i~al
Spirituality and Ageing
Health Problems
Health A sessment and Promotion
439
442
LEADING, MANAGING AND DELEGATING
527
546
554
555
556
Contents
UNIT 7
ASSESSING HEALTH
561
CHAPTER 29
VITAL SIGNS
562
The Neurologic System
SKI LL 30.17 Assessing the Neurologic System
The Fem ale G enitals and Ln guinal Area
679
680
687
SKI LL 30.18 Assessing the Female G enitals and
Inguinal Area
The Male Genitals and Inguinal Area
687
689
Body Temperature
SKI Ll29.1 Assessing Body Temperature
Pulse
SKJ Ll29.2 Assessing a Peri pheral Pul se
563
573
SKI LL 30.19 Assessing the Male Genitals and
Inguinal Area
The Rectum and Anus
575
SKI LL 30.20 Assessing the Rectum and Anus
SKILL 29.3 Assessing an Apical Pulse
SKILL 29.4 Assessing an Apical-Radial Pulse
582
584
5Mb
SKI Ll29.5 Assessing Respirations
Blood Pressure
SKILL 29.6 Assessing Blood Pressure
Oxygen Saturation
589
59 1
596
599
SKI LL 29.7 Measuring Oxygen Saturalion
60 1
CHAPTER 30
607
UNIT 8
INTEGRAL COMPONENTS OF
CLIENT CARE
ASEPSIS
702
Hospital-Acqui red infecti ons
702
703
705
707
608
General Assessment
SKI LL30.1 Assessing Appearan ce and Mental Status
615
616
The Integument
SKI LL 30.2 Assessing the Skin
619
SKI LL 30.3 Assessing the Hair
SKI LL 30.4 Assessing the Nails
The Head
SKILL 30.5 Assessing the Skull and Face
SKI LL30.6 Asses ing the Eye Structures and
Visual Acuity
625
629
Body Defences Against Infection
Factors Increasing Susceptibil ity to Infection
NURSING MANAGEMENT
SKILL31.1 Hand Washing
Isolation Precautions
Isolation Practi ces
S Kl Ll 31.2 Do nning and Remov ing Personal Protective
Equipment (Gloves, Gown, Mask, Eyewear)
SKI LL 30.7 Assessing the Ears and Hearing
SKI LL 30.8 Assessing the Nose and Sinuses
SKI LL30.9 Assessing th e Mouth and Oropharynx
The Neck
SKILL JO.JO Assess ing the Neck
The Thorax and Lungs
SKI Ll30.1! Assessing the Thorax and Lungs
The Cardiovascul ar and Peripheral Vasc ul ar Systems
638
641
643
646
The Atxlomen
SKI LL 30.15 Assessing th e Abdomen
The Musc ul oskeletal System
SKILL 30. 16 Assessing the Musc ul oskeletal System
630
630
633
647
649
652
656
658
661
663
664
667
668
672
673
700
Types of Infections
Phys ical Health Assessment
023
699
CHAPTER 31
Chain of Infection
SKILL 30.12 Assessing the Heart and Central Vessels
SKI LL 30.13 Assessing the Peripheral Vascular System
The Breasts and Axillae
SKI LL 30.14 Assessing the Breasts and Ax illae
691
693
693
580
Kespirati ons
HEALTH ASSESSMENT
IX
711
7 16
720
723
724
Sterile Technique
SKILL 31.3 EstabUshing and Maintaining a Steril e
Field
SKI LL 31.4 Donning and Removing Steri le Gloves
(Upen Method)
SKI LL 31.5 Donning a Steril e Gown and Gloves
(Closed Method)
Infection Control for Health Care Workers
Role of the Infection Control Nurse
728
736
737
738
EV:l IIiMing
738
730
734
CHAPTER 32
SAFETY
744
Factors Affecting Safety
745
748
NURSING MANAGEMENT
SKI LL 31.1 Using a Bed or Chair exit Safety
Monitoring Device
SKI LL 32.2 Implementing Seizure Precauti ons
SKI LL32.3 Appl ying Restraints
761
763
77 1
X Contents
CHAPTER 33
HYGIENE
780
Hygienic Care
Skin
NURSING MANAGEMENT
SKI LL 33.:1 Bathing an Adult or Paediatric Client
SKI LL 33.2 Providing Perineal-Geniwl Care
781
78 1
787
786
795
797
798
80 1
802
802
ROl
804
809
Feel
NURSING MANAGEMENT
SKILL 33.3 Providing Foot Care
Nails
NURSING MANAGEMENT
Mouth
NURSING MANAGEMENT
SKILL 33.4 Brushing and Flossing the Teeth
NURSING MANAGEMENT
SKI LL 33.6 Providing Hair Care for Cl ients
SKI LL 33.7 Shampooing the Hair of a Client
Confined 10 Bed
Eyes
NURSING MANAGEMENT
Ears
SKI LL 33.8 Removing, Cleaning and Inserting a
lleari ng Aid
Nose
Supporting a Hygienic Environment
Making Beds
SKI LL 33.9 Changing an Unoccupied Bed
SKI LL 33.10 Changing an Occupied Bed
FaClOrs Affecting Medication ACli oll
ROlltes of Administration
Medication Orders
Systems of Measurement
Admi nistering Medications Safely
OraJ Medicati ons
SKI LL 35.1 Administering Oral Medications
Nasogastric and Gastrostomy Medication
Parenteral Medications
SKI LL 35.2
SKI LL 35.3
SKI LL 35.4
SKI LL 35.5
Preparing Medications from Ampoule
Preparing Medications from Vials
Milling Medications Using One Syringe
Administering an Intradermal Injection
for Skin Test"
SKlll 33.5 Prov iding Spec iaJ OraJ Care rur lbe
Unconscious Client
Hair
Drug Misuse
Actions of Drugs on the Body
812
8 14
814
817
8 18
820
R20
824
825
826
826
828
829
833
SKI LL 35.6 Administering a Subcutaneous Injection
SKI LL 35.7 Administering an Intram uscular Injection
DIAGNOSTIC TESTING
Diagnostic Testing Phases
Blood Tests
839
840
84 1
SKJ Ll34.l OlJWillillg A Capillaly Blood Specimen lO
Measure Blood Glucose
848
Specimen Collection
85 1
SKI LL 34.2 Collecting a Urine Sample for Culture and
Sensitivity by Mid-stream Specimen of Urine (MSU) 855
Visualisation Procedure
86 1
Aspiration/Biopsy
863
CHAPTER 35
MEDICATIONS
875
Drug Standards
876
877
879
Legal Aspects of Drug Admi nistrati on
Effects of Drugs
9 13
9 16
922
SKI lL 35.8 Adding Medications La IlllfavellUus F luitl
Containers
925
SKILL 35.9 Administering Intrave nous Medications
Using IV Push
SKI LL 35.10 Administering Ophthalmic Instillations
SKI LL 35.11 Administering Otic Instillations
SKI LL 35.12 Adminislering Vaginal Instillations
Respiratory Inhalation
929
933
936
940
942
I rrigations
944
CHAPTER 36
SKIN INTEGRITY AND WOUND CARE
949
Skin lntegrity
Types of Wounds
950
950
951
955
958
Pressure Ulcers
CHAPTER 34
880
88 1
883
884
886
888
892
898
898
902
902
908
909
9 11
Wound HeaHng
