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12th Edition
Copyright © 2010 by Wolters Kluwer Health / Lippincott Williams & Wilkins.
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987654321
Library of Congress Cataloging-in-Publication Data
Handbook for Brunner & Suddarth’s textbook of medical-surgical nursing.
—12th ed.
p. ; cm.
Rev. ed. of: Handbook for Brunner & Suddarth’s textbook of
medical-surgical nursing / Joyce Young Johnson. 11th ed. c2008.
Includes index.
ISBN 978-0-7817-8592-1
1. Nursing—Handbooks, manuals, etc. 2. Surgical nursing—Handbooks,
manuals, etc. I. Johnson, Joyce Young. Handbook for Brunner &
Suddarth’s textbook of medical-surgical nursing. II. Title: Textbook of
medical-surgical nursing. III. Title: Handbook for Brunner and
Suddarth’s textbook of medical-surgical nursing.
[DNLM: 1. Nursing Care—Handbooks. 2. Perioperative Nursing—
Handbooks. WY 49 H2326 2010]
RT41.J56 2010
617'.0231—dc22
ISBN-13: 978-0-7817-8592-1
2009028731
Care has been taken to confirm the accuracy of the information presented and to describe
generally accepted practices. However, the authors, editors, and publisher are not responsible
for errors or omissions or for any consequences from application of the information
in
this book and make no warranty,
express or implied, with respect to the content of the
publication.
The authors, editors, and publisher have exerted every effort to ensure that drug selection
and dosage set forth in this text are in accordance with the current recommendations
and
practice at the time of publication. However,
in view of ongoing research, changes in
government
regulations, and the constant flow of information relating to drug therapy and
drug
reactions, the reader is urged to check the package insert for each drug for any change
in
indications and dosage and for added warnings and precautions. This is particularly important
when the recommended agent is a new or infrequently employed drug.
Some drugs and medical devices presented in this publication have Food and Drug
Administration (FDA) clearance for limited use in restricted research settings. It is the
responsibility of the health care provider to ascertain the FDA status of each drug or device
planned for use in his or her clinical practice.
LWW.com
Preface
This Handbook for Brunner & Suddarth’s Textbook of MedicalSurgical
Nursing,
12th edition, is a comprehensive yet concise
clinical
reference designed for use by nursing students and professionals.
Perfect for use across multiple health care settings,
the
Handbook presents need-to-know information on nearly
200 commonly encountered diseases and disorders. The easyto-use,
colorful, consistent, and alphabetized outline format
enables
readers to gain quick access to vital information on
• Disease (Pathophysiology)
• Clinical Manifestations
• Assessment and Diagnostic Methods
• Medical, Surgical, and Pharmacologic Management
• Nursing Management according to the Nursing Process
For readers requiring more in-depth information, the
Handbook is completely cross-referenced to chapters in Brunner
& Suddarth’s
Textbook
of Medical-Surgical Nursing,
12th edition.
Special Features
The Handbook places special emphasis on home- and community-based
nursing practice, patient education, and
expected
outcomes of care. Additional features include the
following:
Gerontologic Considerations—Thumbnail descriptions and
interventions related to the care of the older adult population,
whose health care needs continue to expand at a rapid rate.
Nursing Alerts—Instant notes focused on priority care issues
and hazardous or potentially life-threatening situations.
Selected tables and boxes—At-a-glance presentations of additional
diseases, disorders, measurements, and the like.