NURSING MANAGEMENT
SKI LL 36.1 Obtaining a Wound Drainage Specimen
for Culture
SKlLL 36.2 Irrigating a Wound
960
973
CHAPTER 37
PERI OPERATIVE NURSING
Types of Surgery
Preoperative Phase
NURSING MANAGEMENT
SKILL 37.1 Teaching Moving, Leg Exercises, Deep
Breathing and Coughing
SKI LL 37.2 Applying Antiemboli Stockings
Intraoperative Phase
NURSING MANAGEMENT
Postoperative Phase
987
988
990
991
995
1000
1003
1004
1005
Contents
NURSING MANAGEMENT
SKILL 37.3 Managing Gastrointestinal Suction
S KJ LL 37.4 C leaning a Sutured Wouml
dllli
1007
1015
ApjJlying
a Sterile Dressing
10 19
VOLUME 0
UNIT 9
PROMOTlNG PSYCHOSOCiAL
HEALTH
1031
Components of the Sensory Experience
1032
Se.nsory Alterations
1033
1033
Factors Affecting Sensory Function
1035
NURSING MANAGEMENT
Self-Concept
Formation of Self-Concept
Components of Self-Concept
Factors that Affect Self-Concept
NURSING MANAGEMENT
LOSS, GRIEVING AN D DEATH
1139
Loss and Grief
NURSING MANAGEMENT
Dying and Death
NURSING MANAGEMENT
1I40
PROMOTING PHYSIOLOGIC
HEALTH
1056
Normal Movement
Exercise
1057
1059
1060
1062
10 7 3
Two Nurses
SKILL 44.7 Assisting the Client to Sit on the Side of
the Bed
SKI LL 44.8 Assisti ng the Client to Ambulate
1079
1080
108 1
1083
1086
CHAPTER 41
Spi rituality Described
Related Concepts
Spiritual Development
Spiritual Practices Affecting Nursing Care
Spiritual Health and the Nursing Process
NURSING MANAGEMENT
1098
1099
1100
Concepl of Stres ~
Models of Stress
Physiology of Sleep
Functions of Sleep
Normal Sleep Patterns and Requirements
Factors Affecting S leep
Common Sleep Disorders
NURSING MANAGEMENT
1106
PAIN MANAG EMENT
1118
111 9
1120
1181
1196
1196
11 97
11 98
1198
1199
11 99
1205
CHAPTER 15
SLEEP
1102
1102
11 06
CHAPTER 42
STRESS AND COPING
1166
1I71
1175
SKI LL 44.6 Bed to Chair (4-Poinl Frame) :
SPIRITUALITY
1164
1177
1077
NURSING MANAGEMENT
1163
Factors Affecting Body A lignment and Activity
Sexual Health
Varieties of Sexuality
Altered Sexual Function
1152
Effects of Immobility
NURSING MANAGEMENT
SKILL 44.1 Client-Assisted Bed Slide: One Nurse
SKILL 44.2 Bed S.lide: Two Nurses
SKILL 44.3 Lateral Shift and Roll : Two Nurses
SKI LL 44.4 Logroll ing a Client: Two to Four Nurses
SKILL 44.5 Bed to Chair Slide: One Or Two Nurses
1074
Sexual Response Cycle
1149
IU57
Development of Sex uality
Factors Influencing Sexuality
1146
CHAPTER 44
AGIVITY AND EXERCISE
CHAlJTER40
SEXUALITY
1127
CHAPTER 43
1036
CHAPTER 39
SELF-CONCEPT
1122
1126
UNIT 10
CHAPTER 38
SENSORY PERCEPTION
Indicators of Stress
Coping
NURSING MANAGEMENT
XI
1220
1221
1223
1223
1226
1228
1231
CHAPTER 46
The Nature of Pain
Physiology of Pain
NURSING MANAGEMENT
SKI LL 46.1 Providing a Back Massage
1246
1247
1249
1257
1280
Xl [
Contents
CHAPTER 47
Factors Affecting Respiratory Function
NUTRITION
1292
SKI Ll47.3 Admjnistcring u Tube Feeding
1293
1296
1297
1299
1303
1307
13 13
1313
1327
1329
1333
SKI LL 47.4 Administering a Gastrostomy or
Jejunostomy Feeding
1335
Essential Nutrients
Energy Balance
Body Weight and Body Mass Standards
Factors Affecting Nutrition
Nutritional Variations Throughout the Life Cycle
Standards for a Healthy
Di~l
Altered N utrition
NURS ING MANAGEMENT
SKI LL 47.1 Inserting a Nasogaslric Tube
SKI LL 47.2 Removing a Nasogastric Tube
1345
Physiology of Urinary Elimi nation
Factors Affecting Voiding
1346
1348
Altered Urine Production
135 1
Altered Urinary Elimination
1352
NURS ING MANAGEMENT
1354
SKlll48.1 Applying a Uri dome (Uri sheath) Catheter 1364
SKI LL 48.2 Performing Urinary Catheterisation
1367
SKI LL 48.3 Performing Bladder Irrigation
1375
CHAPTER 49
FAECAL ELIMINATION
1386
Physiology of Defecation
Factors that Affect Defecation
1387
1389
139 1
1395
1398
1406
Faecal Elimin ation Problems
Bowel Diversion Ostomies
NURS ING MANAGEMENT
SKI LL 49.1 Administering an Enema
SKILL 49.2 Changing a Bowel Diversion Stoma
Applhmce
NURSING MANAGEMENT
SKI LL 50.1 Administering Oxygen by Cannula,
Face Mask, Non-rebreather Mask or Face Tent
SKILL 50.2 Oropharyngeal and Nasopharyngeal
14 11
1129
1441
1448
Suclioning
SKILL 50.3 Suctioning a Tracheostomy or
Endotracheal Tube
SKI LL 50.4 Providing Tracheostomy Care
1452
1455
CHAPTERS1
1467
CIRCULATION
Phys iology of the Cardiovasc ul ar System
Lifespan Considerations
Faclors Affecting Cardiovascular Function
Alterations in Cardiovascular Function
CHAPTER 48
URINARY ELIMINATION
Alterations in Respiratory Function
1426
1428
NURS ING MANAGEMENT
SKI LL 51.1 Sequential Compression Devices
1468
1473
1474
1477
1479
1484
CHAPTER 52
FLUID, ELECTROLYTE AND ACID-OASE OALANCE
Body Fluids and Electrolytes
Acid- Base Balance
Factors Affecting Body Fluid, Electrolytes and
Acid-Base Balance
Disturbances in Fluid Volume, Electrolyte and
Acid- Base Balances
NURS ING MANAGEMENT
SKJ II 52 1 Starting an Jntravenotls Infu sion
SKILL S2.2 Monitoring an Intravenous Infusion
SKILL 52.3 Changing an Intravenous Container,
Tubillg i:lmJ
DrclS~ill~
SKI LL 52.4 Discontinuing an Intravenolls
Infusion
SKILL 52.5 Changing an Intravenous Cannula to an
Intermittent Infusion Lock
SKILL 52.6 Initiating, Maintaining and Terminating
a Blood Transfusion
1492
1493
1501
1502
1503
1511
1530
1537
1539
1540
154 1
1545
CHAPTER SO
OXYGENATION
Structure and Function of the Respiratory System
Respiratory Regulation
1422
1422
1426
GLOSSARY
INDEX
G1
11
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tr
: "'.~'
Audrey
,0
:
• • • • • • • • • • • • • • : ••
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....
Berman received her
BS N from th e Uni ve rs ity of Ca li-
forni a, San Francisco, and later
returned to that campu s to obtain
her MS in physiologic nursing and
ber PhD in nursing. Her dissenation was entitled Sailing a Course
throltRIz chemotherapy; The ex-
,
periellce of women with breast
cancer. She wo rked in onco logy at
Sam uel Merritt Hospital prior to
beginning her teachin g career in the diploma program at
Samuel Merritt Hos pital School of Nursing in 1976. As a
facu lty member, she parti cipated in the transition of that program into a baccalau reate degree and in the development of
the master of science in nu rs ing program. Over the years, she
has taught a vari ety of medical-surgical nursing courses in the
prelicensure programs. She currently serves as the dean of
Shirlee J. Snyder graduated from
Columbia Hospital School of
Nursing in Milwaukee, Wisconsin,
and subseq uently received a bachelor of science in nursing from
University of Wisconsin- Milwau-
•
•
•••••••••
••••••••
'
•
.
••••••
"
~
• ..........
.
,
::•• '
'.J. -:•
l
~ ••••••
nursing at Samuel Merritt College <an affiliate of Sutter
Health).
Dr Bennan has travelled ex tensively, visiting nursing and
health care institutions in Gennany, Israel, Spain, Korea, Bolswana Australia. Japan and Brazil. She serves on the board of
directors for the Bay Area Tumor Institute. Sbe is a member of the
American Nurses Association and Sigma Theta Tau and is a site
visitor for the Commission on Collegiate Nursing Education. She
has twice panicipated as an NCLEX- RN item writer for the
National Council of State Boards of Nursing. She is cenified as an
advanced oncology nurse and as an AIDS educator and has preented locally, nationally and internationally on topics related to
nu rsing education, breast cancer and technology in health care.
Dr Bennan authored the sc ri pts for more than 35 nursing
ski lls videotapes in the I 990s. She was a co-author of the sixth
and seventh editions of Fundamentals of nursing and, with
Shirlee Snyder, co-author of the fifth edition of Kozier & Erb's
techniques in cli"icalllursing.
4
kee:. Bt:cause of an inLt:rest in cardiac nursing and teaching, she
earned a master of science in nurs-
assessment testing for student learning. She presented locally
and nationally on topics related to using multimedia in the
classroom and promoting etbnic and minority student success.
Another career opponunity in t998 ted her to the Community College of Southern Nevada in Las Vegas, Nevada, where
Dr Snyder was the nurs ing program director with responsibiliLies fur the associate degree and practical nurs ing programs
for five years, During this time she became involved in coauthoring the fifth edition of Kozier & Erb's techniques ill
ing w ith a minor in cardiovascula r
clillicalllursi1l8 with A udrey Be rman.
clinical specialist and teaching from
the University of Alabama in Binningham. A move to California
r
In 2003, Dr Snyder returned to baccalaureate nursing educati on. She embraced the opponunity to be one of the nursing
resulted in becoming a fac ulty me mbe r at Sa mue l M erritt H ospi -
faculty teaching the first nurs ing c lass in the baccalaureate
tal School of Nursing in Oakland, California, Shirlee was fonunate to be involved in the phas ing out of the diploma and ADN
nu.rsing program at the first state college in Nevada, wh ich
opened in 2002, She is currentl y the Associate Dean of the
program s :mrl developme nt of a bacca laureate inte rcoll egiate
Sc hool of Nurs.i ng at Nevada State Coll ege in He nders.on,
nursing program. She held numerous poSitions during her 15·
year tenure at Samuel Menitt College, including cuniculum coordinator. assistant director-instruction. dean of instruction and
assoc iate dean of Ule Intercollegiate N ursing Program. She is an
associate professor alumnus at Samuel Menitt College. Her
interest and experiences in nursing ed ucation resulted in Shirlee
obtaining a doctorate of education focused in curriculum and
instruction from the University of San Franc isco.
Dr Snyder moved to Portland, Oregon, in 1990 and taught in
the ADN program at Ponland Communi ty College for eight
years. During thi s teachi ng ex perience she became interested in
computer-assisted instruction (CAl) and initiated web-based
Nevada.
Dr Snyder is an advisory board member for lbe Nevada
Geriatric Education Center and a member of the American
Nu rses Association, Sigma Theta Tau, and a variety of task
groups addressing the Southern Nevada nursi ng shonage, She
has been a site vis itor for the National League for Nurs ing
Accrediting Commission and the Nonhwest Association of
Schools and Colleges.
Dr Snyder'S experiences in nursing education and teach ing
keep her current in nursing and nu rs i ng education. She appreciales all she has learnt from the students she has taught and her
past and present facu lty colleagues.
'.
XIV
About the Originating Authors
Barbara Kozier was educated In
Vancouver,
British
Columbia,
laught medical and surgical nursmg. pediatric nursing. psychiatric nursing and community nurs ing courses at the Vancouver
Canada. After obtaining a bachelor
General Hospital School of Nursing. Ms Kozier then enrolled
at arts degree from the University
of British Columbia, she entered
at the University or Washington where she studied for two
years, taught prot time and obtained her master of nursing
Lhe nursing program at thal institu-
title.
tiOll. After tour years of study she
Barbara is a member o t three ho no llr societies: Sigma Theta
graduated with a bachelor's degree
in nursing. She obtained a position
Tau (nursing), Pi Lambda Theta (education) aDd Delta Sigma
Pi (Canadian Honor Society fo r University Women). Barbara
at HeUa Hella, an aboriginaJ seltle-
was a member and a chair of many nurs ing and government
ment on the nonhem coast of British
Columbia. She then nursed with the Victorian Order of Nurses
committees. She wrote a number of texts and collaborated with
providing home care. Following a position with a large general
Fundamentals of nursing. Concepts and Issues II/nursing prac-
hospital as an acute care nurse in a medical-surgical unit, she
tice and Esselltials of nursing practice.