Up-to-date appendices for use in clinicals, on the unit, and at
home or in the community. These include the following:
• Important lab values
• Current nursing diagnoses
• Acronyms and abbreviations
A
Contents
Acquired Immunodeficiency Syndrome
(HIV Infection) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Acute Coronary Syndrome and Myocardial
Infarction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Acute Respiratory Distress Syndrome . . . . . . . . . . . . . . . . . 22
Addison’s Disease (Adrenocortical Insufficiency) . . . . . . . 25
Alzheimer’s Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Amyotrophic Lateral Sclerosis . . . . . . . . . . . . . . . . . . . . . . 33
Anaphylaxis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Anemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Anemia, Aplastic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Anemia, Iron Deficiency . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Anemia, Megaloblastic (Vitamin B
and Folic
Acid Deficiency) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
12
Anemia, Sickle Cell . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Aneurysm, Aortic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Aneurysm, Intracranial . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Angina Pectoris . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Aortic Insufficiency (Regurgitation) . . . . . . . . . . . . . . . . . . 66
Aortic Stenosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Appendicitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Arterial Embolism and Arterial Thrombosis . . . . . . . . . . . 71
Arteriosclerosis and Atherosclerosis . . . . . . . . . . . . . . . . . . 73
Arthritis, Rheumatoid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
Asthma: Status Asthmaticus . . . . . . . . . . . . . . . . . . . . . . . . 82
B
Back Pain, Low . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Bell’s Palsy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
Benign Prostatic Hyperplasia and Prostatectomy . . . . . . . . 90
Bone Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
Bowel Obstruction, Large . . . . . . . . . . . . . . . . . . . . . . . . . . 96
Bowel Obstruction, Small . . . . . . . . . . . . . . . . . . . . . . . . . . 97
Brain Abscess . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Brain Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100
Bronchiectasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Bronchitis, Chronic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Buerger’s Disease (Thromboangiitis Obliterans) . . . . . . . . 106
Burn Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
C
Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
Cancer of the Bladder . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136
Cancer of the Breast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138
Cancer of the Cervix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
Cancer of the Colon and Rectum
(Colorectal Cancer) . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Cancer of the Endometrium . . . . . . . . . . . . . . . . . . . . . . . 158
Cancer of the Esophagus . . . . . . . . . . . . . . . . . . . . . . . . . . 159
Cancer of the Kidneys (Renal Tumors) . . . . . . . . . . . . . . 161
Cancer of the Larynx . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164
Cancer of the Liver . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Cancer of the Lung (Bronchogenic Carcinoma) . . . . . . . 175
Cancer of the Oral Cavity and Pharynx . . . . . . . . . . . . . . 178
Cancer of the Ovary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180
Cancer of the Pancreas . . . . . . . . . . . . . . . . . . . . . . . . . . . 181
Cancer of the Prostate . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184
Cancer of the Skin (Malignant Melanoma) . . . . . . . . . . 191
Cancer of the Stomach (Gastric Cancer) . . . . . . . . . . . . 196
Cancer of the Testis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200
Cancer of the Thyroid . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202
Cancer of the Vagina . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203
Cancer of the Vulva . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204
Cardiac Arrest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207
Cardiomyopathies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 208
Cataract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213
Cerebral Vascular Accident (Ischemic Stroke) . . . . . . . . 214
Cholelithiasis (and Cholecystitis) . . . . . . . . . . . . . . . . . . 225
Chronic Obstructive Pulmonary Disease (COPD) . . . . . 231
Cirrhosis, Hepatic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235
Constipation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 238
Contact Dermatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 240
Coronary Atherosclerosis and CAD . . . . . . . . . . . . . . . . . 241
Cushing Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243
Cystitis (Lower UTI) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249
D
Diabetes Insipidus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 253
Diabetes Mellitus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
Diabetic Ketoacidosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 264
Diarrhea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269
Disseminated Intravascular Coagulation . . . . . . . . . . . . . . 272
Diverticular Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275
E
Emphysema, Pulmonary . . . . . . . . . . . . . . . . . . . . . . . . . . . 280
Empyema . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 281
Endocarditis, Infective . . . . . . . . . . . . . . . . . . . . . . . . . . . . 282
Endocarditis, Rheumatic . . . . . . . . . . . . . . . . . . . . . . . . . . 285
Endometriosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 286
Epididymitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 288
Epilepsies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 290
Epistaxis (Nosebleed) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 296
Esophageal Varices, Bleeding . . . . . . . . . . . . . . . . . . . . . . . 297
Exfoliative Dermatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . 300
F
Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 302
G
Gastritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 313
Glaucoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 316
Glomerulonephritis, Chronic . . . . . . . . . . . . . . . . . . . . . . 319
Gout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 321
Guillain–Barré Syndrome (Polyradiculoneuritis) . . . . . . . 324
H
Headache . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 330
Head Injury (Brain Injury) . . . . . . . . . . . . . . . . . . . . . . . . 335
Heart Failure (Cor Pulmonale) . . . . . . . . . . . . . . . . . . . . . 346
Hemophilia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 354
Hepatic Encephalopathy and Hepatic Coma . . . . . . . . . . 356
Hepatic Failure, Fulminant . . . . . . . . . . . . . . . . . . . . . . . . 359