Glenoro Leo Erb was born in
Calgary, Alberta, Canada. All her
schooling took place in Calgary
and, with her identical twin sister,
she attended the Nursing School of
CaJgary General Hospital. She was
awarded a gold medal when she
graduated and was recognised as
an outstanding bedside nurse.
Following two years travelling
in Asia, Europe, Ind ia, Australia
Glenora Erb on four books: Techlliques of clillical lIursing ,
and New Zealand, Ms Erb returned to Vancouver and taught
nursing at St Paul 's Hospital Schoo l of Nursing, and later
m a 2-year program at the British Columbia Institute of
Technology. At thi s time she also coauthored tex tbooks on
FUlldal/lellta/s of nursing, Techniques of clinical nursing,
Concepts and issues in nursing pracIfce and Essemiais of
lIursing practice.
Glen died at home on 24 December 200 1 of breast cancer.
Her death has meant (ha( nursing has lost a highly skilled clinical nurse and her friends and fami ly have lost a sensitive and
giving person.
The authors listed below are the Unit coordinators for the first Australian edition of FlIndamentals oj Nursing. For a complete list
or contributors, see page xxiv.
Tracy Levett-Jones is th e Deputy
Head of School (Teachi ng and
Learning) at the School of Nursi ng
and Midwifery at the University of
chapters and is the co-author of the hi ghl y successful SllIdenr
nurse: Clinical survival gllide.
Majella Holes works at the Austra lian Catho lic Uni versity in Brisbane. Original ly hospita l trained,
Newcastle. Her research interests
include the phenomenon of
'belonging' , clinical education,
she completed a post-regi stration
Bache lor of Nursing, Master's of
Applied Science (Research), and a
information and communicating
technology (JCT) in health care,
clinical reasoning and simu lation.
Tracy's doctoral research explored the clin ical learning experiences of students in Australia and the United Kingdom. She has
Education. She is currently enrolled in a PhD investigating simu-
a broad clinical background and pri or to her academic career
lation in nursing education. MajeUa
Graduate Certificate
in Higher
worked as a women's health nurse, nurse ed ucator and new
lectures primarily in the science
graduate program coord inator. She is a co-author of the book
"and nUr.iing uni ts uf lh~ ulJ(J~rgrwJ ua t ~ Hursi llg tl~g n::e. Sht! is
passionate about teaching and learni ng and al so offers critical
The c1inicll l placemelll: All essential g uide fo r IlLlfsing slltdellts,
the 2007 recipient of the NS W Minister fo r Ed ucati on Quality
Tt:a<.: hing Award amJ il 2008 n:~dpi~m uCall Aus Lralian Tei.lt.:hing
and Learnin g Council Citation for Outstanding Contri butions
to Student Learni ng.
Trudy
Dwyer completed a
hospital-based nursing program at
care electives and online education for postgrad uate students
enroll ed in eardiothoraeie nnd emergency specia lties.
With a long history in emergency and cardiothoracic intensive care, she has also been a member of teams providing crit ical care and education assistance to So lomon Is lands, Fiji and
Brazil.
Bachelor of Health Science degree.
After seven years trave ll ing, she
Nichole Harvey has been a registered nurse si nce 1988 and an
endorsed midwife since 1995.
Nichole's qua lifications include a
Critical Care Certificate, Trauma
Nursing Cert ificate , Non-Medical
Vaccinator's Cert ificate, Bachelor
of Nurs ing, Master of Nursing
returned to Rockharnpton to work as a nurse academic with
Studies and a Graduate Certificate
the RnckhAmpton H m:pi IHI . Q ueens-
land, where she developed
a
passion for critical care nursing
and travel. Working her way around
Australia she completed a PostBasic 1.00ensive Care course and a
j
Central Queensland University (CQU) and nurse clini cian at
in Ed ucation (Tertiary Teaching).
the Rockhamplon Hospital iJl iIllensive care. She then completed a Graduate Certificate of Flexible Learni ng, a Master's
Nichole has extensive clinical ex-
of Clinical Ed ucation from the Un iversity of New South Wa les
and a PhD. ror the past 2U years she has been an active member
of the Australian College of Critical Care Nurses and was the
foundation president of the Central Queensland sub-branch of
tile ACCCN.
Trudy is currently a Senior Lecturer of Nursing in the
Faculty of Sciences. Engineering and Health at CQU. Trudy
perience, having worked in both large city and ru ral and remote
locations, as well as overseas. Her main area of clinical expertise is emergency and trauma nursing with a special interest in
midwifery.
Nichole has held an academic role with the School of
Nursing, Midwifery and Nuuilion, James Cuuk Ulli\'cr:sily, :siu<.:t:
2000. Since that time Nichole has been involved in the development and teaching of both nursing and midwifery curricula. Nic-
coordinating
hole is a fC.viewer for tht: Australian Journal of Rural alld Remote
undergraduate and postgraduate nursing courses and the
Honours program . She is also a supervisor of Master's and
PhD reseureh students. Her researc h in terests inc lude
Health, a past panel member for the Queensland Nursing Coun-
has a
long
career as
a
nu.rse
academic,
re uscitation , clinical ed ucati on and popul at ion health. She has
published in international refereed schola rly journ als, book
cirs Midwifery Review Panel and a member of a number of local
and state nursing and midwifery conunjuees/organisations. N ich-
ole is undertaking her PhD to investigate the u·iage and management of pregnant women in emergency departments.
XVI
About the Australian Authors
Yoni Luxford is a Seni or Lecturer
in Nursing in the School of Health
Health Nurses and reviewer for the Imernational Jot/mal oj
Mental Health Nursing.
at the University of New England.
Armidale, NSW.
Ilarbara Parker has worked ex-
Yoni has writte n a number of
publications. and is co-a uthor (w ith
Anderson) of Women gmwill g
older: A health Gnti wellness manualforwo rking with womanamwuJ
60 yea rs & over, published by the
te nsively in the clini cal environ -
ment, specificall y in the areas of
anaesthetics
recovery
and
has expertise in gastrointestinal
Southern Women's Health and
Community Centre.
and nutritional physiology as well
as expertise
Lorna Moxham actively contributes to the nu rsing profession at
and
orthopaedic and urology surgical
nursing. She has published in th e
area of obesity and diabetes and
ill
programs in obes ity,
state. natio nal and intern ational
impaired glucose tolerance and diabetes in both pharmacological and lifes tyle interventions. Dr Parker is a Program Director
in the School of Nursing and Midwifery and teaches witllin
levels as well as to the broader
the undergraduate nursing prog ram at the Uni versity of South
community in numerous ways.
Lorna has served on numerous
ministerial committees as a mem-
Australia.
ber
and
chair and
has
Kerry Reid-Searl is a Senior
Lecturer at Centra.1 Queensland
held
Uni versily. Ke lTY first co mpleteu
her nursin g qu al ifications in Tas-
several leadership and governance
roles both within the terti ary education sector and in industry. These currently include Chair of
the CQU ni versity HREC and Chmr of the Kockll ampton and
District Health Community Council (HCC). As the current
chair of the mental health peer review panel and a member of
~x.pt;::.ri~ n\:t;::.
the education co mmittee, Lo rna's invo lvement in nurse regu lation and licensure via the QNC enables her to actively contrib-
slit; has wurk..eu LlI Ule cLi uical ill ea
of paediatrics. Kerry has over
mania. Since then she has gained
in Qut;: .t;: . lI slallu as a r~­
mote area nurse, a generali st nurse,
a midwife and in more recent years
ute to on-going professional integrity and development.
17 years experience in undergrad uate nursing education. She
Pass ionate about nursing, its past, present and future, Lorna
has an extensive publication record and has led and been an
holds a Bachelor of Health Science degree, a Master's qualiJi-
investigator in many research projects. A fellow of the Austra-
cation in Clinical Education and a PhD. Kerry has a strong interest in clinical education, wound care and medi cation safety.
li an CoUege of Memal Health N urses idemifies her di sc ipline
ex pertise and pass ion.
David Stanley began his nursing
career in the days when nurses
Tanya Pork is a registered nurse. an
wore hugc belt bucklcs and funny
hats. He 'trained' as a regi stered
nu rse and mid wife in South Au stralia and workcd through hi s
formati ve career in a number of
hospitals and clinical environments
in Australia. In 1993 he completed
endorsed mental health nurse, an
endorsed midwife and a credentiaJlcd mcntal hcalth nursc. Hcr
nursing experi ence includes private
and publ ic settings (in rural, remote
and urban ccntrcs) including crisis,
co mmunity and emergency mental
health services. She joined the
a Bachelor of Nursi ng at Flinders
University, Adelaide (for which he was awarded the University
School of Nursing, Midwifel), &
Medal) and after a number o f years of volunteer work in A fri ca
Nub'ilion at James Cook University
in 2005 and has had the opportunity to teach both undergraduate
he moved to th e United Kingdom and worked as the Co-
and postgraduate students. S he is currently undertaking her PhD
ordinator of Chi ldre n's Services and as a nurse prac titioner. He
co mple ted a Master's o f Health Science degree at B irmingham
to investigate the ' Prevention of weight gain with second genera-
University. For a short time he worked in Central Australia for
tion antipsychotics: a nurse-led intervention' . She is a Member
of the A ustralian College of M ental Health Nurses, vice-presi-
Remote Health Services , before returning to the Un ited Kingdom to complete hj s nursing doctorate, researching in the area
dent and member of the Management Committee for the Mental
Hlness Fellowship North Queensland, Secretary for the North
of clinical leadership. He is currentl y teaching undergraduate
and postgrad uate nursing at Curtin Uni versity of Technology,
Queensland Sub-Branch of the Austral ian College of Mental
Western Australia.
Contemporary nursing in Australia and internationally is chal-
in recognition of the broadening global scope of its member-
lenging, complex, dynamic and very rewarding. Many of our
ship. The NANDA- I taxonomy provides nu rses with a shared
cl ients are older
~U1d
sicker that they were a decade ago, often
with complex health and psychosocial needs. This means that
nurses today must be clinically competent, flexible and knowledgeable. They must have a broad and deep knowledge of
physiology, pathophysiology, pharmacology, epidemiology,
th erapeutics, culture, ethics and law, as well as an understanding of evidence-based practice. Today's nurses have many roles
language of diagnostic terminology and is partic ularly useful
for the beginning nurse, and thus we have incorporated it into
our text. We do acknowledge, however, that Australian nurses
often adapt rhe NANDA-I terminology 10 meet their own context and specific clien t needs.
and function s--ciinic ian, ed ucator, manager, researcher, to
ORGANISATION OF THE BOOK
name just a few. They must be highly skilled with the abili ty
The detailed table of contents at the beginning of the book
to problem solve and they must possess sophisticated c ri tical
thinking skills. They must be life-long learn ers and confident in
the use of informati on and comm unication technology. Nurses
must he ah le to communicate effective ly, with their dip.nts .
with each other and with other members of the health care team.
Above all, they must care for their patients in ways that signify
respect, acceptance, empathy, connectedness, c ul tural sensitiv-
ity and genuine concern.
provides a clear structural map to the content incl uded in the
to un its and 54 chapters.
Unit 1, The Nature of Nursing, clusters five chapters that
pruvitle comprehensive coverage of introduclolY cOll(;epts of
nursing. T he history of nursing in Australia and the Australian
legal system provide a contextual backdrop to the chapters that
fo ll ow.
In Unit 2, Contemporary Healtb Care, four chapters focus
Against this background, the first Australian editi on of
Kozier and Erb 's fundamentals of nursing will be of immense
benefit to both beginning students and those who are more
advanced. This comprehensive textbook, with its unique A us-
on contemporary health care topics such as health care delivery
syste-,m s , comm llni ty-bflsP.n CMf':, home: ~Mf': finn the: 1I ~f': of in-
tralian perspective, introduces the reader to vitally important
dents to this important framework. with each chapter dedicated
nurs ing issues, concepts, practices and theories. The book wi ll
prepare students for practice in a range of diverse clinical settings and help them understand what it means to be a competent
professional nurse in the twenty-first century.
LANGUAGE AND TERMINOLOGY
Patient, clients and health care consumers
[n developing this text we have used terminology that is familiar and appl icable to most Australians. To achieve this, we have
used the terms 'client', 'patient' and 'health care consumer'
throughout the text, applying each according to its context. This
remains co nsistent with the term inology set out in the Code Of
ethics/or nurses in Austrctiia, published by the Australian Nurs-
ing and Midwifery Council (ANMC 2005).