Hepatitis, Viral: Types A, B, C, D, E, and G . . . . . . . . . . 360
Hiatal Hernia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 365
Hodgkin’s Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 368
Huntington Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 371
Hyperglycemic Hyperosmolar Nonketotic Syndrome . . . 373
Hypertension (and Hypertensive Crisis) . . . . . . . . . . . . . . 375
Hyperthyroidism (Graves’ Disease) . . . . . . . . . . . . . . . . . . 381
Hypoglycemia (Insulin Reaction) . . . . . . . . . . . . . . . . . . . 387
Hypoparathyroidism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 390
Hypopituitarism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 392
Hypothyroidism and Myxedema . . . . . . . . . . . . . . . . . . . . 392
I
Idiopathic Thrombocytopenic Purpura . . . . . . . . . . . . . . . 397
Impetigo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 399
Increased Intracranial Pressure . . . . . . . . . . . . . . . . . . . . . 401
Influenza . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 406
K
Kaposi’s Sarcoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 408
L
Leukemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 410
Leukemia, Lymphocytic, Acute . . . . . . . . . . . . . . . . . . . . . 416
Leukemia, Lymphocytic, Chronic . . . . . . . . . . . . . . . . . . . 417
Leukemia, Myeloid, Acute . . . . . . . . . . . . . . . . . . . . . . . . 419
Leukemia, Myeloid, Chronic . . . . . . . . . . . . . . . . . . . . . . . 421
Lung Abscess . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 422
Lymphedema and Elephantiasis . . . . . . . . . . . . . . . . . . . . . 424
M
Mastoiditis and Mastoid Surgery . . . . . . . . . . . . . . . . . . . . 427
Ménière’s Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 431
Meningitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 434
Mitral Regurgitation (Insufficiency) . . . . . . . . . . . . . . . . . 437
Mitral Stenosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 438
Mitral Valve Prolapse . . . . . . . . . . . . . . . . . . . . . . . . . . . . 439
Multiple Myeloma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 440
Multiple Sclerosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 442
Muscular Dystrophies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 449
Musculoskeletal Trauma (Contusions, Strains,
Sprains, and Joint Dislocations) . . . . . . . . . . . . . . . . 451
Myasthenia Gravis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 454
Myocarditis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 457N
Nephritic Syndrome, Acute . . . . . . . . . . . . . . . . . . . . . . . 460
Nephrotic Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 462
O
Obesity, Morbid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 464
Osteoarthritis (Degenerative Joint Disease) . . . . . . . . . . . 466
Osteomalacia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 468
Osteomyelitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 469
Osteoporosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 473
Otitis Media, Acute . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 477
Otitis Media, Chronic . . . . . . . . . . . . . . . . . . . . . . . . . . . . 479
P
Pancreatitis, Acute . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 481
Pancreatitis, Chronic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 486
Parkinson’s Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 488
Pelvic Infection (Pelvic Inflammatory Disease) . . . . . . . . 494
Pemphigus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 497
Peptic Ulcer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 501
Pericarditis (Cardiac Tamponade) . . . . . . . . . . . . . . . . . . . 507
Perioperative Nursing Management . . . . . . . . . . . . . . . . . 511
Peripheral Arterial Occlusive Disease . . . . . . . . . . . . . . . . 536
Peritonitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 538
Pharyngitis, Acute . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 541
Pharyngitis, Chronic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 543
Pheochromocytoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 544
Pituitary Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 546
Pleural Effusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 547
Pleurisy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 549
Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 550
Pneumothorax and Hemothorax . . . . . . . . . . . . . . . . . . . . 556
Polycythemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 559
Prostatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 561
Pruritus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 563
Psoriasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 565
Pulmonary Edema, Acute . . . . . . . . . . . . . . . . . . . . . . . . . 570
Pulmonary Embolism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 572
Pulmonary Heart Disease (Cor Pulmonale) . . . . . . . . . . . 577
Pulmonary Arterial Hypertension . . . . . . . . . . . . . . . . . . . 579
Pyelonephritis, Acute . . . . . . . . . . . . . . . . . . . . . . . . . . . . 581
Pyelonephritis, Chronic . . . . . . . . . . . . . . . . . . . . . . . . . . . 582
R
Raynaud’s Phenomenon . . . . . . . . . . . . . . . . . . . . . . . . . . . 584
Regional Enteritis (Crohn’s Disease) . . . . . . . . . . . . . . . . 585
Renal Failure, Acute . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 587
Renal Failure, Chronic (End-Stage Renal Disease) . . . . . 591
S
Seborrheic Dermatoses . . . . . . . . . . . . . . . . . . . . . . . . . . . 595
Shock, Cardiogenic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 596
Shock, Hypovolemic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 598
Shock, Septic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 600
Spinal Cord Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 602
Syndrome of Inappropriate Antidiuretic
Hormone Secretion . . . . . . . . . . . . . . . . . . . . . . . . . . 612
Systemic Lupus Erythematosus . . . . . . . . . . . . . . . . . . . . . 613
T
Thrombocytopenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 616
Thyroiditis, Acute . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 617
Thyroiditis, Chronic (Hashimoto’s Thyroiditis) . . . . . . . . 619
Thyroid Storm (Thyrotoxic Crisis) . . . . . . . . . . . . . . . . . . 619
Toxic Epidermal Necrolysis and
Stevens–Johnson Syndrome . . . . . . . . . . . . . . . . . . . .621
Trigeminal Neuralgia (Tic Douloureux) . . . . . . . . . . . . . . 626
Tuberculosis, Pulmonary . . . . . . . . . . . . . . . . . . . . . . . . . . 628
U
Ulcerative Colitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 632
Unconscious Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 639
Urolithiasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 646
V
Vein Disorders: Venous Thrombosis, Thrombophlebitis,
Phlebothrombosis, and Deep Vein Thrombosis . . . . 653
Appendix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 659
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 685
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