Indigenous Austrolians
Throughout the text we have integrated issues relevant to the
Indigenous Australian popu lation. In covering the issues we have
acknowledged the importance of using non-discriminatory and
appropri ate language to describe groups of people, policies and
events, and have thus followed the gu.idelines as set out by NS W
Health in its pubHcation Communicating positively: A guide to
appropriate Aboriginal terminology.
formation and communication technology in healtb care.
Unit 3 is The Nursing Process. Six chapters introduce stuto a specific step of the nursing process. Chapter 10 outlines
critical thinking and the nursing process. A Nu rsing in Acti on
case study is used as the frame of reference for applying content
in all phases of the nursing process in Chapter 11 , Assessing,
Chapter 12, Diagnosing, Chapter 13, Planning, and Chapter 14,
lmplementing and Evaluating. Chapter 15 covers documenting
and reporting.
Starting in this un it and incorporated throughout the book,
we refer to the new NANDA International (NANDA-I) nursing
diagnoses.
In Unit 4, Health Beliefs and Practices, four chapters cover
health-related beliefs and practices for indi viduals and fa milies
from a variety of different cultu ral backgrou nds. This U nit
emphasises the importance of cultural sensiti vity when caring
for clients from different backgrounds and it has a particular
focus on ln digenous Australi an people-a focus that continues
throughout the book. Practical issues related to nursing
management is an additional strength of this unit.
Unit 5, Lifespan Development. cons ists of five
chapter~
that discuss development from concepti on to old age. Chapter
23 is a new chapter devoted specifically to the care of the older
adu lt.
Unit 6, Integral Aspects of Nursing, disc usses topics such
as caring. comm unicating, teaching , leading, managing and
delegating. These topics are all crucial elements for providing
competent nursing care.
Nursing Diagnoses
[n 2002, the North American Nursing Diagnosi s Association
(NANDA) was changed to NANDA-lnternational (NANDA-l),
Unit 7, Assessing Health, covers vital signs and health
assessment in two separate chapters, so beginning students can
understand
nonnal
assess ment
techniques
and
tindings .
xv [[ 1 Preface
Chapter 29, Vital Signs, introduces students to the health assessmem skills that are crucial to competent professional practice.
In U nit 8, Integra l CUiupone nts of Clie nt Cal"C, lht: [ul:wo.l
Sensory perception, self-concept, sexuality, spirituality, stress
and loss are all things that a nurse needs to consider to properly
can: fur a clicnl.
shifts La those issues of relevance to all clients: asepsis, safety,
hygiene, diagnostic testing. medications, wound care and pre-
Unit 10, Promoting Physiologic Health , discusses a variety of physiologic concepts that provide the foundations for
u~.ralivt: (';iUt!.
lIur~ ill~ care. These include activity and exercise; s leep; pain:
nutrition; eLimination; oxygenation; circulation ; and fluid, elec-
Unit 9, Promotin g Psychosocial Health, includes six chapters that cover a wide range of areas that affect one's health.
tro lYle and acid- base balance.
XIX
Preface
FEATURES
For years, theAmerican edition of Kozier & Erb's Fundamentals
of Nursing has been a gold standard that helps students embark
on their careers in nursing. This first Australian edition retain s
appl ication for Austral ian students, nursi ng academics from
across Australia were invited to review and comments on each of
the 52 chapters. Their delailerl fp.p.dh~ck has ensured that Kozier
many of the features tilat have made this textbook the number-
& Erb 's Fundamentals of nursing: Firs! Australian edition is a
one choice of nursing students and lecturers. To further enhance
this popu lar fundamentaJs textbook and ensu re its appropriate
cu rrent, engaging and uniquely A ustralian textbook that will heJp
students succeed in their nursing studies.
Anatomy C:r Physiology
Reviews provides students with a
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students how to ask appropriate
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guide for what to say when
educating clients.
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Client Teaching gives students a
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Clinical Alerts highlight special
information such as safety issues.
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xx Preface
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Drug Capsules boxes help
student learn the implications of
certain medications that they may
~ee
in their clinical encounters.
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Home Care Considerations
instruct students to cons ider
adaptation for performing the slcill
in the home.
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Practice Guidelines provide
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dos and don'ts.
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provide brief case studie
followed by questions that
encourage students to analyse,
compare, contemplate, interpret
=-
and c.::.valuale infurmatiun.
.
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Concept Maps reinforce the
steps of the nursing process by
using different colours and by
mf'pping difficult concepts
~l~~
diagramaticail y.
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Step-by-step Skill. help slUdems
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understand techniques and
practice sequence. They include a
complete equipment list and fullcolour photos and illustrations for
critical steps .
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Lifespan Considerations alert
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different ages.
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Real·World Practice provides
students with a real-worid
perspective of practice.
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Research Notes introduce
students to the concept of
evidence-based nursing practice
by reviewing relevant nursing
research and discussing the
implications for nursing practice.
XXI
XXII
Preface
SUPPLEMENTS FOR STUDENTS AND EDUCATORS
To su pplement the textbook and facil itate ac tive student learning, we iJ1Ciude a variety of teaching and learnlll g aids in o ur compre-
hensive supplements package.
MYNURSlNGKIT <www.pearson.com.au!mynursingkil>
MyN ursingKit is designed to help students apply concepts
In
the book. Each chapter contains learning o utco rnes, a
Home
I Lean More I Textbooks I
glossary, case studies, care plan activilies and application
acti vities, as weU as a full eBook. Instructors ca n use grade
tracker to monito r studen t progress.
t-Lrshg catalog I contact
Select Your Book
Welcome to f'.1yNurslngKitl
Book Resources
)
.......
)
You can find everything you need to be successful
and ultimately on the NCLEX. In MyNurslm;;JKit.
)
MyNurslnoKit
case Studies
)
leamlng objectives, chapter summanes and practice tests as well as video
dies and activities to aid student leamino and comprehension.
)
Smulaic:rl
j~
In
the dassroom, In dlnlcals
en onlone supplement thet offen students
book-soet;ifj~
MyNur51f'101C1t also provides Instructors with easy and convenIent access to
Important teachino resources indUdino lecture slides, Classroom Response
Questions, te"t-benj.;, end mOr8 ,
To beo!n, simply dick on your tel!tbook
IPEA RSO N Ie> la IDf'ea'5(IfIE.oi.ation ~as Ptlll"ltte tW · l~ Notice· Pm-«y Policy- ~
NURSING SKILLS VIDEOS offer students the essential
POWERPOINT
fo undation fo r competency in performing c lini cal nursing
LIDRARY. To fac ilitate classroom prese ntation , thi s dy namic,
SLIDES
a nd
DIGITAL
[MAGE
skilJ s, The vo lumes in this seri es consist of comprehensive
procedures, de monstrated in hundreds of realistic video clips,
Illultimedia reso urce pairs key points covered in the chapters
with images from the textbook to e ncourage effective lectures
ani mati o ns, illustrati ons nnd ph otograph s. Throug ho ut the vi d
and c lassroom di scuss ions.
eos, student will experi ence the real-life as pects of therapeutic
communication betwee n the nurse and the patient, patients'
COMPUTERISED TEST BANK. The test bank allows
reaction to invasivp: skill s, and iss ues related to culture, gender
edl1 cators to c ustomise the bank of qllf': ~ tions to meet specific
and age.
LNSTRUCTORS' MANUAL. This manual contains a
wealth of material to help instructors with the planning of
c urri cul a, particularl y for first-year nursing programs, [t
includes chapter overvi ews, detail ed lecture sugges ti ons and
ou tlines, learning outcomes, teaching tips, and more, for each
chapter.
teaching needs and add/revise questio ns as needed. It consists
of more than 2,000 true-false, multiple-choice, short-answer,
essay and matching questions complete with solutions. Using
Pearson's TestGen software, educators can create professionallooki ng exams in just minutes by building tests from the existing
database of questions, editing questions, or addi ng their own.
TestGen also allows instructors to prepare printed, network and
online tests.
Preface
XXIII
ACKNOWLEDGMENTS
gestions for th is edition. We also th ank the editorial team at
pictures team including Loui se Burke and Emma Gaulton.
Many of the new photos in the Ist edition were photographed
by Beau Lark and overseen by Clara Williams, director of photography for Corbis, on site at Central Queensland University,
and ably hosted by our terrific authors Dr Lorna Moxham and
Dr Trudy Dwyer.
Pearson, including Michelle Aarons, acquisitions editor, for
commissioning this project and putting a stellar team of authors
together; Michael Stone, development editor, for keeping our
noses to the grindstone; Katie Millar, senior project editor, for
producing this book with precision; and the copyright and
Tracy Levett-Jones, Trudy Dwyer, Majella Hales,
Nichole Harvey, Yoni Luxford, Lorna Moxham,
Tanya Park, Barbara Parker, Kerry Reid-Searl and
David Stanley
We extend a sincere thank-yo u to the talented team i_nvolved in
the first Australian edition of this book: the contributors and
reviewers who provided content and very helpful feedback; the
nursing students, for their questioning mi nds and motivat ion;
and the nursing academics, who provided many valuable sug-
REVIEWERS
We also wish to thank the foll owing reviewers:
Pam McCrorie
Edith Cowan Unive rsity
Renee M cG ill
C harl es Stull U ni versity
Helene Metcalfe
lonathan Mould
Ed ith Cowan University
Flinders U ni versity
University of South A ustralia
Sleve Parker
Fli nders U niversilY
A nn Paterson
Central Queensland Uni versity
Carol Piercey
RMlT University
Curtin University of Technology
Kasia Bail
U ni vers ity of Canberra
Jan Barlin g
lngrid Belan
Southern Cross University
Karyn Bentley
Julie Bradshaw
Jo McDonnali
Debra Nizetle
Tracey Thornley
Deakin U ni versity
Australian Catholic University
Edith Cowan U niversity
Maryanne Pod ham
C harles Stull U ni versity
James Cook University
Uni versity of Notre Dame
Marion Tower
Marc Broadbent
Central Queensland Uni ve rsity
Stephanie Burnip
Southern Cross U ni versiry
Robin Ray
Lyn Raymond
Cobie J Rudd
Catherine Stokes
Peter Thomas
Neal Tolley
Tony Bush
Maureen Chapman
RMIT Univers ity
Central Queensland University
Caroline Vafeas
Griffith Uni versi ty
Edith Cowan University
Li esa Clague
A ustra lian Carholic University
University of Notre Dame
Uni versity of Sydney
Sharon Bourgeois
Jenni Brackenreg
Universiry of Western Sydney
C harles Stllrt University
Karen Clark- Burg
Leonie Cox
Carol C revacore
Annie Das
Clare Harvey
Noelene Hickey
Elspeth Hillman
Edith Cowan Universiry
University of Canberra
University of Wollongong
AusrraJian Catholic Universiry
Jane Walker
D eakin University
Matthew Walsh
Catheri ne Ward
University of Newcastle
Curtin University of Technology
Technology
Paul 'Varner
Edith Cowan Uni versity
Uni verSity of Notre Dame
Julie Watkinson
Louise Wells
Chru'les SlUll Un ivers ity
University of South Au straLia
Flinders Universi ty
Kerre Will sher
University of SQUIh Au stralia
U ni versity of Newcas tl e
Melanie Zilembo
Michele Zolezzi
Ed ith Cowan U ni versi ty
Queensland University of
James Cook University
Charles Stu n University
University of Notre Dame
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Wendy Madsen
BA, RN, MHSc, PhD, GCFL
CQUniversity Australia
Chapter J Historical and COl1temporQl)1 Nursillg Practice
Antllea Fagan
RN, BN, Grad Dip Neuroscience Nursing, MN
Un iversity of New England
Chapter 12 Diagllosing
Lorna Moxham
RN, MHN, PhD, DAS (Nsg), BHSc, MEd, CerLOH&S , Cert
Qual Mgmt, Cert IV (Training & Assessment), FACMHN,
MAQNL
CQUniversity Australia
Chapter 2 Nurse Education, Research alltl Evidence-based
Practice
Chapter 44 Activity and Exercise
Becky Ingh~lm-Broomnt!ld
RN, Cert Ed, DipN (Lon), BSc, MSc. PhD candidate
University of New England
Chapter 13 Planning
Sandra Walker
RN, RM , Neonatal Intensive Care Cen, BN, BEd, MNS, PhD
CQU ni versity Australia
Chapter 3 Nursing Theories and Conceptual Frameworks
Chapter 52 Fluid, Electrolyte alld Acid-Base Baltlllce
Julie Zetler
RN, BA, LLB , LLM, Master's of Bio, Urad <':e11 ArbItration
and Mediation
Macquarie University
Chaprer 4 Legal A~pecrs uf Nur::;ing
Keri C hater
RN, BA (Sciences), MN, PhD
Royal Melbourne Institute of Technology
Chapter 5 Vailles, Ethics alld Advocacy
Penny Paliadelis
PhD, RN , EN, MN(Hons)
University of New England
Chapter 14 Implementing and Evalualing
Glenda Parmenter
PhD, RN, BSocSc, MLitt, MRCNA , MPCA , MAAG
Uni versity of New England
Chapter 15 DOCllmelllillg and Reporting
Natarla Brooks
BSc (NurSing), Post Grad CenTI
Formerly Curtin University
Chapter 16 Health Promotioll
David Stanley
NursD, MSc, BA Ng, Dip HE (Nursing), RN, RM , TF,
Gerontic Cert
Cunin Uni versity
Chapter 17 Health, Welb,ess and IIIlIess
Chapter 19 Complemelllary alld Allemative Healing
Judy Gonda
RN, RM , B App Sci Adv Nsg (Educat ion), MN, PhD
Australian Catholic Universi ty, McAuley Campus
Chapter 6 Health Care Delivery Systems
Modalities
Majella Hales
RN, BN, Grad Cert HE, MAppSci, PhD candidate
Australian Catholic University, McA uley Campus
Chapter 7 Community Health Nursing
Chapter 8 Home Care
Chapter 9 Nursing In/ormatics
Chapter 18 Cultures alld Nursing
Roianne West
RN,BN, MMHN
James Cook Un ive rsity
Jennifer Lapsley
RN, BAppSc, MSC (Nsg)
CUI1i n Uni versity
Chapter /8 Cultures and Nursing
Yoni Luxfo.-d
PhD, RN, RM, BSW, Grad Dip PHC, Grad Cert Tertiary Ed
University of New England
Chapter 10 Critical Thinking and the Nursing Process
RN, EM , MNSt
James Cook University
Chapter 11 Assessing
Chapter 43 Loss, Grieving alld Death
Alan Avery
RN, BCom(Econ), BHSc(Nursing), MEd, Coronary Care
NurseCert. MCN, EdD
University of New England
Nichole Harvey
RN. EM, CritCareCert, BN (Post Reg), MNSr, Grad Cen Ed
(TI), PhD candidate
James Cook University
Chapter 18 Cullures ami Nursing
Chapter 10 Critical Thinkillg alld the Nursing Process
Adele Baldwin
Clwpler 20 ConcepTs ofCrmlith and DevelopmenT
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•••
Contributors
ChapTer 21 PromoTing HealTh/rom ConcepTion Through TO
Adolescence
Tom Laws
RN, RM , Ophthalmic Nursing Dip, BEe, Grad Dip Ed,
ChapTer 38 Sensory PercepTion
lirad Dip Public Health
Amanda Fillingham
RON. RMW. RHV, BA(Hons), MA
James Cook University
ChapTer 22 PromOTing HealTh in Young and Middle-Aged AdulTS
ChapTer 31 Asepsis
Ma ri a Fed oruk
Chnpll!r 42 Stress and COpin8
Orad Con Ed (Hi gher Ed), PhD, Grad Dip Mgt, MHA,
XXV
University of South Australia
S ue Brown
RN, 0 HthSc, M HthSc , Orad
James Cook University
ChaplPr 37 Perioperalive Nursing
BAppSc (Nsg Admin), CCRN, RN, GAICD
University of South Australia
C~n
(Tf), ON
ChapTer 23 PromOTing HealTh in Older AdulTS
CltulJ/er 24 Promo ri"g Family Health
Chapter 32 Safety
Barbara Pa rker
R , BSc(Hon ), Grad Cen Ed (Higher Ed), PhD
University of South Australia
Chapter 33 Hygiene
Sha ron Bourgeois
RN, PhD, MA, MEd, BA , FRCNA, FCN
University of Western Sydney
Angela Kucia
ChapTer 25 Caring
Coronary Care Cert. Prof Cert Pharmaco logy for Nurses, BN,
Pa mela Va n d er Riet
RN, PhD, MEd. BA (Soc Science). Dip Ed (Nursing),
ICUI CCU Cen, Dip Remedial Massage
University of Newcastle
MA (Sc and Tech Studies), Grad Cer! Ed (Higher Ed), PhD
University of South Austra lia
C hapler 34 Diagllostic Tes/ins
ChapTer 25 Caring
ChapTer 27 Teaching
Pamela Aide
BA (Ling), BN (Hons), PhD Candidate
University of Sou th Australia
Tracy Levett-J ones
C /wpr er 35 Medicaliolls
Chapter 23 PromOTing Health ill Older Adults
RN, PhD, MEd & Work, BN, Dip AppSc (Nursing)
University of Newcastl e
ChapTer 27 Teaching
C raig Phillips
Dip AppSc (Nu rsi ng), BN , MN (Adva nced Practice),
PhD candidate
University of South Australia
Jeuny Day
ChapTer 36 Skinllllegrity ant! Wound Care
Chapler 26 Communicating
RN , ADClfN , BHSc (N ursin g), MEd (Ad ult Ed)
University of Newcastle
Chapler 26 Communicating
Teresa Stone
RN , Reg Psychiauic Nurse, BA, MA Health Management
University of Newcastle
Chapter 28 Delegating, Managing and Leading
Matthew Wa lsh
RN, MN (Clinical Practice), BN, BSe (Biomedical Sc)
University of Newcastle
ChapTer 29 ViTal Siglls
Lyn ne Slater
RN, RM, Grad Dip HSc (Primary Health Care). MMid, MN,
MRCNA
University of Newcastle
Chapter 30 HealTh AssessmenT
Trm ya Park
RN, EM, EMHN, BNSc, Grad Dip MHN, MMid, Grad Cen
Ed (TI), PhD candidate
James Cook Uni ve rsity
ChapTer 18 Culll/res and Nursing
ChapTer 39 Self-ConcepT
Chapter 40 Sexuo!;ry
K ristin Wicking
RN, BSN, MSN, Grad cen Ed (n ' ), PhD candidate
James Cook University
Chapter 41 SpiriTuality
Peter Rea burn
BHMS(Erl)(Holl <), PhD. Grad Cert Flex Leom
CQ University Australia
Chapter 44 Activity alld Exercise
XXVI
Contributors
Judith Applegarth
Trudy Dwyer
RN EM BHSc (Nsg), Grad Cert Child & Family Health, Grad
CQUniversity Australia
Chapler 45 Sleep
Chapter 46 fbi" MwwgcmcnI
RN, lCUNsgCert, BHlthScn (Nsg), Grad Cer! FlexLearn,
MClinEdu. PhD
CQU nive rsity Australia
Chapler 50 Oxygellation
Chapler 51 Circulation
Susan Lee Williams
Sandra Walker
RN, DIlSc(N.g), Grad Cerl SpNUl, Grad D;p HllmNul
RN. RM. Neonatal Intensive Care Cert, B ,BEd, MNS, PhD
CQUniversity
Chapler 52 Fillid, Elec/roly/e alld Acid-Base Balallce
Dip Ilealth Admjn & Info Systems, MClin Practice (Nc;:g)
CQUniversity Austra lia
Cht/Pler 47 N",ritioll
Kerry Reid-Searl
RN, RM, BHSc (Nsg), MClinEdu, PhD, MRCNA, FCN
CQUnivcrsity Au stralia
Chapler 48 Urillary Eliminatioll
Chapler 49 Faecal Elimination